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Management of hyperthyroidism in pregnancy and lactation has been the topic for many years. This article has discussed the use of antithyroid drugs(ATDs) in pregnancy and lactation, including the choice, the safety, as well as the influences of ATDs to infants.

Objective: To investigate Leptin resistance of patients with metabolic syndrome. Methods: 50 patients with metabolic syndrome and 30 health persons as control were investigated. Body mass index(BMI)、waist to hip ratio(WHR)、blood pressure(Bp) were recorded. Serum Leptin、plasma glucose、insulin、total cholesterol(TC)、triglyceride(TG)、high density lipoprotein cholesterol(HDL C)、low density lipoprotein cholesterol(LDL C)、lipoprotein(a) were determined,and HOMA IR was calculated. Results: Compared to controls, serum Leptin concentration was significantly higher in metabolic syndrome〔(23.82?15.63)?g/L vs (11.20?4.70)?g/L, P

Objective To investigate the effect of propofol on LPS-induced TLR4 expression in rat alveolar type Ⅱ epithelial cells. Methods The primarily cultured alveolar type Ⅱ epithelial cells isolated from male rats were randomly assigned to one of 5 groups: group Ⅰ cells were incubated for 3 h without any additive (control) ; group Ⅱ cells were incubated with LPS 1 μg/ml for 3 h (LPS) ; group Ⅲ , Ⅳ , Ⅴ cells were incubated with LPS 1 μg/ml + propofol 25, 50 and 100 μmol/L respectively for 3 b (P1-3). TLR4 mRNA and TLR4 protein expression was detected by real time PCR and Western blot. TNF-α release amount was measured using ELISA. Results LPS significantly' increased TLR4 mRNA and protein expression in alveolar type Ⅱ epithelial cells as well as TNF-α release amount. Propefol at 50 and 100 μmol/L significantly inhibited LPS-imluced increase in TLR4 mRNA and protein expression and TNF-α release amount. Conclusion Propofol can dose-dependently inhibit LPS-induced inflammation in alveolar type Ⅱ epithelial ceils, through down-regnlation of TLR4 gene and protein expression.

OBJECTIVE:To investigate the cognition of clinical pharmacists on the clinical pharmacy practice and their profes-sion,and provide reference for further developing clinical pharmacy practice. METHODS:A questionnaire was designed,and ran-dom sample was conducted for the clinical pharmacists from 30 secondary and tertiary hospitals in Shanghai,and the investigation results were analyzed statistically. RESULTS:Totally 130 questionnaires were sent out,and 102 were effectively received with valid response rate of 78.46%. 94.11% of the investigated subjects were willing to be a clinical pharmacist,but 17.65% of them consid-ered that they were incompetent for their work;29.41% of them thought the current situation of clinical pharmacy practice was not ideal;all the respondents considered that the clinical pharmacist system should be implemented in medical and health institu-tions;the cognition and evaluation of investigated subjects in tertiary hospitals on clinical pharmacy practice and their profession was generally higher than those in secondary hospitals(P<0.05). CONCLUSIONS:The clinical pharmacists in medical and health institutions in Shanghai showed high cognition on their profession,and the clinical pharmacy practice has already made some achievements,but many work still need to be improved. Therefore,clinical pharmacists should continuously study their profession-al knowledge and improve their professional skills and quality;hospitals and universities should strengthen the subject construction and personnel training of clinical pharmacy and deeply carry out the clinical pharmacist system;health administration departments should strengthen the related laws and regulations of clinical pharmacy;colleges and universities should strengthen the discipline construction and personnel training.

[Objective]To explore the experience of the correction of severe kyphosis and kyphoscoliosis by total spinal osteotomy.[Method]To correct kyphosis and kyphoscoliosis by total spinal osteotomy and screws-rods internal fixation apparatus,then graft the bone.[Result]From 1984 to 2005,50 patients were cured with the way above.There were no neural injury observed.The clinical symptom was improved in some extent.All patients were follow up from 2 months to 15 years,averaged 2.4 years,and the postoperative X ray and CT scans verifies all screws were in a proper position.No cases of implant failure were observed,and all the patients had a solid bone fusion on radiographs taken 3 months after surgery.[Conclusion]The operation to correct severe kyphosis and kyphoscoliosis by total spinal osteotomy with efficient screws-rods internal fixation apparatus,not only have a larger operate area which made opreation easier and more safe,but combine osteotomy with internal fixation and finished at the same time,it is an efficient way to correct kyphosis and kyphoscoliosis.

Objective To study the short term and long term response and the safety of the different doses of recombinant interferon alfa 1b(IFN? 1b) for the treatment of the patients with chronic hepatitis B and the predictive factors of the response. Methods 146 Chinese patients with chronic hepatitis B entered randomly into four groups. Three groups were given with IFN ? 1b 3 million unit (MU), 5 MU and 10 MU respectively. The control group was given placebo. The short term(ETR) and long term(SR 12) responses and side effect were observed. Selected nineteen items (host related, drugs related and virus related), which affected the response of IFN alfa 1b probably (host, virus and drugs, et al) were analyzed. Results The end treatment response (ETR) of the IFN ? 1b 5 MU therapy was 55.3%, and 10 MU was 58.1%. Both efficacy were higher than the group of 3 MU IFN alfa 1b (32.6%) and control therapy group (5.9%, P

Objective To understand the clinical significance and diagnosis value of serum interleukin-6(IL-6) levels in the patients with respiratory infection and non-small cell lung cancer(NSCLC).Methods The serum levels of IL-6 in 61 patients with NSCLC,and 36 patients with respiratory infection and 30 of the healthy was measured by enzyme-linked immunosorbent assay(ELISA).Results The data showed that mean serum IL-6 levels in patients with NSCLC was higher than in the healthy( P 0 05).Conclusion We consider that increased IL-6 level could be used as one of differential diagnostic marker of NSCLC;Serum IL-6 levels may be a reference of judging each stage of NSCLC and predicting prognosis.

To treat large facial defect (more than 6 cm x 4 cm in diameter) or a wound with bone exposure to atmosphere by less-traumatic, easier-healing reconstruction method, a pedicle flap including facial, neck, posterior auricle and occipital skin flap was designed and transferred, one by one, to repair facial defect as well as other flap donor sites, but occipital skin flap was only used to cover posterior auricle area. After 2-3 years follow-up, well-healed skin flaps with good color, elasticity and sensation were observed in all 16 patients. It is concluded that this method is effective and practical.
Carcinoma, Basal Cell/surgery ; Cicatrix/*surgery ; Face ; Neck ; Orbital Neoplasms/*surgery ; Parotid Neoplasms/*surgery ; Reconstructive Surgical Procedures/methods ; Scalp ; *Surgical Flaps

Objective To analyze retrospectively the clinical efficacy that the application with vascularized greater trochanter to reconstruct the collapse of femoral head necrosis.Methods Followed-up the data of 21 patients who underwent reconstruction of the femoral head from January,2008 to December,2012,by this we made the clinical and radiological assess,Harris hip scoring system was used to evaluate the situation of hip function.All patients were followed up regularly for X-ray film (after 3 months,6 months and then be reviewed once a year),by the film we assessed the bone healing and repair of the femoral head,and determined whether had the progress in phases.The clinical survival was decided by receiving or not the arthroplasty.Results All 21 patients were followed up for 24-72 months,with an average of 47 months.The postoperative Harris hip score was 82.8 ± 7.1 points,compared with the preoperative,the score improved significantly (average 52.4 ± 4.3 points for preoperative),the difference was statistically significant (P ＜ 0.05).Based on Ficat stage for osteonecrosis,8 patients in this group had progress after 24 to 48 months (mean 33 months),whose femoral heads got collapse worsened.The radiographic success rate was 61.9％.Six cases received arthroplasty in 18 to 48 months (mean 34 months) due to progressive collapse of the femoral head or severe hip pain,or both.FicatⅢ contained 25％ (4 hips),and Ⅳ had 40％ (2 hips),the clinical survival rate was 71.4％.Conclusion The application with vascularized greate.r trochanter transfer coverage to rebuild the collapse of the femoral head in patients with osteonecrosis is a good way.It' s worthy to be applied.