Objective To observe the dynamic changes of endothelial progenitor cells (EPC)and vascular endothelial growth factor (VEGF) in the patients with acute myocardial infarction (AMI)after percutaneous transluminal coronary intervention (PCI). Methods The level of VEGF before and after PCI in 50 cases with AMI were determined by fluorescence immunoassay and enzyme-linked immunosorbnent assay (ELISA),and the ratio of EPC in flood was checked by flow cytometry.Results The level of EPC was higher after PCI than before PCI [(4.15 ± 0.22)％ vs.(0.59 ±0.02) ％,P＜0.01],and there were positive correlations between EPC and number of coronary artery disease (r=0.45,P ＜ 0.05 ),coronary artery lesions ( r =0.76,P ＜ 0.01 ),left ventricular enddiastolic diameter (r=0.68,P＜0.01),ejection fraction (r=0.75,P＜0.01).The VEGF levels after PCI was increased [(506± 120)μg/L vs.(204±98)μg/L,P＜0.01],and its level was positively related with coronary lesions (r=0.66,P＜0.01),left ventricular ejection fraction(r=0.90,P＜0.01).There was association between rising rates of EPC and VEGF in a short time after PCI within 24 h period (r=0.56,P＜0.01). Conclusions The clinical efficacy and prognosis can be assessed by the changes of VEGF level and EPC ratio before and after PCI operation in AM1 patients.

Objective:To investigate the correlation between 25-hydroxyvitamin D3 (25 (OH) D3), insulin-like growth factor 1 (IGF-1) and glycolipid metabolism in patients with diabetes 2 mellitus (T2DM), as well as their predictive value in retinopathy.Methods:A total of 120 T2DM patients admitted to Linyi Central Hospital of Shandong Province from Oct. 2020 to Oct.r 2023 were selected as the study objects (defined as the study group). Another 120 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. Serum 25 (OH) D3, IGF-1, fasting blood glucose (FBG), 2 h plasma glucose (2 hPG) ) and lipid levels (triglycerides) were compared between the two groups. The levels of TG, total cholesterol (TC) and serum 25 (OH) D3 and IGF-1 were analyzed by Pearson correlation analysis. At the same time, the patients in the study group were divided into diabetic group with retinopathy (DR Group, 40 cases) and non-retinopathy group (NDR group, 80 cases) according to the status of retinopathy. Multivariate analysis was used to analyze the risk factors affecting the occurrence of retinopathy in T2DM patients, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum 25 (OH) D3 and IGF-1 levels in the occurrence of retinopathy in T2DM patients.Results:The level of serum 25 (OH) D3 was (36.15±4.25) nmol/L in the study group, lower than that in the control group (51.24±5.32) nmol/L ( P<0.05), and the level of IGF-1 was (30.26±4.52) mg/L was in the study group, higher than that in the control group ( P<0.05). The levels of FBG, 2 hPG, TG and TC in the study group were (8.67±2.52) mmol/L, (11.36±2.43) mmol/L, (2.05±0.72) mmol/L, (5.05±1.54) mmol/L respectively, higher than those in the control group [ (5.02±0.42) mmol/L, (6.32±0.54) mmol/L, (1.21±0.32) mmol/L, (3.42±0.68) mmol/L] ( P<0.05). Pearson correlation analysis showed that serum 25 (OH) D3 levels were negatively correlated with FBG, 2 hPG, TG and TC levels in T2DM patients ( r=-0.762, -0.782, -0.736, -0.721, P<0.05). Serum IGF-1 levels were positively correlated with the levels of FBG, 2 hPG, TG and TC in T2DM patients ( r=0.741, 0.756, 0.715, 0.698, P<0.05). Family history of diabetes in DR group, FBG, 2 hPG, TG, TC, IGF-1 levels was 35.00%, (9.31±2.49) mmol/L, (12.52±2.34) mmol/L, (2.76±0.61) mmol/L, (5.92±1.42) mmol/L, (37.89±4.41) mg/L respectively, higher than those in NDR group [16.25%, (8.35±2.15) mmol/L, (10.78±1.75) mmol/L, (1.69±0.52) mmol/L, (4.62±1.31) mmol/L, (26.45±4.06) mg/L] ( P<0.05). 25 (OH) D3 in DR group was (30.21±3.51) nmol/L, lower than that in NDR group (39.12±3.85) nmol/L ( P<0.05). Logistic regression analysis showed that family history of diabetes mellitus, duration of diabetes mellitus, 25 (OH) D3, IGF-1, FBG, 2hPG, TG and TC levels were all risk factors for the occurrence of retinopathy in elderly T2DM patients ( P<0.05). ROC curve analysis showed that AUC and sensitivity of 25 (OH) D3 and IGF-1 combined to predict retinopathy in elderly T2DM patients were 0.854 and 92.50%, respectively, higher than that of 25 (OH) D3 and IGF-1 alone ( P<0.05) . Conclusion:Serum 25 (OH) D3 and IGF-1 levels are abnormally expressed in elderly patients with T2DM, and there is a close relationship between glucose and lipid metabolism in elderly patients with T2DM, and the combined detection of these indicators has a higher predictive value for the occurrence of DR In elderly patients with T2DM.

Objective:To investigate the effect of levothyroxine withdrawal before radioiodine therapy on blood lipids and renal function in patients with differentiated thyroid carcinoma (DTC) after operation.Methods:From Mar. 2020 to Apr. 2022, 214 patients with differentiated thyroid cancer were enrolled in the General Surgery Department, Linyi Central Hospital, Shandong Province. All patients stopped taking levothyroxine sodium after total thyroidectomy. The thyroid function index, blood lipid index and renal function index were measured and compared before and after drug withdrawal (before operation) and after drug withdrawal (before radioiodine treatment). The patients were divided into groups according to the duration of drug withdrawal (drug withdrawal group for 3 weeks, drug withdrawal group for 4 weeks), and the differences of thyroid function index, blood lipid index, and renal function index among patients with different drug withdrawal time were compared. The measurement data in accordance with normal distribution were compared between groups, and independent sample t-test was performed. Results:The levels of free thyroxin T4 (FT 4) and free triiodothyronine (FT 3) in DTC patients decreased significantly ( t=57.60, 71.74,all P<0.001), and the levels of thyroid-stimulating hormone (TSH) increased significantly ( t=102.15, P<0.001). After drug withdrawal, the serum lipid index [triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low density lipoprotein (LDL) ] and renal function index [blood urea nitrogen (BUN), serum creatinine (SCR) ] of DTC patients increased significantly ( t=20.17, 42.50, 12.13, 30.73, 16.09, 43.73, all P<0.001). The levels of FT 3 and FT 4 in the 4-week group were significantly lower than those in the 3-week group ( t=7.75 and 10.07, both P<0.001), and TSH was significantly higher than that in the 3-week group ( t=26.46, P<0.001). The levels of TG, LDL, HDL, TC, BUN and Scr in the 4-week group were significantly higher than those in the 3-week group ( t=10.13, 10.29, 8.53, 11.47, 10.54, 8.55, all P<0.001). Correlation analysis showed that the levels of FT 3 and FT 4 in DCT patients were negatively correlated with the levels of TG, LDL, HDL, TC, BUN and Scr ( r=-0.256, -0.189, -0.249, -0.314, -0.352, -0.231, -0.342, -0.259, -0.304, -0.216, -0.391, -0.271, P=0.011, 0.029, 0.007, 0.004, 0.015, 0.036, 0.002, 0.009, 0.019, 0.017, 0.016, 0.003), and the levels of TSH were correlated with TG, LDL, HDL, TC and BUN Scr level was positively correlated ( r=0.257, 0.308, 0.219, 0.311, 0.251, 0.271, P=0.006, 0.013, 0.032, 0.004, 0.006, 0.014) . Conclusion:Stopping levothyroxine sodium before radioactive iodine treatment after DTC can easily lead to dyslipidemia and decreased renal function in patients, and the longer the withdrawal time is, the more obvious the changes of blood lipids and renal function in patients, and the withdrawal time should be shortened in clinical treatment.