Objective To explore the correlation between thyroid hormone (TH) sensitivity and metabolic dysfunction-associated steatotic liver disease (MASLD) in euthyroid patients. Methods The euthyroid patients hospitalized in the Department of Endocrinology at Zhongshan Hospital, Fudan University, from January 2016 to December 2020 were enrolled. All patients were evaluated for free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH). The FT3/FT4 ratio, thyroid-stimulating hormone index (TSHI), FT3 feedback quantile index (TFQIFT3), and FT4 feedback quantile index (TFIQFT4) were calculated. Hepatic controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were assessed by FibroScan. Results A total of 4 869 participants were enrolled, 3 485 (71.58%) were diagnosed with MASLD. Compared with non-MASLD group of patients, MASLD group had significantly higher levels of serum FT3 and thyroid sensitivity-related parameters, including FT3/FT4, TSHI, TFQIFT3, and TFIQFT4 (P＜0.05). After multivariate adjustment for potential confounders, serum FT3, FT3/FT4, TFQIFT4, TFQIFT3, and TSHI remained positively correlated with the risk of MASLD (P＜0.05). Further analysis revealed that, after adjustment for confounders, FT3, FT3/FT4, TFQIFT4, TFQIFT3, and TSHI were positively correlated with CAP, and TFQIFT4, TFQIFT3, and TSHI were also positively correlated with LSM (P＜0.05). Conclusions Reduced thyroid hormone sensitivity are independently associated with MASLD. Moreover, higher levels of FT3 and decreased thyroid hormone sensitivity are correlated with the progression of MASLD.

BACKGROUND: Allogeneic blood transfusion in humans of the same blood type has been implemented, but studies regarding swine blood type and how to perform allogeneic blood transfusion have been rarely reported. OBJECTIVE: To investigate the feasibility of preoperative autologous blood donation using the leap-frog technique for cardiopulmonary bypass surgery in a swine model.METHODS: Sixteen domestic swine were randomly divided into two groups: autologous blood donation and allogeneic blood transfusion. Another four swine were used as blood donors. Two groups of swine underwent cardiopulmonary bypass surgery. The autologous blood donation group received self-transfusion reserved before surgery while the allogeneic blood transfusion group received the same amount of allogeneic blood. Hemoglobin (Hb) concentration and hematocrit (Hct) level prior to and after donation in the autologous blood donation group was recorded. Hb concentration in the two groups was recorded prior to, during, immediately after, and 1 day after the surgery. RESULTS AND CONCLUSION: The total blood volume of each experimental swine was (2500±428) mL. For the autologous blood donation group, the predicted blood volume of the first donation was (501±86) mL and the actual blood volume was (493±93) mL; in the second donation, the predicted blood volume was (750±128) mL and the actual blood volume was (719±98) mL. There was a significant difference in Hb concentration and Hct level between prior to and after donation in the autologous blood donation group (P < 0.01). Hb concentration at 1 day after the surgery was significantly higher in the autologous blood donation group than in the allogeneic blood transfusion group (P < 0.01), while no significant difference in Hb concentration existed between these two groups prior to, during, and immediately after the surgery (P > 0.05). Compared with prior to surgery, Hb concentration in each group was significantly lower at 1 day after the surgery (P < 0.01). The autologous blood donation group exhibited significantly higher survival rate of swine than the allogeneic blood transfusion group (P < 0.01). These findings indicate that compared with allogeneic blood transfusion, preoperative autologous blood donation using the leap-frog technique appears to be a safe, effective method with a high survival rate for cardiopulmonary bypass surgery.

Objective To define urban community public health service programs by classification so as to better the mechanism of compensation for community health services. Mothods A preliminary classification of community health service programs was made in accordance with public product theories, which was then further improved by means of interviews with focal groups. Results At present a total of 99 community health service programs were offered in the cities under investigation, of which 45 were public health service programs, 21 para-public health service programs, and 33 private health service programs. Conclusion On condition that basic public health service is guaranteed, the government can make corresponding adjustments in compensation for public and para-public health service programs in light of economic development.

Objective To estimate the cost of community medical aid programs for the urban poor in Shenyang, Chengdu, Xining and Yinchuan so as to provide the primary basis for improving the compensation mechanisms for such programs. Methods A survey was made on the cost consumption of six major categories in the course of health service delivery and the amount of various community health services actually delivered by the pilot community health service institutions in 2003. The cost of each service program was estimated and then the cost of medical aid programs for the urban poor was estimated. Results The per capita cost of the medical aid programs for the poor in the cities was less than 5 yuan and the total cost of the medical aid programs accounted mostly for 0.05‰ or so of the financial expenditure of each of the cities. Conclusion The government ought to make rational compensation for community medical aid programs, the cost of which is low. Setting up community health service based mechanisms of medical aid for the poor conforms to the actual condition of our country.