At present,reports at home and abroad suggest a low probability of successful preservation of ovarian endocrine function after ovarian shift radiotherapy.After radiotherapy for cervical carcinoma,the ovarian function is associated with various factors,such as radiotherapy dose and method,patient's age,shift position,and concurrent chemotherapy drugs.Therefore,as for each patient,the dose to the ovarian tissue should be controlled within the individual dose limit to effectively preserve the ovarian function.

Objective To evaluate the efficacy of adjustable oral appliance (OA) on ventilation of patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Databases were searched from Junuary 1990 to July 2014 for randomized controlled trials on the use of adjustable OA for the promotion of ventilation in OSAHS.Meta analysis was performed with RevMan5.2 software,and descriptive analysis of the data that could not be converted and merged was performed.Results Totally 6 RCTs involved,including 1 109 patients,which involved 4 random parallel controlled trials and 2 random crossover controlled trials.Meta-analysis showed that adjustable OA were associated with a decreased apnea-hypopnea index(AHI) [fixed effect model,WMD=-2.38,95％CI (-3.59--1.17),P＜0.01] and an improvement in minimum arterial oxygen saturation (SaO2)[randomized effect model,WMD=3.09,95％CI(1.16-5.02),P＜0.01] of OSAHS patients.The descriptive analysis showed that the difference in the sleep score was not statistically significant because the data could not be converted.Conclusions Compared to fixed oral appliance,adjustable oral appliance produced greater effect in reduction of AHI and the improvement in minimum SaO2,but the sleep score is not improved significantly,the large sample and multi-center randomized controlled test needs to be designed for the verification of comprehensive effect of adjustable oral appliance.

nal abnormalities of pediatric heart diseases.

Objective To investigate the relationship between thyroid hormone levels and carotid artery disease in maintenance hemodialysis ( MHD ) patients and evaluate its value. Methods Clinical data of one hundred and twenty?one MHD patients during January 2014 to July 2016 in Yanan University Affiliated Hospital were collected. The patients were divided into the normal carotid artery group and the carotid artery lesion group according to whether there was plaque or stenosis in the carotid artery ultrasonography. Clinical data related to the carotid artery lesions was collected, and the single factors that may affect the carotid artery lesions were analyzed,multivariate logistic regression was used to analyze independent risk factors for carotid artery disease, and the greatest independent risk factor of OR value was used to establish a ROC curve for evaluating carotid atherosclerosis in patients with MHD. Results The levels of serum calcium, TC, TG, LDL?C, TSH, CRP and Hcy in the carotid artery group were higher than those in the normal group ( P<0. 05 ) . The levels of serum phosphorus and FT3 in the lesion group were lower than those in the normal group ( P<0. 05 ) . Multivariate logistic regression analysis of risk factors for carotid atherosclerosis showed that CRP ( OR=1. 620,95%CI1. 288-2. 038,P=0. 048),Hcy (OR=1. 976,95%CI 1. 135?3. 441,P=0. 021),FT3 (OR=2. 521,95%CI 1. 584-4. 012,P=0. 017) were independent risk factors for carotid artery disease. FT3 evaluation of the ROC curve showed AUC=0. 848,P=0. 000,the cut?off value was 3. 705pmol/L,the diagnostic sensitivity was 0. 670,and the specificity was 0. 879. CRP valuation of the ROC curve suggested that AUC=0. 619,P=0. 000,the cut?off value was 16. 215 mg/L,the diagnostic sensitivity was 0. 932 and the specificity was 0. 333. Hcy evaluation of the ROC curve showed AUC=0. 767,P=0. 000,the cut?off value was 12. 565μmol/L,the diagnostic sensitivity was 0. 784 and the specificity was 0. 881. Conclusion Low concentration of FT3,high concentration of Hcy and high concentration of CRP in MHD patients were independent risk factors for carotid artery disease. The use of FT3 to evaluation the carotid atherosclerosis has a certain value.

Objective To investigate the influence of mental intervention on the self-image of breast cancer patients.Methods Fifty patients with breast cancer who were hospitalized in our hospital from January to September,2015 were enrolled as the control group in the study,where routine nursing intervention,health education on disease related knowledge and psychological nursing were carried out.During October 2015 to June 2016,50 patients with breast cancer were enrolled as the observation group,where psychological awareness intervention was carried out apart from the routine nursing intervention.The self-image level of breast cancer patients from the two groups was evaluated by self-image questionnaire for breast cancer patients (BIBCQ).Result After intervention,the scores on self-image in the observation group were significantly higher than those in the control group (P＜0.05).Conclusion Mental intervention can improve the self-image of breast cancer patients and help improve their quality of life.

Objective To assess the effect and safety of lanthanum carbonate vs conventional phosphate binders for hyperphosphatemia in patients undergoing maintenance hemodialysis.Methods According to the collaborative search strategy,MEDLINE (1996 to 2012.12),EBCO (1996 to 2012.12),the clinical control test database of Cochrane Library and Chinese Wanfang database (1996to 2012.12) were searched.Related literature,whether Published or not and meeting summary included,were searched by hand.Quality assessment and data extraction were conducted by two independent investigators.Meta-analysis was conducted by RevMan 5.0.The following outcomes were assessed:serum phosphorus levels,serum iPTH levels,serum calcium levels and adverse events.Results were expressed as OR with 95％ confidence interval for dichotomous outcomes and WMD with 95％ confidence interval for continuous outcomes.Results A total of 10 reports were identified which met the inclusion criteria.The meta-analysis showed that the efficacy of treating hyperparathyroidism in hemodialysis patients was similar between lanthanum carbonate and conventional phosphate binders (WMD =-0.06,95％ CI-0.27 to 0.15,P =0.57) and the incidences of discontinuing due to adverse events were also similar.However,there were fewer hypercalcemic episodes and lower serum calcium levels in the lanthanum carbonate group compared to calcium-based phosphorus binders group.Conclusion Lanthanum carbonate is effective and well tolerated in treating hyperphosphatemia in hemodialysis patients with fewer hypercalcemia and lower serum calcium levels compared to calciumbased phosphate binders.

Objective To observe the effect of Yingliu mixture combined with methimazole on autoantibodies and traditional Chinese medical syndromes of patients with Graves’ disease ( GD) . Methods A randomized, paralleled and controlled trial was carried out in 92 GD patients. The patients were evenly randomized into treatment group and control group, and were separately treated with Yingliu mixture combined with methimazole, and methimazole. The treatment for both groups lasted 12 weeks, and forty patients in each group completed the whole treatment. The changes of thyroid function, thyroid autoantibodies, and traditional Chinese medical syndrome scores were observed before and after treatment, and the clinical efficacy was also evaluated. Results (1) After treatment for 12 weeks, serum levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody ( TGAb) and thyrotrophin receptor antibody ( TRAb) were decreased, and thyroid stimulating hormone ( TSH) was increased obviously in both groups after treatment ( P<0.01 compared with those before treatment) . The treatment group has better effect on improving TGAb and TRAb than the control group ( P<0.05). ( 2) Compared with those before treatment, the total scores of clinical symptoms and signs were decreased in the two groups at different time points of treatment course ( P<0.001) , and the decrease value in the treatment group was larger than that in the control group ( P<0.05) . ( 3) The total effective rate of the treatment group was 92.50%, higher than 82.50% of the control group ( P<0.05) . Conclusion Yingliu mixture combined with methimazole is effective on improving thyroid function, decreasing autoantibodies levels and relieving clinical symptoms and signs, and has better effect than methimazole alone for the treatment of GD.

Objective To explore the changes of programmed death receptor-1 (PD-1) in chronic hepatitis B (CHB) patients with different baseline of hepatitis B virus (HBV) DNA levels after treatment with adefovir dipivoxil (ADV).Methods One hundred CHB patients with positive hepatitis B e antigen (HBeAg),1 × 104 copy/mL≤HBV DNA≤1 × 107 copy/mL,and positive human leukocyte antigen-A2 were divided into two groups according to the baseline HBV DNA level:47 cases in low virus load group whose HBV DNA level was ≤1 × 105 copy/mL; 53 cases in high virus load group whose HBV DNA level was＞1 × 105 copy/mL.Both groups were treated with ADV 10 mg/d.Serum HBV DNA,HBeAg seroconversion rate,alanine aminotransferase (ALT) and total bilirubin (TBil) levels of both groups before treatment and 12 months after treatment were compared.Flow cytometry was used to test peripheral blood HBV-specific cytotoxic T lymphocyte (CTL) surface PD-1 and peripheral blood HBV-specific CTL level.Categorical data were tested by x2 test; quantitative data was compared with t-test.Results Peripheral blood HBV-specific CTL surface PD-1 of CHB patients in low virus load group was 20.17 ％±1.69％,which was lower than that in high virus load group (41.38％±2.30％,t =53.02,P＜0.01) ; peripheral blood HBV specific CTL levels in two groups were 0.37％±0.02％ and 0.17％± 0.02％,respectively (t=50.47,P＜0.01) ; ALT and TBil levels in low virus load group were both lower than those of high virus load group (t=13.07,P＜0.01; t=5.06,P＜0.01).Twelve months after treatment,HBV DNA of 25 cases (53.2％) in low virus load group and 10 cases (18.9％) in high virus load group were lower than the detectable level (HBV DNA＜500 copy/mL,x2 =12.89,P＜0.01);HBeAg seroconversion was achieved in 15 cases(31.9％) and 1 case (1.9％),respectively (x2 =16.72,P＜0.01) ; peripheral blood HBV-specific CTL surface PD-1 expression levels were 9.00 ％ ±1.38 ％ and 29.40 ％ ± 3.76 ％,respectively (t =36.80,P＜ 0.01) ; peripheral blood HBV-specific CTL levels were 0.65％±0.10％ and0.48％±0.07％,respectively (t=9.61,P＜0.01).Conclusions After treatment with ADV,along with the decrease of HBV DNA load,HBV-specific CTL surface PD-1 expression decreases,while HBV-specific CTL level increases.The changes in low virus load group are much more remarkable.

Objective To explore the application effects of online tests through two-dimensional code in the course of Fundamental Nursing. Methods A total of 79 nursing students in 2016 were included in the study. Compared with traditional method in the first term, online tests through two-dimensional code were implemented in the second term. The students′ appraisal on online tests through two-dimensional code was investigated with a self-designed questionnaire. Results The students showed a positive attitude to online tests through two-dimensional code. 97.3%(71/73) of the students thought online tests through two-dimensional code was easy to implement, and 93.2%(68/73) of them agreed that online tests help them to know how they learned and improved the efficiency and quality of class. Conclusions Online tests through two-dimensional code, which are novel, energy-saving and environmental friendly,can improve students′learning interest and enhance learning effect.Therefore,it is worthy to be applied and recommended.

Objective To study the clinical significance of cell factors in plasma samples of hand?foot?mouth disease. Methods Sixty?nine cases hand?foot?mouth diseases children who were treated in Fifth People’ s Hospital of Wuxi from July to December 2014 were selected as research objects,and divided into normal hand?foot?mouth disease group with 48 cases and severe hand?foot?mouth disease group with 21 cases. Twenty healthy children were selected as healthy control group. Serum samples were collected from 3 groups of subjects. The lev?el of IgA,IgG and IgM were detected by immune turbidity method. The level of IFN?γ, IL?10, IL?13 and IL?2 were detected by flow cytometry. Results The level of serum IgG,IgA of severe hand?foot?mouth disease group patients were (12. 33±8. 58) g/L,(0. 78±0. 55) g/L,significantly lower than control group((7. 09±6. 36) g/L,(0. 61±0. 36) g/L) and the normal hand?foot?mouth disease group((7. 41±5. 07) g/L,(0. 57±0. 41) g/L),the differences were significant(P<0. 05),while there was no significant difference between normal hand?foot?mouth disease group and control group( P>0. 05) ,and there was no significant difference in term of the level of IgM among the three groups( P>0. 05) . The level of serum IFN?γ,IL?2,IL?13 of severe hand?foot?mouth dis?ease group were (0. 95±0. 67) ng/L,(1. 07±0. 64) ng/L,(1. 25±0. 46) ng/L,significantly lower than normal hand?foot?mouth disease group((2. 72±1. 15) ng/L,(2. 07±1. 53) ng/L,(2. 31±1. 35 ) ng/L) and the control group((1. 83±1. 12 ) ng/L,(1. 61±1. 37) ng/L,(1. 99±0. 75) ng/L),the differences were significant(P<0. 05). The level of serum IL?10 of normal hand?foot?mouth disease group was (2. 69±1. 33) ng/L,significant?ly higher than severe hand?foot?mouth disease group ( ( 1. 54 ± 1. 23 ) ng/L ) and control group ( ( 1. 35 ± 1. 12 ) ng/L) ,the differences were significant( P<0. 05) . Conclusion The level of serum cytokines can reflect the ge?netic profile status,understand the development trend of the disease,provide a reliable index for early clinical in?tervention.