Objective:To investigate the association between metabolic dysfunction-associated steatotic liver disease(MASLD)and the risk of adverse pregnancy outcomes,and to analyze the impact of the type and severity of cardiometabolic risk factor(CMRF)abnormalities on this association.Methods:A retrospective cohort study was conducted among primiparous women with singleton pregnancies who had registered at Beijing Friendship Hospital from March 10,2020,to December 31,2022.A total of 2 623 women were included.Basic characteristics and delivery outcomes were documented,liver ultrasound and relevant prenatal examinations were performed,and adverse pregnancy outcomes were diagnosed.Modi-fied Poisson regression models were used to analyze the association between MASLD and adverse pregnan-cy outcomes.The relationship between the type or severity of CMRF abnormalities in MASLD and the risk of adverse pregnancy outcomes was also explored.Results:After adjusting for confounding factors including age,gestational weight gain,and education level,MASLD was associated with an increased risk of cesarean section(RR=1.531,95％CI:1.304-1.799,P＜0.001),gestational diabetes melli-tus(GDM;RR=2.409,95％CI:1.948-2.979,P＜0.001),pregnancy-associated hypertension(PAH;RR=3.062,95％CI:2.069-4.533,P＜0.001),preterm birth(RR=2.145,95％CI:1.342-3.429,P=0.001),and large for gestational age(LGA;2.224,95％CI:1.599-3.095,P＜0.001).However,no significant associations were found for small for gestational age or postpartum hemorrhage.After adjusting for other CMRF abnormalities,the risk of adverse pregnancy outcomes varied among MASLD pregnant women with different CMRF abnormalities:the body mass index abnormal group had higher risks of cesarean section,GDM,PAH,preterm birth,and LGA;the glucose abnormal group had an increased risk of GDM;the blood pressure abnormal group had a higher risk of PAH;the high density lipoprotein cholesterol abnormal group had higher risks of cesarean section,GDM,and PAH;and the tri-glyceride abnormal group was associated with higher risks of GDM and preterm birth.Additional,as the severity of CMRF abnormalities increased,the risks of cesarean section(RR=1.199,95％CI:1.112-1.292,P＜0.001),GDM(RR=1.478,95％CI:1.345-1.624,P＜0.001),PAH(RR=1.626,95％CI:1.367-1.934,P＜0.001),preterm birth(RR=1.384,95％CI:1.120-1.710,P=0.003),and LGA(RR=1.422,95％CI:1.224-1.650,P＜0.001)continued to rise.Conclusion:MASLD during pregnancy is associated with an increased risk of multiple adverse pregnancy outcomes,and the type and severity of CMRF abnormalities significantly influence this association.These results suggest that attention should be paid to the specific CMRF abnormalities when diagnosed MASLD,as this may help to facilitate targeted interventions and reduce the risk of adverse pregnancy outcomes.

Objective:To investigate the association between metabolic dysfunction-associated steatotic liver disease(MASLD)and the risk of adverse pregnancy outcomes,and to analyze the impact of the type and severity of cardiometabolic risk factor(CMRF)abnormalities on this association.Methods:A retrospective cohort study was conducted among primiparous women with singleton pregnancies who had registered at Beijing Friendship Hospital from March 10,2020,to December 31,2022.A total of 2 623 women were included.Basic characteristics and delivery outcomes were documented,liver ultrasound and relevant prenatal examinations were performed,and adverse pregnancy outcomes were diagnosed.Modi-fied Poisson regression models were used to analyze the association between MASLD and adverse pregnan-cy outcomes.The relationship between the type or severity of CMRF abnormalities in MASLD and the risk of adverse pregnancy outcomes was also explored.Results:After adjusting for confounding factors including age,gestational weight gain,and education level,MASLD was associated with an increased risk of cesarean section(RR=1.531,95％CI:1.304-1.799,P＜0.001),gestational diabetes melli-tus(GDM;RR=2.409,95％CI:1.948-2.979,P＜0.001),pregnancy-associated hypertension(PAH;RR=3.062,95％CI:2.069-4.533,P＜0.001),preterm birth(RR=2.145,95％CI:1.342-3.429,P=0.001),and large for gestational age(LGA;2.224,95％CI:1.599-3.095,P＜0.001).However,no significant associations were found for small for gestational age or postpartum hemorrhage.After adjusting for other CMRF abnormalities,the risk of adverse pregnancy outcomes varied among MASLD pregnant women with different CMRF abnormalities:the body mass index abnormal group had higher risks of cesarean section,GDM,PAH,preterm birth,and LGA;the glucose abnormal group had an increased risk of GDM;the blood pressure abnormal group had a higher risk of PAH;the high density lipoprotein cholesterol abnormal group had higher risks of cesarean section,GDM,and PAH;and the tri-glyceride abnormal group was associated with higher risks of GDM and preterm birth.Additional,as the severity of CMRF abnormalities increased,the risks of cesarean section(RR=1.199,95％CI:1.112-1.292,P＜0.001),GDM(RR=1.478,95％CI:1.345-1.624,P＜0.001),PAH(RR=1.626,95％CI:1.367-1.934,P＜0.001),preterm birth(RR=1.384,95％CI:1.120-1.710,P=0.003),and LGA(RR=1.422,95％CI:1.224-1.650,P＜0.001)continued to rise.Conclusion:MASLD during pregnancy is associated with an increased risk of multiple adverse pregnancy outcomes,and the type and severity of CMRF abnormalities significantly influence this association.These results suggest that attention should be paid to the specific CMRF abnormalities when diagnosed MASLD,as this may help to facilitate targeted interventions and reduce the risk of adverse pregnancy outcomes.

To analyze the disease burden of Alzheimer′s disease (AD) in China from 1990 to 2021 and its trend of change, providing evidence for targeted interventions to reduce the burden of AD. A descriptive analysis of AD and its main risk factors among males and females of different ages in China from 1990 to 2021 was conducted using the Global Burden of Disease (GBD) 2021 database. The evaluation indicators were incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs). The risk factors included high body mass index (BMI), high fasting plasma glucose, and smoking. The results showed that in 2021, the number of AD incidence among the Chinese population was 2 914 112 (204.8/100 000), the number of prevalence was 16 990 827 (1 194.2/100 000), the number of DALYs was 10 072 477 (708.0/100 000), and the number of deaths was 491 773 (34.6/100 000), which increased by 242.7%, 249.1%, 208.2%, and 239.4% respectively compared with 1990. In 2021, the AD incidence rate (264.4/100 000), prevalence rate (1 558.9/100 000), DALYs rate (935.8/100 000), and mortality rate (47.3/100 000) were all higher in women than in men. All rates showed a clear age-dependent trend. In 2021, the DALYs attributable to smoking, high BMI, and high fasting plasma glucose in the AD population in China were 602 501.1 (42.3/100 000), 466 728.7 (32.8/100 000), and 1 204 039.4 (84.6/100 000), respectively, with death tolls of 24 897.3 (1.7/100 000), 20 856.3 (1.5/100 000), and 58 838.2 (4.1/100 000). The proportion of DALYs attributable to high BMI showed an upward trend during 1990-2021, while the proportion of DALYs attributable to smoking showed a gradual decrease. The difference in the attributable risk factors between the genders was significant. In 2021, the highest risk among men was attributed to smoking, with DALYs rate and mortality rate of 68.3/100 000 and 2.7/100 000, respectively. In contrast, the highest risk among women was attributed to high fasting blood sugar, with DALYs rate and mortality rate of 111.1/100 000 and 5.6/100 000, respectively. In conclusion,the disease burden of AD is still increasing, and targeted interventions should be taken for both males and females to reduce the burden of AD by reducing unhealthy lifestyles.

To analyze the disease burden of Alzheimer′s disease (AD) in China from 1990 to 2021 and its trend of change, providing evidence for targeted interventions to reduce the burden of AD. A descriptive analysis of AD and its main risk factors among males and females of different ages in China from 1990 to 2021 was conducted using the Global Burden of Disease (GBD) 2021 database. The evaluation indicators were incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs). The risk factors included high body mass index (BMI), high fasting plasma glucose, and smoking. The results showed that in 2021, the number of AD incidence among the Chinese population was 2 914 112 (204.8/100 000), the number of prevalence was 16 990 827 (1 194.2/100 000), the number of DALYs was 10 072 477 (708.0/100 000), and the number of deaths was 491 773 (34.6/100 000), which increased by 242.7%, 249.1%, 208.2%, and 239.4% respectively compared with 1990. In 2021, the AD incidence rate (264.4/100 000), prevalence rate (1 558.9/100 000), DALYs rate (935.8/100 000), and mortality rate (47.3/100 000) were all higher in women than in men. All rates showed a clear age-dependent trend. In 2021, the DALYs attributable to smoking, high BMI, and high fasting plasma glucose in the AD population in China were 602 501.1 (42.3/100 000), 466 728.7 (32.8/100 000), and 1 204 039.4 (84.6/100 000), respectively, with death tolls of 24 897.3 (1.7/100 000), 20 856.3 (1.5/100 000), and 58 838.2 (4.1/100 000). The proportion of DALYs attributable to high BMI showed an upward trend during 1990-2021, while the proportion of DALYs attributable to smoking showed a gradual decrease. The difference in the attributable risk factors between the genders was significant. In 2021, the highest risk among men was attributed to smoking, with DALYs rate and mortality rate of 68.3/100 000 and 2.7/100 000, respectively. In contrast, the highest risk among women was attributed to high fasting blood sugar, with DALYs rate and mortality rate of 111.1/100 000 and 5.6/100 000, respectively. In conclusion,the disease burden of AD is still increasing, and targeted interventions should be taken for both males and females to reduce the burden of AD by reducing unhealthy lifestyles.

Objective:To examine the value serum calcium and intact parathyroid hormone (iPTH) levels measured on the first day after total thyroidectomy on prediction for permanent hypoparathyroidism.Methods:Totally 546 patients with thyroid cancer and benign thyroid lesions who underwent total thyroidectomy at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from February 2008 to December 2018 were analyzed retrospectively. There were 158 males and 388 females aging (50.9±13.2) years (range: 19.0 to 79.2 years). Serum calcium and iPTH levels were collected before surgery, on the first day and 6 months after surgery. Logistic regression was used to analyze the correlation between each data and the occurrence of permanent hypoparathyroidism after surgery.The area under the receiver operating characteristic curve was used to evaluate the predictive power of iPTH for postoperative occurrence of permanent hypoparathyroidism.Results:Among the 546 cases of total thyroidectomy, 22 cases of permanent hypoparathyroidism occurred, with an incidence of 4.0% (22/546). Multivariate analysis showed that iPTH levels on the first day after total thyroidectomy ( OR=2.932, 95 %CI: 1.129 to 7.616, P=0.027) and serum calcium levels ( OR=2.584, 95 %CI: 1.017 to 6.567, P=0.046) were independent prognosis factors for postoperative permanent hypoparathyroidism. When the threshold value of iPTH at 24 hours after total thyroidectomy was 5.51 ng/L, the AUC was 0.956 (95 %CI: 0.936 to 0.972, P=0.000), sensitivity was 100%, specificity was 85.1%, positive predictive value was 22%, negative predictive value was 100%. When the threshold value of serum calcium at 24 hours after total thyroidectomy was 1.93 mmol/L, the AUC was 0.733 (95 %CI: 0.694 to 0.770, P=0.000), sensitivity was 63.6%, specificity was 78.1%, positive predictive value of 10.8% and negative predictive value of 98.1%. Conclusions:Serum iPTH and calcium levels on the first day after total thyroidectomy were related to the occurrence of permanent hypoparathyroidism postoperatively. The predictive value of iPTH level is higher than that of serum calcium level.

Objective:To examine the value serum calcium and intact parathyroid hormone (iPTH) levels measured on the first day after total thyroidectomy on prediction for permanent hypoparathyroidism.Methods:Totally 546 patients with thyroid cancer and benign thyroid lesions who underwent total thyroidectomy at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from February 2008 to December 2018 were analyzed retrospectively. There were 158 males and 388 females aging (50.9±13.2) years (range: 19.0 to 79.2 years). Serum calcium and iPTH levels were collected before surgery, on the first day and 6 months after surgery. Logistic regression was used to analyze the correlation between each data and the occurrence of permanent hypoparathyroidism after surgery.The area under the receiver operating characteristic curve was used to evaluate the predictive power of iPTH for postoperative occurrence of permanent hypoparathyroidism.Results:Among the 546 cases of total thyroidectomy, 22 cases of permanent hypoparathyroidism occurred, with an incidence of 4.0% (22/546). Multivariate analysis showed that iPTH levels on the first day after total thyroidectomy ( OR=2.932, 95 %CI: 1.129 to 7.616, P=0.027) and serum calcium levels ( OR=2.584, 95 %CI: 1.017 to 6.567, P=0.046) were independent prognosis factors for postoperative permanent hypoparathyroidism. When the threshold value of iPTH at 24 hours after total thyroidectomy was 5.51 ng/L, the AUC was 0.956 (95 %CI: 0.936 to 0.972, P=0.000), sensitivity was 100%, specificity was 85.1%, positive predictive value was 22%, negative predictive value was 100%. When the threshold value of serum calcium at 24 hours after total thyroidectomy was 1.93 mmol/L, the AUC was 0.733 (95 %CI: 0.694 to 0.770, P=0.000), sensitivity was 63.6%, specificity was 78.1%, positive predictive value of 10.8% and negative predictive value of 98.1%. Conclusions:Serum iPTH and calcium levels on the first day after total thyroidectomy were related to the occurrence of permanent hypoparathyroidism postoperatively. The predictive value of iPTH level is higher than that of serum calcium level.

OBJECTIVE: To explore the association between low flow rate and reperfusion injury during the process of preserving liver by cold machine perfusing perfluorochemical oxygen carder solution. METHODS: Forty-four male adult Wister rats were randomly divided into normal, control, experimental Ⅰ and experimental Ⅱ groups. In the normal group, the removed liver was performed isolated reperfusion guided by Clavien method. In the other 3 groups, the removed liver was infused through the portal vein by the 4-5 ℃ conserved perfluorochemical oxygen carder solution. The infused rate was controlled at 0.4, 0.2, 0.1 mL/(min·g) with 18 hours perfusion, After that, isolated reperfusion was performed. The activity of aspartate aminotransferase, alanine transaminase and endotheiin mass concentration of the effluent was detected at minutes 10, 30, and 60 after reperfusion. The histopathological changes of liver under light and election microscopy were also observed. RESULTS: The activity of aspartate aminotransferase, alanine transaminase and endothelin mass concentration had no remarkable differences between the experimental Ⅰ group and control group (P > 0.05). The differences between the experimental Ⅱ group and control group were remarkable (P < 0.05). The light and electron microscopy showed that the histopathological changes of liver in the control and experimental Ⅰ groups was lightener than experimental Ⅱ group. CONCLUSION: During the process of preserving liver by cold machine perfusion, the rate of 0.1 ml/(min·g) perfluorochemical oxygen carder solution increase the injury of hepatocyte and sinusoidal endothelial cells, which eventually result in severity of reperfusion injury.

Objective To investigate the effect of salvia miltiorrhiza (SM) on the expression of Bcl 2?Bax and hepatocyte apoptosis in hepatic preservation and reperfusion in a murine model.Methods The model of the preservation reperfusion of isolated rat liver was established. Bcl 2?Bax expression of the liver tissue and hepatocyte apoptosis were studied respectively by flow cytometry and in situ terminal deoxynucleotidyl transferase mediated dUTP FITC nick end labeling (TUNEL) technique. Results In SM treated group levels of Bcl 2 expression was significantly increased ( P