This report describes a case of maturity-onset diabetes of the young(MODY)type 3(MODY3)complicated with type 5(MODY5),including the patient's clinical features,diagnosis,and treatment,and reviews relevant literature.Using next-generation sequencing of MODY(types 1-14)gene exons and Sanger sequencing for verification,the patient and her mother were assessed.Based on the clinical phenotype and genetic test results,the patient was diagnosed as MODY3 combined with MODY5.Treatment included insulin and linagliptin,with monitoring of blood glucose changes.Clinicians should enhance their understanding of MODY clinical phenotypes.In adolescents with diabetes who have congenital pancreatic and renal developmental defects,elevated high-density lipoprotein cholesterol,no spontaneous ketosis,insulin secretion defects,negative pancreatic autoantibodies,no significant insulin resistance,and who are not obese,gene testing should be conducted to screen for MODY.Accurate diagnosis and personalized treatment can aid in achieving glycemic control,improving quality of life,and optimizing reproductive planning.

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.

In recent years, conventional targeting of chemotherapeutic drugs on colorectal tumor tissue is poor in the clinical application. Due to the multidrug resistance of colorectal tumors, penetration and cytotoxicity of conventional drugs greatly reduced on tumor tissue. With the advent of tumor-penetrating peptides, a new and highly effective antitumor drug delivery system has become a research topic of international scholars. This article will briefly describe the research progress of iRGD peptides with the modified nanomicelles drug delivery system on targeted drug delivery and resistance to drug-resistant colorectal tumors in recent years. These studies show that iRGD peptide-modified nanomicelles will be a highly potential anti-drug delivery system.

Objective To explore the mechanism of immunoregulation by investigating the effects of polysaccharides from Millettia speciosa Champ (MSC) on proliferation of spleen lymphocyte and secretion of cytokine in mice.Methods The effects of MSC polysaccharides on Con A-induced spleen T lymphocyte proliferation were determined by MTT.The contents of TNF-α, IL-6 and PGE2 were determined by ELISA.Results The Con A-induced T lymphocyte proliferation was significantly increased by MSC polysaccharides at the concentrations from 50 to 200 μg·mL-1.Coupled with TNF-α and IL-6 were significantly increased while PGE2 was significantly decreased.Conclusion MSC polysaccharides could increase proliferation of spleen lymphocyte and enhance the immune responses by increasing the secretion of TNF-α and IL-6 in mice.

Objective To investigate the changes of platelet aggregation rate and platelet surface CD 41+CD62P+ expression af-ter clopidogrel discontinuation in the patients with percutaneous coronary interventions (PCI)) .Methods The platelet aggregation rates and platelet surface CD41+CD62P+ in 52 PCI patients with oral clopidogrel for near 12 months and discontinuation soon were measured before clopidogrel therapy(T0 ) ,in 1 week after clopidogrel therapy(T1 ) ,1 week before clopidogrel discontinuation(T2 ) , 1 week(T3 ) and 1 month after clopidogrel discontinuation (T4 ) .Results Compared with T0 ,the platelet aggregation rate and the expression of platelet CD41+CD62P+ at T1 were significantly decreased ,the difference showing statistical significance (P<0 .05) , which at T2 maintained the lower levels ;which at T3 were increased ,which at T4 were recovered to those at T0 .The platelet aggre-gation rates at various time points were (44 .20 ± 18 .36)% ,(25 .38 ± 12 .10)% ,(23 .74 ± 8 .15)% ,(51 .79 ± 10 .55)% and(45 .97 ± 16 .42)% respectively ,and the positive rates of CD41+ CD62P+ were(12 .96 ± 11 .48)% ,(3 .93 ± 3 .33)% ,(4 .72 ± 3 .14)% , (13 .90 ± 10 .38)% and(10 .84 ± 8 .13)% ,respectively .Conclusion In the patients treated with 12-month clopidogrel after PCI ,the platelet aggregation rate and the CD41+CD62P+ positive rate are mildly increased at 1 week after clopidogrel discontinuation and gradually returned to the level before discontinuation at 1 month after clopidogrel discontinuation .

Objective To investigate the analgesic efficacy of intrathecal injection of RC-13,a competitive kinesin superfamily protein 17 antagonist,in a mouse model of bone cancer pain.Methods Forty male C3H/HeJ mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 5 groups (n=8 each): sham operation group (group S); bone cancer pain + 5 μl dimethyl sulfoxide (DMSO) group (group R0); bone cancer pain + 2.5 μg RC-13 group (group R1); bone cancer pain + 5 μg RC-13 group (group R2) and bone cancer pain + 10 μg RC-13 group (group R3).In groups R0-3,bone cancer pain was induced by implantation of α-min-imal essence medium (α-MEM) containing osteosarcomaNCTC 2472 cells into the intramedullary space of right femur.In group S,culture medium α-MEM containing no cancer cell was injected instead.10％ DMSO 5 μl and RC-13 2.5 μg/5 μl,5μg/5μ1 and 10 μg/5 μ1 dissolved in 10％ DMSO were injected intrathecally in groups R0-3,respectively,once a day for 3 consecutive days starting from 14th day after inoculation of the tumor cells.Pain behavior was assessed by the paw withdrawal mechanical threshold (PWMT) and spontaneous lifting times (SLTs) measured at 1 day before inoculation and at 3,5,7,10,14 days after inoculation.The same tests were also performed at 1,3,5 and 7 days after administration in groups R0-3.Results Compared with group S,PWMT was significantly decreased and SLTs were increased at 7-14 days after inoculation in the other groups (P ＜ 0.05).Compared with group R0,PWMT was significantly increased and SLTs were reduced at 1 day after administration in group R1,at 1and 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R1,PWMT was significantly increased and SLTs were reduced at 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R2,PWMT was significantly increased and SLTs were reduced at 1 and 3 days after administration in group Rs (P ＜ 0.05).Conclusion Intrathecal RC-13,a competitive kinesin superfamily protein 17 antagonist,has a good analgesic efficacy in a mouse model of bone cancer pain and the efficacy is dose-dependent.

To create a comparative referential system for syndrome classification study by viewing from the thinking characteristics of TCM on syndrome differentiation dependent therapy (SDDT), through analyzing the thinking process of SDDT, and the basic features of disease, syndrome and prescription, combining the basic principles of modern evidence-based medicine and feasibility of establishing integrative disease-syndrome animal model. The practice of creating a comparative referential system based on clinical efficacy of prescription was discussed around syndrome pathogenesis and its relationship with disease and prescription, which was one of the important scientific problems in TCM syndrome study. The authors hold that, it may be one of the available approaches for the present study on integration of disease with syndrome by way of insisting on the thinking pathway of stressing the characteristics of TCM and intermerging with modern scientific design; on taking the efficacy of prescription as the comparative reference system to accumulate and improve unceasingly according to the TCM method of syndrome diagnosis inferred from effect of prescription with reverse thought (i.e., to differentiate syndrome from the effect of prescription), and thus build up the syndrome diagnostic standard on the solid clinical and scientific base.
Clinical Medicine ; methods ; Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; methods ; standards

Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound (TRUS) for prostate cancer detection.Methods Four hundred and thirty-eight patients referred for biopsy of the prostate from August 1999 to August 2004. Every patient received 6-13 biopsy cores of the prostate. If a hypoechoic was identified, the biopsy was taken from this lesion. Correlation between hypo-echoic lesions, isoechoic areas and cancer detection for each core was performed. Results Among 438 patients, cancer was detected in 112(25.6%). Hypo-echoic lesions were seen in 75 (67%) patients with prostate cancer, the isoechoic were as in 37 (33%). A total of 3504 biopsy cores were obtained from 438 patients, and 636 biopsy cores were taken from hypoechoic lesions. Among 636 biopsy cores, 163 (25.6%) were cancer and 473(74.4%)were not. The cancer detective rate in patients with hypoechoic lesions (75/298, 25.2%) was similar to non-hypoechoic lesions (37/140, 26.4%) on TRUS. There was no statistically significant difference between them (P

OBJECTIVETo determine the influence of androgen deprivation therapy (ADT) on bone mineral density (BMD) in men with prostate cancer.

METHODSForty-nine men with prostate cancer underwent BMD determination and then were classified into two groups: non-ADT group (21 cases), who were about to receive ADT, and ADT group (28 cases), who had received ADT for more than 1 year. BMD was determined by dual energy X-ray absorptiometry (DEXA) in the lumbar spine (L2-4) and femoral neck in all the patients. The Age-Matched Z scores were used as the reference standard for controlling the difference of age, sex and weight.

RESULTSThirteen (62%) of the non-ADT group and 23 (82%) of the ADT group fulfilled the BMD criteria for osteopenia or osteoporosis. Z scores for the Age-Matched control in the lumbar spine and femoral neck were -(0.9 +/- 0.7) and -(0.6 +/- 0.5) in the non-ADT group, and -(1.8 +/- 1.1) and -(1.6 +/- 1.0) in the ADT group, respectively (P<0.01). The men of the ADT group had significantly lower BMD in the lumbar spine and femoral neck than those of the non-ADT group.

CONCLUSIONPre-existing osteopenia and osteoporosis are common in men with prostate cancer before ADT. ADT is significantly associated with the loss of BMD and the evaluation of BMD is necessary before ADT for men with prostate cancer.

Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Bone Density ; Humans ; Male ; Middle Aged ; Orchiectomy ; Osteoporosis ; complications ; physiopathology ; Prostatic Neoplasms ; complications ; physiopathology ; surgery

Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound(TRUS) for prostate cancer detection Methods 438 patients referred to our hospital between August 1999 and August 2006 for biopsy of the prostate.Every patient received 6～13 biopsy cores of the prostate.If a hypoechoic was identified,the biopsy was taken from this lesion.Correlation between hypoechoic lesions,isoechoic areas and cancer detection for each core was performed.Results Among 438 patients,cancer was detected in 112(25.6%) patients.Hypoechoic lesions were seen in 75(67%)patients with prostate cancer,the isoechoic areas in 37(33%).A total of 3504 biopsy cores were obtained from 438 patients.Among them,636 biopsy cores were taken from hypoechoic lesions.163(25.6%)biopsy cores taken from hypoechoic lesions harbored cancer and 473(74.4%) had no cancer.The cancer detection rate was similar in patients with hypoechoic lesions on TRUS or not,25.4%(75/298)and 26.4%(37/140)respectively.The difference was not statistically significant(P