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Background Thyroid cancer (TC) is the most common malignant tumor of the endocrine system, and its incidence has increased rapidly in recent years. Papillary thyroid cancer (PTC) is the most common type of thyroid cancer, accounting for 80% of all thyroid cancers. Despite the efficacy of surgical treatment, radioactive iodine therapy, TSH inhibition therapy and novel targeted drug therapy, early diagnosis and intervention are the key to stop its occurrence and development, however, the sensitivity indexes related to PTC are still lacking in clinical practice. Objective To investigate the correlation between lipid metabolism, inflammatory markers and sex of patients with PTC. Methods The data of PTC patients (n=370) diagnosed and treated in the Affiliated Hospital of North China University of Science and Technology from January 2018 to December 2020 were selected for retrospective analysis, and the normal population of physical examination in the same period was matched according to age and gender as the control group (n=1 112). Age, gender, smoking status, BMI, peripheral blood white blood cell count (WBC), platelet count (PLT), lymphocyte count (LYM), monocyte count (MON), neutrophil count (NEU), fasting blood glucose (FBG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), were collected in both groups, triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), urea (UREA), creatinine (Cr), and uric acid (UA), and calculate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-HDL cholesterol ratio (MHR). Analyze the correlation between the above indicators and PTC and their diagnostic value. Results Compared with control group, WBC, LYM, MON, LDL-C and MHR in case group were higher than those in control group (P

Background Acute Stanford type A aortic dissection (ATAAD) is a fatal disease, and rapid and effective identification of its postoperative prognostic indicators is of great significance for stratifying patient prognosis. Serum chloride (Cl-) is an important anion in the body associating with the occurrence and development of many diseases, but the relationship between serum Cl- and ATAAD is not completely clear. Objective To investigate the relationship of admission serum Cl- level with postoperative 30-day all-cause mortality and admission serum sodium (Na+) in patients with ATAAD. Methods A retrospective cohort design was adopted. Two hundred and six consecutive ATAAD patients who underwent Sun's procedure from February 2016 to December 2019 in the Fourth Hospital of Hebei Medical University were selected. All-cause death and adverse events within postoperative 30 days of patients were followed up. The clinical baseline, laboratory and intraoperative data and postoperative 30-day prognosis were compared between tertile groups of admission serum Cl-〔T1≤102 mmol/L (n=69), 102106 mmol/L (n=67) 〕. ROC curve analysis was used to measure the performance of admission serum Cl- and Na+ in predicting all-cause mortality in ATAAD, in which the area under the ROC curve (AUC), the Youden index, sensitivity, specificity, and optimal cut-off value were calculated. Multivariate Logistic regression model was used to evaluate the association between admission serum Cl- and postoperative 30-day all-cause mortality. For assessing the relationship between admission serum Cl- and Na+, postoperative 30-day all-cause mortality and cumulative survival rate were compared between ATAAD patients in four groups divided by the optimal cut-off value of admission serum Cl- (107 mmol/L) and Na+ (139 mmol/L): high Cl- and high Na+ (Cl->107 mmol/L+Na+>139 mmol/L, n=35), high Cl- and low Na+ (Cl->107 mmol/L+Na+≤139 mmol/L, n=21), low Cl- and high Na+ (Cl-≤107 mmol/L+Na+>139 mmol/L, n=41), low Cl- and low Na+ (Cl-≤ 107 mmol/L+Na+≤ 139 mmol/L, n=109). The cumulative survival curves in different Cl- groups or Cl- and Na+ groups were presented as Kaplan-Meier curves and compared by Log-rank test. Pearson correlation analysis was used to explore the correlation between serum Cl- and Na+. Then their relationship was further analyzed by age (≥ 50 and 139 mmol/L (Na+>139 mmol/L and ≤139 mmol/L), and the interaction between serum Cl- and age, sex, hypertension, smoking and drinking was examined using multiplicative interaction model. Results The AUC of admission serum Cl- for predicting postoperative 30-day all-cause mortality was 0.695 〔95%CI (0.595, 0.795), P107 mmol/L group was 3.367 times higher than that in Cl- ≤ 107 mmol/L group 〔95%CI (1.469, 9.186), P=0.005〕. Kaplan-Meier survival analysis showed that the cumulative survival rate within 30 days after surgery was lower in T3 group than that of T1 group (χ2=8.711, P=0.003) or T2 group (χ2=9.079, P=0.011). Cl->107 mmol/L group had a lower cumulative survival rate within 30 days after surgery than Cl-≤107 mmol/L group (χ2=13.326, P 0.05). But there was a certain interaction effect between admission serum Cl- and Na+ (Na+>139 mmol/L, Pinteraction =0.012) . Conclusion Admission serum Cl- associates with admission serum Na+ level in ATAAD patients. And elevated admission serum Cl- may be an independent risk factor for postoperative 30-day all-cause mortality.

BackgroundClinically, when metformin (Met) combined with acarbose (Aca) cannot achieve the ideal hypoglycemic effect, a third drug will be usually added, such as insulin (Ins) or dipeptidyl peptidase-4 inhibitor (DPP-4i) etc., but there are few reports on the effect of triple therapy on complications related to type 2 diabetes (T2DM) .ObjectiveTo explore the risk of adverse events of DPP-4i combined with Met and Aca, Ins combined with Met and Aca in the treatment of T2DM patients, in order to provide help for the choice of drugs for clinical T2DM treatment.MethodsIn the retrospective cohort study, patients diagnosed with T2DM and treated with Met+Aca+ DPP-4i or Met+Aca+Ins in Shijiazhuang Second Hospital from November 1, 2017 to August 1, 2020 were selected as the study subject. Telephone follow-up was conducted from November 20, 2017 to August 4, 2020, the follow-up wasn't terminated until a preset outcome occurred, then that was recorded. The three prespecified outcome events were non-fatal cardiovascular disease, death from all causes, and severe hypoglycemic events. The comprehensive outcome events including all-cause death, or composite non-fatal cardiovascular events, or severe hypoglycemic events. Propensity score matching (1∶1 ratio for data matching, caliper value set to 0.02) was used, and multivariate Cox proportional hazards regression model was used to analyze the risk of comprehensive outcome events in T2DM patients after drug treatment. Stratified analysis was performed on the effect of each covariate on the risk of comprehensive outcome events in patients treated with different drugs.ResultsFinally, 1 570 patients with T2DM were enrolled, including 1 089 patients who received Met+Aca+Ins treatment (Met+Aca+Ins group) and 481 patients who received Met+Aca+DPP-4i treatment (Met+Aca+DPP-4i group) . There were 434 cases in both groups after propensity score matching. Compared with the Met+Aca+Ins group, the incidences of comprehensive outcome events (6.53/100 person-per year) , non-fatal cardiovascular disease (5.03/100 person-years) , all-cause death (0.73/100 person-per year) , and severe hypoglycemic (0.73/100 person-er year) were lower in the Met+Aca+ DPP-4i group. The multivariate Cox proportional hazards regression model analysis showed that the risk of comprehensive outcome events in the Met+Aca+DPP-4i group was 67% lower than the Met+Aca+Ins group 〔HR=0.34, 95%CI (0.23, 0.50) , P7 h/d) , non-smoking, and no family history of cardiovascular disease, Met+Aca+DPP-4i treatment reduced the incidence of comprehensive outcome events in T2DM patients compared with Met+Aca+Ins treatment (P values were 0.008, 0.031, and 0.042, respectively) .ConclusionAfter failure treatment of Met and Aca in T2DM patients, the supplementation of DPP-4i was associated with a lower risk of comprehensive outcome events, cardiovascular disease, all-cause mortality, and severe hypoglycemia compared with the Ins addition, particularly in patients with adequate sleep, no smoking, and without family history of cardiovascular disease.

Water scarcity is a major challenge facing agricultural production in China. Unconventional water resources such as reclaimed wastewater can be used as a complimentary resource for irrigation. However, reclaimed wastewater is rich in salt and its long-term use for irrigation could lead to secondary soil salinization. In this review, we analyze the factors that have potential effects on accumulation of salt in soil. They include irrigation method, soil texture, crop types and crop variety, irrigation time, and reclaimed wastewater modification. Results show that our current understanding of the effect of long-term reclaimed water irrigation on soil salt accumulation is still unclear. As a result, more systematic studies are needed to elucidate the main factors that affect salt accumulation in soil. While reclaimed water modification is promising, more studies are required before it can be widely implemented. We suggest that future research on reclaimed water irrigation should focus on field experiments to systematically study how irrigation method, soil texture, crops, agronomic management and reclaimed water modification interactively affect salt accumulation in soils irrigated with reclaimed wastewater. [ABSTRACT FROM AUTHOR]

In view of the contradiction between straight lifting type heald spring and structural arrangement, a non-contact type of flat scroll leaf spring for heald return was designed and developed. A CAD entity model of spiral spring based on archimedes spiral was constructed according to national machinery industry standard (JB/ T 7366-1994). The results of finite element analysis with static and dynamic show that elastic deformation and stress distribution of the spring can meet requirements of static strength design, and low-order modal frequencies of the spring is less than 1Hz, which can effectively avoid working frequency of high-speed cam lifting. Through dynamic simulation and data processing of flexible spiral spring, stiffness characteristic curve and energy storage curve of the spring in tightening process were obtained, which provided an important basis for accurate calculation of reaction torque T and energy storage density ρE, which is beneficial to dynamic design and practical application of spiral spring. [ABSTRACT FROM AUTHOR]

Objective: To explore the changes of intracranial pressure in intensive care unit (ICU) patients during the occurrence and evolution of delirium by using bedside ultrasound to measure the optic nerve sheath diameter (ONSD) to evaluate intracranial pressure., Methods: A retrospective observational study was conducted. Adult patients who developed delirium during hospitalization in the general ICU of Beihai People's Hospital from October 2020 to November 2021 were enrolled, and patients who did not have ultrasonographic ONSD records within 24 hours after the diagnosis of delirium were excluded. The ONSD measured before delirium was recorded as ONSD 0 , the ONSD measured within 24 hours of the onset of delirium recorded as ONSD 1 , and the ONSD reexamined after ONSD 1 recorded as ONSD 2 . Patients were divided into intracranial hypertension group (ONSD 1 > 5 mm) and normal intracranial pressure group (ONSD 1 ≤ 5 mm) according to the size of ONSD 1 . According to the outcome of delirium, the patients were divided into cured, improved, and non-improved groups. The reduction ratio of ONSD 2 to ONSD 1 in the three groups were calculated and compared. Pearson correlation test was used to analyze the correlation between fluid balance and ONSD changes after delirium., Results: There were 43 patients, including 40 cases in the intracranial hypertension group (the incidence rate was 93.0%), 3 cases in the normal intracranial pressure group, 23 cases were cured, 13 cases were improved, and 7 cases were not improved. In the intracranial hypertension group, 11 cases had ONSD 0 and ONSD 1 records, and ONSD 1 was significantly higher than ONSD 0 [mm: 5.88±0.61 vs. 5.34±0.57, 95% confidence interval (95%CI) -0.85 to -0.23, P = 0.003]. The reduction ratio of ONSD 2 to ONSD 1 in the cured group was significantly higher than that in the improved group and the non-improved group [(12.04±6.20)% vs. (5.68±4.10)%, (0.17±3.96)%; 95%CI were 2.37 to 10.33, 6.41 to 17.31, P values were 0.003 and 0.000, respectively]. The correlation analysis showed that the reduction ratio of ONSD 2 to ONSD 1 was negatively correlated with fluid balance (r = -0.42, 95%CI was -0.66 to -0.10, P = 0.012)., Conclusions: The incidence of intracranial hypertension in ICU delirium patients is high. A more pronounced decrease in intracranial pressure predicts a better delirium outcome. Dynamic ONSD measurement can provide valuable information for the prevention and treatment of delirium.