Hereditary Severe Insulin-resistance Syndrome and Acanthosis Nigricans Caused by Novel Mutations in the INSR Gene.

Most cases associated with Hereditary Severe Insulin Resistance Syndrome (H-SIRS) are linked to mutations in the insulin receptor (INSR) gene. Patients with H-SIRS typically manifest symptoms of hyperinsulinemia, insulin resistance, and diabetes mellitus. Other symptoms include impaired glucose regulation, hyperandrogenism, and the presence of acanthosis nigricans (AN). In this report, we present two cases of H-SIRS in female children exhibiting various symptoms, such as hyperinsulinemia, fasting hypoglycemia, postprandial hyperglycemia, overweight, fatty liver, hyperandrogenism, and varying degrees of AN. One patient also presented with mental retardation. Gene sequencing identified specific mutations in the INSR gene for both patients: c.2663A > G (p.Tyr888Cys) and c.38_61del (p.Pro13_Ala20del). These mutations have the potential to disrupt the interaction between INSR and insulin, leading to abnormal insulin signaling, insulin resistance, and various clinical manifestations.

Use of Thread-hanging Microwave Antenna to Assist in Precise Puncture of Lung Nodule and Influencing Factors / 肿瘤防治研究

Objective To explore a precise method with a microwave antenna for puncture of pulmonary nodules and analyze phenomena that affect the puncture results. Methods Clinical data of 107 cases with solitary malignant pulmonary nodules were collected, and the mean length of pulmonary nodules was 13.6±0.6 mm in CT axial position. A thread-hanging method was used to assist the puncture of pulmonary nodules. The procedure was successful when the needle was not withdrawn and inserted into the central region of the nodule. The success rate and complications of the pulmonary procedure were recorded. The incidence of the following phenomena were also documented: needle coercing, needle slipping, needle tip pushing, pulmonary nodule prolapsing, radial nodule deformation, nodular masking, and radial movement distance of needle tip. Results In all of 107 cases evaluated, the antenna puncture was successful in 101 cases (94.4%) but failed in 6 cases (5.6%). Pneumothorax and pulmonary hemorrhage occurred in 23 (21.5%) and 19 cases (17.8%), respectively. The following phenomena occurred: needle coercing in 9 cases (8.4%), needle slipping in 6 cases (5.6%), needle tip pushing in 19 cases (17.8%), pulmonary nodule prolapsing in 15 cases (14%), radial nodule deformation in 14 cases (13.1%), and nodular masking in 5 cases (4.7%). The mean radial adjusting distance of needle tip was 0.7±0.4 cm. Conclusion The thread-hanging method can assist in the accurate puncture of microwave antenna for pulmonary nodules. We should focus and deal with phenomena that may occur and affect the result of puncture.

Loss of primary cilia promotes migration of TPC-1 in papillary thyroid cancers / 中华内分泌代谢杂志

Objective:To investigate the role of miR-182-5p regulated primary cilia loss on migration of TPC-1 in papillary thyroid cancers(PTC).Methods:Ten cases of PTC and adjacent tissues were collected from the First Hospital of Lanzhou University, The expression of miR-182-5p in PTC tissue and TPC-1 cells was detected by qPCR, and the frequency of primary cilia was detected by immunofluorescence; Overexpressing miR-182-5p, the migrated number of TPC-1 was detected by Transwell assay; Interfering TPC-1 with siRNA-IFT88, the migrated number of TPC-1 and the frequency of primary cilia were detected, respectively.Results:Compared with control, the expression of miR-182-5p was significantly upregulated in PTC and TPC-1, the frequency of primary cilia in PTC and TPC-1 was downregulated. Overexpressing miR-182-5p increased the migrated number of TPC-1 cell and reduced the number of TPC-1 cell migration(27%, P=0.002); After siRNA-IFT88 treatment, primary cilia in TPC-1 became shorter and thinner, with a decrease in frequency( P=0.001), the migrated number of TPC-1 cell increased, and TPC-1 cell showed smaller nuclei and fewer microvilli. Conclusion:The regulation of primary cilia loss by miR-182-5p through the PI3K pathway contributes to the migration of TPC-1 cells. The loss of primary cilia has an adverse impact on the prognosis of PTC.

Application of non-invasive inflammation diagnosis model in the diagnosis of non-alcoholic fatty liver disease and liver fibrosis in patients with combined hepatitis B virus infection / 中国医师杂志

Objective:To analyze the application value of non-invasive inflammation diagnosis model in the diagnosis of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) combined with hepatitis B virus (HBV) infection.Methods:A total of 98 patients with NAFLD complicated with HBV infection admitted to some coastal China Coast Guard Hospital of People′s Armed Police from June 2019 to October 2021 were selected. Their liver stiffness (LSM), aspartate aminotransferase to platelet ratio (APRI), γ-glutamyltranspeptidase to platelet ratio (GPR), and fibrosis index based on factor 4 (FIB-4) were measured, The receiver operating characteristic (ROC) curve was used to analyze its clinical diagnostic efficacy for liver fibrosis caused by NAFLD combined with HBV infection.Results:Among 98 patients, there were 7 cases in S0 stage, 47 cases in S1 stage, 21 cases in S2 stage, 14 cases in S3 stage, and 9 cases in S4 stage; Including 35 cases of obvious liver fibrosis and 9 cases of cirrhosis. There was no statistically significant difference in gender and body mass index (BMI) among patients in different stages (all P>0.05). Age: the S0 group<the S1 group<the S2 group<the S3 group<the S4 group ( P<0.05); LSM, APRI, FIB-4: S0 group<S1 group<S2 group<S3 group<S4 group (all P<0.05); The GPR of the S0 and S1 groups was significantly lower than the other groups ( P<0.05), and the S2 group<the S3 group<the S4 group ( P<0.05). The sensitivity and specificity of LSM in diagnosing obvious liver fibrosis were 71.6% and 83.1%, respectively; The sensitivity and specificity of APRI were 61.4% and 80.9%, respectively; The sensitivity and specificity of GPR were 82.3% and 66.8%, respectively; The sensitivity and specificity of FIB-4 were 66.2% and 69.5%, respectively. The sensitivity and specificity of LSM in diagnosing liver cirrhosis were 86.1% and 67.5%, respectively; The sensitivity and specificity of APRI were 77.4% and 75.2%, respectively; The sensitivity and specificity of GPR were 79.6% and 75.3%, respectively; The sensitivity and specificity of FIB-4 were 81.2% and 60.4%, respectively. Conclusions:Patients with NAFLD combined with HBV infection show a significant increase in LSM, APRI, GPR, and FIB-4 as liver fibrosis worsens. These non-invasive inflammatory diagnostic models have certain diagnostic value for liver fibrosis, with LSM and GPR having higher diagnostic efficacy.

Application of health self-management intervention program for metabolic syndrome patients in the bereaved population following the Wenchuan earthquake.

Background: The destructive Wenchuan earthquake has led to approximately 800,000 people being bereaved. In the previous cross-sectional study, we explored the long-term incidence of Metabolic Syndrome (MS) and studied its influencing factors among the bereaved population 12 years after the Wenchuan earthquake. Chronic disease self-management has become a recognized public health service. Studies have shown that demographic and genetic factors, stress, geographical environment, society, culture, dietary habits, lifestyle, and other aspects influence MS. Due to the Wenchuan earthquake being a serious stress event, the implementation of targeted interventions should be discussed further. Objectives: To verify the effect of applying a self-management intervention program for patients with MS among the bereaved population following the Wenchuan earthquake. Design: A randomized controlled trial (RCT) design was adopted. Participants: A total of 132 bereaved patients with MS following the Wenchuan earthquake constituted the sample. Methods: The study was based on the Cognitive-Phenomenological-Transaction, Chronic Disease Self-Management Program, and Patient Empowerment Conceptual Model, which combined with the latest evidence-based guidelines, were used to systematically evaluate cross-sectional results of this study that were used to construct a stress management-based health self-management intervention program and MS health self-management manual for bereaved patients with MS following the Wenchuan earthquake. In addition, we revised and completed a health self-management intervention program and health self-management manual for patients with MS by using the expert consultation method. General data were collected prior to intervention (T0). We collected the patients' MS disease-related physiological indicators before intervention (T0), after intervention (T1), and 2 months after intervention (T2). EipData3.1 software was used to input data in duplex and duplicate, and SPSS22.0 software was used for statistical analysis. Results: The variance analysis showed that the total score of healthy self-management behavior and the score of diet management, exercise management, drug management, and emotional management have intergroup effects, time effects, and group-time interaction effects (p < 0.05). When the differences between groups were further compared, we found that the total score and the score of six dimensions (excluding disease self-monitoring management) were higher than those of the control groups at T1 and T2, and the differences were statistically significant (p < 0.05). Conclusion: The intervention program of healthy self-management for patients with MS who come from bereaved families following the Wenchuan earthquake can effectively improve patients' health self-management behaviors.

Systematic review and meta-analysis of stress management intervention studies in patients with metabolic syndrome combined with psychological symptoms.

BACKGROUND: Metabolic syndrome is affected by many factors, including lifestyle, mood, etc. Self-management of chronic diseases has attracted significant attention from researchers. Some studies have shown that patient self-management is a very important link, which can effectively alleviate the risk of further deterioration of the disease. However, so far, there has been no report on the basis of the summary of self-management intervention programs based on emotion management, which needs further in-depth discussion by researchers. METHODS: The Medline (PubMed), Embase (Elsevier), PsycINFO (Ovid), CBM, CNKI and Wanfang databases were searched from the establishment of the databases to June 2022, and a total of 25 studies were traced. The inclusion criteria on stress management in patients of metabolic syndrome complicated with psychological symptoms uses meta-analysis. Two investigators independently assessed the risk of bias for each study using the Cochrane risk of bias tool.16 studies and 2687participants and relevant characteristics of studies. RESULTS: In the effects of intervention measures based on stress management on depression, fasting plasma glucose, 2hFPG, high-density cholesterol, self-management behavior and quality of life in patients with psychological symptoms (depression, anxiety, and schizophrenia) complicated with metabolic diseases, there are statistically significant differences between the intervention group and the control group (P < .05). CONCLUSIONS: Stress management intervention can effectively improve the health outcomes of patients. In all included analysis indicators, the results of the experimental group are better than those of the control group.

Influencing factors of adult thyroid volume in Lanzhou City / 中华地方病学杂志

Objective:To investigate the thyroid volume of adults in Lanzhou City, and analyze its influencing factors.Methods:In June 2016, according to the principle of multi-stage stratified cluster sampling, Han residents aged 18 and above in Chengguan, Xigu and Qilihe districts of Lanzhou City who had lived there for more than 5 years were selected as research subjects, and a portable B-ultrasound machine was used for thyroid examination. Morning urine samples of the subjects were collected to test urinary iodine; fasting venous blood samples of the subjects were collected to test serum thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TgAb), blood lipids [triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL)] and blood uric acid (Ua) levels. At the same time, body indexes systolic blood pressure (SP), diastolic blood pressure (DP), waist circumference, height and weight were measured, and the body mass index (BMI) was calculated. Multiple linear regression was used to analyze the influencing factors of thyroid volume.Results:A total of 1 009 subjects were included, aged (43.50 ± 15.16) years, and the thyroid volume was (8.74 ± 3.39) ml. Among them, 534 males had a thyroid volume of (9.46 ± 3.43) ml; 475 females had a thyroid volume of (7.93 ± 3.15) ml, the thyroid volume of males was larger than that of females ( t = 7.36, P < 0.01). Thyroid volume was positively correlated with age, height, weight, BMI, SP, waist circumference, LDL, Ua and TgAb ( r = 0.07, 0.23, 0.33, 0.27, 0.10, 0.27, 0.10, 0.08, 0.07, P < 0.05), and it was negatively correlated with thyroid nodules, TPOAb, TSH and urinary iodine ( r = - 0.16, - 0.07, - 0.10, - 0.08, P < 0.05). After multiple linear regression analysis, TSH, TPOAb, TgAb and thyroid nodules were included in the regression equation, and the standardized B values were - 0.135, - 0.065, 0.123 and - 0.197, respectively. Conclusions:The thyroid volume of males is larger than that of females in Lanzhou City. TSH, TPOAb, TgAb and thyroid nodules are influencing factors of thyroid volume.

Bilateral basal ganglia hemorrhage due to tentorial dural arteriovenous fistula: a case report and systematic literature review / 中华神经科杂志

Objective:To investigate the clinical characteristics of cerebral hemorrhage caused by tentorial dural arteriovenous fistula (TDAVF).Methods:An unusual TDAVF case admitted to the Department of Neurology, Qilu Hospital, Shandong University in March 2020, complicated with hypertension with successive bilateral basal ganglia hemorrhage in short term was reported. The characteristics of cerebral hemorrhage caused by TDAVF reported in the literature were summarized and analyzed.Results:Digital subtraction angiography (DSA) revealed that there was arteriovenous fistula in the tentorial foramen area of this patient (male, 33 years old), and the TDAVF was fed by the right meningohypophyseal trunk, bilateral middle meningeal artery and posterior cerebral artery. A shunted pouch was present in the tentorial foramen area, and retrograde reflux drainage was seen in the deep venous system, from the meningeal vein to superior sagittal sinus or sigmoid sinus. Transarterial embolization was performed and subsequently DSA showed obliteration of the fistula. This patient experienced no clinical decline or rehemorrhage during the 12 months follow-up period. Forty-one cases of TDAVF with hemorrhage of cerebral parenchyma which were reported before March 30, 2021 with detailed clinical and imaging data were summarized. The average age of onset of this group of patients was 57.2 years, and the ratio of male to female was about 3∶1. The hemorrhage was located in superior of the tentorium in 17 cases (41%), while in inferior of the tentorium in 24 cases (59%). Supratentorial intracerebral hemorrhage mainly occurred in occipital lobe and thalamus. DSA showed that the arteriovenous fistula was classified as Borden type Ⅲ or Cognard type Ⅳ in 36 cases (88%). Twenty-nine patients (71%) underwent a single surgical procedure, while 12 cases (29%) underwent combined surgical or other treatments. Overall, 37 patients (90%) achieved angiographically documented obliteration of the fistula and 39 patients (95%) experienced good or excellent outcomes.Conclusions:TDAVF often presents as cerebral parenchymal hemorrhage which is common in supratentorial region, but rare in basal ganglia region. The cause of cerebral hemorrhage in patients with hypertension may not be attributed to hypertension. Early diagnosis and intervention are of great significance to improve the prognosis of patients.

Correlation Between Serum TSH Levels Within Normal Range and Serum Lipid Profile.

The aim of the work was to investigate the correlation between serum TSH (thyrotropin) levels within normal range and serum lipids. A total of 1962 subjects with normal thyroid function were enrolled. The subjects were divided into four groups according to the quartiles of serum normal TSH levels, [Q1 (0.27-1.68) mIU/l, Q2 (1.69-2.35) mIU/l, Q3 (2.36-3.07) mIU/l, and Q4 (3.08-4.20) mIU/l]. The effect of serum normal TSH levels on serum lipid profiles of different age or gender was analyzed. The total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) levels of the Q3 group and TG levels of the Q4 group were higher than those of the Q1 group in youth (p <0.05). The TC levels of the Q3 group were higher than those of the Q2 group in middle age (p <0.05). The LDL-C levels of middle age or elderly were higher than those of youth at the same TSH levels (p <0.05), while the TC levels of middle age were higher than those of youth in Q1, Q3, or Q4 group (p <0.05), and the TC and HDL-C levels of elderly were higher than those of youth in the Q2 group (p <0.05). The TG levels of the Q3 group were higher than those of Q1 group in males (p <0.05). The LDL-C levels of the Q3 group were higher than those of the Q1 group in females (p <0.05). In conclusion, the normal serum TSH levels were found to be closely related to serum lipid profiles, and with increasing TSH levels, serum lipids levels increased gradually.

Mental symptoms and its influencing factors of patients with malignant tumor undergoing chemotherapy in general hospital / 中华行为医学与脑科学杂志

Objective:To estimate the mental symptoms in malignant tumor patients undergoing chemotherapy using DSM-5 cross cutting symptom measure.Methods:A total of 314 patients who undergoing chemotherapy in oncology department of Zhongshan Hospital, Fudan University who met all standards were chosen. The DSM-5 cross cutting symptom measure Level 1 Scale was used to assess the mental symptoms of the patients. SPSS 25.0 software was used for χ 2 test, Pearson correlation analysis and multiple regression analysis. Results:The most common symptoms in the patients were depressive symptoms(85/314, 27.1%), somatic symptoms (79/314, 25.2%), manic symptoms (78/314, 24.5% ) and anxiety symptoms (76/314, 24.3%). The proportion of anxiety symptoms in malignant tumor patients who were taken care of by other personnel(26/64, 40.6%) was significantly higher than that in patients who were taken care of by immediate relatives(50/250, 20.0%)(χ 2=12.23, P<0.05). Patients with unstable working conditions were more likely to have depressive symptoms (χ 2=7.64, P<0.05). There was a significant negative correlation between the patients' understanding of the disease and their scores of depressive symptoms, somatic symptoms, manic symptoms, anxiety symptoms and the total score of mental symptoms( r= -0.26, -0.15, -0.12, -0.25, -0.22, all P<0.05). In addition, the total score of mental symptoms of malignant tumor patients was significantly positively correlated with family burden and family status( r=0.11, 0.11, both P<0.05), and negatively correlated with patients' education ( r=-0.13, P<0.05). Multiple regression analysis showed that the degree of understanding of the disease( β=-0.203) and family status( β=0.197) were the influencing factors of mental symptoms of inpatients malignant tumors undergoing chemotherapy in general hospital ( F=13.653, P<0.001). Conclusion:Malignant tumor patients undergoing chemotherapy may have a variety of mental symptoms. The high incidence mainly includes depressive symptoms, somatic symptoms, manic symptoms and anxiety symptoms. The understanding of the patients to the disease and family situation are the main influencing factors.

Detection of thyroid nodules in people with abnormal lipid metabolism and related factors / 中华地方病学杂志

Objective:To investigate the detection rate and related factors of thyroid nodules in people with abnormal lipid metabolism.Methods:From September 4, 2016 to February 1, 2017, community residents living in Lanzhou City, Longnan City, Dingxi City and Linxia City of Gansu Province for more than 5 years were selected as the respondents. General data were recorded, venous blood was collected, blood lipid related biochemical indexes were detected, and thyroid ultrasound was performed. By comparing the general data and biochemical indexes, the detection of abnormal lipid metabolism and thyroid nodules were analyzed, and the risk factors of thyroid nodules in people with abnormal lipid metabolism were analyzed by logistic regression.Results:Two thousand and fifty-nine residents were included in this study (1 049 males and 1 010 females). The total detection rate of thyroid nodules was 23.17% (477/2 059). The detection rate of thyroid nodules in people with abnormal lipid metabolism [34.16%(151/442)] was significantly higher than that in people with normal lipid metabolism [20.16% (326/1 617) , P < 0.01], and the detection rate of thyroid nodules of women [43.37% (85/196) ] was higher than that of men [26.83% (66/246) , P < 0.01]. Among the people with abnormal lipid metabolism, the highest detection rate of thyroid nodules was in mixed hyperlipidemia [57.14% (16/28)], followed by hypertriglyceridemia [34.59% (92/266)]. The detection rates of thyroid nodules in the groups with elevated total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels [35.16% (32/91), 34.85% (23/66)] were higher than those in the marginal elevated group [27.04%(86/318), 30.42% (73/240)] and the normal groups [21.76% (359/1 650), 21.73% (381/1 753), P < 0.05]. The results of logistic regression analysis showed that the risk factors of thyroid nodules in people with abnormal lipid metabolism were increased age, elevated fasting blood glucose (FPG), elevated blood glucose 2 hours (2 h PG) after oral glucose tolerance test (OGTT) load and elevated glycosylated hemoglobin [HbA1c, odds ratio ( OR)=1.065, 1.387, 1.866, 1.384, P < 0.05]. Conclusions:The prevalence of TN is higher in populations with abnormal lipid metabolism. The control of blood sugar and blood lipid levels may play a role in the prevention of thyroid nodules.

Metabolic syndrome risk in relation to posttraumatic stress disorder among trauma-exposed civilians in Gansu Province, China.

This study included 1456 men and 1411 women who were trauma-exposed and underwent routine health examinations in a community epidemiological investigation. The participants completed the posttraumatic stress disorder (PTSD) Check List-Civilian Version (PCL-C) for PTSD and medical examinations to detect metabolic syndrome. Adjustments for age, marriage, exercise, education, cigarette smoking, cancer, stroke, angina, and thyroid disease were performed. The relationship between PTSD and metabolic syndrome and each of its components was analyzed by multiple logistic regression.In women, PTSD was associated with metabolic syndrome (OR = 1.53, 95% CI = 1.01-1.95, P = .047) and the high-density lipoprotein cholesterol component (OR = 1.98, 95% CI = 1.04-2.12, P = .002). In men, PTSD was related to the hypertension component of metabolic syndrome (OR = 0.54, 95% CI = 0.31-0.92, P = .023). There was also a relationship between PTSD severity and metabolism (OR = 1.141, 95% CI = 1.002-1.280, P = 0.037) in women, and PTSD was inversely associated with the hypertension component (OR = 0.54, 95% CI = 0.31-0.92, P = .023) in men.PTSD was related to metabolic syndrome only in women. We plan to further research the mechanism of sex differences and dyslipidemia.

A study on urinary iodine levels and influencing factors of urban and rural residents in some areas of Gansu Province / 中华地方病学杂志

Objective@#To analyze the urinary iodine status of urban and rural residents in some areas of Gansu Province and its related influencing factors, and to provide certain references for scientific iodine intake of urban and rural residents in Gansu Province.@*Methods@#Subjects in Gansu Province with normal thyroid function were recruited in the investigation of thyroid diseases and iodine nutritional status, conducted a questionnaire survey and measured height, weight, waist circumference, collected 1 urine sample, and tested their urinary iodine levels. The urinary iodine levels of different groups were compared based on different gender, region, age, body weight, the waist, and salt intaking. The affecting factors of urinary iodine levels were analyzed by multiple linear regression models.@*Results@#Totally 1 964 subjects were recruited, including 1 099 males, and 865 females. The age was (41.23 ± 14.75) years old. The median urinary iodine of the selected group was 225.60 (158.80, 311.58) μg/L. The urinary iodine level of rural residents was significantly higher than that of urban residents [μg/L: 249.80 (180.58, 336.88) vs 206.25 (148.03, 280.33), Z=-8.015, P < 0.05], and there was no significant difference between the urinary iodine levels of male and female [μg/L: 222.40 (161.60, 298.90) vs 230.60 (158.00, 326.40), P > 0.05]. The composition ratio of < 100 μg/L group in rural areas was lower than that in urban areas (5.14% vs 8.27%, χ2= 7.45, P < 0.05), and the composition ratio of ≥300 μg/L group was higher than that in urban areas (34.93% vs 21.51%, χ2= 43.87, P < 0.05). The composition ratio of ≥300 μg/L group in male was lower than that in female (24.57% vs 31.21%, χ2= 10.73, P < 0.05). The multiple linear regression analysis showed that lived in rural areas, age, moderate and severe salt intaking, student, and weight were independently correlated with urinary iodine levels (β= 0.074, -0.001, 0.059, 0.034, 0.096, -0.003, P < 0.05). And the urinary iodine levels were decreased with age and weight increased (P < 0.05).@*Conclusions@#At present, the iodine nutrition level of urban and rural residents in some areas of Gansu Province is generally over the adequate level. The urinary iodine level of rural residents is higher than that of urban residents. In the future, we should pay attention to the impact of different living areas, salt intaking and body weight on urinary iodine levels to prevent thyroid diseases.

A study on urinary iodine levels and influencing factors of urban and rural residents in some areas of Gansu Province / 中华地方病学杂志

Objective To analyze the urinary iodine status of urban and rural residents in some areas of Gansu Province and its related influencing factors,and to provide certain references for scientific iodine intake of urban and rural residents in Gansu Province.Methods Subjects in Gansu Province with normal thyroid function were recruited in the investigation of thyroid diseases and iodine nutritional status,conducted a questionnaire survey and measured height,weight,waist circumference,collected 1 urine sample,and tested their urinary iodine levels.The urinary iodine levels of different groups were compared based on different gender,region,age,body weight,the waist,and salt intaking.The affecting factors of urinary iodine levels were analyzed by multiple linear regression models.Results Totally 1 964 subjects were recruited,including 1 099 males,and 865 females.The age was (41.23 ± 14.75) years old.The median urinary iodine of the selected group was 225.60 (158.80,311.58) μg/L.The urinary iodine level of rural residents was significantly higher than that of urban residents [μg/L:249.80 (180.58,336.88)vs 206.25 (148.03,280.33),Z=-8.015,P ＜ 0.05],and there was no significant difference between the urinary iodine levels of male and female [μg/L:222.40 (161.60,298.90) vs 230.60 (158.00,326.40),P ＞ 0.05].The composition ratio of ＜ 100 μg/L group in rural areas was lower than that in urban areas (5.14％ vs 8.27％,x2 =7.45,P ＜0.05),and the composition ratio of ≥300 μg/L group was higher than that in urban areas (34.93％ vs 21.51％,x2 =43.87,P ＜ 0.05).The composition ratio of ≥300 μg/L group in male was lower than that in female (24.57％ vs 31.21％,x2 =10.73,P ＜ 0.05).The multiple linear regression analysis showed that lived in rural areas,age,moderate and severe salt intaking,student,and weight were independently correlated with urinary iodine levels (β =0.074,-0.001,0.059,0.034,0.096,-0.003,P ＜ 0.05).And the urinary iodine levels were decreased with age and weight increased (P ＜ 0.05).Conclusions At present,the iodine nutrition level of urban and rural residents in some areas of Gansu Province is generally over the adequate level.The urinary iodine level of rural residents is higher than that of urban residents.In the future,we should pay attention to the impact of different living areas,salt intaking and body weight on urinary iodine levels to prevent thyroid diseases.

Correlation analysis between macular thickness and visual field mean defect in pseudoexfoliation glaucoma / 中华实验眼科杂志

Objective To compare and analyze differences in macular thickness and to discuss the correlation between macular thickness and visual field mean defect (MD) in early and moderate,late pseudoexfoliation glaucoma (PXG) patients and normal control subjects.Methods A series of cases-observation study was adopted.Thirty-three early and moderate PXG patients (33 eyes) and 24 late PXG patients (24 eyes) were collected in the First Hospital of Shijiazhuang from May 2013 to May 2018.Meanwhile,34 age,gender and diopermatched healthy subjects (34 eyes) were included as normal control group.Spectral domain optical coherence tomography (SD-OCT) was used to measure macular thickness and volume in every quadrant.The correlation between the macular thickness and visual field MD were analyzed.This study followed the Helsinki declaration and was approved by the ethics committee of the First Hospital of Shijiazhuang.Written informed consent was obtained from each subject prior to any medical examination.Results The average macular thickness in normal control group,early and moderate PXG group and late PXG group were (305 ± 15),(297 ± 15) and (287 ± 17) μm,respectively;the average macular volume were (0.94 ± 0.05),(0.91 ± 0.05) and (0.89 ± 0.05) μm3,respectively.The macular thickness and volume differences between the 3 groups were statistically significant in nasal inner macula,superior inner macula,temporal inner macula,inferior inner macula,superior outer macula,temporal outer macula,inferior outer macula quadrants (Fthickness =4.226,9.335,12.133,10.115,11.298,8.243,12.142;all at P＜0.05.Fvolume =3.812,9.152,12.774,8.889,11.284,7.937,11.652;all at P＜0.05).The macular thickness of early and moderate PXG group in superior inner macula,temporal inner macula,inferior inner macula,superior outer macula and temporal outer macula quadrants were statistically thinner than those in the normal control group (all at P＜0.05);the macular thickness of late PXG group in inferior inner macula,temporal inner macula,superior outer macula and inferior outer macula quadrants were statistically thinner than those in the early and moderate PXG group (all at P＜0.05);the macular thickness of late PXG group in inner and outer rings were statistically thinner than those in the normal control group (all at P＜0.05).The macular thickness was not correlated with visual field MD in normal control group and the early and moderate PXG group in every quadrants (all at P＞0.05),but it was positively correlated with visual field MD in the late PXG group in nasal inner macula,superior outer macula and temporal inner macula quadrants (r =0.527,0.544,0.417;all at P＜0.05).Conclusions SD-0CT can quantify the macular thickness,and can be used an important reference index for the staging and follow-up of PXG combined with perimetry.

Determination of the Related Substances in Edaravone and Sodium Chloride Injection by HPLC / 中国药师

Objective: To establish an HPLC method for the determination of the related substances in edaravone and sodium chlo-ride injection. Methods: The column was Kromasil C18(250 mm×4. 6 mm, 5 μm) at the temperature of 30℃. The mobile phase A for gradient elution was a solution containing 0. 2% acetic acid and 0. 2% trimethylamine, and methanol was used as the mobile phase B. The flow rate was 0. 8 ml·min-1, the detection wavelength was 244 nm, and the injection volume was 20 μl. Results: Under the described chromatographic conditions, edaravone was completely separated from its impurities. Edaravone and its impurities had good linear relationships within the range of 0.1 μg·ml-1-3 μg·ml-1(r >0.998). The average recoveries ranged from 90.0% to 110. 0% (RSD<10% , n=9), and the contents of their related substances were all below the limits (0. 3% ). Conclusion: The method is accurate, simple and convenient, which can be used for the determination of the related substances in edaravone and sodium chloride injection.

One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis

STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis. OVERVIEW OF LITERATURE: There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature. METHODS: Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery. RESULTS: All patients completed a follow-up survey 9–48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6–12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from 38.1±12.5 to 11.3±7.1 mm/hr, C-reactive protein decreased from 6.2±4.2 to 1.6±1.3 mg/dL, the visual analog scale score decreased from 4.6±1.1 to 1.4±1.0, the Oswestry disability index score decreased from 50.2%±11.9% to 13.0%±6.6%, and the lumbosacral angle increased from 20.0°±4.8° to 29.0°±3.9° (p<0.05). CONCLUSIONS: One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.

The clinical effect and safety on budesonide combined with ipratropium bromide in the treatment of acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

Objective To explore the effect of budesonide combined with ipratropium bromide in the treat-ment of acute exacerbations of chronic obstructive pulmonary disease,and observe the adverse reactions during treat-ment.To analyze the treatment of safety and to provide the basis for clinical treatment.Methods 160 cases of acute exacerbations of chronic obstructive pulmonary disease were selected,they were randomly divided into the control group A,B,C and the observation group,with 40 cases in each group.The control group A was treated with prednisone and other conventional,control group B was treated with aminophylline and other conventional treatment,the control group C application included prednisone,aminophylline and other conventional treatment,all the control group were treated with 0.9% sodium chloride solution inhaled as a placebo spray.And the observation group application of budesonide was combined with ipratropium bromide based on the routine treatment.Mainly the effect of treatment was observed,and the blood carbon dioxide partial pressure (PaO2 ),partial pressure of oxygen (PaCO2 ),forced expiratory volume in one second (FEV1 ),forced expiratory volume in one second (FEV1 )and forced expiratory volume in one second to forced vital capacity ratio of FVC (FEV1 /FVC)before and after treatment were detected.And the adverse reactions were observed to evaluate its safety.Results The total effective rate of the observation group was 95.00%(38 /40),which were higher than the control group A,B and C,the differences were statistically significant (χ2 =9.68,9.70,9.91,all P 0.05). Conclusion It has good clinical curative effect on budesonide combined with ipratropium bromide for the treatment of acute exacerbations of chronic obstructive pulmonary disease patients,which can significantly improve the pulmona-ry function of patients,shorten recovery time,and has high security.It is worthy of clinical application.

Obsessive-compulsive disorder in general hospital outpatients: prevalence, correlates, and comorbidity in Lanzhou, China.

INTRODUCTION: The prevalence of obsessive-compulsive disorder (OCD), risk factors, and comorbidity rates of Chinese outpatients in Lanzhou general hospitals are unknown. METHOD: The prevalence rate of OCD was estimated in a representative sample of outpatients in three classes of general hospitals in Lanzhou, China. The rate of OCD within the sample, which was composed of 1,576 individuals aged 16 years or older, was assessed using the World Health Organization Composite International Diagnostic Interview Version 3.0. RESULTS: The weighted prevalence of OCD were 4.31% (lifetime), 2.86% (12-month), and 1.97% (30-day). Multivariate logistic regression identified the following independent predictors of having lifetime OCD: having a higher level of education, being unemployed, an internal medicine outpatient, a female, 16-35 years old, divorced/widowed/separated, and having a low family income. OCD had a significant comorbid association with neuroses, based on the International Statistical Classification of Diseases and Related Health Problems-10th Revision. DISCUSSION: These findings show a lower prevalence rate of OCD in Lanzhou general hospitals than that reported for some specialized outpatient clinics in Western countries. Further investigations are required to explore the relationships between OCD and the risk factors identified in the current study. Resolving methodological problems may lead to more accurate prevalence estimates in future epidemiological studies. Our findings suggest that there is an urgent need to improve the ability of clinicians to detect OCD in outpatients.

Twin Block appliance combined with straight wire appliance used in cor-recting Angle Ⅱmalocclusion / 中国现代医生

Objective To investigate the efficacy of Twin Block appliance combined with straight wire appliance in the correction of AngleⅡ malocclusion. Methods Sixteen patients with Angel Ⅱ malocclusion were selected. Twin Block appliance combined with straight wire appliance was used for correction without tooth extraction. The lateral films of head were shot before and after treatment in order to conduct X-ray cephalometric analysis. Results All patients com-pleted active corrective treatment within (18±2.0) months. After treatment, the lower jaw moved forward and the classⅠ molar-canine relationship was established. Normal overbite and cover was obtained. The patients with lower mandible retrusion achieved obvious corrective effects and their appearance improved. After treatment, X-ray cephalo-metric analysis showed that SNB increased by 3.25° on average, SNA remained the same, ANB reduced by 6.50° on av-erage, IMPA reduced by 6.95° on average, FMIA increased by 3.61° on average, FMA increased by 2.53° on average, Po-Co increased by 5.12 mm on average, and Vits reduced by 1.29 mm on average(P<0.05). Conclusion In the correc-tion of early Angle Ⅱ malocclusion, Twin Block functional appliance combined with straight wire appliance shows evi-dent effects and patient satisfaction, thereby worthy of clinical promotion.