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Exhaled ammonia(NH3)is an essential noninvasive biomarker for disease diagnosis.In this study,an acetone-modifier positive photoionization ion mobility spectrometry(AM-PIMS)method was developed for accurate qualitative and quantitative analysis of exhaled NH3 with high selectivity and sensitivity.Acetone was introduced into the drift tube along with the drift gas as a modifier,and the characteristic NH3 product ion peak of(C3H6O)4NH4+(K0=1.45 cm2/V·s)was obtained through the ion-molecule reaction with acetone reactant ions(C3H6O)2H+(K0=1.87 cm2/V·s),which significantly increased the peak-to-peak resolution and improved the accuracy of exhaled NH3 qualitative identification.Moreover,the interference of high humidity and the memory effect of NH3 molecules were significantly reduced via online dilution and purging sampling,thus realizing breath-by-breath measurement.As a result,a wide quantitative range of 5.87-140.92 μmol/L with a response time of 40 ms was achieved,and the exhaled NH3 profile could be synchronized with the concentration curve of exhaled CO2.Finally,the analytical capacity of AM-PIMS was demonstrated by measuring the exhaled NH3 of healthy subjects,demon-strating its great potential for clinical disease diagnosis.
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Objective:To analyze the research hotspots and frontiers in the training of health management talents in China based on knowledge mapping.Methods:The literature related to talent training in health management was retrieved from the databases of CNKI, Wanfang Data, and VIP Journals from 2007 to 2022. The keywords used for retrieval included “health management” “curriculum system” “health manager” “evaluation system” “health service and management” and “talent training”. The time distribution of the literature was analyzed using Excel. Bibliometric analysis was conducted to visually analyze the research in health management talent training, focusing on authorship and collaboration, research institutions, high-frequency keywords, and research hotspots. A knowledge map was created to outline the research framework.Results:A total of 378 journal articles were retrieved. Over the past decade, there has been an overall increasing trend in the number of research publications related to health management talent training. The highest number of articles was published in 2021 (63 articles). In terms of spatial distribution, highly productive authors were relatively concentrated, and research institutions were mostly universities, with Hangzhou Normal University having the highest number of publications (14 articles). The research hotspots included health managers, practice teaching modes, cross-cultivation, and discipline construction. The research frontiers concentrated on talent training modes, health service and management professions, talent demand, and curriculum system construction.Conclusions:In the past decade, health management talents training in China has received more attention and importance. However, there is limited exchange and cooperation among authors and research institutions, and the research hotspots continue to extend in the direction of specialization and diversification. The transformation from vocational education to academic education and strengthening professional construction are the frontiers of the research.
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Objective:To explore the correlation between changing trajectories of serum uric acid and the onset of nonalcoholic fatty liver disease (NAFLD).Methods:A longitudinal cohort study. Total of 3 353 subjects who had routine health examination every year from January 2017 to December 2019 in the Health Management Center of the Second Affiliated Hospital of Dalian Medical University and met the inclusion criteria were selected as the research subjects. Four different serum uric acid trajectory groups were determined by using the group-based trajectory model: the low stability group, medium stability group, medium-high stability group and high stability group. During the follow-up to December 2021, the differences in cumulative incidence of NAFLD in different serum uric acid trajectory groups were calculated and compared. Cox proportional hazard regression model was used to evaluate the hazard ratio ( HR) and 95% confidence interval ( CI) of the NAFLD onset in different serum uric acid trajectory groups. The dose-response relationship between baseline serum uric acid and NAFLD was evaluated by a restricted cubic spline regression model. Results:The cumulative incidence of NAFLD in two years was 10.77%, and the cumulative incidence increased with the rising trajectory of serum uric acid, it was the highestin the high stability group ( P<0.05). Compared that in the low stability group, the risk of NAFLD in the other three groups was as follows: 2.24 (95% CI: 1.59-3.14) in the medium stability group, 2.89 (95% CI: 1.92-4.33) in the medium-high stability group and 4.55 (95% CI:2.83-7.31) in the high stability group (all P<0.05). The risk of NAFLD gradually increased with the rising of serum uric acid level, and the cut-off value of serum uric acid for women and men was 260.32 μmol/L and 365.09 μmol/L, respectively. Conclusions:Long-term moderate and high levels of serum uric acid are independent risk factors for the occurrence of NAFLD. With the rising of serum uric acid trajectory, the risk of NAFLD increases. Attention should be paid to the longitudinal change trend of serum uric acid level in the prevention of NAFLD, and it should be controlled within lower level of the normal range.
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Objective:To establish an integrated model with KANO model and quality function deployment theory to determine the priority of measures in improving the quality of physical examination service.Methods:It was a cross-sectional study. A total of 196 physical examinees from the Health Management Center of the second affiliated Hospital of Dalian Medical University were selected by simple random sampling. Reliability test was used to analyze the reliability and validity of the questionnaire. KANO model was used to determine the importance of physical examination needs in health examination population. The quality function deployment model was used to create the house of quality and determine the priority of the importance of various service measures.Results:In the high important attribute requirements of physical examination, the final importance of emergency ability, outpatient time, professional and advanced equipment are 0.054, 0.052, 0.047 and 0.046 respectively. The measures that needed to be given priority to improve the quality of physical examination services were to improve the quality of medical services (absolute importance=107.5), strengthen skill assessment (absolute importance=70.1), define guidance, consultation and clinic identification (absolute importance=56.2), introduce advanced equipment and facilities (absolute importance=53.7), timely and accurate physical examination report (absolute importance=51.9) and interpretation of physical examination report (absolute importance=50.9).Conclusions:The physical examination center should give priority to the measures such as improving the medical level, strengthening the skill examination, introducing advanced equipment and facilities, defining the guidance of examination, consultation and consultation room identification, and strengthening service management.
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Objective:To understand the research status, research hotspots and research frontiers of quality control of health checkup in the past 15 years.Methods:Journal literatures with the theme of "Health checkup and Quality control" from China National Knowledge Infrastructure (CNKI) database from 2006 to 2020 were retrieved and analyzed. Excel was used to analyze the time and sequence and discipline distribution of literatures. CiteSpace V software was used for visual analysis of institutions and keywords.Results:A total of 306 literatures were obtained, and the number of literatures published in the past 15 years showed an overall growth trend, with the highest number of literatures published in 2019 (36). They mainly focused on the research of medical and health policies and laws and regulations, clinical medicine, preventive medicine and hygiene and other disciplines, with a few literatures belonging to interdisciplinary disciplines. The top three institutions were Physical Examination Center of Naval General Hospital, Health Management Center of the General Hospital of Tianjin Medical University, Health Management Research Institute of PLA General Hospital. The institutions with high centrality were Physical Examination Center of Naval General Hospital, Editorial Board of Chinese Journal of Health Management, and Chinese Health Management Association and so on. There were fewer cooperative links between institutions. The high-frequency keywords found in 306 literatures were"quality control","health checkup","quality management","health management","physical examination center","Deming Cycle (Plan-Do-Check-Action Cycle, PDCA Cycle)","quality of health checkup", etc."Health management"was the key emergence word in the recent three years.Conclusions:In the past 15 years, the attention on the quality control of health checkup in China has gradually increased, but there is less cross-connection between disciplines and institutions. The research focuses on the internal quality control and the application of advanced management theories in health examination institutions. The transformation from simple health checkup to health management service is the research frontier.
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Objective@#This study aimed to investigate and analyze the application effect of cross-field training of clinical, prevention, and management in health management talent training.@*Methods@#The simple random sampling method was used. 30 clinical, prevention, and management students were randomly selected as the cross-training group from 2013 to 2017 in the Second Affiliated Hospital of Dalian Medical University, and 30 students in the same class were randomly selected as the control group. The cross-training group conducted case analysis teaching, symposium, and scientific research ability training practice. After the internship, subjective practice effect and health management knowledge test were conducted for each group. TOPSIS method was adopted to evaluate the subjective effect of cross-teaching and routine practice training.@*Results@#The cross-training group had higher scientific research ability, development, satisfaction, and flexibility scores than the management group[3.0（3.0，3.0） vs 2.0（2.0，3.0）, （2.8±0.6） vs （2.4±0.5）, 3.0（3.0，3.3） vs 2.0（2.0，3.0）, 3.0（3.0，3.0） vs 2.0（2.0，3.0）, respectively]; higher participation, communication ability, development scores than the prevention group[（2.8±0.7） vs （2.4±0.6）, （3.1±0.6） vs （2.6±0.5）, （2.8±0.6） vs （2.4±0.5）, respectively]; and higher suitability degree and strain ability score than the clinical group[（2.9±0.6） vs （2.5±0.7）, 3.0（3.0，3.0） vs 3.0（2.0，3.0）, respectively]. Health management test scores of cross-training students were significantly higher than the clinical group[（7.1±1.3分） vs （6.1±1.9分）]. Differences were statistically significant (P<0.05). After TOPSIS model evaluation, the results of comprehensive subjective evaluation in the cross-group ranked first, followed by the prevention group, clinical group, and management group.@*Conclusion@#The cross-field of clinical, prevention, and management is better than conventional practice training, which is beneficial for promoting the training of health management talents to meet the needs of social health.
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Objective:To obtain an accurate understanding of the true perceptions and potential needs of physical examination population on the services provided by the health management center, so as to improve the quality of the services provided.Methods:All of 250 subjects were randomly selected from those who underwent physical examinations in the health management center of the second affiliated hospital of Dalian medical university. Based on the perceived service quality theory, the Servqual model scale was to evaluate the service quality with five dimensions and 25 items for tangibility, reliability, responsiveness, assurance, and empathy. This measure can be used in service quality evaluation, evaluation of physical examinations to the expectations of service quality, and perceived value in the screening, and computing service quality measurement value (SQ). A two-dimensional quadrant diagram was used to analyze the results of the survey.Results:A total of 234 valid questionnaires were collected with an effective recovery rate of 93.6%. The mean age of the 234 physical examinees was 42.0±7.3 years, including 114 males (48.7%) and 120 females (51.3%). The results of the Servqual scale showed that SQ was -0.44, expectation was 4.45, and perceived value was 4.01. Of the 25 evaluation items, only 1 evaluation item (complete convenience of services of the health management center) SQ was positive, while the other 24 evaluation items were all negative. The average perceived value of service quality of the 25 evaluation items were higher than 3.5. As per the two-dimensional quadrant diagram analysis, 7 items in quadrantⅠwere in the “charm” area, and the expectation of the medical and perceived values were higher than average; 6 items located in quadrant Ⅱ were in the “surprise” area, and the medical expectation and perception values were higher than average and below average; 7 items in quadrant Ⅲ were in the “potential” area, while the expectation of the physical examination and perception values were lower than average; 5 items were in the quadrant Ⅳ “region” area, while physical examination expectations than average perception value is lower than the average.Conclusion:The expectations of physical examinees based on each attribute of the service in the health management center of our hospital is high, and there is a gap between the perceived value and the expected value. Therefore, the service level should be improved according to the four regions in the two-dimensional quadrant diagram to enhance the brand competitiveness of the health management center.
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Objective:This study aimed to investigate and analyze the application effect of cross-field training of clinical, prevention, and management in health management talent training.Methods:The simple random sampling method was used. 30 clinical, prevention, and management students were randomly selected as the cross-training group from 2013 to 2017 in the Second Affiliated Hospital of Dalian Medical University, and 30 students in the same class were randomly selected as the control group. The cross-training group conducted case analysis teaching, symposium, and scientific research ability training practice. After the internship, subjective practice effect and health management knowledge test were conducted for each group. TOPSIS method was adopted to evaluate the subjective effect of cross-teaching and routine practice training.Results:The cross-training group had higher scientific research ability, development, satisfaction, and flexibility scores than the management group[3.0（3.0，3.0） vs 2.0（2.0，3.0）, （2.8±0.6） vs （2.4±0.5）, 3.0（3.0，3.3） vs 2.0（2.0，3.0）, 3.0（3.0，3.0） vs 2.0（2.0，3.0）, respectively]; higher participation, communication ability, development scores than the prevention group[（2.8±0.7） vs （2.4±0.6）, （3.1±0.6） vs （2.6±0.5）, （2.8±0.6） vs （2.4±0.5）, respectively]; and higher suitability degree and strain ability score than the clinical group[（2.9±0.6） vs （2.5±0.7）, 3.0（3.0，3.0） vs 3.0（2.0，3.0）, respectively]. Health management test scores of cross-training students were significantly higher than the clinical group[（7.1±1.3分） vs （6.1±1.9分）]. Differences were statistically significant ( P<0.05). After TOPSIS model evaluation, the results of comprehensive subjective evaluation in the cross-group ranked first, followed by the prevention group, clinical group, and management group. Conclusion:The cross-field of clinical, prevention, and management is better than conventional practice training, which is beneficial for promoting the training of health management talents to meet the needs of social health.
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Objective To explore the associations between physiological factors, psychosocial factors, dietary habits, lifestyles and hyperuricemia (HUA) and provide the evidence for hyperuricemia intervention. Methods From 2016 to 2017, adults during their checkup in the health management center of the Second Affiliated Hospital of Dalian Medical University were interviewed with self-designed questionnaire and received the health examinations. To determine the influence of socio-economic data, life style habits and psychological factors on the risk of HUA, the classification tree model was adopted. Results A total of 4 118 subjects were enrolled in the study, with an average age of (52.8±7.9) years. The results showed that the prevalence of HUA was higher among people under 30 years old and 40-50 years old who are smoking, drinking and doing the sedentary work, who unsatisfied with their work and under a great mental stress. Factor analysis model identified three dietary patterns, traditional model,fried and smoked food and dessert model and high quality protein model, the cumulative variance contribution rate was 53.886%. In multivariate model, it was found that high-quality protein pattern, physical exercise and fasting plasma glucose (FPG) were negatively associated with HUA. Male, smoking, drinking, having dyslipidemia, higher body mass index (BMI) were risk factors for HUA. Subgroup analysis showed that in both male and female, the high-quality protein patterns were negatively associated with HUA. The pattern of fried and smoked food and dessert patterns was the independent risk factors for HUA in female. Classification tree model showed that male, dyslipidemia, higher BMI grade, and the fried and smoked food and dessert pattern were the risk factors for HUA. Conclusions The influencing factors of HUA in different gender were different, which indicate the individualized health management should be adopted. Male who is overweight or obese should quit smoking and drinking. Women should pay more attention to avoid of the excess intake of fried and smoked food and dessert. Meanwhile, a high-quality protein diet and more physical exercise should be encouraged.
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Objective To investigate the clinical value of the real-time shear wave elastography(RT-SWE) in the assessment of salivary gland lesions by measuring the hardness of parotid gland and submaxillary gland in patients with Sj?gren′s syndrome (SS). Methods Forty patients with SS were chosen as SS group,and 35 age and gender matched healthy volunteers were chosen as control group.The patients were divided into mild SS group ( n =18) and severe SS group ( n =22) according to the decrease of uptake and secretion of salivary gland in Salivary gland scintigraphy.The Supersonic AixPlorer real-time quantitative diagnostic shear wave elastography was used to detect the parotid gland and submaxillary gland in 35 healthy volunteers and 40 patients.The RT-SWE elasticity indices of mean(Emean) was obtained and draw the SWE technology in the diagnosis of mild and severe SS patients with parotid and submandibular glands of the ROC curves. Results ① There was no significant difference in the Emean of left and right glands among the three groups (all P > 0.05). The Emean of parotid gland and submaxillary gland in patients with SS was higher than that in control group,especially in the severe SS group(all P <0.05). ②The cutoff value,sensitivity,specificity and the area under ROC for Emean with SWE diagnosing the parotid gland lesions of mild SS were 7.75 kPa,94.4%,97.1% and 0.998,and those in severe SS were 10.65 kPa, 90.9%,97.1% and 0.999,respectively.The cutoff value,sensitivity,specificity and the area under ROC for Emean with SWE diagnosing the the submaxillary glands lesions of mild SS were 8.15 kPa,100%,91.4%and 0.998,and those in severe SS were 10.40 kPa,95.5%,88.6% and 0.994,respectively.Conclusions RT-SWE can be successfully applied to assess parotid gland and submaxillary gland′s hardness in patients with SS,and provide a new method for the clinical evaluation of salivary gland diffuse lesions.
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Objective To reveal pathogenesis and etiology in adrenal incidentaloma. Methods The clinical data of 116 patients with adrenal incidentaloma from January 1, 2015 to January 1, 2017 were retrospectively analyzed. Results In 116 patients with adrenal incidentaloma, 49 cases (42.2％) were male and 67 cases (57.7％) were female; there were 14 cases (12.1％) aged from 20 to 40, 63 cases (54.3％) aged from 40 to 60, and 39 cases (33.6％) > 60 years. Forty-three patients (37.1％) were found by health examination, 26 patients (22.4％) were found because of hypertension, 27 patients (23.3％) were found by CT detection because of other diseases, and 20 cases (17.2％ ) were found because of other reasons. The result of endocrine function examination showed that nonfunctioning adrenal tumor was in 56 cases (48.3％); functional adrenal tumor was in 44 cases (37.9％), among whom primary aldosteronism was in 27 cases, Cushing syndrome was in 10 cases, and pheochromocytoma was in 7 cases;nonfunctioning non- adenoma was in 16 cases (13.8％ ). Conclusions It is frequent that the adrenal incidentaloma is found by health examination. The patients with adrenal incidentaloma should examine the endocrine function and identify the benign or malignant. And if necessary, surgical treatment should be performed.
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Objective To study the relationship between chronic obstructive pulmonary disease (COPD) and osteoporosis by measuring the bone mineral density (BMD),lung function,blood gas analysis,calcium ion,high sensitive C reactive protein (hs-CRP) and the quality of life.Methods BMD measuring was performed by ultrasound dry bone densitometer in 32 patients with COPD (COPD group) and 35 healthy controls (control group).The ultrasonic transmission speed (SOS),SOS T,fracture risk factor (OSI) and bone strength (TI) were measured at the sites of the left calcaneus.COPD group was divided into three groups according to lung function,3 cases of mild,14 cases of moderate and 15 cases of severe.According to the level of BMD,there were another three groups,3 cases with normal BMD,24 cases with lower BMD,and 5 cases with osteoporosis.According to the history of systemic glucocorticoid application,COPD group was divided into two groups,10 cases with glucocorticoid application and 22 cases without glucocorticoid application.The levels of BMD between COPD group and control group were compared,and the correlation between BMD and lung function,blood gas analysis,calcium ion,hs-CRP and the quality of life in patients with COPD was analyzed.Results COPD group had lower BMD than that in control group (P ＜ 0.05).In COPD group,the severe patients had lower BMD than the moderate patients (P ＜ 0.05),and the severe patients had only lower SOS than the mild patients(P ＜ 0.05),but there was no statistic significant difference in BMD between the moderate and mild patients(P ＞ 0.05).According to the level of BMD,the osteoporosis patients had lower arterial oxygen tension (PaO2) and higher hs-CRP and COPD assessment test (CAT) than the normal BMD and lower BMD patients,and the lower BMD patients had lower PaO2 and higher CAT than the normal BMD patients (P ＜ 0.05),but there was no statistic significant difference in calcium ion among them(P ＞ 0.05).According to the history of systemic glucocorticoid application,the patients with glucocorticoid application had lower level of BMD than the other patients (P ＜ 0.05).SOS,SOS T,OSI and TI was correlated with one second forced expiratory volume percent predicted (FEV1％) (r =0.389,0.262,-0.295,0.265; P＜0.05),also correlated with PaO2 (r =0.391,0.100,-0.374,0.122;P＜0.05),and also correlated with CAT (r =-0.659,-0.463,0.175,-0.178 ; P ＜ 0.05).There was only a negative correlation between SOS and hs-CRP (r =-0.390,P ＜ 0.05).Further in Logistic regression analysis,the results showed that both PaO2 and FEV1％ were the risk factors of BMD reduction.Conclusions Patients with COPD have lower BMD than their peers of healthy.The reduction of blood oxygen pressure and lung function are the risk factors of BMD reduction.There is a conjecture that the reduced BMD is correlated with chronic inflammation in patients with COPD.
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Objective To determine the influence of gender on the association between serum uric acid and branchial-ankle pulse wave velocity (baPWV).Methods Cross-sectional data from 1418 adults who underwent routine laboratory tests and baPWV measurements were analyzed in a gender-specific manner.BaPWV≥ 1400 cm/s was defined as abnormality.The individuals were assigned to four groups (Q1,Q2,Q3 and Q4) according to the gender-specific quartiles of serum uric acid.The relationship between serum uric acid and the baPWV values was assessed by Spearman's correlation coefficients.In female,the relationship of serum uric acid quartiles with baPWV was evaluated by logistic regression analysis.Results In male and female,diastolic blood pressure,fasting blood glucose,triglyceride and body mass index were increased with serum uric acid level,in contrast to high-density lipoprotein cholesterol.The Spearman's correlation coefficient for the relationship between serum uric acid and baPWV was 0.18 in female and-0.05 in male (P =0.16).In female,univariate logistic regression analysis showed that in comparison with group Q1,odds ratio (OR) value of baPWV abnormality of group Q4 was 2.45 (95％confidence interval (CI) 1.48 to 4.06).In multivariate logistic regression,after adjusting for creatine and estimated glomerular filtration rate,OR value of baPWV abnormality of group Q4 was 2.45 (95％ CI 1.48 to 4.06) when compared with group Q1.However,after adjustment for age and other risk factors of cardiovascular diseases,there were no significant differents in ORs among serum uric acid quartile groups.Conclusions The association between serum uric acid level and baPWV in female may depend on age and metabolic syndrome components.
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Objective To determine the relationship between normal weight obesity (NOW) and cardiovascular risk factors.MethodsA total of 940 adults who received a health examination in out hospital were recruited in a cross-sectional study,and 407 with a body mass index (BMI) of18.5 to 25 kg/m2were enrolled for further analysis.Body fat percentage ( BF％ ) was measured by bioelectrical impedance analysis (BIA),and the subjects were assigned to the NOW group ( BF％ ≥25％ for male or BF％ ≥35％for female) or the control group ( BF％ ＜ 25％ for male or BF％ ＜ 35％ for female).Cardiovascular risk factors and their detection rates were compared between the two groups by using independent sample t test and x2 test.The correlationbetweenNOW and cardiovascular risk factors was assessedbylogistic regression.Results The prevalence of NOW in men and women were13.1％ and14.9％,respectively.The prevalence of NOW was increased with age ( x2 =6.90,P ＜0.05 ).Systolic blood pressure (SBP),diastolic blood pressure ( DBP ),total cholesterol ( TC ),triglycerides ( TG ),low-density lipoprotein cholesterol ( LDL-C) and serum uric acid (SUA) were significantly increased in the NOW group (t values were 2.97,2.44,2.54,5.09,2.71and 3.91,respectively; all P ＜ 0.05 ) ; whereas high-density lipoprotein cholesterol ( HDL-C) was significantly decreased in the NOW group (t =-3.90,P ＜ 0.05 ).The prevalence of hypertension,hyperglycemia,high triglyceride,low HDL-C,dyslipidmia and hyperuricemia was increased in the NOW group in comparison with the control group ( x2 values were 6.76,5.58,14.50,11.97,10.97 and 8.76,respectively;allP＜ 0.05 ).LogisticregressionshowedNOWincreasedtheriskof hypertension,hyperglycemia,dyslipidmia or hyperuricemia by 2.186,2.120,2.088 or 4.175 times.After adjustment for age and gender,the risk for hyperuricemia was decreased to 3.491,but remained statistically significant higher.Conclusions NOW may be correlated with cardiovascular risk factors,and those with NOW could be at higher risk for cardiovascular diseases.
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ObjectiveTo develop a simple scoring system to identify individuals with higher risk of type 2 diabetes mellitus ( T2DM ).Methods Major risk factors of T2DM were fixed after literature review.Logistic regression was used to select risk factors of T2DM.Target populations were randomly assigned to 2 groups,and group A was used for the development of risk factor scoring method and group B for the confirmation of this new method.Results The threshold for T2DM risk was 65.0 for men and 65.5 for women ( sensitivity 90.6％ and 83.3％,respectively; specificity 89.4％ and 97.7％,respectively ; positive predictive value 58.8％and 80.0％,respectively;negative predictive value 98.3％and 98.2％,respectively ; area under the curve 0.955 and 0.899,respectively).There was significant difference of T2DM detection between screening and risk scoring system ( P =0.000 ).Conclusion Our T2DM risk scoring system may provide an effective tool to identify individuals with a higher risk of developing T2DM.
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Objective To evaluate the relationship of metabolic syndrome (MS) and MS components with thyroid nodule. Methods A total of 10 357 subjects ( age ＞ 18 years old) who received physical checkup at the Second Affiliated Hospital of Dalian Medical University between June 2009 and June 2010 were enrolled in this retrospective study. Anthropometric parameter, fasting plasma glucose (FPG),serum lipid profile, blood uric acid, alanine aminotransferase and thyroid ultrasonography were measured. Results The prevalence of thyroid nodule,MS,and thyroid nodule + MS was 46. 96% ,23. 6%,and 11.6%, respectively. The prevalence of thyroid nodule was significantly higher in MS patients than in non MS patients ( 75.9% vs 38. 0%, P ＜ 0. 05 ). Multifactor logistic analysis showed that MS, body mass index (BMI) and FBG (β vales were 0. 78,1.22,and 0. 62,respectively; odds ratios were 4. 167,3. 876,and 2. 359, respectively; all P ＜ 0. 05 ) were independently correlated with the development of thyroid nodule. Conclusions Significantly increased prevalence of thyroid nodule could be found in MS patients. BMI and FBG may be independent risk factors of thyroid nodule.
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Objective To study the levels of senlm uric acid(UA)in normal glucose(NC),impaired glucose regulation(IGR)and type 2 diabetes mellitus(T2DM),and investigate its relationship with insulin resistance and dyslipidemia.Method The levels of blood glucose,lipids,fasting insulin(HNS)and serum UA were measured in patients of 45 T2DM(T2DM group),20 IGR(IGR group)and 29 NC(NC group).Status of insulin resistance and insulin secretion function was evaluated by HOMA-IR and ISI.Results The levels of triglyceride(TG)and UA in T2DM group and IGR group were significantly higher than those in NC group[(3.34±8.77),(1.85±0.67),(1.26±0.38)mmoi/L and(316.71±96.20),(403.62±76.80),(325.45±94.43)mmol/L](P<0.01).HDL-C levels in T2DM group were significantly lower than those in IGR and NC group[(1.05±0.30),(1.07±0.21),(1.12±0.20)mmol/L](P<0.01).NO significant difference of FINS levels was found in the three groups.HOMA-IR level in T2DM and IGR group was higher than that in NC group(3.84,3.77,2.34)(P<0.01).ISI in T2DM and IGR group was lower than that in NC group(-4.52±0.79,-4.44±0.19,-4.03±0.58)(P<0.01).Correlation analysis indicated that the level of UA was positively related with BMI.TG and negatively related with HDL-C.Conclusion Increased UA in IGR indicates that hyperurieacidemia developes before DM.
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To develop a more efficient antithrombotic way after coronary artery bypass grafting (CABG), the anticoagulant effects were compared of human tissue factor pathway inhibitor (TFPI) gene transfection and aspirin oral administration (traditional method) on vein grafts. An eukaryotic expression plasmid pCMV-(Kozak) TFPI was prepared. Animal model of carotid artery bypass grafting was constructed. In operation, endothelial cells of vein grafts in TFPI group and empty plasmid control group were transfected with pCMV-(Kozak) TFPI and empty plasmid pCMV respectively, while no transfection was conducted in aspirin control group. After operation, aspirin (2 mg.kg(-1).(-1)) was administered (i.g.) in aspirin control group. Three days later, grafts (n=10) were harvested for RT-PCR, Western blotting and immunohistochemical analyses of exogenous gene expression and for pathological, scanning electron microscopic observation of thrombus. Thirty days later, the patency rates of remnant grafts (n=10) were recorded by vessel Doppler ultrasonography. Human TFPI gene products were detected in gene transferred vein grafts. Three days later, thrombi were found in 7 animals of aspirin control group and in 8 animals of empty plasmid control group, but in only 1 of TFPI group (P<0.01). Thirty days later, 5 grafts were occluded in empty plasmid control group, but none of grafts was occluded in the other groups (P<0.05). The endothelial surfaces of grafts in both of the control groups were covered with aggregated erythrocytes and platelets, and it were not seen in TFPI group. It was suggested that the anticoagulant effects on vein grafts of human TFPI gene transfection are better than those of aspirin.