Objective The aim of this article is to discuss the relation between serum uric acid and prehypertension, and to evaluate the influence of age, obesity, fasting plasma glucose (FPG) and lipids in Chinese adults. Methods All the 14 451 non-hypertensive samples were analyzed for blood pressure, body mass index (BMI), FPG, lipids and serum uric acid. Results The serum uric acid levels were stratified by quintiles, after adjustment for relevant factors, OR values of prehypertcnsion increased with the elevated uric acid levels. Serum uric acid level was 200-380 μmol/L, it had a linear relationship with the risk of prehypertension, 200 μmol/L as a turning point for this linear relationship, FPG could affect their correlation (P ＜ 0.0001 ). Conclusions Serum uric acid was associated with prehypertension, independent of metabolic risk factors. The associations were not significant in old individuals. FPG may modify the associations.

The interactions between genetic variations and dietary factors in type 2 diabetes mellitus have attracted some attention. Several studies revealed that dietary carbohydrate quality and quantity and increased dietary fat intake might interact with genetic variations of type 2 diabetes mellitus and increase risk of this disease. Genome-wide association studies suggest that genetic variance may modulate the association between dietary pattern and type 2 diabetes mellitus.

ObjectiveTo explore the relationship between serum uric acid and prehypertension and the effects of age,obesity,fasting glucose and lipids in Chinese adults.Methods14,451 non-hypertensive cases from a community-based health examination survey in Xuzhou,Jiangsu province of China were enrolled in this study.Blood pressure,BMI,and determination of fasting glucose,lipids and serum uric acid were measured in all cases.ResultsThe odds ratios ( OR,95％ CI ) of prehypertension across increased serum uric acid after adjusting for age,sex were 1.0,1.20 ( 1.07 - 1.35 ),1.55 ( 1.36 - 1.76),1.82(1.60-2.09),2.33(2.03-2.67) (Pfor trend ＜0.01).The odds ratios were 1.0,1,04(0.92-1.18),1.21(1.06-1.38),1.26(1.09 - 1.45),1.36(1.17 - 1.58),( Pfor trend ＜0.01) after adjusting for age,sex,BMI,glucose,and lipids.In addition,fasting glucose significantly interacted with uric acid ( P for interaction ＜ 0.01 ).Conclusions Serum uric acid was associated with prehypertension,which might be an independent metabolic risk factor.Fasting glucose may reinforce the associations.

Objective To detect the gene mutation of thyroid hormone receptor β ( TRβ ) in a family with thyroid hormone resistance syndrome.Methods The genomic DNA was extracted from peripheral blood leukocytes of the patient and his 5 family members.The exons 1-10 ofTRβ gene were amplified by PCR.The products of PCR were sequenced directly to detect the gene mutation.Results Two members of this family were confirmed to have the C y A transition mutation at nucleotide 1642 site within exon 10 of TRβ gene,which was a missense mutation causing the substitution of Proline to Threonine (P453T).The mutation was Heterozygous.Conclusions It was confirmed that the patient has TRβ gene mutation P453T in exon 10.The mutation may lead to the occurrence of thyroid hormone resistance syndrome.

The relationship between serum uric acid(SUA) and hypertension was investigated and the interactions of SUA with metabolic risk factors was assessed. Blood pressure and biomarkers features were evaluated for all the8 415 individuals from a community-based health examination survey in Xuzhou, and the statistical analysis was made. Raised blood pressure was associated with increased SUA concentration(P＜0.01). Age and high density lipoprotein cholesterol(HDL-C) significantly interacted with SUA(P for interaction=0.012 and 0.001, respectively). There is significant association between SUA and hypertension, which may be affected by age and HDL-C levels.

Objective:To compare the maternal and neonatal outcomes between 5-minute immediate cesarean section and emergency cesarean section.Methods:One hundred and seven puerperas who underwent 5-minutes cesarean section in Jinan University Affiliated Shenzhen Bao′an Maternal and Child Health Hospital during the period of January 2018 to December 2019(immediate cesarean section group), and 214 puerperas who underwent emergency cesarean section in the same period (emergency cesarean section group) were enrolled in the study. The top five indications of 5-minute immediate cesarean section were severe fetal distress ( n=26), complete placental abruption ( n=22), massive hemorrhage from placenta previa ( n=18), severe oligohydramnios ( n=10) and severe eclampsia ( n=9); while the top five indications of emergency cesarean section were mild and moderate fetal distress ( n=58), breech position ( n=17), mild and moderate eclampsia ( n=16), fetal head depression and stagnation ( n=16), oligohydramnios ( n=16). The hemorrhage 2 hours after parturition, cost of hospitalization, postpartum heart rate and blood pressure, Apgar score and death were compared between two groups. The influencing factors on NICU admission rate was analyzed with multivariate logistic regression analysis. Results:The volume of hemorrhage 2 hours after parturition and cost of hospitalization in the immediate cesarean section group were significantly higher than those in the emergency cesarean section group ( t=4.48, P<0.05; t=2.05, P=0.04). There was no significant difference in heart rate and blood pressure between the two groups ( t=0.23, P=0.82; t=-0.12, P=0.90; t=0.34, P=0.73). The 1 min Apgar score and 5 min Apgar score were lower in the immediate cesarean section group than those in the emergency cesarean section group ( t=-6.12, P<0.05; t=-3.61, P<0.05). The rate of NICU admission in the immediate cesarean section group was higher than that of the emergency cesarean section group (χ 2=11.95, P<0.05). The binary logistic regression analysis showed the influencing factors on neonatal admission to NICU were neonatal birth weight ( OR=1.31,95 %CI:1.06-1.62, P<0.05), gestational age ( OR=1.40, 95 %CI:1.11-2.40, P<0.05) and the way of cesarean section ( OR=2.32, 95 %CI:1.15-4.78, P<0.05). Conclusion:The puerparas undergoing 5-minutes immediate cesarean are prone to postpartum hemorrhage, and increased neonatal NICU admission. The management for acute and critically ill pregnant women needs to be further strengthened.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.