Research progress of low grade inflammation in obese patients with type 2 diabetes mellitus / 中国医师杂志

Obesity and diabetes mellitus (T2DM) are metabolic related diseases with high incidence rate at present. Obesity is considered as one of the risk factors of T2DM. At present, the interaction mechanism between obesity and T2DM has not been clearly studied.Adipose tissue is an endocrine organ related to the pathophysiology of obesity and its complications. Adipose tissue can not only store a lot of energy, but also secrete many hormones, oxidative stress and inflammatory factors, which may be related to the occurrence and development of T2DM. Under long-term and low-dose stimulation, the sustainable low grade inflammation of fat is considered to be an important mechanism for the occurrence and development of obese T2DM. Therefore, this paper mainly summarizes the research progress of low grade fat inflammation in obese T2DM.

Clinical effects of robot-assisted esophageal hiatal hernia repair and laparoscopic esophageal hiatal hernia repair: a retrospective comparative study / 中华外科杂志

Objective: To analyze the short-term clinical effects of robot-assisted and laparoscopic repair of the hiatal hernia. Methods: The clinical data of 56 patients underwent minimally invasive hiatal hernia repair from January 2021 to January 2022 in the Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed. There were 32 males and 24 females, aging (59.7±10.7) years (range: 28 to 75 years). All patients were divided into laparoscopy group (n=27) and robot group (n=29) according to surgical procedures. Perioperative conditions, hospital stay, and improvement in symptoms before and after surgery were compared between the two groups by the t test, Wilcoxon rank-sum test and χ2 test. Results: All surgical procedures were successfully completed, without conversion to laparotomy or change in operation mode. There were no serious complications related to the operation. The intraoperative blood loss of the robot group was less than that of the laparoscopic group (M (IQR)): (20 (110) ml vs. 40 (80) ml, Z=-4.098, P<0.01). The operation time ((111.7±33.6) minutes vs. (120.4±35.0) minutes, t=-0.943, P=0.350) and hospitalization time ((3.9±1.4) days vs. (4.7±1.9) days, t=-1.980, P=0.053) of the robot group and the laparoscopic group were similar. Follow-up for 12 months after the operation showed no postoperative complications and recurrence. The score of the health-related quality of life questionnaire for gastroesophageal reflux disease in the robot group decreased from 10.8±2.8 before the operation to 6.5±0.6 after the operation, and that in the laparoscopic group decreased from 10.6±2.1 before the operation to 6.3±0.6 after the operation. There was no difference in the influence of different surgical methods on the change in score (t=0.030,P=0.976). Conclusion: Compared with laparoscopic repair of the hiatal hernia, robot-assisted hiatal hernia repair has the advantages of less bleeding, rapid postoperative recovery and good short-term effect.

Detection of Phosphatidylethanol in Whole Blood by UPLC-MS/MS / 法医学杂志

OBJECTIVES@#To establish the ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to detect ethanol metabolites phosphatidylethanol (PEth) in whole blood.@*METHODS@#An appropriate amount of aqueous solution including 1% formic acid was added to 100 μL whole blood, the protein was precipitated with acetone, centrifuged and the supernatant was purified and enriched by using Bond Elut Certify column. The eluent was redissolved with 1/1 isopropanol/acetonitrile (v/v) solution after nitrogen blowing and then tested by UPLC-MS/MS. Selective reaction monitoring scanning was carried out in negative ionization mode, and quantitative analysis was performed by external standard method.@*RESULTS@#PEth showed a linear relationship over the concentration range of 1-160 ng/mL in whole blood (r=0.999 9) with peak area. The detection limit was 0.2 ng/mL, the quantification limit was 1 ng/mL, the recovery rate was 97.43%-103.61%, the accuracy was 0.99%-1.77%, the intra-day precision was 0.4%-2.4%, and the inter-day precision was 1.1%-3.3%, and the matrix effect was 91.00%-99.55%. PEth was not detected in the in vitro blood samples supplemented with ethanol. PEth was detected positive in three drunk driving cases, and the concentration were 195.49, 83.67 and 876.12 ng/mL, respectively.@*CONCLUSIONS@#The established method has high sensitivity and specificity and the analysis results are accurate. It is suitable for the qualitative and quantitative analysis of PEth in whole blood.

Application of digital technology assisted free ALTPF in reconstruction of large-area soft tissue defect of limbs / 中华显微外科杂志

Objective:To explore the application value of digital technology in free transfer of ALTPF to repair large-area soft tissue defect of limbs.Methods:A total of 13 patients with large-area soft tissue defects of limbs treated from April 2017 to April 2020 were selected in the study, including 9 males and 4 females, aged 39-58 years old. The average age was (42.75±1.94) years old. The area of flap was 16 cm×10 cm-27 cm×18 cm. Before operation, CTA was performed on the donor and recipient areas, and the 3-dimensional image of arterial blood supply in the donor area was obtained by 3-dimensional digital reconstruction technology of CT angiography, so as to clarify the origin, course, classification, length vascular pedicle, of diameter and location of perforating fulcrum of the blood supply of ALTPF. According to the image parameters 3-dimensional, of the defect of the recipient area was reconstructed and designed with Mimics software, and the 3-dimensional digital designed flap was used accurately and standardized during the operation.Results:All the 13 flaps survived without a vascular crisis. The patients entered the follow-up for 6 to 24(mean 16) months by outpatient clinic visits combined with WeChat reviews. At the last follow-up, the surviving flaps had soft texture and good blood supply, the shape and colour of the flap were basically the same as those of normal skin. The limb function recovered well. According to Chinese Medical Association Upper Limb Function Evaluation (TAM) method and Maryland ankle function evaluation method: 8 cases were in excellent, 3 cases were in good and 2 cases were in fair.Conclusion:The preoperative application of digital technology to assist the reconstruction of large-area soft tissue defects of limbs with free ALTPF has high accuracy and standardisation. It improves the quality and success rate of free flap repair. This method is reliable, practical and with clinical value.

Research progress of the relationship between the effect of laparoscopic sleeve gastrectomy on blood glucose and GLP-1/DPP-4 pathway in obese patients with type 2 diabetes mellitus / 中国医师杂志

Obesity and type 2 diabetes (T2DM) are all the metabolic diseases with high incidence rate. There is a clear correlation between the them. Weight-loss surgery is the important treatment of surgical method for obesity and T2DM.However, the mechanism of T2DM for weight loss surgery is not yet clear.The secretion level of glucagon like peptide-1 (GLP-1) was affected after weight loss surgery. The secretion of GLP-1 can delay gastric emptying, increase satiety, improve insulin resistance (IR) and promote β insulin release, inhibition of glucagon synthesis and secretion, and improvement of pancreatic function β cell function. All of these changes were conducive to glycemic control. Therefore, this paper aims to summarize and describe the relationship between the effect of laparoscopic sleeve gastrectomy (LSG) on blood glucose and GLP-1/dipeptidyl peptidase-4 (DPP-4) pathway in obese T2DM patients.

HIV/AIDS antiretroviral treatment and its influencing factors in Yining of Xinjiang / 公共卫生与预防医学

Objective To investigate the current status and its influencing factors of ART coverage and VL inhibition rate of HIV/AIDS in Yining City, Xinjiang, and to provide reference for AIDS prevention and treatment. Methods The ART data for 2017-2019 years in Yining, Xinjiang was retrieved from the National AIDS Antiretroviral Treatment Information System, to analyze the changing trend of ART coverage rate and VL inhibition rate of HIV/AIDS. Logistics regression model was used to analyze the influencing factors of untreated HIV/AIDS and uninhibited VL. Results The coverage rate of antiviral treatment in Yining city from 2017 to 2019 was 73.39%, 78.06% and 87.03%, respectively. The inhibition rates of VL were 83.91%, 85.05% and 86.09%, respectively, showing an increasing trend year by year. Female, other transmission routes, positive sexual partner detection, and testing and special investigation reduced the risks of untreated HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of untreated HIV/AIDS. Female, 26-35 years old, 36-45 years old, 46~55 years old, >55 years old, primary school, junior high school, high school or technical secondary school, junior college or above, and male-male sex behavior reduced the risks of unsuppressed VL of HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of unsuppressed VL in HIV/AIDS. Conclusion The ART coverage rate and VL inhibition rate in Yining, Xinjiang rise year by year, approaching the expected target. Targeted education and supervision should be conducted to promote the realization of “90-90-90” in 2020 and “95-95-95” target in 2030.

Prevalence and influencing factors of multi-site work-related musculoskeletal disorders among workers in coal mining enterprises / 环境与职业医学

Background Coal workers are inclined to report multi-site work-related musculoskeletal disorders (WMSDs) due to their specific working environment and extensive exposure to occupational hazards, which seriously affect the physical and mental health of coal workers. objective To investigate the prevalence of multi-site WMSDs among workers in coal mining enterprises in Xinjiang, and analyze the related factors influencing multi-site WMSDs. Methods Using stratified cluster random sampling method, Musculoskeletal Disorders Questionnaire, Job Burnout Questionnaire, and Brief Occupational Stress Questionnaire were distributed in six Xinjiang coal mining enterprises to collect data on general information, prevalence of WMSDs in the past year, work-related information, job burnout, and occupational stress among coal miners with a working experience ≥ 1 year. A multiple logistic regression model was used to analyze the influencing factors of multi-site WMSDs. Results A total of 1730 questionnaires were distributed in this survey, 1448 valid questionnaires were recovered, and the valid recovery rate was 83.7%. Among the 1448 coal miners, 93.2% were males and 6.8% were females; 39.2% were aged ≤ 35 years, 31.1% were aged 35-45 years, and 29.6% were aged > 45 years; 58.4% reported ≤ 10 years of working experience, 20.0% reported 10-20 years, and 21.6% reported > 20 years. The total prevalence rate of WMSDs in the coal miners was 75.6% (1095/1448), the prevalence rate of multi-site WMSDs was 58.4% (846/1448), and the prevalence rate of one-site WMSDs was 17.2% (249/1448). The results of multiple logistic regression analysis showed that working experience > 20 years (OR=2.245, 95%CI: 1.655-3.045), severe burnout (OR=2.644, 95%CI: 1.549-4.516), and multiple repetitive operations per minute very often (OR=2.038, 95%CI: 1.339-3.101), often bending at larger angles (OR=1.467, 95%CI: 1.111-1.938), long-time bending the neck forward (OR=1.671, 95%CI: 1.294-2.159), and slipping or falling down (OR=2.459, 95%CI: 1.908-3.168) were positively correlated with multi-site WMSDs; sufficient rest time (OR=0.718, 95%CI: 0.565-0.913) was negatively correlated with multi-site WMSDs. Conclusion Multi-site WMSDs is common among workers in coal mining enterprises, and the prevalence rate of multi-site WMSDs is higher than that of one-site WMSDs. Working experience, job burnout, frequent multiple repetitive operations per minute, often bending at larger angles, long-time bending the neck forward, slipping or falling down, and sufficient rest time are influencing factors of multi-site WMSDs in coal workers.

Research progress on the correlation between gastroesophageal reflux disease and obesity and related treatment / 中国医师杂志

Obesity has been recognized as a health problem worldwide because of its negative effects. Obesity has increased the incidence rate of some diseases. Among them, gastroesophageal reflux disease (GERD) is more typical. Recently, GERD has become more and more popular among obese people. Scholars have begun to pay attention to the association between obesity and GERD. Some literatures and data point out that obesity is one of the important factors related to GERD. In the face of these problems, surgical and non-surgical treatment can be used, but recently, surgical treatment, especially weight loss surgery, has become more and more popular. In order to provide reference for clinicians and patients, this paper reviews the relationship between obesity and GERD, and the treatment methods and development of obesity complicated with GERD in recent years.

Changes of choroid thickness in primary angle-closure glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the changes and related factors of choroidal thickness(CT)in acute primary angle-closure glaucoma(APACG), and chronic primary angle-closure glaucoma(CPACG).<p>METHODS: It was a retrospective study. A total of 35 patients(43 eyes)with APACG, 26 patients(46 eyes)with CPACG and 46 patients(81 eyes)with normal eye condition and used as the control group in the study. EDI-OCT was used to measure and compare the foveal, nasal, temporal, superior and inferior CT of APACG, CPACG and normal control groups. The CT were labeled as subfoveal choroidal thickness(SFCT), nasal 2mm(N 2mm), temporal 2mm(T 2mm), superior 2mm(S 2mm), inferior 2mm(I 2mm).Linear regression analysis was used to explore the related factors of CT. Logistic regression analysis was used to evaluate the association between CT and presence of APACG and CPACG.<p>RESULTS: There was no significant difference in CT of APACG, CPACG and normal control group(<i>P</i>>0.05). CT of all sites was negatively correlated with axial length(AL). N 2 mm and I 2 mm were also negatively correlated with age, anterior chamber depth(ACD), SFCT was negatively correlated with age and AL(<i>P</i><0.05). Multivariate Logistic analysis showed that there was an association between S 2mm and APACG(<i>P</i>=0.029), the odds ratio(<i>OR</i>)and 95% confidence interval(<i>CI</i>)was 0.975(0.953, 0.997). There was no association between CPACG and CT at all locations(<i>P</i>>0.05).<p>CONCLUSION: Age, AL and ACD are the factors that related to choroidal thickness. It is also confirm that there is an association between decreased S 2mm and APACG. However, there is no correlation between CPACG and CT at all locations.

Effects of FGB gene polymorphism on fibrinogen level and gallstones incidence in Xinjiang, China / 临床肝胆病杂志

Objective To investigate the association of the polymorphisms of the FGB gene rs4220 and rs1044291 loci with plasma fibrinogen (Fg) level and gallstones in Xinjiang, China. Methods Blood samples were collected from 150 Uygur and Han patients with gallstones and 150 Uygur and Han individuals without gallstones who were hospitalized or underwent physical examination in The People's Hospital of Xinjiang Uygur Autonomous Region from December 2017 to May 2020. Plasma Fg level was measured, and based on the previous results of whole exon sequencing of the FGB gene, the SNaPshot method was used to identify the genotype at rs4220 and rs1044291 loci of the FGB gene. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups; a multivariate logistic regression analysis was used to investigate the association between each variable and gallstones. Results For the Chinese Han population, the gallstones group had a significantly higher plasma Fg level than the control group [2.90 (2.43-3.49) g/L vs 2.47 (2.06-3.02) g/L, Z =-3.62, P 0.05). For the Chinese Han population, the subjects carrying GG genotype at the rs4220 locus in the gallstones group had a significantly higher plasma Fg level than those in the control group [2.84(2.32-3.61) g/L vs 2.34(2.05-2.75) g/L, Z =-3.04, P 0.05). Conclusion The influence of FGB gene polymorphism on plasma Fg level may be associated with race, and FGB gene polymorphisms at the rs4220 and rs1044291 loci may be involved in the pathogenesis of gallstones by regulating Fg level in the population in Xinjiang.

Immunohistochemical identification of GM-CSF in testis of rats with oligozoospermia with the intervention of Cuscuta chinensis flavonoids / Identificación inmunohistoquímica de GM-CSF en testículos de ratas con oligozoospermia con la intervención de flavonoides de Cuscuta chinensis

Oligozoospermia is a common infertility disease, and the incidence rate is increasing year by year. Cuscuta chinensis is a commonly used medicine for the treatment of oligozoospermia in Chinese medicine. Flavonoids are its main component. GM-CSF is a multifunctional cytokine that plays an important role in the inflammatory response. In this paper, we performed HE staining and immunohistochemical staining on the testis of rats with oligozoospermia. We intend to study the expression changes of GM-CSF in rats with oligospermia and the effect of flavonoids on the expression of GM-CSF in testis of rats with oligozoospermia.

La oligozoospermia es una enfermedad común de infertilidad, con una tasa de incidencia que aumenta año tras año. Cuscuta chinensis es un medicamento de uso común para el tratamiento de la oligozoospermia en la medicina china. Los flavonoides son su componente principal. GM-CSF es una citocina multifuncional que tiene un rol importante en la respuesta inflamatoria. En este trabajo, realizamos tinción con hematoxilina y eosina y tinción inmunohistoquímica en testículos de ratas con oligozoospermia. TNuestro objetivo fue estudiar los cambios de expresión de GM-CSF en ratas con oligozoospermia y el efecto de los flavonoides en la expresión de GM-CSF en testículos de ratas con oligozoospermia.

A finite element analysis of two internal fixation methods for unstable femoral neck fractures in young adults / 中华创伤骨科杂志

Objective:To compare internal fixation with 3 cannulated screws versus with an anteromedial support plate plus 3 cannulated screws using finite element analysis for unstable femoral neck fractures (Pauwels type Ⅲ).Methods:Recruited for this study was a 34-year-old male volunteer with a height of 173 cm and a weight of 75 kg. Continuous thin-layer helical CT was conducted to scan the segment from his hip joint to the middle shaft of his tibia. Digital medical software was used to establish three-dimensional models of the femur based on his femoral CT data. The digital femoral necks were dissected as necessary to simulate femoral neck fractures of Pauwels type Ⅲ. The fractures were fixated with 3 ordinary cannulated screws in a mode of inverted triangle (screw group) and with 3 ordinary cannulated screws in a mode of inverted triangle plus an anteromedial steel plate (screw-plate group). After the 2 groups of models were subjected to identical constraints and 3 kinds of load (slow walking, twisting and standing on one leg), they were compared in terms of distribution of Von Mises stress and deformation.Results:Under various loads in both groups, the maximum deformation occurred in the femoral head. In the condition of slow walking, the deformation in the screw-plate group was 1.97 mm, which was smaller than that in the screw group (2.26 mm). In the conditions of twisting and standing on one leg, similar deformations were observed in both groups. Under all kinds of load, the maximum stress occurred in the middle part of the bottom screw and the fracture line in all the models. In the screw group, the peak stresses were 318.09 MPa, 92.11 MPa and 147.21 MPa for conditions of slow walking, twisting and standing on one leg, greater than those in the screw-plate group (229.86 MPa, 86.94 MPa and 124.48 MPa).Conclusions:The cannulated screws plus an anteromedial support plate are a recommendable fixation method for young adults with unstable femoral neck fracture, because they can effectively share the stress on the cannulated screws, lead to better mechanical stability of the fracture ends than the fixation with merely 3 cannulated screws and effectively prevent shortening of the femoral neck.

Clinical research progress in the treatment of obesity with gastroesophageal reflux disease by sleeve gastrectomy combined with hiatal hernia repair / 中国综合临床

Obesity is an independent risk factor of gastroesophageal reflux disease, which is usually related to the existence of esophageal hiatal hernia.Similarly, hiatal hernia is an independent risk factor of gastroesophageal reflux disease, which is prevalent in about 40% of obese patients.Although laparoscopic sleeve gastrectomy is becoming more and more popular in weight-loss surgery, and it is safe and effective, it may be accompanied by symptoms of gastroesophageal reflux disease and the need for esophageal hiatal hernia repair.In addition, the effect of laparoscopic sleeve gastrectomy combined with hiatus hernia repair on the symptoms of gastroesophageal reflux disease is controversial and the efficacy is not clear.Therefore, this article mainly reviews the influence of laparoscopic sleeve gastrectomy combined with hiatus hernia repair on obesity with gastroesophageal reflux disease and the existing problems.

Prevention and treatment of postoperative complications of laparoscopic sleeve gastrectomy for obesity / 中国医师杂志

More and more clinical studies have found that weight-loss surgery is a long-term and effective way to treat obesity. Laparoscopic sleeve gastrectomy (LSG) has been widely used in recent years due to its advantages of simple operation, high safety and obvious curative effect. With the increasing popularity of LSG, clinicians are aware of the possibility of many complications. In this paper, the common complications of obesity after LSG and its prevention and treatment status were reviewed. The risk factors of common complications of obesity after LSG were analyzed, and the prevention and treatment experience was summarized, so as to provide reference for clinical peers.

The expression of NADPH oxidase-4 and acid sensitive receptors in the esophagus of chronic restraint mice / 中国医师杂志

Objective:To investigate the chronic restraint stress induced expressions of acid sensitive receptors and its role in the esophageal inflammation and oxidative stress.Methods:Twenty male specific pathogen free (SPF) Kunming mice were randomly divided into two groups: stress group and control group (each group, n=10). Stress mice were restrained in self-made restraint device for 2 hours per day and lasted for total 14 days. The histopathological changes of esophageal mucosa were observed by hematoxylin eosin (HE) staining under light microscope. The expression of nicotinamide adenine dinucleotide phosphate (Nox-4) was detected by immunohistochemistry, real time fluorescent quantitative polymerase chain reaction (qRT-PCR) and enzyme linked immunosorbent assay (ELISA). The mRNA expressions of acid sensitive receptors were detected by qRT-PCR. Results:HE staining showed that stress mice had obvious infiltrations of neutrophils and eosinophils, and also showed inflammatory change in esophgus, while no significant abnormality was found in the esophagus of control mice. The inflammotory scores in stress group were significantly higher than that in control group ( P<0.001). Immunohistochemistry showed that Nox-4 was mainly expressed in the lamina propria, mucosa and submucosa of esophagus. The mRNA expression levels of Nox-4 in stress group was (2.67±0.62) times higher than control group, with statistically significant difference ( P<0.001). In addition, the plasma concentration of Nox-4 in stress group was significantly higher than that of control group [(0.42±0.01)ng/ml vs (2.13±0.35)ng/ml, P<0.001]. The transcription levels of acid sensitive receptors in stressed mice, such as transient receptor potential vanilloid-1 (TRPV-1), TRPV-4, acid-sensing ion channel-1 (ASIC-1), ASIC-2 and ASIC-3 were significantly higher than those in the control group, with statistically significant difference ( P<0.001). Pearson correlation analysis showed that there was a positive correlation between Nox-4 mRNA expression and TRPV-1, TRPV-4, ASIC-1, ASIC-2, ASIC-3 mRNA expression in stress group ( r=0.97, 0.94, 0.98, 0.95 and 0.99, P<0.01). Conclusions:Stress may increases the expression of acid sensitive receptors and result in an esophageal inflammation and oxidative stress, which may contribute to the formation of esophageal hypersensitivity.

Clinical analysis of 56 cases with surgical operation of congenital tumor in conus medullaris position / 中国医师杂志

Objective To analyze the curative effect of 56 cases with surgical operation of congenital tumor in conus medullaris position,to provide valuable reference information for the surgical operation of congenital tumor in conus medullaris position.Methods The cases were from 56 patients with congenital tumors in conus medullaris position in Xinjiang Uygur municipal people's hospital from January 2015 to February 2018.According to the classifications of congenital tumors in the conus medullaris position,surgical operation was performed on patients.The curative effect of patients with all kinds of congenital tumors in the conus medullaris position was analyzed and summarized.Results After 9 months of the follow-up:(1) There were totally 18 cases of epidermoid cysts,16 cases with obvious improvement in lower limb numbness and lower limb motor function,13 cases with the pain degree effectively relieved and 3 cases without significant improvement in early defecation function.(2) There were 15 cases of teratomas,13 cases without significant improvement in lower extremity numbness,2 cases with reduced lower extremity numbness,3 cases with reduced urination and defecation function disturbance and 1 case not recovered.There was no recurrence of tumor.(3) There were 8 lipoma patients who were cured and discharged without urination and defecation function disturbance.Life was basically self-sustaining.(4) There were 9 cases of hemangioblastoma with significant improvement in spinal cord function,5 cases without postoperative pain symptoms and 1 case with significant improvement in pain degree.(5) There were 6 cases of ependymoma,2 cases with significant reduction on limb numbness symptoms,1 case with urinary retention after surgery.There was no significant change in muscle strength of the 2 cases before and after surgery.Conclusions The clinical effect of surgical operation of congenital tumor in conus medullaris position is clear.Combined with imaging examination and attention to surgical precautions,the surgical treatment effect of congenital tumors in the conus region of the spinal cord can be effectively improved.

Correlation between rs231775 polymorphism of CTLA4 gene and autoimmune thyroid disease of Uygur in Xinjiang Uygur Autonomous Region / 中华地方病学杂志

Objective:To explore the correlation between rs231775 polymorphism of cytotoxic T lymphocyte-associated antigen 4 (CTLA4) gene and autoimmune thyroid disease (AITD) of Uygur in Xinjiang Uygur Autonomous Region.Methods:A total of 382 Uygur patients with AITD [including 328 Hashimoto's thyroiditis (HT) patients and 54 Graves' disease (GD) patients] diagnosed in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2017 to December 2018 were selected as the case group, and 383 Uygur health physical examiners in the same period were selected as the control group. The whole blood genomic DNA of the study subjects was extracted, and the Sequenom-mass spectrometry analysis platform was used to determine the genotyping of CTLA4 gene single nucleotide polymorphism (SNP) locus rs231775 and analyze the genetic model, and the correlation between rs231775 polymorphism and AITD under different genetic models was compared. The logistic regression analysis model was used to analyze the influencing factors of AITD. And the thyroid function index of different genotype population was compared.Results:In the case group and the control group, the differences of CTLA4 gene rs231775 alleles (A: 41.88%, 49.35%; G: 58.12%, 50.65%) and genotype frequencies (AA: 17.80%, 23.24%; AG: 48.17%, 52.22%; GG: 34.03%, 24.54%) were statistically significant (χ 2=8.586, 9.260, P < 0.05). Compared with the control group, the genotype frequency of rs231775 in HT group, the alleles and genotype frequencies of rs231775 in GD group were significantly different (χ 2=5.997, 11.130, 10.210, P < 0.05). Under the additive and dominant models, the CTLA4 gene rs231775 was correlated with AITD [odds ratio ( OR)=0.67, 0.55, 0.63] and HT ( OR=0.69, 0.62, 0.67, P < 0.05); and correlated with GD under the additive, dominant and recessive genetic models ( OR=0.53, 0.23, 0.44, 0.34, P < 0.05). The logistic regression analysis showed that genotype, gender, age, thyroid stimulating hormone (TSH) and free thyroxine (FT 4) were independent influencing factors of AITD ( P < 0.05). Among all the subjects, the level of thyroglobulin antibody(TgAb) in the population with the recessive genotype (GG) at the rs231775 of the CTLA4 gene was higher than that in the dominant genotype (AA+AG) population ( P < 0.05). Conclusion:The CTLA4 gene rs231775 polymorphism is significantly related to AITD of Uygur in Xinjiang Uygur Autonomous Region, and the level of TgAb in GG genotype is higher than that in other genotypes.

A case-control study on the correlation of multiple single nucleotide polymorphisms of TPO and Tg genes with Hashimoto′s thyroiditis in Xinjiang / 中华内分泌代谢杂志

Objective:To investigate the correlation of multiple single nucleotide polymorphisms(SNPs)of thyroid peroxidase(TPO)and thyroglobulin(Tg)genes with Hashimoto′s thyroiditis(HT).Methods:Based on the gene mutation sites obtained from the second-generation sequencing of the target region of the previous autoimmune thyroid disease cases in our research group, the representative sites were selected for confirming in the expanded samples. A total of 301 Uyghur patients with HT and 383 controls were selected to determine the genotypes of representative SNPs(rs4927631, rs2071400, rs2071403, rs2403883, rs4236899, rs4736434, rs180195)using MassArry Sequenom platform. Correlation analysis and linkage analysis were performed with SPSS 21.0 software.Results:(1)The SNP rs4927631 gene frequency and genotype of TPO gene were significantly different between the case and control groups. The SNP rs2071403 gene frequency of TPO gene revealed statistically different between the case and control groups.(2)With analysis under different genetic models, the rs4927631 and rs2071403 of TPO gene were associated with HT under the additive model(AA/GG)and dominant model( P<0.05). The rs180195 of Tg gene was associated with HT in a recessive model( P<0.05). (3)All subjects were grouped according to the dominant genotype(AA+ GA)and recessive genotype(GG)of the TPO gene rs2071403, and mean age, gender distribution, proportion of those with higher TSH, and lower FT 4 were compared between two groups. Only thyroid peroxidase antibody(TPOAb) level displayed a statistical difference( P<0.05). This was the case for the patients with HT after grouped according to the above method( P<0.05). Conclusion:The rs4927631 and rs2071403 loci of TPO gene are associated with the pathogenesis of HT in Xinjiang Uygur.

Dynamic changes of thyroid hormone levels in pregnant women in previous iodine deficiency regions of Xinjiang Uygur Autonomous Region / 中华地方病学杂志

Objective:To observe the dynamic changes of thyroid hormone levels and thyroid autoimmune antibodies in pregnant women in Xinjiang Uygur Autonomous Region during pregnancy, and to investigate the significance of repeated screening of thyroid function in different gestational ages.Methods:A retrospective study was carried out of pregnant women who completed thyroid function screening in Clinic, People's Hospital of Xinjiang Uygur Autonomous Region from January 2015 to December 2017, and the test results of thyroid stimulating hormone (TSH), free thyroxine (FT 4), free triiodothyronine (FT 3), thyroid peroxidase antibody (TPOAb), and anti-thyroglobulin antibody (TGAb) were collected and analyzed of their changes during pregnancy. Pregnant women were divided into 2 different gestational age groups by the age limit of 30, the changes of thyroid dysfunction rate with pregnancy were analyzed, and the clinical significance of repeated screening in different pregnancy stages was discussed. Results:Changes of thyroid-related indicators with pregnancy: first, second, and third trimesters were 404,725, and 767 cases, respectively; TSH level in the third trimester (2.76 mU/L) was significantly higher than those in the first and second trimesters (2.55, 2.36 mU/L, P < 0.05), there was no significant difference between the first trimester and the second trimester ( P > 0.05); the FT 4 and FT 3 levels decreased gradually with pregnancy ( P < 0.05); the positive rate of TPOAb was significantly higher in the first and second trimesters than that in the third trimester ( P < 0.05), there was no significant difference between the first trimester and the second trimester ( P > 0.05); the positive rate of TGAb decreased gradually with pregnancy ( P < 0.05). Comparison of abnormal rate of TSH in different gestational ages: the first, second, and third trimesters were 352, 664, 735 cases, respectively; the abnormal rate of TSH in the overall study was statistically significant at different stages of pregnancy (χ 2=31.627, P < 0.05), the first trimester was significantly higher those in the second and third trimesters ( P < 0.05). In pregnant women aged ≥30 years old, the abnormal rate of TSH in the first trimester was significantly higher than those in the second and third trimesters ( P < 0.05); in pregnant women aged < 30 years old, the abnormal rate of TSH in the first trimester was significantly higher than that in the third trimester ( P < 0.05). There were no significant differences in the abnormal rate of TSH in the first, second, and third trimesters between the < 30 years old group and ≥30 years old group ( P > 0.05). Comparison of abnormal rate of FT 4 in different gestational ages: there were no significant differences in the FT 4 abnormal rate among different pregnancy groups in the overall, < 30, ≥30 years old groups (P > 0.05). In early pregnancy, the abnormal rate of FT 4 in the ≥30 years old group was higher than that in the < 30 years old group ( P < 0.05); in second and third trimesters, there were no significant differences between the two age groups ( P > 0.05). Conclusions:Screening for thyroid function in the first trimester of pregnancy is important for women of different ages. Except for women with abnormal thyroid function who have not been treated during the first trimester, the rest may not need to be screened again. Pregnant women aged ≥30 years old may have a higher risk of thyroid dysfunction than those < 30 years old.

Clinical efficacy of laparoscopic sleeve gastrectomy for obesity complicated with obstructive sleep apnea syndrome / 中华消化外科杂志

Objective:To investigate the clinical efficacy of laparoscopic sleeve gastrectomy (LSG) for obesity complicated with obstructive sleep apnea syndrome (OSAS).Methods:The retrospective and descriptive study was conducted. The clinical data of 74 patients with obesity complicated with OSAS who were admitted to People's Hospital of Xinjiang Uygur Autonomous Region from January 2017 to June 2018 were collected. There were 40 males and 34 females, aged (39±10)years, with a range from 20 to 56 years. Observation indicators: (1) surgical and postoperative situations; (2) follow-up; (3) correlation analysis between obesity indicators and OSAS indicators; (4) analysis of factors influencing the postoperative efficacy of OSAS. Follow-up using hospitalization examination was conducted to detect the incidence of complications and the improvement of obesity and OSAS indicators after patients discharge. The follow-up was up to June 2019. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages. Repeated measurement data was analyzed using the mixed-effects model. Correlation analysis was conducted using the Pearson correlation coefficients. Multivariate analysis was conducted using the COX proportional risk regression model. Results:(1) Surgical and postoperative situations: 74 patients underwent LSG successfully, without conversion to open surgery, including 12 cases undergoing LSG combined with laparoscopic cholecystectomy and 9 cases undergoing LSG combined with esophageal hiatal hernia repair. The operation time and volume of intraoperative blood loss of 74 patients were (88±22)minutes and (57±25)mL. There was no severe postoperative complications and perioperative mortality. The duration of postoperative hospital stay of 74 patients were 5 days (range, 3-8 days). (2) Follow-up: among 74 patients, 71 were followed up at 1 month, 68 were followed up at 3 months, 64 were followed up at 6 months and 61 were followed up at 12 months after operation, respectively. The body mass, body mass index (BMI), abdominal circumference, chest circumference, neck circumference, apnea hypopnea index (AHI), average oxyhemoglobin saturation (ASaO 2), lowest oxygen saturation, epworth sleepiness scale score, excess weight loss rate of the 71 patients who were followed up at 1 month after operation were (108±16)kg, (38±5)kg/m 2, (121±14)cm, (122±13)cm, (41.3±2.5)cm, (25±15)times/hour, 88.1%±3.8%, 70.0%±9.3%, 17.8±2.3, 30%±8%, respectively. The above indicators of the 68 patients who were followed up at 3 month after operation were (96±14)kg, (33±5)kg/m 2, (113±13)cm, (120±12)cm, (39.7±2.3)cm, (17±11)times/hour, 90.2%±3.1%, 78.5%±7.1%, 15.0±2.2, 52%±13%, respectively. The above indicators of the 64 patients who were followed up at 6 month after operation were (88±11)kg, (31±4)kg/m 2, (105±11)cm, (113±11)cm, (37.5±1.7)cm, (10±7)times/hour, 92.4%±2.2%, 84.2%±3.5%, 13.6±1.7, 63%±14%, respectively. The above indicators of the 61 patients who were followed up at 12 month after operation were (80±8)kg, (28±3)kg/m 2, (97±8)cm, (108±10)cm, (36.5±1.4)cm, (6±4)times/hour, 93.7%±1.4%, 88.0%±3.1%, 9.2±1.5, 75%±16%, respectively. There were significant differences in the body mass, BMI, abdominal circumference, chest circumference, neck circumference, AHI, ASaO 2, lowest oxygen saturation, epworth sleepiness scale score of patients before and after operation ( F=109.855, 108.632, 90.565, 27.846, 96.353, 49.969, 48.561, 115.938, 257.762, P<0.05). There were 39 cases with AHI<5 times/hour in the 61 patients who were followed up at 12 month after operation, and the clinical complete response rate of OSAS was 63.93%(39/61). (3) Correlation analysis between obesity indicators and OSAS indicators: results of the Pearson correlation analysis showed that the AHI was positively correlated with the body mass and BMI ( r=0.267, 0.317, P<0.05) and negatively correlated with the ASaO 2 and lowest oxygen saturation ( r=-0.525, -0.551, P<0.05), and there was no correlation between AHI and neck circumference ( P>0.05) in the 74 patients before operation. The lowest oxygen saturation was negatively correlated with the body mass and BMI ( r=-0.330, -0.400, P<0.05), and there was no correlation between lowest oxygen saturation and neck circumference ( P>0.05) in the 74 patients before operation. The AHI was negatively correlated with the ASaO 2 and lowest oxygen saturation ( r=-0.406, -0.373, P<0.05), and there was no correlation between AHI and the body mass, BMI or neck circumference ( P>0.05) in the 61 patients who were followed up at 12 month after operation. There was no correlation between lowest oxygen saturation and the body mass, BMI or neck circumference ( P>0.05) in the 61 patients who were followed up at 12 month after operation. (4) Analysis of factors influencing the postoperative efficacy of OSAS: results of the multivariate analysis showed that preoperative AHI was an independent influence factor for postoperative efficacy of OSAS ( hazard ratio=1.039, 95% confidence interval: 1.016-1.063, P<0.05). Conclusion:LSG can effectively reduce the body mass and improve OSAS of patients with obesity complicated with OSAS in the short term.