Objective:To establish a reference interval for serum iodine of pregnant women with normal thyroid function and to analyze the relationship between serum iodine and thyroid disease risk.Methods:From July 2022 to October 2023, using cross-sectional survey method, pregnant women aged 18 to 48 years old who had lived in iodine-deficient areas in the six provinces of China (Shanxi Province, Fujian Province, Yunnan Province, Xinjiang Uygur Autonomous Region, Zhejiang Province, and Anhui Province) for more than six months were selected as the survey subjects. Blood samples were collected, serum iodine was tested, and the percentile method was used to establish a reference interval for serum iodine of pregnant women with normal thyroid function. Meanwhile, serum levels of free thyroxine, thyroid stimulating hormone, thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPOAb) were tested, and logistic regression was used to analyze the relationship between serum iodine and thyroid disease risk.Results:A total of 1 409 pregnant women from 6 provinces were investigated, including 1 087 with normal thyroid function and 322 with abnormal thyroid function. The median serum iodine level of pregnant women with normal thyroid function was 79.74 μg/L, and the preliminary reference interval for serum iodine was 47.57 - 128.96 μg/L. When serum iodine levels were lower (< 47.57 μg/L), pregnant women had a significantly increased risk of developing TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis ( OR = 4.44, 2.91, 3.41, 41.67, 23.43, P < 0.05). When serum iodine levels were high (> 128.96 μg/L), pregnant women had a significantly increased risk of developing hyperthyroidism ( OR = 9.91, P = 0.001). Conclusions:The reference interval for serum iodine of pregnant women with normal thyroid function is successfully established. Low serum iodine levels are associated with an increased risk of TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis, while high serum iodine levels are associated with an increased risk of hyperthyroidism.

Objective:To establish a reference interval for serum iodine of pregnant women with normal thyroid function and to analyze the relationship between serum iodine and thyroid disease risk.Methods:From July 2022 to October 2023, using cross-sectional survey method, pregnant women aged 18 to 48 years old who had lived in iodine-deficient areas in the six provinces of China (Shanxi Province, Fujian Province, Yunnan Province, Xinjiang Uygur Autonomous Region, Zhejiang Province, and Anhui Province) for more than six months were selected as the survey subjects. Blood samples were collected, serum iodine was tested, and the percentile method was used to establish a reference interval for serum iodine of pregnant women with normal thyroid function. Meanwhile, serum levels of free thyroxine, thyroid stimulating hormone, thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPOAb) were tested, and logistic regression was used to analyze the relationship between serum iodine and thyroid disease risk.Results:A total of 1 409 pregnant women from 6 provinces were investigated, including 1 087 with normal thyroid function and 322 with abnormal thyroid function. The median serum iodine level of pregnant women with normal thyroid function was 79.74 μg/L, and the preliminary reference interval for serum iodine was 47.57 - 128.96 μg/L. When serum iodine levels were lower (< 47.57 μg/L), pregnant women had a significantly increased risk of developing TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis ( OR = 4.44, 2.91, 3.41, 41.67, 23.43, P < 0.05). When serum iodine levels were high (> 128.96 μg/L), pregnant women had a significantly increased risk of developing hyperthyroidism ( OR = 9.91, P = 0.001). Conclusions:The reference interval for serum iodine of pregnant women with normal thyroid function is successfully established. Low serum iodine levels are associated with an increased risk of TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis, while high serum iodine levels are associated with an increased risk of hyperthyroidism.

Objective:To identify early predictors of factors influencing the efficacy of infliximab (IFX) treatment in patients with Crohn's disease (CD) .Methods:This study is a nested case-control study, including CD patients treated with IFX at the Second Affiliated Hospital of Soochow University from November 2015 to April 2021 and at the First Affiliated Hospital of Nanjing Medical University from November 2015 to December 2022. All the patients were followed up until June 2023 and categorized into IFX non-response and treatment-effective groups based on changes in clinical symptoms and endoscopic image during the follow-up. Laboratory data of inflammatory markers, post-induction trough IFX concentration and antibody levels in both groups were retrospectively collected and compared. Logistic regression models were employed to identify potential factors associated with the risk of IFX non-responsiveness. Machine learning using random forest analysis was utilized to quantitatively assess the predictive features for IFX treatment efficacy and ROC curves was used to evaluate the model's accuracy.Results:This study included 147 CD patients undergoing IFX treatment, with 58 from the Second Affiliated Hospital of Soochow University and 89 from the First Affiliated Hospital of Nanjing Medical University. Among them, 38 were classified as the IFX non-response group, and 109 as the effective group. Patients in the IFX non-response group had lower trough concentration ( P < 0.001), higher antibody levels ( P < 0.001), and a less pronounced reduction in ESR during the induction therapy ( P < 0.001). Univariate and multi-variate Logistic regression models demonstrated that IFX trough concentration and the ratio of ESR before and after induction therapy was associated with the risk of non-responsiveness. After the induction period, for each unit increase in IFX trough concentration (1 μg/ml), the risk of IFX non-response decreased by 23% ( RR = 0.77, 95% CI = 0.68-0.89), while each doubling of the ESR ratio after induction was associated with a 1.43-fold increase in the risk of non-response ( RR = 2.43, 95% CI = 1.48-4.00). Random forest machine learning analysis revealed that IFX trough concentration below 1.5 μg/ml could predict IFX non-response, with area under the ROC curve was 0.722. Conclusion:Lower post-induction IFX trough concentrations is predictive of IFX non-response, while a lack of significant decrease in ESR during the induction phase is also significantly associated with IFX non-response.

Objective To explore the effect of oral neuromuscular training combined with intermittent theta burst stimulation(iTBS)on dysphagia of nasopharyngeal carcinoma patients after chemoradiotherapy.Methods Seventy-six nasopharyngeal carcinoma patients with dysphagia who received chemoradiotherapy in The Second Affiliated Hospital of Air Force Medical University from March 2021 to March 2022 were enrolled and divided into two groups by random number table methods.Control group received conventional swallowing training,and observation group received oral neuromuscular training combined with iTBS.The swallowing function was assessed by video fluoroscopic swallowing study(VFSS)and Rosenbek penetration aspiration scale(PAS)at the baseline and after treatment.The quality of life and treatment effect were compared between the two groups.Results After intervention,the PAS score was decreased and the Swallowing Quality-of-Life Questionnaire(SWAL-QOL)score was increased in both groups(P＜0.05),with significant differences between the two groups(P＜0.05).The treatment efficacy of dysphagia in the observation group was significantly higher than that in the control group(86.84%vs 44.74%,P＜0.05).Conclusion Oral neuromuscular training combined with iTBS can effectively ameliorate dysphagia and improve the quality of life of patients with nasopharyngeal carcinoma after chemoradiotherapy.

Objective:To identify early predictors of factors influencing the efficacy of infliximab (IFX) treatment in patients with Crohn's disease (CD) .Methods:This study is a nested case-control study, including CD patients treated with IFX at the Second Affiliated Hospital of Soochow University from November 2015 to April 2021 and at the First Affiliated Hospital of Nanjing Medical University from November 2015 to December 2022. All the patients were followed up until June 2023 and categorized into IFX non-response and treatment-effective groups based on changes in clinical symptoms and endoscopic image during the follow-up. Laboratory data of inflammatory markers, post-induction trough IFX concentration and antibody levels in both groups were retrospectively collected and compared. Logistic regression models were employed to identify potential factors associated with the risk of IFX non-responsiveness. Machine learning using random forest analysis was utilized to quantitatively assess the predictive features for IFX treatment efficacy and ROC curves was used to evaluate the model's accuracy.Results:This study included 147 CD patients undergoing IFX treatment, with 58 from the Second Affiliated Hospital of Soochow University and 89 from the First Affiliated Hospital of Nanjing Medical University. Among them, 38 were classified as the IFX non-response group, and 109 as the effective group. Patients in the IFX non-response group had lower trough concentration ( P < 0.001), higher antibody levels ( P < 0.001), and a less pronounced reduction in ESR during the induction therapy ( P < 0.001). Univariate and multi-variate Logistic regression models demonstrated that IFX trough concentration and the ratio of ESR before and after induction therapy was associated with the risk of non-responsiveness. After the induction period, for each unit increase in IFX trough concentration (1 μg/ml), the risk of IFX non-response decreased by 23% ( RR = 0.77, 95% CI = 0.68-0.89), while each doubling of the ESR ratio after induction was associated with a 1.43-fold increase in the risk of non-response ( RR = 2.43, 95% CI = 1.48-4.00). Random forest machine learning analysis revealed that IFX trough concentration below 1.5 μg/ml could predict IFX non-response, with area under the ROC curve was 0.722. Conclusion:Lower post-induction IFX trough concentrations is predictive of IFX non-response, while a lack of significant decrease in ESR during the induction phase is also significantly associated with IFX non-response.

Objective:To analyze the functional connectivity (FC) characteristics of sensory motor network (SMN) in patients with bipolar disorder type Ⅰ (BD-Ⅰ) by independent component analysis (ICA), and explore the correlation between abnormal SMN and clinical symptoms.Methods:Eighteen patients with BD-Ⅰ (BD-Ⅰ group) and 20 matched normal controls (HC group) were included.Both groups received resting state fMRI (rs-fMRI) scanning.Based on ICA-fMRI data, one-sample t-test and two-sample t-test were used to analyze the components of SMN and to explore abnormal brain regions between the two groups.Functional network analysis (FNC) was also used to explore the functional connectivity between SMN and other brain networks.Pearson correlation analysis were conducted by SPSS 17.0 to measure the potential associations between intra-and inter-network functional connectivity and age, education, score of Bech-Rafaelsen mania rating scale (BRMS), score of positive and negative syndrome scale (PANSS) and other indicators. Results:In BD-Ⅰ group, the functional connection in the right paracentral lobule (MIN: x=8, y=-32, z=68, t=4.86, P<0.001) and the right postcentral gyrus (MIN: x=41, y=-26, z=53, t=3.33, P<0.001) in SMN were higher than those in HC group.Compared with HC group, the connectivity value in patients with BD-Ⅰ increased between SMN-DAN (0.247±0.073, -0.078±0.080, t=-2.974, P<0.01, FDR adjusted), while the connectivity value decreased between SMN-DMN(-0.037±0.054, 0.272±0.067, t=3.520, P<0.01, FDR adjusted) and between SMN-rFPN(-0.034±0.055, 0.231±0.070, t=2.939, P<0.01, FDR adjusted). Conclusion:The sensorimotor network of patients with BD-Ⅰ has abnormal functional connections within and between networks, and FC values in some networks are positively correlated with manic symptoms, which may be part of the neural mechanisms of patients with BD-Ⅰ.

Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory disease, and its treatment includes traditional medicines and biological agents. Therapeutic drug monitoring is an important tool to optimize the treatment of biological agents. Therapeutic drug monitoring of tumor necrosis factor inhibitors has been used to guide the clinical decision ⁃ making. However, the value of therapeutic drug monitoring of novel biological agents (vedolizumab and ustekinumab) in IBD remains unclear. This article summarized the pharmacokinetics, drug concentration and treatment outcome, optimization of the novel biological agents in the treatment of IBD.

Objective:To systematically evaluate the diagnostic value of fine-needle aspiration washout fluid for measuring thyroglobulin (FNA-Tg) and fine-needle aspiration cytology (FNAC) in cervical lymph node metastasis of papillary thyroid carcinoma.Methods:Chinese Journal Full-Text Database, Wanfang Database, VIP Chinese Science and Technology Journal Database and other databases from January 2016 to December 2020 were retrieved. And then diagnostic trials from the databases regarding the comparison of FNA-Tg and FNAC in the diagnosis of papillary thyroid carcinoma with neck lymph node metastasis based on the histopathological diagnosis as the gold standard were included. The literatures were screened out according to the diagnostic test inclusion criteria recommended by the Cochrane Collaboration Screening and Diagnostic Test Methods Group; and then the quality of the included literatures was evaluated and feature information was extracted. Review Manager 5.0 and MetaDiSc software were used to conduct Meta analysis, and a summary receiver operating characteristic (SROC) curve of FNAC and FNA-Tg in the diagnosis of lymph node metastasis was drawn to calculate the area under the curve and to judge the diagnostic efficacy.Results:A total of 19 articles and 2 792 cervical lymph nodes were finally included. The sensitivity of FNAC and FNA-Tg in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma was 0.80 (95% CI 0.78-0.81) and 0.92 (95% CI 0.91-0.93), respectively; the specificity was 0.93 (95% CI 0.92-0.95) and 0.91(95% CI 0.89-0.93); the diagnostic odds ratio was 51.55 (95% CI 38.61-68.81) and 110.03 (95% CI 82.18-147.32), respectively; the areas under the SROC curve was 0.900 and 0.968, respectively. Conclusions:The accuracy of FNA-Tg in the diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma is higher than that of FNAC. FNA-Tg can be used as an important diagnosis supplement to FNAC and it can be widely used in clinical practice.

This paper introduced a liver normothermic machine perfusion repair and assessment system. This system consists of a liver normothermic machine perfusion device, a fluorescence imaging system and a tissue oxygen detector. The normothermic machine perfusion device can continuously perfuse the donor liver and monitor and control the perfusion parameters in real time. The fluorescence imaging system can detect the indocyanine green metabolized by the liver to evaluate the microcirculation and the metabolism function of hepatocytes. The tissue oxygen detector can monitor the change of oxygen partial pressure of liver tissue in real time to evaluate the state of cell oxygen consumption.
Humans ; Liver ; Liver Transplantation ; Living Donors ; Organ Preservation ; Perfusion

To investigate the neuroprotective effect and possible mechanism of masitinib on cerebral ischemia-reperfusion injury in rats, healthy adult male Sprague-Dawley rats were divided into sham group (n = 12), model group (n = 12), masitinib low dosage group (n = 12), masitinib middle dosage group (n = 12), and masitinib high dosage group (n = 12). All rats was subjected to middle cerebral artery occlusion (MCAO) for two hours and reperfusion except sham group, and received treatment twice per day for 7 days once reperfusion started.Neurological score, infarct volume, and brain water content were detected; some autophagic markers, apoptotic and inflammatory cytokines were evaluated by Western blot and PCR after 7 d of reperfusion. Treatment with masitinib significantly ameliorated neurologic deficit, infarct volume and brain water after I/R injury. Masitinib also decreased the ratio of LC3II/I and the expression of Beclin-1 and increased the expression of p62 in the brain tissues of rats with I/R injury.Furthermore, it could inhibit apoptosis-related proteins and NF-κB expression. Masitinib could relieve the cerebral ischemia-reperfusion injury in rats through inhibiting autophagy and apoptosis.