This paper reports the clinical data and the diagnosis and treatment of a patient with exogenous insulin autoimmune syndrome(EIAS)induced by long-term use of exogenous insulin(Eucrin 50).For diabetes patients with hyperinsulin-induced hypoglycemia,detection of IAA is helpful for diagnosis EIAS.Due to different test methods affect IAA results,if negative,EIAS cannot be completely excluded.The polyethylene glycol precipitation method can assist in early diagnosis.

Objective:To analyze the effect of different doses of estrogen on endometrial blood flow after tran-scervical resection of adhesion(TCRA)surgery in patients with intrauterine adhesion(IUA).Methods:A total of 70 moderate and severe IUA patients who underwent TCRA in the General Hospital of Ningxia Medical University from 2021 to 2023 were divided into group A(4 mg/day)and group B(6 mg/day)according to the dosage of es-trogen after operation.Reexamination of hysteroscopy was performed 2 months later,menstrual volume was fol-lowed up,uterine parameters in secretory phase were detected by B-ultrasound,and factors related to prolifera-tion,fibrosis and blood flow were detected by immunofluorescence after 3 months.Results:① In the severe IUA group,there was no difference in the rate of intrauterine re adhesion between group A2 and group B2.The satis-faction rate of endometrial epithelialization and endometrial glandular duct density in group B2 was higher than that in group A2,and the difference was statistically significant(P＜0.05).There was no significant difference in the three indicators within the moderate IUA group(P＞0.05).②Three months after operation,in the severe IUA group,there were statistically significant differences(P＜0.05)in menstrual flow,endometrial thickness ET,endo-metrial volume EV,endometrial blood flow values(VI,FI,VFI),and uterine artery blood flow values(PI,RI)be-tween the two groups;The above indicators showed no statistically significant differences within the moderate IUA group(P＞0.05).③Detection of endometrial markers:the expression of proliferation marker(Ki-67)and angio-genesis marker(CD31,CD34,CD146,b-FGF,VEGF)in group B2 was higher than that in group A2,while the ex-pression of fibrosis marker(α-SMA,TGF-β1)was lower,with statistical significance(P＜0.05).There was no sig-nificant difference in the expression of above indexes between group A,and group B,in moderate IUA group(P＞0.05).Conclusions:Short-term application of relatively high dose estrogen(6 mg/day)after TCRA can pro-mote better endometrial repair by improving endometrial blood flow in patients with severe IUA,while in patients with moderate IUA there is no significant difference in the effect on endometrial repair.

This study investigates the clinical differentiation and treatment strategies for bipolar disorder （BD） by analyzing the relationship of its core pathomechanisms including qi stagnation， blood stasis， phlegm turbidity， and heat constraint with bile acid metabolism. The imbalance of "yin in form and yang in function" leads to qi stagnation， blood stasis， phlegm turbidity， and heat constraint， which are critical in the pathogenesis and progression of BD. Bile acids regulate neuroinflammation， neural plasticity， and intestinal flora homeostasis through receptor-mediated pathways. It is believed that the physiological functions of bile acids concretely embody the concept of the "liver is yin in form and yang in function" theory. Clinically， prescriptions such as Sini Powder （四逆散） with the function of venting pathogen and resolving constraint， Wendan Decoction （温胆汤） of drying dampness and resolving phlegm， Longdan Xiegan Decoction （龙胆泻肝汤） of clearing liver and draining fire， and Huanglian Ejiao Decoction （黄连阿胶汤） of nourishing yin and blood can be used to nourish liver yin and restore liver yang function. These strategies may improve BD prognosis by modulating bile acid synthesis and metabolism.

BackgroundMetabolic syndrome （MetS） is highly prevalent in patients with mental disorders， including elevated diastolic or systolic blood pressure， elevated fasting glucose， hypercholesterolemia， abdominal obesity and so on. As an important component of MetS， the relationship between hypercholesterolemia and mental disorder has been extensively reported， whereas few genome-wide association studies （GWAS） have been conducted to identify the causal role of mental disorders in hypercholesterolemia. ObjectiveTo explore the potential causal relationship between mental disorders and hypercholesterolemia by two-sample Mendelian randomization （MR） method. MethodsSummary data from GWAS were analyzed. Single nucleotide polymorphisms （SNPs） strongly associated with mental disorders were chosen as instrumental variables， and hypercholesterolemia was used as outcome variable. MR analysis utilized inverse-variance weighted （IVW）， MR-Egger regression and weighted median estimation （WME） as the primary analytical tool， and supplemented by simple mode （SM） and weighted mode （WM）. The causal relationship between mental disorders and the risk of hypercholesterolemia was illustrated in terms of odds ratio （OR）. ResultsA total of 36 SNPs associated with mental disorders were identified as instrumental variables. The primary findings from IVW revealed existence of a causal relationship between mental disorders and hypercholesterolemia （IVW： OR=1.067， 95% CI： 1.026~1.109， P=0.001）. Findings from the additional methods （MR-Egger regression， WME， SM， WM） were basically consistent with those reported in IVW method. Further verification indicated that the causal relationship between mental disorders and the risk of hypercholesterolemia was not affected by genetic polymorphism （P>0.05）. The absence of heterogeneity was confirmed through Cochran's Q test and MR-Egger regression （P>0.05）. Furthermore， no causal association in the reverse direction was found （P>0.05）. ConclusionThere is a causal relationship between mental disorders and hypercholesterolemia， and patients with mental disorders may have an increased probability of suffering from hypercholesterolemia.

Objective:To analyze the effect of different doses of estrogen on endometrial blood flow after tran-scervical resection of adhesion(TCRA)surgery in patients with intrauterine adhesion(IUA).Methods:A total of 70 moderate and severe IUA patients who underwent TCRA in the General Hospital of Ningxia Medical University from 2021 to 2023 were divided into group A(4 mg/day)and group B(6 mg/day)according to the dosage of es-trogen after operation.Reexamination of hysteroscopy was performed 2 months later,menstrual volume was fol-lowed up,uterine parameters in secretory phase were detected by B-ultrasound,and factors related to prolifera-tion,fibrosis and blood flow were detected by immunofluorescence after 3 months.Results:① In the severe IUA group,there was no difference in the rate of intrauterine re adhesion between group A2 and group B2.The satis-faction rate of endometrial epithelialization and endometrial glandular duct density in group B2 was higher than that in group A2,and the difference was statistically significant(P＜0.05).There was no significant difference in the three indicators within the moderate IUA group(P＞0.05).②Three months after operation,in the severe IUA group,there were statistically significant differences(P＜0.05)in menstrual flow,endometrial thickness ET,endo-metrial volume EV,endometrial blood flow values(VI,FI,VFI),and uterine artery blood flow values(PI,RI)be-tween the two groups;The above indicators showed no statistically significant differences within the moderate IUA group(P＞0.05).③Detection of endometrial markers:the expression of proliferation marker(Ki-67)and angio-genesis marker(CD31,CD34,CD146,b-FGF,VEGF)in group B2 was higher than that in group A2,while the ex-pression of fibrosis marker(α-SMA,TGF-β1)was lower,with statistical significance(P＜0.05).There was no sig-nificant difference in the expression of above indexes between group A,and group B,in moderate IUA group(P＞0.05).Conclusions:Short-term application of relatively high dose estrogen(6 mg/day)after TCRA can pro-mote better endometrial repair by improving endometrial blood flow in patients with severe IUA,while in patients with moderate IUA there is no significant difference in the effect on endometrial repair.

Objective To explore the relationship between thyroid function and hyperactivity behavior(HB)in children with attention deficit hyperactivity disorder(ADHD),and further understand the potential factors contributing to increased risk of ADHD,and provide references for the treatment of ADHD in children.Methods A total of 134 pediatric ADHD patients who were treated and followed up at Huzhou Central Hospital from February 2018 to August 2023 were selected as the research subjects.According to the hyperactivity index(HI),they were divided into non HB group(n=71)and HB group(n=63).General information and routine laboratory parameters were compared between two groups.HB-related factors were evaluated by using binary Logistic regression analysis.Finally,Pearson linear correlation analysis and receiver operating characteristic curve were used to study the relationship between HB and thyroid stimulating hormone(TSH)and the potential diagnostic value of TSH levels in distinguishing ADHD children with HB.Results The differences in lactic acid and TSH levels between two groups of cases were statistically significant,with HB group significantly higher compared to non HB group(P＜0.05).Among them,TSH level was independently associated with HB and positively correlated with HI score(r=0.668,P＜0.00 1).Additionally,TSH level had a certain value in distinguishing ADHD children with HB,with a cut-off point of 2.57 μIU/ml(sensitivity was 65.1％,specificity was 74.7％).Conclusion This study revealed a positive correlation between serum TSH level and HB in children with ADHD,and it can be used to differentiate ADHD children with HB.

This paper reports the clinical data and the diagnosis and treatment of a patient with exogenous insulin autoimmune syndrome(EIAS)induced by long-term use of exogenous insulin(Eucrin 50).For diabetes patients with hyperinsulin-induced hypoglycemia,detection of IAA is helpful for diagnosis EIAS.Due to different test methods affect IAA results,if negative,EIAS cannot be completely excluded.The polyethylene glycol precipitation method can assist in early diagnosis.

Objective To explore the relationship between thyroid function and hyperactivity behavior(HB)in children with attention deficit hyperactivity disorder(ADHD),and further understand the potential factors contributing to increased risk of ADHD,and provide references for the treatment of ADHD in children.Methods A total of 134 pediatric ADHD patients who were treated and followed up at Huzhou Central Hospital from February 2018 to August 2023 were selected as the research subjects.According to the hyperactivity index(HI),they were divided into non HB group(n=71)and HB group(n=63).General information and routine laboratory parameters were compared between two groups.HB-related factors were evaluated by using binary Logistic regression analysis.Finally,Pearson linear correlation analysis and receiver operating characteristic curve were used to study the relationship between HB and thyroid stimulating hormone(TSH)and the potential diagnostic value of TSH levels in distinguishing ADHD children with HB.Results The differences in lactic acid and TSH levels between two groups of cases were statistically significant,with HB group significantly higher compared to non HB group(P＜0.05).Among them,TSH level was independently associated with HB and positively correlated with HI score(r=0.668,P＜0.00 1).Additionally,TSH level had a certain value in distinguishing ADHD children with HB,with a cut-off point of 2.57 μIU/ml(sensitivity was 65.1％,specificity was 74.7％).Conclusion This study revealed a positive correlation between serum TSH level and HB in children with ADHD,and it can be used to differentiate ADHD children with HB.

OBJECTIVE To study the inhibitory effect and mechanism of curcumin and its derivatives A and B on TGF-β induced LX-2 cell fibrosis. METHODS Established the liver fibrosis model of LX-2 cells induced by TGF-β(10 ng·mL−1).The effects on cell proliferation were detected by CCK-8. The effects on cell apoptosis was detected by flow cytometry. The effects on fibrosis related factors(Collagen I, Collagen Ⅳ, Fibronectin, Vimentin, α-SMA, PDGFRβ, TGFβR1, TGFβR2, MMP2, MMP9, TIMP1 and TIMP2) protein expression and gene transcription levels were detected by Western blotting and q-PCR. RESULTS The curcumin and its derivative A and B had the inhibition effects on normal LX-2 cells, and the IC25 values were 15.7, 2.6, 10.2 μmol·L−1, respectively. Compared to the model group, the curcumin(15.7 μmol·L−1) and its derivative A(2.6 μmol·L−1) and B(10.2 μmol·L−1) had the significant inhibition effects on cell proliferation of the TGF-β induced LX-2 cells(P<0.05). The cell apoptosis rate of curcumin derivative B group was higher than the model group(P<0.05). Collagen I, Fibronectin, Vimentin, α-SMA, TGFβR1 and TIMP-1 protein expression levels in curcumin group were lower, while the protein expression level of MMP-9 was higher(P<0.05). The protein expression levels of Collagen I, Collagen IV, Fibronectin, Vimentin, α-SMA, TIMP-1 and TIMP-2 in curcumin derivative A group were lower, while the protein expression level of MMP-2 was higher(P<0.05). The protein expression levels of Collagen I, Collagen IV, Fibronectin, Vimentin, α-SMA, PDGFRβ, TGFβR1, TGFβR2, TIMP-1 and TIMP-2 in curcumin derivative B group were lower, while the protein expression level of MMP-2 was higher(P<0.05). The gene transcription levels of Collagen I, Fibronectin, α-SMA and TIMP-1 in curcumin group were lower(P<0.05). The gene transcription levels of Collagen I, Fibronectin and α-SMA in curcumin derivative A and B groups were lower(P<0.05). CONCLUSION Curcumin and its derivatives A and B inhibit the abnormal activation and proliferation of TGF-β-induced LX-2 cells, inhibit the excessive secretion and accumulation of its extracellular matrix components, and promote its degradation, thus playing an anti-fibrotic effect in vitro, especially the curcumin derivative B.

【Objective】 To investigate the differential diagnosis of 1 anti-C, e alloantibodies combined with anti-e, Jk^b mimicking alloantibodies by absorption-elution test and titer integral method. 【Methods】 ABO, Rh and Kidd blood group antigens were identified by tube method. Two sets of panel cells were used for antibody screening and antibody specificity identification by saline method, polyamine method and microcolumn gel method.The antibody was further confirmed by multiple absorption-elution tests and titer integral method. RHCE and JK gene were sequenced by multiple PCR. 【Results】 Serological gene sequencing analysis showed that the ABO blood group of the patient was A type with Rh subtype ccDEE and was positive for direct antiglobulin test (DAT). Multiple absorption-elution tests and titer integral method demonstrated that the serum of the patient contained anti-C, e alloantibodies along with anti-e, Jk^b mimicking autoantibodies and there were anti-e, Jk^b mimicking autoantibodies on red blood cells(RBCs). According to gene sequencing analysis, there was G>C at exon 676 of the RHCE gene, and the remaining exons were not mutated, suggesting that the RHCE phenotype was ccEE. The 838 G/A heterozygote of exon 9 in JK gene, Jk blood group phenotype was Jk (a+ b+ ). Cross matched type A ccDEE and Jk(a+ b-) RBCs were transfused, and no adverse reactions occurred. 【Conclusion】 Serology combined with molecular biology to identify the phenotype of the patient′s RBCs, absorption-elution test and titer integral method to identify the antibody of the patient′s serum can detect the alloantibody type, thus providing strategies for targeted blood transfusion.