Objective To explore the correlation between the ratio of free triiodothyronine/free thyroxine(FT3/FT4)and the early-phase insulin secretion index(ΔI30/ΔG30)in type 2 diabetes mellitus(T2DM)patients with normal thyroid function.Methods 200 patients with T2DM with normal thyroid function in Hebei General Hospital from September 2019 to June 2021 were selected and divided into the Q1 group with FT3/FT4≤0.26(n=67),the Q2 group with 0.27≤FT3/FT4≤0.29(n=67),and the Q3 group with FT3/FT4≥0.30(n=66)according to the tertiles of the FT3/FT4.The general data,biochemical indicators and islet functions of the three groups were compared,and the relationship between the FT3/FT4 ratio and the ΔI30/ΔG30 as well as the islet β cell function was analyzed.Results The fasting insulin(FIns),2 h postprandial insulin(2 hIns),homeostatic model assessment of islet β cell(HOMA-β)and area under the curve of insulin(AUCI)in Q3 group were higher than those in Q1 and Q2 groups(P<0.05),2 h postprandial blood glucose(2 hPG)in Q3 group was lower than those in Q1 and Q2 groups(P<0.05).Systolic blood pressure in Q2 group was higher than those in Q1 group(P<0.05).Compared with Q1 group,diastolic blood pressure,body mass index(BMI),alanine aminotransferase(ALT),fasting C-peptide(FC-P),area under curve of C-P(AUCC),2 h postprandial C-peptide(2 hC-P)and ΔI30/ΔG30 in Q3 group were significantly higher(P<0.05),and HbA1c was significantly lower(P<0.05).Spearman correlation analysis showed that Δ I30/Δ G30,HOMA-β,AUCI,AUCC and HOMA-IR were positively correlated with BMI,ALT,FC-P,2 hC-P,FIns,2 hIns and FT3/FT4(P<0.05),it was negatively correlated with HbA1c and 2 hPG(P<0.05).Linear regression analysis showed that ΔI30/ΔG30,HOMA-β,AUCI and AUCC were the influencing factors of FT3/FT4 after adjusting for confounding factors.Conclusions ΔI30/ΔG30,HOMA-β,AUCI and AUCC are the influencing factors of FT3/FT4 in T2DM patients with normal thyroid function,suggesting that FT3/FT4 is higher in patients with better islet β cell secretion function.

Objective To investigate the predictive capacity of the Triglyceride-Glucose(TyG)index and the Triglyceride-Glucose-Body Mass Index(TyG-BMI)for the development of hyperuricemia(HUA)in a health examination population,and to identify suitable indicators as risk assessment tools for HUA.Methods This study ultimately included 12 004 participants from a health examination cohort.According to SUA levels,the partici-pants were categorized into a normal group(n=9 952)and a hyperuricemia(HUA)group(n=2 052).The TyG index and TyG-BMI index were calculated,and participants were further stratified into four groups(Q1—Q4)based on the quartiles of these indices.Binary logistic regression analysis was performed to assess the association between TyG,TyG-BMI,and HUA.The predictive value of TyG,TyG-BMI,and their combination for HUA was evaluated using Receiver Operating Characteristic(ROC)curves and the Area Under the Curve(AUC).Subgroup analyses were carried out by gender and age.Results The TyG and TyG-BMI indices were significantly elevated in the HUA group compared to the normal group.The prevalence of HUA was markedly higher in the TyG-Q4 and TyG-BMI-Q4 groups than in the other three corresponding quartile groups.Binary logistic regression analysis revealed a positive association between TyG,TyG-BMI levels,and the risk of HUA.The AUC values for predicting HUA using TyG,TyG-BMI,and their combination were 0.700,0.747,and 0.822,respectively.Specifically,for males,the AUC values were 0.641,0.674,and 0.709,respectively,whereas for females,they were 0.742,0.776,and 0.829,respectively.Among individuals younger than 60 years old,the AUC values were 0.716,0.759,and 0.835,respectively,while for those aged 60 years or older,the values were 0.614,0.645,and 0.731,respectively.Conclusions TyG and TyG-BMI are significantly associated with the risk of HUA.Specifically,TyG-BMI demon-strates superior predictive performance compared to TyG alone.Moreover,the combination of TyG and TyG-BMI further improves predictive accuracy,particularly among female and middle-aged or younger populations.

Objective To explore the correlation between the ratio of free triiodothyronine/free thyroxine(FT3/FT4)and the early-phase insulin secretion index(ΔI30/ΔG30)in type 2 diabetes mellitus(T2DM)patients with normal thyroid function.Methods 200 patients with T2DM with normal thyroid function in Hebei General Hospital from September 2019 to June 2021 were selected and divided into the Q1 group with FT3/FT4≤0.26(n=67),the Q2 group with 0.27≤FT3/FT4≤0.29(n=67),and the Q3 group with FT3/FT4≥0.30(n=66)according to the tertiles of the FT3/FT4.The general data,biochemical indicators and islet functions of the three groups were compared,and the relationship between the FT3/FT4 ratio and the ΔI30/ΔG30 as well as the islet β cell function was analyzed.Results The fasting insulin(FIns),2 h postprandial insulin(2 hIns),homeostatic model assessment of islet β cell(HOMA-β)and area under the curve of insulin(AUCI)in Q3 group were higher than those in Q1 and Q2 groups(P<0.05),2 h postprandial blood glucose(2 hPG)in Q3 group was lower than those in Q1 and Q2 groups(P<0.05).Systolic blood pressure in Q2 group was higher than those in Q1 group(P<0.05).Compared with Q1 group,diastolic blood pressure,body mass index(BMI),alanine aminotransferase(ALT),fasting C-peptide(FC-P),area under curve of C-P(AUCC),2 h postprandial C-peptide(2 hC-P)and ΔI30/ΔG30 in Q3 group were significantly higher(P<0.05),and HbA1c was significantly lower(P<0.05).Spearman correlation analysis showed that Δ I30/Δ G30,HOMA-β,AUCI,AUCC and HOMA-IR were positively correlated with BMI,ALT,FC-P,2 hC-P,FIns,2 hIns and FT3/FT4(P<0.05),it was negatively correlated with HbA1c and 2 hPG(P<0.05).Linear regression analysis showed that ΔI30/ΔG30,HOMA-β,AUCI and AUCC were the influencing factors of FT3/FT4 after adjusting for confounding factors.Conclusions ΔI30/ΔG30,HOMA-β,AUCI and AUCC are the influencing factors of FT3/FT4 in T2DM patients with normal thyroid function,suggesting that FT3/FT4 is higher in patients with better islet β cell secretion function.

Objective To investigate the predictive capacity of the Triglyceride-Glucose(TyG)index and the Triglyceride-Glucose-Body Mass Index(TyG-BMI)for the development of hyperuricemia(HUA)in a health examination population,and to identify suitable indicators as risk assessment tools for HUA.Methods This study ultimately included 12 004 participants from a health examination cohort.According to SUA levels,the partici-pants were categorized into a normal group(n=9 952)and a hyperuricemia(HUA)group(n=2 052).The TyG index and TyG-BMI index were calculated,and participants were further stratified into four groups(Q1—Q4)based on the quartiles of these indices.Binary logistic regression analysis was performed to assess the association between TyG,TyG-BMI,and HUA.The predictive value of TyG,TyG-BMI,and their combination for HUA was evaluated using Receiver Operating Characteristic(ROC)curves and the Area Under the Curve(AUC).Subgroup analyses were carried out by gender and age.Results The TyG and TyG-BMI indices were significantly elevated in the HUA group compared to the normal group.The prevalence of HUA was markedly higher in the TyG-Q4 and TyG-BMI-Q4 groups than in the other three corresponding quartile groups.Binary logistic regression analysis revealed a positive association between TyG,TyG-BMI levels,and the risk of HUA.The AUC values for predicting HUA using TyG,TyG-BMI,and their combination were 0.700,0.747,and 0.822,respectively.Specifically,for males,the AUC values were 0.641,0.674,and 0.709,respectively,whereas for females,they were 0.742,0.776,and 0.829,respectively.Among individuals younger than 60 years old,the AUC values were 0.716,0.759,and 0.835,respectively,while for those aged 60 years or older,the values were 0.614,0.645,and 0.731,respectively.Conclusions TyG and TyG-BMI are significantly associated with the risk of HUA.Specifically,TyG-BMI demon-strates superior predictive performance compared to TyG alone.Moreover,the combination of TyG and TyG-BMI further improves predictive accuracy,particularly among female and middle-aged or younger populations.

Objective:To compare the effects of different test meals on postprandial triglycerides and to optimize the standard meal composition and the blood sampling protocol for the oral fat tolerance test.Methods:This study is a prospective, open-label, randomized, cross-over trial. In March 2023, 36 volunteers were recruited in Hebei General Hospital. They underwent a health examination and oral glucose tolerance test. Twenty-six healthy volunteers(11 males and 15 females) were included in this study, with an average age of(39.08±4.56) years. Each volunteer received 75 g protein meal, 75 g fat meal, 700 kcal fixed-calorie high-fat mixed meal, and a high-fat mixed meal with energy adjusted based on 10 kcal/kg body weight. A one-week washout period of regular diet was applied before each trial. Blood was collected at fasting status and 1, 2, 3, 4, 5, and 6 hours after a meal to detect serum triglycerides, total cholesterol, low density lipoprotein-cholesterol(LDL-C), high density lipoprotein-cholesterol(HDL-C), glucose, and insulin. The variations of postprandial metabolic indicators over time following the consumption of different test meals were analyzed. The disparities in postprandial metabolic responses between the two types of mixed meals were compared.Results:The protein meal, fat meal, fixed-calorie high-fat mixed meal, and adjusted-calorie high-fat mixed meal resulted in postprandial triglyceride increases of 22.45%, 115.40%, 77.14%, and 63.63%, and insulin increase of 560.43%, 85.69%, 554.18%, and 598.97%, respectively, and with reductions in total cholesterol, LDL-C, and HDL-C ranging from 5.64%-21.81%, respectively. The blood glucose changed slightly. Changes in metabolic indicators mainly occured within 4 hours. The comparison of the characteristics of postprandial triglycerides between the two high-fat mixed meals showed no statistically significant differences( P>0.05). Conclusion:A standardize protocol with a 700 kcal fixed-calorie high-fat mixed meal as test meal, and blood lipid levels measured at fasting and at 1, 2, 3, and 4 hours after consumption, can serve as an optimized approach for oral fat tolerance test.

Objective To establish an HPLC method for the simultaneous determination of harpagide and harpagoside content in Scrophularia ningpoensis (SN). Methods An Eclipse C₁₈ column was used for determination of methanol extract of S. ningpoensis with a HPLC-PDA method and mobile phase of acetonitrile-0.03% phosphate solution in a gradient elution manner. The flow rate of mobile phase was 1.0 ml/min, and the detection wavelengths were 210 nm and 280 nm. Results Harpagide and harpagoside contents in SN showed good linear relationships within 0.1020-0.5100 mg/ml (r=0.9999) and 0.0340-0.1700 mg/ml (r=0.9999). Their average recovery rates were 97.44% and 97.08%.The RSDs were 0.93% and 1.24%.. There were significant differences in the contents of harpagide and harpagoside in SN from 15 origins (P<0.01). The content of harpagoside in Sichuan Long-dong, Zhejiang Lin-an, Zhejiang Pan-an and Henan Nan-feng is higher. Conclusion This method is stable, accurate and reproducible and can be used for the quality control of SN.

Objective:In order to provide guidance strategies for the establishment and application of self-report inventory in nursing research, we discussed the mental response model regarding tested nurses during its application.Methods:From September to November 2020, based on the grounded theory, we conducted semi-structured interviews for 9 tested nurses, who were from Qilu Hospital of Shandong University and Jinan Central Hospital, and data were analyzed to extract the psychological response topic.Results:A response model for tested nurses, which formed three psychological responses that factored in exam motivation, exam situation and individual will was built.Conclusion:The present study reveals the correlations among exam motivation, exam situation, individual will and psychological responses during the application of self-report inventory on tested nurses, which could provide references for the establishment and application of self-report scale in nursing research.

OBJECTIVE: To explore the genetic basis for a patient with Leydig cell hypoplasia. METHODS: Whole exome sequencing was used to detect genetic variants in the patient. Suspect variants were verified by PCR and Sanger sequencing of the family members. RESULTS: The patient was found to carry two novel variants, namely c.265A>T (p.Ile189Leu) and c.422T>C (p.Val141Ala), of the luteinizing hormone receptor gene (LHCGR), where were respectively inherited from her father and mother. Upon prenatal diagnosis, the fetus was found to be a heterozygous carrier of the c.265A>T (p.Ile189Leu) variant. CONCLUSION The compound heterozygous variants of c.265A>T (p.Ile189Leu) and c.422T>C (p.Val141Ala) of the LHCGR gene probably underlie the Leydig cell hypoplasia in the patient.

Objective To investigate he intervention effect of knockdown of activating transcription factor 4(ATF-4)on fructose-induced lipid accumulation in liver cells. Methods HepG2 cells were divided into the control group(C),high fructose group(F),high-fructose+negative control group(F+NC)and high-fructose+ATF-4 siRNA group(F+ATF-4-). The mRNA level of gens of the upstream transcriptional factors and ERS markers was detected. The protein level of ACC,FAS and SCD-1 was also detected. Results Compared with group C,the mRNA expression of SREBP-1c,ChREBP,GRP78 and CHOP was increased(P < 0.01),while ATF-4 knock-down decreased the expression of the above genes(P < 0.01 ,respectively). Compared with group C ,the protein expression of ACC,FAS and SCD-1 was increased in group F(P<0.01,respectively). While ATF-4 knockdown decreased the protein expression of ACC ,FAS and SCD-1. Conclusions ATF-4 knockdown can improve the lipid steatosis induced by fructose through down-regulating lipid lipogenesis ,indicating ATF-4 possesses a regulatory effect on lipogenesis.

Objective To observe the effect of fenofibrate intervention on high-fructose-feeding-induced liver steatosis in rats and explore the possible mechanism. Methods Male Wistar rats were randomly divided into control group ,high fructose group and fenofibrate group[fenofibrate intervention started after 8 weeks of high fructose feeding ,30 mg/(kg · d)]. Rats were sacrificed after 12-week of high fructose feeding. Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),free triglyceride(TG)and liver TG content were determined;protein levels of fatty acid synthase(FAS),endoplasmic reticulum stress mark-er Bip and autophagy markers such as Atg7,Beclin1,LC3 and the related pathway mTOR in liver tissues were de-tected. Results Compared with those in control group and fenofibrate group,serum AST,serum total cholesterol, blood free TG and hepatic TG were significantly increased in high-fructose group(P < 0.01). The protein expres-sion of Fas,Bip and mTOR were significantly increased in high-fructose group compared with those in control group and fenofibrate group;the protein expression of Atg7,beclin1 and LC3 were significantly decreased in high-fructose group compared with those in control group and fenofibrate group. Conclusions Long-term high-fructose-feeding induces fatty liver and liver cell injury ,and may affect ERS and autophagy. High-fructose-feeding-in-duced fatty liver may be improved by fenofibrate and its underlying mechanism might be associated with Fas,ERS and autophagy in liver.