Objective To discuss the significance of the diagnosis of hypothyroidism or subclinical hypothyroidism and evaluate the correlation of adverse pregnancy outcomes and the intervention effects of levothyroxine in early pregnancy .Methods 500 pregnant women who from April 2015 to April 2016 came to our hospital obstetrics do prenatal outpatient service were served as the objects in our study, at the same time, all the pregnant women received the five items of thyroid function screening.The statistically analyzed the results and followed up the pregnant women who with hypothyroidism and subclinical hypothyroidism to learn the treatment and adverse pregnancy outcomes, so as to evaluate the correlation and the intervention effects. Results In 500 cases of pregnant women,there were 6 cases of hyperthyroidism (1.2%),55 cases of hypothyroidism or subclinical hypothyroidism (11%),includeing four cases of hypothyroidism and 51 cases of subclinical hypothyroidism.The values of TSH,T3, T4,FT3 and FT4 in the group of hypothyroidism pregnant women were significant different to the normal control group (P<0.05), the values of TSH, T3, T4 and FT4 in the group of subclinical hypothyroidism pregnant women were significant different to the normal control group (P<0.05).Then the 25 cases of pregnant women with hypothyroidism or subclinical hypothyroidism received the treatment with levothyroxine, and the incidence rate of adverse pregnancy outcomes in treatment group was significantly lower than the untreated group ( P<0.05 ) .Conclusion The diagnosis of hypothyroidism or subclinical in early pregnancy and then treated with levothyroxine has important significant in decreasing the adverse pregnancy outcomes .

Objective To evaluate the value of echocardiography in the evaluation of congestive heart failure (PHC) in peripartum cardiomyopathy patients.Methods 64 patients with congestive heart failure were randomly divided into two groups.The control group were treated with routine therapy.The study group were treated with levocarnitine in combination with routine therapy.Echocardiography was performed before and after treatment, and the changes of each index were compared.Results There was no significant difference in left ventricular end diastolic diameter, left ventricular ejection fraction and cardiac output between the two groups before treatment.After treatment, the left ventricular end diastolic diameter, left ventricular ejection fraction and cardiac output in study group after treatment were higher than those in control group(P<0.05).There was no significant difference in left ventricular short axis shortening, left ventricular end-systolic diameter and stroke volume between the two groups before treatment, but the left ventricular short axis shortening and stroke volume in study group after treatment were higher than those in control group (P<0.05), the left ventricular end-systolic diameter was lower ethan that in control group ( P<0.05 ) .The treatment effect of the study group was significantly higher than that in control group (P<0.05).The adverse reactions was significantly lower than that in the control group (P<0.05).Conclusion L-carnitine is effective in the treatment of heart failure in peripartum cardiomyopathy patients.It can be used to evaluate the therapeutic effect of cardiac ultrasound in order to provide guidance for clinical treatment.

Objective To compare the differences of liver function indexes in patients with acute left heart failure and congestive heart failure , and to provide the basis for the diagnosis of heart failure .Methods 142 cases of heart failure from March 2014 to December 2015 in our hospital were selected and divided into 68 cases of acute left heart failure group and 74 cases of congestive heart failure group.The differences in liver function tests were compared between the two groups by comparing the differences in the indexes of heart failure, liver blood biochemistry, general biochemical indexes and late follow-up data.Results Compared with the indexes of heart failure, there were no significant differences in ejection fraction, NT-proBNP, history of heart failure>one years, and the number of patients with right heart failure, the difference was statistically significant (P<0.05).Comparison of liver blood biochemistry: patients with acute left heart failure were alanine aminotransferase, aspartate amino transferase, albumin increased, the difference was statistically significant (P<0.05), and glutamyl aminotransferase, total bilirubin, direct bilirubin, indirect bilirubin decreased, the difference was statistically significant (P<0.05).There was no significant difference between the two groups of patients with alkaline phosphatase and total protein.Compared with the general biochemical indexes, increased triglyceride levels in patients with congestive heart failure group, the difference was statistically significant (P<0.05), there was no significant difference in other indexes.Conclusion AHF patients with ALT, AST increased, CHF with GGT, TBIL, DBIL, IBIL increased, ALB decreased mainly.

Objective To investigate the drug sensitivity and distribution of main pathogenic pathogens in hospitalized patients with respiratory hospital diabetes bacteria and provide reference for the prevention and treatment of diabetes mellitus in experimental infection in patients with respiratory hospital.Methods 69 cases of diabetes mellitus complicated with respiratory infection were selected, their clinical data ( laboratory, imaging and etiological examination data) were complete,and their intact specimens for testing and identificated were throat swabs, sputum smear, sputum culture, protected specimen brush sampling, pathogens culture, and drug susceptibility test of pathogenic bacteria were isolated from the statistical data of 69 patients and prognosis.Results 69 strains of pathogenic bacteria were isolated, identified and isolated from the specimens of all the patients in the study.Among them, there were a total of 86 strains of pathogenic bacteria, including gram positive bacteria (46 strains), gram negative bacteria (27 strains) and fungi (13 strains) .Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis to teicoplanin, clindamycin, amoxicillin and levofloxacin sensitive rate is less than 50%, while to oxacillin, vancomycin, linezolid, ampicillin, imipenem, moxifloxacin susceptibility rate >50%.Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae to ceftriaxone, ceftazidime, amoxicillin, amikacin drug sensitivity of less than 50% of cefoxitin, piperacillin/tazobactam, cotrimoxazole, imipenem, meropenem, netilmicin susceptibility rate >50%.69 patients were diagnosed before treatment with antiviral drugs, antibiotics, antibiotics adjusted according to the etiology and drug sensitivity test results and antiviral drugs, improved in 49 cases of patients to the hospital treatment of 14 cases, 6 cases were converted to sepsis after rescue invalid death.Conclusion The diabetic patients hospitalized in respiratory pathogens of nosocomial infection in a wide range of pathogen susceptibility differences , understand the distribution of pathogens in patients with regular and drug resistance, provide guidance for the prevention and treatment experience, reduce the infection rate of patients with respiratory infection in patients with hospital provided treatment of high pertinence has important significance.

Objective To study curative efficacy of cyclophosphamide combined with VAD regimen in treatment of multiple myeloma and its effects on coagulation function.Methods 78 patients of multiple myeloma who received therapy from July 2013 to July 2016 in our hospital were selected as research objects, and divided into the control group and the observation group , the control group was treated with VAD regimen, while the observation group was treated with cyclophosphamide combined with VAD regimen.Then coagulation factor and anti-coagulation factor activity, adverse reaction, therapeutic effect after treatment between two groups were compared.Results After treatment, decreased blood coagulation factor, Protein C, protein S and antithrombin were increased between two groups , the difference was not statistically significant.Incidence of adverse reactions in observation group was less than the control group[15.38%(6/39)vs 46.15%(18/39)], the difference was statistically significant(P<0.05);The total effective rate of observation group was statistically higher than that in the control group [ 89.74%( 35/39 ) vs 58.97%( 23/39 ) ] , the difference was statistically significant(P<0.05).Conclusion Cyclophosphamide combined with VAD regimen is well for multiple myeloma, which can effectively improve the patient's condition, improve the life quality of patients, and will not cause a greater impact on blood coagulation function.

Objective To investigate the changes of vital signs, serum potassium and postoperative comfort of patients treated with MECT in the treatment of low-dose rocuronium.Methods 200 patients with MECT from June 2014 to June 2016 were selected and randomly divided into two groups, and the life signs and adverse reactions were analyzed and compared.Results There was no significant difference between the experimental group and the control group in the recovery time, the recovery time and the recovery time of the pharyngeal reflex.The recovery of spontaneous respiration in the experimental group was earlier than that in the control group, and the difference was statistically significant ( P<0.05 ) .There was no significant difference between the two groups (headache, drowsiness, postoperative irritability) compared with the control group, the incidence of muscle pain in the experimental group was significantly lower than that in the control group, the difference was statistically significant (P<0.05).Conclusion Pre-injection of rocuronium can reduce the level of serum potassium, shorten the recovery time of spontaneous breathing, and reduce the incidence of postoperative muscle soreness.Compared with the conventional MECT method, it can reduce the contraindication of MECT treatment and increase the comfort of patients.

Objective To investigate the clinical effect of salmon calcitonin in the treatment of senile osteoporosis , and to observe the effect of salmon calcitonin on bone mineral density ( BMD ) and pain.Methods 180 cases of patients diagnosed as osteoporosis from September 2015 to September 2016 in our hospital were retrospectively analyzed, the patients were divided into control group and treatment group according to the random number table method.The clinical efficacy and side effects of the two groups were evaluated.The bone mineral density (BMD) of the lumbar vertebrae, femur and radius were measured by dual energy X-ray absorptiometry.The VAS was used to evaluate the two groups before and after the treatment.( ODI) were used to evaluate the functional status of the patients before and after treatment.The self-made questionnaire was used to evaluate the quality of life of the patients before and after treatment.Results The total effective rate of treatment group was 94.44%, significantly higher than the control group 75.56%(P<0.05).After treatment, the treatment group of lumbar spine bone mineral density, bone mineral density and radial bone mineral density was significantly higher than the control group (P<0.05).After treatment, spontaneous low back pain, flexion extension pain, turn over pain and weight pain were significantly lower in the treatment group than in the control group (P<0.05).The ODI index of the treatment group was significantly lower than that of the control group (P<0.05).After treatment, the quality of life scores in the two groups were significantly higher than those before treatment, and the treatment group was higher than the control group(P<0.05).No significant adverse reactions occurred in two groups during the treatment.Conclusion Salmon calcitonin treatment of osteoporosis in elderly patients with a significant effect, help to improve bone mineral density, reduce pain and improve its dysfunction, and has high security.

Objective To observe and compare the clinical effect of aerosol inhaled and systemic glucocorticoid treatment and its influence on the expression of procalcitonin ( PCT) and hyper-sensitive C reactive protein ( hs-CRP) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods 146 elderly patients with AECOPD were enrolled prospectively.The patients were divided in three groups randomly, including inhalation group (48 cases referred as 2 mg of budesonide nebulization every 8 hours with therapeutic course of 5 days), intravenous group (50 cases referred as 40 mg methylprednisolone intravenous injection once daily with therapeutic course of 5 days), and control group (48 cases with no glucocorticoid ) .All the patients were treated with routine oxygen therapy, anti-inflammation, bronchodilators (β2 receptor agonist and doxofylline) and mucolytics, and so on.The levels of serum PCT and hs-CRP were detected before and after five days treatment, and also the clinical parameters such as symptoms, blood gas analysis, lung function, hospital days, fasting blood glucose and adverse reaction were simultaneously recorded. Results The general clinical data demonstrated no significant difference among the groups.Compared with the control group, the total effective rate, improvement rate of lung function (FEV1%pred and FEV1/FVC) and of blood gas parameters (pH value, PaO2 and PaCO2) in the inhalation group and intravenous group were higher, with shorter hospital days(P<0.05), while with no obvious difference between the two group.The levels of the serum PCT and hs-CRP were decreased in the patients enrolled after treatment, compared with the prior treatment (P<0.05).Compared with the control group, the levels of serum PCT and hs-CRP in the inhalation group and intravenous group decreased significantly, while with no obvious difference between the two groups.The levels of fasting blood glucose in the intravenous group were the highest;compared with the control group, the adverse effect incidence of the inhalation and intravenous groups were higher obviously, with the most obvious in the intravenous group ( P<0.05 ). Conclusion Application of glucocorticoid is benefit to improving the clinical symptom and lung function, and to rectifying hypoxemia and to shortening hospital days.The aerosol inhaled and systemic glucocorticoid application shows equivalent clinical efficiency on anti-airway inflammation.The glucocorticoid inhalation has fewer adverse effects and is recommended to treat the elderly patients with AECOPD .

Objective To analyze the clinical effects of sevoflurane and propofol anesthesia on hemorrheology in elderly patients with colorectal cancer undergoing radical mastectomy.Methods 86 patients with colorectal cancer undergoing radical surgery in our hospital from March 2014 to December 2016 were selected and randomly divided into sevoflurane group and propofol group group with 43 cases in each group.Two groups of elderly patients were anesthetized before, 40 minutes after induction, 80 minutes after induction, 140 minutes after induction and 30 minutes after entering the anesthesia monitoring room 30 minutes to draw the neck 4 mL venous blood.Analysised of two groups of patients with hemorheology ( low cut blood viscosity, blood viscosity in the cut, high shear whole blood viscosity, plasma viscosity, erythrocyte deformation index, erythrocyte aggregation index) index.Results There was no significant difference in the difference of detection indexes between sevoflurane group and propofol group at each time point Comparison of sevoflurane group and propofol group in elderly patients, 40 min, 80 min after induction and 140 min after induction compared with those of pre-anesthesia low-cut whole blood viscosity, middle whole blood viscosity, high shear whole blood viscosity and plasma viscosity, the difference was statistically significant(P<0.05), erythrocyte deformation index and erythrocyte agglutination index were not significantly different between the two groups.The blood viscosity in the propofol group was significantly lower than that in the anesthesia group at 80 minutes after induction and 140 minutes after induction, the difference between the two groups was statistically significant (P<0.05).The whole blood viscosity of the sevoflurane group was significantly lower than that before anesthesia at 140 min, and the difference between the two groups was statistically significant (P<0.05).Conclusion From the point of view of hemorheology, sevoflurane and propofol anesthesia can be used in elderly patients with colorectal cancer radical operation.

Objective To investigate the effect of Calcium Dobesilate Capsules in the treatment of diabetic retinopathy ( DR ) and its effect on hemorheology, vascular endothelial function and thrombin.Methods According to the random number table the 80 cases of DR patients admitted in our hospital from September 2014 to August 2016 were divided into observation group and control group, 40 cases in each group, two groups of patients were treated with conventional therapy, the observation group was treated with Calcium Dobesilate capsules.Two groups of treatment were three months.Compared of the therapeutic effects, the before and after treatment changes of visual acuity, hemorheology, vascular endothelial function and thrombin index.Results The total efficiency of the observation group 92.50% was higher than the control group 72.50% (P<0.05);After treatment, two groups visual acuity increased, and the observation group after treatment higher than the control group (P<0.05); Plasma viscosity, whole blood viscosity at high shear and low shear whole blood viscosity, erythrocyte aggregation index in two groups were decreased, and observation group lower than the control group (P<0.05);Plasma NO and ET-1 levels in two groups were reduce, and observation lower than the control group after treatment (P<0.05); After treatment, two groups PT, TT and APTT increased, and observation group PT, TT and APTT higher than the control group (P<0.05) .There were no obvious adverse reactions in the two groups during the treatment period.Conclusion The effect of calcium dobesilate capsules in the treatment of patients with DR is obvious, and it can improve hemorheology.