Objective: The purpose of this study was to further clarify the association of Hashimoto's thyroiditis (HT) and vitamin D deficiency, and to seek the connection between them and related influencing factors. Methods: Data were obtained from subjects who underwent health examinations from January 2018 to December 2018. The diagnosis of HT was based on: antithyroid peroxidase antibody (TPO-Ab) levels >35 IU/ml and/or antithyroglobulin antibody (Tg-Ab) levels >40 IU/ml. Based on the Endocrine Society guidelines, 25-hydroxyvitamin D [25(OH)D] levels ≥30.0 ng/ml were classified as a vitamin D sufficiency; those between 20 and 29.9 ng/ml, as an insufficiency; and those <20 ng/ml, as a deficiency. All statistical analysis was performed by software R. Results: Of a total of 75,436 individuals who were physically examined, 5,656 of them had 25(OH)D levels tested at the same time; 5,230 were enrolled. The level of 25(OH)D in the non-HT group was higher than that in the HT group. Multiple regression analysis showed that HT was statistically significantly correlated with being male, body mass index (BMI), waist circumference, and thyroid-stimulating hormone (TSH). TSH levels in the insufficiency group and deficiency group were higher than those in the sufficiency group. Free triiodothyronine (FT3) and thyroxine (FT4) levels in the insufficiency group and deficiency group were lower than those in the sufficiency group. 25(OH)D increased by 1 ng/ml at the normal reference level, with an increase of 2.78 ng/dl in FT4 concentration and a decrease of 0.17 mIU/L in TSH. Conclusions: Patients with HT present with a reduced 25(OH)D level, and TSH is an independent risk factor for HT. TSH is negatively correlated with 25(OH)D level. FT3 and FT4 levels were positively correlated with 25(OH)D levels.

Toll-like receptor 5 (TLR5) is a pattern recognition receptor that specifically recognizes flagellin and consequently plays a crucial role in the control of intestinal homeostasis by activating innate and adaptive immune responses. TLR5 overexpression, on the other hand, might disrupt the intestinal mucosal barrier, which serves as the first line of defense against harmful microbes. The intestine symbiotic bacteria, mucous layer, intestinal epithelial cells (IECs), adherens junctions (such as tight junctions and peripheral membrane proteins), the intestinal mucosal immune system, and cytokines make up the intestinal mucosal barrier. Impaired barrier function has been linked to intestinal illnesses such as inflammatory bowel disease (IBD). IBD is a persistent non-specific inflammatory illness of the digestive system with an unknown cause. It is now thought to be linked to infection, environment, genes, immune system, and the gut microbiota. The significance of immunological dysfunction in IBD has received more attention in recent years. The purpose of this paper is to explore TLR5’s position in the intestinal mucosal barrier and its relevance to IBD.

Objective: To study the distribution of fecal microbiota in diarrhea‐predominant irritable bowel syndrome (IBS‐D) patients of spleen–kidney‐yang deficiency and liver depression and spleen deficiency, to make an objective foundation for dialectics of different type of IBS‐D. And to provide the clinical doctors an experimental basis for medication by regulating dysbacteriosis.Methods: We collected feces from the control group, spleen–kidney‐yang deficiency IBS‐D group, and liver‐depression and spleen‐deficiency IBS‐D group. After the extraction of fecal DNA, global DNA was isolated from every sample, and 16S ribosomal RNA was sequenced, and then we analyzed the results for bacteria such as Alpha diversity, community composition, LEfSe, and partial least squares discriminant analysis.Results: We compared the changes among the fecal bacteria in the intestine of the IBS‐D patients and healthy controls and found the specificity of spleen–kidney‐yang deficiency syndrome and liver‐depression and spleen‐deficiency syndrome. The control group has the highest flora diversity (control group > liver‐depression and spleen‐deficiency > spleen–kidney‐yang deficiency group). The control group, spleen–kidney‐yang deficiency group, and liver‐depression and spleen‐deficiency group are different in phylum (Actinobacteria, Fusobacteria), class (Actinobacteria, Fusobacteria), order (Enterobacteriales, Bifidobacteriales, Fusobacteriales), and family (Bifidobacteriaceae, Ruminococcaceae, Enterobacteriaceae, Acidaminococcaceae, Veillonellaceae, Fusobacteriaceae). Bifidobacteriaceae and Ruminococcaceae in the control group, Enterobacteriales, Fusobacteriales, Acidaminococcaceae, and Phascolarctobacterium in the spleen–kidney‐yang deficiency group, and streptococcus are the specific bacteria in the liver‐depression and spleen‐deficiency group. Intestinal flora disturbance is closely related to IBS‐D.Conclusions: There is a correlation between traditional Chinese medicine syndrome type and intestinal flora. The control group, the spleen–kidney‐yang deficiency group, and the liver‐depression and spleen‐deficiency group have specific bacteria.

Objective This study aims to further explore the relevant influencing factors of depression and explore the correlation between multimorbidity coexistence and depression to find the goals and methods of early intervention of depression in the elderly. Design This study adopts a cross-sectional approach. Setting The study population of this project came from the China Health and Retirement Longitudinal Study. Depression was grouped according to the 10-item version of Centre for Epidemiological Research Depression Scale. Chronic diseases, height, weight, grip strength, education, marital status, alcohol consumption, exercise and other indicators were included in the analysis. Participants 2239 adults over 60 years of age were included. Results The proportion of women in the depression group was higher (p<0.001). The depression group had a lower grip strength than the control group (p<0.05). The sleep duration was shorter in the depression group (p<0.001). There were differences in education, marital status and alcohol consumption in the depression group (p<0.05). The depression group might have more types of coexisting chronic diseases (p<0.001). The depression group was more likely to have hypertension, dyslipidaemia, chronic lung diseases, heart attack, stroke, stomach disease and memory-related disease. Grip strength was connected with the risk of depression in the elderly (0.971 (95% CI 0.959 to 0.984)). Sleep (0.827 (95% CI 0.785 to 0.872) and education level (0.790 (95% CI 0.662 to 0.942) were related to the risk of depression in the elderly. Concomitant chronic diseases could affect the risk of depression in the elderly (1.455 (95% CI 1.243 to 1.703)). Conclusion The coexistence of multiple chronic diseases and depression is very common in the elderly. The coexistence of multiple chronic diseases is more common in older women and older depressed people. With the increase in the number of chronic diseases, the risk of depression in the elderly is significantly increased.