Objective:To investigate the predictive value of thyroid hormone sensitivity indicators for adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM) complicated by hypothyroidism.Methods:A cross-sectional study was conducted to retrospectively analyze the clinical data of 80 pregnant women with GDM complicated by hypothyroidism who were admitted to the Department of Obstetrics, Second Affiliated Hospital of Shaanxi University of Chinese Medicine from February 2022 to February 2024. The patients were divided into two groups: the adverse outcome group ( n = 48) and the normal outcome group ( n = 32) based on the occurrence of adverse pregnancy outcomes. Logistic regression analysis was conducted to identify the risk factors for adverse pregnancy outcomes in these women. Additionally, receiver operating characteristic curve analysis was performed to evaluate the predictive value of thyroid hormone sensitivity indicators for adverse pregnancy outcomes. Results:In the adverse outcome group, the proportion of women with a pre-pregnancy body mass index ≥ 24 kg/m2, triglyceride level, activated partial thromboplastin time, fibrinogen level, thyroid-stimulating hormone level, and thyroid-stimulating hormone index were 58.33% (28/48), (5.77 ± 0.25) mmol/L, (31.79 ± 2.68) seconds, (4.39 ± 0.37) g/L, (5.05 ± 1.07) mU/L, and (3.15 ± 0.24), respectively, which were significantly higher than those in the normal outcome group ( χ2 = 4.41, t = -3.56, -3.23, -2.61, -4.17, -9.15, all P < 0.05). Conversely, the levels of free thyroxine, free triiodothyronine, thyrotroph T4 resistance index, and thyroid feedback quantile index in the adverse outcome group were (9.32 ± 1.04) pmol/L, (3.17 ± 0.42) pmol/L, (33.09 ± 4.26), and (0.19 ± 0.07), respectively, which were all significantly lower than those in the normal outcome group ( t = 4.44, 3.51, 4.31, 2.21, all P < 0.05). Logistic regression analysis revealed that pre-pregnancy body mass index [ OR = 2.673, 95% CI(1.057,6.761)], triglyceride level [ OR = 25.623, 95% CI(3.208,204.673)], activated partial thromboplastin time [ OR = 1.365, 95% CI(1.106,1.685)], fibrinogen level [ OR = 3.111, 95% CI(1.257,7.701)], thyroid-stimulating hormone level [ OR = 2.969, 95% CI(1.613,5.465)], free thyroxine level [ OR = 0.441, 95% CI(0.280,0.695)], free triiodothyronine level [ OR = 0.172, 95% CI(0.057,0.516)], thyroid-stimulating hormone index [ OR = 6.298, 95% CI(1.099, 36.094)], thyrotroph T4 resistance index [ OR = 0.799, 95% CI(0.704,0.907)], and thyroid feedback quantile index [ OR = 0.057, 95% CI(0.168,0.478)] were all factors that influence adverse pregnancy outcomes in pregnant women with GDM complicated by hypothyroidism (all P < 0.05). The area under the curve for predicting adverse pregnancy outcomes using the combined thyroid hormone sensitivity indicators was 0.809 [95% CI (0.704, 0.915), P < 0.001], with a sensitivity of 0.896, specificity of 0.687, and a maximum Youden index of 0.583. Conclusions:The thyroid hormone sensitivity indicators have a certain predictive value for adverse pregnancy outcomes in pregnant women with GDM complicated by hypothyroidism. These indicators can provide important reference for clinical prediction and intervention of adverse pregnancy outcomes in this patient population.

Objective:To investigate the predictive value of thyroid hormone sensitivity indicators for adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM) complicated by hypothyroidism.Methods:A cross-sectional study was conducted to retrospectively analyze the clinical data of 80 pregnant women with GDM complicated by hypothyroidism who were admitted to the Department of Obstetrics, Second Affiliated Hospital of Shaanxi University of Chinese Medicine from February 2022 to February 2024. The patients were divided into two groups: the adverse outcome group ( n = 48) and the normal outcome group ( n = 32) based on the occurrence of adverse pregnancy outcomes. Logistic regression analysis was conducted to identify the risk factors for adverse pregnancy outcomes in these women. Additionally, receiver operating characteristic curve analysis was performed to evaluate the predictive value of thyroid hormone sensitivity indicators for adverse pregnancy outcomes. Results:In the adverse outcome group, the proportion of women with a pre-pregnancy body mass index ≥ 24 kg/m2, triglyceride level, activated partial thromboplastin time, fibrinogen level, thyroid-stimulating hormone level, and thyroid-stimulating hormone index were 58.33% (28/48), (5.77 ± 0.25) mmol/L, (31.79 ± 2.68) seconds, (4.39 ± 0.37) g/L, (5.05 ± 1.07) mU/L, and (3.15 ± 0.24), respectively, which were significantly higher than those in the normal outcome group ( χ2 = 4.41, t = -3.56, -3.23, -2.61, -4.17, -9.15, all P < 0.05). Conversely, the levels of free thyroxine, free triiodothyronine, thyrotroph T4 resistance index, and thyroid feedback quantile index in the adverse outcome group were (9.32 ± 1.04) pmol/L, (3.17 ± 0.42) pmol/L, (33.09 ± 4.26), and (0.19 ± 0.07), respectively, which were all significantly lower than those in the normal outcome group ( t = 4.44, 3.51, 4.31, 2.21, all P < 0.05). Logistic regression analysis revealed that pre-pregnancy body mass index [ OR = 2.673, 95% CI(1.057,6.761)], triglyceride level [ OR = 25.623, 95% CI(3.208,204.673)], activated partial thromboplastin time [ OR = 1.365, 95% CI(1.106,1.685)], fibrinogen level [ OR = 3.111, 95% CI(1.257,7.701)], thyroid-stimulating hormone level [ OR = 2.969, 95% CI(1.613,5.465)], free thyroxine level [ OR = 0.441, 95% CI(0.280,0.695)], free triiodothyronine level [ OR = 0.172, 95% CI(0.057,0.516)], thyroid-stimulating hormone index [ OR = 6.298, 95% CI(1.099, 36.094)], thyrotroph T4 resistance index [ OR = 0.799, 95% CI(0.704,0.907)], and thyroid feedback quantile index [ OR = 0.057, 95% CI(0.168,0.478)] were all factors that influence adverse pregnancy outcomes in pregnant women with GDM complicated by hypothyroidism (all P < 0.05). The area under the curve for predicting adverse pregnancy outcomes using the combined thyroid hormone sensitivity indicators was 0.809 [95% CI (0.704, 0.915), P < 0.001], with a sensitivity of 0.896, specificity of 0.687, and a maximum Youden index of 0.583. Conclusions:The thyroid hormone sensitivity indicators have a certain predictive value for adverse pregnancy outcomes in pregnant women with GDM complicated by hypothyroidism. These indicators can provide important reference for clinical prediction and intervention of adverse pregnancy outcomes in this patient population.

Objective To establish a multi-component quantitative control method for Shenhuang Yangyin Capsules;To explore the application of chemical pattern recognition and grey relational analysis(GRA)model in the quality evaluation of Shenhuang Yangyin Capsules.Methods The contents of ginsenoside Rg1,ginsenoside Rb1,ginsenoside Rb3,ginsenoside Rd,calycosin 7-O-β-D-glucopyranoside,ononin,calycosin,medicarpin,sodium danshensu,salvianolic acid B,tanshinone ⅡA,methylophiopogonanone A and methylophiopogonanone B in Shenhuang Yangyin Capsules were determined by HPLC.Agilent Eclipse Plus C18 column was adopted with acetonitrile as mobile phase A and 0.5％phosphate acid solution as mobile phase B,gradient elution.The detection wavelengths were 203,280 and 296 nm.Through chemical pattern recognition analysis and GRA,the results of multi-component content were analyzed,and the comprehensive quality evaluation system of Shenhuang Yangyin Capsules was constructed.Results The results of methodological verification of external standard method met the requirements.Chemometric analysis showed that salvianolic acid B,ononin,tanshinone ⅡA,calycosin,ginsenoside Rb3 and ginsenoside Rb1 were the main factors affecting the quality of Shenhuang Yangyin Capsules.The relative correlation degree of GRA were 0.319 8-0.642 1,and it was helpful for enterprises to analyze the differences between products.Conclusion Multi-component quantitative combined chemical mode recognition and GRA can be used for quality evaluation of Shenhuang Yangyin Capsules.

Objective To explore the impact of sleep quality in early pregnancy on gestational diabetes. Methods A total of 657 pregnant women in the obstetrics clinic of our hospital were selected as the research subjects. The basic information of pregnant women, sleep time and sleep quality in early period of pregnancy were collected through questionnaires. Glucose tolerance screening tests were performed at 24-28 gestational weeks to screen out GDM pregnant women. Multivariate unconditional logistic regression analysis was used to analyze the effect of sleep status in early pregnancy on the incidence of gestational diabetes. Results 112 pregnant women were diagnosed with gestational diabetes, and 92 women in early pregnancy were indicated of abnormal sleep quality. Sleep disorders might lead to an increased risk of gestational diabetes (OR=1.031, 95％CI=1.027-1.115). Age, pre-pregnancy BMI, early pregnancy sleep quality and number of pregnancy and delivery were risk factors for gestational diabetes. Conclusion Poor sleep quality in early pregnancy is a high risk factor for gestational diabetes. Treatment of abnormal sleep during early pregnancy can reduce the incidence of gestational diabetes.

Objective To investigate the effect of nuclear factor erythroid-2-related factor 2(Nrf2) on the anti-hypoxia and anti-apoptotic ability of mesenchymal stem cells(MSCs). Methods Human embryonic kidney cells(293FT) were transfected with recombinant plasmid which overexpressed Nrf2 and helper plasmid. High-titer lentivirus which overexpressed Nrf2 were obtained. MSCs were transfected with lentivirus with Nrf2 overexpression and empty lentiviral vector to establish Nrf2-MSCs which stably overexpressed Nrf2 (Nrf2 overexpression group) and green fluorescent protein (GFP)-MSCs(control group). The expression of green fluorescent in 2 groups was observed by fluorescence microscope. The expression level of Nrf2 protein in 2 groups was measured by Western Blot. The anti-hypoxia ability of 2 groups was observed by light microscope. The anti-apoptotic ability of 2 groups was measured by flow cytometry. Results Nrf2-MSCs which stably overexpressed Nrf2 were successfully established. Western Blot analysis revealed that the expression level of Nrf2 protein in the Nrf2 overexpression group was significantly higher than that in the control group(P<0.01). After 15 h hypoxia treatment, the cell activity in the Nrf2 overexpression group was significantly higher than that in the control group. Flow cytometry showed that the apoptosis rate in the Nrf2 overexpression group was (30.9±1.4)%, significantly lower than (61.3±1.3)% in the control group(P<0.05). Conclusions Nrf2-MSCs which can stably overexpress Nrf2 possess certain anti-hypoxia and anti-apoptotic ability in hypoxia environment.

Objective To establish the method for simultaneous determination of epimedium glycoside and other 4 kinds of active ingredients in Xianling Gubao Capsules by three wavelength switching method. Methods An Waters Atlantis T3 C18 column (4.6 mm × 250 mm, 5 μm) was used with the mixture of acetonitrile-0.05％ formic acid solution as the mobile phase in gradient elution (0–5 min, 12％–20％ A; 5–15 min, 20％–55％ A; 15–35 min, 55％ A;35–55 min, 55％–76％ A; 55.1 min, 12％ A; 55.1–60 min, 12％ A). Detection wavelength was as follow: 0–30 min, 212 nm; 30–42 min, 246 nm; 42–60 min, 270 nm. The flow rate was 1.0 mL/min. The column temperature was 30 ℃. Results The calibration curves of asperosaponin Ⅵ, psoralen, angelicin, epimedin C, and icariin were in good linearity among the ranges of 101.6–3048 ng, 8.7–261 ng, 7.9–237 ng, 117.2–3516 ng, 78–2340 ng, respectively. In the instrument precision test, stability test, repeatability test, the RSD was less than 3％. The average recoveries were 99.83％, 100.35％, 100.59％, 100.60％, 99.72％, respectively, and all the RSD were less than 3％. Conclusion The method is sensitive, accurate, and separation effect is good, which can provide a basis for quality evaluation standard of Xianling Gubao Capsules.

Objective To explore the mixed infection of bacteria and viruses of community-acquired pneumonia (CAP) in children. Methods A total of 204 children with CAP were tested for sputum bacteria, viruses and atypical pathogen, and children with bronchoscope indications were performed with bronchoscope for alveolar lavage (BAL), and the BAL lfuid (BALF) was subjected to quantitative culture and intracellular bacteria detection. All the children were given antimicrobial sequential therapy. Results There were 153 strains of pathogenic bacteria isolated in 122 cases, the detection rate was 59.80%(122/204). Thirty cases were found with mixed bacterial and viral infections. BAL was performed on 70 cases, positive lavage germiculture were detected in 8 cases, of theses BALF specimen inducible co-stimulator (ICOS) positivity were found in 5 cases. Using BALF quantitative culture as control, the sensitivity of ICOS in the diagnosis of CAP was 37.50%and the speciifcity was 96.77%. In 30 cases of mixed infection with bacteria and viruses, 27 cases were younger than 5 years old, accounting for 90.00%. Duration of fever greater than 10 d in mixed infection group of children (43.33%, 13/30) was higher than that of the non-mixed infection group (23.12%, 40/173) (P??0.05). Average hospitalization time in children with mixed infection (13.5+1.5) d was higher than that with non-mixed infection (8.6+1.1) d (P?

Objective To investigate effect of serum apoptosis factor and long-term effect on medical abortion patients by sequential misoprostol. Methods 80 cases of early pregnancy patients who required termination pregnancy, were selected and randomly divided into 2 groups.40 cases in control group were treated with mifepristone 25mg oral, misoprostol 600μg, 4 times a day.40 cases in experiment group were treated with sequential use of misoprostol.Effect of medical abortion, survivin and caspase-3 were compared after 7d treatment.Gynecological inflammation, dysmenorrhea and infertility were compared for 2 years.Results Compared with control group, complete abortion rate of the experiment group was higher (P<0.05).The incidence of adverse drug reactions of the experiment group was lower than control group (P<0.05) after 2 years follow.up.Compared with the control group, HCG,E3 and P of experimental group were lower (P<0.05).After 7 days of medication,survivin decreased,caspase-3 increased,compared with control group, survivin of the experiment group was lower, caspase-3 was higher ( P<0.05 ) .Conclusion Misoprostol sequential can improve the success rate of medical abortion abortion, reduce the complications of abortion, presumably with the inhibition of survivin expression, is associated up regulation of caspase-3 levels.

Objective To investigate the expression of Hippo pathway component in hepatic cancer tissues and investigate its effects on the tumor recurrence after Iiver transplantation.Methods The clinical data of 105 patients with liver cancer who were admitted to the Third Affiliated Hospital of Sun Yat-Sen University from July 2004 to September 2009 were retrospectively analyzed.The samples of liver cancer tissues were collected.The maximum diameter,number of foci,blood vessel involvement,preoperative level of alpha-fetoprotein (AFP),results of postoperative pathological examination were analyzed.All the patients were followed up via out-patient examination,mail and phone call.Patients were followed up once a week within the first month after operation,and once a month within the 6 months after operation,and then once every 3 months at 1 year later.The follow-up ended in December 2012 or tumor recurrence.The disease-free survival time began at the date of operation and ended at the time of tumor recurrence.The expressions of Yes-associated protein (YAP),phosphorylated YAP,Hippo pathway component (Lats1/2,pLats1/2,Mst1,pMst1/2) were detected by immunohistochemical staining.All data were analyzed using the chi-square test or Student t test.Factors might influence the postoperative tumorfree survival time after liver transplantation were analyzed using the Cox regression model.The survival curve was drawn by Kaplan-Meier method,and the disease-free survival was analyzed using Log-rank test.Results Positive expressions of YAP and phosphorylated YAP were detected in the nucleus and cytoplasm,and the positive expressions of Lats1/2,pLats1/2,Mst1 and pMst1/2 were detected in the cytoplasm.The positive expressions of YAP,phosphorylated YAP,Latsl/2,pLats1/2,Mst1 and pMst1/2 protein were 51.43％ (54/105),55.24％ (58/105),45.71％ (48/105),9.52％ (10/105),64.76％ (68/105) and 20.00％ (21/105),respectively.The positive expression of YAP was correlated with the tumor diameter,venous infiltration and AJCC stage (x2=4.173,9.611,7.233,P ＜ 0.05).The positive expression of Lats1/2 protein was correlated with tumor diameter and AJCC stages (x2=14.413,7.969,P ＜ 0.05).The positive expression of Mst1 protein was correlated with the tumor diameter (x2=4,129,P ＜0.05).The results of univariate analysis showed that the protein expressions of YAP,Lats1/2,pMst1/2,age,tumor diameter,tissue differentiation,preoperative level of AFP,venous infiltration and AJCC stages were risk factors influencing tumor recurrence after liver transplantation (HR =2.603,0.502,1.802,0.955,3.559,2.395,2.414,2.915,2.086,95％ CI:1.452-4.666,0.287-0.880,1.040-3.123,0.931-0.981,1.921-6.595,1.475-3.889,1.313-4.337,1.604-5.229,1.370-3.176,P ＜ 0.05).The results of multivariate analysis showed that the positive expression of YAP,tumor diameter ＞ 5 cm,low differentiation of tissue and AJCC stages Ⅲ were independent risk factors influencing tumor recurrence after liver transplantation (HR=2.011,2.176,2.390,1.574,95％CI:1.115-3.628,1.125-4.206,1.448-3.945,1.041-2.381,P ＜ 0.05).The median time of follow-up was 13.0 months (range,1.0-96.0 months).Eight patients missed follow-up.Fifty-four patients had tumor recurrence,and the mean time of tumor recurrence was 6.7 months (range,1.0-41.0 months).The disease-free survival time of patients with positive expression of YAP were significantly shorter than those with negative expression of YAP (Log-rank value =12.890,P ＜ 0.05).Conclusions Positive expressions of YAP and phosphorylated YAP were detected in the nucleus and cytoplasm,and the positive expressions of Lats1/2,pLats1/2,Mst1 and pMst1/2 were detected in the cytoplasm.The positive expression of YAP is the independent risk factor for tumor recurrence after liver transplantation.

Objective To investigate the correlation between the Yes-associated protein (YAP) expression and epithelial-mesenchymal transition (EMT) by transiently transfecting with YAP small-interfering RNA (siRNA) in MHCC97H and MHCC97L cells.Methods MHCC97H and MHCC97L cells were transiently transfected by YAP siRNA.Furthermore,protein expressions and mRNA levels of characteristic markers of EMT (E-cadherin,N-cadherin) were examined by Western blotting and real-time polymerase chain reaction.Transwell invasion assay was used to detect changes of invasiveness of MHCC97H and MHCC97L cells.Results The YAP siRNA transfected group in MHCC97H was examined after 72 hours by Western blotting.The result showed obviously higher expression of E-cadherin in transfected group compared with the control group (P ＜ 0.05),and lower expression of N-cadherin (P ＜ 0.05).In MHCC97L cells,the expression of E-cadherin was also significantly increased (P ＜ 0.05),however,N-cadherin expression did not significantly change (P ＞ 0.05).Moreover,compared with the control group,transwell invasion assay showed that the number of the transfected group cells significantly decreased in MHCC97H(66 ± 6.89 vs 117 ± 7.23,P ＜ 0.05),and compared with the control group,the number of the transfected group also significantly decreased in MHCC97L (40 ±2.65 vs 77 ±4.33,P ＜0.05).The result of real-time polymerase chain reaction indicated that mRNA levels of E-cadherin increased (P ＜ 0.05),but mRNA levels of N-cadherin did not significantly change (P ＞ 0.05).This is considered as post-transcriptional regulation after silencing YAP in MHCC97H and MHCC97L.Conclusions YAP silencing is able to inhibit EMT in MHCC97H and MHCC97L cells by modulating the characteristic markers of EMT.The inhibition of YAP expression can reduce the invasion ability of hepatocellular carcinoma cells.