Objective:To investigate the value of diameter of pulmonary nodules,radiological indicators,serum tumor markers(CEA,CYFRA21-1,and SCC),and methylation of HOXA7 and SOX17 in circulating tumor DNA(ctDNA)in the early diagnosis of lung can-cer.Methods:A total of 60 patients with malignant pulmonary nodules and 60 patients with benign pulmonary nodules who were admit-ted to our hospital from September 2021 to December 2022 were enrolled as lung cancer group and benign nodule group,respectively,and 80 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group.The three groups were compared in terms of the diameter of nodules,spiculation sign,levels of serum tumor markers,and meth-ylation rates of HOXA7 and SOX17 in plasma ctDNA,and a multivariate regression analysis was performed to identify the independent risk factors for carcinogenesis and establish a predictive model.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of the model.Results:Compared with the benign nodule group and the control group,the lung cancer group had significantly higher diameter of pulmonary nodules,proportion of patients with spiculation sign,CEA,ProGRP,CYFRA21-1,and methylation rates of serum HOXA7,and SOX17,and the lung can-cer group had a significantly higher level of SCC than the control group(all P<0.05).The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in serum ctDNA were independent risk factors for malignant pulmonary nodules(P<0.05),and a predictive model was established as Y=ex/(1+ex),where x=-7.233+(0.108×nodule diameter)+(3.860×spiculation sign)+(0.021×HOXA7 methylation rate)+(0.043×SOX17 methylation rate).The predictive model had an area under the ROC curve(AUC)of 0.981,with a significantly larger AUC than each indicator alone and the Mayo and LCBP models(P<0.05).Conclusion:The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in ctDNA have a relatively high value in the early diagnosis of lung cancer,and the predictive model based on these indicators can significantly improve diagnostic performance.

Objective To explore the correlation between brachial and ankle pulse wave conduction velocity(baPWV)and cardiac structure and function in patients with type 2 diabetes mellitus(T2DM).Methods A total of 443 patients with T2DM who were treated in The Endocrinology Department of Gansu Provincial People's Hospital were enrolled in this study from June 2022 to October 2023.All the patients were divided into simple T2DM group(T2DM,baPWV<1400 cm/s,n=221)and atherosclerosis group(AS,baPWV≥1400 cm/s,n=222)based on baPWV.The cardiac ultrasound diagnostic instrument was used to record left ventricular ejection fraction(LVEF),end diastolic left ventricular diameter(LVd),end diastolic interventricular septal thickness(IVSd),end diastolic left ventricular posterior wall thickness(LVPWd),ratio of early to late diastolic peak velocity of mitral valve annulus(E/A),and ratio of early diastolic peak velocity of mitral valve orifice to early diastolic peak velocity of mitral valve annulus(E/E').Results Age,DM duration,SBP,DBP,HbA1c,TG,ABI,LVEF,IVSd,LVPWd,E/A<1,E/E'＞14,were higher in AS group than in T2DM group(P<0.05 or P<0.01).Spearman correlation analysis shows that E/A<1 was positively correlated with age,DM duration,BMI,SBP,DBP,and ABI(P<0.05 or P<0.01),while negatively correlated with baPWV(P<0.01).Pearson correlation analysis shows that LVPWd was positively correlated with age,DM duration,BMI,SBP,DBP,baPWV,and Scr(P<0.05 or P<0.01).Logistic regression analysis shows that baPWV,ABI,and SBP were the influencing factors for left ventricular diastolic dysfunction.The analysis of the working characteristic curve of the subjects shows that the area under the curve of baPWV,SBP and ABI for predicting left ventricular diastolic dysfunction is 0.647,0.643,and 0.624,with the best cutoff points being 1398.5 cm/s,125.5 mmHg,and 1.107.Conclusions baPWV is closely related to cardiac structure and function in T2DM patients.As baPWV increases,the risk of left ventricular diastolic insufficiency and hypertrophy rises.

BACKGROUND: Insulin-like growth factor 1(IGF-1) plays an important role in regulating osteocyte function and bone metabolism. The association of insulin-like growth factor 1 receptor (IGF-1R) gene polymorphisms with osteoporosis in postmenopausal women has not yet been reported.OBJECTIVE: To investigate the correlation between IGF-1R gene rs2229765 single nucleotide polymorphism and osteoporosis in postmenopausal women.METHODS: IGF-1R gene rs2229765 SNPs were detected using PCR-RFLP in 218 patients with postmenopausal osteoporosis and 270 postmenopausal women with normal bone mineral density. The bone mineral density of the lumbar spine, femoral neck and forearm was determined by dual-energy X-ray absorptiometry. Serum IGF-1 level was investigated by ELISA.RESULTS AND CONCLUSION: The AA genotype (29% vs. 17%, P=0.001) and A allele (51% vs. 40%, P=0.000)distributions of the rs2229765 polymorphism in the osteoporosis group were significantly higher than those in the control group. Compared with GG genotype of rs2229765, AA genotype was significantly associated with an increased risk of osteoporosis (OR=2.12, 95%CI=1.27-3.54, P=0.004). The analysis of serum IGF-1 showed that osteoporotic women with rs2229765AA (P=0.007) and GA (P=0.016) genotype were found to have a lower serum IGF-1 level than osteoporotic women with GG genotype. Our results indicate that the IGF-1R gene rs2229765 polymorphism capable of regulating serum IGF-1 level is associated with postmenopausal osteoporosis.

Objective To investigate the prevalence of vitamin D deficiency and its associated metabolic risk factors in the healthy adults in Gansu Province, a western province of China.Methods Through stratified, multistage probability population sampling, 11 300 adults (4 740 men and 6 417 women aged 18-79 years) who had been living in their current residence for at least 5 years were arbitrarily chosen from seven representative geographical cities in Gansu Province from June 2014 to December 2015.The data obtained from a questionnaire-based survey, anthropometric and biochemical assessments, and areal bone mineral density measurement were collected and analyzed.Results The overall mean serum 25(OH)D was (16.07±9.40) μg/L.The prevalence of severe deficiency (<10 μg/L), deficiency (≥10 μg/L and <20 μg/L), insufficiency (≥20 μg/Land <30 μg/L), and sufficiency (≥30 μg/L) among these adults were 17.3％, 64.6％, 11.8％, and 6.3％, respectively.The significant predictors of vitamin D deficiency included younger age and female sex(P<0.05), whereas sun exposure, physical activity, and calcium supplementation were protective (P<0.05).Serum 25(OH)D was inversely associated with parathyroid hormone (r=-0.279, P<0.001) and positively associated with serum calcium (r=0.239, P<0.001), serum phosphorus (r=0.090, P=0.018), low-density lipoprotein cholesterol(r=0.100, P=0.008), and body mass index (r=0.093, P=0.014).The 25(OH)D concentration showed no significant correlation with bone mineral density (P>0.05).Conclusions Vitamin D deficiency is highly prevalent among adult populations in Gansu, northwestern of China, and is largely attributed to younger age and female sex.The cumulative effects of factors including sun exposure, physical activity, and calcium supplementation play an influential role in maintaining vitamin D levels.

Objective To investigate the prevalence and epidemiological characteristics of hypothyroidism, possible related lifestyle and metabolic risk factors of hypothyroidism in adults of Gansu province, and to provide scientific evidence for the prevention of hypothyroidism. Methods Stratified multi-stage cluster sampling with probability proportionate to size method was used to collect data from 10071 residents aged 18 to 79 years and who had lived in the local area for more than 5 years. All participants were asked to fill in the questionnaire, and to take physical examination including anthropometric measurements and venous blood samples. Risk factors of hypothyroidism were analyzed by Chi-square test and multivariate logistic regression analysis. Result The prevalence of hypothyroidism was 10.1％ (overt hypothyroidism: 1.5％, subclinical hypothyroidism: 8.7％). Female (12.1％) had a higher percentage when compared to male (7.5％). In addition to the increased odds with older age and female gender, current or previous smoking history (OR: 0.467, 95％CI: 0.289-0.754, P=0.002), salty taste preference (OR:0.355, 95％CI:0.162-0.776, P=0.022) and a frequent seafood intake (OR:0.148, 95％CI:0.057-0.385, P<0.001) were tended to be associated with reduced risk of hypothyroidism. Logistic regression analysis showed that positive thyroid peroxidase antibodies (OR:1.976, 95％CI:1.037-3.768, P=0.039), positive thyroglobulin antibodies (OR:2.419, 95％CI:1.160-5.043, P=0.018) and triglycerides (OR:1.241, 95％CI:1.044-1.474, P=0.014) were associated with increased risk of hypothyroidism. Conclusion The prevalence of hypothyroidism in Gansu province was high, affecting approximately one in ten adults, and majority of which were SCH. Both lifestyle factors and metabolic factor were associated with hypothyroidism. Developing a healthy lifestyle at work and home, and paying attention to the control of blood lipids are conducive to the prevention of hypothyroidism.