Objective To evaluate the relationship of metabolic syndrome (MS) and MS components with thyroid nodule. Methods A total of 10 357 subjects ( age ＞ 18 years old) who received physical checkup at the Second Affiliated Hospital of Dalian Medical University between June 2009 and June 2010 were enrolled in this retrospective study. Anthropometric parameter, fasting plasma glucose (FPG),serum lipid profile, blood uric acid, alanine aminotransferase and thyroid ultrasonography were measured. Results The prevalence of thyroid nodule,MS,and thyroid nodule + MS was 46. 96% ,23. 6%,and 11.6%, respectively. The prevalence of thyroid nodule was significantly higher in MS patients than in non MS patients ( 75.9% vs 38. 0%, P ＜ 0. 05 ). Multifactor logistic analysis showed that MS, body mass index (BMI) and FBG (β vales were 0. 78,1.22,and 0. 62,respectively; odds ratios were 4. 167,3. 876,and 2. 359, respectively; all P ＜ 0. 05 ) were independently correlated with the development of thyroid nodule. Conclusions Significantly increased prevalence of thyroid nodule could be found in MS patients. BMI and FBG may be independent risk factors of thyroid nodule.

Objective: To establish HPLC method for determination of pterostilbene in Dragon's Blood with different extraction technology. Method: Applying a C 18 phase column and acetonitrile 1% acetic acid(41∶59) as mobile phase, detecting at 319nm and quantitating with external standard method. Results: The standard curves of pterostilbene was linear in the concentration range of 10.4～104ng, r =0.9992. The average recovery was 98.28%, RSD =1.97%. The content of pterostilbene in Dragon's Blood extracted with ordinary temperature was lower than that with heating technology. Conclusion: The content of pterostilbene extracted with ordinary temperature extraction in Dragon's blood have the advantage of heating extraction.

Objective To study the levels of senlm uric acid(UA)in normal glucose(NC),impaired glucose regulation(IGR)and type 2 diabetes mellitus(T2DM),and investigate its relationship with insulin resistance and dyslipidemia.Method The levels of blood glucose,lipids,fasting insulin(HNS)and serum UA were measured in patients of 45 T2DM(T2DM group),20 IGR(IGR group)and 29 NC(NC group).Status of insulin resistance and insulin secretion function was evaluated by HOMA-IR and ISI.Results The levels of triglyceride(TG)and UA in T2DM group and IGR group were significantly higher than those in NC group[(3.34±8.77),(1.85±0.67),(1.26±0.38)mmoi/L and(316.71±96.20),(403.62±76.80),(325.45±94.43)mmol/L](P<0.01).HDL-C levels in T2DM group were significantly lower than those in IGR and NC group[(1.05±0.30),(1.07±0.21),(1.12±0.20)mmol/L](P<0.01).NO significant difference of FINS levels was found in the three groups.HOMA-IR level in T2DM and IGR group was higher than that in NC group(3.84,3.77,2.34)(P<0.01).ISI in T2DM and IGR group was lower than that in NC group(-4.52±0.79,-4.44±0.19,-4.03±0.58)(P<0.01).Correlation analysis indicated that the level of UA was positively related with BMI.TG and negatively related with HDL-C.Conclusion Increased UA in IGR indicates that hyperurieacidemia developes before DM.

ObjectiveTo explore linkage relationship between polymorphisms of (AC)n (AT)xTy and mutations in the β-globin gene in patients with mild β-thalassemia.MethodsThe subjects were 89 mild β-thalassemia patients with known mutations and 110 healthy subjects from People's Hospital of Baoan District of Shenzhen from February 2009 to July 2010.Genomic DNA was extracted from peripheral leukocytes.Sequence of the BP1 binding site upstream of the β-globin gene was amplified by polymerase chain reaction,polymorphisms of (AC)n (AT)xTy were determined by DNA sequencing.Allelic frequencies of (AC)n (AT)xTy between mild β-thalassemia patients and healthy subjects were compared using x2 test.Mutation rates between two groups were also compared using x2 test for subjects carrying same haplotype. Linkage relationship was conducted according to allelic frequencies and mutations. Results Analysis of the (AC)n(AT) xTy polymorphisms of the BP1 binding site upstream of the β-globin gene showed 9 different genotypes: (AC)2( AT)7T7,( AC)2( AT)8T5,( AC)3( AT)7T5,( AC)2( AT)9T5,( AC)2(AT)8T9,(AC)3(AT)8T5,(AC)2(AT)10T3,(AC)2(AT)7T5 and (AC)2(AT)11T3.The (AC)2(AT)7T7 and (AC)2 (AT)8T5 genotypes were common for patients with mild β-thalassemia.Allele frequencies of (AC)2(AT)7T7,(AC)3 ( AT)7T5 and ( AC)2( AT)8T9 were 38.8％ (69/178),11.8％(21/178),9.0％ ( 16/178 ) for mild β-thalassemia patients,and 24.1％ ( 53/220),5.4％ ( 12/220),3.2％(7/220)for healthy subjects, respectively, there were significant differences between mild β-thalassemia patients and healthy subjects (x2 =9.966,4.371,6.093,P ＜ 0.05 ).Allele frequency of (AC)2(AT)9T5 was 10.1％ (18/178) and 33.2％ (73/220) for mild β-thalassemia patients and healthy subjects,frequency of (AC)2 (AT)9T5 was significandy lower in mild β-thalassemia patients than in healthy subjects (x2 =29.691,P ＜0.01 ).Allele frequency of (AC)2(AT)8T5 was 25.3％ (45/178) and 29.1％(64/220) for mild β-thalassemia patients and healthy subjects,there wasn't significant difference between patients and healthy subjects (x2 =0.718,P ＞0.05).The mutation rates of codon41/42(-TTCT) and IVSⅡ-654(C→T) were 59％ (10/17) and 29％ (5/17) for mild β-thalassemia patients carrying (AC)2(AT)7T7 allele,and 29％ (4/14) and 57％ (8/14) for patients carrying ( AC)2 (AT)8T5 allele.There were not significant differences between codon41/42(-TTCT) mutation rate and IVS-Ⅱ-654(C→T) mutation rate (x2 =2.982,2.333,P ＞ 0.05 ) for mild β-thalassemia patients carrying ( AC)2 ( AT)7T7 and ( AC)2(AT)8T5 allele.ConclusionsAllele of (AC)2(AT)7T7,(AC)3(AT)7T5 and (AC)2(AT)8T9 are in linkage disequilibrium with β-thalassemia.Most mild β-thalassemia patients carrying (AC)2 (AT)7T7 allele are caused by codon41/42 (-TTCT) mutation in the β-globin gene,and IVS-Ⅱ-654 (C→T) is a major mutation for patients carrying (AC)2(AT)8T5 allele.

Objective To determine the influence of gender on the association between serum uric acid and branchial-ankle pulse wave velocity (baPWV).Methods Cross-sectional data from 1418 adults who underwent routine laboratory tests and baPWV measurements were analyzed in a gender-specific manner.BaPWV≥ 1400 cm/s was defined as abnormality.The individuals were assigned to four groups (Q1,Q2,Q3 and Q4) according to the gender-specific quartiles of serum uric acid.The relationship between serum uric acid and the baPWV values was assessed by Spearman's correlation coefficients.In female,the relationship of serum uric acid quartiles with baPWV was evaluated by logistic regression analysis.Results In male and female,diastolic blood pressure,fasting blood glucose,triglyceride and body mass index were increased with serum uric acid level,in contrast to high-density lipoprotein cholesterol.The Spearman's correlation coefficient for the relationship between serum uric acid and baPWV was 0.18 in female and-0.05 in male (P =0.16).In female,univariate logistic regression analysis showed that in comparison with group Q1,odds ratio (OR) value of baPWV abnormality of group Q4 was 2.45 (95％confidence interval (CI) 1.48 to 4.06).In multivariate logistic regression,after adjusting for creatine and estimated glomerular filtration rate,OR value of baPWV abnormality of group Q4 was 2.45 (95％ CI 1.48 to 4.06) when compared with group Q1.However,after adjustment for age and other risk factors of cardiovascular diseases,there were no significant differents in ORs among serum uric acid quartile groups.Conclusions The association between serum uric acid level and baPWV in female may depend on age and metabolic syndrome components.

Objective To investigate the characteristics of VP1 gene hypervariable region in hu-man enterovirus type 68(HEV68)strains isolated in China. Methods Nucleotide sequences of the VP1 gene in the Chinese strains and strains isolated in other countries were aligned by using Clustal W in the MEGA6 program. The phylogenetic trees were constructed by using Neighbor-Joining(NJ)method in the MEGA6 program. Sequence of the amino acids encoded by that region was analyzed by compared with that of the standard strain Fermon. Results A total of 80 strains of EV68 had been isolated in China by the end of 2015. Most of the mutations occurred in BC and DE loops. The mutation sites lied in the VP1 gene of Chi-nese isolates were at 83,89,91,94,96,97,98,102,109,139,141,142,143,144 and 147. Glycine was missing from most of the amino acid sequences encoded by the VP1 gene of Chinese strains. The phylo-genetic analysis indicated that 53 and 21 EV68 strains isolated in China belonged to B and C clades,respec-tively. Conclusion Compared with the standard strain Fermon,the Chinese strains changed a lot in BC-loop and DE-loop,which were associated with the antigenicity and virulence of EV68. The EV68 strains iso-lated in China belonged to B and C clades.

Objective To explore the relationship between the polymorphisms of the primary gout predisposing gene (BCAS3) rs11653176 locus and the incidence of gout in Han Chinese men in coastal areas of Shandong Province. Methods One hundred and fifty-two cases of patients with gout remission,68 cases of acute stage,252 patients with hyperuricemia, and 280 healthy subjects, total males, were enrolled. Genotyping the rs11653176 locus of BCAS3 gene by TaqMan probe technique. The expression level of BCAS3 gene mRNA in each PBMC was measured by RT-qPCR. The levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and interleukin-18(IL-18)in serum were measured by ELISA. Results The change of allele frequency of rs11653176 locus in BCAS3 gene was associated with gout(P<0.01). BCAS3 mRNA in patients with gout was significantly higher than that of healthy people and patients with hyperuricemia(P<0.01). In gout patients, the expression level of BCAS3 gene containing C allele was higher than that of T allele(mRNA,P<0.05). The inflammatory factors in the acute phase of gout were significantly higher than those in phases of remission and hyperuricemia(P<0. 01). Conclusion Changes in the allele frequency of BCAS3 alleles rs11653176(high C, low T)may contribute to the expression of this gene,and lead to gout. And the onset of gout is closely related to the production of inflammatory factors.

Objective To analyze how enterovirus D68 (EV-D68) protease 2A affects the anti-vi-ral interferon typeⅠ(IFN-Ⅰ) pathway in 293T cells following infection. Methods Western blot was used to detect the expression of recombinant protease 2A, IFN-α and signal transducers and activators of tran-scription 1 (STAT1) at protein level. Expression of EV-D68 viral protein (VP1) and protease 2A was ana-lyzed by immunofluorescence at different time points. Cytopathic effects were recorded to calculate 50％ cell culture infective dose ( CCID50 ) . Expression of the genes involved in the anti-viral IFN-Ⅰ pathway was measured by real-time PCR (RT-PCR). Results The recombinant plasmid pCLIPf-2A was successfully constructed and the expression of recombinant protease 2A could be detected by Western blot 24 h after transfection. The recombinant protease 2A promoted the proliferation of EV-D68 at the late stage of infection and induced the production of IFN-α. Expression of the genes involved in the anti-viral IFN-Ⅰ pathway at mRNA level was up- or down-regulated to different degrees with various trends in different groups following infection. Expression of STAT1 was enhanced in all groups. Conclusions EV-D68 protease 2A promoted the activation of anti-viral IFN-Ⅰpathway in response to viral infection and enhanced the proliferation of virus at the late stage of infection.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

Background Some studies have shown that PM_2.5 exposure is closely related to central nervous system diseases that lead to cognitive dysfunction and change the composition of intestinal flora. However, there are few studies on the role of intestinal flora in PM_2.5-induced depression- and anxiety-like behaviors in mice. Objective To observe the effects of PM_2.5 exposure on depression- and anxiety-like behaviors and the composition of intestinal flora in mice, and to explore the role of intestinal flora in regulating 5-hydroxytryptamine (5-HT) in depression- and anxiety-like behaviors in mice exposed to PM_2.5. Methods Eight-week-old male SPF C57BL/6J mice were randomly divided into control group (NS group), probiotic group (LGG group), PM_2.5 group (PM group), and combined exposure group (PML group), 6 mice in each group. Mice in the PM group and the PML group were exposed to PM_2.5 in a dynamic exposure cabinet for 6 h per day, 6 d a week for 7 consecutive weeks, and the PM_2.5 concentrations were approximately 8 times higher than the outdoor concentration. The LGG group and the PML group were orally administered with Lactobacillus rhamnosus while the NS group and the PM group were orally administered with the same amount of saline. Elevated plus maze test and open field test were used to detect depression and anxiety in mice. Fecal samples of mice were collected to evaluate intestinal flora abundance, diversity, and structure between groups using high-throughput sequencing of 16S rRNA. ELISA was employed to detect the levels of 5-HT in serum and hippocampus. Spearman correlation was used to analyze the correlations of differential intestinal flora with 5-HT level in hippocampus and depression- and anxiety-like behavior indicators in mice. Results The percentage of open-arm entry [M(P₂₅, P₇₅)] in the PM group was 0.0% (0.0%, 33.3%), lower than those in the NS group [47.7% (25.0%, 50.8%) ] and the PML group [46.9% (40.0%, 50.0%)], and the differences were statistically significant (P<0.05). The total travelled distance and the time spent in central area (\begin{document}$\bar x \pm s $\end{document}) in the PM group were (2.01±0.90) m and (10.31±1.99) s respectively, shorter than those of the NS group [(3.80±0.89) m, (14.47±3.07) s], the total travelled distance in the PML group [(2.73±1.12) m] was shorter than those of the NS group and the LGG group [(4.21±1.08) m], and the differences were statistically significant (P<0.05). Compared to the NS group, the Simpson index of the PM group significantly increased (P<0.05). Compared to the LGG group, the Simpson index of the PML group significantly decreased (P<0.05). The results of Beta diversity analysis showed that there were differences in the composition of intestinal flora among the four groups of mice. Compared with the NS group and the LGG group, the abundances of Erysipelotrichaceae and Dubosiella in the PM group and the PML group increased, while the abundances of Prevotellaceae_UCG-001 decreased, and the differences were statistically significant (P<0.05). In hippocampus, the level of 5-HT in the PM group [(135.02±10.31) μg·g⁻¹] was lower than those in the NS group [(178.77±43.15) μg·g⁻¹] and the LGG group [(224.85±22.98) μg·g⁻¹], and the level of 5-HT in the PML group [(161.27±15.81) μg·g⁻¹] was lower than that in the LGG group (P<0.05). 5-HT level in hippocampus was significantly positively correlated with the relative abundance of Prevotellaceae_UCG-001 (r=0.6090, P=0.012). The percentage of open-arm entry was significantly negatively correlated with the relative abundance of Dubosiella (r=−0.4630, P=0.023). Conclusion Atmospheric PM_2.5 exposure may cause depression- and anxiety-like behaviors in mice. The observed behavior dysfunction may be associated with the changes in diversity and relative abundance of intestinal flora as well as the decrease of 5-HT level. Such depression- and anxiety-like behaviors are alleviated after adding probiotics.