Objective:To investigate the relationship between thyroid hormone sensitivity indicators and the risk of mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM) who have normal thyroid function.Methods:A retrospective study design was used to gather data from 100 patients with T2DM who had normal thyroid function and were treated at Shangluo Central Hospital between June 2022 and January 2024. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used for evaluation. Patients with an MMSE score of ≤ 26 or a MoCA score of ≤ 26 were included in the MCI group ( n = 22), whereas those with an MMSE score of > 26 and a MoCA score of > 26 were included in the non-MCI group ( n = 78). Multivariate logistic regression analysis was performed to identify factors influencing MCI in patients with T2DM. Additionally, receiver operating characteristic curve analysis was conducted to assess the predictive value of thyroid hormone sensitivity indicators for MCI in this patient population. Results:In the MCI group, 68.18% of patients had an education level of high school or below. The level of glycosylated hemoglobin in this group was (8.45 ± 1.95)%, insulin resistance index was (3.34 ± 0.25), the level of triglycerides was (2.59 ± 0.19) mmol/L, the level of uric acid was (354.76 ± 46.16) μmol/L, thyroid-stimulating hormone index was (3.09 ± 0.26), and thyroid feedback quantile-based index was [0.2 (0.0, 0.5)]. All of these values were significantly higher than those in the non-MCI group: [43.59%, (7.63 ± 1.61)%, (3.05 ± 0.17), (2.09 ± 0.15) mmol/L, (311.74 ± 67.15) μmol/L, (2.87 ± 0.13), 0.2 (-0.1, 0.4), χ2 = 4.15, t = 2.01, 6.32, 12.99, 3.47, 5.47, Z = -2.54, all P < 0.05]. In the MCI group, the level of free triiodothyronine was (4.32 ± 0.21) pmol/L, and thyrotroph T4 resistance index (TT4RI) was (34.54 ± 4.30), both of which were significantly lower than those in the non-MCI group [(4.61 ± 0.36) pmol/L, (37.15 ± 5.55), t = 2.58, 2.04, both P < 0.05]. There were no significant differences in gender, age, body mass index, alcohol consumption, smoking, history of cerebral infarction, hypertension, duration of diabetes, use of only metformin, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, alanine aminotransferase, aspartate aminotransferase, free thyroxine, and thyroid-stimulating hormone between the two groups (all P > 0.05). Logistic regression analysis indicated that education level, triglyceride, uric acid, free triiodothyronine, thyroid-stimulating hormone index, and TT4RI were risk factors for MCI (all P < 0.05). The predictive value of the combined thyroid hormone sensitivity indicators for MCI in patients with T2DM was high, with an area under the receiver operating characteristic curve of 0.778 [95% CI(0.676, 0.880), P < 0.001], a sensitivity of 0.538, a specificity of 0.909, and a maximum Youden index of 0.447. Conclusions:In patients with T2DM who have normal thyroid function, the thyroid hormone sensitivity indicators (TT4RI and thyroid feedback quantile-based index) exhibited a negative correlation with MCI, whereas TSHI demonstrated a positive correlation with MCI. The combined use of these thyroid hormone sensitivity indicators is valuable for predicting MCI and offers significant guidance for the early intervention of cognitive impairment in patients with T2DM.

Objective This study aims to analyze the factors influencing per capita current health expenditure in Guizhou Province from 2016 to 2022 using the gray correlation analysis method.Methods Based on the"SHA2011"accounting results of current health expenditure in Guizhou Province,as well as data from the"Guizhou Statistical Yearbook"and"Guizhou Health Statistical Yearbook",the gray correlation analysis method was used to analyze the factors influencing per capita current health expenditure in Guizhou Province from 2016 to 2022.Results The factors with the highest correlation to per capita current health expenditure in Guizhou Province were health expenditure(0.829),followed by the number of health technical personnel per thousand people(0.715),the number of practicing(assistant)physicians per thousand people(0.705),and per capita GDP(0.704).The factor with the lowest correlation was the proportion of the tertiary industry to GDP(0.543).Conclusion Health expenditure investment has the strongest correlation with per capita current health expenditure in Guizhou Province.Health re-source investment and health service capacity are the main influencing factors of per capita current health expenditure in Guizhou Province.At the same time,the impact of economic and social factors on current health expenditure should be fully recognized.

Objective:This study aimed to analyze the genetic variation of the human papillomavirus (HPV) type 39 genomes and to predict and screen the dominant T-cell and B-cell epitopes of the viral early proteins (E1, E2, E6, E7) and late proteins (L1, L2).Methods:A total of 70 full-length sequences of HPV39 variants were retrieved from the clinical samples and the National Center for Biotechnology Information (NCBI) to construct a phylogenetic tree, analyze genetic polymorphisms, and predict the physicochemical properties of the viral proteins. Next, T-cell and B-cell epitopes were predicted using IEDB and ABCpred, and potential dominant epitopes were further selected based on parameters such as the secondary structure of the epitope region, peptide flexibility, hydrophilicity, surface accessibility and antigenicity. Finally, a homology analysis of the potential dominant epitopes was performed with 12 high-risk HPV types.Results:HPV39 variants from different sources can be clustered into two lineages (A and B), each exhibiting distinct mutation patterns. The mutation rate was the highest in E7 and the lowest in E1 among the different viral genes. However, these nucleotide/amino acid mutations did not significantly impact the physicochemical properties of the viral proteins. After prediction and screening, 5 and 6 potential dominant B-cell epitopes were identified in both L1 and L2, respectively. E1, E2, E6, and E7 yielded 18, 10, 4, and 1 potential dominant HLA-I restricted T-cell epitopes, respectively. Additionally, E1, E2, and E6 yielded 7, 3, and 2 potential dominant HLA-II restricted T-cell epitopes, respectively. Homology analysis indicated that T-cell dominant epitopes in E1, E2, and E6, as well as B-cell epitopes in L2, showed high homology (93%-100%) with HPV68, HPV33, HPV45, and HPV59.Conclusions:Bioinformatics analysis and prediction revealed that HPV39 variants can be clustered into two main evolutionary branches, A and B, each exhibiting a specific mutation pattern. The viral proteins contain potential dominant T-cell and B-cell epitopes that can be further investigated, providing valuable theoretical support for the development of HPV39-related peptide-based vaccines and therapeutics.

Objective:This study aimed to analyze the genetic variation of the human papillomavirus (HPV) type 39 genomes and to predict and screen the dominant T-cell and B-cell epitopes of the viral early proteins (E1, E2, E6, E7) and late proteins (L1, L2).Methods:A total of 70 full-length sequences of HPV39 variants were retrieved from the clinical samples and the National Center for Biotechnology Information (NCBI) to construct a phylogenetic tree, analyze genetic polymorphisms, and predict the physicochemical properties of the viral proteins. Next, T-cell and B-cell epitopes were predicted using IEDB and ABCpred, and potential dominant epitopes were further selected based on parameters such as the secondary structure of the epitope region, peptide flexibility, hydrophilicity, surface accessibility and antigenicity. Finally, a homology analysis of the potential dominant epitopes was performed with 12 high-risk HPV types.Results:HPV39 variants from different sources can be clustered into two lineages (A and B), each exhibiting distinct mutation patterns. The mutation rate was the highest in E7 and the lowest in E1 among the different viral genes. However, these nucleotide/amino acid mutations did not significantly impact the physicochemical properties of the viral proteins. After prediction and screening, 5 and 6 potential dominant B-cell epitopes were identified in both L1 and L2, respectively. E1, E2, E6, and E7 yielded 18, 10, 4, and 1 potential dominant HLA-I restricted T-cell epitopes, respectively. Additionally, E1, E2, and E6 yielded 7, 3, and 2 potential dominant HLA-II restricted T-cell epitopes, respectively. Homology analysis indicated that T-cell dominant epitopes in E1, E2, and E6, as well as B-cell epitopes in L2, showed high homology (93%-100%) with HPV68, HPV33, HPV45, and HPV59.Conclusions:Bioinformatics analysis and prediction revealed that HPV39 variants can be clustered into two main evolutionary branches, A and B, each exhibiting a specific mutation pattern. The viral proteins contain potential dominant T-cell and B-cell epitopes that can be further investigated, providing valuable theoretical support for the development of HPV39-related peptide-based vaccines and therapeutics.

Objective:To analyze the research and development of control system for airbag pressure of intelligent tracheal catheter,and its application effect in clinical practice.Methods:The hospital designed an intelligent self-adaptive control system for cuff pressure of tracheal catheter,which can rationally apply main components such as single chip microcomputer,display screen,control panel,pressure monitoring module,inflation device and solenoid valve,etc..This control system connected the measuring module of pressure through single chip microcomputer,so as to continuously detect the airbag pressure of tracheal catheter.An inflation and deflation algorithm was independently researched and developed to control air pump or solenoid valve to inject or release part of the gas to the airbag,so as to achieve intelligent control for the pressure of airbag.Sixty patients underwent endotracheal intubation who admitted to the department of general surgery of Wuhan Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the study objects,and they were divided into control group(n=30)and observation group(n=30)according to random number table method.The cuff pressure of endotracheal intubation of patients in control group were managed by conventional method.The intelligent adaptive control system was adopted to manage the cuff pressure of endotracheal intubation for patients in the observation group.The complications,compliance rate of airbag pressure,the instantaneous maximum value of airbag pressure during sputum aspiration,insertion of gastric tube,and turning over of body were compared between the two groups after intubation.Results:The incidence of complication included cough,trachyphonia,dysphagia and bloody sputum after tracheal intubation in the observation group were 6.66%,which was significantly lower than 33.33%in the control group,and the difference was statistically significant(x2=6.667,P<0.05).The compliance rate of the pressure(25-30cmH2O)of airbag in the control group was 92.83%,which was significantly lower than 97.78%in the observation group,and the difference was statistically significant(x2=14.698,P<0.05).The instantaneous maximum values of airbag pressure during sputum aspiration,insertion of gastric tube and turning over were(28.24±3.65)cmH2O,(27.98±4.25)cmH2O and(28.65±4.87)cmH2O in observation group,respectively,which were significantly lower than those in control group,and the differences were significant(t=17.930,19.208,16.485,P<0.05).Conclusion:The application of intelligent adaptive control system for cuff pressure of tracheal catheter can maintain the airbag pressure of tracheal catheter at normal level(20-30 cmH2O),and reduce complications,and improve the compliance rate of airbag pressure.

Objective:To investigate the relationship between thyroid hormone sensitivity indicators and the risk of mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM) who have normal thyroid function.Methods:A retrospective study design was used to gather data from 100 patients with T2DM who had normal thyroid function and were treated at Shangluo Central Hospital between June 2022 and January 2024. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used for evaluation. Patients with an MMSE score of ≤ 26 or a MoCA score of ≤ 26 were included in the MCI group ( n = 22), whereas those with an MMSE score of > 26 and a MoCA score of > 26 were included in the non-MCI group ( n = 78). Multivariate logistic regression analysis was performed to identify factors influencing MCI in patients with T2DM. Additionally, receiver operating characteristic curve analysis was conducted to assess the predictive value of thyroid hormone sensitivity indicators for MCI in this patient population. Results:In the MCI group, 68.18% of patients had an education level of high school or below. The level of glycosylated hemoglobin in this group was (8.45 ± 1.95)%, insulin resistance index was (3.34 ± 0.25), the level of triglycerides was (2.59 ± 0.19) mmol/L, the level of uric acid was (354.76 ± 46.16) μmol/L, thyroid-stimulating hormone index was (3.09 ± 0.26), and thyroid feedback quantile-based index was [0.2 (0.0, 0.5)]. All of these values were significantly higher than those in the non-MCI group: [43.59%, (7.63 ± 1.61)%, (3.05 ± 0.17), (2.09 ± 0.15) mmol/L, (311.74 ± 67.15) μmol/L, (2.87 ± 0.13), 0.2 (-0.1, 0.4), χ2 = 4.15, t = 2.01, 6.32, 12.99, 3.47, 5.47, Z = -2.54, all P < 0.05]. In the MCI group, the level of free triiodothyronine was (4.32 ± 0.21) pmol/L, and thyrotroph T4 resistance index (TT4RI) was (34.54 ± 4.30), both of which were significantly lower than those in the non-MCI group [(4.61 ± 0.36) pmol/L, (37.15 ± 5.55), t = 2.58, 2.04, both P < 0.05]. There were no significant differences in gender, age, body mass index, alcohol consumption, smoking, history of cerebral infarction, hypertension, duration of diabetes, use of only metformin, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, alanine aminotransferase, aspartate aminotransferase, free thyroxine, and thyroid-stimulating hormone between the two groups (all P > 0.05). Logistic regression analysis indicated that education level, triglyceride, uric acid, free triiodothyronine, thyroid-stimulating hormone index, and TT4RI were risk factors for MCI (all P < 0.05). The predictive value of the combined thyroid hormone sensitivity indicators for MCI in patients with T2DM was high, with an area under the receiver operating characteristic curve of 0.778 [95% CI(0.676, 0.880), P < 0.001], a sensitivity of 0.538, a specificity of 0.909, and a maximum Youden index of 0.447. Conclusions:In patients with T2DM who have normal thyroid function, the thyroid hormone sensitivity indicators (TT4RI and thyroid feedback quantile-based index) exhibited a negative correlation with MCI, whereas TSHI demonstrated a positive correlation with MCI. The combined use of these thyroid hormone sensitivity indicators is valuable for predicting MCI and offers significant guidance for the early intervention of cognitive impairment in patients with T2DM.

Objective This study aims to analyze the factors influencing per capita current health expenditure in Guizhou Province from 2016 to 2022 using the gray correlation analysis method.Methods Based on the"SHA2011"accounting results of current health expenditure in Guizhou Province,as well as data from the"Guizhou Statistical Yearbook"and"Guizhou Health Statistical Yearbook",the gray correlation analysis method was used to analyze the factors influencing per capita current health expenditure in Guizhou Province from 2016 to 2022.Results The factors with the highest correlation to per capita current health expenditure in Guizhou Province were health expenditure(0.829),followed by the number of health technical personnel per thousand people(0.715),the number of practicing(assistant)physicians per thousand people(0.705),and per capita GDP(0.704).The factor with the lowest correlation was the proportion of the tertiary industry to GDP(0.543).Conclusion Health expenditure investment has the strongest correlation with per capita current health expenditure in Guizhou Province.Health re-source investment and health service capacity are the main influencing factors of per capita current health expenditure in Guizhou Province.At the same time,the impact of economic and social factors on current health expenditure should be fully recognized.

Objective:To analyze the research and development of control system for airbag pressure of intelligent tracheal catheter,and its application effect in clinical practice.Methods:The hospital designed an intelligent self-adaptive control system for cuff pressure of tracheal catheter,which can rationally apply main components such as single chip microcomputer,display screen,control panel,pressure monitoring module,inflation device and solenoid valve,etc..This control system connected the measuring module of pressure through single chip microcomputer,so as to continuously detect the airbag pressure of tracheal catheter.An inflation and deflation algorithm was independently researched and developed to control air pump or solenoid valve to inject or release part of the gas to the airbag,so as to achieve intelligent control for the pressure of airbag.Sixty patients underwent endotracheal intubation who admitted to the department of general surgery of Wuhan Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the study objects,and they were divided into control group(n=30)and observation group(n=30)according to random number table method.The cuff pressure of endotracheal intubation of patients in control group were managed by conventional method.The intelligent adaptive control system was adopted to manage the cuff pressure of endotracheal intubation for patients in the observation group.The complications,compliance rate of airbag pressure,the instantaneous maximum value of airbag pressure during sputum aspiration,insertion of gastric tube,and turning over of body were compared between the two groups after intubation.Results:The incidence of complication included cough,trachyphonia,dysphagia and bloody sputum after tracheal intubation in the observation group were 6.66%,which was significantly lower than 33.33%in the control group,and the difference was statistically significant(x2=6.667,P<0.05).The compliance rate of the pressure(25-30cmH2O)of airbag in the control group was 92.83%,which was significantly lower than 97.78%in the observation group,and the difference was statistically significant(x2=14.698,P<0.05).The instantaneous maximum values of airbag pressure during sputum aspiration,insertion of gastric tube and turning over were(28.24±3.65)cmH2O,(27.98±4.25)cmH2O and(28.65±4.87)cmH2O in observation group,respectively,which were significantly lower than those in control group,and the differences were significant(t=17.930,19.208,16.485,P<0.05).Conclusion:The application of intelligent adaptive control system for cuff pressure of tracheal catheter can maintain the airbag pressure of tracheal catheter at normal level(20-30 cmH2O),and reduce complications,and improve the compliance rate of airbag pressure.

Objective:To investigate the clinical characteristics and offer diagnostic and therapeutic approaches for adult-onset idiopathic hypogonadotropic hypogonadism(AIHH).Methods:Clinical, laboratory, and imaging data, as well as follow-up information, of three male patients diagnosed with AIHH at the Department of Endocrinology and Metabolism of Nanfang Hospital, Southern Medical University, were systematically reviewed and analyzed.Results:All three patients were male, with a median age of 39 years(range, 22 to 40). Two patients reported symptoms of enlarged breasts and reduced sexual function, while one case solely reported a decline in sexual function. Physical examination showed that the median length of the penis was 6 cm(range, 5 to 6 cm), and the bilateral testicular volume was 7.96 mL(4.70-8.82 mL). Basal hormone levels at the time of initial visit to our hospital as follows: the median testosterone level was 0.32 ng/mL(0.24-2.96 ng/mL), median follicle stimulating hormone(FSH) level was 0.56 mIU/mL(0.1-0.75 mIU/mL), and the median luteinizing hormone(LH) level was 0.69 mIU/mL(0.1-1.03 mIU/mL). The levels of other hormones secreted by the anterior pituitary gland were normal. Hypothalamic-pituitary magnetic resonance imaging(MRI) showed that 1 patient had a pituitary microadenoma. Three patients were treated with pulsatile GnRH or gonadotropins, one of which had hypothalamic-pituitary-gonadal(HPG) axis function reversal after GnRH pulse pump therapy and lasted for 1 year, but then still had irreversible reduction.Conclusion:AIHH is marked by adult-onset disease and idiopathic hypogonadism. Enhancing fertility remains a critical requirement for these patients. Pulsatile GnRH treatment or gonadotropin therapy, as viable treatments, exhibit therapeutic effects, albeit with occasional fluctuations. Therefore, the emphasis lies in the timely consideration of fertility preservation.

Objective:To investigate the changes of mortality，causes of death，and cause-specific mortality rate（CMR）of hospitalized neonates in NICU of the First Affiliated Hospital of Sun Yat-sen University.Method:A retrospective study was performed to compare the mortality，cause of death，and CMR of hospitalized neonates in period Ⅰ（2005-2009），period Ⅱ（2010-2014）and period Ⅲ（2015-2020）.Result:The overall mortality of hospitalized neonates in NICU of our hospital was 0.51%（104/20 493）through 2005 to 2020. The mortality in period Ⅰ，Ⅱ and Ⅲ were 0.61%（48/7 855），0.43%（27/6 209），and 0.45%（29/6 429），respectively. Compared with period Ⅰ，the mortality of preterm infants decreased significantly in period Ⅱ（3.14% vs 1.24%， χ2=14.076， P<0.01）and in period Ⅲ（3.14% vs 0.90%， χ2=25.157， P<0.01）. Eighty-five（81.7%）neonates were premature，and ninety-one（89.2%）neonates had definite abnormal perinatal factors. The CMR of hospitalized neonates related to pulmonary hemorrhage，congenital anomalies，and NRDS were 1.22‰（25/20 493），0.93‰（19/20 493），and 0.59‰（12/20 493），respectively. The CMR of other causes were sepsis 0.44‰（9/20 493），extremely premature 0.34‰（7/20 493），and perinatal asphyxia 0.24‰（5/20 493），respectively. Compared with period Ⅰ，specific mortality of NRDS in period Ⅱ（1.27‰ vs 0.16‰， χ2=5.487， P=0.016）and period Ⅲ（1.27‰ vs 0.16‰， χ2=5.738， P=0.014）significantly decreased. The leading causes of neonatal death in period Ⅰ，period Ⅱ，and period Ⅲ were NRDS，pulmonary hemorrhage，and congenital anomalies，respectively.And 71.2%（74/104）of neonatal deaths occurred within 7 days after birth. Conclusion:The mortality of preterm infants and specific mortality of NRDS in NICU have significantly decreased over the past 16 years.Congenital anomalies and infections remain important causes of death，and further efforts are needed to improve perinatal care.