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The article summarized professor SUN Weizheng's clinical experience in treating multiple myeloma using the clearing-releasing therapy. It is believed that the mechanism of multiple myeloma is kidney essence insufficiency， pathogenic toxin erosion， and blinding of phlegm and stasis. The treatment should consider both the deficiency and the excess， and the root and branch. Thus， the clearing-releasing therapy is proposed. “Clearing” refers to the approach of supplementing deficiency and reinforcing health while advocating the use of clearing and supplementing products to replenish without generating additional pathogenic factors. Additionally， products that clear heat， resolve toxins， dispel stasis， dissolve phlegm， and eliminate masses is suggested to benefit for clearing away pathogenic toxins. “Releasing” means to replenish the normal yang qi with sweet-warm and acrid-warm products on the basis of “clearing” method， and to release the cold pathogen constraint in the muscles and bones. Based on the principle of clearing and releasing， the selfmade Jishi Beverage （济世饮） is formulated to supplement the kidney and secure essence， dispel phlegm and dissolve stasis， resolve toxins and dissipate masses. The prescription can be modified according to syndrome differentiation. It is also advocated to use multiple methods and pay attention to external therapies such as enema for relieving constipation and draining heat， and to combine acupuncture and medicine to relieve pain.
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How to improve the ability of nursing undergraduates in medical colleges to face more difficulties and reverse the dilemma in response to public health emergencies is a topic that needs to be further studied. It is an effective way to improve the level of students' adversity quotient by cultivating students' adversity quotient. This paper expounds the four dimensions of the composition of the four-dimensional adversity quotient, analyzes the factors influencing the formation of the four-dimensional adversity quotient, and puts forward the exploration of the path and method to cultivate the four-dimensional adversity quotient of undergraduate nursing students. In the practical teaching of nursing specialty, the adversity quotient can be cultivated through listening and communication.
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Objective:To explore the attitudes of Chinese medical students toward the elderly and their willingness to practice in geriatrics, and to investigate the influence of geriatrics education on their attitudes.Methods:Medical students studying diagnostics in four medical universities were enrolled in a cross-sectional survey and, for the intervention study, graduate trainees from non-geriatrics specialties taking a geriatrics course were interviewed before and after the course.An electronic questionnaire was used to collect general information, the experience of interacting with the elderly, attitudes towards the elderly and the willingness to develop careers in geriatric medicine.Changes in attitudes towards the elderly and their willingness to practice in geriatrics before and after the 40-hour geriatric medicine course were compared.Results:A total of 648 medical students completed the cross-sectional survey, with the highest score in compassion for the elderly(3.54±0.54)and the lowest score for medical services for elderly patients(3.36±0.78). Only 2.2%(14/648)of the students showed strong interest in geriatric medicine.The results of the intervention from 42 graduate trainees showed that the average scores of revised Geriatric Attitude Scale(r-GAS)were 3.80±0.43 and 3.92±0.40 before and after the course, respectively, and the difference was statistically significant( t=2.148, P=0.038). At the end of the course, 7 trainees(16.7%, 7/42)showed great interest in geriatrics, significantly different from 2 trainees(4.8%, 2/42)before the course( χ2=8.211, P=0.025). Conclusions:Chinese medical students show a serious lack of interest in geriatrics, and geriatrics education can improve their attitudes towards the elderly and their willingness to work in geriatrics.With the rapid population aging in China, it is urgent to strengthen the education of geriatric medicine.
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Objective:To identify effective biomarkers for glioma patients.Methods:The mRNA expression profiles of 464 glioma patients with complete clinical follow-up information were downloaded from the Chinese Glioma Genome Atlas (CGGA). Weighted gene co-expression network analysis (WGCNA) was used to identify gene modules related to World Health Organization (WHO) grading of glioma, and univariate and multivatiate Cox regression analysis were performed to identify gliomas survival-related genes.Results:In weighted gene co-expression analysis, the module Brown was significantly positively correlated with glioma WHO stage ( r=0.55, P<0.05). In univariate analysis, five genes (TAGLN2, IGFBP2, METTL7B, ARAP3, PLAT) that were most significantly associated with clinical prognosis were selected for multivariate survival analysis, and the prognosis model was established to calculate the risk score. The receiver operating characteristic curve (ROC) confirmed that the risk score had high accuracy in predicting the 1-, 3-, 5-year survival rate of glioma patients. The above survival analysis results were verified in the Cancer Genome Atlas (TCGA) database. Conclusions:We use mRNA expression profiles to establish prognostic markers for gliomas to assess the overall survival of patients with glioma.
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Objective:To summarize the achievements in standardized development of pulmonary and critical care medicine discipline, for references of developing respiratory discipline at secondary and tertiary hospitals.Methods:Questionnaire survey was used to understand the input and technical promotion of the secondary and tertiary medical institutions in the standardized construction.Results:The secondary and tertiary medical institutions invested 1.116 billion yuan to carry out standardized development of the discipline, recruiting 1 164 doctors, 2 535 nurses and 334 technicians. In terms of key medical technologies, 58 tertiary medical institutions and 45 secondary medical institutions meet the basic standards of " guidance on medical service capacity of respiratory discipline(2018 edition)" after carrying out standardized development.Conclusions:The discipline of pulmonary and critical care medicine should continue to strengthen its input in the development of respiratory and critical medical integration, with standardized development projects as the breakthrough. Evaluation should be carried out persistently so as to promote the development, for the purpose of improving the prevention and treatment capability of pulmonary and critical care medicine.
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Objective:To analyze the causes of death of elderly inpatients,so as to provide direction for the precaution of geriatrics.Methods:The first page data of hospitalized medical records of elderly inpatients in medical department in the Second Hospital of Dalian Medical University from 2102 to 2019 were extracted, and the causes of death were analyzed. The statistical analysis was performed by Excel and SPSS 21.0 statistical software.Results:The number of deaths of elderly inpatients in medical department from 2012 to 2019 was 5 249. The proportion of deaths in ICU was 34.43%(1 807/5 249), in oncology department was19.03%(999/5 249), and in cardiovascular department was12.08%(634/5 249). The average age was (78.52 ± 7.82) years. Besides, the age of men was younger than women: (78.18 ± 8.00) years vs. (79.02 ± 7.52) years, and the differences was statistically significant ( P<0.01). Men(59.1%, 3 099/5 249) were more than women (40.96%, 2 150/5 249). The largest number of deaths was in the age of 75-84 years (42.56%, 2 234/5 249). The number of cases with combined above five diseases was 4 552(86.72%, 4 552/5 249). The top three causes of deaths of elderly inpatients in medical department from 2012 to 2019 were cardiocerebrovascular diseases (27.21%, 1 428/5 249), malignant tumor (25.74%, 1351/5 249) and respiratory system diseases (22.10%, 1160/5 249). From 2012 to 2015, the top three causes of deaths were malignant tumor, cardiocerebrovascular diseases and respiratorysystem diseases. From 2016 to 2019,the top three causes of deaths were cardiocerebrovascular diseases, malignant tumor, and respiratory system diseases. The most common cause in cardiocerebrovascular diseases of death was coronary heart disease (51.47%,735/1 428), cerebrovascular disease (43.70%,624/1 428),and hypertension(4.34%, 62/1 428). Among the patients with malignant tumor death, first cause of death waslung malignant tumor (37.53%, 507/1 351), the others in turn were gastric carcinoma (11.10%,150/1 351) and intestinal cancer (11.10%,150/1 351). Among the patients with respiratory system diseases, first cause of death was pulmonary infection (69.66%,808/1 160), the others in turn were chronic obstructive pulmonary disease (15.43%, 179/1 160) and interstitial lung disease (5.09%, 59/1 160). Conclusions:The average age of elderly inpatients in medical department is (78.52 ± 7.82) years. The death age of male is less than that of female, and the number is slightly more than that of female. The top three causes of deaths of elderly inpatients in medical department are cardiocerebrovascular diseases, malignant tumor, respiratorysystem diseases. From 2012 to 2015 the first cause of deaths is malignant tumor. From 2016 to 2019, the cardiocerebrovascular diseases rise to the first.
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Objective:To investigate the relationship of interleukin (IL)-37, osteoprotegerin with coronary artery disease and its stenosisdegree.Methods:The prospective research method was used. From April 2018 to June 2019, two hundred and eleven suspected or diagnosed coronary artery disease patients who had chest pain or discomfort in Dalian Friendship Hospital were selected. The patients underwent selective percutaneous coronary angiography and completed coronary stenosis score (Gensini score). According to the degree of coronary stenosis, 211 patients were divided into the control group(coronary stenosis<50%, 45 cases), single-vessel stenosis group (single-vessel stenosis ≥ 50%, 52 cases), double-vesselstenosis group (double-vesselstenosis ≥ 50%, 58 cases), and triple-vessel stenosis group (triple-vessel stenosis ≥ 50%, 56 cases). The levels of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), lipoprotein a, uric acid, creatinine were measured by the automatic biochemical analyzer. The serum levels of IL-37 and osteoprotegerin were detected by enzyme-linked immunosorbent assay.Results:There were no statistical differences in FBG, uric acid, creatinine, TC, TG, LDL-C, HDL-C, ApoA1 and ApoB among 4 groups ( P>0.05). In the control group, single-vessel stenosis group, double-vessel stenosis group and triple-vessel stenosis group, lipoprotein a was (0.266 ± 0.060), (0.283 ± 0.070), (0.289 ± 0.066) and (0.307 ± 0.084) mg/L respectively; coronary stenosis score was (8.27 ± 7.08), (437.45 ± 98.47), (493.72 ± 125.19) and (522.61 ± 149.34) scores respectively; IL-37 was (342.27 ± 122.36), (437.45 ± 98.47), (493.72 ± 125.19) and (522.61 ± 149.34) ng/L respectively; osteoprotegerin was (378.29 ± 111.95), (458.39 ± 115.37), (502.50 ± 116.88) and (533.39 ± 139.83) ng/L respectively; and there were statistical differences among 4 groups ( P<0.05 or <0.01). IL-37, osteoprotegerin and lipoproteina were positively correlated with coronary stenosis score ( r = 0.43, 0.42 and 0.23, P<0.05), the osteoprotegerin was positively correlated with IL-37( r = 0.73, P<0.05). The multivariate linear regression analysis result showed that the IL-37 and osteoprotegerin were independent protective factors of coronary stenosis degree( β = 0.07 and 0.07, t = 2.72 and 2.57, P<0.01 or <0.05),and lipoproteina was independent risk factor of coronary stenosis degree ( β = 0.97, t = 2.89, P<0.01). Conclusions:IL-37 and osteoprotegerin are positively correlated with the degree of coronary stenosis. They are anti-inflammatory and protective factors of coronary heart disease.
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Objective:To investigate the clinical characteristics and outcomes of monochorionic monoamniotic (MCMA) twin pregnancy.Methods:The clinical data of 60 MCMA twin pregnant women who were terminated in Peking University Third Hospital from January 2011 to December 2019 were collected, and the general clinical data, prenatal examination and pregnancy outcomes were analyzed retrospectively.Results:The age of 60 MCMA twin pregnant women was (31.0±4.1) years old, among which 44 cases were primiparas (73%, 44/60) and 16 cases were multiparas (27%, 16/60). Fifty-eight cases were diagnosed as MCMA twin pregnancy prenatally and were confirmed after delivery. Median ultrasonic diagnosis of gestational age was 12 weeks (range: 8-30 weeks). In the 60 MCMA twin pregnancies, 6 cases were conjoined twins, 5 cases were complicated with twin reversed arterial perfusion sequence (TRAPS), and 10 cases were diagnosed as other fetal malformation by prenatal ultrasound examination. Among the 60 MCMA twin pregnant women, 19 cases had spontaneous abortion or induced abortion due to fetal malformation, fetal death or other reasons within 28 weeks of pregnancy, 41 cases entered the perinatal period, a total of 70 newborns survived. The main cause of perinatal fetal or neonatal death was fetal dysplasia.Conclusions:There is a high incidence of fetal abnormality and perinatal mortality in MCMA twin pregnancy. Accurate early diagnosis, enhanced management and monitoring during pregnancy, and individualized treatment are the keys to improve MCMA twin pregnancy outcomes.
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Various contents, relatively insufficient class hours, few practical operation opportunities and lack of teacher-student interaction are the main difficulties in clinical clerkship teaching of gynecology and obstetrics. In this study, the flipped classroom, surgery simulation training system and online self-test module are added to the clinical clerkship teaching of obstetrics and gynecology, and also the WeChat group interactive platform is established to make up for the deficiency of traditional teaching mode. The questionnaire survey showed that 59 clerkship students' satisfaction with the course was 92.6 points, 98.3% of students thought that the surgery simulation training was helpful, and 93.2% of them thought that the flipped classroom was helpful, and the students' scores of the final exam was higher than those of the previous students in the same period with the same difficulty of the exam. Therefore, rational use of flipped classroom, surgery simulation training system and other modules can improve the overall effect of clinical clerkship teaching in gynecology and obstetrics to a certain extent.
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Objective:To study the diagnosis and treatment of osteoporotic fractures in the elderly in two third Grade A hospitals in Shenyang and Dalian, and to provide scientific basis for prevention and treatment of osteoporotic fractures in Dalian and Shenyang.Methods:Patients of osteoporotic fractures over 60 years old from January 2015 to December 2015 in the Second Hospital of Dalian Medical University and the People′s Hospital of Liaoning Province were chosen, and the basic characteristics, fracture site, the number of fracture site, diagnosis treatment and secondary prevention of osteoporosis fractures of them were analyzed.Results:Among the patients of osteoporotic fractures over 60 years old in the hospitals of Shenyang and Dalian, women were more than men ( P = 0.00). The predilection sites of elderly osteoporotic fractures in two hospitals were both followed by the hip, spine, ulnar and radial distal, proximal humerus. The rates respectively were 38.26%(295/771), 34.63% (267/771), 9.34%(72/771), 5.71%(44/771). The rate of fracture-again was 10.89%(84/771). The rates of in-hospital diagnosis, in-hospital treatment and treatment of discharged medical advice among osteoporosis were 13.88%(107/771), 24.64%(190/771) and 18.81%(145/771). There were 0.65% (5/771) patients who had diagnosis of osteoporosis, basic osteoporosis treatment (vitamin D 3 and calcium) and anti-osteoporosis treatment in both in-hospital and discharged medical advice. Conclusions:The rates of in-hospital diagnosis, in-hospital osteoporosis treatment and anti-osteoporosis treatment in discharged medical advice are both very low in the two third Grade A hospitals. The secondary prevention of osteoporosis fractures in the elderly has not been taken attention, and the situation of prevention and treatment are serious.
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Liver cirrhosis can lead to continuous pathological elevation of portal venous pressure, resulting in various complications such as esophageal and gastric varices, ascites, hepatic encephalopathy, and secondary circulatory dysfunction. Multimodality therapy is the main treatment method for portal hypertension, among which surgical treatment is mainly used to control and prevent massive esophagogastric variceal bleeding. Currently, interventional therapy and liver transplantation have gradually become a routine method for surgical intervention and can significantly improve patients’ quality of life, but devascularization and shunt are still the mainstream surgical procedures. Each surgical strategy for cirrhotic portal hypertension has its own characteristics. It will be a trend in the future to evaluate patients’ general conditions and clinical features and select individualized treatment regimens to achieve the best treatment outcome.
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Respiratory disease is currently one of the main causes of human deaths. Due to the shortage, fragmentation, imbalance and heterogeneity of health resources and medical resources in China, it is urgent to strengthen the prevention and control system and capacity construction for respiratory science and innovate the prevention and treatment mode.The authors expounded the necessity of constructing a medical alliance for respiratory diseases, and held that such an alliance can achieve the purpose of patient care and discipline development, by means of integration of resources and system building, from such aspects as healthcare, teaching, research and department construction.
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Objective To investigate job satisfaction and influencing factors of medical staff in China.Methods From December 2017 to January 2018, based on the third round third-party evaluation of the Healthcare Improvement Initiative, data on job satisfaction of medical staff at 136 tertiary public hospitals in 31 provinces of China were collected.Chi-square test and binary multivariate logistic regression were used to analyze the influencing factors of job satisfaction.Results The job satisfaction of medical staff at 136 sample hospitals was relatively low. 34.6% of the doctors were satisfied with their job, while the corresponding rate in the nurses was 48.7%. Multi-factor analysis showed that income level, workload, doctor-patient relationship, hospital′s compensation policy, and promotion policy were all significant factors influencing medical staff′s job satisfaction ( workload OR <1, remaining variables OR >1, P <0.05 ). Conclusions Improvement of the medical staff′s job satisfaction depends on optimizing their income distribution policy, increasing their income, improving the promotion policy of professional titles, reducing their workload rationally and building a harmonious relationship between doctors and patients.
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Objective To explore the prenatal ultrasound image features and clinical significance of fetal ductus venosus abormalities . Methods Fifteen fetuses with ductus venosus abormalities diagnosed by prenatal ultrasonography at Peking University T hird Hospital were retrospective review . T he prenatal findings ,umbilical shunting type ,perinatal outcomes ,and autopsy reports were analyzed . Results Fourteen fetuses were found with absence of ductus venosus . In 6 fetuses the umbilical vein connected to the portal vein ,5 fetuses the umbilical vein connected to the inferior vena cava and 3 fetuses the umbilical vein connected to the right atrium . T he remaining 1 fetus was found obliteration of ductus venosus . Absence of ductus venous showed no normal ductus venous and the umbilical vein almost always drained directly into portal vein ,inferior vena cava or right atrium . Obliteration of ductus venous showed normal ductus venous was replaced by a tiny echogenic string without blood flow . T hree cases had intracardiac and extracardiac abnormalities ; 4 cases had extracardiac abnormalities only ; 8 of these ,ductus venosus abormality were isolated . T wo cases had trisomy 21 syndrome . Four patients underwent legal termination of pregnancy ; 2 were intrauterine fetal death ; and 8 carried to term wit normal outcome ; the remaining one underwent operation due to extracardiac abnormality and postoperative course was uneventful . Conclusions Prenatal ultrasound can be used to diagnose fetal ductus venosus abormalities . Hemodynamic depends on umbilical venous drainage site and diameter . T he prognosis for this group of anomalies depends on the chromosomal abnormalities and additional findings . Chromosome and ultrasonic monitoring are suggested for following pregnancy .
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Objective To explore the survival condition of hemodialysis patients in Ningxia Hui Autonomous Region. Methods Interviewed 15 patients with hemodialysis by applying Modified Grounded Theory Approach put forward by KinoSitaYasuHito,a Japanese scholar,the data of which were from qualitative inductive comparative analysis. Results As for the survival condition of hemodialysis patients in Ningxia,two relative themes were extracted, Helpless dialysis life Desire to return to society, the former contained 2 subtopics of hardship in life and susceptible mood, the latter contained 2 subtopics of cherish life and desire for care. Conclusion We should set up a social supporting system to improve the living condition of hemodialysis patients with the purpose of helping them return to the society.
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Objective:To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes.Methods: A series of 100 consecutive,unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed.There were 50 male patients and 50 female patients.The average patient age was 51 years,and the average body mass index was 24.69 kg/m2.The preoperative diagnosis included avascular necrosis of femoral head,hip osteoarthritis,osteoarthritis se-condary to acetabular dysplasia,sequelae of hip old infection,ankylosing spondylitis,rheumatoid arthritis and avascular necrosis of femoral head after cannulated screws fixation of femoral neck fracture.There were 7 hips which had surgical history prior to the index hip arthroplasty,including 3 cases with bone graft treatment for avascular necrosis of femoral head through Smith-Peterson approach,2 cases with acetabular shelf procedures for acetabular dysplasia through Smith-Peterson approach,and 2 cases with cannulated screws fixation for femoral neck fracture (internal fixation residual).All were uncemented hips.The stems used in this study included 67 Triloc stems (DePuy company,USA),45 Corail stems (DePuy company,USA),2 Accolade stems (Stryker company,USA),1 Synergy stem (Smith-Nephew company,USA) and 1 Polarstem (Smith-Nephew company,USA).Results: The average follow up period was 8.5 months,the average incision scar length was 10 cm,and the average postoperative Harris score was 93.62.There was 95％ postoperative leg length discrepancy within 3 mm.The average cup inclination angle was 38.7°with 94.8％ in the range of 30° to 50°.The average cup anteversion angle was 14.3° with 94.2％ within the target range of 5° to 25°.The were 15 (12.9％) operative complications,including two femoral perforations (changing stem from Triloc to Corail),three calcar fractures (treated with cerclage wires),four greater trochanter fractures (2 were treated wire tension band,and 2 nondisplaced fractures untreated),one deep infection (debridement and retaining of the prothesis),one superficial infection (debridement),one hematoma and three wound healing complications (debridement).All the complications were successfully treated without any sequelae at the end of the latest follow-up.There was no postoperative dislocation.There was no major nerve and vascular injuries.There were 35 cases (30.2％) reporting symptoms of lateral femoral cutaneous nerve palsy.Conclusion: Direct anterior approach to total hip arthroplasty allows accurate and reproducible cup orientation positioning and leg length restoration and decreases the risk of postoperative dislocation,which is helpful for early rapid postoperative recovery.
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Objective To analyze the ultrasonic features of gynecological emergency and severe cases.Methods To analyze 431 cases in clinical,ultrasonic images and examination data of gynecological emergency and severe patients in Peking University Third Hospital from September 2014 to September 2015,and to study clinical pathological and ultrasonic imaging examination.Results In 431 severe cases of gynecologic emergency,the clinical symptom were shown as acute abdominal pain or and vaginal bleeding.They were divided into seven types by clinical examination,operation or conservative treatment under dynamic observation.There were 137 cases of fracture disease,accounting for 31.8％,with corpus luteum rupture in 67 cases,ectopic pregnancy burst in 59 cases and tumor rupture in 11 cases.There were 114 cases of pelvic inflammatory disease,accounting for 26.5％,with hemorrhagic disease of department of gynaecology in 67 cases (15.5％),dysfunctional uterine bleeding in 39 cases,cervical cancer in 11 cases,submucosal myoma in 7 cases,endometrial carcinoma in 6 cases,carcinosarcoma in 4 cases.There were 58 cases of early pregnancy related diseases,accounting for 13.5％.Among them,32 cases were incomplete abortion,and 21 cases were inevitable abortion and 5 cases were hydatidiform mole.Forty-six cases were torsion of pedicle (10.6％).Five cases were genital tract malformation,accounting for 1.2％,with vaginal septum obliquumevery 4 cases and cervical atresia in one case.There were damages after the operation in 4 cases (0.9％),uterus perforation in 2 cases,abdominal wall hematoma in 1 case after cesarean section,and false aneurysm in 1 case after cesarean section.In the 431 cases,there was emergency surgery oroperation after symptomatic treatment in 329 cases,interventional treatment in one case and non-operative treatment in 101 cases.Conclusions There are corresponding typical ultrasonographic characteristics in different diseases of emergency and severe gynaecologic cases,combined with clinical symptoms and medical history.The right diagnosis can be made.Therefore,there are important clinical values of ultrasound in the treatment of emergency and severe gynecologic cases.
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Benzoxazinoids (BXs) are important secondary metabolites in plants.There has been a wide range of attention and research of them because of their role in defensive and allelopathy.With the development of genomics and molecular biology,the BXs biosynthesis and other molecular areas research has made great progress.The BXs profile,the function of BXs,the genetic basis of BXs biosynthesis and expression regulation were briefly introduced.
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Objective To investigate the relation between 25-hydroxyvitamin D3[25(OH)D3] and coronary artery disease. Methods Three hundred and ten patients with selective coronary angiogram (CAG) were enrolled in this study and they were divided into two groups: non-coronary artery stenosis group with 76 patients and coronary artery stenosis group with 234 patients. The degree of coronary artery stenosis was evaluated by the international general Gensini integration system. The levels of fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) were detected by automatic biochemistry analyzer. The level of 25(OH)D3 was detected by tandem mass spectrometry. The relationship of Gensini integration scores and risk factors were analyzed. Logistic regression analysis was used in multicity factors analysis. Results The levels of age, Gensini integration scores, 25(OH)D3, FPG and LDL-C in non-coronary artery stenosis group and coronary artery stenosis group had significant differences (P<0.05). The number of coronary stenosis and Gensini integration scores in 25(OH) D3 deficiency group were significantly higher than those in non-25 (OH)D3 deficiency group (P<0.01). Logistic regression analysis showed that age, FPG and 25(OH)D3 levels were risk factors for coronary artery stenosis (P<0.01 or<0.05), and the level of 25(OH)D3 had negative correlation with coronary artery stenosis (B =- 0.100), and it was a protection factor (OR =0.904, 95%CI:0.911-0.983, P=0.000). Conclusions 25(OH)D3 deficiency is one of the risk factor of coronary artery disease.
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Objective To study on the relationship between insulin resistance and thyroid nodule in the patients of normal glucose metabolism. Methods The clinical data of 105 patients of normal glucose metabolism were analyzed. The patients were divided into nodules group (54 patients) and non- nodules group (51 patients). The age, sex, body mass index (BMI), fasting plasma glucose (FPG), postprandial 2 h blood glucose (2 h PG), fasting insulin (FINS), postprandial 2 h (2 h INS), fasting C peptide (FC-P), postprandial 2 h C peptide (2 h C-P), glycosylated hemoglobin (HbA1c), blood uric acid (BUA), homeostatic model assessment insulin resistance index (HOMA-IR) were compared between two groups. According the level of HOMA-IR, 105 patients were divided into different subgroups, the detection rate of thyroid nodules was compared. The influencing factors of thyroid nodules were analyzed by multi-factor Logistic regression analysis. Results The age and sex between two groups had no significant differences (P>0.05). The levels of BMI, BUA, HOMA-IR, FPG, FINS, 2 h INS, FC-P, 2 h C-P and HbA1c in nodules group were significantly higher than those in non-nodules group (P 4.00 group (20/20) was higher than that in HOMA-IR 0- 1.00 group (0), HOMA-IR 1.01- 2.00 group (39.5%, 17/43) and HOMA-IR 2.01-3.00 group (5/17), there were significant differences (P0.05). Conclusions The detection rate of thyroid nodules in HOMA-IR>3.00 patients is significantly higher. The insulin resistance, higher BMI and hyperuricemia are the independent risk factors of thyroid nodules.