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This article reported a male patient with neonatal onset mental retardation autosomal dominant 35 (MRD35). The boy presented with repeated convulsions, hypotonia, enlarged head circumference, congenital muscular torticollis and feeding difficulties in the neonatal period. Dynamic electroencephalogram showed paroxysmal epileptic discharges in the left central-temporal region. High-throughput whole-exome sequencing revealed a heterozygous mutation of c.139G>A (p.Glu47Lys) in the PPP2R5D gene, which was a de novo mutation not inherited from his parents. The child had significant developmental delay at the age of one year. MRD35 lacks typical clinical manifestations and requires whole-exome sequencing for definitive diagnosis. Currently, there is no specific treatment for MRD35 and symptomatic treatments, including rehabilitation training, language training and seizure control, are mostly adopted.
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Novel therapies are urgently needed to improve global treatment of SARS-CoV-2 infection. Herein, we briefly provide a concise report on the medicinal chemistry strategies towards the development of effective SARS-CoV-2 inhibitors with representative examples in different strategies from the medicinal chemistry perspective.
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Objective:To investigate the outcomes and influencing factors of newly diagnosed prediabetic subjects aged 40 years and above in Guiyang.Methods:A total of 10 015 residents aged 40 years and above were recruited from the Yunyan community, Guiyang, from May to August 2011. Physical examination, laboratory measurements, and questionnaires were conducted. The follow-up survey was conducted in July 2014. A total of 2 530 newly diagnosed prediabetic subjects at baseline were included in the analysis.Results:The 3-year cumulative morbidity of diabetes mellitus was 14.3%, and the risk of diabetes mellitus in combined impaired fasting glucose(IFG)and impaired glucose tolerance(IGT)groups was significantly higher than that in isolated IFG(i-IFG)or isolated IGT(i-IGT)group( P<0.01). High baseline fasting plasma glucose, 2 h plasma glucose, and HbA 1C levels were the independent risk factors for the development of diabetes( OR=1.836, 95% CI 1.374-2.454; OR=1.398, 95% CI 1.261-1.550; OR=2.526, 95% CI 1.804-3.538, all P<0.01)and the inhibitory factors for reversion to normal glucose tolerance( OR=0.511, 95% CI 0.409-0.638; OR=0.715, 95% CI 0.661-0.774; OR=0.638, 95% CI 0.500-0.816, all P<0.01). High level of high density lipoprotein-cholesterol(HDL-C)was an promoting factor for reversion to normal glucose tolerance( OR=1.306, 95% CI 1.017-1.678, P=0.036). Subjects in the highest tertile of baseline HbA 1C level and body mass index(BMI)change before and after follow-up(ΔBMI=follow-up BMI minus baseline BMI)had a higher risk of diabetes mellitus than those in the lowest tertile( OR=2.398, 95% CI 1.733-3.322; OR=2.402, 95% CI 1.859-3.105, both P<0.01). The risk of diabetes mellitus in the significant weight loss group was reduced by 40.4% compared with the non-significant weight loss group when the subjects were divided into two groups according to the cutoff of the lower tertile of ΔBMI( RR=0.596, 95% CI 0.463-0.766, P<0.01). Conclusion:The risk of diabetes mellitus in combined IFG/IGT group was significantly higher than that in i-IFG or i-IGT group. High baseline fasting plasma glucose, 2 h plasma glucose, and HbA 1C levels were the independent risk factors for the development of diabetes. High level of HDL-C was an promoting factor for reversion to normal glucose tolerance. Weight loss can significantly reduce the risk of progression to diabetes in individuals with prediabetes.
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Objective:To investigate the correlation between sleep duration, sleep timing and the risk of osteoporosis in postmenopausal women, to identify contributing mechanisms and guide the prevention and treatment of osteoporosis.Methods:A total of 5 449 postmenopausal women were included in this study. All participants completed questionnaires, medical examinations, blood test and the measurement of bone mineral density using calcaneal quantitative ultrasonography. After adjusting for potential confounders, logistic regression model was used to assess the association of sleep duration, sleep timing with the risk of osteoporosis. Results:In postmenopausal women, there were significant differences in sleep duration and timing among groups with different risk of osteoporosis( P<0.05). After controlling ages, BMI, diabetes, hypertension, dyslipidemia, smoking, alcohol consumption and physical activity, sleep duration was correlated with the risk of osteoporosis, long sleep duration(≥9 h)increased the risk of osteoporosis( OR=1.39, 95% CI 1.17-1.65, P<0.05)compared with the group with sleep duration of 7~8 hours. In analysis of the combined effect of sleep duration and sleep time on the risk of osteoporosis, compared with normal sleep duration(7-8 h)and normal sleep timing(22: 00-23: 00), long sleep duration(≥9 h)and normal sleep timing(22: 00-23: 00)increased the risk of osteoporosis( OR=1.38, 95% CI 1.01-1.87, P<0.05), which was higher in the group of long sleep duration(≥9 h)and late sleep timing(≥23: 00; OR=1.43, 95% CI 1.01-2.01, P<0.05). Conclusion:Long sleep duration(≥9 h)and late sleep timing(≥22: 00)are risk factors for the increased risk of osteoporosis in postmenopausal women, the late sleep timing leads to the higher risk.
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Objective To explore the epidemiological characteristics of the prevalence and incidence of metabolic syndrome(MS) in subjects with different TSH levels, which can provide a certain clinical basis for the prevention and treatment of MS. Methods According to the reference range of the TSH test system in our hospital, the subjects were divided into TSH normal group and TSH elevation group. From May to August of 2011, the whole group sampling method was used to conduct a baseline survey of 10140 permanent residents aged 40 and above in Yunyan district of Guiyang City. A total of 9618 cases were included. The prevalence of MS and its components were calculated with different TSH levels at baseline. After eliminating 3926 MS in 2011, 5692 patients with no MS were followed up for 3 years. Incidence of MS and its components were compared among different TSH levels. The median follow-up was (38. 6 ± 1. 6) months and the completion rate was 75. 40％. Results The total crude and standard prevalence of MS were 40. 82％ and 34. 46％ respectively. The crude and standard prevalence of MS in TSH normal group were 39. 96％ and 33. 90％, respectively, and in TSH elevation group were 44. 3％ and 37. 56％respectively . The comparison of crude prevalence of MS between the two groups was statistically significant (P>0. 05) and the standard prevalence of MS in TSH elevation group was also higher than that in TSH normal group. After 3 years of follow-up, the total crude and standard incidences of MS were 22. 51％ and 20. 64％, respectively. The total crude and standard incidence of MS in TSH normal group were 22. 01％ and 20. 22％, respectively and in TSH elevatlon group were 24. 69％ and 23. 20％, respectively. There was no statistically significant difference between crude incidences of MS in two groups, but the standard incidence of MS in TSH elevation group was higher than that in TSH normal group. Binary Logistic regression analysis showed that there was a positive correlation between TSH and incidence of MS in TSH elevation group. Conclusion Higher than normal levels of TSH may increase the prevalence and incidence of MS and its some components.
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To improve clinicians'understanding of the diagnosis and treatment of pseudohypoparathyroidism with hypokalemia and hypomagnesemia. The clinical manifestations, laboratory examinations, imaging data, gene results, diagnosis and treatment of a pseudohypoparathyroidism type Ⅰb with hypokalemia and hypomagnesemia patient were retrospectively analyzed. The literatures related to pseudohypoparathyroidism in recent years were also summarized. A young man, mainly manifested as repeated tetany. The physical examination showed short stature, round face, short neck, with positive Trousseau sign. The laboratory examination revealed parathyroid hormone resistance, hypocalcemia, hyperphosphatemia, hypokalemia and hypomagnesemia. The urinary calcium and phosphorus levels were low. Cerebral magnetic resonance imaging ( MRI ) showed bilateral basal ganglia calcification. Genetic screening revealed a hybrid deletion mutation of GNAS-AS1 gene Exon 5E. After the supplement of element calcium 720 mg/d, plain vitamin D 375 U/d, active vitamin D 0.5 μg/d and potassium chloride 3 g/d, the levels of blood potassium and phosphorus rise to normal, the levels of blood calcium and magnesium were close to normal. Pseudohypoparathyroidism typeⅠb may accompany with hypokalemia and hypomagnesemia.
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Objective To explore the relationship between metabolic syndrome(MS) and glomerular filtration rate(GFR).Methods A total of 10 140 adults aged 40 years and older inhabitants in Zhaiji community of Guiyang urban areas were investigated from May 2010 to August 2010 by adopting stratified cluster sampling method.The venous blood sample was drawn for the measurements of serum creatinine(Cr), fasting plasma glucose(FPG), OGTT 2hPG, fasting insulin, triglyceride(TG), total cholesterol(TC), high-density lipoprotein-cholesterol(HDL-C), low-density lipoprotein-cholesterol(LDL-C), and fasting plasma insulin.The definition of MS in our study was modeled after the Adult Treatment Panel Ⅲ(ATP-Ⅲ).Decreased GFR was defined as an estimated GFR<60 ml·min-1·(1.73 m2)-1.Results The prevalence of GFR less than 60 ml·min-1·(1.73 m2)-1 were 3.0% and 1.2% in participants with and without MS, respectively.The multivariate-adjusted odds ratios[95% confidence interval(CI)] of MS, which were independently associated with decreased GFR, were with elevated blood pressure, higher TG, lower HDL-C, and elevated FPG, their statistically odds ratios were 1.78, 2.96, 1.06, and 1.22, respectively.The prevalence of GFR decreased with the increase of MS components by 0.56%, 1.10%, 1.50%, 2.87%, 3.23%, and the odds ratios were 1.00, 1.57, 1.93, 3.07, and 2.89, respectively.Conclusion With the increase of MS components the risk of GFR decline increased.The occurrence of chronic renal dysfunction(CKD) might integrate multiple different risk factors of MS.
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Objective To investigate the relationship between brachial ankle pulse wave velocity and the incidence of cardio-cerebral events in people aged over 40. Methods Cluster sampling method was used to prospectively study 4 380 residents aged over 40 in Guiyang City District from May to August in 2011. Data of ba-PWV were collected. The follow-up examination was conducted from July to November of 2014. According to ba-PWV values, participants were divided into three groups:<14 m/s (control, n=1 039) group, 14-17.9 m/s group (n=1 393) and≥18 m/s group (n=809). Multi-factor Logistic regression model was used to analyze the relationship between ba-PWV values and risk factors of cardio-cerebral events. Results After three-year follow-up, a total of 3 241 participants were included in the final analysis. The cardio-cerebral events were identified in 63 (2.0%) cases, which were 0.6%, 2.2%and 3.2%in control group, 14-17.9 m/s group and≥18 m/s group. The value of ba-PWV increased significantly in those two groups compared with that of normal group. Logistic regression analysis showed that the incidence rates of cardiovascular and cerebralvascular events in 14-17.9 m/s group and≥18 m/s group were 2.777 (1.123-6.864) and 2.786 (1.032-7.526) times of control group after adjusting age, gender, systolic blood pressure, risk factors of diabetes, hypertension and blood lipids. Conclusion There is higher incidence rate of cardio-cerebral events in people aged over 40 in higher ba-PWV group. The value of Ba-PWV can be used to predict the occurrence of cardio-cerebral events.
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Objective To investigate the relationship between changes of ankle brachial index (ABI) and adverse cardiovascular events. Methods Baseline survey was conducted in 4 160 forty-year-old or older citizens living in Yunyan District of Guiyang City from May to August of 2011, which was in the way of cluster sampling to obtain their ABI and to collect information related to physical and blood biochemical examination and disease history. These citizens were conducted a follow-up survey for (39.29±1.47) months from July to December of 2014. Based on the change of ABI (ΔABI) from initial survey to follow-up survey, participants were subsequently divided into three groups: ΔABI>0.15 group,-0.15≤ΔABI≤0.15 group and ΔABI<-0.15 group. The adverse cardiovascular events during follow-up survey were compared between three groups. The risk factors affecting the adverse cardiovascular events were analyzed. Results Follow-up surveys were completed in 3 220 citizens in 3 years. The follow-up rate was 77.4%. Eighty-two new cases (2.5%) of adverse cardiovascular events were found in 3 220 cases in follow-up. The incidence rates of adverse cardiovascular events were higher inΔABI<-0.15 group compared with those of-0.15≤ΔABI≤0.15 group (8.3%vs. 2.4%, P<0.016 7). Logistic regression analysis indicated that age, hypertension history, and ΔABI<-0.15 were risk factors for adverse cardiovascular events. Exercise was the protective factor for adverse cardiovascular events. Conclusion Subjects withΔABI<-0.15 are at high risk for adverse cardiovascular events. The ΔABI can be used as a means of monitoring of adverse cardiovascular event, which provides certain forecast value for determining the possibility of adverse cardiovascular event.
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Objective To explore the relationship between risk of stroke and calcaneal quantitative ultrasound(QUS)T score under-2. 5. Methods 5 847 subjects over the age of 40 from Yunyan District, Guiyang City were investigated with questionnaire, physical examination, blood lipids, other metabolic indexes and calcaneus bone density determination from May to October, 2011 by cluster sampling method and were followed up for 3 years. Subjects were divided into stroke group(99 subjects) and non-stroke group(5 748 subjects) according to the occurrence of stroke in the follow-up period. The relationship between risk of stroke and QUS T score under-2. 5 was analyzed. Results Compared to the non-stroke group, the number of subjects with T score under-2. 5 in calcaneal QUS was larger in the stroke group, the difference of which was statistically significant(P<0. 05). T score of bone density under-2. 5 in calcaneal QUS was found to be an independent risk factor for predicting stroke after adjusting for age, sex, and body mass index(HR=1. 467, 95%CI 0. 753-2. 855). The relationship between risk of stroke and T score under-2. 5 in calcaneal QUS remained unchanged after further adjust ment of smoking, diabetes, education, and hypertension(HR=1. 265, 95%CI 0. 647-2. 475). Conclusion The risk of stroke and T score of bone density under-2. 5 in calcaneal QUS was independently associated, and the latter is an independent risk factor for predicting stroke.
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Objective To investigate the relationship between the brachial‐ankle pulse wave velocity (baPWV) with the ca‐rotid arterial intima‐media thickness(IMT) and carotid artery plaque in the patients with type 2 diabetes mellitus(T2DM) and to analyze the related risk factors causing atherosclerosis .Methods A total of 426 patients with T2DM were collected and conduct the records of baPWV ,carotid artery ultrasound ,biochemical index detection andrelated risk factors record .The correlation between baPWV with carotid arterial IMT was analyzed .The patients were divided into the abnormal group and normal group according to the baPWV results .The carotid artery IMT ,carotid artery plaque and related risk factors were compared between the two groups . Results The DM duration ,systolic blood pressure ,diastolic blood pressure ,pulse pressure ,low density lipoprotein cholesterol (LDL‐C) ,number of atherosclerosis risk factors had statistically significant differences between the two groups (P0 .05) .The detection rate of plaque by carotid artery ultrasound had no statistically signifi‐cant difference between the two groups(P>0 .05);but the statistically significant difference was found in the number of plaque be‐tween the two groups(P<0 .01) ,the abnormal group was obviously more than the normal group;the normal IMT ratio had statisti‐cally significant difference between the two groups(P<0 .05) ,the normal group was obviously higher than the abnormal group .The IMT value had statistical difference between the two groups(P<0 .01) ,which in the abnormal group was significantly thickened compared with the normal group .The analysis of correlation between baPWV and IMT showed that IMT was positively correlated with baPWV(r=0 .228 ,P<0 .05) .Conclusion T2DM patients with reduced arterial elasticity could complicated with the obvious thickening of carotid arterial IMT and increase of plaque number .Combining baPWV with carotid arterial ultrasound examination can better conduct the arteriosclerosis evaluation .
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Objective To evaluate the value of the neutrophil-lymphocyte ratio (NLR) in elderly type 2 diabetic patients (T2DM) with coronary heart disease (CHD).Methods We performed a retrospective observational study on 228 patients undergoing coronary angiography in Guizhou Provincial People's Hospital from April 2014 to July 2015.Patients were divided into three groups:the simple T2DM group (n=77),simple CHD group (n=72),and T2DM complicated with CHD group (n=79).Meanwhile,70 healthy elderly subjects served as the control group.The white blood cell count,high-sensitivity C-reactive protein (hs-CRP) and other clinical and laboratory parameters were collected,and NLR was calculated.Risk factors for CHD in T2DM patients were determined by logistic regression analysis.Multiple stepwise regression analysis was adopted to identify factors influencing NLR.Results The white blood cell count,neutrophil count,NLR and hs-CRP level in the simple T2DM,CHD,and T2DM+CHD groups were higher than in the control group [(7.48 1.81) 109/L,(7.72± 1.89) 109/L,(7.98±2.12) 109/L vs.(6.22± 1.61) 109/L;(4.49±1.38) 109/L,(4.88±1.56) 109/L,(5.35±1.40) 109/L vs.(3.52±0.84) 109/L;(2.84± 0.77),(3.07±0.79),(3.34±0.83) vs.(1.58±0.42);(2.92±0.65) mg/L,(3.20±0.86) mg/ L,(4.98±1.10) mg/L vs.(1.105±0.23) mg/L;respectively,P＜0.05 or P＜0.01].The lymphocyte count in the simple T2DM,CHD,and T2DM+CHD groups were lower than in the control group [(1.57±0.41) × 109/L,(1.58±0.40) × 109/L,(1.61±0.48) × 109/L vs.(2.22± 0.51) × 109/L,P＜0.05].NLR and hs-CRP levels in the T2DM+CHD group were higher than in the former two groups (all P＜0.05).Pearson correlation analysis showed that NLR was positively correlated with the Gensini score and hs-CRP level (r=0.7455 and 0.7792,both P＜0.01).Logistic regression analysis showed that NLR,hs-CRP levels and glycosylated hemoglobin A1c (HbA1c) were the risk factors for CHD in T2DM patients (OR=4.331,3.997 and 2.928,all P＜0.05).Multiple stepwise regression analysis showed that NLR was positively correlated with fasting plasma glucose,HbA1 c levels and systolic blood pressure (β' =0.3133,0.4720 and 0.3069,all P＜0.05).Conclusions NLR may be a valuable predictive factor for CHD in elderly T2DM patients.
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Objective To determine the concentration of blood serum visfatin and some iron metabolism‐related indicators:Ser‐um ferritin、hepcidin、serum transferring receptor(sTfR)level in newly diagnosed type 2 diabetes patients and explore the inter‐rela‐tionship between blood serum visfatin and iron metabolism .Methods Eighty‐five patients with newly diagnosed type 2 diabetes mellitus were selected and divided into 2 groups including 43 patients with normal weight (the normal weight of diabetic group , group B)and 42 obese patients (the obese diabetic group ,group D) .Meanwhile ,86 healthy examinees were selected and divided into 2 groups including 43 cases with normal weight (the control group ,group A)and 43 cases with obese (simple obesity group ,group C) .Serum visfatin ,ferritin ,hepcidin ,serum transferring receptor level and other clinical parameters of all groups were determined . Results Blood serum visfatin concentration was not found to be associated with ferritin ,hepcidin ,serum transferring receptor in all the groups(r=0 .111 ,P>0 .05) .Conclusion Blood serum visfatin may be not associated with ferritin ,hepcidin ,serum transferring receptor in newly diagnosed type 2 diabetes patients .
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Objective To investigate the association of serum 25-hydroxyvitamin D (25OHD),parathyroid hormone (PTH),blood glucose,blood lipid,uric acid,obesity,insulin etc with blood pressure.Methods A total of 1 403 residents aged (45.3 ± 14.4) years were enrolled from Guiyang residents during a health survey in 2009.The standard questionnaire survey and physical examination were performed in all subjects.The fasting plasma glucose,postprandial 2 h plasma glucose (2hPG),triglyceride,high density lipoprotein-cholesterol,serum calcium,phosphorus,creatinine,and uric acid were determined by automatic biochemical analyzer,serum insulin by chemiluminescence method,and serum 25OHD and PTH by radioimmunoassay.Results Path analysis showed that age,gender,body mass index (BMI),insulin,25OHD,PTH,2hPG,and triglyceride affected systolic blood pressure,with the repective path coefficients of 0.453,0.294,0.120,-0.106,-0.049,0.047,0.030,and 0.030.BMI,age,gender,insulin,2hPG,triglyceride affected diastolic blood pressure,with the path coefficients 0.348,0.217,-0.146,0.134,0.035,and 0.035 respectively.Insulin,triglyceride,2hPG indirectly influenced blood pressure through BMI.BMI,PTH,and 25OHD had a significant and direct effect on blood pressure.Gender and age directly and indirectly influenced blood pressure through BMI.Conclusion The most significant influential factors on blood pressure are age,serum insulin,triglyceride,and 2hPG in the population of Guiyang.Serum 25OHD is negatively associated with systolic blood pressure while PTH level is positively associated with systolic blood pressure.
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Objective To explore the serum levels of progestrone (Prog) and dehydroepiandrosterone sulfate(DHEAS),and the effect of sodium valproate(VPA) and lamotrigine(LTG) on the levels of Prog and DHEAS in infantile spasms.Methods A total of 36 cases of infantile spasms (spasms group) before treatment and 40 cases health infants(control group) were detected the serum Prog and DHEAS levels by electrochemiluminescence immunoassay,and were compared with 21 cases receiving monotherapy with VPA(VPA group),and 13 cases receiving therapy plus lamotrigine(LTG group) before and 4 months after treatment to observe the changes of sex hormone.Results There were no significant differences in Prog and log(DHEAS) (logarithmic transformation) levels between spasms group and control group (P ＞0.05).The serum Prog level of baby girls and baby boys were lower after treatment than those before treatment in VPA group respectively (t =2.603,3.146 ; P =0.003,0.008,respectively).The log (DHEAS) level of baby girls and baby boys were higher in LTG group after treatment than those before treatment respectively(t =3.185,2.663 ;P =0.007,0.041).Conclusion Infantile spasms would not influence the hormone metabolism,while VPA and LTG can influence the sex hormone.The hormone level should be monitored in the treatment.
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Objective To evaluate vitamin D status in healthy adults living in Guiyang. Method 1 500 healthy volunteers aged 20-79 years ( mean 45.2 years ) were recruited from a community in Guiyang by cluster sampling method. Questionnaires for living habits and fasting blood samples were collected from November, 2009 to February, 2010. Serum 25 ( OH ) D concentrations were measured by radioimmunoassay, using the DiaSorin kit,USA. Results The average serum 25 ( OH ) D level was ( 20. 4±9.0 ) ng/ml. The percentages of vitamin D deficiency [25 ( OH ) D ＜ 20 ng/ml], insufficiency [20 ng/ml ≤ 25 ( OH ) D ＜ 30 ng/ml], and sufficiency [25 ( OH ) D ≥ 30ng/ml] were 52. 3% , 32. 3% , and 15.4% , respectively. The 25 (OH) D concentrations in the young, middle-aged,and elderly were ( 18. 2±9. 2), (22. 8±8. 7), and ( 19. 9±7.8) ng/ml, respectively. The percentages of vitamin D deficiency in these groups were 62. 8%, 40. 2%, and 55.4%, being 61.6% in higher educational group ( ≥ 13 years) and 64. 4% in the group with lower body mass index ( ＜ 18.5 kg/m2 ). Conclusion Vitamin D deficiency is common in Guiyang including all age groups, especially among the youth and the elderly. Serum 25-hydroxyvitamin D level is also influenced by education, age, smoking, and other factors.
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Twenty-seven cases of simple type 2 diabetes mellitus,30 cases of coronary heart disease,and 32 cases of type 2 diabetes with coronary heart disease were enrolled in this study according to the results of coronary angiography.Meanwhile,32 healthy subjects were taken as a control group.The serum matrix metalloproteinase-9 (MMP-9) and other clinical and laboratory parameters were determined.The results showed that serum MMP-9 may play a minor role in the progression of coronary heart disease in type 2 diabetic patients.
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The research of epilepsy drug-resistant mechanism has been paid more and more attention. Pglycoprotein(Pgp) ,being one of the hot points of recent research,plays the transporting role in the body,and its coding genetic polymorphism also affects its expression. The relationship between Pgp and drug-resistant epilepsy is reviewed based on the coding genetic polymorphisms, multidrug transporters hypothesis, concentration equilibrium transport assay, and Pgp inhibition effect.
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To investigate the changes of serum ghrelin levels and their relationship with body mass index (BMI) ,waist-to-hip ratio(WHR) ,thyroid function, blood glucose, insulin, and insulin resistance parameters in different thyroid functional status. The fasting serum ghrelin, insulin, glucose, and thyroid hormone levels were determined, BMI, WHR, and homeostasis model assessment for insulin resistance index (HOMA-IR) were calculated in 50 hyperthyroid and 30 hypothyroid patients at diagnosis and after normalization of thyroid function. 30 euthyroid subjects served as control. The ghrelin levels in hyperthyroid patients before treatment were lower than that in control group [(63.2±9.6) ng/L vs (80.9±13.9) ng/L,P<0.01]. Multiple regression analysis showed that HOMA-IR was an independent factor related to fasting ghrelin levels (r = -0.314, P = 0. 027). The ghrelin levels were similar in hypothyroid patients and the controls before and after the treatment. It suggests that insulin resistance might be an important factor in regulating serum ghrelin levels in different thyroid functional status.
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It was found that Ag nanoparticles (NPs) could enhance the chemiluminescence (CL) intensity of luminol- potassium ferricyanide system. On the basis of enhancement effect,a flow injection method was developed for the determination of terbutaline sulfate. The structure and shape of Ag NPs were characterized by transmission electron microscopy. The UV-Vis absorption spectra and chemiluminescence spectra suggested that new luminophor was not formed after Ag NPs introducing in luminol-potassium ferricyanide chemiluminescence system. A possible mechanism of Ag NPs strengthening on luminol-potassium ferricyanide CL reaction was also discussed. The effect of concentration of luminol,potassium ferricyanide,sodium hydroxide and Ag NPs on CL reaction was investigated respectively. In the optimum conditions,the linear range was 1.0×10~(-9) -2.0 ×10~(-5) g/L(r =0.9935) and the detection limit was 1×10~(-10) g/L. The relative standard deviation (RSD) was 3.6% for 1. 0 ×10~(-6) g/L terbutaline sulfate (n = 11 ). The recommended method has been successfully applied to the determination of terbutaline sulfate tablets and the recovery was between 98. 5% - 102. 5% ,moreover the results were almost identical with the same results of Pharmacopoeia method.