Objective To investigate the relationship between gestational hypothyroidism and preeclampsia.Methods A retrospective study was conducted on 1 776 patients with gestational hypothyroidism,who gave birth in the International Peace Maternity & Child Health Hospital of China Welfare Institute,Shanghai Jiaotong University School of Medicine from January 2013 to December 2014.They were divided into three groups,including Improving Group (n=1 469),Progressing Group (n=133) and Remaining Group (n=174),based on their thyroid function at the first and third trimesters.Levels of thyroid hormones in the first and third trimesters were analyzed.Incidences of preeclampsia in those patients were calculated.And the correlation between thyroid function and incidence of preeclampsia was analyzed.T-test,Mann-Whitney U test,Chi-square test,variance analysis (SNK method) and Kruskal-Wallis H test or Logistic regression were performed for statistical analysis.Results (1) There were no statistical differences in age,gravidity and parity among the three groups.The pregestational body mass index in Progressing Group was lower than that in Improving group (21.1 ±2.9 vs 21.8±2.8,P＜0.05).(2) In the first trimester,the level of thyroid stimulating hormone (TSH) in Remaining Group was higher than those in Improving and Progressing Groups [(4.21 ± 1.69) vs (3.77±.3.03) and (2.00±0.57) mU/L,F=27.635,P＜0.01],and that in Improving Group was higher than that in Progressing Group (P＜0.05).The level of free thyroxine (FT4) in Progressing Group was higher than those in Improving and Remaining Groups [(16.18±9.67) vs (14.58± 1.71) and (14.54± 1.74) pmol/L,F=16.188,P＜0.01].In the third trimester,the TSH level in Remaining Group was higher than those in Improving and Progressing Groups [(5.07±0.86) vs (2.57±0.77) and (4.31 ±0.87) mU/L,F=28.986,P＜0.01],while the TSH level in Improving Group was higher than that in Progressing Group (P＜0.05).No statistical differences in FT4 levels (in the third trimester) and positive rates of thyroid peroxidase antibody (TPOAb) Were observed in the three groups.(3) Blood pressures (including diastolic and systolic blood pressures) in the first trimester and diastolic pressures in the third trimester showed no significant differences among the three groups.Systolic pressure of Improving Group in the third trimester was lower than that of Progressing Group [(119.4± 11.9) vs (121.8± 14.2) mmHg,P＜0.05,1 mmHg=0.133 kPa].(4) The incidence of preeclampsia in Progressing Group was higher than those in Improving and Remaining Groups [7.52％ (10/133) vs 1.29％ (19/1 469) and 3.45％ (6/174),x2=26.646,P＜0.01],and the incidence in Progressing Group was higher than those in Remaining and Improving Groups (both P＜0.05).The incidence of severe preeclampsia in Progressing Group was higher than that in Improving Group [6.02％ (8/133) vs 0.41％ (6/1 469),P＜0.05].There were no significant differences in incidences of mild preeclampsia among the three groups.(5) After adjusting for age,body mass index,gravidity and parity,the risk of severe preeclampsia in Improving Group was lower than that in Remaining Group (OR=0.233,95％CI:0.057-0.946,P＜0.05).Conclusions By improving thyroid function in pregnant women with hypothyroidism,the risk of preeclampsia,especially severe preeclampsia,could be reduced,which could improve maternal and neonatal outcomes.

BACKGROUND:Psychiatric patients are the high risk group of people who are liable to commit suicide.Recently,research on neurobiology and genetics of suicide mainly concentrates in the study of 5 hydroxytryptamine(5 HT) system.It is found that T102C polymorphism of 5 HT2A receptor gene is associated with suicide in depressive patients. OBJECTIVE:To investigate the correlation of A 1438G polymorphism of 5 HT2A receptor gene with attempted suicide in psychiatric patients. DESIGN:An observational comparative study of taking the patients as subjects and healthy physical examinee as the controls. SETTINGS:A psychiatric department in a municipal hospital and a neurological department in a university hospital. PARTICIPANTS:All the samples in the research were collected from the Department of Psychiatry of Yangzhou Wutaishan Hospital from March to September 2002.Analysis of genotype was completed in the Neurobiological Laboratory of Xuzhou Medical Institute from October to December 2002.Inclusive criterion:patients met the diagnostic criteria of schizophrenia or affective disorder in the third edition of the Chinese Classification and diagnostic criteria of Mental Disorders(CCMD 3) and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM IV).Exclusive criterion: parasuicider with idea or behavior of hurting oneself,but without intention to die.According to whether there was suicidal behavior or intention,116 patients were divided into 2 groups:attempted suicide group[n=52,35 males and 17 females,with an average age of (44± 13) years old] and no suicide group [n=64, 44 males and 20 females, with an average age of (48± 15) years old].Other 63 cases were taken as the normal controls[33 males and 30 females, with an average age of (55± 17) years old]. INTERVENTIONS:DNA of all the participants was extracted with the routine method of chloroform saturatedphenol leukocyte pheresis.The polymorphism of 5 HT2A receptor gene was analyzed with the restriction fragment length polymorphism. RESULTS:The G allele frequency of A 1438G polymorphism in the attempted suicide group(0.52) was significantly higher than that in the normal control group(0.39)(χ 2=3.91,P< 0.05).There were significant differences in the distribution of the 3 genotypes of AA, AG and GG between the attempted suicide group(0.23,0.50, 0.27) and normal control group(0.32, 0.59, 0.09)(χ 2=6.12,P< 0.05). CONCLUSION:Attempted suicide of psychiatric patient is associated with A 1438G polymorphism of 5 HT2A receptor gene.G allele may be a risk factor for the attempted suicide of psychiatric patient.

Objective To study the characteristic of cognitive function impaired and its relationship with the psychiatric symptoms in patients with first-episode schizophrenia.Methods 43 first-episode male schizophrenia patients diagnosed with DSM-Ⅳ were recruited in the study and received the atypical antipsychotics treatment 8weeks.The total score and sub-scores of Chinese Cognitive Ability Scale (CCAS)were obtained for all the patients pre-and post-treatments,and the patients were also assessed by the Positive and Negative Syndrome Scale (PANSS).Results The differences of the intelligence quotient(IQ) and its cognitive function factors between pre-and post-treatment of the patients were significant(P＜ 0.01).The total IQ score (85.7 ± 11.5),learning ability (17.9± 2.3),reasoning ability (16.1 ± 3.4),processing speed (16.9 ± 2.1),working memory (13.8 ± 2.6),space/calculate (17.5 ± 2.9),verbal IQ (86.8 ± 11.7),performance IQ (83.9 ± 12.4) before treatment and cognitive score (97.6 ± 14.3) as well as cognitive function factor (learning ability (20.1 ± 2.9),reasoning ability (18.9± 3.1),processing speed (19.7 ± 1.8),working memory (15.7 ± 2.5),space/calculate (20.8 ± 2.5),verbal IQ (98.3 ± 13.7),performance IQ (95.8 ± 14.6) after treatment,there were significant differences pre-and posttreatment (P ＜ 0.01).The difference of IQ pre-and post-treatment was significantly correlated with that of total score and positive score of PANSS(r =0.596 or 0.783).Conclusions (1) This finding supports that the cognitive function impairment exists in the early stage of schizophrenia.(2)The typical antipsychotic drugs can improve the cognitive function impairment and psychiatric symptoms of schizophrenia.(3) The cognitive function impairment of schizophrenia has significant relation to the positive symptoms,but no relation to the negative symptoms.

Objective To investigate the effects of ischemic postconditioning (I-post) on intestinal mucosa mitochondrion after ischemia-reperfusion (IR) injury in rat intestine.Methods By using rat model of intestine IR injury,male Sprague-Dawley rats were divided into 4 groups:sham-operation group (S),IR group (IR),ischemic preconditioning group (IPC),and I-post group.Intestinal mucosa mitochondrial ultrastructural changes were observed by using transmission electron microscope (TEM).Mucosal cellular mitochondrial respiration function was studied by measuring the mitochondrial dehydrogenase-dependent reduction of MTT to its formazan derivative,and intestinal mucosal mitochondrial membrane potential was detected by confocal laser scanning microscopy.Results Compared with that in IR group,the injury of mitochondrion in I-post group and IPC group began to recover.The mitochondrial respiratory function and the mitochondrial membrane potential were significantly improved in I-post group and IPC group (P0.05).Conclusion The mechanism of ischemic postconditioning against IR injury of intestine in rats is partly related to maintaining the mitochondrial ultrastructural changes and respiratory function and improving mitochondrial membrane potential.

0.05). A significant excess of C allele was in patients with TD compared to those without TD(? 2 =4.36,?=1,p0.05). Conclusion:Our result suggest that the T102C polymorphism in 5-HT2A receptor gene may be association with TD in chronic male schizophrenic patients

Objective To investigate the role of ischemic postconditioning(I-post) on intestinal mucosa in rats with ischemia-reperfusion (I/R) injury.Methods By using rat model of intestine I/R injury,32 male Sprague-Dawley rats were randomly divided into 4 groups: sham-operation group(S),I/R group(I/R),ischemic preconditioning group(IPC),and ischemic postconditioning group(I-post),respectively.The contents of malondialdehyde(MDA), the activity of superoxidase dismutase(SOD),and the activity of myeloperoxidase(MPO) in intestinal mucosa were measured respectively.The status of intestinal mucosa cellular apoptosis was detected by TdT-mediated dUTP-biotin nick end labeling(TUNEL).Chiu's count was used to assess the changes in intestinal pathological morphology.Results The content of MDA and activity of MPO were significantly reduced and the activity of SOD was enhanced in IPC group and I-post group compared with I/R group.There was obvious cellular apoptosis after reperfusion,and the apoptotic index in I-post group and IPC group was significantly lower than that in I/R group.Conclusion Ischemic postconditioning can result in protection against intestinal mucosa with I/R injury,which may be related to reducing the production of oxygen free radicals,maintaining the activities of antioxidant systems,and reducing intestinal mucosa cellular apoptosis.

Objective To determine the capability of emergency physicians (EPs) after goaldirected training to make accurate judgement and assessment of left ventricular systolic function (LVSF) as they own manipulated the hand-held echocardiography.Methods Eighty-one patients with acute dyspneic symptom admitted into emergency department of Xinhua Hospital Affiliated to Shanghai qaotong University School of Medicine from November 2011 to February 2012 were enrolled for a prospective,observational study.Patients with a history of trauma or acute myocardial infarction diagnosed by electrocardiogram were excluded.Four EPs after a intensive course of goal-oriented training in a good command of trans-thoracic echocardiography (TTE) in 81 emergency patients using hand-held echocardiography.EPs attempted to obtain images at the parasternal (long and short axis),apical,and subcostal positions,and visually estimated left ventricular ejection fraction (LVEF) and categorized LVSF as normal function,mild or moderate or severely depressed function.The results of echocardiographic LVEF got by EPs were compared quntitatively with those measured by an professional echocardiographer.The kappa statistical test by using SPSS version 13.0 software was used to allow for comparison in agreement between EPs and the professional echocardiographer's interpretations of TTE findings.Results Using the results of TTE measured by the professional echocardiographer as agold standard,EPs correctly distinguished the normal LVSF from decreased LVSF in 89％ patients.The rate of positive predictive value for the EPs identifying any abnormality in LV function was 83％ and the rate of negative predictive value was 93％.The kappa coefficient for the agreement between EPs and the professional echocardiographer' s interpretations for any abnormality in LV function was 0.77 (95％ CI:0.70-0.84,P ＜ 0.01).EPs correctly placed LV function into one of three categories in 68 of 81 cases (84％),The kappa coefficient for the agreement was 0.71 (95％ CI:0.64-0.78,P ＜0.01).Conclusions Emergency physicians after a intensive course of training in mastering echocardiography can accurately determine the left ventricular systolic function.

Objective To evaluate the efficacy of sequential psychotherapy combined with selective serotonin reuptake inhibitors(SSRI) s on refractory obsessive-compulsive disorder(OCD). Methods 50 patients with refractory OCD were given to sequential psycho therapy in the original basis of the SSRIs drugs treatment. The patients were given psychoanalysis,cognitive behavioral therapy and reality therapy for 8 weeks at the end of in the first stage, second stage and the third stage. The efficacy was assessed by the Yale-Brown Obsessive Compulsive Scale(Y-BOCS) before treatment,8 weeks, 16 weeks, and 24 weeks after treatment, respectively. Results The total score of the YBOCS before the treatment and at the 24th week after treatment was (21.10 ±4.69) and ( 10.18±6. 14). According to the score-reducing rate of the YBOCS , recovery rate was 34.0%, effective rate was 42.0%. Conclusion Sequential psychotherapy combined with SSRIs is an effective treatment for refractory OCD.

To study the possible mechanism of the effect of glucagon-like peptide-1 (GLP-1) on injury to neonatal rat cardiomyocytes induced by hypoxia-reoxygenation. Lactate dehydrogenase activity [(210.0±11.5) vs (101.4±6.5) U/L] ,apoptosis rate [(8. 138±1. 512) vs(0. 575±0. 168)%] ,and caspase-3 activity [(44.52± 5.69)vs(19.98±1.97) ,all P<0.01] were all increased after hypoxia-reoxygenation. GLP-1 appears to directly act on cardiomyocytes and to protect them from hypoxia-reoxygenation injury [lactate dehydrogenase (190.2±9.0) U/ L, apoptosis rate (2.688±0.580) %, caspase-3 activity 30.34±4.18] mainly by inhibiting the apoptosis probably via the PBK/Akt signaling pathways.

Objective To explore the relationship between serum uric acid and fasting blood glucose ( FBG) in newly-diagnosed type 2 diabetes in regard to different genders. Methods In 282 patients of newly diagnosed type 2 diabetes(208 males and 74 females), detection of serum FBG, uric acid, creatinine, transaminases, blood lipids, etc were determined. FBG<7. 0 mmol/L was found in 118 cases (89 males and 29 females);7. 0 mmol/L≤FBG≤9. 0 mmol/L in 114 cases ( 88 males and 26 females ); FBG>9. 0 mmol/L in 50 cases ( 31 males and 19 females). Results (1)Serum uric acid showed statistically significant difference in regard to sex[Male:(325. 82±92. 26)μmol/L, Female:(292. 26±76. 19)μmol/L, P<0. 01]. (2) FBG and serum uric acid were negatively related(r=-0. 316, P<0. 01). (3) FBG and serum uric acid were negatively related both in male(r=-0. 320, P<0.01)andinfemale(r=-0.291,P<0.05). (4)Multiplestepwiseregressionanalysisshowedthatthethreegroups of FBG and serum uric acid showed regression relationship in male and female patients(P<0. 01). Conclusion With the increased FBG, serum uric acid was decreased in both males and females. Therefore, serum uric acid might serve as a potential biomarker of glucose metabolism.