Objective:To explore the reference interval of urinary iodine concentration(UIC)/urinary creatinine(UCr) ratio evaluating the iodine nutritional status in early pregnancy women.Methods:A reference interval of UIC/UCr ratio was determined among 5 609 early pregnant women with normal thyroid function, negative thyroid autoantibodies, and no history of diseases or taking drug that may affect thyroid function. Then we verified the reliability of this reference interval in a group of 7 514 women in early pregnancy.Results:We determined the UIC/UCr ratio of 75-149 μg/g as the reference interval. In the reference interval, thyroglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb), and thyroglobulin(Tg) were all at lower levels, and the overall distributions were approximately U-shaped. The prevalence of thyroid dysfunction, the positive rates of antibodies and the proportion of Tg>40 μg/L were the lowest within the reference interval, while higher on both sides of the interval.Conclusion:The reasonable reference interval of the UIC/UCr ratio in iodine-sufficient regions is 75-149 μg/g in early pregnerty women.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective:To examine associations of sex hormone levels with bone turnover markers(BTMs) among men in the Northeast region of Henan Province.Methods:From December 2015 to March 2016, 707 male subjects were selected from a National Epidemiological Survey-2014(Thyroid Disorders, Iodine status and Diabetes, TIDE)research—Henan sub-center survey by using multistage stratified cluster random sampling. Fasting venous blood was collected to determine the levels of luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E 2), testosterone(T), dehydroepiandrosterone-sulfate (DHEAS), androstenedione(AD), sex hormone binding globulin(SHBG), dihydrotestosterone(DHT), free testosterone(FT), osteocalcin(OC), pro-collagen type 1 N-terminal propeptide(PINP), C-terminal-cross-linking telopeptide of type 1 collagen(β-CTX), 25-hydroxyvitamin D [25(OH)D], and parathyroid hormone(PTH). Results:A total of 697 men with an average age of(46.6±15.9)years were included in the study. Pearson correlation analysis showed that age was positively associated with LH, FSH, T, and SHBG, while negatively associated with E 2, DHEAS, AD, FT, β-CTX, OC, and PINP, without significant correlation with DHT, 25(OH)D, and PTH. Pearson correlation analysis and linear regression analysis showed that E 2 was negatively associated with β-CTX; T was positively associated with OC, FSH was negatively associated with OC; LH, FSH, and SHBG were negatively associated with PINP; E 2, T, FT, DHT, and AD were positively associated with PINP. After adjusting for age and BMI, linear regression analysis showed that T was still significantly positively associated with OC and PINP, with 0.302 ng/ml and 0.015 ng/ml increasing for OC and PINP every 1 ng/ml increase in T; E 2 and DHT were positively associated with PINP, with 0.250 and 0.047 ng/ml increasing for PINP every 1 pg/ml increase in E 2 and DHT. Conclusions:Age is an important factor influencing sex hormones and BTMs. Serum levels of T, E 2, and DHT are associated with bone formation and bone absorption markers.

OBJECTIVE： To set up a standard for evaluating core competency of clinical pharmacists， and to provide reference for competency training and evaluation of clinical pharmacists. METHODS： By Delphi method， the first-level and second-level indicators were summarized and sorted out in three dimensions as research ability， professional ability and comprehensive ability that clinical pharmacists should possess. The second-level indicators were designed as questionnaire items， so as to consult their importance according to Likert 5 grade scoring method. During Jun.-Oct. 2017， 35 experts were selected for the first round of questionnaire consultation， and then the corresponding items were deleted， merged and added. Then the second round of questionnaire consultation was conducted. SPSS 20.0 software was used to input the data of the questionnaire and establish the database， and the experts’ enthusiasm degree， the  authority degree and opinion coordination degree were analyzed statistically. RESULTS： The positive coefficients of expert consultation in the first and second rounds of questionnaire consultation were 100％ and 92.9％； the authority degrees of experts were 0.878 6 and 0.901 9； the coordination coefficients of experts were 0.298 and 0.681， respectively. The evaluation standard for core competency of clinical pharmacists was established finally， involving 16 first-level indicators and 41 second-level indicators. The dimension of research ability contained 5 first-level indexes and 8 second-level indexes （3 “extremely important” indexes in latter ones）； the dimension of professional ability contained 5 first-level indexes and 21 second-level indexes （9 “extremely important” indexes in latter ones）； the dimension of comprehensive ability included 6 first-level indexes and 12 second-level indexes （4 “extremely important” indexes in latter ones）. CONCLUSIONS： The most important core competence of clinical pharmacists is professional competence， and the most important responsibility orientation and work assessment focus is to participate in clinical treatment of patients. Clinical pharmacists should pay attention to communication with medical staff and patients， and establish the concept of lifelong learning. The experts in this consultation and research are highly motivated and authoritative， and have good coordination of opinions. The core competence evaluation criteria can provide a basis for the training and evaluation of clinical pharmacists.

OBJECTIVE： To provide reference for the formulation of Chinese pharmacy accreditation criteria. METHODS： By literature method， the evolution of American Association of Colleges of Pharmacy （AACP） membership criteria were described， and the development of Chinese pharmacy accreditation criteria were also described. RESULTS & CONCLUSIONS： The membership criteria of AACP are characterized by attaching importance to investigation and research， highlighting goal orientation， keeping pace with the times， and strengthening process supervision. The pharmacy accreditation criteria in China was mainly promoted by the competent education department from top to bottom， which has the characteristics of government dominance， decision-making authority and caution. Compared with the American pharmacy accreditation criteria， there were some problems in our country， such as slow response to professional changes， poor flexibility of system and insufficient reflection of overall professional development. Although there is no real similar organization in China， the development of AAPA membership criteria can be used for reference in China， such as the close relationship between pharmacy industry associations and accreditation organizations， strengthening the construction of pharmaceutical accreditation organizations to maintain their independence and specialty， pharmacy standards dynamic adjustment， etc.

Objective To investigate the expression of sialic acid-binding immunoglobulin-like-lectin-1 (Siglec-1)in the peripheral blood mononuclear cell (PBMC) of patients with autoimmune thyroiditis ( AIT) and its relationship with AIT. To explore the moduratory role of activated Siglec-1 on the differentiation of T cells and the promotion of in flammation after PBMC culture. Methods The peripheral whole blood and serum samples were collected from 30 AIT patients with normal thyroid function and 30 sex-and age-matched controls. The expression of sSiglec-1 in serum was detected by ELISA. The expression of Siglec-1 in PBMC was detected by RT-PCR and WB. The expression of Siglec-1 in CD14+ monocytes and the proportion of Th1 and Th17 cells in each group were detected by flow cytometry. The PBMC in AIT or control was stimulated with NaI in the presence or absence of LPS for 72 h. The expression of Siglec-1 in CD14+ monocytes and the proportion of Th1 and Th17 cells were detected by flow cytometry. Results sSiglec-1 in serum, Siglec-1 mRNA, and Siglec-1 protein in AIT patients'PBMC were higher than those in control group ( P＜0. 01). The expression of Siglec-1 in CD14+ monocytes by flow cytometry and differentiation of Th1 and Th17 cells were significantly higher than that in control group ( both P＜0. 01). The expression of Siglec-1 in control and AIT patients was up-regulated by 5×10-5 mmol/L to 1×10-2 mmol/L stimulated with NaI in the presence or absence of LPS for 72 h (P＜0.01), but the differentiation of Th1 and Th17 cells was up-regulated only in patients (P＜0.01), and in a dose-dependent manner. Conclusion Elevated Siglec-1 expression in PBMCs and monocytes can potentially serve as a biomarker for AIT. Iodine may affect Th1 and Th17 cell differentiation by activating Siglec-1 to adjust the AIT immune response.

Objective: To investigate the relationship between the erythrocyte membrane protein gene mutations and the clinical severity of hereditary spherocytosis (HS). Methods: Targeted sequencings were performed on 25 HS patients, correlation between HS mutations and patients’ clinical characteristics were evaluated. Results: A total of 25 HS patients were enrolled, including 13 males and 12 females with median age of 20 (4-55) years, including 9 compensatory hemolysis patients, 9 patients with mild anemia, 3 patients with moderate anemia and 4 patients with severe anemia. Of them, 18 patients (72%) harbored HS-related mutations, including ANK1 mutation in 6 cases, SLC4A1 mutation in 6 cases, SPTB mutation in 5 cases and 1 case with EPB41 mutation. Seven patients (28%) didn’t carry common HS mutations. SPTB and SLC4A1 mutations mainly affected male patients. There was no significant difference between the age of diagnosis (P=0.130) and HGB level (P=0.585) in patients with HS mutation and those without mutation, however, the EMA binding fluorescence intensity (P=0.015), AGLT50 (P=0.032) and EOF minimal hemolytic concentration (P=0.027) were significantly different in these two groups of HS patients. Conclusion To screen erythrocyte membrane protein coding gene mutations could favor the diagnosis of HS, and patients without mutations have mild clinical phenotype.

Objective To systematically analyze the relevant scientific literature on the effect of nasopharyngeal carcinoma radiotherapy on thy?roid function and to elucidate the current research status in this field. Methods We searched the relevant literature published over a recent de?cade using the PubMed database,and parameters such as the number of published articles and high?frequency keywords were counted. Cluster analysis of the high?frequency keywords was performed using SPSS software. Results We identified 2928 references and 11 high?frequency key?words. The clustering analysis results identified five main aspects. Conclusion In recently published articles on the effect of nasopharyngeal carci?noma radiotherapy on thyroid function,the high?frequency keywords were clustered mainly in the following five categories:nasopharyngeal carcino?ma radiotherapy,complications of nasopharyngeal neoplasms and etiology of hypothyroidism,radiation dose and side effects,effect of radiation ther?apy on thyroid functional,nasopharyngeal neoplasm pathology,and secondary carcinoma.

Background:1 α,25-dihydroxyvitamin D3 [1,25 (OH) 2 D3],the active form of vitamin D,is reported in some studies having antifibrotic potential in liver fibrosis,however,its mechanism is not fully clarified.MicroRNAs (miRNAs) have recently been shown could regulate the proliferation and activation of hepatic stellate cells (HSCs),and are involved in the promotion or inhibition of liver fibrosis.Aims:To explore whether the inhibiting effect of 1,25 (OH) 2 D3 on activation of HSCs is by regulating miRNAs expression.Methods:Literature review and qPCR method were used to screen out the differentially expressed miRNAs between transforming growth factor-β1 (TGF-β1)-stimulated (activated) HSCs and the inactivated HSCs.Then the HSCs were co-cultured with TGF-β1 and the mimic of differentially expressed miRNA,the negative control mimic,1,25(OH)2D3 and DMSO,respectively,and the cell viability and apoptosis were determined by CCK-8 assay and flow cytometry.Results:Expression of miR-146a was down-regulated in activated HSCs (P ＜ 0.05).Compared with HSCs in DMSO group,the expression of miR-146a was significantly up-regulated in HSCs treated with 1,25 (OH) 2 D3;meanwhile,the cell viability was decreased and the apoptosis was increased (P all ＜ 0.05).In HSCs transfected with miR-146a mimic,the expression of miR-146a was up-regulated,the cell viability was decreased,and the apoptosis was increased similarly with HSCs in 1,25 (OH)2D3 group (P all ＜ 0.05).Conclusions:Regulation of miR-146a expression might be one of the important mechanisms of 1,25 (OH) 2 D3 in inhibiting TGF-β1-stimulated HSC activation and inducing apoptosis in HSCs.