OBJECTIVE:To explore the effects of tirofiban with different medication timing on blood flow and complications in patients with acute myocardial infarction after percutaneous coronary intervention(PCI). METHODS:214 cases of acute ST-seg-ment elevation myocardial infarction were divided into late stage group(n=98)and early stage group(n=116)based on the order of admission. Te latter was given intravenous injection of tirofiban after PCI;the former was given intravenous injection of tirofi-ban before entered emergency room [1-2 h before PCI]. The injection-balloon dilation time was compared between 2 groups. The coronary TIMI flow situation,cardiac function and microcirculatory perfusion index before and after operation,and complications during hospitalization were also compared. RESULTS:Intravenous injection of tirofiban to balloon dilation time were 3-40 min in early stage group,and 30-65 min in late stage group,with statistical significance (t=8.94,P=0.00);during angiography,the number of patients with IRA prorsal blood flow rate to reach 2 and 3 grade was 16 cases(13.8% and 20 cases(17.2%)in early stage group,which were higher than in late stage group [7 cases (7.1%),9 cases (9.2%)],with statistical significance (P<0.05). After PCI,occluded artery of 2 groups opened up,there were 2 cases of no-reflow in early stage group and 6 cases of no-re-flow;there was no statistical significance in 3 grade blood flow of TIMI between 2 groups(χ2=1.21,P>0.05). The amount of 4 and 8 h creatine kinase MB,and postoperative 24 h LVEF of 2 groups were similar after operation,without statistical significance (P>0.05);ST segment of early stage group drop value was (1.93 ± 0.57) mm,which was significantly higher than that of late stage group(1.07±0.29)mm,with statistical significance(P<0.05);the incidence of cardiac adverse events and bleeding compli-cation were 3.45%and 7.76%in early stage group,and 4.08%and 5.10%in late-stage group,without statistical significance(P<0.05). CONCLUSIONS:Different medication timing has no significant effect on the safety of tirofiban,but clinical outcomes and angiographic results are consistent. However,early treatment can improve IRA prorsal blood flow rate before PCI,which is the good medication timing of tirofiban.

Guidelines of the American Thyroid Association (ATA) proposed two diagnostic criteria for subclinical hypothyroidism during the first trimester of pregnancy:criterion 1 was based on the pregnancy-specific TSH reference range and criterion 2 on serum TSH＞2.5 mIU/L level with normal serum FT4.According to the results of the Subclinical hypothyroidism during early pregnancy study,author proposed that criterion 2 is not appropriate for Chinese pregnant women because the TSH concentration has become significantly higher in whole Chinese population.By using criterion 2,the prevalence may be as high as 27.8％,which may result in over-diagnosis and over treatment.

Recently, more and more attention have been paid to the impact of maternal thyroid hormones on neuropsychologic development of offspring. In the first 20 weeks of gestation, neuropsychologic development of the fetus is mostly dependent on thyroxine from the mother. Limited epidemiological data showed that full-scale WISC IQs averaged 7 points lower among children born to mothers with undiagnosed thyroid deficiency during pregnancy, in comparison with control children. The main cause of subclinical maternal hypothyroidism is autoimmune thyroiditis. Data from basic studies have confirmed the impacts of maternal thyroid hormones on the neurodevelopmental outcomes of offspring. In a Chinese female population, the positive rate of thyroid autoantibodies was 11.0%, and the prevalence of postpartum thyroiditis was 11.9%. Hence, it is necessary to set up a screening schedule for subclinical hypothyroidism and autoimmne thyroiditis in pregnant women, which is of great value for the health of both women and children.

For the first time,the iodine-induced thyroid diseases group of China Medical University has finished a five-year prospective epidemiological study on the incidences of thyroid diseases in the three communities with various levels of iodine intake.The results indicated that increased incidences of subclinical hypothyroidism and autoimmune thyroiditis in the communities with more than adequate and excessive iodine intake.The individuals with positive thyroid autoantibodies at baseline more likely became hypothyroid due to more than adequate and excessive iodine intake.These adverse effects are mainly involved in the susceptible populations for thyroid diseases.Hence it appears to be reasonable that iodine supplementation should be conducted by localization and individualization.

hypothyroidism is a common subclinical disease in endocrinology. Its diagnosis is based on an elevated serum TSH but normal FT 4 levels. The adverse outcome of subclinical hypothyroidism is progressing to overt hypothyroidism with an increased risk for atherosclerosis and myocardial infarction . Two factors may affect the development of overt hypothyroidism: the levels of serum TSH and thyroid autoantibodies and both factors have additional effects on the outcome. The benefits of treatment with T 4for preventing the development of overt hypothyroidism is not yet certain; subclinical hypothyroidism is a strong indicator of risk for atherosclerosis and myocardial infarction, just like other known major risk fators such as hypercholestrolemia, hypertension, smoking and diabetes (odds ratio for aortic atherosclerosis 1.9; odds ratio for myocardial infarction 3.1). The treatment with T 4 for the patients could reduce the levels of serum cholesterol. The effects of subclinical hypothyroidism in pregnant women on the IQ of their children have been widely focused. According to the results from a published epidemiological study, the normal reference values of TSH, thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) detected by immunochemiluminesence assay (ICMA) method and the cut-off values of TPOAb and TgAb associated with thyroid diseases have been proposed.

In many cancers the chronic inflammation caused by microorganisms can be observed, espe-cially in gastrointestinal system. Atrophic gastritis is thought to be a precancerous lesion. Studies have approved that Helicobacter pylori plays an important role in the genesis and development of gastric caner. It is now known to be responsible for inducing chronic gastric inflammation that progresses to atrophy, metaplasia, dysplasia and gastric cancer.

[Summary] The incidence of thyroid cancer in China is increasing rapidly, at an annual percentage change (APC)of 20. 1%, while the APC of mortality of thyroid cancer is only 1. 6%, which is defined asoverdiagnosis by the experts of tumor field. This tendency is due to the over-screening for thyroid nodules and cancers with high resolution of B ultrasound equipments. The prevalence of latent thyroid cancer is 11. 5% in human-being as found by the autopsy. However, the prognosis of the majority of patients is good. The clinical doctors and health-care department of government in China should take actions to deal with the tendency of over-screening andoverdiagnosisfor thyroid nodules and cancers.

In order to improve the management of drugs in hospital pharmacy, on the basis of pharmacological principles, we have worked out a classification and coding system with four layers and five digits. The codes are standardized in six aspects, namely, the catalogue of drugs in common use, the inventory of stock in storehouse and in hospital pharmacy, registration of inlet and output of stock in both departmernts, and the record of stock taking.

Objective: This study was to evaluate the effects of inhalation of nitric oxide combined with intravenous phenylephrine on the arterial hypoxemia and tissues acidosis in patient with tetralogy of Fallot. Method: The 34 pa tients were randomly divided into Ⅰ(n=17) and Ⅱ(n=17) groups. In both groups, when the patient's SpO_2 was less than 80%, the intervention began. In Ⅰ group,a bolus dose(1?g/kg) of phenylephrine was given intermittently, until the SpO_2 was large than 90% or blood pressure increased to 120%, of baseline. In Ⅱ group, inhalation of 20 ppm NC was combined with intermittent bolus of phenylephrine 1?g/kg. Result: The value of SpO_2, MAP and BE had no sig nificant differences between two groups at pre-treatment. In Ⅱ group, SpO_2 was higher, meanwhile MAP, the negative value of BE,the total dose of phenylephrine used were lower than those in Ⅰ group after treatment (P

This paper introduces the concept, characteristics and applications of fault tolerant technique, which can ensure high availability of network server.