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Objective:To explore the effect of subclinical hypothyroidism(SCH) on complications after coronary artery bypass grafting(CABG).Methods:The data of CABG patients hospitalized in TEDA International Cardiovascular Disease Hospital from January 2016 to December 2017 were retrospectively analyzed. According to the thyroid function after admission, the patients were divided into normal thyroid function group(NC group, 814 cases, 0.27 mIU/L≤TSH≤4.2 mIU/L) and subclinical hypothyroidism group(SCH group, 106 cases, TSH>4.2 mIU/L). The preoperative clinical data, surgical conditions, recent complications and one-year bridge stenosis rate were compared between the two groups in male or female.Results:Compared with NC group, SCH group had more female patients(53.8% vs 24.4%, P=0.000), lower smoking rate (38.7% vs 58.0%, P=0.000). There was no statistical difference in other baseline data and postoperative complications( P>0.05). Subgroup analysis depending on gender showed that the incidence of respiratory tract infection increased in female patients with SCH(10.5% vs 3.5%, P=0.034) compared with those in NC group, there was no significant difference in male. The TSH level was an independent risk factor for respiratory tract infection in female patients( OR=1.307, 95% CI=1.110-1.539, P=0.001). Compared with the male patients, the prevalence of hypertension(84.2% vs. 67.3%, P=0.041), diabetes mellitus(45.6% vs 16.3%, P=0.001), hospitalization time in ICU(44 h vs. 42 h, P=0.003), acute renal failure(10.5% vs 0, P=0.019) and massive blood transfusion(8.8% vs 0, P=0.034)increased. Conclusion:SCH appears to influence the postoperative outcome for female patients by increasing the development of postoperative respiratory tract infection.
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Objective To investigate the expression of miR-155 ,nuclear factor kappa B (NF-κB) and soluble intercellular adhesion molecule -1 (sICAM-1 ) in peripheral blood in patients with type 2 diabetes mellitus (T2DM ) ,and to explore the role of miR-155 in vascular lesions of T2DM. Methods A total of 165 T2DM patients and 60 health subjects from health examinations were enrolled in this study. All the subjects were divided into two groups :subjects without vascular lesions group and vascular disease group. Vascular disease group was further divided into microangiopathy group ,macroangiopathy group , microangiopathy+ macroangiopathy group ;based on 24 hUAlb level normal urinary albumin (NAU ) group ,microalbuminuria (MAU) group ,macroalbuminuria (MAAU) group. MiR-155 ,NF-κB and sICAM-1 in peripheral blood were tested by RT-PCR. Single factor analysis of variance was used for comparison among groups. Stepwise regression analysis was used for correlation factors analysis. Results The expression of miR-155 ,NF-κB and sICAM-1 were significantly higher in T2DM group than in NC group [(1.82 ± 0.71) vs (1.00 ± 0.12) ,(2.28 ± 0.66) vs (1.04 ± 0.33) ,(1.88 ± 0.80) vs (1.03 ± 0.30) ,P<0.05]. The level of miR-155 ,NF-κB ,sICAM-1 were significantly higher in T2DM vascular lesions group than in subjects without vascular lesions group [(1.95 ± 0.73) vs (1.34 ± 0.29) ,(2.40 ± 0.65) vs (1.65 ± 0.16 ) ,(2.01 ± 0.77 ) vs (1.07 ± 0.41 ) ,P < 0.05 ]. The expression of miR-155 was higher in microangiopathy+ macroangiopathy group than in macroangiopathy group [(2.36 ± 0.61 ) vs (1.77 ± 0.59) ,P < 0.05 ].The expression of NF-κB was also significantly higher in microangiopathy +macroangiopathy group than in microvascular disease group and macroangiopathy group (P<0.05). The level of miR-155 was significantly higher in group MAU group and MAAU group than in NAU group [(1.41 ± 0.49) ,(2.64 ± 0.52) vs (1.04 ± 0.20) ,P<0.05] ,and NF-κB and sICAM-1 were also higher than NAU group (P<0.05). Multiple stepwise regression analysis showed that miR-155 was positively correlated with NF-κB and sICAM-1(t=4.235 ,9.728 ,P<0.01). Conclusion The expression of miR-155 increases in T2DM patients with vascular complications ,and this trend is the same as NF-κB and sICAM-1. It suggests that miR-155 maybe involves in the pathogenesis of diabetic chronic vascular disease.
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Objective To investigate the accuracy of real-time continuous glucose monitoring(RT-CGM)system in the type 2 diabetes mellitus(T2DM). Methods A total of 318 subjects hospitalized between 2013 May to 2014 August were recruited. Each subject received a RT-CGM system. In order to calibrate the interstitial glucose level, finger-stick blood glucose were measured at least four times every day. Patients were divided into three groups according to their finger-stick blood glucose level:≤6.99 mmol/L, 7.0-10.0 mmol/L and≥10.01 mmol/L. Pearson correlation was used to analyze the relationship between the finger-stick glucose and interstitial glucose gained from RT-CGM. Clarke error grid analysis was used to analyze the accuracy of RT-CGM. Results (1)A total of 2, 815 glucose meter values from finger-stick were com?paired with glucose from RT-CGM. A positive relationship(r=0.847)were found between CGM and finger-stick blood glu?cose. The correlation was closer with higher finger-stick blood glucose levels(r=0.457, 0.648 and 0.852 respectively in≤6.99 mmol/L group, 7.0-10.0 mmol/L group and≥10.01 mmol/L group. P0.05). Conclusion RT-CGM provides accu?rate blood glucose values to guide the treatment of diabetes, and the accuracy is more reliable in high glucose environment.
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Objective:To study the effect of thyroid function on bone metabolism. Methods:Serum FT3,FT4 were investigated by radioimmunoassay (RIA) and bone mineral density of spine (L2～4) weremeasured by dual energy x-ray absorptinmetry and other markers related to bone metabolism were alsomonitored in 30 patients with hyperthyroidism and 30 healthy volunteers. Results :The levels of FT3,FT4,ALP were significantly higher than those of the normal controls. BMD of spine decreased significantly incomparison with the controls ,and the degree of severity and incidence increased with age. Conclusion:Thy-roid hormone might speed up bone turnover directly with increased bone resorption to induce bone massloss.