Low T3 syndrome and long-term mortality in chronic hemodialysis patients

AIM： To investigate the predictive value of low freeT3 for long-term mortality in chronic hemodialysis （HD） patients and explore a possible causative role of chronic infammation.METHODS： One hundred fourteen HD patients （84 males） consecutively entered the study and were assessed for thyroid function and two established markers of inflammation, high sensitivity C-reactive protein （hsCRP） and interleukin-6 （IL-6）. Monthly blood samples were obtained from all patients for three consecutive months during the observation period for evaluation of thyroid function and measurement of infammatory markers. The patients were then divided in two groups based on the cut-off value of 1.8 pg/mL for mean plasma freeT3, and were prospectively studied for a mean of 50.3 ± 30.8 mo regarding cumulative survival. The prognostic power of low serum fT3 levels for mortality was assessed using the Kaplan-Meier method and univariate and multivariate regression analysis.RESULTS： Kaplan-Meier survival curve showed a negative predictive power for low freeT3. In Cox regression analysis low freeT3 remained a significant predictor of mortality after adjustment for age, diabetes mellitus, hypertension, hsCRP, serum creatinine and albumin. Regarding the possible association with inflammation, freeT3 was correlated with hsCRP, but not IL-6, and only at the frst month of the study.CONCLUSION： In chronic hemodialysis patients, low plasma freeT3 is a significant predictor of all-cause mortality. Further studies are required to identify the underlying mechanisms of this association.

STUDY ON THE ATTACK CONTROL ACTION OF ELECTRO-ACUPUNC-TURE ON T■IYANG(太阳EX-HN5)FOR MIGRAINE DUE TO HYPERAC-TIVITY OF LIVER YANG:RANDOMIED CONTROLED TRIAL

Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified cases were randomly divided into treatment group （146 cases according to the design） and control group （140 cases）, which were respectively treated with electro-acupuncture and drugs （Compound Aminopyrine Phenacetin Tablets, Ergotamine Caffeine Tablets, Diazepam Tablets）, and observed the overall effect and scores of headache, accompanying symptoms, psychological and social adaptability scores, life quality scores, TCM symptoms scores and follow-up results before and after the treatment. Results In treatment group, the successful rate of attack control was 47.3 %, the improvement rate was 73.3 %, and the total effectiveness was 90.4 %, the clinical control rate and improvement were much superior to control group （the clinical control rate 35.7 %, improvement 61.4 %, the total effectiveness 85. 7 % ）, P〈0. 01, the difference in effect was mainly reflected in patients with moderate severity; the total scores of TCM syndrome after the treatment was obviously significant or very obviously significant（ P〈0. 05, P〈0. 01 ）, but the headache scores between two groups was not obviously significant（P〉0.05）, the difference in accompanying symptoms was significant（ P〈0. 01 ） ;the long term attack control action in two groups was not satisfactory, the recurrence was similar （P〉0. 05） ,the severity of headache in recurrence cases of treatment group was alleviated and superior to control group（ P 〈 0. 01 ）, the occurrence of headache after the treatment is much less than that before the treatment and the situation after 2 months was superior to control group （P〈0. 01 ）. Sleepiness and redness of face in some patients which were seen in control group weren＇t seen in treatment group. Conclusion Electro-acupuncture on Tàiyáng （太阳 EX-HN5） can control the attack of migraine due to hyperactivity of liver yang, and it has advantages in improving the accompanying symptoms and reducing the toxic and side effects of western drugs.

Severe Sinus Bradycardia in Anorexia Nervosa-A Case Report

A case of anorexia nervosa complicated with severe sinus bradycardia and low T3 syndrome was reported.

The difference of immunologic parameters between SARS patients of mild type and severe type

The aim of this study is to study the difference of immunologic parameters between severe acute respiratory syndrome （SARS） patients of mild type and severe type. Data including white blood cell （WBC） count, lymphocyte count, CD3, CD4 and CD8 T lymphocyte count, levels of C3, C4, ESR （erythrocyte sedimentation rate） and CRP （C-reactive protein） from 1291 patients with SARS in each week from onset of illness were recorded. The clinical progress of each sign was analysed and the difference between mild type and severe type was compared. Lymphocyte count, CD8 T lymphocyte count declined in the first two weeks and recovered from the third week, while CRP and CA- levels rose in the first week and then recovered gradually. Lymphocyte count and CD8 T lymphocyte count of severe cases were much lower than that of mild type （P 〈 0.01）, while CRP and CA- levels in severe type were much higher than that of mild type （P 〈 0.01）. Lymphocyte count, CD8 T lymphocyte count, CRP and CA- levels are useful signs for the diagnosis of SARS of severe type and are valuable for the evaluation of its severity.

The relationship between serum interleukins and T-lymphocyte subsets in patients with severe acute respiratory syndrome

Objectives To observe the changes of serum interleukins (IL), T lymphocyte subsets, and white blood cell (WBC) count in patients with severe acute respiratory syndrome (SARS), and to investigate the relationship between injured immune function, immune response and disturbed immune adjustment in SARS patients Methods The levels of serum IL 2, IL 10, IL 12 and T lymphocyte subset counts were measured in 35 clinically diagnosed SARS patients by using enzyme linked immunosorbant assay (ELISA) The relationship between the measured results and WBC count was further analyzed Results The level of serum IL was increased to a great extent in the 35 SARS patients, and the levels of serum IL 2, IL 10 and IL 12 were 242 53 (92 69) pg/ml, 77 43 (63 37) pg/ml and 65 94 (43 21) pg/ml, respectively The level of serum IL 2 increased markedly ( P <0 01) The peripheral blood CD 3 +, CD 4 + and CD 8 + counts were lower than normal in 23 patients (67 7%), 26 patients (74 3%) and 15 patients (42 9%), respectively The peripheral blood WBC counts were lower than 4 0×10 9/L in 10 patients, and their CD 3 +, CD 4 + and CD 8 + counts were 583 90 (315 58)×10 6/L, 272 00 (94 13)×10 6/L and 209 00 (72 21)×10 6/L, respectively The peripheral blood WBC counts were (4 0-10 0)×10 9/L in 20 patients, and their CD 3 +, CD 4 + and CD 8 + counts were 700 00 (502 96)×10 6/L, 347 00 (247 58)×10 6/L and 322 05 (228 47)×10 6/L, respectively The peripheral blood WBC counts were higher than 10 0×10 9/L in 5 patients, and their CD 3 +, CD 4 + and CD 8 + counts were 1466 00 (630 86)×10 6/L, 783 00 (311 14)×10 6/L and 640 00 (294 40)×10 6/L, respectively The decreased CD 3 +, CD 4 + and CD 8 + counts were consistent with the decreased WBC counts The level of IL in SARS patients was significantly higher than that in patients with chronic hepatitis B ( P <0 01) Conclusions The level of serum IL is closely related to cell immunity in SARS patients The level of serum IL is increased evidently while CD 3 +, CD 4 + and CD 8 + counts decrease Both serum IL and CD are associated with injury of immune function, and thus they could be regarded as a monitoring index for judging the condition of SARS patients and prescribing immune therapy

Measurement of subgroups of peripheral blood T lymphocytes in patients with severe acute respiratory syndrome and its clinical significance

Objective To investigate the changes of subgroups of peripheral blood T lymphocytes in patients with severe acute respiratory syndrome (SARS) and its clinical significance.Methods Subgroups of blood T lymphocytes in 93 patients with SARS were detected by flow cytometer. The results detected in 64 normal subjects and 50 patients with AIDS served as controls.Results The numbers of CD3 +, CD4 +, and CD8 + lymphocytes all significantly decreased in acute phase of patients with SARS [(722±533)/μl, (438 ±353)/μl, (307±217)/μl)] compared with those in normal controls [ (1527±470)/μl, (787±257)/μl, (633±280)/μl, all P<0. 01) ], which was different from what we observed in patients with AIDS who had decreased CD4 + [ (296±298)/μl] but increased CD8 + [ (818 ±566)/μl counts. The counts of CD3+, CD4+, and CD8 + lymphocytes decreased more apparently in patients with severe SARS. All the five patients who died had CD4 + counts less than 200/μl. As the patients' condition improved, CD3 +, CD4 +, and CD8 + counts gradually returned to normal ranges.Conclusion The damage of cellular immunity is probably an important mechanism of pathogenesis of SARS.

A novel demand-responsive control strategy for district heating systems,featuring return temperature reduction

The paper presents a novel demand-responsive control strategy to be equipped centrally at the district level for district heating systems.The demand-responsive feature was maintained as to both the direct and the indirect substation configurations(by basing on their rating measures)in order to achieve lowest possible return temper-ature degrees from the end-user substations.Different than the traditional weather-compensation based supply temperature resetting,the new control strategy was formulated to adjust the supply temperature at the district level as to the cooling performance at the end-user substations.Two different simulations were carried out in order to quantify the benefits of the novel control strategy as compared to the traditional weather-compensation,equipped both at the substation level and the district level.The results obtained showed that the new control strategy,when considering the electricity loss at the heat production plant,shows superiority when compared to other control strategies.