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 analyze the timing and frequency of spontaneous gasping during cardiopulmonary resuscitation in a rat model,and evaluate its value bearing some relation to duration of cardiac arrest (CA ) in predicting the severity of post-resuscitation myocardial dysfunction.Methods Twenty-seven healthy Sprague-Dawley rats were randomly (random number)divided into 3 groups according to different durations of CA:CA 4 min (n=9),CA 6 min (n=9)and CA 8 min (n=9).CA of rats was electrically induced and untreated for 4,6 or 8 min respectively in the corresponding groups,and then cardiopulmonary resuscitation (CPR)was initiated and continued for 8 min in all animals.The emergence timing and frequency of spontaneous gasping during cardiopulmonary resuscitation and resuscitation outcomes were documented.Myocardial function such as cardiac output,ejection fraction and Tei index was measured by echocardiography prior to CA and at 1 h,2 h and 4 h post-resuscitation.Results The earliest appearance of gasping with highest frequency was observed in the CA 4 min group during CPR.Gasping appeared later with decreased frequency observed following longer duration of CA.There were statistically significant differences in the timing and frequency of gasping among the 3 groups.In the CA 4 min group with frequent gasping,all animals were successfully resuscitated with 8-min CPR with the least number of defibrillation,which was significantly better than that in the CA 8 min group.During the evaluation of post-resuscitation myocardial function,cardiac output,ejection fraction and myocardial work index (Tei index) were better in the CA 4 min group with frequent gasping,worse in the CA 6 min group and worst in the CA 8 min group, showing statistically significant differences in cardiac function among the 3 groups. Conclusions The spontaneous gasping appeared sooner with higher frequency during cardiopulmonary resuscitation indicated shorter duration of CA,and predicted better success of resuscitation and post-resuscitation myocardial function.

Background and purpose: Radiation therapy is still the most primary treatment of brain metastases, and prognosis is affected by many factors. The aim of this study was to identify the prognostic factors and to establish a prognostic index model in patients with brain metastases after whole-brain radiotherapy (WBRT). Methods: We reviewed the clinical date of 140 patients with brain metastases radiotherapy in our hospital from Jan. 2008 to Jul. 2011. The signiifcance of prognostic variables in the survival was resulted from both univariate analysis and multivariate analysis. The prognostic index (PI) was established based on Cox regression analysis and subgrouping values. It was assessed whether recursive partitioning analysis classes (RPA), basic score for brain metastases (BS-BM) and the graded prognostic assessment index (GPA) were related to prognosis. Results:The median survival time was 222 days. The univariate analysis showed that the independent prognostic factors were KPS performance status, number of brain metastases, presence of extracranial metastases, primary tumor status, radiation dose, hemoglobin. The multivariate analysis showed that KPS performance status (P=0.002, Wald=9.700), presence of extracranial metastases (P=0.018, Wald=5.604) and primary tumor status (P=0.001, Wald=10.212) were signiifcantly correlated with overall survival. RPA, BS-BM and GPA were closely related to their prognosis by Log-rank test. In predicting 3 months and 6 months of survival for patients, PI was better than other modes. Conclusion:Our data suggest that the 3 indexes RPA,BS-BM and GPA are valid prognostic index models, but PI model is better.

The prognosis of patients with brain metastases from non-small cell lung cance (NSCLC) is dismal,and whole brain radiation therapy(WBRT) cannot simultaneously control the extracranial lesions.Study results of Tyrosine kinase inhibitor(TKI) for brain metastases in patients with lung cancer are encouraging,and treatment efficacy is related to EGFR mutation status.The sensitizing theoretical foundation exists in utilizing erlotinib combined with WBRT for the treatment in brain metastases patients with lung cancer.Currently,a small clinical trial data shows that erlotinib combined with WBRT has better efficacy compared to erlotinib alone,and the toxicity can be tolerated.

This article was aimed to study the correlation between microstructure and stability of cream contained Span and Tween as compound emulsifier by factor analysis. Techniques such as microscopic observation and rheolog-ical examination were used to perform the microstructure. And the thermal analysis and near-infrared stability ana-lyzer was carried out to quantify characterization of the physical stability of cream. The results showed that among the series of S60-T80 and S60-T60 creams based on compound emulsifier, cream conductivity increased and more and more spherical lamellar liquid crystalline structures appear on micrographs with increasing Span 60 fraction. The greatest viscoelastic was appeared when the mass ratio of Span and Tween was 2:2 and 1:3, respectively. From the thermogravimetric analysis, the increase of Span 60 fraction led to the weight loss of samples between 50℃-70℃ in-crease, but it decreased within 70℃-110℃. It was concluded that there was positive correlation between the intensi-ty of microstructure and the ability of resistance to structural failure when the experiment conditions were stable. It had negative correlation with the hydrophilic gel phase water distribution index.

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.

BACKGROUND: Supraspinatus tendon injury is common in rotator cuff injury, the repair difficulty of which is reconstructing the bone-tendon interface. Currently, there are no effective therapeutics and suitable experimental animal models.OBJECTIVE: To establish rabbit rotator cuff injury prosthetic experimental animal model and to observe the effect of continuous passive motion (CPM) on early healing of rabbit rotator cuff bone-tendon interface by MRI, which can provide guidance for preparing an optimal rehabilitation strategy after rotator cuff injury.METHODS: Sixteen male New Zealand rabbits, aged 8 months, were received a rotator cuff acute injury and reconstructing insertion of supraspinatus tendon on greater tuberosity of humerus. The rabbits were randomly divided into cage activity group (n=4) and CPM group (n=12). At 2 days after operation, rabbits were treated by rabbit shoulder joint continuous passive motion apparatus of 75°～75° flexion-extension with various CPM speeds[2 (°)/s, 4 (°)/s, and 10 (°)/s)]. General state and MRI changes of rabbit rotator cuff bone-tendon interface was observed prior to and at weeks 1,2, and 4 after operation.RESULTS AND CONCLUSION: Gross observation showed that the incisions healed very well at 2 weeks after operation. There was no infection, haematoma or disruption after removing the suture. Compared to the cage activity group, the tendon-bone interface of CPM group heeled better at weeks 1, 2 and 4, especially at the speed of 4°/s with 75°-75° flexion-extension. Results demonstrated that this animal model can be satisfied to experimental study. From the following day after operation, various CPM speeds can accelerate the healing of tendon-bone interface, and the optimal speed of CPM was 4 (°)/s.

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.

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.