Objectives:To investigate the clinical and cardiopulmonary functional characteristics of cardiopulmonary-phenotype idiopathic pulmonary arterial hypertension(IPAH)patients in comparison with classical IPAH patients and pulmonary hypertension patients associated with chronic lung disease(CLD-PH).Methods:In this retrospective study,data were collected from 30 patients with classical IPAH,20 cardiopulmonary phenotype IPAH patients,and 20 patients with CLD-PH,who were hospitalized in the Department of Respiratory and Critical Care Medicine at Beijing Chaoyang Hospital from November 2017 to February 2025.Pulmonary hypertension was diagnosed via right heart catheterization and all patients underwent pulmonary function tests,chest computed tomography(CT),echocardiography,and patients were followed up to 5 years.Results:Compared to classical IPAH patients,both cardiopulmonary phenotype IPAH patients and CLD-PH patients exhibited later onset age,higher proportions of World Health Organization(WHO)functional class Ⅲ-Ⅳ,males,and smokers(all P<0.05).The cardiopulmonary-phenotype IPAH patients also had higher rates of coronary artery disease and diabetes compared to classical IPAH patients(all P<0.05).Physiologically,the cardiopulmonary-phenotype IPAH patients showed reduced diffusing capacity for carbon monoxide(DLCO)and partial pressure of oxygen(PaO2),along with higher rates of emphysema and pulmonary fibrosis compared to classical IPAH(all P<0.05).In contrast,CLD-PH patients had lower mean pulmonary arterial pressure(mPAP),pulmonary vascular resistance(PVR),and pulmonary artery wedge pressure(PAWP),as well as reduced forced expiratory volume in the first second(FEV1%predicted),FEV1/forced vital capacity(FVC)ratio,and DLCO.However,CLD-PH patients demonstrated higher tricuspid annular plane systolic excursion(TAPSE),peak systolic velocity of the tricuspid annulus(S`),and partial pressure of carbon dioxide(PaCO2),along with increased rates of emphysema and pulmonary fibrosis(all P<0.05).Compared with LCD-PH,cardiopulmonary-phenotype IPAH patients had higher mPAP,PVR,FEV1%predicted,FEV1/FVC ratio,PAWP,and systolic pulmonary artery pressure,but lower DLCO,cardiac output,TAPSE,S′,and PaCO2(all P<0.05).No statistical difference was observed in PaO2 between these two groups.All cardiopulmonary-phenotype IPAH patients and classical IPAH patients received targeted medications,55%of CLD-PH patients did not receive targeted therapy,45%received monotherapy only(compared with cardiopulmonary-phenotype IPAH patients and classical IPAH groups,P<0.05).The 1,2,and 5-year survival rates were 79.2%,62.2%,and 46.7%,respectively in patients with cardiopulmonary-phenotype IPAH,100%,94.4%,and 94.4%,respectively in classic IPAH patients,and 92.9%,77.4%and 77.4%,respectively in patients with CLD-PH.Survival rates for cardiopulmonary-phenotype IPAH patients were significantly lower than those of classical IPAH and CLD-PH patients(log-rank P=0.008).Conclusions:IPAH cardiopulmonary phenotype patients are older,predominantly male,and often have a smoking history(median 30 pack-years).They exhibit severe hypoxemia,markedly reduced DLCOc,preserved spirometry,and severe pulmonary hypertension and lower survival rate.

Objective This study examined changes in serum growth hormone(GH)and insulin-like growth factor 1(IGF-1)levels,as well as insulin resistance,in patients with type 2 diabetes mellitus(T2DM)across different stages of diabetic kidney disease(DKD).It explored the relationship between these factors and the occurrence and progression of DKD,with the aim of identifying new targets for the prevention and treatment of DKD.Methods In this cross-sectional study,T2DM patients aged 18-80 years were selected from the Department of Endocrinology,The Second Affiliated Hospital of Xi'an Jiaotong University,from November 30,2019 to March 30,2021.Their serum GH and IGF-1 levels were tested.Results The serum GH level increased gradually in the groups,and the difference was statistically significant(P＜0.05).The level of serum IGF-1 decreased first and then increased among the groups,but with no significant difference(P＞0.05).HOMA-IR showed no significant correlation among the groups(P＞0.05),but HOMA-β gradually decreased among the groups,with statistically significant difference(P＜0.05).Multivariate Logistic regression analysis showed that the increase of serum GH level was closely related to the progression of T2DM to early DKD,and that the increase of serum IGF-1 level might be related to the deterioration of renal function in patients with T2DM at DKD stage.HOMA-IR and HOMA-β were not found to have correlation with the occurrence or development of DKD in T2DM patients.Conclusion In patients with T2DM,elevated serum GH level is closely associated with the occurrence and progression of early DKD.The increase of serum GH level may promote the occurrence of early DKD in T2DM,and the increase of serum IGF-1 level may be related to the deterioration of renal function in clinical DKD stage.In this study,we did not find correlation of HOMA-IR and HOMA-β with the occurrence or development of DKD in T2DM patients.

Objective This study examined changes in serum growth hormone(GH)and insulin-like growth factor 1(IGF-1)levels,as well as insulin resistance,in patients with type 2 diabetes mellitus(T2DM)across different stages of diabetic kidney disease(DKD).It explored the relationship between these factors and the occurrence and progression of DKD,with the aim of identifying new targets for the prevention and treatment of DKD.Methods In this cross-sectional study,T2DM patients aged 18-80 years were selected from the Department of Endocrinology,The Second Affiliated Hospital of Xi'an Jiaotong University,from November 30,2019 to March 30,2021.Their serum GH and IGF-1 levels were tested.Results The serum GH level increased gradually in the groups,and the difference was statistically significant(P＜0.05).The level of serum IGF-1 decreased first and then increased among the groups,but with no significant difference(P＞0.05).HOMA-IR showed no significant correlation among the groups(P＞0.05),but HOMA-β gradually decreased among the groups,with statistically significant difference(P＜0.05).Multivariate Logistic regression analysis showed that the increase of serum GH level was closely related to the progression of T2DM to early DKD,and that the increase of serum IGF-1 level might be related to the deterioration of renal function in patients with T2DM at DKD stage.HOMA-IR and HOMA-β were not found to have correlation with the occurrence or development of DKD in T2DM patients.Conclusion In patients with T2DM,elevated serum GH level is closely associated with the occurrence and progression of early DKD.The increase of serum GH level may promote the occurrence of early DKD in T2DM,and the increase of serum IGF-1 level may be related to the deterioration of renal function in clinical DKD stage.In this study,we did not find correlation of HOMA-IR and HOMA-β with the occurrence or development of DKD in T2DM patients.

Objectives:To investigate the clinical and cardiopulmonary functional characteristics of cardiopulmonary-phenotype idiopathic pulmonary arterial hypertension(IPAH)patients in comparison with classical IPAH patients and pulmonary hypertension patients associated with chronic lung disease(CLD-PH).Methods:In this retrospective study,data were collected from 30 patients with classical IPAH,20 cardiopulmonary phenotype IPAH patients,and 20 patients with CLD-PH,who were hospitalized in the Department of Respiratory and Critical Care Medicine at Beijing Chaoyang Hospital from November 2017 to February 2025.Pulmonary hypertension was diagnosed via right heart catheterization and all patients underwent pulmonary function tests,chest computed tomography(CT),echocardiography,and patients were followed up to 5 years.Results:Compared to classical IPAH patients,both cardiopulmonary phenotype IPAH patients and CLD-PH patients exhibited later onset age,higher proportions of World Health Organization(WHO)functional class Ⅲ-Ⅳ,males,and smokers(all P<0.05).The cardiopulmonary-phenotype IPAH patients also had higher rates of coronary artery disease and diabetes compared to classical IPAH patients(all P<0.05).Physiologically,the cardiopulmonary-phenotype IPAH patients showed reduced diffusing capacity for carbon monoxide(DLCO)and partial pressure of oxygen(PaO2),along with higher rates of emphysema and pulmonary fibrosis compared to classical IPAH(all P<0.05).In contrast,CLD-PH patients had lower mean pulmonary arterial pressure(mPAP),pulmonary vascular resistance(PVR),and pulmonary artery wedge pressure(PAWP),as well as reduced forced expiratory volume in the first second(FEV1%predicted),FEV1/forced vital capacity(FVC)ratio,and DLCO.However,CLD-PH patients demonstrated higher tricuspid annular plane systolic excursion(TAPSE),peak systolic velocity of the tricuspid annulus(S`),and partial pressure of carbon dioxide(PaCO2),along with increased rates of emphysema and pulmonary fibrosis(all P<0.05).Compared with LCD-PH,cardiopulmonary-phenotype IPAH patients had higher mPAP,PVR,FEV1%predicted,FEV1/FVC ratio,PAWP,and systolic pulmonary artery pressure,but lower DLCO,cardiac output,TAPSE,S′,and PaCO2(all P<0.05).No statistical difference was observed in PaO2 between these two groups.All cardiopulmonary-phenotype IPAH patients and classical IPAH patients received targeted medications,55%of CLD-PH patients did not receive targeted therapy,45%received monotherapy only(compared with cardiopulmonary-phenotype IPAH patients and classical IPAH groups,P<0.05).The 1,2,and 5-year survival rates were 79.2%,62.2%,and 46.7%,respectively in patients with cardiopulmonary-phenotype IPAH,100%,94.4%,and 94.4%,respectively in classic IPAH patients,and 92.9%,77.4%and 77.4%,respectively in patients with CLD-PH.Survival rates for cardiopulmonary-phenotype IPAH patients were significantly lower than those of classical IPAH and CLD-PH patients(log-rank P=0.008).Conclusions:IPAH cardiopulmonary phenotype patients are older,predominantly male,and often have a smoking history(median 30 pack-years).They exhibit severe hypoxemia,markedly reduced DLCOc,preserved spirometry,and severe pulmonary hypertension and lower survival rate.

【Objective】 To investigate the correlation between body composition and thyroid function indicators in type 2 diabetic patients with euthyroidism of different genders. 【Methods】 Type 2 diabetic patients with euthyroidism who were hospitalized in the Endocrinology Department of The Second Affiliated Hospital of Xi’an Jiaotong University from February 2016 to September 2018 were enrolled in this study. Bioelectric impedance analysis was used to measure body composition, and the thyroid function indicators (FT3, FT4, and TSH) were tested. The male and female subjects were matched according to the ratio of 2:1 using the propensity score matching method, and the correlation between body composition and thyroid function indicators was studied in different genders by correlation analysis. 【Results】 The basal metabolic rate, trunk fat mass, fat-free mass, fat-free mass index, bone mass, water mass, total body muscle mass, skeletal muscle mass, and skeletal muscle index were positively correlated with FT3 in male patients (P<0.05). The percentage of body fat mass and fat mass index were positively correlated with FT3 and TSH (P<0.05), and the percentages of lean mass, water mass, and total body muscle mass were negatively correlated with FT3 and TSH (P<0.05), and the basal metabolic rate was negatively correlated with FT4 (P<0.05) in female. 【Conclusion】 In euthyroid type 2 diabetic patients, the correlation between body composition and thyroid function indicators are different between males and females. In males, only FT3 is positively correlated with basal metabolic rate, trunk fat mass, and fat free-related composition; while in females, both FT3 and TSH are positively correlated with fat-related composition, but negatively correlated with fat-free-related composition.

ObjectiveTo preliminarily investigate the relationship between the chronic hepatitis C virus (HCV) genotypes, 2a and 1b, and thyroid hormone levels and autoantibodies. MethodsIn patients who were admitted to our hospital and diagnosed with chronic hepatitis C from October 2013 to December 2014, reverse transcription-polymerase chain reaction was performed to determine the HCV genotype. A total of 196 patients with HCV genotype 2a or 1b were enrolled as subjects. The levels of thyroid hormone and thyroid autoantibodies were determined by chemiluminescence immunoassay, and the relationship between the HCV genotype and thyroid function was analyzed. Between-group comparison of continuous data was performed by t test, and the risk factors were evaluated by logistic regression analysis. ResultsIn the 196 patients with hepatitis C, 57.7% (n=113) were infected with HCV-2a, and 42.3% (n=83) were infected with HCV-1b. There were no significant differences in levels of thyroid hormone and thyroid autoantibodies between patients with HCV-2a and HCV-1b (P＞0.05). In the 92 patients who were treated with interferon, there were no significant differences in levels of thyroid hormone and thyroid autoantibodies between patients with HCV-2a and HCV-1b (P＞0.05). Logistic regression analysis showed that the genotype classification was not a risk factor for abnormal thyroid autoantibodies (OR=2.012, P＞0.05). ConclusionThere is no intrinsic link between chronic HCV genotype classification and thyroid function. The genotype classification has no substantial effect on thyroid function.

Humans ; Neurotoxicity Syndromes ; etiology ; Xylenes ; toxicity

Currently,the medical technology and service capability in grass-root medical institutions are still at low level.This article emphasizes the need for pilot bases of appropriate medical emergency technologies,introducing our experiences in this respect and the effects.We hope to offer reference for the promotion of appropriate medical emergency technologies.

Objective:To observe the effect of metformin on the expression of SIRT1 and UCP2 in rat liver of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD), and discuss the pathogenesis of T2DM with NAFLD, and the treatment with and possible mechanism of metformin.Methods:Thirty-six male SD rats were randomly divided into a normal control group (group NC, n=12), a T2DM with NAFLD group (group MC, n=12), and a metformin group (group A, n=12). We established the model of T2DM with NAFLD rats by feeding high-fat and high-sugar diet and injecting STZ. After the success establishment of the model, the metformin group was given metformin 300 mg/(kg.d) for 8 weeks. At the end of the experiment, we measured FBG, ALT, AST, TC, TG, HDL-C, LDL-C, VLDL, FFAs, FINs and HOMA-IR respectively in group NC, MC and A. We observed the change of liver tissue pathology by HE, determined the expression of SIRT1 and UCP2 in rat liver by immunohistochemical method and real-time quantitative method. Results:FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were higher in group MC than in group NC (P<0.05), while HDL-C was obviously lower in group MC than in group NC (P<0.05). After the metformin treatment, the serum parameters in the rats had improved in group NC compared with in group MC (P<0.05). On immunohistochemical staining and mRNA level, the expression of SIRT1 was obviously lower in group MC than in group NC (P<0.05), and the expression of UCP2 was obviously higher in group MC than in group NC (P<0.05). After the metformin treatment, the expression of SIRT1 was higher than in group MC (P<0.05), and the expression of UCP2 was lower than in group MC (P<0.05). There was negative correlation between the expression of SIRT1 and UCP2 (r=-0.61, P<0.01).
Conclusion:The expression of SIRT1 is low and the expression of UCP2 is high in rat liver of T2DM with NAFLD. Metformin can increase the expression of SIRT1 and reduce the expression of UCP2, with negative correlation between the expression of SIRT1 and UCP2.

OBJECTIVETo observe the expression of SIRT1 and mitochondrial uncoupling protein 2 (UCP2) in the liver of rats with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver (NAFLD) and explore the possible pathogenesis of T2DM and NAFLD.

METHODSTwenty-four male SD rat were randomized equally into control group and T2DM and NAFLD group (MC group), fed with standard diet and high-fat and high-sugar diet, respectively. At 12 weeks, the rats in MC group received a single dose of STZ (30 mg/kg) injected into the abdominal cavity for pancreatic islet destruction, and those in the control group received an equivalent volume of citric acid buffer. At 14 weeks, the body weight, FBG, hepatic function, blood lipid levels, FFAs, FINs and HOMA-IR of the rats were measured, and the liver pathology was examined with HE staining. The expression of SIRT1 and UCP2 in the rat liver was detected by immunohistochemistry and real-time quantitative PCR.

RESULTSAt 14 weeks, FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were significantly higher and HDL-C was significantly lower in MC group than in the control group (P<0.05). Pathological examination showed good structural integrity of the liver in the control group, and the liver cells were closely arranged with rich cytoplasm and round cell nuclei; in MC group, moderate to severe fatty liver was detected, and the liver cells showed severe ballooning degeneration and contained lipid vacuoles in the cytoplasm. The expression of SIRT1 was significantly lower and UCP2 significantly higher in MC group than in the control group (P<0.05).

CONCLUSIONThe expression of SIRT1 is significantly lowered and UCP2 increased in the liver of rats with T2DM and NAFLD.

Animals ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; Fatty Liver ; complications ; metabolism ; Ion Channels ; metabolism ; Liver ; metabolism ; Male ; Mitochondrial Proteins ; metabolism ; Non-alcoholic Fatty Liver Disease ; Rats ; Rats, Sprague-Dawley ; Sirtuin 1 ; metabolism ; Uncoupling Protein 2