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Objective@#To observe the association between puberty development and thyroid function among school-aged girls in Minhang District of Shanghai, in order to explore the effect of puberty development on thyroid function. @*Methods@#The study was based on a cohort of adolescent girls recruited in iodine-suitable areas of Minhang District, and the baseline and follow-up survey have been carried out from January to March 2019. The method of phased cluster sampling was used to select one junior high school in the east, south, north and middle of Minhang District, Shanghai, respectively. Finally, 464 new junior high school girls were included in the Cohort study for physical examination, and girls were followed up from January to March 2021. The Puberty Development Scale (PDS) was used to assess the stage of puberty. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant. Thyroid homeostasis structure parameters (THSPs) was calculated. Changes of Thyroid hormones at baseline and follow-up were compared by Wilcoxon signed rank sum test. Multiple linear regression analyses were used to evaluate the associations of thyroid hormones (THs) and THSPs changes with pubertal develepment.@*Results@#Serum TSH levels of female studentds decreased significantly, while their FT3 and FT4 levels increased significantly during the study period ( Z=-10.53, -4.71, -12.46, P <0.01). In multiple linear regression analysis after adjustment for co-variables (including baseline age, change of BMI and waist circumference), FT4 and thyroid feedback quantile-based index (TFQI) in the higher puberty category scores changes (△PCS) group were further reduced compared with those in the low △PCS group ( β =-0.66, -0.55 ). Compared to the late puberty at baseline and follow-up (BLFL) group, FT4 and TFQI showed higher decline in the pre-puberty at baseline and late puberty at follow-up (BPFL) group with the pre-puberty at baseline and end of puberty at follow-up (BPFT) group ( β =-0.55, -0.44)( P <0.05). There were no association of △TSH, △FT3, △FT4/FT3 and TSH index changes (△TSHI) with △PCS or the puberty pattern.@*Conclusion@#Serum TSH decreases while serum FT3 and FT4 increase among girls during puberty. Both the initial stage and the velocity of pubertal development are related to thyroid hormone fluctuations.
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Objective:To explore the efficacy of mecobalamin combined with insulin in the treatment of patients with gestational diabetes (GDM) and its effect on Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) signaling pathway and maternal and infant outcomes.Methods:A total of 132 patients with GDM in the Fourth Central Hospital of Baoding City were selected and they were randomly grouped according to the principles of stratified random design and controlled design trials, with 66 cases in each group. The control group was treated with insulin, and the observation group was treated with mecobalamin combined with insulin. The curative effect, fasting blood glucose (FBG) and 2 h postprandial blood glucose (2 h PBG), TLR4, MyD88, tumor necrosis factor-α (TNF-α), white blood cells interleukin 1β (IL-1β) before and after treatment and infant outcomes were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.45%(63/66) vs. 84.85%(56/66), and the difference was statistically significant ( χ2 = 4.181, P<0.05). After 1, 2, 3 weeks of treatment, the levels of FBG and 2 h PBG in the observation group were lower than those in the control group: after 1week of treatment, the differences were statistically significant ( P<0.05). After 1, 2, 3 weeks of treatment, the levels of serum TLR4, MyD88, TNF-α, IL-1β in the observation group were lower than those in the control group: after 1 week of treatment, the differences were statistically significant ( P<0.05). The incidence of cesarean section, polyhydramnios, macrosomia and premature birth in the observation group were lower than those in the control group: 7.58%(5/66) vs. 21.21%(14/66), 4.55%(3/66) vs. 16.67%(11/66), 1.52%(1/66) vs. 13.64%(9/66), 3.03%(2/66) vs. 7.58%(5/66), the differences were statistically significant ( P<0.05). Conclusions:Mecobalamin combined with insulin can regulate the TLR4/MyD88 signaling pathway, which can help to control blood sugar and improve the maternal and infant outcomes.
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Objective:To analyze the correlation between serum ferritin (SF), perilipin, leptin and the outcome of patients with gestational diabetes mellitus (GDM).Methods:From October 2017 to December 2019, 126 patients with GDM who underwent maternity checkups in Baoding Fourth Central Hospital and gave birth were selected as the GDM group, and 82 normal pregnant women during the same period were selected as the control group for retrospective analysis. The levels of serum SF, perilipin, and leptin in the GDM group and the control group were measured and compared, and the expressions of serum indexes of patients with different blood glucose control and different pregnancy outcomes in the GDM group were measured. Pearson correlation analysis was used to explore the correlation between the expression of serum indexes in GDM patients and fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h PG), and insulin resistance index (HOMA-IR). Logistic regression was used to analyze the relationship between the expression of serum indicators and adverse pregnancy outcomes in GDM patients. The receiver operating characteristic (ROC) curve was used to observe the value of single serum indexes and to predict the pregnancy outcome of GDM patients.Results:The levels of SF, perilipin and leptin in GDM group were higher than those in control group: (152.48 ± 37.64) μg/L vs. (109.27 ± 32.16) μg/L, (857.06 ± 192.35) ng/L vs. (262.83 ± 104.7) ng/L, (23.54 ± 2.28) μg/L vs.(14.62 ± 1.83) μg/L, the differences were statistically significant ( P<0.05). The levels of SF, perilipin and leptin in patients with good blood glucose control in GDM group were lower than those in patients with poor blood glucose control: (132.10 ± 36.52) μg/L vs. (176.37 ± 40.06) μg/L, (176.37 ± 40.06) ng/L vs. (946.42 ± 205.37) ng/L, (21.49 ± 2.16) μg/L vs. (25.94 ± 2.40) μg/L, the differences were statistically significant ( P<0.05). The levels of serum SF, perilipin and leptin in GDM patients were positively correlated with FPG, 2 h PG and HOMA-IR levels ( P<0.05). The levels of serum SF, perilipin and leptin in GDM patients with adverse pregnancy outcomes were higher than those in patients without occurrence: (182.86 ± 42.29) μg/L vs. (138.86 ± 35.47) μg/L, (1 013.35 ± 216.07) ng/L vs. (787.00 ± 183.49) ng/L, (27.04 ± 2.5) μg/L vs. (21.97 ± 2.07) μg/L, the differences were statistically significant ( P<0.05). Logistic regression analysis showed that serum SF, perilipin and leptin were closely related to the adverse pregnancy outcomes in GDM patients ( P<0.05). ROC curve analysis showed that the sensitivity and the specificity of SF, perilipin, leptin combined detection to predict GDM patients with adverse pregnancy outcomes was 76.92% and 83.91%. Conclusions:The serum SF, perilipin and leptin are abnormally high expression in GDM patients, and it is positively correlated with blood glucose level and HOMA-IR. Joint detection can improve the predictive value of adverse pregnancy outcomes and provide a basis for early intervention.
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Objective To study the clinical curative effect of small needle knife combined with manipulation on adhesive capsulitis.Methods Totally 120 adhesive capsulitis patients treated from March 2014 to November 2015 were enrolled in the study,and divided into a treatment group and a control group randomly and equally.The patients in the treatment group were treated with small needle knife combined with manipulation,and the ones in the control group took anti-inflammatory analgesics orally.The changes of shoulder joint pain and function scores as well as the clinical effects were observed and compared in the two groups.Results The treatment group behaved significantly better than the control group in the indexes of shoulder pain,pressing pain,nyctalgia,internal and external rotation,adduction,abduction and etc (P＜0.05).The total effective rate was 93.3％ in the treatment group,which was obviously higher than that (68.3％) in the control group (P＜0.05).Conclusion The curative effect of combined manipulation and small needle knife gains advantages over oral antiinflammatory analgesics when used to treat adhesive capsulitis patients,and thus is worthy promoting practically.
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Objective To investigate the influencing factors for post-discharge treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB).Methods MDR-TB patients who were hospitalized in a tubercu-losis hospital between November 2011 and January 2013 were chosen,post-discharge follow-up was conducted regu-larly through telephone call.Medicine-taking and re-examination of patients was inquired,factors influencing pa-tients’treatment compliance were analyzed.Results 299 patients were included in the study,the total treatment compliance rate was 81 .94% (n=245);249(83.28%)patients regularly took medicine,50(16.72%)didn’t regu-larly take medicine;254 (84.95%)were re-examined on time,45 (15.05%)were not re-examined on time;37 (12.37%)discontinued treatment,260 (86.96%)continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate,timely re-examination rate,interrupted treat-ment rate,and total compliance rate)was significantly different among MDR-TB patients of different ages,education levels,treatment time,and with or without adverse reactions(all P <0.05 ).Logistic regression analysis revealed that treatment compliance of MDR-TB patients was negatively correlated with treatment time(β=-1 .47,Wald χ2=24.28,P <0.05)and adverse reactions(β=-2.02,Waldχ2 =24.24,P <0.05 ),while positively correlated with education levels(β=0.79,Wald χ2 =6.50,p <0.05 ).Conclusion Prolonged treatment time and adverse reactions can reduce the treatment compliance of MDR-TB patients,the higher education levels of MDR-TB patients have, the better treatment compliance they implement.