Objective To study the relationship between thyroid function and disease severity or insulin resistance in patients with type 2 diabetes.Methods A total of 500 patients with type 2 diabetes and 60 normal controls were enrolled in our study.Fasting blood free three iodine thyroid original thyroid hormones(FT3) and free amino acid(FT4),thyroid stimulating hormone(TSH),thyroid related antibodies(thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)) of two groups of selected objects were detected.In patients with type 2 diabetes group,blood insulin,glycated hemoglobin(HbA1c),and the determination of trace albumin urine creatinine(UCr) and (UMA) were assayed.Results FT3 and TSH of control group was (4.14±1.52) pmol/L,(2.10±1.33) mIU/L,but the level of case group was (4.53±0.72) pmol/L,(1.78±0.97) mIU/L respectively,the difference between case group and control group of serum FT3 and TSH were statistically significant(P=0.03,0.025).The serum FT3 significantly decreased in patients with high blood sugar,the difference between HbA1C>11% group(FT3=(3.76±0.78) pmol/l) and HbA1C≤7%(FT3=(4.37±0.78) pmol/l),7-9%(FT3=(4.24±0.62) pmol/l),9-11% (FT3=(4.36±1.68) pmol/l) groups were statistically significant(P=0.014,0.009,0.000).The higher urine MA/Cr,the more serum FT3 decreased,the difference between urine MA/Cr<30 mg/g group(FT3=(4.31±0.18) pmol/l) and 30 mg/g≤MA/Cr<300 mg/g(FT3=(4.00±0.79) pmol/l),MA/Cr≥300 mg/g (FT3=(3.50±0.76) pmol/l) groups were statistically significant(P=0.041,0.001).The differences between MA/Cr≥300 mg/g group and 30 mg/g≤MA/Cr<300 mg/g group was statistically significant(P=0.044).In addition,we found a correlation between serum TSH and insulin resistance index(HOMA-IR)(r=0.302,P=0.001).Conclusion As a sign of serious high blood sugar,it can predict the severity of diabetic nephropathy.There is intimate relationship of serum TSH and HOMA-IR.

A total of 1 870 patients who had undergone thyroidectomy were investigated.The mean TSH level in patients with differentiated thyroid cancer (DTC) was significantly higher than that in patients with benign thyroid nodules[(1.95±1.69 vs 1.40±1.98)mIU/L,P＜0.01].DTC patients who had lymphatic metastasis or the diameter of tumor more than 10 mm had higher serum TSH level.Serum thyrotropin is an independent risk predictor for DTC.

Objective To investigate the relationship between serum 25-(OH) D3 and autoimmune thyroid diseases (AITD).Methods Serum levels of 25-(OH) D3, thyroid antibodies (thyroid stimulating hormone receptor antibody (TRAb), TGAb (thyroid globulin antibody), thyroid peroxidase antibody (TPOAb) and thyroid function of 32 cases patients with Graves' diseases (GD), 17 cases patients without remission of GD,10 cases patients with remission of GD,35 cases patients with Hashimoto's thyroiditis (HT),and 58 cases healthy subjects were measured,and the relationships between serum 25-(OH) D3 and the above clinical index were analyzed.Results The serum level of 25-(OH) D3 in patients with GD or HT were obviously lower than that in healthy subjects((50.75±17.60) μg/L, (36.40±21.65) μg/L, (43.05±19.53) μg/L,P＜0.05).No significant difference of the serum level of 25-(OH) D3 was found between patients refractory of GD and those with GD in remission((32.43±17.50) μg/L, (31.88±14.48) μg/L,P=0.866).However,compared with the normal control group,both diseased groups showed significantly decrease (P＜0.05).No correlation was found between serum 25-(OH) D3 and TRAb, FT3, Fr4 as well as TSH in GD group.No correlation was found between serum 25-(OH) D3 and TGAb, TPOAb (P＞ 0.05).Conclusion Serum vitamin D levels are decreased in patients with AITD, which has been speculated as a potential therapeutic method for AITD, though further investigations are needed to establish the precise role of 25-(OH) D3 in AITD.

Objective To evaluate the risk factors for diabetic foot in patients with type 2 diabetic mellitus (T2DM).Methods One hundred and forty-three patients with T2DM including 63 cases with diabetic foot(DF) and 80 cases with non-diabetic foot (NDF) were recruited.All possible risk factors for diabetic foot were documented,including low density lipoprotein-cholesterol (LDL-C),homocysteine (Hcy),diabetic polyneuropathy(DPN),diabetic retinopathy(DR),peripheral vascular disease(PVD) and so on.Results (1) There were significant differences between DF group and NDF group in terms of general clinical data,including age(65.38±11.58) years old and (60.12±9.92) years old,precious history of foot ulcer(28.6％ (18/63) and 3.8％(3/80)),serum homocysteine(Hcy) ((23.24± 11.77) μmol/L and (18.62±7.74) μmol/L)),glycosylated hemoglobin(HbA1c) ((10.22±2.81) ％ and (8.67±2.30) ％),blood albumin (Alb) ((32.45±5.83) g/L and (38.58±4.71) g/L),LDL-C ((2.15±0.72) mmol/L and (2.60±0.78) mmol/L),diabetic nephropathy (DN) (77.8％ (49/63) and 45.0％ (36/80)),diabetic retinopathy (DR) ((73.0％ (46/63) and 33.8％ (27/80)),diabetic peripheral vascular disease (PVD) (93.7％ (59/63) and 65.0％ (52/80)) and diabetic peripheral neuropathy (DPN) (77.8％ (46/63) and 60.0％ (48/80)) (P ＜0.05).(2) Logistic regression analysis showed that the development of diabetic foot was significantly correlated with age(OR =1.09,95％ CI:1.02-1.16,P =0.01),Hcy (OR =1.12,95％ CI:1.03-1.22,P =0.01),DR(OR=8.47,95％CI:1.85-38.87,P=0.01),PVD(OR=8.73,95％CI:1.07-70.92,P =0.04) and precious history of foot ulcer (OR =12.28,95％ CI:1.57-96.28,P =0.02).Conclusion Complications due to multiple factors of Diabetic foot,and Hcy is another risk factor for that.

Objective To investigate the relationship between serum thyrotrophin(TSH)and dyslipidemia in subclinical hypothyroid and euthyroid subjects. Methods An epidemiological study on diabetes and thyroid diseases was performed in Dadong community, Shenyang city, in 2007. 110 subjects with subclinical hypothyroidism(SCH)and 1 240 euthyroid subjects were enrolled in the study. Neither history of thyroid diseases nor administration of thyroid-related and lipid-regulating medicines were reported in these subjects. The levels of serum thyroid hormones, lipids, fasting plasma glucose(FPG), and insulin were determined. Results (1)Patients with SCH had significantly lower HDL-C levels than those who were euthyroid.(2)According to the guideline of treatment of adult dyslipidemia in China, the lipid profiles were each categorized. Mean TSH levels were higher in subjects in the dyslipidemia subclass than subjects in the normal subclass. The differences were significant in high LDL-C subclass in overweight individuals. In euthyroid overweight women, mean TSH levels were significantly higher in high LDL-C subclass. In the euthyroid population, TSH was positively associated with total cholesterol in overweight population. The association was not modified by the homestasis model assessment for insulin resistance(HOMA-IR)values.(3)TSH was associated positively with serum triglycerides and negatively with serum HDL-C in women. TSH was positively associated with total cholesterol in overweight population and positively associated with total cholesterol and LDL-C in overweight women after adjustment for age, sex, and body mass index. Conclusion Raised serum TSH seems to be a risk factor of dyslipidemia in subclinical hypothyroid and euthyroid subjects, which is independent of insulin sensitivity.

Objective To explore the relationship between serum thyrotropin and the components of metabolic syndrome.Methods A total of 1534 adult inhabitants in Dadong district of Shenyang were asked to fulfill the questionnaires and have physical examination and oral glucose tolerance test(OGTT).The vein blood was drawn to measure thyrotropin(TSH),fasting plasma glucose(FPG),OGTT 2hPG,fasting insulin,triglyceride(TG) and high density lipoprotein cholesterol(HDL-C).Results Serum TSH in the MS group was higher than in the Non-MS group(2.54 vs 2.22 mU/L,P

Objective:To construct the impact factor model of primary traditional Chinese medicine (TCM) health management service quality, and put forward corresponding policy suggestions.Methods:In this cross-sectional study, the typical sampling and random sampling method were used to select 39 insiders of primary TCM health management service from 15 communities in Zhejiang Province from August to October in 2022. Interviews on service projects, implementation effects and impact factors were conducted, the three-level coding of interview record was carried out using the grounded theory research method, a model of impact factor for health management service quality of basic TCM was constructed, and the corresponding policy recommendations were put forward.Results:Based on the open coding of 39 original interview data, a total of 516 reference points were obtained, and 53 initial concepts related to the topic were formed and summarized into 17 first-level categories. Through the summary of main axis coding, 6 main categories of “policy environment”，“health literacy”，“community orientation”，“capacity building”，“health preference” and “conflict of interest” were extracted. The logical correlation between the six main categories were analyzed with selective coding, an impact factor model was constructed in accordance with the story line of factors affecting service quality. The story line of this model was as follows: first, the policy environment was the external guarantee of community TCM service quality; second, as the demand-side of the services, the health literacy and requirement of residents was the regulatory factor for service quality; in addition, the community played the role of the supply-side of the services, the service ability construction was the key factor, and the community functions and target orientation was the internal driving factor, meanwhile, the internal/external conflicts of interest had a negative constraint on the service quality.Conclusions:The guarantee intensity of external policy environment is limited, the service demand side pays insufficient attention, and the service supply side functions are absent at the present stage. It is necessary to improve the external policy environment, deepen the connection between supply and demand sides in the field of TCM health service, promote the capacity building of TCM service at the grass-roots level, balance the interests of relevant departments of TCM service, in order to improve the quality of TCM health management service at the grass-roots level.

Objective:To investigate the predictive value of diffusion tensor imaging (DTI) parameters in upper extremity motor function recovery after surgery in patients with acute cervical spinal cord injury (CSCI).Methods:Twenty-three patients with acute CSCI who received postoperative systemic rehabilitation therapy in Department of Neurosurgery, 900 th Hospital of Joint Logistics Team of People's Liberation Army from May 2019 to July 2021 were selected as an experimental group, and 22 healthy subjects (healthy control group) matched with age and gender were selected from Physical Examination Center of the same hospital at the same period. Routine MRI sequence and DTI scan of the cervical spinal cord, scale of American Association for Spinal Cord Injury (ASIA) and modified Barthe index (mBI) were performed in patients of the experimental group 1 d and 3 months after surgery. Routine MRI sequence and DTI scan of the cervical spinal cord were performed in healthy subjects after enrollment. The DTI parameters in different regions between the two groups were compared, and the differences in DTI parameters, ASIA scores and mBI in patients of the experimental group before and after surgery were compared. Correlations of preoperative DTI parameters with preoperative upper extremity motor ASIA scores and upper extremity motor recovery rate 3 months after surgery were analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of preoperative fractional anisotropy (FA) in upper extremity motor function recovery in CSCI patients 3 months after surgery. Results:As compared with the healthy control group, the experimental group had significantly lower preoperative FA in the injury area and distal injury area, and statistically higher preoperative apparent diffusion coefficient (ADC, P<0.05). In patients of the experimental group, preoperative FA in the injury area was significantly lower and ADC in the injury area was significantly higher as compared with those in the distal injury area ( P<0.05); patients of the experimental group had significantly higher FA in these two regions, upper extremity motor ASIA scores and mBI, and significantly lower ADC 3 months after surgery as compared with those 1 d before surgery ( P<0.05). The preoperative FA in the injury area and distal injury area in CSCI patients were positively correlated with preoperative upper extremity motor ASIA scores and upper extremity motor recovery rate 3 months after surgery ( P<0.05). ROC curve results showed that the area under the curve (AUC) of preoperative FA in injury area in predicting upper extremity motor function recovery 3 months after surgery was 0.912 ( 95%CI: 0.783-1.000, P<0.001); that of preoperative FA in the distal injury area was 0.842 ( 95%CI: 0.682-1.000, P<0.001). Conclusion:DTI parameters FA and ADC are sensitive indicators for detecting CSCI; preoperative FA in the injury area and distal injury area can be used to predict the upper extremity motor function recovery, but the efficacy of the former is superior to that of the later.

This study investigated the relationship between serum thyrotrophin levels and dyslipidemia in subclinical hypothyroid and euthyroid subjects. A total of 110 subjects with subclinical hypothyroidism and 1,240 euthyroid subjects enrolled in this study. Patients with subclinical hypothyroidism had significantly lower high density lipoprotein cholesterol (HDL-C) levels than those who were euthyroid. The lipid profiles were each categorized and mean thyrotrophin levels were higher in subjects in the dyslipidemia subclasses than subjects in the normal subclasses. Thyrotrophin was positively associated with serum triglyceride and negatively associated with serum HDL-C in women. Thyrotrophin was also positively associated with total cholesterol (TC) in the overweight population along with TC and LDL-C in overweight women. In the euthyroid population, thyrotrophin was positively associated with TC in the overweight population. In conclusion, serum thyrotrophin was correlated with dyslipidemia in subclinical hypothyroid and euthyroid subjects; the correlation was independent of insulin sensitivity.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cholesterol/blood ; Cholesterol, HDL/blood ; Dyslipidemias/*blood ; Female ; Humans ; Insulin Resistance ; Lipids/blood ; Male ; Middle Aged ; Thyrotropin/*blood ; Triglycerides/blood ; Young Adult