Objective To explore the diagnosis and treatment process, clinical manifestation and outcome of lung cancer patients with hyponatremia as the first symptom. Methods Retrospective analysis of 4 patients with hyponatremia. Results Four patients with lung cancer were first diagnosed with hyponatremia, their serum sodium was between 112~122mmol/L, and their plasma osmotic pressure was low and urine osmotic pressure was high, so they were diagnosed as SIADH. The treatment of water restriction and sodium supplement can significantly increase the concentration of serum sodium. Through follow-up, we know that 3 patients with primary disease are in stable condition after active treatment, but the other one patient has died. Conclusion The clinical manifestation of SIADH, caused by lung cancer is hyponatremia. This provides clues for the diagnosis of lung cancer. However, the incidence of the disease is hidden, if early detection and active treatment will help to improve the prognosis of patients.

Objective: To explore the effects of closed-loop target-controlled infusion (TCI) of propofol based on bispectral index (BIS) in surgery of elderly fracture patients. Methods: 80 elderly fracture patients were randomly divided into group A and group B with 40 patients in each group. The patients in group A were given propofol with BIS-based closed-loop TCI target-controlled infusion, while the patients in group B were given propofol with constant-speed infusion. The perioperative indicators and the incidence of perioperative events, as well as BIS, heart rate (HR) and mean arterial pressure (MAP) at five time point (T ₁ before anesthesia induction, T ₂ endotracheal intubation, T ₃ skin incision, T ₄ 30 minutes after operation, T ₅ at the end of operation) of patients in 2 groups were compared. Results: The propofol dosage, recovery time and the time of tracheal extubation of patients in group A were obviously lower than group B (P˂0.05). At time point T ₂ to T ₅, the BIS and MAP of patients in group A were obviously higher than group B (P˂0.05), the HR were obviously lower than group B (P˂0.05). The incidence rate of perioperative events of group A was obviously lower than group B (5.00% vs 20.00%, P˂0.05). Conclusions: BIS-based closed-loop TCI target-controlled infusion of propofol can reduce the stress level surgery of elderly fracture patients and the propofol dosage, and also can improve the safety of operation effectively.

Objective: To investigate the correlations between serum cystatin C level and estimated glomerular filtration rate (eGFR) in patients with early diabetic nephropathy. Methods: 60 patients with early diabetic nephropathy were divided into group A (n=33) and group B (n=27) according to serum cystatin C level; 70 health examination people in our hospital during the same period were selected as group C. The serum cystatin C level, serum creatinine of all the subjects were detected and the eGFR was calculated using MDRD formula. Linear correlation analysis was used to analyze the correlations between serum cystatin C level and eGFR in patients with early diabetic nephropathy. Results: The serum cystatin C level of early diabetic nephropathy patients in group A and group B were all significantly higher than group C, while the eGFR were significantly lower (P<0.05). The serum cystatin C level of early diabetic nephropathy patients was negatively correlated with eGFR (r=-0.7193, P<0.05). Conclusions: The serum cystatin C level is negatively correlated with eGFR in patients with early diabetic nephropathy, which may be a predictor of early diagnosis of diabetic nephropathy.

Objective: To investigate the relationships between bone turnover markers and diabetic microvascular complications in type 2 diabetes mellitus. Methods: 146 type 2 diabetes mellitus patients were divided into experimental group (77 patients, complicated with diabetic nephropathy and/or diabetic retinopathy) and control group (69 patients, no diabetic microvascular complications). The general informations of patients in 2 groups were recorded; and the blood biochemical indicators and bone turnover markers of patients were detected. Results: The course of disease of patients in experimental group was remarkably longer than control group (P<0.05); the carboxy-terminal collagen crosslinks (CTX) of patients in experimental group was remarkably higher than control group, the osteocalcin (OC) was remarkably lower (P<0.05). Logistic regression analysis showed that CTX and course of disease were risk factors of type 2 diabetes mellitus with microangiopathy, OC was protective factor. Conclusions: Bone turnover markers CTX and OC are associated with the risk of microvascular complications in patients with type 2 diabetes mellitus, which are expected to be markers for monitoring microangiopathy and bone metabolism in patients with type 2 diabetes mellitus.