Objective:To investigate the causal relationship between type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM), body mass index (BMI) and papillary thyroid cancer using Mendelian randomization(MR) study.Methods:Publicly available genome-wide association studies (GWAS) were used as the data source to screen single nucleotide polymorphisms significantly associated with exposure factors (instrumental variables), and the inverse variance weighting (IVW), weighted median, MR-Egger analysis, simple mode, and weighted mode of two-sample MR were used to assess the causal association between T2DM, T1DM, BMI and papillary thyroid cancer. The reliability and stability of the results were assessed by heterogeneity analysis, multiple validity analysis and sensitivity analysis.Results:A total of 118 strong instrumental variables for T2DM, 76 for T1DM, and 486 for BMI were screened respectively to conduct two-sample MR analysis. Among the 5 MR analysis methods, the results of the IVW method showed that T2DM was significantly associated with papillary thyroid cancer (odds ratio ( OR)=1.147, 95% CI: 1.026-1.282; P=0.016), and the genetic effect values ( β values) of the other 4 analysis methods and IVW method were in the same direction; the results of heterogeneity analysis, multiplicity analysis and sensitivity analysis showed all P>0.05. T1DM (IVW method: OR=1.000, 95% CI: 0.952-1.051; P=0.994) and papillary thyroid cancer, BMI (IVW method: OR=1.214, 95% CI: 0.923-1.598; P=0.166) and papillary thyroid cancer were not clearly causally related. Conclusions:There is a causal association between T2DM and papillary thyroid cancer, and T2DM increases the risk of papillary thyroid cancer. There is no clear causal association between T1DM, BMI and papillary thyroid cancer.

Objective:To investigate the causal relationship between type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM), body mass index (BMI) and papillary thyroid cancer using Mendelian randomization(MR) study.Methods:Publicly available genome-wide association studies (GWAS) were used as the data source to screen single nucleotide polymorphisms significantly associated with exposure factors (instrumental variables), and the inverse variance weighting (IVW), weighted median, MR-Egger analysis, simple mode, and weighted mode of two-sample MR were used to assess the causal association between T2DM, T1DM, BMI and papillary thyroid cancer. The reliability and stability of the results were assessed by heterogeneity analysis, multiple validity analysis and sensitivity analysis.Results:A total of 118 strong instrumental variables for T2DM, 76 for T1DM, and 486 for BMI were screened respectively to conduct two-sample MR analysis. Among the 5 MR analysis methods, the results of the IVW method showed that T2DM was significantly associated with papillary thyroid cancer (odds ratio ( OR)=1.147, 95% CI: 1.026-1.282; P=0.016), and the genetic effect values ( β values) of the other 4 analysis methods and IVW method were in the same direction; the results of heterogeneity analysis, multiplicity analysis and sensitivity analysis showed all P>0.05. T1DM (IVW method: OR=1.000, 95% CI: 0.952-1.051; P=0.994) and papillary thyroid cancer, BMI (IVW method: OR=1.214, 95% CI: 0.923-1.598; P=0.166) and papillary thyroid cancer were not clearly causally related. Conclusions:There is a causal association between T2DM and papillary thyroid cancer, and T2DM increases the risk of papillary thyroid cancer. There is no clear causal association between T1DM, BMI and papillary thyroid cancer.

Background Individuals may experience significant alterations in sleep hygiene during the major public health emergencies,consequently impacting their sleep quality.Objective To explore the relationship between sleep quality and sleep hygiene among adult residents during the major public health emergencies,so as to provide references for improving the sleep quality of residents during such a period.Methods A sample of 1 364 adult residents were enrolled as the research subjects from February 20 to 29,2020.All participants were asked to complete self-administered questionnaire to obtain basic-demographic information and sleep hygiene.Pittsburgh Sleep Quality Index(PSQI)was applied to assess sleep quality.Residents were classified into poor sleepers with PSQI score≥8 and good sleepers defined as PSQI score<8.Binary Logistic regression analysis was conducted to identify factors associated with sleep quality.Radar chart was used to visualize and compare the sleep hygiene between poor sleepers and good sleepers.Results According to PSQI score,891(65.32%)residents were good sleepers,while 473(34.68%)residents were poor sleepers.Comparison revealed that age(χ2=3.887),past medical history(χ2=27.938),awareness rate of importance of sleeping before major public health emergencies(χ2=4.337),impact of sleep quality on quality of life during the major public health emergencies(χ2=178.138),frequency of staying up late during the major public health emergencies(χ2=139.390),compensatory sleep behaviors(χ2=39.257),impact of sleep problems on daytime functioning(χ2=285.879),change of bedtime(χ2=63.031),sleep latency(χ2=168.672),wake-up time(χ2=59.221),changes in sleep duration(χ2=172.332),time spent in the bedroom(χ2=23.071),and sum of money spent on improving sleep environment(χ2=58.584)yielded statistical difference between poor sleepers and good sleepers(P<0.05 or 0.01).Logistic regression analysis denoted that past medical history(OR=1.680,95%CI:1.185～2.382),negative impact of sleep quality on quality life(OR=4.181,95%CI:2.722～6.422),staying up late 3 to 4 times per week(OR=3.145,95%CI:1.497～6.605),staying up late almost every day(OR=4.271,95%CI:1.970～9.260),negative impact of sleep problems on daytime functioning(OR=7.169,95%CI:5.188～9.907),prolonged sleep latency(OR=2.836,95%CI:2.019～3.982)and shortened sleep duration(OR=3.518,95%CI:2.144～5.772)were risk factors of poor sleep quality.The sum of money spent on improving sleep environment following the major public health emergencies≤500 RMB(OR=0.334,95%CI:0.134～0.830)was related to the incidence rate of poor sleep quality.Radar chart showed that poor sleepers were characterized by extravagant concerns,excessive cleanliness and poor sleep hygiene practices during the major public health emergencies,and poor sleepers were more likely to stay up late due to stress and emotional issues.Conclusion Some residents are facing poor sleep quality during the major public health emergencies,and poor sleep hygiene practice also contributes to poor sleep quality.

Objective:To analyze the imaging manifestations of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the patients with pleural and peritoneal mesothelioma,and to enhance the diagnostic accuracy for this disease.Methods:A retrospective analysis was conducted on the 18F-FDG PET/CT imaging and immunohistochemical results of 22 patients confirmed pleural and peritoneal mesothelioma(21 malignant and 1 benign)by pathology.The imaging features and glucose metabolism characteristics were summarized.Results:The majority of the patients with malignant pleural mesothelioma presented with unilateral pleural diffuse thickening accompanied by increased radiotracer uptake,and the thicknesses were ranged from 1.0 to 10.6 cm and the average semi-quantitative maximum standard uptake value(SUVmax)was 10.1.Over half of these patients also had a small amount of pleural effusion.The patients with malignant peritoneal mesothelioma mostly showed diffuse thickening of the peritoneum,omentum,and mesentery with increased radiotracer uptake,and the thicknesses were from 1.2 to 6.6 cm and the average SUVmax was 8.4,and over half of these patients had a significant amount of abdominal ascites.Besides the primary sites,nodular,striated,and mass-like abnormal radiotracer uptakes were observed in other metastatic sites in 17 cases of malignant mesothelioma,suggesting metastasis,and the average SUVmax was 7.4,predominantly surrounding lymph node metastasis.Bone and muscle metastases were visible in the patients with malignant pleural mesothelioma,while no such metastasis were seen in those with malignant peritoneal mesothelioma.One patient with benign pleural mesothelioma presented with bilateral pleural diffuse thickening approximately 3.5 cm thick,without significant abnormal radiotracer uptake and with a minor pleural effusion.Conclusion:The 18F-FDG PET/CT imaging manifestations of pleural and peritoneal mesothelioma exhibit the distinctive characteristics.The mode and thickness of pleural and peritoneal thickening,the presence and degree of 18F-fluorodeoxyglucose uptake,can preliminarily differentiate between benign and malignant mesothelioma,thus providing valuable references for the early clinical diagnosis of mesothelioma.PET/CT based on whole-body imaging can determine whether there are other sites of metastasis,which is helpful for clinical staging.

With good prognosis of differentiated thyroid cancer (DTC), the 10-year survival rate of DTC patients is more than 90%. As a kind of radiation exposure, radioactive iodine (RAI) treatment has the potential to induce malignancies. Based on this view, whether RAI treatment will increase the risk of secondary primary malignancy (SPM) still has a lot of controversy. This review summarizes current situation of related researches, and also summarizes the limitations of the current researches and the problems to be solved in the future research. In this review, it is believed that RAI treatment does not increase the overall risk of SPM in postoperative-DTC patients.

Objective:To explore the predictive value of amplitude integrated electroencephalography(aEEG)in the neurological prognosis of children with neonatal bacterial meningitis(NBM).Methods:The clinical data and aEEG results from 148 children diagnosed with NBM who completed aEEG examinations in the Department of Neonatology at Kunming Children′s Hospital from January 2018 to December 2019 were retrospectively analyzed.According to whether aEEG is abnormal, the children were divided into aEEG abnormal group and aEEG non-abnormal group.According to the degree of aEEG abnormality, children with aEEG abnormality were divided into aEEG mild abnormal group and aEEG severe abnormal group.The abnormal rate and abnormal characteristics of aEEG were analyzed; The clinical data of two groups were compared.Results:(1)Among the 148 children with NBM, 49 children had abnormal aEEG, 99 children had no abnormality, and the aEEG abnormal rate was 33.1%.The abnormal aEEG was manifested as delayed sleep-wake cycle maturation in 39 (26.3%) cases, abnormal discharge in eight (5.4%) cases, and abnormal background activity in one (0.6%) case.(2)The proportion of children with convulsive seizures and refractory NBM in aEEG abnormal group were significantly higher than those in aEEG non-abnormal group ( P<0.05). In the routine and biochemical abnormal indexes of cerebrospinal fluid, the proportion of protein >3 g/L, cerebrospinal fluid leukocyte>500×10 6/L, cerebrospinal fluid glucose<1.5 mmol/L, positive cerebrospinal fluid culture, positive blood and cerebrospinal fluid culture, abnormal head MRI in aEEG abnormal group significantly increased ( P<0.05); While there was no significant difference regarding blood routine leukocyte abnormality, CRP increase, and positive blood culture ratio between two groups ( P>0.05). (3) 148 cases of NBM children were followed up to 15 months old, 119 (80.4%) cases completed the follow-up, the loss rate was 19.6%, three cases died, and 11 cases had psychomotor retardation.Compared with the children with abnormal aEEG, the prognosis of children with NBM was significantly different, the Spearman rank correlation coefficient r was 0.315 ( P<0.05). COX regression was used to analyze the predictive value of each index for adverse outcomes. Abnormal aEEG was an independent risk factor for adverse outcomes in children with NBM ( OR=7.452, 95% CI 1.605-34.591, P<0.05). Conclusion:The aEEG monitoring of children with NBM, if abnormal, may indicate severe NBM, which is likely to be transformed into refractory NBM or has a poor prognosis.

【Objective】 To investigate the diagnostic value of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) specific antibodies IgM and IgG on coronavirus disease 2019 (COVID-19). 【Methods】 1) The test results of SARS-CoV-2 IgM/IgG antibodies and nucleic acid(NAT), which were tested by colloidal gold test and fluorescent quantitative PCR respectively, were collected from 145 febrile outpatients during early March, 2020, named Fever group, in which retrospective analysis and paired chi-square test were performed. 2) 612 cases of SARS-CoV-2 IgM/IgG antibodies test results, which were done on March 5, 2020, were collected. They were named COVID-19 group (Our hospital was provisionally assigned as a specialized hospital for COVID-19, and 1500 COVID-19 patients admitted to our hospital from February 12, 2020 to March 18, 2020). The SARS-CoV-2 IgM/IgG antibodies and NAT were respectively tested on the 30th and the 60th day after the date of discharge. The clinical application values of the antibodies was clarified by statistical analysis. 【Results】 1) In the fever group, the positive rate of SARS-CoV-2 IgM, IgG and IgM+ IgG antibodies were 26.21% (38/145), 54.48% (79/145) and 26.21% (38/145), respectively(P<0.01), and the positive rate of NAT was 4.14% (6/145), which was lower than that of antibody (P<0.01). One (1/145, 0.69%) positive NAT was implicated in initially negative IgM and IgG antibodies samples. 2) In the COVID-19 group, the positive rate of IgM antibody was low (5%) and IgG antibody was high (65%) during 2~14 days after infection, and stably increased during the 15~56 days [IgM 47.68%(277/581) vs IgG 94.15% (547/581) ], then both decreased after 57 days. The positive rates of IgM antibody and IgG antibody were 45.8% (280/612) and 93.1% (570/612) in 612 patients during hospitalization. 15 patients′ data after dischange were not collected as they were later transferred to Huoshenshan Hospital for treatment. The coronavirus NAT results of the rest 597 COVID-19 patients, tested on the 30th and 60th days after the date of discharge, were negative, and the positive rates of IgG antibody and IgM antibody were still ≥80% and ≥40% respectively at the second month after discharge. 【Conclusion】 IgM, IgG antibody against SARS-CoV-2 can be well detected by Colloidal gold method(Innovita), whose positive rate is higher than that of NAT. IgG antibody is produced earlier than IgM, and it keeps high positive rate and persists for a long time. The combination of colloidal gold antibody test and NAT can improve the diagnose rate of COVID-19 and the exclusion of suspected cases.

Objective: To investigate the clinical efficacy and adverse effects of stereotactic body radiotherapy (SBRT) in the treatment of T₂N₀M₀ non-small cell lung cancer (NSCLC) patients. Methods: By retrospectively analyzing the clinical data of 30 inoperable patients with stage T₂N₀M₀ NSCLC treated by SBRT, the overall survival, progression-free survival, cancer-specific survival and adverse effects were determined. Results: The median follow-up was 18.4 months. The 1-, 2-, and 3-year overall survival rates were 92.2%, 92.2% and 80.6%, respectively. The corresponding cause-specific survivals were 95.7%, 95.7% and 83.7%. The progression-free survivals were 70.2%, 54.1% and 40.6%. The local control rates were 100%, 94.4%, and 94.4%. The regional controls were 84.2%, 72.1%, and 54.1%; and distant controls were 84.6%, 72.4% and 64.3%, respectively. Twenty patients (66.7%) developed symptoms of grade 1 radiation-related toxicities: dyspnea, chest pain, fatigue, cough, esophagitis, or pneumonia. Among these, 5 patients suffered grade ≥2 radiation pneumonitis, and one patient experienced grade 4 radiation pneumonitis. Conclusions SBRT was efficient and safe for patients with inoperable T₂N₀M₀ NSCLC, imposing tolerable toxicities.

Reduced graphene oxide-BiPO4 ( RGO-BiPO4 ) nanocomposite was synthesized successfully via a one-pot solvothermal method using graphene oxide and bismuth nitrate as precursors and glycerin as solvent at 200℃ for 1 h. The morphology and structure of as-prepared nanocomposite were characterized by SEM, TEM, XRD, XPS, SERS and UV-Visible spectrum. The photocatalytic activity of the nanocomposite was evaluated by the photodegradation of Rhodamine B ( RhB) dye under UV irradiation and it was found that RGO-BiPO4 nanocomposite possessed higher photocatalytic activity than that of pure BiPO4 . RhB could be decomposed 87. 5% within 2 h. Under the same conditions, only 45. 7% of the RhB dye could be decomposed by BiPO4 . The enhancement of photocatalytic activity could be attributed to the effective charge separation due to the electron-accepting and transporting properties of graphene.

Objective To investigate the association between serum ferritin(SF) level at early and mid trimester of pregnancy and gestational diabetes mellitus (GDM) and insulin resistance (IR).Methods A total of 192 cases of women who were accepted antenatal examination from the first trimester of pregnancy at Yueqing People Hospital from July,2012 to October,2013 was prospectively analyzed and followed up.All cases were divided into two groups:96 cases of GDM pregnant women who were diagnosed as GDM at mid trimester of pregnancy as GDM group,and 96 cases of pregnant women with normal glucose tolerance at the same time as the control,normal glucose tolerance (NGT group).The differences in clinical data were compared between two groups.The relationship between SF level and fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment insulin resistance (HOMA-IR),and C-peptide was investigated with Spearman rank correlation analysis.The predictive values of SF and relative variables to GDM were calculated by receiver operating characteristic curve (ROC) or Logistic regression analysis.Results (1) There was statistically significant difference in body weight and body mass index (BMI) at prepregnancy and mid trimester of pregnancy,Hb,FPG,FINS,SF,and C-peptide at the first trimester of pregnancy,SF level and FPG and HOMA-IR and C-peptide at mid trimester of pregnancy between two groups (P ＜ 0.01 or P ＜ 0.05).(2) As showed by Spearman rank correlation analysis,there was statistical correlation between SF at mid trimester of pregnancy,and FPG,FINS,HOMA-IR and C-peptide (P ＜0.01 or P ＜ 0.05);while no statistical correlation was found between SF at the first trimester of pregnancy and the same factors above (P ＞ 0.05).(3) The area under the ROC curve of SF at mid trimester of pregnancy for GDM was 0.653.The sensitivity and specificity were 68.8％ and 59.4％ in predicting GDM at the cut-off value of 16.61 ng/ml.As showed by Logistic regression analysis,high level of SF at mid trimester of pregnancy was a independent risk factor for GDM.Odds ratio (OR) was 1.032 (95％ CI:1.008 ～ 1.058,P ＜ 0.01).Conclusions The relationship between SF at different trimester of pregnancy and GDM is variant.There is relationship between high level SF of mid trimester of pregnancy in GDM pregnant women and IR.The level of SF might predict the occurrence of GDM.