Dysregulated thyroid hormones correlate with anxiety and depression risk in patients with autoimmune disease.

BACKGROUND: Autoimmune disease (AID) patients always present with increased risk of psychiatric disorders, and thyroid function or thyroid hormone may play a critical role in the development of anxiety and depression. Thus, this study aimed to assess the free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH) levels, and their correlations with anxiety/depression in patients with AID. METHODS: Ninety-eight AID patients and 100 health controls (HCs) were recruited. Serum samples were obtained from all the participants to detect FT3, FT4, and TSH levels. Anxiety and depression were determined using the HADS assessment. RESULTS: HADS-Anxiety score, anxiety subject percentage, HADS-Depression score, and depression subject proportion were elevated in AID patients compared with HCs. FT3 and FT4 were downregulated while TSH was upregulated in AID patients compared with HCs. In AID patients, FT3 and FT4 negatively correlated with HADS-Anxiety score, and they were downregulated in patients with anxiety compared to patients without anxiety. Meanwhile, FT3 and FT4 were negatively associated while TSH level positively associated with HADS-Depression score. Besides, FT3 and FT4 reduced, but TSH level was of no difference in patients with depression compared to patients without depression. Additionally, increased FT4 independently correlated with both reduced anxiety risk and depression risk. CONCLUSIONS: FT3, FT4, and TSH are dysregulated, and FT4 has the potential to serve as an independent biomarker related to anxiety as well as depression in AID patients. These findings may provide some information on the values of thyroid hormones in facilitating the management of AID patients with anxiety/depression.

[Influence of intermittently monitoring on endotracheal tube cuff pressure using handheld pressure gauge].

OBJECTIVE: To discuss the influence of intermittently monitoring on endotracheal tube cuff pressure using handheld pressure gauge, and to provide some reference for the clinical work. METHODS: The experiment was carried out on the model of the glass tube, which was divided into three parts. Each part of the experiment was divided into normal pressure group and high pressure group according to the different inflation pressure target value. The endotracheal tube cuff pressure was determined intermittently by using the transparent tracheal models which had a static diameter of 2 cm. The target press value of normal pressure group was 32 cmH2O (1 cmH2O = 0.098 kPa) while that of high pressure group was 40 cmH2O. The handheld pressure gauge was connected with the indicated cuff through a tee joint, and the pressure in the cuff in both groups was determined. The pressure loss caused by intermittent measurement of the two groups was compared. By switching the tee joint, the pressure loss through the gauge self-structure and the pressure loss when connecting and disconnecting the indicated cuff were determined to analyze the causes of pressure loss caused by intermittent measurement of pressure gauge. RESULTS: The pressure loss caused by intermittent measurement of high pressure group was significantly higher than that of normal pressure group (cmH2O: 15.10±0.43 vs. 10.19±0.45) with statistical significance (t = -24.875, P = 0.000). The pressure loss through the gauge self-structure of high pressure group was also significantly higher than that of normal pressure group (cmH2O: 13.91±0.48 vs. 8.77±0.53), which showed a statistics significance (t = -22.854, P = 0.000). The pressure loss when connecting and disconnecting the indicated cuff of the normal pressure and high pressure groups were (1.33±0.49) cmH2O and (1.23±0.55) cmH2O, respectively, without statistics significance (t = 0.445, P = 0.662). It was figured that the total pressure loss caused by intermittent measurement of the endotracheal intubation cuff was approximately equal to the value of the pressure loss caused by the pressure gauge self-structure and the pressure loss when the indicated cuff was connected and disconnected [normal pressure group: (10.19±0.45) cmH2O ≍ (8.77±0.53) cmH2O + (1.33±0.49) cmH2O, high pressure group: (15.10±0.43) cmH2O ≍ (13.91±0.48) cmH2O + (1.23±0.55) cmH2O]. CONCLUSIONS: The intermittently monitoring on endotracheal tube cuff pressure is the main cause of the pressure loss. The total pressure loss consists of the pressure leak from the cuff to the gauge and the pressure leak when connecting and disconnecting the gauge and the indicated cuff during each test. When the pressure in the cuff is increased, it will cause more pressure loss.