Background and Aims:Autoimmune thyroid disease(AITD)are closely associated with metabolic dysregulation,but the causal role of specific metabolites remains unclear.This study aimed to systematically evaluate the causal relationships between approximately 1 400 blood metabolites and two major AITD subtypes-Graves'disease(GD)and Hashimoto's thyroiditis(HT)-using a two-sample Mendelian randomization(MR)approach,to identify potential risk or protective metabolites and provide genetic evidence for mechanistic studies and targeted metabolic interventions.Methods:Summary-level genome-wide association study(GWAS)data for blood metabolites and AITDs were analyzed using inverse-variance weighted MR as the primary method,supplemented by MR-Egger,weighted median,and mode-based methods.Heterogeneity,pleiotropy,and robustness were assessed through Cochran's Q test,horizontal pleiotropy test,and leave-one-out analyses.Results:Forty-nine metabolites showed significant causal associations with GD and 89 with HT.Hexanoylglutamine and ceramide(d18∶1/16∶0)were identified as GD risk factors,while N2,N2-dimethylguanosine and β-hydroxyisovalerylcarnitine were protective.Pregnanediol sulfate and theobromine were associated with increased HT risk,whereas dihomo-linolenate(20:3n3 or n6)and caprylate appeared protective.The α-ketoglutarate/succinate ratio was positively associated with both diseases,suggesting a shared metabolic risk pathway.Conclusion:This MR study provides genetic evidence supporting causal links between multiple blood metabolites and GD or HT.Several metabolites may serve as predictive or protective biomarkers,offering novel insights into the pathophysiology,early screening,and personalized metabolic intervention strategies for AITDs.

Background and Aims:Autoimmune thyroid disease(AITD)are closely associated with metabolic dysregulation,but the causal role of specific metabolites remains unclear.This study aimed to systematically evaluate the causal relationships between approximately 1 400 blood metabolites and two major AITD subtypes-Graves'disease(GD)and Hashimoto's thyroiditis(HT)-using a two-sample Mendelian randomization(MR)approach,to identify potential risk or protective metabolites and provide genetic evidence for mechanistic studies and targeted metabolic interventions.Methods:Summary-level genome-wide association study(GWAS)data for blood metabolites and AITDs were analyzed using inverse-variance weighted MR as the primary method,supplemented by MR-Egger,weighted median,and mode-based methods.Heterogeneity,pleiotropy,and robustness were assessed through Cochran's Q test,horizontal pleiotropy test,and leave-one-out analyses.Results:Forty-nine metabolites showed significant causal associations with GD and 89 with HT.Hexanoylglutamine and ceramide(d18∶1/16∶0)were identified as GD risk factors,while N2,N2-dimethylguanosine and β-hydroxyisovalerylcarnitine were protective.Pregnanediol sulfate and theobromine were associated with increased HT risk,whereas dihomo-linolenate(20:3n3 or n6)and caprylate appeared protective.The α-ketoglutarate/succinate ratio was positively associated with both diseases,suggesting a shared metabolic risk pathway.Conclusion:This MR study provides genetic evidence supporting causal links between multiple blood metabolites and GD or HT.Several metabolites may serve as predictive or protective biomarkers,offering novel insights into the pathophysiology,early screening,and personalized metabolic intervention strategies for AITDs.

Objective:To investigate the effects of atorvastatin combined with alendronate in the treatment of type 2 diabetes mellitus (T2DM) with osteoporosis (OP) on bone metabolism, tumor necrosis factor alpha (TNF-α) , interleukin 6 (IL-6) , and 25-hydroxyvitamin D[25- (OH) D] level.Methods:A total of 152 patients with T2DM and OP who were diagnosed and treated in our hospital from Jul. 2017 to Jul. 2020 were selected. According to the different treatment methods, they were divided into control group (73 cases with alendronate treatment) and study group (79 cases receiving atova Statins combined with alendronate sodium treatment) . The two groups were compared in terms of bone metabolism indexes, bone mineral density, changes in serum TNF-α, IL-6, 25- (OH) D levels, and adverse reactions before and after treatment.Results:After treatment, osteocalcin (BGP) , bone-specific alkaline phosphatase (BAP) , lumbar spine L1-4 bone mineral density, femoral neck bone mineral density, and 25- (OH) D of the two groups increased ( P< 0.001) , and the study group was significantly higher than the control group (BGP: 7.68±0.89 vs 6.88±0.93; BAP: 18.62±3.97 vs 16.82±3.24; lumbar spine L1-4: 0.95±0.08 vs 0.92±0.05; femoral neck: 0.79±0.07 vs 0.75±0.06; 25- (OH) D: 31.35±10.1 vs 26.54±7.14; all P<0.05) . After treatment, the serum type I collagen C-terminal peptide (s-CTX) , human tartrate acid phosphatase (TRAP-5b) , TNF-α, IL-6 were decreased for both groups ( P<0.001) , and they were significantly lower in the study group than those in the control group (s-CTX:0.37±0.12 vs 0.55±0.12; TRAP-5b: 2.43±0.66 vs 2.99±0.75; TNF-α: 9.93±1.91 vs 11.77±2.69; IL-6: 10.65±1.26 vs 12.91±1.21; all P<0.001) . The incidence of adverse reactions in the study group was significantly lower than that in the control group (16.46% vs 39.73%, P=0.001) . Conclusion:Atorvastatin combined with alendronate in the treatment of T2DM patients with OP can effectively increase 25- (OH) D levels, reduce inflammation, and promote bone metabolism and bone density.

Objective To study the clinical,pathological and molecular biology features of myotonic myopathies.Methods Eighty-one patients with myotonic myopathies,admitted to our hospital from June 2005 to June 2018,were chosen in our study.All patients accepted clinical and skeletal muscle pathology examination,and genetic features of 55 patients were analyzed by molecular biological method.Results (1) All patients suffered from typical myotonia,and electromyography shows typical myotonic discharges;47 patients exhibited myotonic dystrophy (DM) and 34 patients exhibited non-myotonic dystrophy (NDM).(2) In muscle biopsy of DM,typical central nuclei,pyknotic clumps and sarcoplasmic masses were observed;and characteristic pathological changes were not observed in muscle biopsy of NDM.(3) Totally,32 DM1 patients,3 DM2 patients,9 MC patients and 5 paramyotonia congenita patients were confirmed by molecular biology technology;7 independent mutations in the CLCN1 gene and 3 independent mutations in the SCN4A gene were novel mutations.Conclusions (1) Myotonic myopathies are some single gene inheritance diseases with multisystem disorders and their main symptoms include myotonia.(2) Skeletal muscle biopsy is a trustworthy method for definite diagnosis of myotonic myopathies;gene analysis is the gold standard for diagnosis and classification ofmyotonic myopathies.

Objective To develop a scale for measuring CHD patients' health belief and to rectify its reliability and validity.Methods The primary items were obtained through reviewing literature and semi-structured interviewing with CHD patients.After team discussion and experts evaluation,the pretesting scale was developed.Two hundred and sixty subjects were recruited in the first study to finish the questionnaire by convenience sampling.The reliability and validity of this scale were tested by exploratory factor analysis,reliability analysis and correlation analysis.Results It was found that eight common factors extracted by exploratory factor analysis.Factor loading of each item ranged between 0.489 and 0.850.The 8 factors explained for 60.698％ of total variance.The correlations between the subscales and the total scale were ranging from 0.811 to 0.876.The correlations between the subscales of the scale were ranging from 0.330 to 0.732.The Cronbach's α coefficients of the total scale was 0.802,and the subscales Cronbach's α coefficients were ranging from 0.684 to 0.834.Test-retest reliability was 0.880,and that of subscales were 0.673～0.841.Conclusions The newly developed coronary artery disease health belief scale has showed acceptable reliability and validity,which can be used as a useful tool for the assessment and intervention of patients' health belief.

Objective To explore the effect of auricular-plaster therapy combined with aromatherapy on anxiety and quality of life in patients with colorectal surgery.Methods A total of 135 patients with colorectal surgery were randomly divided into group A (auricular-plaster therapy combined with aromatherapy),group B(auricular-plaster therapy),group C (aromatherapy),group D(blank).Anxiety and life quality levels of four groups were determined by using self-rating anxiety scale(SAS),quality of life instruments for cancer patients (QLICP-CR)and were compared between four groups before and after intervention.Results The SAS and QLICP-CR scores of group A were lower than those of group B,group C and group D after intervention.The SAS and QLICP-CR scores of group B and group C were lower than that of group D after intervention.There were no statistical significant differences in SAS and QLICP-CR scores between group B and group C after intervention.Conclusions Auricular-plaster therapy combined with aromatherapy can effectively alleviate anxiety of patients with colorectal surgery and improve their quality of life,and the effect is better than that of auricular-plaster therapy and aromatherapy.

Objective To investigate the effects of preoperative iv different doses of pantoprazole on acidity of gastric fluid in patients undergoing elective surgery. Methods Sixty ASA Ⅰ -Ⅲ patients aged 38-80 yr,weighing 44-72 kg undergoing elective surgery were randomly allocated into 3 groups (n = 20 each): group Ⅰ control (group C); group Ⅱ pantoprazole 40 mg(group P1) and group Ⅲ pantoprazole 80 mg(group P2). The patients received intravenous normal saline (NS) 100 ml, pantoprazole 40 and 80 mg in NS 100 ml respectively in group C, P1 and P2 at 30 min before surgery. Gastric content was aspirated using a gastric tube on the patients'arrival in the operating room and at 1,2 h and the end of surgery. The pH of the gastric fluid was measured. The adverse effects including dizziness, diarrhea, PONV and incidence of stress ulcer were recorded. Results The pH was significantly increased in group P1 and P2 as compared with control group but there was no significant difference in pH between group P1 and P2 . There were no significant difference in the incidence of stress ulcer and pH of the gastric fluid≤2.5 among the 3 groups. Conclusion Preoperative intravenous pantoprazole 40 mg can effectively increase pH of gastric juice and is helpful in reducing the incidence of stress ulcer and the risk of acid aspiration.