Objective To explore the hyperthyroidism patients with Graves disease before and after treatment serum adiponectin level changes.Methods 108 cases of hyperthyroidism patients with Graves disease as the research object,they are divided into GD1 and GD2 two subgroups,and the other in the same period to our line of health inspection in 50 cases of healthy controls,fully explore hyperthyroidism before and after treatment in patients with Graves disease changes of the serum adiponectin level.Results Compared with healthy controls,GD1 group of adiponectin level is higher,the GD2 group of the low level of adiponectin,compared with those of GD2 group had significantly higher GD1 group,P<0.05.Data statistical differences between groups,P<0.05.GD group of TSH is lower than healthy controls,GD1 TSH level below the GD2 group.P<0.05,compared with healthy controls,GD two subgroups of FT3 level was significantly higher,data statistical differences between groups,P<0.05,compared with those of GD2 group GD1 group of FT3 level is higher,data statistical differences between groups,P<0.05 compared with control group,GD1 group had a significantly higher FT4 levels,P<0.05.GD2 group FT4 level slightly lower than the control group,P>0.05,compared with those of GD2 group GD1 group had a significantly higher FT4 levels,P<0.05.The control group,the GD1 and GD2 group of serum adiponectin level and TSH is negative correlation,and FT4,FT3 is positive correlation,and there is no correlation between the baseline data.Conclusion Graves disease hyperthyroidism in treatment,adiponectin levels rise,after drug treatment,obtain relief,adiponectin increase cholesterol and FT4 influence,and the correlation between glucose metabolism index is not strong.After treatment,Graves disease in patients with hyperthyroidism adiponectin level is lower than normal group,the low and FT4 levels after treatment with a certain relevance.

Specialty English of Medical Laboratory is a comprehensive and overlapping discipline and plays a major role in multiple medical courses, including Life Science, Clinical Medicine and Laboratory Medicine.However, its teaching practices are limited due to the extensive contents, scattered basic knowledge points, complexities of language learning processes and high demanding of sophisticated teaching skills.Since internet technology′s breakout and the web-based education expanding in the past decade, personalized flipped classroom has drawn considerable attention in the education field and became a hop-spot in teaching practice system.In the present study, the concepts of flipped classroom and basic characteristics of Specialty English of Medical Laboratory were elaborated, as well as the reconstructing teaching processes, exploring the concrete plan for teachers and students in undergraduate program.

Objective To explore the correlations of dyslipidemia and hypertension with diabetic retinopathy in diabetic patients aged 80 years and over. Methods The 487 diabetic patients admitted to endocrine department of our hospital from January 2013 to June 2017 were recruited and their medical records were retrospectively analyzed. According to the results of examination ,they were divided into three groups :non-diabetic retinopathy group (n = 306 ) ,non-proliferative diabetic retinopathy group (n = 143)and proliferative diabetic retinopathy group (n = 38).The course of diabetes ,levels of blood glucose and lipids ,and the course of hypertension were compared among the three groups. Results Prevalence of diabetic retinopathy was 37.2% (181/487) ,and was increased along with the prolongation of diabetes duration ,and occurrence of coexisted hypertension and dyslipidemia.Statistically significant differences were found among the 3 groups(all P＜0.05)in the levels of glycosylated hemoglobin A1c ,low-density lipoprotein cholesterol ,high-density lipoprotein cholesterol ,triglyceride ,apolipoprotein A ,apolipoprotein B and the ratio of apolipoprotein A over apolipoprotein B.Multivariate analysis showed that the levels of glycosylated hemoglobin A 1c ,low-density lipoprotein cholesterol and the ratio of apolipoprotein A and apolipoprotein B were correlated with the development and progression of diabetic retinopathy ( OR = 3.00 ,0.22 and 2.96 , respectively). Conclusions The incidence of diabetic retinopathy is higher in diabetic patients aged 80 years and over.Dyslipidemia is correlated with development and progression of diabetic retinopathy.

Objective:To compare the clinical effects of discectomy combined with transpedicular dynamic stabilization and transforaminal lumbar interbody fusion (TLIF) in treating single-level lumbar disc herniation.Methods:From November 2012 to November 2015, a total of 96 patients with single-level lumbar disc herniation (disc height decreased more than 1/3, the width of the basilar part of the herniated disc >6 mm, massive disc herniation or Modic type I endplate changes) treated by discectomy combined with Dynesys dynamic stabilization (Dynesys group, n=48) or TLIF (fusion group, n=48) were enrolled. Clinical assessments included operation duration, intraoperative blood loss, MacNab score, visual analogue scale (VAS), Oswestry disability index (ODI) and rate of complications. Radiographs were evaluated for lumbar mobility, intervertebral height, etc. Results:A total of 86 patients were included in the final analysis (44 in Dynesys group and 42 in fusion group) and were evaluated after 5 years follow-up. The operation duration of Dynesys group (159.61±37.29 min) was less than that of the fusion group (177.42±39.90 min) significantly ( t=2.140, P=0.035). Intraoperative blood loss in Dynesys group (151.78±50.88 ml) was less than that in fusion group (197.74±76.55 ml) with significant difference ( t=3.293, P=0.001). At 5 years follow-up, there were 2 cases with screw loosening and 5 cases with adjacent segmental degeneration in Dynesys group without symptom. In fusion group, there were 12 cases with adjacent segmental degeneration and two of them with symptom. There were significant differences in the incidence of adjacent segment degeneration between the two groups ( χ2=4.012, P=0.045). According to the MacNab criteria, excellent or good cases accounted for 95% in Dynesys group and 93% in fusion group without significant differences ( Z=0.425, P=0.671). VAS back, VAS leg and ODI scores were improved significantly in both groups after 2 years and 5 years ( P<0.05). However, there were no significant differences between the two groups ( P<0.05). The activity of the surgical segment was 4.59°±0.48° in Dynesys group and 1.00°±0.42° in fusion group at 5 years after surgery. The height of intervertebral space in Dynesys group decreased from 11.19±2.07 mm before surgery to 9.98±2.02 mm at 2 years after surgery and to 9.86±1.64 mm at 5 years after surgery ( F=6.462, P=0.002). However, there was no statistically significant difference between the 2 and 5 years follow-up ( q=0.415, P>0.05). At 5 years after surgery, the activity of the first proximal segment in the two groups was 9.74°±3.29° and 11.69°±3.89°, respectively ( t=2.514, P=0.014). Conclusion:Both discectomy combined with dynamic stabilization and TLIF can achieve satisfied clinical effects in treating single-level lumbar disc herniation. Dynamic stabilization preserves the intervertebral activity of surgical segments and results in a lower incidence of adjacent segment degeneration compared with that in fusion surgery. Furthermore, discectomy combined with dynamic stabilization is a less invasive intervention with shorter operation duration and less blood loss compared with TLIF.