Objective To explore the relationship between subclinical hypothyroidism(SCH)and microvascular complications(diabetic nephrop-athy and diabetic retinopathy)in type 2 diabetic patients. Methods According to the condition of complicating with SCH,157 patients with type 2 diabetes were divided into SCH group(40 cases)and the euthyroid group(117 cases). The age,sex,duration of diabetes,smoking status,blood pressure,body mass index(BMI),glycosylated hemoglobin(HbA1c),blood lipid,renal function,thyroid function,urine albumin/urine creatinine, and fundus examination were analyzed and compared between the two groups. The relationship between SCH and microvascular complications in type 2 diabetic patients was explored. Results There was no significant difference of age,sex,duration of diabetes,smoking,blood pressure,BMI, HbA1c,blood lipid,or serum creatinine between the two groups. The incidence of diabetic retinopathy in SCH group was significantly higher than those in euthyriod group(32.5%vs 14.5%,P=0.044);however there was no difference in the incidence of diabetic nephropathy. After adjustment for potential confounding factors(age,sex,duration,blood pressure,BMI,HbA1c,diabetic nephropathy)by multivariate logistic regression analy-sis,SCH was still the risk factor of diabetic retinopathy(OR=2.210,95%CI 1.512-4.117,P=0.032)in type 2 diabetic patients. Conclusion SCH could be a risk factor of diabetic retinopathy in type 2 diabetic patients,and there was no significant effect on diabetic nephropathy.

Objective　To examine the intraindividual reproducibility of the octanoic acid breath test in normal subjects and diabetics and to investigate whether cardiovascular autonomic neuropathy and delayed gastric emptying influence the intraindividual reproducibility.Methods　Nine normal subjects (six men, three women,mean age 38 years) and 15 diabetics with insulin treatment ［nine men, six women; mean age 47 years; six had cardiovascular autonomic diabetic neuropathy (CADN) and/or delayed gastric emptying time］ were, after a nocturnal fasting period, given a standard test meal (labeled with 13C-octanoic acid, 1 046 kJ). Breath samples were taken at ten minute intervals over first one hour and at fifteen minute intervals over the following three hours and examined for 13CO2 by isotope ratio infrared spectrometry. Using a regression method gastric emptying half times (t1/2) and lag phase (tlag) were determined.Results　There was not a significant difference of t1/2 and tlag between two measurements in normal subjects and diabetics. The coefficients of variation of day-to-day reproducibility were 11.7% for t1/2, 19.4% for tlag in normal subjects and 17.8% for t1/2, 28.2% for tlag in diabetics, but there was not significant difference between normal subjects and diabetics. There was not significant difference of intraindividual coefficient of variation of t1/2 and tlag between diabetics with/without CADN and between diabetics with normal gastric emptying time and diabetics with delayed gastric emptying time.Conclusions　 The 13C-octanoic acid breath test has a high intraindividual reproducibility which is not affected by the cardiovascular autonomic neuropathy and delayed gastric emptying. It can be recommended as a non-invasive test for assessing gastric emptying time after a solid test meal in diabetics.

Abstract: Objective　To investigate the frequency of peripheral blood T cells among patients positive for both hepatitis B virus surface antigen (HBsAg) and surface antibody (HBsAb). Methods　 Thirty six patients with co-existence of HBsAg and HBsAb diagnosed were enrolled as the experimental group, who were admitted by Shanghai tenth people's hospital and Wuxi 9th people's hospital from 2014 to 2020. while 40 patients tested positive for HBsAg and negative for HBsAb served as controls, who were admitted by Wuxi 9th people's hospital. Flow cytometry was used to detect and compare the proportions of peripheral blood CD3+, CD4+ and CD8+ T cells between the experimental and control groups. In addition, the associations of serum HBsAb level with peripheral blood T cell proportions, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were examined among chronic hepatitis B patients with co-existence of HBsAg and HBsAb using Pearson correlation analysis. Results　The median age, gender distribution, mean ALT and AST concentrations, proportion of HBV DNA viral load>103 copies/mL, seroprevalence of HBV E antigen (HBeAg), seroprevalence of HBV E antibody (HBeAb), seroprevalence of HBV core antibody (HBcAb) were comparable between the experimental and control groups, and there were no significant difference in them (P>0.05). There were no significant difference between the experimental and control groups in terms of CD3+ T cell proportion [(71.83±1.50)% vs (72.75±1.47)%; t=0.66, P>0.05], CD4+ T cell proportion [(36.81±1.53)% vs (39.88±1.57)%; t=1.43, P>0.05] and CD8+ T cell proportion [(33.17±2.04)% vs (32.40±1.75)%; t=0.77, P>0.05]. Pearson correlation analysis revealed that the serum HBsAb level did not significantly correlate with peripheral blood CD3+ (r=0.026, P=0.65), CD4+ (r=‒0.08, P=0.16) and CD8+ T cell proportions (r=0.09, P=0.24), CD4+/CD8+ T proportion (r=‒0.005, P=0.35), serum ALT (r=0.04, P=0.56) and AST levels (r=0.002, P=0.69) among chronic hepatitis B patients with co-existence of HBsAg and HBsAb. Conclusions　There are no significant differences between HBsAg+/HBsAb+ and HBsAg+/HBsAb- CHB patients in terms of peripheral blood CD3+, CD4+ and CD8+ T cell proportions.

Objective To explore CT features and clues to diagnosis of rhabdmyosarcoma(RMS) in head and neck .Methods 14 cases of rhabdmyosarcoma scanned by CT were co llected retrospectively during 1992～2001 and comparatively studied by the age o f patients and the pathologic types. Results Children and adolecence were mainly involved in R MS in head and neck which pathologic types were embryonal type and adeno-vesicle type ,and the former was the main type .CT features of rhabdomyosarcoma include d round and oval masses which had a homogeneous high density and close relation to muscles ,obvious enhancement after injection of contrast media ,often complic ated with the wide destruction of bone and other adjacent tissues,the collecting lymph node enlargment.Conclusion CT findings of rhabdomyosarcoma in head and ne ck had some features and combined with the age of patients can be made the diagn osis of RMS.

OBJECTIVE:To provide reference for the hospitals about emergency drug supply and pharmaceutical support in case of emergent events.METHODS:The pertinent literature both at home and abroad was retrieved and summarized analytically.RESULTS:The definition and the classification of emergent events were introduced,and the emergency drug supply and pharmaceutical support both at home and abroad in case of emergent event were introduced.CONCLUSIONS:Drugs are essential thing in medical aid in case of emergent events,and medical institutions should establish a scientific and practical drug supply system,and the pharmacists should bring their professional talents into full play by participating in medical aid in case of emergent event to ensure safe,effective and economic drug use.

Objective To study CT manifestations of the malignant pleural mesothelioma(MPM) in rat.Methods 100 Wistar rats in the test group were injected with asbestos fibrous mixed fluid into closed right chest cavity 20 mg/ml one per month,the overall volume of asbestos was 40 mg,19 rats in the control group were injected with sterilized saline water of 1 ml per time,totally 2 ml as the same way.Dying or died rats were undergone CT scanning and pathologic examination,the experiment lasted for 2 years.Results In experimental group,there were 66 rats of MPM,14 cases of pleural hyperplasia and 12 cases without pleural change.There were 4 cases of pleural hyperplasia,10 cases without pleural change and no one of MPM in the control group.According to pathologic changes,they were divide into 66 cases of MPM,26 cases of non-MPM in the experimental rats and 14 cases of non-MPM in the control group.The occurrence rate,morphology and thickness of pleural thickening were significant among MPM group,non-MPM group and the control group.The specificity of nodular pleural thickening was 100%.The mean CT number of pleural thickening had no significance.The occurrence rate of masses of MPM in the chest cavity was 94.5%.The masses included tumors,abcesses or encapsulated effusion,the masses of MPM accounted for 62.5%.The mediastinal changes included irregular widening mediastinum,mediastinal pleural changes and masses and so on.But irregular widening mediastinum and adjacent invasion were more common and specified signs.Enlarge lymph nodes were not seen.Conclusion There were some specific CT signs in induced MPM.

Objective:Elaborated the system cloud platform based on wireless coverage of automatic temperature measuring system, complete the body temperature measurement, collection, transmission and processing, discusses the intelligent temperature monitoring in the medical role in the process of practical application.Methods: through the establishment of information system cloud and accurate and the design of the portable detector, by constantly monitor the temperature; put forward the study of the importance of the temperature in the clinical diagnosis and treatment. Results: based on the information platform, the real temperature of the intelligent detection, which changes the traditional temperature measurement model.Conclusion: the clinical information and make full use of the equipment and software resources of integration, further perfecting the existing function of hospital information system, reduce the work intensity of medical staff, improve the utilization of medical resources.

Based on the ongoing clinical experiences at our outpatient pharmacy and geriatrics multidisciplinary inpatient and outpatient services,we believe that polypharmacy among elderly patients is serious and pervasive in China.This observation is supported by the findings from literature review.To help address this serious issue in senior care,we recommend to gain better understanding of age-related physiological changes of the elderly as well as those in pharmacokinetics and pharmacodynamics,and to conduct prescription review and medication reconciliation.The multi-and interdisciplinary approach employed by modern geriatrics care model,involving doctors,pharmacists and nurses,should further help address this issue and promote rational use of pharmaceuticals in the elderly patients.

A general evaluation indexing system is constructed based on hospital specifics, in HR evaluation theory, on job orientation, HR competence, and by means of expert consultation and level of analysis. Four tier-1 indexes were earmarked as knowledge, basic competence, management capability, and research capability; 32 tier-2 indexes include education background, foreign language command, computer capability, legal knowledge, and professional knowledge, each having different weight. This indexing system enables hospitals to screen their management staff objectively, reliably and efficiently. Moreover, it serves as a reference not only for their recruitment, training, screening and promotion, but also for their personal development.

BACKGROUND:Vascular endothelial growth factor is found the strongest to promote angiogenesis, which show strong expression in synovial cells in rheumatoid arthritis.
OBJECTIVE:To evaluate the relation between the expression of vascular endothelial growth factor and microvessel density in rheumatoid arthritis.
METHODS:Col agen II and complete Freund’s adjuvant were used to induce experimental arthritis in Sprague-Dawley rats. Synovium expression of vascular endothelium growth factor and microvessel density were assayed at different time points using immunohistochemistry method, and changes in new vessels, vascular endothelial growth factor expression and arthritis index were observed along the time course. The correlations between vascular endothelial growth factor expression and number of new blood vessels as wel as between arthritis index and vascular endothelial growth factor expression were studied with linear correlation analysis and rank correlation analysis, respectively.
RESULTS AND CONCLUSION:With the time lasting, new blood vessels in the synovium proliferated, the synovium was thickened, and the arthritis index rose gradual y as wel as vascular endothelial growth factor expression and number of new microvessels were on the rise. Vascular endothelial growth factor expression was positively correlated with arthritis index (r=0.535, P<0.05) and significantly positively correlated with number of new microvessels (r=0.860, P<0.01). Vascular endothelial growth factor is involved in the course of synovium pannus response, and vascular endothelial growth factor and microvessel density may play an important role in rheumatoid arthritis pathogenesis.