Thyroid dysfunction is particularly common during pregnancy , which may affect pregnancy outcomes , and harm maternal and child health.Since release of 2011 pregnancy thyroid-stimulating hormont(TSH) diag-nostic guidelines by American Thyroid Association (ATA).In 2012,Endocrinology branch and Perinatal Medi-cine Branch of the Chinese Medical Association jointly issued the “pregnancy and postpartum thyroid disease di-agnosis and treatment guidelines”, it is important that each laboratory has its own reference interval for diagnosing thyroid disorders in pregnancy.This article discussed trimester-specific thyroid hormone reference of the area in where the auther live.

Dysregulation of cell metabolism, especially glucose metabolism, is implicated in tumorigenesis and tumor progression.Cancer cells uptake a large amount of glucose and prefer to perform glycolysis in the cytosol even under normal oxygen condition, which fuels fast cell growth and proliferation.Dysregulation of glucose metabolism leads to tumorigenesis and promotes cancer development.Conversely, the initiation and development of cancer reprograms glucose metabolism to confer cancer cells the ability to survive and proliferate.Oncogenes, tumor suppressors or non-coding RNAs could regulate glucose metabolism.Meanwhile, the enzymes and metabolites involved in glucose metabolism could regulate the expression of factors related to cancer.Enzymes, the direct executor of cell metabolism, play a key role in dysregulation of glucose metabolism, tumorigenesis and tumor development.

Objective To investigate the value of two-dimensional speckle tracking imaging (STI) in assessing regional myocardial dysfunction and myocardial fibrosis in a mouse model of myocardial infarction.Methods Twenty C57/B6 mice were randomly divided into two groups:myocardial infarction (MI) group (n =10) and sham-operation (SO) group (n =10).Echocardiography was performed four weeks after surgery.High frame rate two dimensional images were recorded in the left ventricular short axis views at the papillary muscle level and analysised at EchoPac workstation.Peak radical strain (PRS) and peak radical strain rate (PRSR) of each segment were measured at systolic period.Percent segmental fibrosis (PSF) was assessed from histological left ventricular cross sections stained by Masson trichrome.Results Compared with SO group,PRS and PRSR decreased significantly in all segments of MI group (P ＜ 0.01),especially in anterosepetal,anterior and lateral segments (P ＜0.05).PSF of anterosepetal,anterior,lateral and posterior segments in MI group increased significantly than those in SO group(P ＜0.01),and were negatively correlated with PRS and PRSR of these segments(r =-0.88,P ＜0.001 ; r =-0.77,P ＜0.001).Conclusions STI could accurately quantify regional myocardial function in a mouse model of myocardial infarction.Segmental radial strain and strain rate measured by STI were significantly correlated with PSF,which can be a non-invasive tool for monitoring myocardial fibrosis after myocardial infarction.

Objective To determine the level of awareness about thrombolytic therapy for acute ischemic stroke among community residents in Yuzhong district,Chongqing,China.Methods We used multi-stage sampling to select 1500 households distributed in 3 Street of Yuzhong district,and then one member of each household answered the survey.A trained interviewer conducted a face to face survey about the questions regarding stroke warning signs and thrombolytic therapy in acute stroke.Results A total of 1101 participants completed the survey.Only 257 (23.3％,95％ CI 20.8-25.8) participants were aware of thrombolytic therapy for acute stroke and 59.9％ of them (154/257,95％ CI53.9-65.9) knew the time window of thrombolytic therapy.The rate of thrombolytic therapy awareness was higher among people with young age,well-educated,with higher household income with health insurance,and those who knew all 5 stroke warning signs.People aged ≥75 years had higher rate of awareness of the time window.Multivariate logistic regression analysis showed that age,education level,health insurance and knowledge of stroke warning signs were independently associated with the rate of thrombolytic therapy awareness.Conclusions In this population-based survey the community residents had poor awareness of thrombolytic therapy for acute ischemic stroke.It is necessary to improve the level of public knowledge about thrombolytic therapy for acute stroke by health education.

Pulmonary fibrosis is a common respiratory disease in the clinic. Until now, the pathogenesis is still un-clear. Using clotting mechanism as the starting point, this article mainly explored abnormal changes of the coagula-tion - fibrinolysis system in the development of pulmonary fibrosis. The effective treatment through the activation of blood circulation to remove stasis in traditional Chinese medicine (TCM) point of view was also observed on the man-agement of interstitial pulmonary fibrosis. It considered that to carry out the anticoagulant therapy for abnormal coag-ulation, which may become a new target for clinical treatment of interstitial lung diseases. It provided new ideas and theoretical support for clinical treatment of pulmonary interstitial fibrosis.

BACKGROUND:Interleukin-1 receptor-associated kinase 4 activity-induced inflammations and infection have been extensively accepted. However, there was no report concerning its effects on flap ischemia-reperfusion injury. OBJECTIVE:To explore the significance of interleukin-1 receptor-associated kinase 4 activity in flap ischemia-reperfusion injury. METHODS:A total of 36 adult male Sprague-Dawley rats were randomized into sham-operated group (n=12), ischemia-reperfusion group (n=12) and interleukin-1 receptor-associated kinase 4 group (n=12). The models of right lower abdominal island flap ischemia-reperfusion injury were set up. Interleukin-1 receptor-associated kinase 4 group was intraperitoneal y injected with 1 mL of interleukin-1 receptor-associated kinase 4 (100μmol/L) before reperfusion. The flaps were col ected at 1, 2, 4, and 6 hours after ischemia-reperfusion injury for histopathhological observation. At 1 hour after ischemia-reperfusion, protein expression of interleukin-1 receptor-associated kinase 4 was detected in flaps. The proportion of flap survival was calculated at 7 days after surgery.RESULTS AND CONCLUSION:Histopathological observation demonstrated that compared with the ischemia-reperfusion injury group, neutrophil infiltration and edema was evidently improved, and the protein expression of interleukin-1 receptor-associated kinase 4 was gradual y reduced in the interleukin-1 receptor-associated kinase 4 group. Flap survival proportions were respectively (51.70 ±7.62)%and (86.56±12.23)%in the ischemia-reperfusion injury group and interleukin-1 receptor-associated kinase 4 group at 7 days after surgery. There were significant differences in the flap survival proportion between the two groups (P<0.01). These results showed that after flap ischemia-reperfusion injury, the inhibition of interleukin-1 receptor-associated kinase 4 activities could elevate the survival rate of transplanted flap.

Objective To summarize the experience of establishing the stable rat model of chronic allograft nephropathy. Methods We used Fisher rats as donors and Lewis rats as recipients.After the left kidney of the donor perfused in situ under hypothermic condition, the left renal vein,abdominal aorta and bladder flap of the donor was anastomosed with the left renal vein, renal artery and bladder of the recipient, respectively. The recipients were given cyclosporin oral solution 10 mg/kg every day by gavage for 10 days after transplantation. The blood and urine samples were collected 1 month, 2 months and 4 months after transplantation and renal function and total urine protein were examined. The pathological changes of the renal allograft were observed 2 and 4 months after transplantation. Results Forty-five rats received operation and achievement ratio was 85%. The renal transplantations were finished in 120 ± 20 min. The Scr, BUN, Cycs and total urine protein demonstrated a significant increase one month after transplantation. On the second and fourth month,with the exception of urine protein continued to increase, the other indicators did not change significantly. Two months after transplantation renal pathology demonstrated light to moderate interstitial fibrosis, infiltration of lymphocytes and plasma cells. At 4th month the renal allografts showed extensive interstitial fibrosis, a large number of infiltrating interstitial cells, thickening,hardening, occlusion of glomerular basement membrane, and renal tubular atrophy that were consistent with pathological changes of chronic allograft nephropathy. Conclusion Through adequate surgical training and improvement, and specification for rat nephrectomy, transplantation surgery,and postoperative management in every detail, the model with high success rate and stability can be achieved.

Objective To investigate the role of UDP-glucuronosyltransferase 1A (UGT1A),nuclear factor erythroid-2-related factor 2 (Nrf2) and kelch-like ECH-associated protein 1 ( Keapl ) in the tumorigenesis of colonic carcinoma.Methods The expressions of UGT1 A,Nrf2 and Keapl were detected in normal colonic mucosa(24 cases),adenoma tissue (30 cases) and adenocarcinoma tissue (77 cases) by immunohistochemistry,and the relationship between their expressions and the clinical pathological characteristics was analyzed.Results The positive rates of UGT1 A in normal colonic mucosa,adenoma and adenocarcinoma tissue were 83.3％ ( 20/24),80.0％ ( 24/30 ) and 53.2％ ( 41/77 ),respectively.The positive rate of UGT1A in adenocarcinoma was lower than those in colonic mucosa and adenoma ( all P ＜0.05 ).On the contrary,the positive rates of Nrf2 in adenoma [70.0％ (21/30) ] and adenocarcinoma tissue [ 87.0％ (67/77) ] were higher than that in normal colonic tissue [ 41.7％ (10/24),all P =0.000 ].The positive rates of Keapl in normal colonic mucosa,adenoma and adenocarcinoma tissue were 54.2％ ( 13/24),70.0％ (21/30) and 61.0％ (47/77),respectively ( normal colonic tissue vs adenocarcinoma tissue,P =0.040 ; adenoma vs adenocarcinoma,P =0.002 ).There was no correlation between the expression of UGT1 A,Nrf2 and the clinicopathologic features of colon carcinoma,while the differences of Keapl positive rates in the various degrees of tumor differentiation [ moderately-well differentiated vs poorly differentiated:70.0％ (35/50) vs 44.4％ (12/27) ] and invasion [T1-T2 vs T3-T4:78.8％ (26/33) vs 47.7％ (21/44) ]were statistically significant (all P ＜ 0.05 ).Conclusion The decreased expression of UGT1A and the dysregulation of Nrf2/Keapl system may play a role in colonic tumorigenesis.

Objective To investigate the expression and the clinical significance of Lewis y antigen and Mucin 1 (MUC1),as well as to evaluate the correlation between them in epithelial ovarian tumor.Methods The expression of Lewis y antigen and MUC1 in 60 cases of epithelial ovarian malignant tumors,30 cases of borderline ovarian tumors,30 cases of benign ovarian tumors and 20 cases of normal ovarian tissues were detected by immunohistochemical staining.The relationship between Lewis y antigen and MUC1,and their relationship with biology characteristic of ovarian carcinoma were analyzed.An immunofluorescence double labeling methods was performed to detect the correlation between Lewis y antigen and MUC1.Results In malignant epithelial ovarian tumors,the positive rates of Lewis y antigen was 88.33％,which was significantly higher than the positive rates in borderline(60.00％,x2 =9.6405,P ＜0.01) and benign ovarian tumors(33.33％,x2 =28.8095,P ＜0.01) and normal ovarian samples (0,x2 =52.3457,P ＜ 0.01).The positive rates of Lewis y antigen had nothing to do with the clinical pathological parameters of ovarian tumor,but the expression intensity of Lewis yantigen was increased with the development of the malignant degree(P ＜ 0.05).The positive rates of MUC1 in malignant epithelial ovarian tumors was also significantly higher than that in borderline,benign ovarian tumors and normal ovarian samples (86.67％ vs 53.33％,30.00％,25.00％,x2 =12.0321,29.4064,27.8464 ; P ＜0.01).And the expression intensity of MUC1 also increased with the development of clinical stage(P ＜0.01),but had nothing to do with the lymph node metastasis and histological grade(P ＞ 0.05).In ovarian cancer,both Lewis y antigen and MUC1 were highly expressed,and their expression levels were positively correlated (r =0.707,P ＜0.01),and Lewis y antigen colocalized with MUC1.Conclusion Both Lewis y antigen and MUC1 are associated with the occurrence and development of ovarian cancer.Lewis y antigen and MUC1 might be a sigh of biological behavior in ovarian cancers,and this study provides theoretical evidence of ovarian cancer biological treatment.

Objective To investigate the safety and effectiveness of Glifeet in bowel preparation before colonoscopy.Methods A prospective,single blind,randomized controlled trial of patients undergoing colonos-copy was conducted.A total of 67 inpatients were randomized to the control group,who received a low-residue and semiliquid diet (n =31)and the experimental group,who received Glifeet all day (n =36)before the proce-dure.All patients took polyethylene glycol electrolyte powder 1 000 ml at 7 pm on the day before colonoscopy and 2 000 ml at 8 am on the examination day.Bowel preparation quality was scored using the Boston Bowel Prepara-tion Scale (BBPS).Side effects were also observed.Results The time of the first bowel movement of the experi-mental group was significantly shorter [(77.43 ±54.21)min VS (149.35 ±118.15)min,P =0.002].An in-creased defecating frequency was observed in the experimental group,but there was no significant difference when compared with the control group (11.44 ±6.95 VS 8.74 ±3.58,P =0.055).Patient tolerance and acceptance did not differ.There was no significant difference in BBPS between the two groups.But the bowel preparation quality of the right colon was significantly better in the experimental group (2.56 ±0.50 VS 2.23 ±0.81,P =0.045). Conclusion Glifeet could meet the needs of basic energy in most patients for colonoscopy.Furthermore,Glifeet is well tolerated and can partially improve the quality of bowel preparation.