Objective:To explore the association of hemoglobin(HGB) levels with bone mineral density(BMD) and osteoporosis in patients with type 2 diabetes mellitus(T2DM).Methods:A cross-sectional study was conducted in 364 patients with T2DM who were hospitalized in the Department of Endocrinology and Geriatrics of the Affiliated Huaian No. 1 People′s Hospital of Nanjing Medical University from September 2019 to September 2020. Participants were stratified into tertiles(lower, middle, and upper) according to femoral BMD determined by dual-energy X-ray absorptiometry. Demographic characteristics, medical history, chronic diabetes complications, and comorbid conditions were compared among the 3 groups. The association between hemoglobin levels and BMD/osteoporosis was examined using multivariable logistic regression analyses. Interaction and stratified analyses were conducted according to age, body mass index(BMI), duration of diabetes, estimated glomerular filtration rate(eGFR), glycosylated hemoglobin(HbA 1C), total cholesterol(TC), triglycerides(TG), high-density lipoprotein-cholesterol(HDL-C), low-density lipoprotein-cholesterol(LDL-C) and uric acid(UA). Results:After adjusting for age, BMI, and duration of diabetes, there were no significant differences observed in the association between hemoglobin levels and BMD or osteoporosis among postmenopausal women with T2DM(all P>0.05). After adjusting for age, BMI, duration of diabetes, and eGFR, men aged≥50 years with hemoglobin≥130 g/L showed a positive association between hemoglobin level and femoral neck BMD compared to those with hemoglobin<130 g/L( β=0.057, 95% CI 0.014-0.100, P=0.011). However, no significant associations were observed between hemoglobin level and BMDs at the total hip or lumbar spine(L1-L4), nor the risk of osteoporosis(all P>0.05). Stratified analyses revealed no significant differences in the subgroups classified based on age, BMI, diabetes duration, eGFR, HbA 1C, TC, TG, HDL-C, LDL-C, and UA(all interaction P>0.05). Conclusion:In males aged 50 and above with T2DM, elevated hemoglobin levels may be a protective factor for femoral neck bone density.

Objective:To study the expression of miR-496 in gastric cancer cells, and explore its role and mechanism in the proliferation and apoptosis of gastric cancer cells. Methods:Real-time fluorescence quantitative PCR (qPCR) was used to detect the expression of miR-496 in normal gastric epithelial cell lines and gastric cancer cell lines AGS and MKN45. miR-496 was knocked down in AGS cells with the lowest expression level, and a negative control group and a blank control group were set up. Cell proliferation and apoptosis were detected by CCK8 assay and flow cytometry. LYN, the target gene of miR-496, was screened using bioinformatics software, and the effect of transfection of miR-496 on LYN expression was detected by qPCR. Subsequently, rescure experiment was conducted to further study the mechanism of miR-496 on gastric cancer cells through regulation of LYN. Data were analyzed by GraphPad Prism 9 software. Measurement data were presented as mean ± standard deviation, and the comparison between the two groups was performed by t test. Results:The expression of miR-496 in AGS and MKN45 was significantly lower than that in normal gastric epithelial cells ( P<0.05). After overexpression of miR-496, the proliferation of AGS cells could be inhibited and the apoptosis ratio of AGS cells could be significantly increased ( P<0.05). QPCR results showed that miR-496 overexpression group could inhibit the expression of LYN ( P<0.05). Bioinformatics analysis showed that miR-496 binds to LYN kinase ( LYN) 3 ′UTR region, and overexpression of miR-496 can inhibit the expression of LYN in AGS cells, while CCK8 rescue experiment showed that overexpression of LYN could remove the inhibitory effect of miR-496 on cell proliferation. Flow cytometry showed that LYN expression could cancel the promoting effect of miR-496 on apoptosis ( P<0.05). Conclusion:miR-496 is low expressed in gastric cancer cells, and it inhibits the proliferation and promotes apoptosis of gastric cancer cells by targeting the expression of LYN in gastric cancer cells.

The hazard of vehicle emissions mainly come from the four wheel positioning, drum test and vehicle emissions test sections in automobile assembly workshop, which can lead to abnormal hemoglobin and hepatic insufficiency in workers. We researched on preventing toxic gases technologies for the vehicle emissions generated by these three sections, designed the ventilation facilities, and then detected and evaluated the operation effect, thereby improving the working environment, ensuring the occupational health of workers, and providing scientific basis for the control of vehicle emissions hazards.

The hazard of vehicle emissions mainly come from the four wheel positioning, drum test and vehicle emissions test sections in automobile assembly workshop, which can lead to abnormal hemoglobin and hepatic insufficiency in workers. We researched on preventing toxic gases technologies for the vehicle emissions generated by these three sections, designed the ventilation facilities, and then detected and evaluated the operation effect, thereby improving the working environment, ensuring the occupational health of workers, and providing scientific basis for the control of vehicle emissions hazards.

Objective:To evaluate the reliability and repeatability of thoracolumbar AOSpine injury score (TLAOSIS)and thoracolumbar injury severity score (TLICS) classification scoring system in guiding thoracolumbar fracture surgery, and to explore the main reasons for the consistency of classification scoring systems.Methods:Fifty-five thoracolumbar fracture patients with complete clinical data and radiologic data admitted to Second Affiliated Hospital of Zhejiang Chinese Medical University from January 2018 to December 2018 were enrolled. Based on their preoperative X-ray films, CT and MRI, six physicians were assigned to independently determine the classification using the TLAOSIS and TLICS.For the same patient, the classification was identified as inconsistency among 6 observers if there was an observer in a different type.After a 4-week interval, the 55 patients were presented in a random sequence to the same evaluators for repeated evaluation.All data did not contain any marks related to the type. The Cohen's Kappa coefficient was used to determine the interobserver reliability and intraobserver repeatability concerning fracture morphology, posterior ligament classification (PLC) injury classification and neurological function score. Kappa coefficients were used to observe the consistency of pre- and post-measure measurements within each observer.Results:The two classification scoring systems had good consistency and reproducibility in guiding surgery. For TLAOSIS classification scoring system, the interobserver and intraobserver Kappa values for fracture morphology were 0.806 and 0.667; neurological status were 0.937 and 0.891; PLC injury classification were 0.873 and 0.779; the final recommendation surgery were 0.816 and 0.764. For TLICS classification scoring system, the interobserver and intraobserver Kappa values for fracture morphology were 0.878 and 0.788; neurological status were 0.936 and 0.888; PLC injury classification were 0.809 and 0.691; the final recommendation surgery were 0.811 and 0.705. The two classification scoring systems were statistically significant in fracture morphology and PLC injury classification both in the reliability and repeatability analysis ( P<0.05), but there was no significant difference in the neurological function score ( P>0.05). Conclusions:TLAOSIS and TLICS have good consistency and reproducibility in guiding surgery. The fracture morphology and PLC injury classification are the factors influencing the consistency of surgical guidance for the two classification scoring systems.

Objective To discuss the clinical diagnosis and treatment of xanthogranulomatous pyelonephritis (XGP).Methods Clinical data of 41 XGP patients admitted from May 1981 to December 2017 were retrospectively analyzed.There were 17 male cases and 24 female cases,aged from 23 to 78 years,with an average age of 57 years.All were unilateral lesions,including 19 cases on the left and 22 cases on the right.Disease duration ranged from 1 week to 12 years,with an average of 3.5 years.The clinical manifestations showed that 7 cases with gross hematuria (17.1％),16 cases with palpable flank or abdominal mass (39.0％),36 cases with flank pain (87.8％),26 cases with acute or intermittent fever (63.4％) and 17 cases with weight loss (41.5％).Laboratory findings showed that 28 cases with leukocytosis (68.3％),24 cases with anemia (58.5％),27 cases with pyuria (65.9％),positive urine culture 19/34 (55.9％),positive urine lipid-laden macrophages 3/14(21.4％),and 20 cases with rapid erythrocyte sedimentation rate (48.8％).Imaging examination:among 35 patients who received CT examination,25 were diagnosed as XGP,mainly presenting diffuse changes in the kidney with enlarged renal shadow,accompanied by diffusive distribution of multiple low-density lesions.There was no obvious enhancement in the low-density lesions on enhanced scan,accompanied by thickening of renal fascia,adhesion to psoas major muscle or involvement of surrounding tissues and organs.According to the imaging results,there were 33 cases of diffuse type and 8 cases of localized type in this group.Renal biopsy was performed 11 cases and 3 cases were diagnosed as XGP.Results All patients were treated with surgical procedure.33 patients with diffuse type were performed nephrectomy.6 of the 8 patients with localized type underwent partial nephrectomy successfully,and the other 2 patients underwent nephrectomy due to severe renal adhesion and unclear lesion boundaries.All postoperative pathologies suggested xanthogranulomatous pyelonephritis.Patients were followed up for 9 months to 10 years postoperatively,with an average of 4.5 years.All patients had no recurrence.Conclusions The clinical manifestations of XGP are lack of specificity.Diagnosis is difficult and depends on pathology.According to imaging examination,lesions can be divided into diffuse type and localized type.Nephrectomy and partial nephrectomy were performed respectively.

Objective: To investigate the bacterial flora distribution and antimicrobial resistance of patients with pyogenic liver abscess (PLA) in multi-centers of China. Methods: The retrospective and descriptive study was conducted. The clinical data of 897 patients with PLA at 3 medical centers in China from October 2007 to April 2018 were collected, including 656 cases in the First Hospital of Harbin Medical University, 109 cases in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and 132 cases in the Eastern Hepatobiliary Surgery Hospital of Naval Military Medical University. There were 582 males and 315 females, aged (59±11)years, with a range of 6-86 years. Observation indicators: (1) bacterial flora distribution; (2) bacterial resistance. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages. Results: (1) Bacterial flora distribution: among 897 patients, 733 cases of Klebsiella pneumoniae, 75 cases of Escherichia coli, 11 cases of Staphylococcus aureus, 10 cases of Streptococcus viridians, 9 cases of Klebsiella pneumoniae subsp. pneumoniae, 7 cases of β-emolytic streptococcus, 6 cases of Acinetobacter baumannii, 5 cases of Streptococcus intermadius, 5 cases of Enterococcus faecium, 3 cases of Alcaligenes xylosoxidans subsp. xylosoxidans, 2 cases of Proteus mirabilis, 2 cases of Streptococcus isthmus, 2 cases of Enterobacter cloacae subsp. cloacae, 1 case of Citrobacter koseri, 1 case of Proteus vulgaris, 1 case of Pasteurella pneumotropica, 1 case of Curobacter freudii, 1 case of Enterobacter amnigenus, 1 case of Stenotrophomonas maltophilia, 1 case of Acinetobacter lwoffii, 1 case of Streptococcus salivarius, 1 case of Streptococcus bacterium, 1 case of Enterococcus avium, 1 case of Enterococcus faecalis, 1 case of Klebsiella oxytoca, and 1 case of Staphylococcus epidermidis were cultured in the pus respectively. There were 12 cases of double bacterial infection, and 2 cases of multiple bacterial infections. (2) Bacterial resistance. ① Resistance of Klebsiella pneumoniae and Escherichia coli: the drug resistance rates of Klebsiella pneumoniae to ampicillin, piperacillin, cefazolin, cefuroxime, cefotaxime, ceftriaxone, ceftazidime, cefotetan, cefepime, cefoxitin, amoxicillin/carat Retinoic acid, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, ertapenem, gentamicin, tobramycin, amikacin, tigaricycline, ciprofloxacin, levofloxacin, and trimethoprim sulfamethoxazole were 99.79%(474/475), 4.09%(7/171), 12.18%(82/673), 7.34%(49/668), 2.34%(4/171), 1.96%(11/562), 5.85%%(10/171), 0(0/562), 0.55%(4/733), 1.42%(9/635), 0(0/733), 2.46%(18/733), 0.55%(4/733), 0.27%(2/733), 1.36%(10/733), 0.14%(1/733), 0(0/733), 0.36%(2/562), 0.95%(7/733), 0.41%(3/733), 0(0/733), 0(0/562), 1.64%(12/733), 0.95%(7/733), and 4.50%(33/733), respectively. The drug resistance rates of Escherichia coli to above antibiotics were 78.67%(59/75), 40.91%(18/44), 65.33%(49/75), 56.00%(42/75), 38.64%(17/44), 41.94%(13/31), 20.00%(15/75), 3.23%(1/31), 25.33%(19/75), 5.77%(3/52), 18.67%(14/75), 32.00%(24/75), 8.00%(6/75), 16.00%(12/75), 37.33%(28/75), 1.33%(1/75), 0(0/75), 0(0/31), 40.00%(30/75), 14.67%(11/75), 1.33%(1/75), 0(0/31), 54.67%(41/75), 37.33%(28/75), and 52.00%(39/75), respectively. ② Drug resistance of other Gram-negative bacteria: the drug resistance rates of Klebsiella pneumoniae subsp. pneumoniae to ampicillin, cefazolin, cefuroxime, ceftriaxone, ceftazidime, cefotetan, cefepime, amoxicillin/carat Retinoic acid, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, ertapenem, gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, and trimethoprim sulfamethoxazole were 8/8, 0/5, 0/5, 0/1, 0/9, 0/2, 0/9, 0/8, 0/9, 0/9, 0/6, 0/9, 0/9, 0/7, 0/1, 0/9, 0/8, 0/9, 0/9, 0/9, and 0/9. The drug resistance rates of Acinetobacter baumannii to ceftriaxone, ceftazidime, cefepime, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, gentamicin, tobramycin, amikacin, tigaricycline, ciprofloxacin, levofloxacin, and trimethoprim sulfamethoxazole were 2/6, 4/6, 3/6, 0/6, 4/6, 1/6, 2/6, 4/6, 2/6, 4/6, 4/6, 3/6, 0/6, 4/6, 2/6, and 3/6, respectively. The drug resistance rates of Alcaligenes xylosoxidans subsp. xylosoxidans to ampicillin, cefazolin, cefuroxime, ceftazidime, cefepime, amoxicillin/carat Retinoic acid, piperacillin/tazobactam, aztreonam, imipenem, gentamicin, tobramycin, amikacin, ciprofloxacin, and levofloxacin were 3/3, 3/3, 3/3, 1/3, 1/3, 1/3, 0/3, 3/3, 2/3, 3/3, 3/3, 3/3, 3/3, and 1/3. ③ Drug resistance of other Gram-positive bacteria: the drug resistance rates of Staphylococcus aureus to penicillin, ampicillin, piperacillin, cefazolin, cefuroxime, cefotaxime, ceftazidime, cefepime, cefoxitin, amoxicillin/carat Retinoic acid, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, gentamicin, tobramycin, amikacin, tetracycline, tigaricycline, ciprofloxacin, levofloxacin, moxifloxacin, trimethoprim sulfamethoxazole, linezolid, erythromycin, clindamycin, vancomycin, teicoplanin, and rifampin were 2/6, 6/8, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 3/5, 2/5, 2/5, 3/8, 3/5, 3/5, 0/8, 0/8, 3/8, 3/11, 0/5, 1/8, 0/8, 0/8, 2/6, 3/3, 1/3, and 0/3. The drug resistance rates of Streptococcus viridians to penicillin, ampicillin, ceftriaxone, cefoperazone/sulbactam, gentamicin, tetracycline, ciprofloxacin, levofloxacin, moxifloxacin, linezolid, erythromycin, clindamycin, vancomycin, teicoplanin, and rifampin were 3/10, 0/8, 0/7, 0/7, 2/8, 6/10, 0/8, 0/8, 0/7, 0/5, 4/10, 6/10, 0/5, 0/5, and 0/3. The drug resistance rates of β-emolytic streptococcus to antibacterial agents were 0. ④ Drug resistance of complex bacteria. For the 12 patients with double bacterial infection, in the Klebsiella pneumoniae combined with Gram-negative bacteria, the drug resistance rates of Klebsiella pneumoniae to cefotetan, cefoxitin, ampicillin/sulbactam, meropenem, ertapenem, tobramycin, tigecycline, and trimethoprim sulfamethoxazole were 0. The drug resistance rates of Acinetobacter baumannii to ertapenem, levofloxacin, and trimethoprim sulfamethoxazole were 0. The drug resistance rates of Escherichia coli to ceftazidime, cefoxitin, amoxicillin/clavulanic acid, piperacillin/tazobactam, imipenem, meropenem, ertapenem, tobramycin, amikacin, and tigecycline were 0. Citrobacter florida was sensitive to other antibiotics than levofloxacin and trimethoprim cotrimoxazole. In the Escherichia coli combined with Gram-positive bacteria, the drug resistance rates of Escherichia coli to cefotetan, cefepime, cefoxitin, cefoperazone/sulbactam, meropenem, tobramycin, and amikacin were 0. The drug resistance rates of Enterococcus faecalis to penicillin, ampicillin, levofloxacin, moxifloxacin, linezolid, vancomycin, and teicoplanin were 0. The drug resistance rates of Enterococcus casselifavus to ampicillin, tetracycline, levofloxacin, moxifloxacin, linezolid, and erythromycin were 0. The drug resistance rates of Staphylococcus hominis subspecies to levofloxacin, moxifloxacin, linezolid, vancomycin, teicoplanin, and rifampicin were 0. The drug resistance rates of Enterococcus faecium to tetracycline, linezolid, vancomycin, and teicoplanin were 0. In the multiple bacterial infections of Klebsiella pneumoniae + Escherichia coli + Staphylococcus aureus subspecies + Pseudomonas aeruginosa + Torulopsis glabrata, the drug resistance rates of Klebsiella pneumoniae to ceftriaxone, ceftazidime, cefotetan, cefepime, cefoxitin, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, tobramycin, amikacin, and levofloxacin were 0. The drug resistance rates of Escherichia coli to ceftazidime, cefotetan, cefepime, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, and amikacin were 0. The drug resistance rates of Staphylococcus aureus subspecies to ceftriaxone, ceftazidime, cefotetan, cefepime, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, tobramycin, amikacin, tigecycline, moxifloxacin, cotrimoxazole, teicoplanin, vancomycin, linezolid, and clindamycin were 0. The drug resistance rates of Pseudomonas aeruginosa to ceftazidime, cefepime, piperacillin/tazobactam, imipenem, gentamicin, tobramycin, amikacin, ciprofloxacin, and levofloxacin were 0. The drug resistance rates of Torulopsis glabrata to 5-fluorocytosine, fluconazole, itraconazole, and voriconazole were 0. In the multiple bacterial infections of Klebsiella pneumoniae + Escherichia coli + Acinetobacter baumannii, the drug resistance rates of Klebsiella pneumoniae to cefotetan, cefepime, piperacillin/tazobactam, imipenem, ertapenem, tobramycin, ciprofloxacin, and levofloxacin were 0. The drug resistance rates of Escherichia coli to amoxicillin/clavulanic acid, piperacillin/tazobactam, imipenem, meropenem were 0. The drug resistance ratets of Acinetobacter baumannii to trimethoprim sulfamethoxazole was 0. Conclusions Klebsiella pneumoniae is the main pathogen of PLA, followed by Escherichia coli. Klebsiella pneumoniae and Escherichia coli are sensitive to meropenem and tigecycline. Klebsiella pneumoniae subsp. pneumoniae and other Gram-negative bacteria are sensitive to ertapenem. Staphylococcus aureus are sensitive to Linezolid. Antibiotics are selected after drug sensitivity test for patients.

Background and purpose:Prostate-speciifc membrane antigen (PSMA), a cell surface protein with high expression in prostate carcinoma (PC) cells, is an attractive target for PC imaging and therapy. Small-molecule radiopharmaceuticals targeting PSMA can detect the location and extent of disease with high sensitivity and speciifcity. The aim of this study was to evaluate the value of technetium-99m-labelled small molecule against PSMA (HYNIC-Glu-Urea-A,99mTc-PSMA) for the detection of primary and metastatic prostate cancers.Methods:Twenty-four prostate cancer patients and 1 patient with benign prostate hyperplasia received whole-body scan followed by abdominopelvic SPECT/CT 2 h after intravenous injection of99mTc-PSMA. Tumor to muscle uptake ratio of99mTc-PSMA was calcu-lated using region of interest (ROI) technology. The sensitivity and specificity of99mTc-PSMA were evaluated. The relationships between positive99mTc-PSMA and prostate speciifc antigen (PSA) level and Gleason Score were analyzed. Results:Based on per patient, the sensitivity and speciifcity of99mTc-PSMA were 72.7% (16/22) and 100% (3/3), re-spectively. The level of PSA in patients with positive99mTc-PSMA imaging was signiifcantly higher than that in patients with negative99mTc-PSMA imaging [(PSA median 17.31 ng/mL, range: 2.26-3 239.0 ng/mL)vs(PSA median 0.49 ng/mL, range: 0.07-9.28 ng/mL)] (Z=-3.51,P<0.001). Among newly diagnosed patients and recurrent patients with PSA more than 2.0 nm/mL, it was apparent that99mTc-PSMA imaging was able to detect lesions with improved sensitivity of 94.1% (16/17). Gleason Scores between positive99mTc-PSMA patients and negative99mTc-PSMA patients were not significantly different (Z=-0.69,P=0.52).Conclusion:With the combination of whole-body scan and tomography, 99mTc-PSMA SPECT/CT can be an excellent and speciifc molecular imaging strategy to detect prostate cancer and its metastases.

Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with“diluted and iflled bladder”use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-lfuorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods:48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions conifrmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results:89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) signiifcantly and the statistical difference was signiifcant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, speciifcity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder signiifcantly decreased in most patients with“diluted and iflled bladder”. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.

The development of tissue engineering has provided new methods for organ replacement and disease treatment.The research of seed cells includes cell selection,culture,transplantation,tracing and so on.The tracing technique of seed cells involves molecular biology,molecular immunology,molecular imaging and many other subjects,making it difficult to select a label for seed cells.This review summarizes the recent research progress in the tracing technique of seed cells.