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Background Traditional Chinese Medicine (TCM) has a systematic understanding of the occurrence, development, diagnosis and treatment of Hashimoto's thyroiditis complicated with thyrotoxicosis. However, at present, there are few studies on the clinical symptoms and syndrome distribution of TCM in this disease population, and there is also a lack of description of the syndrome distribution and syndrome diagnostic criteria of this disease in the national industry standards. Objective Using factor analysis combine with cluster analysis to explore the distribution of clinical symptoms and syndromes of Hashimoto's thyroiditis complicated with thyrotoxicosis, provide a basis for clinical syndrome differentiation and promote the standardization of Hashimoto's thyroiditis complicated with thyrotoxicosis syndrome. Methods From December 2020 to December 2021, 171 patients with Hashimoto's thyroiditis complicated with thyrotoxicosis who met the diagnostic criteria in the outpatient department of thyroid disease of Dongcheng District, Tongzhou District of Dongzhimen Hospital, Beijing University of Chinese Medicine and Sunsimiao Hospital was collected. The symptoms, signs, tongue, pulse and other four diagnostic information were collected by using the four diagnostic information collection table of Hashimoto's thyroiditis complicated with thyrotoxicosis'. Based on factor analysis and cluster analysis, the symptoms and syndrome distribution of Hashimoto's thyroiditis complicated with thyrotoxicosis were studied. Results Among the 171 patients with Hashimoto's thyroiditis complicated with thyrotoxicosis, there were 17 males and 154 females, with an average age of (39.98±13.30) years. Patients aged 20-60 years accounted for 87.72%. The symptoms with high frequency in the distribution of symptoms were fatigue, palpitation, irritability or impatience. Signs were swelling of the neck, finger tremor. The tongue image with higher frequency had red, thin tongue and tooth marks on the tongue. The moss were white and thin. The pulse condition were pulse string and pulse number. Factor analysis of 82 four diagnostic items of the questionnaire was collected, and 25 common factors were extracted. The cumulative variance contribution rate was 70.562%, and 62 meaningful symptoms were screened out. The 25 common factor results obtained by factor analysis were used as variables to perform R-type system cluster analysis, and a total of 5 types of syndrome types were obtained, namely: pattern of phlegm congealing due to liver depression, pattern of yin deficiency with effulgent fire, pattern of yang deficiency in spleen and kidney, pattern of qi stagnation due to liver depression, pattern of dual deficiency of qi and nutrient phases. Conclusion The basic TCM syndromes of Hashimoto's thyroiditis complicated with thyrotoxicosis can be divided into pattern of phlegm congealing due to liver depression, pattern of yin deficiency with effulgent fire, pattern of yang deficiency in spleen and kidney, pattern of qi stagnation due to liver depression, pattern of dual deficiency of qi and nutrient phases.

Background The serum reverse triiodothyronine (rT3) values of heart failure patients who died during hospitalization were found significantly higher than the upper limit of the biological reference interval in the clinical work of the author. The prediction of thyroid hormones, especially rT3, on death during hospitalization of heart failure patients was rare reported in the previous studies, it is of great clinical significance to explore the indicators with predictive value for death during hospitalization in patients with heart failure. Objective To investigate the relationship between serum thyroid hormones and prognosis during hospitalization in patients with heart failure. Methods A total of 197 patients with heart failure admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from April 2019 to April 2022 were included in the study. Baseline data of the study subjects were collected by the electronic medical record system. Fasting venous blood of all subjects was collected within 24 h after admission for total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), rT3 and N-terminal brain natriuretic peptide precursor (NT-pro-BNP). Subjects were divided into death group (n=18) and non-death group (n=179) according to the occurrence of death during hospitalization. Multivariate Logistic regression analysis was used to investigate the influencing factors of death during hospitalization in patients with heart failure. Receiver operating curve (ROC curve) was plotted to evaluate the predictive value of related indicators on death during hospitalization in patients with heart failure, and the area under curve (AUC) of each indicator was calculated and compared by Delong test. Results The age and rT3 of death group were higher than those of non-death group, while FT3, TT3 and TSH of death group were lower than those of non-death group, with statistically significant differences (P

The aim of this study is to explore a novel classification and investigate the clinical significance of hepatocellular carcinoma (HCC) cells. We analyzed integrated single-cell RNA sequencing and bulk RNA-seq data obtained from HCC samples. Cell trajectory analysis divided HCC cells into three subgroups with different differentiation states: state 1 was closely related to phosphoric ester hydrolase activity, state 2 was involved in eukaryotic initiation factor 4E binding, translation regulator activity and ribosome, and state 3 was associated with oxidoreductase activity and metabolism. Three molecular classes based on HCC differentiation-related genes (HDRGs) from HCC samples were identified, which revealed immune checkpoint gene expression and overall survival (OS) of HCC patients. Moreover, a prognostic risk scoring (RS) model was generated based on eight HDRGs, and the results showed that the OS of the high-risk group was worse than that of the low-risk group. Further, potential therapeutic drugs were screened out based on eight prognostic RS-HDRGs. This study highlights the importance of HCC cell differentiation in immunotherapy, clinical prognosis, and potential molecular-targeted drugs for HCC patients, and proposes a direction for the development of individualized treatments for HCC.

This article uses Ts'ao P'i's "Discourse on Literature" as the principal source to discuss his concept of ch'i in literature. First, it examines different editions of the "Discourse on Literature" to diagnose the causes of controversies among the critics. Then, it defines the key term, ch'i, as life-force the individual writer is endowed with at birth. Lastly, it proves that the central idea of the "Discourse on Literature" is crystallized in the statement, "The main factor in writing is ch'i, whose purity or turbidity has determinate substance." The concluding part is devoted to a brief discussion of Ts'ao's unique contribution to Chinese literary criticism: he is the one who establishes the conceptual framework of ch'i in literature. [ABSTRACT FROM AUTHOR]