Objective To evaluate the association between maternal thyroid diseases in the first trimester of pregnancy and obstetric complications.Methods A total of 2 517 pregnant women from 10 hospitals in Shenyang during the first 12 weeks of gestation were enrolled in this study.All sera obtained from pregnant women were measured for thyroid-stimulating hormone (TSH),free thyroxine ( FT4 ),and thyroid peroxidase antibody (TPOAb).Collected items include obstetric outcomes and complications.Results Serum TSH above 2.5 mlU/L during the first trimester of pregnancy increased the rate of spontaneous abortion ( 8.69％ vs 6.38％,P =0.048 ),even if subclinical hypothyroidism (9.50％ vs 6.38％,P =0.009).TSH above the gestational special reference range,passive smoking,and over 30 years were independent factors for increasing the rate of spontaneous abortion.Hyperthyroidism and hypothyroidism with drug treatment to maintain normal thyroid function during pregnancy reduced the incidence of spontaneous abortion.Increased or decreased levels of serum TSH and TPOAb(+) were not related with other obstetric complications.Conclusion Serum TSH above the gestational special reference range during the first trimester of pregnancy is a risk factor of spontaneous abortion; maintaining TSH within the normal range by treating hyperthyroidism or hypothyroidism may reduce spontaneous abortion rate.

Objective To investigate the effect of spinal cord ischemia/reperfusion injury on hindlimb dysfunction in rabbits.Methods Twenty-eight health adult rabbits were distributed into normal control group (n =4) and model group (n =24) according to the random number table.The modelof spinal cord ischemia/reperfusion injury was established by selective occlusion of lumbar arteries.The model group were submitted to ischemia for 30 min (Group Ⅰ),60 min (Group Ⅱ) and 90 min (Group Ⅲ) before the reperfusion with 8 rabbits each.Jacobs score,Reuters score and Rivlin inclined plane test were used to evaluate the hindlimb function in each Group at days 1,3 and 7 after reperfusion.Changes in nerve conduction function in each group were observed using the cortical somatosensory evoked potential (CSEP).Results At days 1,3 and 7,the paraplegia rates in group Ⅰ were 50％,38％ and 38％ respectively,in Group Ⅱ were 75％,88％ and 100％,and in Group Ⅲ were all 100％.Paraplegia rate differed significantly among the three groups at 1 d and 3 d (P ＜ 0.01).Paraplegia rate differed significantly in Groups Ⅱ and Ⅲ when compared to that in Group Ⅰ at 7 d (P ＜ 0.01),but there was no significant difference between Groups Ⅱ and Ⅲ (P ＞ 0.05).With the prolongation of reperfusion,the Reuters score in Group Ⅰ dropped but not differed from that in control group (P ＞ 0.05);the Reuters score in Groups Ⅱ and Ⅲ increased and differed from that the control group (P ＜0.01),but the difference between Groups Ⅱ and Ⅲ was insignificant (P ＞ 0.05).Critical angle and obstacle rate of the inclined plane in control group were (68.4 ± 3.0)° and 0％.One day after reperfusion,critical angles of the inclined plane in Groups Ⅰ,Ⅱ and Ⅲ were (58.8 ± 4.1) °,(38.5 ± 2.8) ° and (29.8 ± 1.8) °,and the obstacle rates were (14.5 ± 0.9) ％,(43.6 ± 2.4) ％ and (56.0 ± 2.9) ％.There were significant differences compared to control group (P ＜ 0.01).Slight decrease in critical angle of the inclined plane but a minor increase in the obstacle rate was detected in Groups Ⅱ and Ⅲ at 3 d and 7 d after reperfusion,and the differences were significant compared to control group (P ＜ 0.01).Three days after reperfusion,critical angle of the inclined plane raised and obstacle rate of the inclined plate fell in group Ⅰ,not significantly different from these in control group (P ＞ 0.05).Latencies of CSEP N1 and P1 waves in Group Ⅱ [(33.1 ± 1.8) ms and (58.6 ± 4.0) ms] were longer than these in control group [(23.7±0.5)msand (48.1±4.1)ms]andgroup Ⅰ [(26.2±0.7)ms and (50.2±4.2)ms] (P＜ 0.01) 7 days after reperfusion,but the differences between control group and Group Ⅰ were insignificant (P ＞ 0.05).While the CSEP wave disappeared in Group Ⅲ.Conclusions Severity of spinal cord inschemia/reperfusion injury is related to the duration of ischemia.Hindlimb dysfunction caused by ischemia/reperfusion injury is characterized mainly by spastic paraplegia.

Objective To investigate the effects of delayed fluid resuscitation on hemodynamics and visceral perfusion in dogs with hemorrhagic shock. Methods Fourteen Beagle dogs were prepared for cannulation of carotid artery and jugular vein, and 24 hours later they were subjected to hemorrhagic shock with about 42% of total blood volume exsanguinated. Animals were divided into delayed resuscitation group ( DR group, n = 8) and immediate resuscitation group ( IR group, n = 6) . In the first 24 hours after hemorrhage, dogs in Dr group were given no fluid resuscitation, while those in IR group were immediately given resuscitation with intra-venous glucose-electrolyte solution, of which the volume was three times that of blood loss. In the second 24 hours, all animals had intra-venous fluid resuscitation. The variables of hemodynamics and visceral perfusion were determined before hemorrhage and 2, 4, 8, 24, 48 and 72 hours after hemorrhage under conscious state of dogs. Results After hemorrhage, the mean arterial pressure,cardiac output index, max of left ventricular contractility, blood flow of intestinal mucosa and urinary output greatly decreased and systemic vascular resistance obviously increased in each group compared with those before hemorrhage ( P ＜ 0.05 ) . From 4 hours after hemorrhage, the above measurements of dogs in IR group gradually resumed and reach Oh levels in 72 hours after hemorrhage except systemic vascular resistance index and intestinal blood flow. Whereas those measurements in dogs of DR group kept on worsening, and the levels of mean arterial pressure, cardiac output index, intestinal blood flow and urinary output were significantly lower than those in dogs of IR group ( P ＜ 0. 05 ) . Over 72 hours, five of eight dogs died with anuria in DR, and no animals died in IR group. Conclusion The findings indicate that delayed fluid resuscitation deteriorates hemodynamics, handicapping the restoration of visceral perfusion and increasing mortality in dogs with hemorrhagic shock.

Objective To establish a swine model of 10 min prolonged cardiac arrest (CA) induced by electrically triggered ventricular fibrillation,and then evaluate the quality of the model and the value in the establishment of post-cardiac arrest syndrome.Methods Fourteen domestic healthy swine weighing 38 ±3 kg were selected for study.Ventricular fibrillation was induced for 10 min,and then cardiopulmonary resuscitation (CPR) was initiated and continued for 5 min.The resuscitated animals were observed for 72 h after resuscitation.The resuscitation outcomes and survival rate were recorded.The functions of heart,lung and brain,and systemic inflammatory response and tissue perfusion were regularly evaluated for 72 h post-resuscitation.Results Eleven of the fourteen swine obtained restoration of spontaneous circulation (ROSC),and the rate of successful resuscitation and 72 h survival were both 78.6％.Significantly worse post-resuscitation myocardial function was found in all animals compared to the value prior to CA and the myocardial function was evaluated by decreased stroke volume and global ejection fraction,and increased levels of serum cardiac troponin-Ⅰ and n-terminal pro brain natriuretic peptide.Postresuscitation extra-vascular lung water index and pulmonary vascular permeability index were significantly increased accompanied with significantly decreased oxygenation index compared with the values before CA,indicating the occurrence of acute lung injury.In addition,post-resuscitation systemic inflammatory response and tissue low perfusion evidenced by significantly higher levels of serum tumor necrosis factor-α and interleukin-6 and arterial blood lactate were observed.Consequently,severe neurological deficit with significantly higher levels of serum neuron-specific enolase and S-100B was observed following 72 h postresuscitation.Conclusions This swine model of prolonged cardiac arrest induced by electrically triggered ventricular fibrillation was a well established model with high success rate of resuscitation,significant vital organ injury and relatively long duration of survival;it is an excellent model for the study of post-cardiac arrest syndrome.

Objective To investigate the predictive value of dose?volume histograms ( DVHs ) of organs at risk ( OARs ) including the bladder, rectum, and small intestine in volumetric modulated arc therapy ( VMAT) plans for cervical cancer. Methods A total of 100 VMAT plans for cervical cancer were assigned into the learning group. The correlation of the anatomical information with the V30 , V40 , and V50 values of the bladder, rectum, and small intestine was evaluated in the group. The support vector regression ( SVR) algorithm was used to establish the correspondence between the anatomical information and the DVHs of OARs. The DVHs of OARs in the verification group containing 20 VMAT plans were predicted based on the anatomical information. Results The DVHs of the bladder, rectum, and small intestine were likely to be influenced mainly by the spatial relationship between these OARs and target volume. In the verification group, the prediction errors of V30,V40 and V50 by SVR algorithm were-2.4%±3. 5%,-2.5%±3. 8%, and-1.5%±4. 9% for the bladder, 0.5%±2. 6%,-1.5%±5. 1%, and-2.0%±7. 4% for the rectum, and-2.9%± 5. 3%, 2.7%±7. 7%, and 5.3%±11. 1% for the small intestine, respectively. Conclusions After learning the correlation between the anatomical information and the DVHs of OARs from prior VMAT plans for cervical cancer, SVR algorithm can precisely predict the DVHs of the bladder, rectum, and small intestine based on the anatomical information.

OBJECTIVE:To standardized declaration of preparation registration in medical institutions. METHODS:With the combination of registration review of new varieties in the preparation registration in medical institutions in Liaoning province from 2010 to 2014,the existing problems in drug registration information of preparation in medical institutions were introduced,and the solutions and suggestions were proposed. RESULTS & CONCLUSIONS:The main problems of registration information of prepara-tion in medical institutions included non-standardized preparation name,unclear topic and writing,inappropriate instructions and la-bels,and imperfect preparation process,etc. To standardize the preparation registration authenticity and integrity of registration in-formation of medical institutions,it is suggested to increase on-site verification efforts,strengthen the five years clinical using his-torical inspection,improve the level of research and development of hospital preparations declaration units,and strengthen the idea that the medical institutions should be responsible for the quality and safety of preparations to ensure the safety and effectiveness.

OBJECTIVE:To study the chemical compositions of n-butabol extract from Solanum lyratum. METHODS:Glucan LH-20 column chromatography,silica gel column chromatography and TLC were adopted to separate and purity the chemical com-positions,physicochemical property and spectral evidence to identify their structures. RESULTS:Totally 10 chemical compositions were separated from n-butabol extract,namely apigenin-7-O-β-D-apiofuanosyl(1→2)-β-D-glucose (1),apigenin-7-O-β-D-glucose (2),adenosine(3),3-methoxy-4-hydroxy-5-[(8′S)-3′-methoxy-4′-hydroxyl-phenyl-alcohol]-E-cinnamic-phenylpropyl alcohol-4-O-β-D-glucoside (4),N-(4-amino-butyl)-3-(3-hydroxy-4-methoxy-phenyl)-E-acrylamide (5),N-(4-amino-butyl)-3-(3-hydroxy-4-me-thoxy-phenyl)-Z-acrylamide (6),resveratrol (7),naringenin (8),quercetin (9) and dioscin (10). CONCLUSIONS:Compound 1-8 are first separated from S. lyratum,the study can lay a foundation for quality evaluation of S. Lyratum.

Objective To explore the methods and outcome of comprehensive therapeatic for primary liver cancer. Methods Various therapeutic methods and outcome of 265 patients with primary liver cancer admitted in the last five years, were analyzed retrospectively .The group consisted of 238 male, and 27 female patients. The average age 47.5 years. Operation was performed in 215 cases and non-operative treatment is 50 cases. Operative treatment included resection of hepatic cancer and/or adjuvant therapy. Non-operative therapy included transcatheter hepatic chemo-embolization(TACE),percutaneous ethanol injection (PEI)、drug delivery system(DDS)、cryosurgery、radiofrequency ablation(RFA). Results The resection rate, and mortality and morbidity rates were 57%(215/377), 74.9%(161/215), 0.5%(1/215), and 19% respectively. The overall 1-,2-,3-year survival rate were 78.9 %,59.3%,33.5%, respectively, in patients who received comprehensive treatment centered around surgical resection, and 62.3%,32.3%,22.8%, respectively, in 45 patients who received non-surgical resection treatment. Conclusions Liver resection combined with other nonoperative modalities are ideal ways to treat primary liver cancer at the present time, and for different stages of primary liver cancer different treatment modalities are used.

Objective To investigate the value of retention rate of indocyanine green at fifteen minutes(ICGR15)during hemihepatectomy for evaluation of residual liver reserve function in patients with primary liver carcinoma.Methods During hemihepatectomy,ICGR15 was tested in 44 patients after the hepatic artery and portal vein of resected side were ligated.Child-Pugh score,Child-Pugh classification,and MELD score before operation were tested.After operation,the liver function condition was estimated.Results The incidence of liver dysfunction was significantly lower in ICGR150.05).ICGR15 and MELD score in normal liver function group were statistical lower than those in mild insufficiency of liver function group and severe insufficiency of liver function group(P

Objective To investigate the effect of oral rehydration on hemedynamies and mierocirculatory perfusion in dogs with fatal hemorrhagic shock.Methods Twenty male Beagle dogs 16-20 months old weighing 8-12 ks were subjected to a loss of 40% of the total blood volume,then divided into 3 groups:no rehydration group (group NR,n=8),oral rehydration group(group OR,n=6)and intravenous rehydration group(group IR,n=6).Group NR received no treatment within 24 h after blood-letting.Group IR and OR were given glucose-electrolyte solution (GES) either by gastric tube or by intravenous infusion 3 times volume of the blood loss immediately after the establishment of the model.Then the lactated Ringer's solution,glucose saline and compound amino acid(2 times volume of the blood loss)were started to be given to supplement the physiological consumption from 24 h after blood-letting in each group.The MAP,cardiac index(CI),systemic vascular resistance (SVR),dp/dtmax,and intestinal mucoflal blood flow (IMBF) were determined before blood-letting(T0,baseline) and 2 h (T1),4 h(T2),8 h(T3),24 h(T4),48 h(T5) and 72 h(T6)after blood-letting.The fatality rate within 72 h after blood-letting and urinary output were calculated.Results The fatality rates were 63%,33%and O in group NR, OR and IR respectively, which showed significant difference between the groups (P < 0.05).Compared with the baseline values at To, MAP, CI and dp/dtmax were significantly decreased at T1-6, in group NR,at T1-5 in group OR and at T1-4 in group IR, and SVR was significantly increased, while IMBF decreased at each time point after blood-letting in the three groups ( P <0.05), but no significant change was found in MAP, CI and dp/dtmax at T6 in group IR and OR (P>0.05). MAP, CI, dp/dtmax , IMBF and urinary output were significantly higher, while SVR was significantly lower in group OR and IR than in group NR ( P < 0.05). MAP, CI,dp/dtmax, IMBF and urinary output were signiflcandy lower, while SVR was significantly higher in group OR than in group IR ( P < 0. 05). Conclusion Oral administration of GES 3 times volume of the blood loss within 24 h after fatal hemorrhagic shock can obviously improve the hemodynamics and microcirculatory perfusion, then improve the survival state and have obvious resuscitation efficacy.