This article summarizes the current literature about serum test parameters of thyroid function during aging and thyroid dysfunction in the elderly.The aim is to highlight the importance of the individualized strategy and employing additional caution before assigning diagnoses of hypothyroidism or hyperthyroidism to elderly patients and initiation of treatment modalities.In the last few years,the emergence of age-specific reference ranges for thyroid-stimulating hormone (TSH) has added to the complexity of diagnosis of thyroid dysfunction in this age group,especially in thesubclinical category.Application of age-specific TSH reference ranges may avoid misclassification of elderly subjects without thyroid disease.Overt hypothyroidism and hyperthyroidism require immediate treatment.Treatment of subclinical hyperthyroidism may be considered in the part of elderly patients,while follow-up care and monitoring must be provided for the other part of older subjeets.Careful waiting may be an appropriate approach for older patients with subclinical hypothyroidism with TSH＜ 10 mU/L.The senile elderly,especially extreme longevity people with TSH＜10 mU/L are generally not treated with thyroid hormone replacement therapy.

Objective To explore the effect of unsupported arm exercise (UAE) on dyspnea, exercise endurance of upper limbs and qual-ity of life in patients with chronic obstructive pulmonary disease (COPD). Methods From May to October, 2014, totally 70 patients with COPD were recruited and were randomly assigned to control group and intervention group. Both groups received routine care, and the inter-vention group performed UAE for six weeks additionally. The COPD Assessment Test (CAT), baseline dyspnoea index (BDI) and six-min-ute Pegbord and Ring Test (6PBRT) were recorded. Results The scores of CAT and BDI, and the number of turns in six minutes were better in the intervention group than in the control group (P<0.05). Conclusion UAE can increase the exercise endurance of upper limbs, relieve the dyspnea, and improve the quality of life in patients with COPD.

Objective To study the role of expressions of vascular endothelial growth factor C (VEGF-C), vascular endothelial growth factor receptor-3 (VEGFR-3) and lymphatic vessel hyaluronan receptor-1(LYVE-1) on the lymphangio-genesis and prognosis in gastric cancer. Methods The tissue microarray technology was used to detect the expressions of VEGF-C, VEGFR-3 and LYVE-1 in 125 gastric cancer specimens, 96 adjacent normal tissues and 20 benign gastric lesion samples. The lymphatic vessel density (LVD) marked by Podoplanin was detected as well. Results The positive rates of VEGF-C, VEGFR-3 and LYVE-1 in gastric cancer tissues were 62.4%, 56.0%and 58.4%, which were significantly higher than those in adjacent normal tissues (10.4%,12.5%and 9.4%) and benign gastric lesion tissues (20%, 30%and 25%, P<0.05). The LVD score was significantly higher in gastric intra-tumoral and peri-tumoral samples (2.98±0.81 and 4.22±1.09) than that in adjacent normal tissues or benign gastric lesion samples (1.82±0.63 or 0.89±0.45, P<0.01). The LVD score was significantly higher in peri-tumoral samples than that of intra-tumoral samples (P<0.01). There was a positive relationship between expression levels of VEGF-C,VEGFR-3 and LYVE-1 with LVD (P<0.05). The positive expressions of the three indexes were the risk factors of lymph node metastasis and distant metastasis (P<0.05). There was a significantly longer 5-year survival rate in patients with negative expression of the three indexes (P<0.05). Conclusion VEGF-C, VEGFR-3 and LYVE-1 proteins were positively highly expressed in gastric cancer tissues, which were risk factors affecting the progno-sis of gastric cancer. The expression levels of the three indexes can be used to predict the prognosis and lymphangiogenesis of gastric cancer.

OBJECTIVE To explore the application of hydrogen dioxide hypothermic plasma sterilizing system(STERRAD 100S) in operating room,and study the cost.METHODS The cost of sterilizing endoscopic instruments in operating room was analyzed.And the method of using medical material was improved as follows: use the non-woven fabrics and transparent packing bags repeatly to increase the utilization efficiency of medical material.RESULTS Compared with the traditional method,the cost of sterilizing instruments by STERRAD 100S decreased 2-3 times,which brought much economic benefit.CONCLUSIONS 100S Can improve the working efficiency,reduce inventory level of endoscopic instruments and sterilizing cost,which can relief patient economic burden and ensure patient interest.

This study was aimed to explore brain regions which were closely related to the disease onset of premenstrual syndrome (PMS) with liver-qi depression. The BOLD-functional magnetic resonance imaging (fMRI) was used in the study. The processing of imaging data was based on the SPM 8 software and the REST software of the matlab platform. Each cluster was more than 389 continuous voxel. The brain region with single voxel of P < 0.05 (corrected) was defined as region with statistical significance. The 2 Sample T-Test was applied in the case group and the control group. The results showed that compared with the normal control group, the frontal lobe, occipital lobe, insula, limbic lobe, basal nuclei, and cingulate gyrus were activated in the PMS with liver-qi depression cases. It was concluded that the disease onset of PMS with liver-qi depression cases was related to brain regions such as frontal lobe, occipital lobe, insula, limbic lobe, basal nuclei, and cingulate gyrus.

Objective To investigate the compatible stability of alanylglutamine by using continuous series infusion device,and provide experimental evidence for reasonable clinical use of alanylglutamine. Methods pH,osmolality and quantity of insoluble particles were measured by using pH meter, automatic freezing osmometer and intelligent particle detector respectively.A HPLC method was built for the determination of the content of alanylglutamine. Results pH and quantity of insoluble particles of the two tested groups did not change significantly over time. Osmolality and the content of alanylglutamine fluctuated greatly in the first half an hour. Conclusion Continuous series infusion device may not mix each bottle of solution very well.It is suggested to premix these solutions to ensure the stability of the dilution ratio and the osmotic pressure of the mixture in the process of the infusion.

Objective To examine the effects of genetic polymorphisms in GSTM1, GSTT1 and GSTP1 (rs1695) genes on hematologic toxicities of breast cancer patients receiving Anthracycline/Paclitaxel- based chemotherapy. Methods Multiply PCR technique and High Resolution Melting method were used to examine these 3 genes polymorphsim in female breast cancers (n=252). Results The GSTP1(rs1695) AG/GG genotype was a risk factor forⅢ-Ⅳdegree of neu-trophil toxicity when patients received Paclitaxel-based chemotherapy and Anthracycline-Paclitaxel-based chemotherapy (OR=6.111, 95%CI 1.526-24.469, P<0.05 and OR=9.257, 95%CI 2.903-29.522, P<0.01). There were no statistic differ-ence onⅢ-Ⅳdegree hematologic toxicities rates between GSTM1(+) and GSTM1(-), GSTT1(+) and GSTT1(-) patients after they receiced Paclitaxel-based chemotherapy and Anthracycline-Paclitaxel-based chemotherapy( P>0.05);There was no statistic difference onⅢ-Ⅳdegree hematologic toxicities rates between GSTM1(+) and GSTM1(-), GSTT1(+) and GSTT1(-), GSTP1AA and GSTP1AG/GG patients after they receiced Anthracycline-based chemotherapy (P>0.05). Conclusion The genetic polymorphisms in GSTP1(rs1695) can be used as a gene marker for forecasting the chemotherapy, inducing neutrope-nia toxicities in breast cancer patients receiving Paclitaxel-based chemotherapy.

Objective:To establish an HPLC method to determine the content of carfilzomib for injection. Methods:The chroma-tographic column was a Waters symmetry C18(250 mm ×4.6 mm, 5 μm)column, the sample solvent was methanol, the mobile phase was 0. 05% trifluoroacetic acid-acetonitrile(57 ∶43) at a flow rate of 1. 0 ml · min-1 , the detection wavelength was 210 nm, the col-umn temperature was 25℃ and the injection volume was 10 ml. Results:The linear range of carfilzomib was 120-600 μg·ml-1 ( r=0. 999 7). The average recovery was 100. 4%( RSD=0. 24%,n=9). Conclusion:The method is rapid and effective, which can be used for the content determination of carfilzomib for injection.

Objective To investigate the effect of predictive nursing on the living donor liver transplantation.Methods Forty patients undergoing living donor liver transplantation were divided into the intervention group and the control group with 20 patients in each group randomly.We gave routine nursing cooperation to the control group while predictive nursing besides routine nursing cooperation to the intervention group.The operation time,cold ischemia time of donor liver,nursing complication,cost of surgery and satisfaction degree of surgery cooperation were recorded.Results Compared with the control group,the operation time,cold ischemia time of donor liver,nursing complication,cost of surgery were all decreased,and the satisfaction degree of surgery cooperation was improved.Conclusions Predictive nursing can improve nursing operation quality,raise the efficiency of nursing and surgery,reduce the incidence of complication,which is beneficial to smooth progress of operation and increase satisfaction degree of doctors and nurses to nursing cooperation.

Objective To discuss the expression and mutation of β-catenin gene in breast carcinoma.Methods 119 breast carcinomas, 72 adenosis of breast tissues and 40 normal breast tissues were studied.Using immunohistochemistry studies to detect the expressions of β-catenin, then analyzing their relationship with the clinicopathological features of breast carcinomas. Gene mutation of β-catenin (exon 3) in 44 cases of breast carcinoma were analyzed by polymerase chain reaction (PCR) and then by direct sequencing.ResultsIn 40 cases of normal breast tissues, epithelial cells showed equally strong membranous of β-catenin protein at the cell-cell boundaries. The abnormal rate of β-catenin in breast carcinomas (78.15 %) was much higher than that of adenosis of breast tissues (44.44 %), the significant correlation was found (P＜0.01). The abnormal expression of β-catenin was associated with lymph node metastasis (P=0.031). Mutation of β-catenin gene was not detected in 44 cases of breast carcinoma, while the abnormal rate of β-catenin in 44 cases of breast carcinoma was 77.30 %. Conclusionβ-catenin abnormal expression could be considered as an useful marker for determining metastasis and prognosis of human breast carcinoma and for guiding treatment. β-catenin abnormal expression is not caused by β-catenin gene mutation, maybe by other mechanisms. It needs further study.