Objective:To analyze the relationship among thyroid autoimmunity (TAI), thyroid function, and gestational diabetes mellitus (GDM) in early pregnant women in Xi'an.Methods:A prospective study included pregnant women who underwent prenatal check-ups at the Northwest Women's and Children's Hospital from November 2020 to October 2021, with a gestational age of 6 to 14 weeks. Thyroid function, thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and urinary iodine levels were measured, and the prevalence of thyroid disease and GDM was monitored. The subjects were divided into four groups: TPOAb positive only, TgAb positive only, both TPOAb and TgAb positive, and both TPOAb and TgAb negative, to compare the differences in the prevalence of thyroid disease and GDM among the groups. Statistical analysis was performed using Kruskal-Wallis rank-sum test, Bonferroni correction, Chi-square test, and a multivariate logistic regression model was used to analyze the relationship between TAI, thyroid disease, and GDM. Results:A total of 20 243 early pregnant women were included in this study, among which 1 615 (7.98%) were positive for TPOAb only; 865 (4.27%) were positive for TgAb only; 1 672 (8.26%) were positive for both TPOAb and TgAb (both positive group); and 16 091 (79.49%) were negative for both TPOAb and TgAb (both negative group). The thyroid stimulating hormone levels in the TPOAb positive only group, TgAb positive only group, and both positive group were significantly higher than those in the both negative group, respectively (Bonferroni correction, all P<0.05); the free thyroxine level in the TPOAb positive only group was significantly lower than that in the both negative group ( P<0.05). After adjusting for age, pre-pregnancy body mass index, and urinary iodine levels, multivariate logistic regression analysis showed that compared to the both negative group, the risk of developing hypothyroidism during pregnancy was significantly increased in the both positive group ( OR=11.49, 95% CI: 2.84-46.39); the risk of developing subclinical hypothyroidism during pregnancy was significantly increased in the TgAb positive only group ( OR=1.99, 95% CI: 1.05-3.76) and the both positive group ( OR=3.74, 95% CI: 2.49-5.63); the risk of developing GDM was significantly increased in the TgAb positive only group ( OR=1.43, 95% CI: 1.04-1.96) and the both positive group ( OR=1.94, 95% CI: 1.53-2.46). Among early pregnant women with normal thyroid function, after adjusting for age, pre-pregnancy body mass index, and urinary iodine levels, multivariate logistic regression analysis showed that compared to the both negative group, the risk of developing GDM was significantly increased in the TgAb positive only group ( OR=1.46, 95% CI: 1.06-2.02) and the both positive group ( OR=1.80, 95% CI: 1.40-2.32). Conclusion:TgAb positive only is a risk factor for subclinical hypothyroidism and GDM. Screening for thyroid autoantibodies, especially TgAb, during pregnancy helps in the early identification of high-risk pregnant women for thyroid dysfunction and GDM.

Objective To construct a macrophage-related risk assessment model,explore the impact of macrophages on the survival of patients with lung squamous cell carcinoma(LUSC),and predict immune status.Methods We downloaded the data of macrophages and LUSC from the Molecular Signatures DataBase(MSigDB)and The Cancer Genome Atlas(TCGA)database,respectively,screened for differentially expressed macrophage-related genes,and constructed a risk score model using Cox regression analysis.Based on the median value of the risk score,LUSC in the TCGA database was divided into high-and low-risk groups.Kaplan-Meier analyses,receiver operating characteristic curve analyses,clinical case characteristics,and immune analyses were used to evaluate the prognostic model.Finally,we determined the relationship between anticancer drug sensitivity and the risk score using the Genomics of Drug Sensitivity in Cancer(GDSC).Results A total of 124 macrophage-related genes were identified in LUSC.High-risk patients had shorter overall survival and higher infiltration of immunosuppressive cells.Ruxolitinib,vinorelbine,paclitaxel,and sorafenib seemingly exhibited better efficacy in low-risk patients.The mortality rate of LUSC patients decreasd with the reduction of risk scores,and CSF2 and EDN2 had a significant impact on overall survival.Conclusion In this study,we constructed a macrophage gene risk score model for predicting the prognosis of LUSC.The model genes CSF2 and END2 can be used as potential targets for subsequent studies of LUSC.

Objective To construct a macrophage-related risk assessment model,explore the impact of macrophages on the survival of patients with lung squamous cell carcinoma(LUSC),and predict immune status.Methods We downloaded the data of macrophages and LUSC from the Molecular Signatures DataBase(MSigDB)and The Cancer Genome Atlas(TCGA)database,respectively,screened for differentially expressed macrophage-related genes,and constructed a risk score model using Cox regression analysis.Based on the median value of the risk score,LUSC in the TCGA database was divided into high-and low-risk groups.Kaplan-Meier analyses,receiver operating characteristic curve analyses,clinical case characteristics,and immune analyses were used to evaluate the prognostic model.Finally,we determined the relationship between anticancer drug sensitivity and the risk score using the Genomics of Drug Sensitivity in Cancer(GDSC).Results A total of 124 macrophage-related genes were identified in LUSC.High-risk patients had shorter overall survival and higher infiltration of immunosuppressive cells.Ruxolitinib,vinorelbine,paclitaxel,and sorafenib seemingly exhibited better efficacy in low-risk patients.The mortality rate of LUSC patients decreasd with the reduction of risk scores,and CSF2 and EDN2 had a significant impact on overall survival.Conclusion In this study,we constructed a macrophage gene risk score model for predicting the prognosis of LUSC.The model genes CSF2 and END2 can be used as potential targets for subsequent studies of LUSC.

Objective:To analyze the relationship among thyroid autoimmunity (TAI), thyroid function, and gestational diabetes mellitus (GDM) in early pregnant women in Xi'an.Methods:A prospective study included pregnant women who underwent prenatal check-ups at the Northwest Women's and Children's Hospital from November 2020 to October 2021, with a gestational age of 6 to 14 weeks. Thyroid function, thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and urinary iodine levels were measured, and the prevalence of thyroid disease and GDM was monitored. The subjects were divided into four groups: TPOAb positive only, TgAb positive only, both TPOAb and TgAb positive, and both TPOAb and TgAb negative, to compare the differences in the prevalence of thyroid disease and GDM among the groups. Statistical analysis was performed using Kruskal-Wallis rank-sum test, Bonferroni correction, Chi-square test, and a multivariate logistic regression model was used to analyze the relationship between TAI, thyroid disease, and GDM. Results:A total of 20 243 early pregnant women were included in this study, among which 1 615 (7.98%) were positive for TPOAb only; 865 (4.27%) were positive for TgAb only; 1 672 (8.26%) were positive for both TPOAb and TgAb (both positive group); and 16 091 (79.49%) were negative for both TPOAb and TgAb (both negative group). The thyroid stimulating hormone levels in the TPOAb positive only group, TgAb positive only group, and both positive group were significantly higher than those in the both negative group, respectively (Bonferroni correction, all P<0.05); the free thyroxine level in the TPOAb positive only group was significantly lower than that in the both negative group ( P<0.05). After adjusting for age, pre-pregnancy body mass index, and urinary iodine levels, multivariate logistic regression analysis showed that compared to the both negative group, the risk of developing hypothyroidism during pregnancy was significantly increased in the both positive group ( OR=11.49, 95% CI: 2.84-46.39); the risk of developing subclinical hypothyroidism during pregnancy was significantly increased in the TgAb positive only group ( OR=1.99, 95% CI: 1.05-3.76) and the both positive group ( OR=3.74, 95% CI: 2.49-5.63); the risk of developing GDM was significantly increased in the TgAb positive only group ( OR=1.43, 95% CI: 1.04-1.96) and the both positive group ( OR=1.94, 95% CI: 1.53-2.46). Among early pregnant women with normal thyroid function, after adjusting for age, pre-pregnancy body mass index, and urinary iodine levels, multivariate logistic regression analysis showed that compared to the both negative group, the risk of developing GDM was significantly increased in the TgAb positive only group ( OR=1.46, 95% CI: 1.06-2.02) and the both positive group ( OR=1.80, 95% CI: 1.40-2.32). Conclusion:TgAb positive only is a risk factor for subclinical hypothyroidism and GDM. Screening for thyroid autoantibodies, especially TgAb, during pregnancy helps in the early identification of high-risk pregnant women for thyroid dysfunction and GDM.

Objective To study the association between mean platelet volume(MPV),platelet distribution width(PDW)and procalcitonin(PCT)and cardiac function in patients with pulmonary hypertension(PH)and their diagnostic value on heart failure.Methods 103 patients with PH(PH group)in the 3rd People's Hospital of Chengdu from October 2021 to October 2022 and 103 healthy subjects with physical examination(control group)were selected as study subjects.Fasting peripheral venous blood was collected on the 1st day of admission and MPV,PDW and PCT were detected.The left ventricular ejection fraction(LVEF)was measured and the cardiac function was evaluated by New York Heart Association(NYHA)grading criteria.The patients with PH were divided into failure group and non-failure group according to the diagnosis results of heart failure.The relations of MPV,PDW and PCT with cardiac function in patients with PH and the diagnostic value on heart failure were analyzed.Results The levels of MPV,PDW,and PCT were all higher in the experimental group compared to the control group,while the LVEF was lower,and these differences were statistically significant(P<0.05);as the NYHA classification increased,the levels of MPV,PDW,and PCT showed an increasing trend,while LVEF showed a decreasing trend,and the differences between the groups were statistically significant(P<0.05);in the heart failure group n = 65,the levels of MPV,PDW,and PCT were higher compared to the non-heart failure group n = 38,while LVEF was lower,and these differences were statistically significant(P<0.05).The levels of MPV,PDW,and PCT werr signifi-cantly positively correlated with NYHA functional classification and LVEF(P<0.05).The levels of MPV,PDW,and PCT had good reference value for the diagnosis of heart failure in PH patients,with AUC values of 0.816,0.897,and 0.825 respectively,and the combined diagnostic AUC is 0.952,which wass statistically different from the application of the three indicators alone(P<0.05).Conclusion RDW,PDW and PCT are closely related to cardiac function in patients with PH,and can provide reference information for diagnosis and treatment of heart failure in patients with PH.

BACKGROUND: The onset and clinical presentation of systemic lupus erythematosus (SLE) are sex-related. Few studies have investigated the distinctions in clinical characteristics and treatment preferences in male and female SLE patients in the initial cohort. This study aimed to improve the understanding of Chinese SLE patients by characterizing the different sexes of SLE patients in the inception cohort. METHODS: Based on the initial patient cohort established by the Chinese SLE Treatment and Research Group, a total of 8713 patients (795 men and 7918 women) with newly diagnosed SLE were enrolled between April 2009 and March 2021. Of these, 2900 patients (347 men and 2553 women) were eligible for lupus nephritis (LN). A cross-sectional analysis of the baseline demographic characteristics, clinical manifestations, laboratory parameters, organ damage, initial treatment regimens, and renal pathology classification was performed according to sex. RESULTS: In the SLE group, as compared to female patients, male patients had a later age of onset (male vs. female: 37.0 ± 15.8 years vs. 35.1 ± 13.7 years, P  = 0.006) and a higher SLE International Collaborative Clinic/American College of Rheumatology damage index score (male vs. female: 0.47 ± 1.13 vs. 0.34 ± 0.81, P  = 0.015), LN (male vs. female: 43.6% vs. 32.2%, P < 0.001), fever (male vs. female: 18.0% vs. 14.6%, P  = 0.010), thrombocytopenia (male vs. female: 21.4% vs. 18.5%, P  = 0.050), serositis (male vs. female: 14.7% vs. 11.7%, P  = 0.013), renal damage (male vs. female: 11.1% vs. 7.4%, P < 0.001), and treatment with cyclophosphamide (CYC) (P < 0.001). The frequency of leukopenia (male vs. female: 20.5% vs. 25.4%, P  = 0.002) and arthritis (male vs. female: 22.0% vs. 29.9%, P < 0.001) was less in male patients with SLE. In LN, no differences were observed in disease duration, SLE Disease Activity Index score, renal biopsy pathological typing, or 24-h urine protein quantification among the sexes. In comparisons with female patients with LN, male patients had later onset ages (P  = 0.026), high serum creatinine (P < 0.001), higher end-stage renal failure rates (P  = 0.002), musculoskeletal damage (P  = 0.023), cardiovascular impairment (P  = 0.009), and CYC use (P  = 0.001); while leukopenia (P  = 0.017), arthritis (P  = 0.014), and mycophenolate usage (P  = 0.013) rates were lower. CONCLUSIONS Male SLE patients had more severe organ damage and a higher LN incidence compared with female SLE patients; therefore, they may require more aggressive initial treatment compared to female patients.
Humans ; Female ; Male ; Cross-Sectional Studies ; Sex Characteristics ; East Asian People ; Severity of Illness Index ; Lupus Erythematosus, Systemic/diagnosis* ; Lupus Nephritis/pathology* ; Registries ; Cyclophosphamide/therapeutic use* ; Thrombocytopenia ; Leukopenia/drug therapy* ; Arthritis

OBJECTIVE：To explore th e applicatio n of team situatio nal simulation education and teaching mode in clinical pharmacy teaching. METHODS ：A total of 60 clinical pharmacy interns were selected as the research objects ，and course disease was type 2 diabetes mellitus. Thirty interns were randomly selected as control group ，using traditional teaching mode ；other 30 interns were selected as trial group ，which carried out team situational simulation education and teaching mode. The teaching effects were evaluated by using the satisfaction of interns to the two modes ，the comprehensive score of graduation examination and the self-evaluation of learning effect. RESULTS ：Compared with traditional teaching mode ，team situational simulation education and teaching mode was conducive to stimulate the learning interest of interns ，improve their interpersonal communication ability ， cultivate teamwork spirit ，improve the awareness of humanistic care ，and cultivate the professional attitude of clinical pharmacists （P＜0.05）. Compared with control group ，the comprehensive score of trial group was dominantly increased （P＜0.001），and the scores of professional quality ，humanistic care and communication skills in the trial group were significantly higher than control group（P＜0.01）. In terms of self-evaluation of learning effect ，except for the pathogenesis of type 2 diabetes and the commonly used treatment regimens ，the self-evaluation scores of the other items in trial group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Team situational simulation education and teaching mode is superior to traditional teaching mode for clinical pharmacy teaching.

Objective To investigate the prevalence of iron deficiency(ID)and iron deficiency anemia (IDA) in pregnant women in urban areas of China. Methods The study was a national cross-sectional survey conducted from September 19th, 2016 to November 20th, 2016. According to the classification of the National Bureau of Statistics, all survey sites were set up in 6 regions of the country. Pregnant women were continuously selected using multistage stratified sampling. A total of 12 403 pregnant women were collected and examined for serum ferritin and hemoglobin levels. Results The median serum ferritin level during pregnancy was 20.60 μg/L(11.78-36.98 μg/L), the hemoglobin level was(118±12)g/L. With the progress of pregnancy, the levels of serum ferritin and hemoglobin decreased gradually. The median serum ferritin levels in the first, second trimester and third trimester were 54.30 μg/L(34.48-94.01 μg/L), 28.60 μg/L(16.40-50.52 μg/L), and 16.70 μg/L(10.20-27.00 μg/L)respectively(P<0.01). The mean hemoglobin levels were(127 ± 10)g/L,(119 ± 11)g/L and(117 ± 11)g/L respectively(P<0.01). The prevalence of ID in urban pregnant women was 48.16%(5 973/12 403), and IDA prevalence was 13.87% (1 720/12 403). The prevalence of IDA in the first, second trimester and third trimester were 1.96% (20/1 019), 8.40%(293/3 487)and 17.82%(1 407/7 897), respectively(P<0.01). The prevalence of standardized ID and IDA were significantly different in various regions of China(P<0.01). The standardized prevalence of ID were relatively higher in East China and Northeast China, 57.37% and 53.41% respectively, while it was the lowest in Southwest China, 30.51%. The standardized prevalence of IDA in South Central, Northwest, and East China were relatively high, 21.30%, 16.97% and 17.53% respectively, and the standardized prevalence of IDA in Southwest China was the lowest, 5.44%,the differents in various regions were significant(all P<0.01). Conclusion The current phenomenon of ID and IDA in pregnant women is still very common,and nutrition and health care during pregnancy should be strengthened.

Objective To explore the value of retrievable inferior vena cava (IVC) filter placement for prevention of perioperative pulmonary embolism (PE) in patients with lower extremity/pelvic fracture with deep vein thrombosis (DVT).Methods Clinical data of 1 891 lower extremity/pelvic fracture patients combined with DVT were retrospectively analyzed.Totally 411 patients with permanent filters were excluded,and the other patients were divided into filter group (n=843) and control group (n=637) according to whether receiving retrievable IVC filter placement or not.The incidence of perioperative symptomatic PE and mortality were compared between the two groups.Results In filter group,Optease nonpermanent filters were inserted in 218 patients,and the mean indwelling time was (14.3±3.6) days.Celcet filters were inserted in 625 patients,and the filters were successfully removed in 566 out of 578 patients who underwent filter removal surgery (97.92％,566/578),and the mean indwelling time was (15.8±4.1) days.The incidence of PE in filter group (0.12％[1/843]) was significantly lower than that in control group (1.57％ [10/637],P＜0.05).Among the patients who received chemical anticoagulant therapy,the incidence of PE in filter group and control group was 0.14 ％ (1/700) and 1.47％(9/612),respectively (P＜0.05).Conclusion Retrievable IVC filter placement is a safe and effective method for preventing perioperative symptomatic and fatal PE in lower extremity/pelvic fracture patients with DVT.

OBJECTIVE:To establish a method for simultaneously determination of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule. METHODS:HPLC was performed on the column of Agilent TC-C18 with mobile phase of methanol-0.2 mol/L ammonium acetate(gradient elution) at a flow rate of 1.0 ml/min;detection wavelength was 250 nm and column temperature was 25 ℃ and injection volume was 10 μl. RESULTS:The linear range was 0.007 1-0.178 0 mg/ml(r=0.999 8)for glycyrrhizin acid and 0.354 8-8.720 0 μg/ml of glycyrrhetinic acid(r=0.999 8);RSDs of precision,stability and reproducibility tests were no more than 1.74%,average recoveries were 95.49%-100.62%(RSD=1.98%,n=9)and 96.80%-102.26%(RSD=1.83%,n=9),respec-tively. CONCLUSIONS:The method is simple,reproducible,accurate and reliable,and can be used for the simultaneous determi-nation of glycyrrhizic acid and glycyrrhetinic acid in Yaotongning capsule.