Twenty-seven patients with subclinical hyperthyroidism(SH)complicated by paroxysmal atrial fibrillation(PAF)were treated with methimazole plus bisoprolol.All patients were examined by Doppler echocardiogram and 24 h ambulatory electrocardiograms before and 3 months after treatment.Serum FT3,FT4,and TSH levels were measured with RIA.The results showed that low-dose methimazole therapy could improve the left ventricular diastolic function(P < 0.01)and help maintain sinus rhythm.The incidence of subclinical hypothyroidism was low.Low-dose methimazole was effective and safe in patients with SH complicated by PAF.

Objective To investigate the relationship between the polymorphisms of angiotensin Ⅱ receptor gene and the risk of primary aldosteronism (PA).Methods Polymerase chain reaction -restriction fragment length polymorphism (PCR -RFLP)was used to examine the 1 1 66A /C polymorphism of AT1 R gene and 1 675A /G poly-morphism of AT2R gene in 85 patients with PA and 1 00 healthy controls.Results There was no significant difference of AT1 R 1 1 66A /C genotypes (AA,AC,CC)and allele (A and C)frequency among patients and controls (χ2 =0.430,P =0.806).There was obvious difference of AT2R 1 675A /G genotypes (AA,AG,GG)and allele (A and G) frequency among two groups (χ2 =6.1 21 ,P =0.01 3).The G allele was higher than A allele in PA group (χ2 =6.767,P =0.009).Conclusion Homogenic mutation of 1 675A /G site in AT2R gene may be one of risk factors of PA.

Objective To measure the fasting plasma ghrelin and obestatin concentrations in essential hyper-tension (EH)patients with obesity,and to observe their relationship with blood pressure,obesity index,insulin resist-ance (IR),blood glucose and blood lipid.Methods 68 hypertensive obese patients,60 normotensive obese patients and 65 healthy controls were included in the study.The fasting plasma obestatin and ghrelin were measured using a radioimmunoassay method.The ghrelin/obestatin ratio was calculated.Results Hypertensive obese patients had lower plasma ghrelin and obestatin compared with normotensive obese patients (t =3.771,P <0.01;t =4.373,P <0.01) and controls (t =16.451,P <0.01;t =17.862,P <0.01).Normotensive obese patients had lower plasma ghrelin and obestatin compared with controls (t =13.121,P <0.01;t =13.686,P <0.01 ).Hypertensive obese patients had higher ghrelin/obestatin ratio than controls (t =7.720,P <0.01).The ghrelin/obestatin ratio in normotensive obese patients was higher than controls (t =4.587,P <0.01).In hypertensive obese group,the plasma ghrelin and obestatin were negatively associated with BMI (r =-0.882,P <0.01;r =-0.806,P <0.01),SBP (r =-0.787,P <0.01;r =-0.837,P <0.01),DBP (r =-0.769,P <0.01;r =-0.810,P <0.01),and the HOMA-IR (r =-0.800, P <0.01;r =-0.810,P <0.01).In normotensive obese group,ghrelin and obestatin were all negatively associated with BMI (r =-0.577,P <0.01;r =-0.372,P <0.01)and HOMA-IR (r =-0.866,P <0.01;r =-0.662,P <0.01).The ghrelin/obestatin ratio was positively associated with BMI (r =0.460,P <0.01)and HOMA-IR (r =0.420,P <0.01).Conclusion The peripheral blood ghrelin,obestatin and ghrelin/obestatin ratio were significantly correlated with EH,obesity and IR.No correlation was observed between ghrelin/obestatin system and blood lipid or blood glucose.

Objective To observe the Leu72Met single nucleotide polymorphism (SNP)of ghrelin gene and the relationship with essential hypertension (EH).Methods Polymerase chain reaction -restriction fragment length polymorphism (PCR -RFLP)was used to detect the Leu72Met SNP of ghrelin gene in 210 EH patients and 220 healthy controls.The plasma ghrelin was detected by radioimmunoassay method collected from all subjects. Results There were three types of polymorphism of ghrelin gene at the base site Leu72Met.There were significant differences in the genotypes (CC,CA,AA)and alleles (C,A)between the EH patients and the controls (χ2 =6.054,P =0.048;χ2 =5.866,P =0.015).In EH group,the plasma ghrelin level in subjects who were homozygous CC without mutant was not only significantly lower than those who were heterozygous CA,but also lower than those who were nucleotide homozygous mutant AA (t =-8.738,P =0.000;t =-5.103,P =0.000).The patients with CC genotype had higher SBP (t =4.298,P =0.000;t =2.236,P =0.019)and lower HDL -C (t =-11.682,P =0.000;t =-7.872,P =0.000).The patients with A allele had lower plasma ghrelin (t =-16.264,P =0.000), HDL -C (t =-15.332,P =0.000)and higher SBP(t =3.800,P =0.000),DBP(t =11.895,P =0.000),and LDL -C (t =38.401,P =0.000).Conclusion The Leu72Met SNP of ghrelin gene is significantly related to the susceptibility of EH.Base mutation C to A reduced the incidence of EH.The Leu72Met polymorphism of ghrelin gene is related to the plasma ghrelin,blood pressure and blood lipid metabolism.Base mutation C to A elevated plasma ghrelin,and lowered blood pressure and blood lipid.

Objective To observe the morbidity and clinical characteristics of primary aldosteronism (PA) in newly diagnosed patients with hypertension.Methods 255 patients with newly diagnosed high blood pressure were determined plasma renin activity (PRA),angiotensinⅡ(ATⅡ),aldosterone (PAC),cortisol (COR),adrenocortico-tropic hormone (ACTH)and 24h urinary vanilmandelic acid (VMA).They were examined renal artery color doppler and adrenal 64 row CT scan +enhancement scanning.Results 179 patients (70.20%)were diagnosed essential hypertension (EH).In EH patients,24 cases (13.41%)with hypokalemia.42 patients (16.47%)were diagnosed PA.In PA patients,18 cases (42 .86 %)with hypokalemia,25 cases(5 9 .5 2 % )with unilateral adrenal adenoma. Compared with EH patients,there were higher level of high density lipoprotein (HDL -C)(Z =-2.068,P =0.036),lower level of total cholesterol (TC),low density lipoprotein (LDL -C),fasting plasma glucose (FPG), serum kalium (Z =3.594,P =0.000;Z =2.807,P =0.005;Z =3.499,P =0.000;Z =8.435,P =0.000)in PA patients.The levels of plasma PRA and ATⅡin PA patients were lower than in EH patients(Z =3.673,P =0.000;Z =2.215,P =0.026).The levels of plasma PAC and ARR were higher than in EH patients (Z =8.562,P =0.000;Z =19.871,P =0.000).The minimum value of plasma PAC was 292.1pg/L,the ARR was 376.7 in 42 PA patients. The maximum value of plasma PAC was 311.3pg/L,and the ARR was 291.2.Conclusion There is high detection rate of PA in newly diagnosed hypertension.The unilateral adrenal adenoma is a main cause of PA.Hypokalemia is not common in PA patients.PA has little influence on glucolipid metabolism.ARR has high differential diagnosis accuracy for PA and EH.

Objective To investigate the prevalence and risk predictors of depressive tendency in type 2 diabetic patients with peripheral neuropathy.Methods From May 2017 to December 2017,150 diabetic patients with peripheral neuropathy and 150 diabetic patients without peripheral neuropathy in the First Affiliated Hospital of Harbin Medical University were collected.The general clinical data,including age,sex,diabetic duration,height,weight,body mass index (BMI),fasting blood glucose (FBG),fasting insulin (FINS),homeostasis modal assessment-insulin resistance index(HOMA-IR),glycated hemoglobin(HbA1c),blood lipid and blood pressure were collected.The motor nerve and sensory nerve conduction velocity of lower limbs were measured by electromyograph.Zung depression self-rating scale(SDS) was used for self-rating of depression syndrome.Results There were 46 cases(30.67％) suffered from depression(SDS ＞50) in the neuropathic group,and 25 cases(16.67％) suffered from depression in the non-neuropathic group.The incidence rate of depression in the neuropathic group was significantly higher than that in the non-neuropathic group and tended to be severe (x2 =12.732,P =0.005).Non-conditional Logistic multivariate stepwise regression analysis showed that sex,the course of diabetes and low density lipoprotein (LDL) were associated with depressive tendency (x2 =3.994,P =0.049;x2 =5.334,P =0.032;x2 =6.172,P =0.020).Conclusion The prevalence of depression in diabetic patients with peripheral neuropathy is higher and tends to be severe.Sex,the course of diabetes and LDL are risk factors of depressive tendency.

Objective:To investigate the prevalence and risk factors of depression in patients with acute ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI).Methods:From January 2019 to December 2019, 205 patients with STEMI who underwent PCI were selected randomly in Department of Cardiology of Heilongjiang Provincial Hospital.And 200 health examined people from our hospital at the same time were selected as health control group.The Zung self-rating depression scale(SDS) was used to score the depression in STEMI patients one week after PCI.The social demographic data were investigated, including age, gender, education status, place of residence, medical payments, monthly income, marital status, smoking history, drinking history, diabetic history, cardiovascular and cerebrovascular diseases history.The clinical indicators were measured, including height, weight, waist circumference(WC), hip circumference(HC), body mass index(BMI), waist-hip rate(WHR), fasting plasma glucose(FPG), fasting serum insulin(FINS), homeostasis model assessment-insulin resistance index(HOMA-IR), serum total cholesterol(TC), total triglyceride(TG), low density lipoprotein-C(LDL-C), high density lipoprotein-C, (HDL-C), systolic blood pressure(SBP) and diastolic blood pressure(DBP).Results:The prevalence of depression in the STEMI group was obviously higher than that in the control group(17.07% vs.9.50%, χ 2=5.025, P=0.025). There was statistically significant difference in the severity of depression between the two groups(χ 2=8.360, P=0.039). Multivariate Logistic regression analysis showed that the risk factors for depression in order of OR values were FPG, gender(female), age(65 or old), BMI, monthly income(<5 000 RMB), HOMA-IR, self-paying for medical services ( OR=1.894, 1.812, 1.545, 1.428, 1.335, 1.285, 1.202). Conclusion:The prevalence of depression in STEMI patients after PCI is increased.The risk factors for depression include female, old age, obesity, low income, insulin resistance and self-paying for medical services.

Objective:To investigate the relationship between serum thyroid hormone levels in the normal range and body weight, blood glucose, blood lipids, and other obesity-related indexes in patients with type 2 diabetes mellitus.Methods:Seventy obese patients with type 2 diabetes mellitus and ninety-two patients with type 2 diabetes mellitus with normal weight who were treated in the Nangang Branch of Heilongjiang Provincial Hospital from May 2020 to May 2021 were included in this study. Thyroid-stimulating hormone level was in the normal range (0.35-4.94 mU/L) in all participants. Serum levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibody, thyroglobulin antibody, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, glycosylated hemoglobin, fasting C peptide, fasting insulin, systolic blood pressure, diastolic blood pressure, and serum uric acid were measured in all participants.Results:Free triiodothyronine level was positively correlated with fasting blood glucose and glycosylated hemoglobin levels ( r = 0.19, P = 0.021; r = 0.21, P = 0.017). Free thyroxine level was positively correlated with serum glycosylated hemoglobin level ( r = 0.25, P = 0.009) and negatively correlated with total cholesterol ( r = -0.17, P = 0.029). Thyroid-stimulating hormone level was positively correlated with body mass index as well as total cholesterol and low-density lipoprotein cholesterol levels ( r = 0.33, P < 0.001; r = 0.33, P < 0.001; r = 0.32, P < 0.001). Conclusion:Thyroid hormones in the normal range play an important role in the regulation of body weight, blood glucose, and blood lipids in patients with type 2 diabetes mellitus. Blood glucose level increases markedly in patients with relatively high free triiodothyronine and free thyroxine levels. The risks of obesity and dyslipidemia increase in patients with relatively high serum thyroid-stimulating hormone levels