OBJECTIVE:To observe the clinical efficacy and safety of Shenmai injection combined with Trimetazidinee tablet in the treatment of hypothyroid heart disease. METHODS:64 patients with hypothyroid heart disease were randomly divided into control group and observation group. Patients in 2 groups were conventional treatment. Based on the treatment,control group was treated with Trimetazidine tablets 20 mg,orally,3 times a day;based on the treatment in control group,observation group was ad-ditionally treated with Shenmai injection 40 ml by intravenous infusion,once a day. The treatment course was 2 months. The clinic data was observed,including clinical efficacy,and T3,T4,TSH,LVEF,LVEDD and LVESD before and after treatment,pericar-dial effusion depth and incidence of adverse reactions. RESULTS:The total effective rate in observation group was significantly higher than control group(P<0.05). After treatment,T3 and T4 in 2 groups were significantly higher than before,TSH and LVESD were significantly lower than before(P<0.05),however,the difference was not statistically significant between 2 groups (P>0.05);LVEF in 2 groups was significantly higher than before,observation group was higher than control group,LVEDD and pericardial effusion depth were significantly lower than before,observation group was lower than control group(P<0.05). There were no obrious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,Shenmai injection com-bined with trimetazidinee has better efficacy than only trimetazidinee in the treatment of hypothyroid heart disease,with similar safety.

3 ?g/well.All BALB/c mice immunized with pJME by im.and gene gun injection,and JE inactivated vaccines by ip.injection survived for 21 days.BALB/c mice immunized with pJE by im.injection and gene gun injection partially survived for 21 days.Titres of neutralization antibody produced with pJME were higher than pJE.Protective immunity and titre of neutralization antibody produced by im injection was the same as gene gun injection(im/gene gun injection: 1∶320/1∶320) at day 21.The antibody from BALB/c mice sera after twice pJME immunization only reacts with JEV-E protein. Conclusions Expression efficacy of proteins encoded by pJME and pJE in transfected cells is different.Expression level of related proteins was dependant on recombinant amount for transfection in a certain degree.Immunity effect induced with pJME was higher than pJE.The efficacy of DNA immunization produced by gene gun injection was higher than im.injection.Titres of neutralization antibody induced by DNA immunization were correlated to efficacy of protective immunity.Neutralization antibody from BALB/c mice sera produced by pJME immunization contained anti-E antibody against JEV-E protein.

Objective To observe the antioxidative capability and the mRNA expression of sodium pump αl-subunit in kidney of hypothyroid rats by iodine deficiency and illuminate the pathogenesis of kidney damage.Methods Wistar rats were randomly divided into two groups as control group (NT) and hypothyroid group (HT).The rats were all fed with low-iodine diet derived from an endemic goiter area and drank deionized water containing different potassium iodide to duplicate hypothyriod animal models.We determined the morphometric parameters of kidney by routine histology method.The contents of malondialdehyde and free radical scavengers (GSH-PX and SOD) in kid-ney,as well as the activity of Na~+-K~+ ATPase were measured in two groups.The mRNA expression of sodium pump α1 subunit was determined by reverse transcription-polymerase chain reaction.Results Compared with that in the control group,in hypothyroid group (1) serum free T3,free T4,total T3 and total T4 were markedly lower.(2) mean glomerular area and volum diminished markedly.(3)the content of MDA and activity of PGx increased markedly,but the activity of SOD decreased significantly,as well as the one of Na~+-K~+-ATPase.(4)the mRNA expression level of sodium pump α1 subunit was lower.Conclusion In a hypothyroid state,the decrease of antiox-idative capability of kidney resulted in lipid peroxidative damage,atrophy of kidney,decreased activity of Na~+-K~+ -ATPase and degression of sodium pump α1 subunit mRNA expression.

Objective To test the hypothesis that perceived organizational support(POS) plays a moderate role in the process of personality' s effect on emotional exhaustion.Methods Using POS,Revised NEO Personality Inventory and Emotional Exhaustion Inventory,376 special combat soldiers were tested from the Chinese Armed Police Force.Then SPSS 16.0 was used to conduct descriptive analysis,correlational analysis and hierarchical regression analysis.Results The interaction of neuroticism and POS as well as the interaction of conscientiousness and POS were significant or marginally significant,respectively.POS significantly moderated the relationship between neuroticism and emotional exhaustion(β=-0.19,t=-2.82,P＜0.01)as well as the relationship between conscientiousness and emotional exhaustion(β=-0.12,t=-1.95,P=0.052).Conclusion Neuroticism and conscientiousness are more strongly related with emotional exhaustion among individuals with low POS than high POS.

The antioxidative capability and Na+-K+-ATPase α1-subunit mRNA expression in myocardium of hypothyroid rats induced by low-iodine diet were observed. The results showed that the antioxidative capability of myocardium decreased, resulting in lipid peroxidative damage, atrophy of myocardial cells and chondrification of tunica intima, along with decreased expression of sodium pump α1 subunit mRNA in hypothyroid rats.

Objective To build a Monte Carlo dose verification tool for IMRT Plan by implanting an irradiation source model into DPM code and to extend the ability of DPM to calculate any incident angles and irregular-inhomogeneous fields.Methods The virtual source and the energy spectrum unfolded from the accelerator measurement data were used,in combination with optimized intensity maps,to calculate the dose distribution of the irradiation irregular-inhomogeneous field.The irradiation source model of accelerator was substituted by a grid-based surface source.The contour and the intensity distribution of the surface source were optimized by IMRT.The dose calculation was realized by combining the position of the emitter with the fluence map from the IMRT plan.The weight of the emitter was decided by the grid intensity.The direction of the emitter was decided by the combination of the virtual source and the emitting position.The weighted fraction of the emitter was also combined with the flux grid intensity based on the particle transport model of DPM code.Results The accuracy of calculation was verified by comparing with the measured data.It was illustrated that the differences were acceptable (＜ 2％ inside the field,2-3 mm in the penumbra).The dose calculation of irregular field by DPM simulation was also compared with that of FSPB (Finite Size Pencil Beam).The passing rate of gamma analysis was 95.1％ for peripheral lung cancer.The regular field and the irregular rotational field were all within permissible range of error.The calculation time of regular fields were less than 2 h,and that of the test of peripheral lung cancer was 160 min.Conclusions The adapted DPM code with its simple irradiation source model is faster than that with classical Monte Carlo procedure.Its computational accuracy and speed satisfy the clinical requiremcnt,and it can be useful as a Monte Carlo dose verification tool for IMRT Plan.

Objective To observe the association between homocysteine (Hcy)level and low limb vascular disease(LLVD) in newly-diagnosed type 2 diabetic patients. Methods The study subjects were divided into three groups : control group (NC), newly-diagnosed type 2 diabetes group without peripheral artery disease (T2DM) and peripheral artery disease with newly-diagnosed type 2 diabetes group (T2DM+LLVD).Both Hcy and the ankle-brachial index(ABI) were measured in three groups. Results Compared with NC group, clinical parameters of body mass index,waist-to-hip ratio,systolic blood pressure, total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C),and glycated hemoglobin A1C (HbA1c) increased markedly,and the content of high density lipoprotein-cholesterol (HDL-C) was markedly lower in both T2DM and T2DM+LLVD groups.In T2DM+LLVD group the contents of Hcy,LDL-C and HbA1c were markedly higher than in T2DM group,but the content of HDL-C decreased significantly.Hcy was independently associated with the development of peripheral artery disease in newly-diagnosed type 2 diabetic patients by logisitic regression analysis. Conclusions Increased Hcy is an independent risk factor for peripheral artery disease in newly-diagnosed type 2 diabetes.

Objective:To explore the association between triglyceride glucose index (TyG)- waist to height ratio (WHtR)(TyG-WHtR) and cognitive impairment in middle-aged and elderly population.Methods:A cohort database was constructed using the data from the China Health and Retirement Longitudinal Study, with 8 946 participants in 2011 and 2015 as the baseline population. Cox proportional hazards regression models were used to estimate the association between TyG-WHtR levels at baseline and the risk of cognitive impairment in middle-aged and elderly population. The analysis was stratified by age and gender, respectively.Results:A total of 8 946 participants were included, with an average follow-up of 7.08 person-years and incidence density of cognitive impairment for 21.15 per 1 000 person-years. Compared with the Q1 level of TyG-WHtR, its Q3 and Q4 level increased the risk of cognitive impairment by 32% ( HR=1.32, 95% CI: 1.09-1.60) and 47% ( HR=1.47, 95% CI: 1.14-1.91), respectively. Trend test showed that the risk of cognitive impairment increased with the increase of TyG-WHtR level, and there was a dose-response relationship ( P=0.001). Stratified analysis showed that in the population aged 45-59 years, compared with the Q1 level of TyG-WHtR, its Q3 level increased the risk of cognitive impairment by 34% ( HR=1.34, 95% CI: 1.02-1.78). In the population aged 60 years and above, compared with the Q1 level, its Q3 and Q4 level increased the risk of cognitive impairment by 31% ( HR=1.31, 95% CI: 1.01-1.72) and 63% ( HR=1.63, 95% CI: 1.15-2.31), respectively. In the male group, there was no significant association between TyG-WHtR level and the risk of cognitive impairment ( P>0.05). In the female group, compared with the Q1 level of TyG-WHtR, its Q4 level increased the risk of cognitive impairment by 76% ( HR=1.76, 95% CI: 1.26-2.46). Conclusions:Middle-aged and elderly population with a higher TyG-WHtR level may increase the risk of cognitive impairment, and there were age and sex differences. Early cardiovascular health management and scientific and reasonable weight management are of great significance to preventing cognitive impairment.

Objective:To construct a diabetes foot prediction model for adult patients with type 2 diabetes based on retrospective cohort study using data from a regional health data platform.Methods:Using Yinzhou Health Information Platform of Ningbo, adult patients with newly diagnosed type 2 diabetes from January 1, 2015 to December 31, 2022 were included in this study and divided randomly the train and test sets according to the ratio of 7∶3. LASSO regression model and bidirectional stepwise regression model were used to identify risk factors, and model comparisons were conducted with net reclassification index, integrated discrimination improvement and concordance index. Univariate and multivariate Cox proportional hazard regression models were constructed, and a nomogram plot was drawn. Area under the curve (AUC) was calculated as a discriminant evaluation indicator for model validation test its calibration ability, and calibration curves were drawn to test its calibration ability.Results:No significant difference existed between LASSO regression model and bidirectional stepwise regression model, but the better bidirectional stepwise regression model was selected as the final model. The risk factors included age of onset, gender, hemoglobin A1c, estimated glomerular filtration rate, taking angiotensin receptor blocker and smoking history. AUC values (95% CI) of risk outcome prediction at year 5 and 7 were 0.700 (0.650-0.749) and 0.715(0.668-0.762) for the train set and 0.738 (0.667-0.801) and 0.723 (0.663-0.783) for the test set, respectively. The calibration curves were close to the ideal curve, and the model discrimination and calibration powers were both good. Conclusions:This study established a convenient prediction model for diabetic foot and classified the risk levels. The model has strong interpretability, good discrimination power, and satisfactory calibration and can be used to predict the incidence of diabetes foot in adult patients with type 2 diabetes to provide a basis for self-assessment and clinical prediction of diabetic foot disease risk.

Objective:To develop a prediction model for the risk of diabetic retinopathy (DR) in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods:Patients with new diagnosis of T2DM recorded in Yinzhou Regional Health Information Platform between January 1, 2015 and December 31, 2022 were included in the study. The predictor variables were selected by using Lasso-Cox proportional hazards regression model. Cox proportional hazards regression models were used to establish the prediction model for the risk of DR. Bootstrap method (500 resamples) was used for internal validation, and the performance of the model was assessed by C-index, the receiver operating characteristic curve and area under the curve (AUC), and calibration curve.Results:The predictor variables included in the final model were age of T2DM onset, education level, fasting plasma glucose, glycated hemoglobin A1c, urinary albumin, estimated glomerular filtration rate, and history of lipid-lowering agent and angiotensin converting enzyme inhibitor uses. The C-index of the final model was 0.622, and the mean corrected C-index was 0.623 (95% CI: 0.607-0.634). The AUC values for predicting the risk of DR after 3, 5, and 7 years were 0.631, 0.620, and 0.624, respectively, with a high degree of overlap of the calibration curves with the ideal curves. Conclusion:In this study, a simple and practical risk prediction model for DR risk prediction was developed, which could be used as a reference for individualized DR screening and intervention in newly diagnosed T2DM patients.