Humans ; Non-alcoholic Fatty Liver Disease/drug therapy* ; Hypoglycemic Agents/therapeutic use* ; Liver Cirrhosis/pathology* ; Biopsy ; Patients ; Liver/pathology* ; Fibrosis

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective To evaluate biomechanical properties of the personalized titanium alloy short femoral prosthesis by finite element analysis. Methods Based on the validated femoral finite element model, the base of the femoral neck was simulated, and by inserting different short femoral prostheses, four total hip replacement (THR) models, namely, the SMF stem model (Model A), BE1 stem model (Model B), MINI stem model (Model C) and personalized stem model (Model D) were established, respectively. The same loads and constraints were applied to four groups of models, and the von Mises stress distribution and deformation were calculated and analyzed, so as to compare mechanical stability of each model. Results The deformation of all THR models was smaller than that of the femur model under physiological state. The deformation of Model B was close to that of Model C, and the deformation of Model A was close to that of Model D. The peak stress of Model C was higher than that of the other 3 models, reaching 9555 MPa. The overall stress trend was Model C > Model B > Model D> Model A > Model under physiological state. Conclusions The peak stress, stress distribution of personalized short femoral stem were similar to that of SMF stem, with reasonable stress distribution, small stress shielding of the proximal femur, minimum overall deformation and shear stress of the prosthesis, and its effectiveness and stability could meet the requirements of human biomechanics, which could provide references for joint surgeons and prosthesis researchers.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective:To evaluate composite bridge internal fixation in the treatment of limb metaphyseal fractures in children.Methods:From October 2015 to December 2018, 16 children was treated by composite bridge internal fixation for limb metaphyseal fractures at Department of Orthopaedics, The Second People's Hospital of Changzhou. They were 11 boys and 5 girls, aged from 8 to 14 years (average, 11.0 years). Their fractures were located at proximal humerus in 4 cases, at distal femur in 3 cases, at proximal tibia in 3 cases and at distal tibia in 6 cases. According to the Salter-Harris classification, 6 cases were type Ⅱ, 5 cases type Ⅲ and 5 cases type Ⅳ. The time from injury to surgery ranged from 3 to 8 days, averaging 5.3 days. The fracture healing time, postoperative complications (infection and implant failure) and postoperative functional recovery were recorded.Results:This cohort obtained follow-up from 12 to 18 months (average, 13 months). All the children obtained bony union after 2 to 5 months (average, 2.4 months). At the last follow-up, the 4 proximal humeral fractures were evaluated by the Neer scores, giving 4 excellent cases; the 6 distal femoral and proximal tibial fractures were evaluated by the knee function scores of The Hospital for Special Surgery (HSS), giving 5 excellent and one good cases; the 6 distal tibial fractures were evaluated by the Baird scores, giving 5 excellent and one good cases. Follow-ups found no complications like postoperative infection, loosening or breakage of implants, or bone nonunion.Conclusion:Composite bridge internal fixation is a good alternative treatment for children metaphyseal fractures, because it has advantages of minimal invasion, operative simplicity, reliable fixation and limited postoperative complications.

Objective To explore the relationship between different smoking status and hypothyroidism in six iodine-suitable areas of China. Methods A total of 8187 residents were investigated by cluster sampling in six cities, and 7448 residents were included in the survey. The height, weight, waist circumference, and blood pressure were measured by filling out epidemiological questionnaire. Blood samples were collected to detect thyroid stimulating hormone ( TSH) , thyroid peroxidase antibody ( TPOAb) , and thyroglobulin antibody ( TgAb) . Results The mean TSH, TPOAb, and TgAb positive rates in passive smoking and active smoking groups were all lower than those in non-smoking group ( all P<0.01) . In the active smoking group, the TSH value decreased by 0.023 units for every unit increase in smoking index. The positive rates of TgAb and TPOAb in both passive smoking and active smoking groups were lower than those in non-smoking group (all P<0.01). Active and passive smoking reduced the prevalence of hypothyroidism (both P<0.01). Among women, the risks of clinical hypothyroidism and subclinical hypothyroidism were reduced in both active and passive smoking groups. Besides, the risk of subclinical hypothyroidism decreased significantly when the smoking index was more than 70. In male population, the risk of subclinical hypothyroidism in active and passive smoking group decreased. Besides, the risk of clinical hypothyroidism and subclinical hypothyroidism decreased significantly when the smoking index was more than 70. Conclusion Smoking in iodine-suitable areas may reduce TSH level and the positive rates of TPOAb and TgAb.

In 2015, American College of Endocrinology ( ACE), American Association of Clinical Endocrinologists ( AACE ) , European Association for the Study of Diabetes ( EASD ) , Chinese Society of Endocrinology, American Diabetes Association ( ADA ) , American Association of Diabetes Educators ( AADE ) , Academy of Nutrition and Dietetics(AND), etc. published several guidelines and statements on diabetes and its complications. The selection of hypoglycemic drugs, diabetes self-management education and support, the characteristics of blood pressure and blood lipid, the efficacy and adverse reaction of hypoglycemic drugs were also suggested and recommended. These guidelines and statements will play key roles in the clinical diagnosis and treatment of diabetes mellitus, which is reviewed in this article.

Objective To investigate the alteration of energy metabolism and oxidative injury in the myocardia suffering from lethal ventricular tachyarrhythmia (LVTA). Methods Two LVTA-SCD SD rat models, induced by aconitine injection or coronary artery ligation (CAL), respectively, were developed. Rats that died from over-anaesthesia or CAL-induced heart failure were served as their controls, respectively. Mitochondrial membrane potential (MMP), reactive oxygen species (ROS), malonaldehyde (MDA), phosphocreatine (PCr) in the ventricular myocardia, and serum troponin I (cTnI) were detected, and compared between LVTA rats and their controls. Results Fourteen ACO-LVTA and six CAL-LVTA rats were successfully developed. As compared to their controls, ACO-LVTA and CAL-LVTA rats had higher ROS and MDA content, and lower concentration of PCr in the ventricular myocardia. MDA content in ACO-LVTA group is signiifcantly higher than that of its control (P<0.05). MMP in myocardia of ACO-LVTA is lower than that of its control, but is higher than those of two CAL groups. Serum cTnI in rats of both LVTA models is higher than those of their controls and pre-treated control. Specially, serum cTnI in CAL-LVTA was signiifcantly higher than that of ACO-LVTA and its control (P<0.01). The myocardial ROS content is correlated with the duration of VT and VF (P<0.05), with correlation coefifcients being 0.44 and 0.46, respectively. Conclusions After LVTA, the ventricular myocardia had lower MMP and PCr content, higher concentration of ROS, MDA, as well as higher serum cTnI than their controls, indicative of oxidative injury and alteration of energy metabolism under LVTA-SCD.

[Summary] Thyroid nodules are the most common endocrine and metabolic diseases,and most of them are accidental nodules.How to distinguish the state between benign and malignant thyroid nodules is the clinical core problems in diagnosis and treatment.In addition to detailed history collecting and physical examination,highresolution ultrasound,serum thyrotrophin levels,and fine needle aspiration biopsy (FNAB) form the basis for the diagnosis of thyroid nodules.Endocrinologists should grasp the indications of FNAB.When the pathological finding is unable to distinguish between benign and malignant nodules,molecular or genetic diagnosis should be adopted for further diagnosis.Appropriate treatment is selected according to the definitive results.In this article,we share the whole process that one case with thyroid nodule was diagnosed as papillary thyroid carcinoma and eventually treated with surgery,so as to make clinicians pay more attention to thyroid nodules with standardized clinical diagnosis and treatment.

In the past 2013,American Diabetes Association (ADA),American Association of Clinical Endocrinologists(AACE),Chinese Society of Endocrinology,etc.published some guidelines and consensuses on topics such as clinical diagnnsis,treatment,integrated management,and the relationship between reducing body weight and complications.Characters of blood pressure control in diabetic patients were also announced by the Eighth Joint National Committee (JNC 8).Meanwhile,Food and Drug Administration (FDA) declared the statements on safety of several hypoglycemic agents.These guidelines and consensuses will play key roles in standardizing clinical diagnosis,treatment,and medication.