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 risk factors for post-stroke pneumonia and assess the value of A2DS2 score in predicting post-stroke pneumonia in elderly stroke patients. Methods The clinical data were retrospectively collected from elderly stroke patients from January, 2007 to December, 2012. A2DS2 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. Results A 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 A2DS2 score less than 3 to 75% in those with a score higher than 8. The C-statistic of A2DS2 score for predicting post-stroke pneumonia was 0.86 (95%CI: 0.784-0.911) by the ROC analysis. The A2DS2 score was well calibrated to predict post-stroke pneumonia in elderly patients by Hosmer-Lemeshow test (7.083, P=0.528). Conclusion The A2DS2 score can be useful for predicting post-stroke pneumonia and for routine monitoring of high-risk elderly stroke patients in the clinical setting.

Objective To investigate the risk factors for post-stroke pneumonia and assess the value of A2DS2 score in predicting post-stroke pneumonia in elderly stroke patients. Methods The clinical data were retrospectively collected from elderly stroke patients from January, 2007 to December, 2012. A2DS2 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. Results A 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 A2DS2 score less than 3 to 75% in those with a score higher than 8. The C-statistic of A2DS2 score for predicting post-stroke pneumonia was 0.86 (95%CI: 0.784-0.911) by the ROC analysis. The A2DS2 score was well calibrated to predict post-stroke pneumonia in elderly patients by Hosmer-Lemeshow test (7.083, P=0.528). Conclusion The A2DS2 score can be useful for predicting post-stroke pneumonia and for routine monitoring of high-risk elderly stroke patients in the clinical setting.

Objective:To build a sensitive quality index system of dental clinic nursing.Methods:Based on the Donabedian "structure-process-results" three-dimensional quality model, the indicators at all levels of the sensitive quality index system of dental clinic nursing was preliminarily constructed through literature review. The Delphi method was used to develop a system of sensitive quality indicators for dental outpatient care through two rounds of correspondence with 15 experts from the fields of dental care management, oral health care, quality of care management, and health policy.Results:The effective response rates of the two rounds of expert inquiry questionnaires were 100% (15/15), and the average authority coefficient of the experts was 0.93. The Kendall's harmony coefficients of the overall indicators were 0.115 and 0.141, respectively ( P<0.05). A sensitive quality indicator system for dental clinic nursing was finally determined, including 3 primary indicators, 7 secondary indicators and 19 tertiary indicators. Conclusions:The sensitive quality indicator system for dental clinic nursing constructed in this research is scientific and reliable. After verification through future research, it can serve as a basis for improving the quality of dental clinic nursing.