Objective To investigate the relationship between the characteristics of promoter methylation of thyroid stimulating hormone receptor(TSHR) gene in papillary thyroid Carcinomas(PTC) and the clinical manifestation of PTC. Methods The methylation status of TSHR gene was detected by methylation specific PCR technique(MSP).Results (1) The methylation rate of TSHR gene in PTC tissues was 64.7%(22/34),while the methylation rate of TSHR gene in adjacent thyroid tissues(ATT) was 26.5%(9/34),and the rate of methylation of TSHR promoter in PTC was significantly higher than of ATT(P

Objective:To compare the consistency of artificial analysis and artificial intelligence analysis in the identification of fundus lesions in diabetic patients.Methods:A retrospective study. From May 2018 to May 2019, 1 053 consecutive diabetic patients (2 106 eyes) of the endocrinology department of the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 888 patients were males and 165 were females. They were 20-70 years old, with an average age of 53 years old. All patients were performed fundus imaging on diabetic Inspection by useing Japanese Kowa non-mydriatic fundus cameras. The artificial intelligence analysis of Shanggong's ophthalmology cloud network screening platform automatically detected diabetic retinopathy (DR) such as exudation, bleeding, and microaneurysms, and automatically classifies the image detection results according to the DR international staging standard. Manual analysis was performed by two attending physicians and reviewed by the chief physician to ensure the accuracy of manual analysis. When differences appeared between the analysis results of the two analysis methods, the manual analysis results shall be used as the standard. Consistency rate were calculated and compared. Consistency rate = (number of eyes with the same diagnosis result/total number of effective eyes collected) × 100%. Kappa consistency test was performed on the results of manual analysis and artificial intelligence analysis, 0.0≤ κ<0.2 was a very poor degree of consistency, 0.2≤ κ<0.4 meant poor consistency, 0.4≤ κ<0.6 meant medium consistency, and 0.6≤ κ<1.0 meant good consistency. Results:Among the 2 106 eyes, 64 eyes were excluded that cannot be identified by artificial intelligence due to serious illness, 2042 eyes were finally included in the analysis. The results of artificial analysis and artificial intelligence analysis were completely consistent with 1835 eyes, accounting for 89.86%. There were differences in analysis of 207 eyes, accounting for 10.14%. The main differences between the two are as follows: (1) Artificial intelligence analysis points Bleeding, oozing, and manual analysis of 96 eyes (96/2042, 4.70%); (2) Artificial intelligence analysis of drusen, and manual analysis of 71 eyes (71/2042, 3.48%); (3) Artificial intelligence analyzes normal or vitreous degeneration, while manual analysis of punctate exudation or hemorrhage or microaneurysms in 40 eyes (40/2042, 1.95%). The diagnostic rates for non-DR were 23.2% and 20.2%, respectively. The diagnostic rates for non-DR were 76.8% and 79.8%, respectively. The accuracy of artificial intelligence interpretation is 87.8%. The results of the Kappa consistency test showed that the diagnostic results of manual analysis and artificial intelligence analysis were moderately consistent ( κ=0.576, P<0.01). Conclusions:Manual analysis and artificial intelligence analysis showed moderate consistency in the diagnosis of fundus lesions in diabetic patients. The accuracy of artificial intelligence interpretation is 87.8%.

Objective To investigate the effect of health education on the willingness and knowledge about cervical examinations among fertile women.Methods Eight hundred fertile women visiting our hospitals for cervical examinations during January 2006 and December 2009 were managed with health education.Their willingness and knowledge about cervical examinations after the health education were compared with those before the education.Results The rate of willingness to take cervical examinations after the health education was significantly improved,compared to pre-health education(P<0.05).The scores on the knowledge about cervical cancer,impotence for health education,preventive method and regular cervical examinations after health education were all significantly improved compared to pre-education(all P<0.05).Conclusions Health education may significantly improve the willingness and knowledge about the cervical examinations among the fertile women.During health education,we should attach importance to the groups of high risks and adopt individualized and practical interventional strategies.

Objective To analyze the CYP17 gene of two sisters with combined 17-alpha-hydroxylase/17, 20-lyase deficiency, and that of their parents. Methods Genomic DNA of the four members was prepared from peripheral blood by standard methods. All the eight exons and intron/exon boundaries of CYP17 were PCR amplified and sequenced. All the hormone levels were measured by time-resolved immunofluorometric assay. Results Combined 17-?-hydroxylase/17, 20-lyase deficiency was confirmed by marked hormone change. Sequence analysis revealed that the sisters were homozygous 985delTACinsAA of CYP17, and their parents were heterozygous 985delTACinsAA. Conclusion Novel mutation of 985delTACinsAA in CYP17 was found in two sisters with 17-?-hydroxylase/17, 20-lyase deficiency. The homozygous one can induced the phenotype and the heterozygous one is a genomic marker.

A novel hemizygous frameshift mutation in exon1of DAX-1 gene (993delC) was found in a patient with late-onset adrenal hypoplasia congenita and hypogonadotropic hypogonadism.This mutation led the stop codon to appear in advance of 59 amino acids.His mother and two sisters were the carriers of this hemizygous mutation while his father and brother were wild-type.After glucocorticoid hormone replacement therapy, the clinical symptom was improved, but the level of ACTH was not suppressed.

Objective To investigate the relationship between extent of hepatic fibrosis and serum thyroid hormone levels in pa-tients with liver cirrhosis .Methods Chemiluminescence immunoassay technology was adopted to detect serum hyaluronic acid (HA),laminin(LN),collagen type Ⅳ (CIV),procollagen type Ⅲ (PC Ⅲ ),thyroid stimulating hormone(TSH),triiodothyronine (T3) ,thyroxine(T4) ,free thyroxin 3(FT3) and FT4 of 240 patients with liver fibrosis (liver fibrosis group) and 80 healthy people (control group) .Results In the control group ,serum HA ,LN ,CIV ,PCⅢ levels of healthy people in ≥45-year group were signifi-cantly higher than those in <45-year group ,and those in male group were obviously higher than female(P<0 .05) .Serum TSH , T3 ,T4 ,FT3 ,FT4 levels of healthy people in male group were significantly lower than female (P<0 .05) .With the increase of grade in Child-Pugh classification ,serum levels of hepatic fibrosis indexes of patients with liver fibrosis increased markedly (P<0 .05) , while their thyroid hormone levels significantly decreased (P<0 .05) ,especially in T3 and FT3 .Serum HA ,LN ,CIV ,PCⅢ levels of patients with A ,B or C grade were markedly higher than those in control group(P<0 .05) ,and serum T3 ,T4 ,FT3 ,FT4 levels of patients with B or C grade were obviously lower than those in control group (P<0 .05) .Conclusion The extent of liver fibrosis is correlated to serum thyroid hormone levels .

Objective To analyze the clinical risk factors of type 2 diabetes complicated with cerebral infarction .Methods 508 patients with type 2 diabetes were selected and divided into two groups :group A (complicated with cerebral infarction ,n=240) and group B (without cerebral infarction ,n=268) .The basic clinical information of two groups were recorded .The coagulation indica‐tors and biochemical indicators (including blood glucose ,blood lipid ,HbA1c ,blood β2 microglobulin ,urineβ2 microglobulin ,urine microalbuminuria ,fasting insulin ,fasting C peptide etc) were detected respectively .Results There were significant differences in age ,age at onset of diabetes ,duration of hypertension and systolic blood pressure between group A and group B (P<0 .05) .The in‐cidence of hypertension and coronary heart disease in group A were higher than group B (P<0 .05) .Comparing with group B ,the levels of HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,blood β2 microglobulin ,urineβ2 microglobulin ,and urine microalbuminuria of group A were significantly different (P<0 .05) .The ATⅢ level of group A was significantly lower than that of group B (P<0 .05) .Conclusion The risk factors of type 2 diabetes complicated with cerebral infarction include age ,hyper‐tension ,HbA1c ,ApoB ,fasting insulin ,fasting C‐peptide ,lipoprotein (a) ,Hcy ,etc make diabetics be more prone to cerebral infarc‐tion ect .

[Summary] The clinical and genetic characteristics of a patient with male pseudohermaphroditism, being considered as an isolated 17, 20-lyase deficiency case, were analyzed. The social gender of the patient aged 30-year-old was female. The patient presented with 46, XY karyotype, unclosed epiphysis, after perineal block resection, hypergonadotropic hypogonadism, while the production of mineralocorticoids and glucocorticoids hormone was intact. A503V heterozygous mutation in exon 13 and a deletion in intron 11 of POR gene were detected. The gene mutations may lead to the occurrence of the isolated 17,20-lyase deficiency.

Objective To investigate the clinical diagnostic value of serum homocysteine (Hcy) ,serum beta 2-microglobulin(Sβ2-MG),urine beta 2-microglobulin(Uβ2-MG),urine microalbumin(UmAlb) combined detection for diabetic nephropathy (DN). Methods 230 cases of type 2 diabetes in which 100 patients without complications (diabetic group) ,130 patients with DN (DN group) were enrolled ,and another 50 healthy people served as control group .Automatic biochemical analyzer was employed to de-tect serum Hcy and creatinine ,automated chemiluminescence analyzer was used to detect Sβ2-MG and Uβ2-MG ,Glycated hemoglo-bin cytometry was adopted to measure glycosylated hemoglobin A 1c(GHbA1c) .Positive rates were compared among serum Hcy , Sβ2-MG ,Uβ2-MG ,UmAlb detection and sensitivity ,specificity ,accuracy ,positive predictive value and negative predictive value were compared between individual and joint detection .Results Serum Hcy ,GHbA1c ,creatinine ,Sβ2-MG ,Uβ2-MG and UmAlb concen-trations of patients in DN group were significantly higher than those in the diabetic group and the control group (P< 0 .01) . Difference of serum creatinine concentration showed no statistical significance between the diabetic group and the control group (P>0 .05) ,and differences of remaining indicators′concentration in the diabetic group were significantly higher than those in the control group(P<0 .05) .The positive rate of Hcy ,Sβ2-MG ,Uβ2-MG and UmAlb combined detection in the diabetic group was 23 .00% .In DN group ,the positive rate of the four indicators combined detection was 95 .38% ,with 84 .67% ,84 .35% for specificity and posi-tive predictive value ,respectively ,and 95 .38% ,89 .64% ,95 .49% for sensitivity ,accuracy and negative predictive values ,respective-ly .Conclusion Serum Hcy ,Sβ2-MG ,Uβ2-MG and UmAlb combined detection has important value for early diagnosis of DN .