Objective To investigate the early prediction efficacy of adiponectin(ADPN)for gestational diabetes mellitus(GDM),and to explore new indicators for the early diagnosis of GDM and risk models for early prediction.Methods A cohort of 486 pregnant women in early pregnancy(7-12 weeks)was selected from July to November 2023 at Beijing Tongren Hospital,Capital Medical University.According to the diagnostic criteria of GDM recommended by the International Association for the study of Diabetes and Pregnancy Study Group(IADPSG)in 2010,mid-pregnancy pregnancies were divided into GDM group(150 cases)and non-GDM group(336 case).ADPN,insulin(IR),fasting glucose(GLU),and glycated albumin(GA)were collected in early pregnancy,and the homeostatic model assessment of adiponectin(HOMA-AD),homeostatic model assessment of insulin resistance index(HOMA-IR)and hepatic steatosis index(HSI)were calculated.The differences in ADPN,HOMA-AD,and HOMA-IR between the two groups were analyzed and compared,and the value of each type of index in predicting GDM was analyzed with the receiver operating characteristics(ROC)curve,and the predictive risk model was established by combining the relevant indexes.Results There was a statistically significant difference between the GDM and non-GDM groups in ADPN in early pregnancy(P＜0.05).The results of the ROC curve analysis showed that the area under the curve(AUC)of ADPN for early prediction of GDM positivity was 0.723,with a cutoff value 13.38 mg/L.There was a statistically significant difference between the GDM and non-GDM groups in HOMA-AD(P=0.000).The AUC of HOMA-AD for early prediction of GDM was 0.815,with the cutoff value 3.024.Combining GLU,HOMA-AD,HOMA-IR,and HSI in a Logistic regression model improved predictive performance across several metrics,with the final test set of AUC=0.829,accuracy=0.740,sensitivity=0.913,negative predictive value=0.833.Conclusion ADPN levels were reduced in the GDM group compared to the non-GDM group,and the diagnostic efficacy of a single ADPN was poor when it was used for early prediction of the onset of GDM.The HOMA-AD level of the GDM group was lower than that of the non-GDM group,and HOMA-AD was negatively correlated with the disease,which was more effective than ADPN,HOMA-IR,and HIS in the early prediction of GDM.HOMA-AD could be used in combination with these indexes to establish a diagnostic and predictive model to improve the effectiveness of the prediction.

Objective:To verify the performance of the immunoturbidimetric assay(ITMA)kit of detecting oxidized low-density lipoprotein(ox-LDL).Methods:In accordance with the requirements of China National Accreditation Service for Conformity Assessment[(CNAS)-GL037:2019]and the National Health Industry Standards,the precision,trueness,linear range and reportable range of ITMA test kit for ox-LDL were verified on AU5800 fully automatic biochemical analyzer,which were compared with enzyme linked immunosorbent assay(ELISA)of Mercodia comparison reagents for ox-LDL through experiment of methodological comparison.Results:The coefficients of variation(CV)values of within-run and between-run precisions of the two concentration levels of quality control materials in the ITMA reagent kit for ox-LDL were respectively(3.74%,3.36%)and(4.75%,5.49%).The trueness bias of the two concentration levels of standards were respectively 0.46%and 1.78%,and the linear range was(15-120 U/L),which verification regression coefficient was R2=0.999 5 with a slope of 0.989.The maximum dilution multiple was 4 times,and the upper limitation of the clinically reportable range was 240.00 U/L.The manufacturer-provided biological reference interval was 0-64.49 U/L,and the coincidence rate was 100%.The results of hemoglobin,bilirubin,triglycerides,high density lipoprotein(HDL),low density lipoprotein(LDL)and rheumatoid factor were respectively 10 mg/ml,342 μmol/L,10.0 mg/ml,100 mg/dl,200 mg/dl,<200 IU/ml.The stationary duration was there was not influence within 30 h after opened the kit.The correlation between ITMA and ELISA detection methods was excellent(R2=0.9766).The positive and negative coincidence rates of clinical identification were respectively 92.3%and 96.5%.Conclusion:The performances of ox-LDL ITMA test kit based on fully automatic biochemical analyzer can all meet the requirement of clinical application,which shows excellent consistency with the results of ELISA method.

Objective To investigate the early prediction efficacy of adiponectin(ADPN)for gestational diabetes mellitus(GDM),and to explore new indicators for the early diagnosis of GDM and risk models for early prediction.Methods A cohort of 486 pregnant women in early pregnancy(7-12 weeks)was selected from July to November 2023 at Beijing Tongren Hospital,Capital Medical University.According to the diagnostic criteria of GDM recommended by the International Association for the study of Diabetes and Pregnancy Study Group(IADPSG)in 2010,mid-pregnancy pregnancies were divided into GDM group(150 cases)and non-GDM group(336 case).ADPN,insulin(IR),fasting glucose(GLU),and glycated albumin(GA)were collected in early pregnancy,and the homeostatic model assessment of adiponectin(HOMA-AD),homeostatic model assessment of insulin resistance index(HOMA-IR)and hepatic steatosis index(HSI)were calculated.The differences in ADPN,HOMA-AD,and HOMA-IR between the two groups were analyzed and compared,and the value of each type of index in predicting GDM was analyzed with the receiver operating characteristics(ROC)curve,and the predictive risk model was established by combining the relevant indexes.Results There was a statistically significant difference between the GDM and non-GDM groups in ADPN in early pregnancy(P＜0.05).The results of the ROC curve analysis showed that the area under the curve(AUC)of ADPN for early prediction of GDM positivity was 0.723,with a cutoff value 13.38 mg/L.There was a statistically significant difference between the GDM and non-GDM groups in HOMA-AD(P=0.000).The AUC of HOMA-AD for early prediction of GDM was 0.815,with the cutoff value 3.024.Combining GLU,HOMA-AD,HOMA-IR,and HSI in a Logistic regression model improved predictive performance across several metrics,with the final test set of AUC=0.829,accuracy=0.740,sensitivity=0.913,negative predictive value=0.833.Conclusion ADPN levels were reduced in the GDM group compared to the non-GDM group,and the diagnostic efficacy of a single ADPN was poor when it was used for early prediction of the onset of GDM.The HOMA-AD level of the GDM group was lower than that of the non-GDM group,and HOMA-AD was negatively correlated with the disease,which was more effective than ADPN,HOMA-IR,and HIS in the early prediction of GDM.HOMA-AD could be used in combination with these indexes to establish a diagnostic and predictive model to improve the effectiveness of the prediction.

Objective:To verify the performance of the immunoturbidimetric assay(ITMA)kit of detecting oxidized low-density lipoprotein(ox-LDL).Methods:In accordance with the requirements of China National Accreditation Service for Conformity Assessment[(CNAS)-GL037:2019]and the National Health Industry Standards,the precision,trueness,linear range and reportable range of ITMA test kit for ox-LDL were verified on AU5800 fully automatic biochemical analyzer,which were compared with enzyme linked immunosorbent assay(ELISA)of Mercodia comparison reagents for ox-LDL through experiment of methodological comparison.Results:The coefficients of variation(CV)values of within-run and between-run precisions of the two concentration levels of quality control materials in the ITMA reagent kit for ox-LDL were respectively(3.74%,3.36%)and(4.75%,5.49%).The trueness bias of the two concentration levels of standards were respectively 0.46%and 1.78%,and the linear range was(15-120 U/L),which verification regression coefficient was R2=0.999 5 with a slope of 0.989.The maximum dilution multiple was 4 times,and the upper limitation of the clinically reportable range was 240.00 U/L.The manufacturer-provided biological reference interval was 0-64.49 U/L,and the coincidence rate was 100%.The results of hemoglobin,bilirubin,triglycerides,high density lipoprotein(HDL),low density lipoprotein(LDL)and rheumatoid factor were respectively 10 mg/ml,342 μmol/L,10.0 mg/ml,100 mg/dl,200 mg/dl,<200 IU/ml.The stationary duration was there was not influence within 30 h after opened the kit.The correlation between ITMA and ELISA detection methods was excellent(R2=0.9766).The positive and negative coincidence rates of clinical identification were respectively 92.3%and 96.5%.Conclusion:The performances of ox-LDL ITMA test kit based on fully automatic biochemical analyzer can all meet the requirement of clinical application,which shows excellent consistency with the results of ELISA method.

Lumbar brucellar spondylitis is an infectious disease caused by the invasion of brucella. The incidence has been on the rise in recent years. And it threatens people's health seriously. Early and proper diagnosis and treatment is the key to cure patients with lumbar brucella spondylitis. However, in the early stage of the disease, there are only nonspecific symptoms such as back pain, fever, and sweating. If the patient has the above symptoms and epidemiological history of direct or indirect livestock contact, and inflammatory signals of the vertebrae or intervertebral space are visible on MRI, the possibility of early infection of lumbar brucella spondylitis should be considered. It is not difficult to make the diagnosis of lumbar brucella spondylitis in the middle and late stages by taking into account the epidemiology, symptoms, signs, laboratory tests, and the imaging features such as narrowing of the intervertebral space, abnormal signals of the vertebral body and disc, bone destruction and sclerosis, "lace-like" appearance, sequestrum formation and limited paraspinal abscess. Patients in these stages often present with serious manifestations such as lumbar instability due to bone destruction, and the focus is on surgical intervention. The basic principle of surgical treatment is lesion removal combined with fixation. Intraoperative reduction of damage to bone and ligamentous structures such as the posterior ligamentous complex and strong fixation will contribute to the complete cure of the disease. By referring to the literature on lumbar brucellar spondylitis, this paper focuses on the etiology, pathogenesis, clinical manifestations, imaging features, laboratory tests and conservative and surgical treatment of the disease, aiming to provide a basis for clinical diagnosis and treatment.

This paper introduces the structure, contents, function of the digital teaching re-courses database in Clinical Skills course of Central South University, analyses the essence and char-acter of the flipped classroom (FC), and emphasizes flexible environment, learning culture, inten-tional content, professional educator in its implementation process. Meanwhile, it introduces the appli-cation of flipped classroom based on digital resources database in the teaching of Clinical Skills course, mentions the importance of the four aspects:preparing teaching materials, learning before class, guidance and cooperation in class, evaluation and knowledge expansion after class. Lastly, it analyses the advantages and foreground of it.