Objective]Discussesing Professor Lu Su's experience for the treatment of gynecologic tumor bone marrow suppression after chemotherapy. [Methods] Through learning from the teacher, collecting and collating the relevant information and medical records ,summarizing the doctor's treatments for bone marrow suppression,introducing the special treatment from nourishing Yin and Yang, dialectical analysis;combination of Chinese and western, foster strengths and circumvent weaknesses;treatment based on overall, overall consideration;Regulate mood,treat both heart and kidney at the same time,and give examples to prove it. [Results] Professor Lu Su believes that the disease in the Yin and Yang as the main pathogenesis of the disease, the treatment nourishing of Yin and Yang, clinical examination of the combination of the dialectical analysis,nourishing Yin and Yang, dialectical analysis, for the treatment of gynecologic tumor bone marrow suppression after chemotherapy, with a certain clinical significance. [Conclusion ]Professor Lu Su's unique method of treatment of gynecologic tumor bone marrow suppression after chemotherapy, has remarkable curative effect.Her treatment and academic thoughts of bone marrow suppression of gynecological tumor after chemotherapy open a new path, unique method, and the effect is significant, the syndrome differentiation typing, prescription and addition and subtraction cut to clinical treatment after chemotherapy myelosuppression is of practical value, it is worth learning.

Objective To evaluate the impact of subclinical hypothyroidism (SCH) on the outcome of pregnancy and the therapeutic effect of L-T4.Methods A total of 1 786 pregnant women during the first, second, and third trimesters were enrolled for thyroid screening by determining serum free thyroxine (FT4), total thyroxine (TT4), thyrotropin (TSH), and thyroid peroxidase antibody;123 pregnant women with SCH were successfully divided into treated group (n =42) and untreated group (n =81).The treated group was treated by L-T4 based on American Thyroid Association (ATA) 2011 guideline.Collected items include obstetric outcomes and complications.Results (1) Compared to control group, the rate of spontaneous abortion in pregnant women during first trimesters was increased in SCH group (20.99％ vs 8.45％, x2 =12.96, P =0.00), with higher incidence of diabetes during second trimester (24.69％ vs 10.45％, x2 =14.11, P =0.00).The incidences of hypertension during pregnancy, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight showed no difference between two groups (all P ＞ 0.05).(2) Compared with the untreated group, the incidences of spontaneous abortion and diabetes were decreased in the treated group (7.14％ vs 20.99％, x2 =3.89, P =0.05;9.52％ vs 24.69％, x2 =4.05, P =0.04), while the incidences of hypertension, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight infant accident rate were not different between two groups (all P ＞ 0.05).Conclusions SCH during the frist trimester is a risk factor of spontaneous abortion;SCH during the middle stage of pregnancy is a risk factor of gestational diabetes mellitus.Treatment of SCH with L-T4 may be beneficial.

Objective To evaluate the safety of compound Qinghuang powder for myelodysplastic syndromes(MDS). Methods A total of108 patients with MDSwere collected, 60 patients were treated with Qinghuang powder(Qinghuang powder group)and 48 with compound Qinghuang powder(compound Qinghuang group). The treatment time of 3 months was as one course, and all the patients were treated for more than one course. The patients who developed adverse reactions in the Qinghuang powder group changed to receive compound Qinghuang powder. The adverse reactions were recorded during the treatment. Results The overall incidence of adverse reactions in the compound Qinghuang powder group was significantly lower than that in the Qinghuang powder group(18.75% vs. 41.7%; χ2=6.492, P<0.05). None in the compound Qinghuang powder group and 3 patients in the compound Qinghuang powder group developed moderate to severe adverse reactions. The incidences of various adverse reactions in the compound Qinghuang powder group were lower than those in the Qinghuang powder group, especially, lower limb swelling (4.17%vs. 25%;χ2=9.205, P<0.05) epigastric discomfort(18.75% vs. 41.67%; χ2=6.492, P<0.05). Twenty patients who developed adverse reactions in the Qinghuang powder group changed to receive compound Qinghuang powder. Among them, 5 patients (25%) maintained adverse reactions. The various adverse reactions after changing to compound Qinghuang powder were decreased, especially, facial swelling (10% vs. 30%; χ2=2.50, P<0.05), leg swelling (5%vs. 45%;χ2=8.533, P<0.05), and abdominal pain and diarrhea(10%vs. 30%;χ2=2.50, P<0.05). No patient developed liver or kidney dysfunction after the treatment with Qinghuang powder or Compound Qinghuang powder. Conclusion Compound Qinghuang powder is safer than Qinghuang powder in the treatment of MDS.

Totally 1 360 pregnant women during the first trimesters (4-12 weeks) who visited Ningbo University Affiliated Hospital and Ningbo Jiangbei Maternal Health Hospital from February 2010 to October 2011,and 216 non-pregnant healthy women,who contemporaneous by visited the hospital,were enrolled in this study.The thyroid screening was made by determining urinary iodine and serum free thyroxine,free triiodothyronine,total thyroxine,total triiodothyronine,thyrotropin,and thyroid peroxidase antibody (TPOAb).The median concentration of urinary iodine in the pregnant women was not different from that of non-pregnant women (P＞0.05) ; 1 360 pregnant women were screened,268 (19.71％) of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody.29(13.43％) of non-pregnant women were identified to suffer from thyroid disorders or with positive thyroid autoantibody.There was significant difference between the 2 groups (x2 =4.40,P＜0.05).Prevalence of thyroid dysfunction may increase during early pregnancy.The screening for thyroid function and autoantibody should be recommended in that period.

Objective To investigate the expression of nestin, a type Ⅵ intermediate filament protein in the glomeruli with foot process effacement and the potential relationship between nestin expression in the kidney and the degree of proteinuria. Method Immunohistochemistry was used to determine the localization of nestin in the kidney samples obtained from needle biopsies of normal human and patients with minimal change disease (MCD). Puromycin aminonucleoside (PAN) nephrosis rat models were established by a single intraperitoneal injection of PAN. Both real time quatitative reverse PCR and Western blot methods were applied to evaluate the levels of nestin expression at day 1, 4, 10 and 20 after PAN injection. Results Immunohistochemistry showed that the expression of nestin in glomeruli of MCD patients was significantly reduced compared with normal samples (0.93±0.08 vs 1.65±0.12, P<0.05) . The mRNA and protein expressions of nestin in the rat kidney were transitorily increased by 1.23 folds and 1.48 folds of control group (NC) after 1 day of PAN injection (P<0.05), then decreased quickly in the following days. The mRNA levels of nestin in the kidney were 35.8% and 12.1% of NC after 4 days and 10 days of PAN injection, respectively, (P<0.01) as determined by real time PCR. After 20 days of PAN injury, nestin mRNA expression partly recovered to 65.8% of NC (P< 0.05 ). The protein levels of nestin detected by Western blot presented the similar trend, which were 77.0%, 58.0% and 83.4% of NC after 4 days, 10 days and 20 days of PAN injection, respectively (P<0.05). The degree of proteinuria in puromycin aminonucleoside nephrosis rats was negatively correlated with both mRNA and protein levels of nestin in the kidney(r=-0.667,P<0.05 and r=-0.621 ,P<0.05, respectively). Conclusions The expression of intermediate filament protein nestin is down-regnlated in the kidney characterized with foot process effacement and negatively correlated with the degree of proteinuria in puromycin aminonucleoside nephrosis rats. Nestin may play a potential role in modulating the structure and function of podocyte.

Objective:To observe the effects of electroacupuncture(EA)on sleep electroencephalogram(EEG)and event-related potential(ERP)in patients with somatoform disorders(SFD). Methods:Seventy-five SFD patients were recruited as an EA group to receive EA at Shenting(GV24)and Baihui(GV20)once daily,30 min each time,with 6 straight days as a treatment course,and 4 courses were conducted at 1-day intervals.Before treatment,patients underwent a survey using a physical symptom checklist on their primary symptoms.Before and after treatment,their sleep EEG was monitored using Quisi,and the ERP mismatch negativity(MMN)and P300 were detected.The Quisi sleep EEG and ERP were also examined among 40 normal volunteers as the normal group data. Results:During the trial,13 cases were removed from the EA group due to incomplete data,and 62 cases were finally included for statistical analyses.Of the 62 SFD patients,the main disturbing symptoms were cognitive impairments,sleep disorders,respiratory symptoms,digestive symptoms,five-sense organ problems,and cardiovascular symptoms in order.Before treatment,the EA group had increased MMN and P300 latencies and decreased amplitudes compared with the normal control group(P<0.01 or P<0.05);according to Quisi,the EA group also had reduced total sleep time(TST),shorter rapid eye movement sleep(REM)latency(RL)and REM time(RT),smaller number of REM period(NRP),extended sleep latency(SL),longer awaking time(AT),lower sleep efficiency(SE),larger percent of non-rapid eye movement sleep(NREM)stage 1(S1)and smaller percent of NREM stage 2(S2),and the percent of slow wave sleep(SWS),i.e.NREM stage 3(S3)plus stage 4(S4),also went down,all presenting significant differences between groups(P<0.01 or P<0.05).After 4 courses of treatment,the MMN and P300 latencies were reduced,and their amplitudes became larger in the EA group compared with the baseline(P<0.05);they had insignificant differences compared with the normal control group(P>0.05).Quisi showed that the TST and RL increased,and the SL and AT decreased in the EA group,and the predominant change in sleep architecture was reduced S1 percent,increased S2,and improved SE,all showing significant intra-group differences(P<0.01 or P<0.05);however,the intra-group difference in the NRP was statistically insignificant(P>0.05).Except the TST,RT,S1 percent,and SWS,there was no statistical significance in comparing the other Quisi parameters(including RL,NRP,SL,AT,SE,and S2 percent)between the two groups(P>0.05). Conclusion:SFD patients have a variety of clinical symptoms,and most of them show abnormal sleep EEG and ERP;EA can correct abnormal sleep EEG parameters and the MMN and P300 of ERP in SFD patients.

Objective To evaluate the effects of different right ventricular pacing sites on left ventricular systolic synchrony using tissue Doppler imaging(TDI).Methods A tota[of sixty-nine patients with indications for permanent pacemaker implantation were enrolled sequentially by Pace-ROAD study(Pacemaker-right ventricular outflow tract and apex study,a randomized control study).They were randomized to RVOT pacing group(group A)or RVA pacing group(group B).Echocardiographic study with TDl was performed before and after 3 month follow up,and the data were analysed off-line.The peak velocity(Vs),the time to the peak of S wave(Ts)of all 12 basal and middle segments of left ventricle were measured,and then the standard deviation of Ts(Ts-SD),the average of Vs(Vs-M)were calculated.Results Thirty-six patients were randomized to group A,while the other 33 patients to group B.In each group,one patient was rejected due to non-pacing rhythm during follow-up.After 3 month pacing,the Ts-SD of group A was significantly shorter than that of group B[(23.63±2.32)ms vs(31.54±2.93)ms.P=0.0387-].In the patients with the basal Ts-SD longer than 32.6 ms(group A2 and group B2),the Ts-SD was significantly shortened than the baseline in group A2 during follow-up,while no significant difference was found in group B2.And the follow-up Ts-SD of group B2 was significantly longer than that of group A2 r(38.19±18.34)ms vs(28.55±16.93)ms,P=0.0290].Conclusions RVOT pacing is associated with favorable left ventricular systolic synchrony than RVA pacing,especially in patients with worsened baseline systolic synchrony.

To investigate the relationship between serum retinol-binding protein 4(RBP4) and gestational diabetes mellitus (GDM) in Chinese Han pregnant women.195 (23-42 years) pregnant women were recruited (July 2005 to December 2007) from the Department of Gynecology and Obstetric in Ruijin Hospital during their visiting for routine prenatal examination.99 subjects belonged to GDM group,and 96 belonged to the group with normal glucose tolerance (NGT).65 non-pregnant healthy women served as control.Serum RBP4 was measured using sandwich enzyme linked immunosorbent assay (ELISA).Pregnant women had higher level of serum RBP4 than that of non-pregnant control.The concentration of serum RBP4 was significantly increased in GDM group as compared with NGT group[(43.04±1.85 vs 33.84±2.17) rag/L,P<0.01].Multiple stepwise regression analysis showed that triglycerides and homeostasis assessment for insulin resistance (HOMA-IR) were independent variables of RBP4 (r2 =0.165) in pregnant women.The results suggest that serum RBP4 level is significantly increased in pregnant women.Women with GDM had even higher RBP4 level than that of normal pregnant women,and RBP4 levele was positively correlated with triglycerides and HOMA-IR.

Objective To understand the current situation of nurses' professional happiness and preliminary evaluate the effect of intervention measures in order to provide the basis for formulating the corresponding countermeasures. Methods In March 2016, 203 nurses were selected as the research subject by the stratified random sampling method. After consulting the relevant data, a questionnaire was made to investigate the well-being and satisfaction of nurses. After 1-month investigation of current situation, a comprehensive intervention was conducted, the time was 7 months. In December 2016, second investigations were conducted on the same staff to evaluate the effect of intervention measures. Results The subjective feeling of happiness was relatively low of 203 subjects and was 14.8%, proportion with feeling unhappy was 36.5%, and personal income, working environment, personal value, health were the main factor affecting the happiness. After the implementation of comprehensive intervention, happiness and satisfaction scores of the subjects were increased, the differences were statistically significant before and after implementation (P<0.05). Conclusions The subjective feeling of happiness of nurses is low. From the point of view of humanistic care, career planning and fair motivation, the implementation of the plan of promoting occupational well-being based on the perspective of hospital culture is of great significance for stabilizing the nursing team and arousing the enthusiasm of nurses.

Objective To analyze the blood arsenic concentration and the safety of compound Qinghuang powder(compound QHP)in patients with myelodysplastic syndrome(MDS).Methods A total of 45 MDS patients received treatment with compound QHP (the treatment group, n=45). The concentration of blood arsenic in different time was determined by atomic fluorescence spectrometry. The clinical safety of compound QHP was evaluated by analyzing the symptoms of adverse reaction and organ function. The comparison were MDS patients with Qinghuang powder (QHP group, n=47) and healthy people. Results There was no significant difference of the blood arsenic concentration between the treatment group and the healthy control group (P=0.450),while after the treatment for 1 month those concentrations significantly increased (P=0.000). There were no significant difference between the blood arsenic concentration after treatment for 1, 3, and 6 months (P=0.240). The incidence of adverse reaction in the treatment group was significantly lower than that in QHP group(χ2=4.720, P=0.030). The incidence of adverse reactions in the digestive tract was significantly lower in the treatment group than that in QHP group (χ2=4.650, P=0.034). The blood arsenic concentration of patients with abdominal pain diarrhea was significantly lower than those without abdominal pain diarrhea (P=0.020). Before treatment in the compound QHP group, there were 21 cases with increased myocardial enzymes, 10 cases with abnormal liver function and 4 cases with renal dysfunction, respectively. After treatment at 6th month, these indicators returned to normal with 7 cases of myocardial enzymes, 6 cases of liver function and 1 case of renal function, respectively. There was no new case with abnormal myocardial enzymes, liver function and renal dysfunction, respectively. Conclusions Arsenic could be absorbed in the digestive tract into blood in MDS patients after treatment with arsenic-containing compound QHP, and the blood arsenic concentration remained stable during the course of treatment. The adverse reactions were mainly mild gastrointestinal symptoms, but no heart, liver or renal function damage was observed. The incidence of abdominal pain diarrhea in patients treated with compound QHP was significantly lower than that with QHP.