The article reviews the change of thyroid function in the women during pregnancy and the development of fetal thyroid function and introduces the principles of treating pregnancy with hyperthyroidism or hypothyroidism.

ObjectiveTo analyze and summarize the feasibility and characteristics of the posterior spinal canal reduction and fixation in treating mid-upper thoracic spine facture.MethodsA retrospective study was made on 17 patients with mid-upper thoracic spine facture to record the complication, compare the functions of the patients with complete and incomplete spinal cord injuries before and after surgery and examine the iatrogenic injury in patients without spinal cord injuries.ResultsNo complication happened after surgery.Incomplete injury was found in six patients, whose ASIA scales were found to be increased for 1-3 levels during the follow-up.While the complete injury was found in eight patients,whose ASIA scale remained unchanged during the follow-up.The sensory scores of both the incomplete injury group and complete injury group were processed with variance analysis and the results showed a significant difference between pre-operation and post-operation (F = 476.47, P = 0.000).The mean value between complete injury group and incomplete group was with high statistical difference (F = 31.46, P =0.000).The variance analysis of the motor scores showed a significant difference between before and after operation (F=46.75, P =0.000) and the mean value between complete and incomplete injury groups was with statistical difference (F = 158.59, P = 0.000).There were three patients with normal spinal cord function, with no decrease of ASIA scale or no change of the sensory and motor scores.ConclusionsFor patients with mid-upper thoracic spine fracture, posterior spinal surgery is conducive to the recovery of spinal function, for it can safely and effectively avoid worsening the thoracic and other combined injuries and release spinal pressure including the pressure in front part of the spinal cannal.

OBJECTIVETo investigate the risk factors for post-stroke pneumonia and assess the value of A(2)DS(2) score in predicting post-stroke pneumonia in elderly stroke patients.

METHODSThe clinical data were retrospectively collected from elderly stroke patients from January, 2007 to December, 2012. A(2)DS(2) score was then assigned using the clinical information from the medical record. The ability of the score to discriminate between patients with post-stroke pneumonia and those without was quantified using ROC analysis. The calibration of the score was analyzed using Hosmer-Lemeshow goodness-of-fit test.

RESULTSA total of 131 elderly male stroke patients were enrolled in this study, among whom the incidence of post-stroke pneumonia was 29.01%. The independent risk factors for post-stroke pneumonia identified included moderate (P=0.0081, OR: 5.6089; 95%CI: 1.5663-20.0854) and severe (P=0.0048, OR: 44.4827; 95%CI: 3.1847-621.3126) neurological impairment, dysphagia (P=0.0005, OR: 7.5265; 95%CI: 2.4282-23.3292), and atrial fibrillation (P=0.0226, OR: 4.1778; 95%CI: 1.2221-14.2825). The incidence of post-stroke pneumonia ranged from 2.2% in patients with a A(2)DS(2) score less than 3 to 75% in those with a score higher than 8. The C-statistic of A(2)DS(2) score for predicting post-stroke pneumonia was 0.86 (95%CI: 0.784-0.911) by the ROC analysis. The A(2)DS(2) score was well calibrated to predict post-stroke pneumonia in elderly patients by Hosmer-Lemeshow test (7.083, P=0.528).

CONCLUSIONThe A(2)DS(2) score can be useful for predicting post-stroke pneumonia and for routine monitoring of high-risk elderly stroke patients in the clinical setting.

Aged ; Aged, 80 and over ; Atrial Fibrillation ; complications ; China ; Deglutition Disorders ; complications ; Humans ; Incidence ; Male ; Pneumonia ; epidemiology ; etiology ; prevention & control ; ROC Curve ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Stroke ; complications

Objective To evaluate the therapeutic effect of highly active anti-retroviral therapy (HAART) in treatment-na(i)ve Chinese patients with AIDS, to provide evidences for standardizing HAART.Methods Seventy-four treatment-naive AIDS patients were initiated with HAART and followed up regularly for 3 years. The clinical and laboratory data, side effects and drug resistance were observed and analyzed during the follow-up period. Results Of the 74 patients, 46 were males and 28 were females, with the average age being 42 years. The mean HIV viral load was ( 2. 2 ± 2.0 ) × 105 copies/ml and the baseline mean CD4+ T lymphocyte count was (62 ± 71 )cells/μl before treatment. After treatment for 3, 6, 12, 18,24, 30 and 36 months, the percentage of undetectable HIV viral road (less than 50 copies/ml ) was 71.6%, 83.8%, 75.7%, 77.0%, 82.4%, 81.1% and 79.7% respectively, and CD4+T lymphocyte count ascended to ( 167 ± 105), ( 177 ± 129), (238 ± 137), (290 ± 158), (304 ± 191 ), (331 ± 175) and ( 352 ± 202 ) cells/μl. The increase in amplitude of CD4+ T lymphocyte count in different periods examined was different, with the period of 0-3 months post-treatment demonstrating the most obvious augmentation ( P ＜ 0. 01 ) . The most common adverse reactions were liver function injury ( 52/74,70. 3% ), hyperlipemia (52/74, 70. 3%), hematopoietic inhibition of the bone marrow (33/74, 44. 6% ),peripheral neuritis (32/74, 43.2% ) and lipoatrophy (26/74, 35. 1%). Clinical drug resistance were found in nine patients and HIV gene mutations were detected in these patients. Conclusions Chinese treatment-naive AIDS patients have achieved good virological and immunological response to generic-drugpredominant HAART regimes with low drug resistance, but relatively more side effects.

Objective To describe the discovery of a residual foci of bancroftian filariasis in Fuchuan County where the disease was announced to have been eliminated, and reveal its epidemiologic feature.Methods The investigation was carried out from August 2007 to March 2008 among residents in Changtang village where the first caseof filariasiswas found and the neighboring villages.They were screened with two thick blood smears.Immunochromatographic technology(ICT) was conducted for those going out but returned and those in surrounding areas.Vector mosquitoes were collected and dissected to find filaria larvae.Historical documents were reviewed and relevant people were interviewed.Results In Changtang administrative village, 1 052 residents were screened and 19 cases with microfilaremia were found in 2 natural villages, with a Mf-positive rate of 1.8%(5.1% in Gangshang and 1.4% in Yinshan respectively).No Mf-positive case was found in 4 119 residents screened in other 3 villages.The average microfilaria density in the 19 cases was 17.37/60 ?l blood.All the 19 cases belonged to 12 families, and 13 cases were relatives to each other, which showed a feature of spatial clustering and family clustering.More patients were identified in the age groups of 20-29 and 50-59, and 57.9% of them were older than 50 years.No larvae were found in 54 Culex pipiens fatigans dissected.Conclusion The Changtang village is identified as a residual focus of bancroftian filariasis with a low, limited endemicity.More cases have been among the elderly with a low average microfilaremia.

Ovarian cancer is one of the most common gynecological malignancies leading to female deaths, and its early diagnosis and prevention are very complicated. Therefore, biomarkers for this disease prediction and prognosis are urgently needed for early diagnosis and individualized treatment. miRNAs are short-chain, highly conserved non-coding RNA molecules that mainly degrade or inhibit target genes at the post-transcriptional level to regulate cell growth, proliferation, differentiation, metabolism, and apoptosis. Existing studies have confirmed that miRNAs can be used as potential biomarkers for clinical diagnosis and treatment of cancer. Moreover, tumor-related miRNAs play an important role in the occurrence, invasion and metastasis of ovarian cancer by regulating the expression of multiple oncogenes and tumor suppressor genes. In this paper, the roles of miRNAs as biomarkers for early prevention or detection of ovarian cancer, prognostic diagnosis and treatment targets were reviewed, and the future clinical application of miRNA in patients with ovarian cancer was proposed.

Objective:To investigate the associations between small diffusion-weighted imaging (DWI) hyperintensities lesions and total cerebral small vessel disease (cSVD) burden and the influence on prognosis in patients with acute intracerebral hemorrhage (ICH).Methods:Consecutive patients with acute spontaneous ICH from January 2018 to June 2021 were recruited in the Stroke Center of Zhengzhou People′s Hospital. Magnetic resonance imaging was performed to quantify DWI hyperintensities lesions and cSVD imaging markers, including white matter hyperintensities, enlarged perivascular spaces, lacunes and cerebral microbleeds, which were calculated for the total cSVD burden (0-4 points). The prognosis was assessed with the modified Rankin Scale (mRS) at discharge and 90-day. Multivariable Logistic regression models were adopted to explore the associations between DWI lesions and total cSVD burden and clinical outcome.Results:Of 283 included patients, 59 (20.8%) had small DWI lesions, 32 (11.3%) had multiple lesions. They were mostly punctate, mainly located in the cortical and subcortical regions, and scattered in multiple vascular territories. With the increase of cSVD burden, the number of DWI lesions gradually increased. Spearman correlation analysis showed that the total cSVD burden was positively correlated with the number of DWI lesions ( r=0.21, P<0.001). In multivariable regression analyses, the total cSVD burden was independently associated with DWI lesions ( OR=1.63, 95% CI 1.23-2.15, P=0.001). The 90-day poor outcome (mRS scores≥4) in patients with DWI lesions was significantly higher than those without DWI lesions (39.3% vs 16.3%, χ 2=14.38, P<0.001), while there was no statistically significant difference in the poor outcome of discharge between the two groups (26.5% vs 17.7%, χ 2=3.06, P=0.080). With the increase in the number of DWI lesions, the 90-day poor outcome increased significantly (trend chi-squared test χ 2=11.50, P=0.001). Multivariable analyses showed that DWI lesions ( OR=4.39, 95% CI 1.92-10.03, P<0.001) and their number ( OR=1.42, 95% CI 1.06-1.90, P=0.018) were independently associated with the 90-day poor outcome. Conclusions:Higher total cSVD burden is an independent risk factor for small DWI lesions in patients with ICH. Small DWI lesions were independently associated with the 90-day poor outcome, but not with the discharge outcome.

Recombinase polymerase amplification (RPA) is a novel technology for nucleic acid isothermal amplification. It can achieve the rapid amplification and detection of a target gene under 37-42 ℃. This amplification method is highly sensitive, more specific and less instrument-dependent than other existing methods, and it can also integrate multiple detection modes. Therefore, it is especially suitable for applying in low-resource settings and conducting point-of-care tests. Starting from the reaction principles and the experimental design of RPA, this article pointed out some key points when using RPA in a clinical setting. The current development and related problems of RPA were concluded and the various future uses of this method were also prospected.

Objective To investigate the prevalence of hypothyrodism during the first half of pregnancy in the Han nationality women in iodine-adequate area. Methods TSH, FT4 and thyroid peroxidase antibody (TPOAb) levels were detected in 4 800 pregnant women during the first half of pregnancy. Both gestational age-specific reference intervals and population-based reference intervals of thyroid function were applied and the corresponding prevalences of hypothyroidism were compared with each other. Results Based on the gestational age-specific reference intervals, the prevalences of overt hypothyroidism at 4th and 8th weeks of gestation were 1.03%, 0.37% respectively. At 4th, 8th, 12th, 16th and 20th weeks of gestation, the prevalences of subclinical hypothyroidism were 4.59%, 6.15% , 4.68%, 4.53%, 5.96% respectively, while those of hypothyroxinemia were 3.69%, 1.11%, 2.92% , 1.29%, 2.29%, respectively. According to the pepulation-based reference intervals, the rates of missed diagnosis of subclinical hypothyroidism were 0.18%, 2.85%, 4.10%, 3.24%, 3.21% while those of hypothyroxinemia were 3.45%, 0.66%, 2.34%, 1.29%, 1.83%, respectively. During 4th, 8th, 16th weeks of gestation, the positive rates of TPOAb in the group with subclinical hypothyroidism were significantly higher than those with euthyroidism. The prevalences of subclinical hypothyroidism in TPOAb positive group were obviously higher than those in TPOAb negative group at 4th, 8th, 12th, 16th gestational weeks. Conclusion The rates of missed diagnosis of subclinical hypothyroidism and hypothyroxinemia during the first half of pregnancy were decreased by applying the gestational age-specific reference intervals in this prospective study. Positive TPOAb is a risk factor for subclinical hypothyroidism during the first half of pregnancy.