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 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 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 compare the hemodynamic responses to orotracheal intubation between TruviewTM EVO2 optic laryngoscope and Macintosh direct laryngoscope.Methods: Eighty adult patients(ASA physical status Ⅰ-Ⅱ,aged 18-65 years) scheduled for elective surgery under general anesthesia requiring orotracheal intubation were randomly divided into 2 groups(n=40 each):T group and M group.After standard intravenous anesthetic induction,orotracheal intubation was performed with TruviewTM EVO2 optic laryngoscope or Macintosh direct laryngoscope.Non-invasive heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP) and SpO2 were recorded before(T0) and after anesthetic induction(T1),at intubation(T2),1 minutes(T3),3 minutes(T4) and 5 minute after intubation(T5).The laryngeal exposure period and intubation period were also recorded.Statistical analysis was performed using the Statistical Package for Social Sciences(SPSS) Version 13.0.Results: Except for HR at intubation(T2),there was no significant difference in the hemodynamic data at any other time points between the two groups.There was no significant difference in the laryngeal exposure period between the two groups.The intubation time in the T group was significantly longer than that in the M group(P

Objective To investigate the protective effects and mechanism of shenmai injection(SMI) on cardiomyocytes injured by hydrogen peroxide(H 2O 2) or angiotension Ⅱ(AngⅡ). Methods According to the different concentrations of H 2O 2, AngⅡ,SMI,Vitamin C(VitC) added into the cardiomyocytes culture media(CCM), the cultures were divided into 15 groups. Lactate dehydrogenase(LDH ),malondialdehyde(MDA),superoxide dismutase (SOD) of CCM and cardiomyocytes viability(CMV), Na +-K +-ATPase,Ca 2+-ATPase?cardiomyocytes apoptosis rate(CMAR) ,nitrogen oxide(NO), nitrogen oxide synthesis enzyme(NOS),eNOS expression of cardiomyocytes were detected respectively .Results H 2O 2 or AngⅡ could decrease CMV, SOD, Na +-K +-ATPase,Ca 2+-ATPase,NOS,NO,eNOS expression and increase CMAR,LDH and MDA.SMI could lessen the changes of the items mentioned above ,which were caused by H 2O 2 or AngⅡ.The effects of SMI 10 ml/L were stronger than those of SMI 5 ml/L or VitC 50 mg/L.Conclusion SMI has a significant protective effect on cardiomyocyte injured by H 2O 2 or AngⅡ.

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 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.