Objective To investigate the relationship of thyroid hormones and serum lipid profile during Pregnancy. Methods 30 cases of healthy pregnant women were recruited in the study. The thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and serum lipid profile were examined at 9 ~ 12, 14 ~ 17, 23 ~ 26 and 37 ~ 40 weeks of gestation and the correlations between them were analyzed. Results Positive correlation could be found between serum TSH and total cholesterol (CHOL), triglyceride (TRIG), low density lipoprotein cholesterol (LDL-C), ApolipoproteinA-I (APOA-I), ApolipoproteinB (APOB). Negative correlations could be found between serum FT3, FT4 and total cholesterol (CHOL), triglyceride (TRIG), low density lipoprotein cholesterol (LDL-C), ApolipoproteinA-I (APOA-I), ApolipoproteinB (APOB). And no correlation was found between serum thyroid hormones and high density lipoprotein cholesterol (HDL-C). Conclusion The thyroid hormones were closely related to serum lipid profile except of HDL-C.

Objective:To study the metabolism of high density lipoprotein cholesterol ( HDL-C ) and apolipoprotein A-Ⅰ( ApoA-Ⅰ) in different thyroid function status during pregnancy. Methods:This study re-cruited thirty cases of euthyroid, with nineteen cases of subclinical hypothyroid and eight cases of subclini-cal hyperthyroid pregnancy. The concentrations of fasting serum HDL-C and ApoA-Ⅰwere detected and ana-lyzed from 9-12, 14-17, 23-26, and 37-40 gestational weeks. Friedman repeated measures ANOVA on ranks was adopted to analyze the changes of serum HDL-C and ApoA-Ⅰat different stages. General line-ar model ( GLM) was adopted to analyze the differences of serum HDL-C and ApoA-Ⅰin different thyroid function status during pregnancy. Results:There were no significant differences of maternal serum HDL-C among different stages (χ2 =5. 428,P=0. 143,χ2 =2. 027,P=0. 567,χ2 =2. 885,P=0. 410). There were significant differences of serum ApoA-Ⅰduring euthyroid and subclinical hypothyroid pregnancies (χ2 =46. 343, P<0. 001,χ2 =35. 984, P<0. 001), and no significant difference during subclinical hyperthy-roid pregnancy (χ2 =6. 750, P=0. 080). There were significant differences of serum HDL-C and ApoA-Ⅰbetween euthyroid and subclinical hyperthyroid pregnancies (P=0. 025,P=0. 027), and no significant differences between euthyroid and subclinical hypothyroid pregnancies (P=0. 378,P=0. 549). Conclu-sion:Subclinical hyperthyroidism affected the metabolism of maternal serum HDL-C and ApoA-Ⅰ, which could affect the fetal growth and development. Subclinical hypothyroidism ( after treatment with drugs) had no obvious effect on the metabolism of maternal serum HDL-C and ApoA-Ⅰ.

Objective To discuss the impacts of different doses of alcohol on the level of microparticles (EMPs) of rat endothelial cells. Methods Sixty male SD rats were randomly allocated into four groups:high dose group (group A), me-dium dose group (group B), low dose group (group C) and the blank contrast group (group D). There were15 rats in each group. Rats were fed alcohol for 8 weeks. Flow cytometer was used to measure the level of circulating CD31+/CD42-EMPs in four groups, and which was compared with the alcohol dosage. Results Compared with group D, the level of circulating EMPs was significantly increased in group A and B (P＜0.05). There was no significant change in the level of circulating EMPs in group C (P>0.05). Conclusion The moderate and high doses of alcohol are harmful to the function of vascular en-dothelial cells in rats, which show a significant dose-effect relationship. The low dose of alcohol shows no effect on the func-tion of vascular endothelial cells in rats. The protective effect of alcohol needs further investigation.

ObjectiveTo investigate the clinical efficacy of heat-sensitivepoint Yaoyangguan(GV3)moxibustion for sciatica and preliminarily explore the mechanism of its action.MethodOne hundred and twelve sciatica patients were randomly allocated to heat-sensitive point Yaoyangguan moxibustion (observation), non-heat-sensitive point Yaoyangguan suspended moxibustion (control) and medication groups. The observation group received heat-sensitive point Yaoyangguan moxibustion; the control group, non-heat-sensitive point Yaoyangguan suspended moxibustion; the medication group, oral administration of Yaobitong capsules. The clinical symptoms were scored, the Pain Rating Index (PRI), the Visual Analogue Scale (VAS) and the Present Pain Intensity (PPI) scores were counted and serum IL-8 content was measured in the three groups beforeand after 15 days of treatment.ResultAfter 15 days of treatment, all the three treatments had a certain therapeutic effect on sciatica. The therapeutic effect was bestin the observation group (P<0.05). The PRI, VAS and PPI scores and serum IL-8 contentdecreased in all the three groups compared with before treatment (P<0.05) and were lower in the observation group than in the control and medication groups (P<0.05). There was no statistically significant difference between the control and medication groups (P>0.05).ConclusionHeat-sensitive point Yaoyangguan moxibustion has a better therapeutic effect than non-heat-sensitive point Yaoyangguan suspended moxibustion and oral administration of Yaobitong capsules. This method is an ideal treatment for sciatica. The mechanism may be related to a posttreatment decrease in inflammatory factors in the diseased region.

Objective To compare the clinical efficacy of different doses of ultrafine extracted granule preparation (EGP) and traditional herbal decoction (THD) of Li Zhong Tang in treatment of epigastric pain. Methods Sixty cases of epigastric pain patients in accordance with the diagnostic criteria of deficiency and cold pattern of spleen and stomach in TCM were randomly divided into THD group, 1/3 dose group and 1/5 dose group, and were given THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP, respectively. The clinical efficacy of the three groups after one course of medication was comparatively analyzed. Results There were no significant differences in age, course of disease, symptom score before treatment, epigastric pain efficacy and syndrome curative effect among the three groups, the differences had no statistical significance (P>0.05). The severity, frequency and duration of epigastric pain were all reduced in the three groups, with significant differences between before and after treatment (P<0.05). Conclusion There are no significant differences in the clinical efficacy on epigastric pain among THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP. In addition, the effect of 1/3 dose group is very close to the THD group.

Adolescent ; Adult ; Cities ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Occupational Exposure ; Occupational Health ; Private Sector ; Sampling Studies ; Young Adult

Objective:To analyze the risk factors and clinical characteristics of liver injury in patients with sepsis and to provide a reference for early recognition, early diagnosis, early intervention, and improve the survival rate of patients.Methods:The clinical data of sepsis patients admitted to the department of general intensive care unit (ICU) of the Second Affiliated Hospital of Zhejiang University School of Medicine from July 2014 to October 2020 were retrospectively analyzed. According to the occurrence of acute liver injury, patients with sepsis were divided into the liver injury group and the non-liver injury group, and the differences of demographic data, history, history of primary diseases, laboratory indicators on the first time of admission, treatments, the severity of the disease and other indicators were compared and analyzed. Logistic regression was used to analyze the risk factors for sepsis-related liver injury.Results:A total of 527 patients with sepsis were enrolled, and 129 patients with acute liver injury, accounting for 24.48%. Compared with the non-liver injury group, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA), pro-brain natriuretic peptide (pro-BNP), serum MB isoenzyme of creatine kinase (CK-MB), total bile acid (TBA), serum creatinine (SCr), blood urea nitrogen (BUN), lactic acid (Lac), lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT) in liver injury group were significantly increased [APACHEⅡ score: 23.00±10.40 vs. 16.10±8.10, SOFA score: 9.17±4.29 vs. 5.90±3.12, pro-BNP (ng/L): 5 500.0 (1 166.0, 16 865.0) vs. 1 377.2 (448.8, 6 136.5), CK-MB (U/L): 23.0 (13.0, 55.0) vs. 18.0 (13.0, 31.0), TBA (μmol/L): 5.0 (2.4, 12.9) vs. 2.6 (1.4, 4.9), SCr (μmol/L): 146.0 (75.0, 222.0) vs. 71.0 (52.0, 125.8), BUN (mmol/L): 13.4 (8.8, 20.2) vs. 7.9 (4.9, 11.6), Lac (mmol/L): 2.0 (1.4, 4.4) vs. 1.4 (1.0, 2.2), LDH (μmol·s -1·L -1): 6.43 (3.76, 11.99) vs. 4.55 (3.38, 6.63), CRP (mg/L): 113.0 (61.8, 201.0) vs. 95.0 (37.3, 170.1), PCT (μg/L): 3.8 (1.0, 23.3) vs. 0.8 (0.2, 6.4)], prothrombin time (PT), international standard ratio (INR) and activated partial thrombin time (APTT) were significantly longer [PT (s): 19.4±7.6 vs. 16.0±4.0, INR: 1.7±1.0 vs. 1.3±0.5, APTT (s): 54.0±25.8 vs. 44.1±15.1], plasma fibrinogen (FIB), platelet count (PLT), albumin (ALB), and cholesterol (CHOL) were decreased [FIB (g/L): 4.2±2.3 vs. 4.9±1.8, PLT (×10 9/L): 116.3±74.3 vs. 182.7±108.6, ALB (g/L): 25.4±5.5 vs. 27.6±5.5, CHOL (mmol/L): 2.5±1.2 vs. 3.2±1.3], the probability of shock was significantly increased (91.47% vs. 59.19%), and the duration of shock was prolonged [days: 5.0 (2.0, 9.0) vs. 1.0 (0.0, 3.0)], positive rate of microbial culture (81.40% vs. 71.11%), probability of occurrence of drug-resistant bacteria (67.44% vs. 47.99%) were significantly higher, mechanical ventilation time [days: 6.0 (2.0, 12.7) vs. 2.4 (0.0, 6.9)], continuous renal replacement therapy (CRRT) time [days: 1.2 (0.0, 5.0) vs. 0.0 (0.0, 0.0)], the length of intensive care unit (ICU) stay [days: 9.0 (5.0, 18.0) vs. 7.0 (3.0, 13.0)] were significantly longer, 28-day mortality was significantly higher (80.62% vs. 28.89%), and the differences were statistically significant (all P < 0.05). Further Logistic regression analysis showed that PLT decline, PT prolongation, CRRT duration, shock duration and 28-day mortality were correlated with sepsis-related liver injury [odds ratios ( OR) and 95% confidence interval (95% CI) were 0.992 (0.987-0.998), 3.103 (1.507-6.387), 1.198 (1.074-1.336), 1.196 (1.049-1.362), and 0.213 (0.072-0.633), respectively, all P < 0.05]. Conclusions:Prolonged PT and decreased PLT are independent risk factors for sepsis complicated with liver injury. The long duration of CRRT, long duration of shock, and high mortality are independent clinical characteristics of patients with sepsis-related liver injury.

The benefits of early enteral nutrition (EEN) during critical illness have been widely accepted by global experts. To popularize this new concept and provide standardized, reasonable and effective EEN therapy for critically ill patients in China, more than 20 experts from throughout the country discussed and developed this consensus. We used the GRADE approach for consensus development, focusing on important clinical issues such as nutrition assessment, initiating mode, route selection and tolerance monitoring of EEN support therapy for current critically ill patients. This consensus would be certainly help for intensive care physicians in the clinical application of EEN support therapy for critically ill patients.
China ; Consensus ; Critical Care ; Critical Illness ; Enteral Nutrition ; Humans

OBJECTIVETo observe the clinical effectiveness of warm needling combined with element calcium on postmenopausal osteoporosis, and to explore its action mechanism.

METHODSEighty-five postmenopausal patients were randomly divided into an observation group (43 cases) and a control group (42 cases). Both the two groups were treated with oral administration of caltrate-D tablet, 600 mg per day, once a day before sleep for one year. Patients in the observation group were treated with warm needling at Dazhu (BL 11), Shenshu (BL 23), Xuan-zhong (GB 39), once a day; 30 days of treatment were taken as a course, and totally 4 courses were given with an interval of 60 days between courses. The bone mineral density (BMD) of the lumbar vertebra and hip joint, and the level of serum bone gla protein (S-BGP) and hydroxyproline/creatinine (Hyp/Cr) were observed before and after treatment in the two groups.

RESULTS(1)After treatment, the BMD in the observation group was significantly increased [lumbar vertebra (0. 811±0. 024) g/cm2 vs (0. 892±0.019) g/cm2, femoral neck (0. 512±0.014) g/cm2 vs (0. 554±0. 015) g/cm2, femoral trochanter (0. 716±0. 028) g/cm2 vs (0.769±0.026) g/cm2, Ward's trigonum (0. 590±0. 013) g/cm2 vs (0. 660±0. 017) g/cm2, all P<0. 05)]; the improvement in the observation group was more significant than that in the control group (all P<0. 05). (2)After treatment, the index of bone metabolism in the control group was increased, and the serum S-BGP, the Hyp/Cr in the control group were higher than those in the observation group (both P<0. 05).

CONCLUSIONThe treatment of warm needling combined with element calcium on postmenopausal osteoporosis is significant, which is likely to be achieved by reducing the bone metabolism of postmenopausal patients.

Acupuncture Therapy ; Bone Density ; Calcium ; metabolism ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; metabolism ; physiopathology ; therapy

Objective To measure the expression of activin receptor-like kinases 1(ALK1)in dermal fibroblasts from patients with systemic scleroderma(SSc)and to estimate its role in the production of fibronectin and plasminogen activator inhibitor-1(PAI-1).Methods Dermal fibroblasts were isolated from the lesions of 12 patients with SSc as well as the normal skin of 14 healthy controls,and subjected to a primary culture.The third-passage fibroblasts were used in the next experiment.Western blot and indirect immunofluorescence technique were utilized to quantify the expression of ALK1.A specific siRNA targeting ALK1 was designed,constructed,and transiently transfected into the control dermal fibroblasts,which were then classified into 2 groups to be cultured with or without the presence of transforming growth factor(TGF)-β1 for 72 hours followed by the detection of fibronectin and PAI-1 expression with Western blot.Results As Western blot and direct immunofluorescence technique showed,both control and SSc fibroblasts showed an expression of ALK1 in the cytoplasm and membrane,and the expression intensity of ALK1 in SSc fibroblasts was significantly higher than that in the control fibroblasts(1.97 ± 0.05 vs.1.12 ± 0.03,t =50.96,P ＜ 0.05).The expression of ALK1,fibronectin and PAI-1 was decreased by 90％,58％ and 31％ respectively in specific siRNA-transfected SSc fibroblasts compared with the control siRNA-transfected fibroblasts.TGFβ1 significantly increased the expression of ALK1,fibronectin and PAI-1 in the control siRNA-transfected fibroblasts,but the increase was markedly inhibited by the siRNA-targeting ALK1.Conlusion TGFβ1 can promote the production of fibronectin and PAI-1 via ALK1 in fibroblasts,and ALK1 may be involved in the development of sclerosis in SSc.