There is a significance of pregnancy thyroid hormone reference ranges establishment,because the consequences of thyroid dysfunction during pregnancy are terrible.This review will focus on meaning of pregnancy thyroid hormone reference range,importance of TPO antibody testing and current advances of methodology.

Objective To investigate the effects of octreotide (OCT) on gene and protein expressions of collagen Ⅰ,collagen Ⅲ and matrix matrixmetlloproteinases 2 (MMP-2)in hepatic stellate cells(HSC) in vitro,and to clarify the mechanism of its anti-hepatic fibrosis.Methods A rat hepatic stellate cell line,rHSC-99,was treated with OCT.Cell proliferation was assessed by MTT colorimetric assay.The contents of collagen Ⅰ,Ⅲ were examined by ELISA;RT-PCR was used to detect mRNA expressions of MMP-2,collagen Ⅰ and collagen Ⅲ.Results Compared with control group,OCT significantly inhibited rHSC-99 proliferation in vitro (P

Objective To analyze the serum level of 25-hydroxy vitamin D [25-(OH) D] in pregnant women in Nanjing and its relationship with age,gestational week,pre-pregnancy body mass index (BMI) and season,so as to provide some guidance on clinical application of vitamin D measurement and supplementation.Methods 880 pregnant women (in 21-36 gestational weeks) regularly visiting antenatal clinic in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University were selected from January to December 2015.Their serum 25-(OH)D concentrations were measured by enzyme-linked immunosorbent assay (ELISA).Results The mean serum 25-(OH) D concentration in these pregnant women was (42.03 ± 19.22) nmol/L and sufficient in only 42 (4.77％).Vitamin D levels showed seasonal variation (P =0.0164),with the levels in summer [(44.61 ±23.57) nmol/L] and autumn [(43.43 ± 19.31) nmol/L] being higher than spring [(39.68 ± 16.91) nmol/L] and winter [(39.65 ± 13.36) nmol/L].There was no statistically significant difference in serum vitamin D level among different gestational weeks (P =0.929 4).There was statistically significant difference in serum vitamin D level among different age groups (P =0.038 3).Vitamin D level was not associated with pre-pregnancy BMI.Conclusions Vitamin D deficiency is highly prevalent among pregnant women in Nanjing.We suggest vitamin D testing be carried out more actively.

Objective To study comparatively the clinical efficacy of pelvic floor muscle exercise (PFMlE)and surgical therapy in women with moderate stress urinary incontinence(SUI),in order to provide theoretical reference for finding an appropriate SUI treatment method. Methods 114 cases of women with moderate SUI were randomly divided into the treatment group and the control group. The control group Wag given surgical thempy. while the treatment group was given the PFME treatment. After 12 weeks the clinical efficacy and quality of life of the two groups were evaluated, the cost-benefit was analyzed. Results The total effective rate of treatment group was 86.2%.higher than 83.9% of the control group. Compared with before treatment, the I-QOL scores of the two groups increased significantly, the ICIQ scores of the two groups decreased significantly, and the treatment group was significantly different compared with the control group. The cost-benefit analysis showed that the total medical cost and the spending cost of the total clinical effective rate increased l percent and the I-QOL increased 1 score were significantly lower than that of the control group. Conclusions The PFME therapy of women with moderate SUI is the preferred treatment and it is worthy of promotion and application.

Objective To investigate the error monitoring function damages on the patients with schizo?phrenia ( SCH) . Methods A total of 32 patients with schizophrenia were compared with matched 34 health con?trols ( HC) on the error monitoring tasks which were compiled by E?Prime. Results The comparison between SCH group ((713.22±174.52)ms,( 491.14±170.29) ms,( 1060.31±130.84) ms,(8.28±12.55)time,( 8.00± 7.53)time respectively) and HC group ((560.73±156.94) ms,(395.62±188.03) ms,(989.85±104.33) ms, (2.97±4.13) times,(3.12±6.50) times) on the reaction time of choice,assessment,incongruent condition,the numbers of uncertain and the numbers of dropout were significant ( t=-3.737, P=0.000;t=-2.159, P=0.035;t=-2.426, P=0.018;t=-2.282, P=0.022;t=-2.824, P=0.006) . The SCH group and HC group did not signifi?cantly difference in Full Correct((124.72±23.74)/(131.74±21.96)times),Full Error((15.69±17.64)/(13.35± 18.63)times),Part Correct((6.83±10.40)/(4.21±7.03)times),Part Error((2.91±10.91)/(0.62±1.10)times) and Accuracy((0.831±0.161)/(0.874±0.159))(P>0.05).There was no significantly correlation among the course of disease,HAMA,HAMD and the error monitoring. Conclusion These results demonstrate that the error monitoring function damages on the patient with SCH may be involved in the dysfunction of anterior cingulate cortex.

ObjectiveTo explore the attentional biases in male alcohol dependent (AD) patients and the correlations between the attentional bias and alcohol-related factors.MethodsA total of 30 recently detoxified male individuals with alcoholism were compared with 37 healthy controls ( HC ) on the Chinese Emotional Stroop Task using negative,neutral,and alcohol-related words.ResultsThe comparison between AD group( ( 1382.13 ±323.38) ms,( 1365.76 ±313.03)ms,( 1433.20 ±342.23) ms,respectively) and HC group( (797.27 ±216.97)ms,( 794.11 ± 209.41 ) ms,(799.40 ± 215.82 ) ms respectively) on the reaction time of neutral,negative and alcohol-related words were significant ( t =8.822,P ＜ 0.001 ; t =8.922,P ＜ 0.001 ; t =9.234,P ＜ 0.001 ).The error number of of the neutral and negative- related words of the patients ( ( 3.70 ± 2.56) time,( 4.23 ± 2.53 ) time)was worse than that of HC group( ( 2.11 ± 1.87 ) time,( 1.92 ± 1.82 ) time) ( t =2.939,P =0.005 ; t =4.355,P ＜0.01 ).Error number of the alcohol- related words between two groups were not significant;Its alcohol-related words attentional bias negative correlation to the age of initial alcohol use(P＜ 0.05 ),and positive correlation to continue drinking and score of self-rating depression scale (P＜0.05).Age of addiction and the score of self-rating anxiety scale enter the regression equation of alcohol-related words.ConclusionThese results demonstrate that alcoholics have attentional bias in alcohol-related words and reward-related brain regions may be associated with craving among male patients with attentional bias.

Objective In view of the trend of networking development in modern high education and the characteristics of students' strong self-learning ability, Peking Union Medical College established a multimedia morphological teaching website from 2013 including human anatomy, neuroanatomy, histology and embryology.Methods According to the teaching demand, the use of the ASP script, combined with Mysql database completed the website development, from the interface design to the curriculum, the syllabus, presentations and laboratory videos uploading.Results Through the questionnaire survey, 45% of the students use website more than 3 times a week, and course content column has the highest use frequency (79%).An independent learning platform effect has been achieved.Conclusions After nearly 4 years exploration and practice, multimedia website has become an important part of morphological courses, as a kind of new teaching mode, not only popular for college teachers and students, but also widely used in clinical teaching.

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when fetal platelets are sensitized and then phagocytized by macrophages in the reticuloendothelial system after antibodies specific for allogeneic platelets in the pregnant women cross the placenta and enter the fetus. In severe cases, intracranial hemorrhage and even fetal death may occur. This article reviews the recent progress in the following aspects: the mechanisms of pregnancy-related platelet alloimmunity, platelet destruction mechanisms in FNAIT, correlation of anti-angiogenic effects and intracranial hemorrhage, correlation between anti-GPIbα antibodies and miscarriage, and the diagnosis, treatment and prevention of FNAIT.

Objective To explore the effects of stress and self-efficacy on the quality of life in patients with gallstones and the effect relationship of self-efficacy in the quality of life and stress, and provide guidance for the health intervention of patients with gallstones. Methods Totally 362 patients with gallstones after operative that already returned to the community for 12 months were investigated, and their stress condition, self-efficacy and quality status of life were measured by the life events scale ( LES ) , self-efficacy scale and gastrointestinal quality of life index (GIQLI). The effect relationship of self-efficacy in the quality of life and stress was analyzed.Results The self-efficacy played partial mediating effect between stress and quality of life. When the intermediary variables-self-efficacy sense was participated in, the regression coefficient between stress and quality of life was significantly reduced (β was reduced from -0. 695 to -0. 548 ) . Self efficacy played regulating effect between stress and quality of life, which means that self efficacy sense × stress partial regression coefficient in the regression which regard the quality of life as the dependent variable can reach to a significant level (β=-0.086, P<0.05) , and introduced interaction terms after new interpretation (△R2 ) also can reach to a significant level (△R2 = 0. 017, P<0. 05 ) . Conclusions Self efficacy played the mediating effect and regulating effect in the relationship between stress and quality of life. Nursing staff can reduce the negative effects of stress events in patients′quality of life through the interventions in patients′self-efficacy.

Objective To inverstigate the effects of follow-up management based on social goals model on social relation quality in hepatocellular carcinoma patients after transcatheter arterial chemoebolization (TACE).Methods By convenience sampling method, a total of 113 patients after TACE were divided into the control group ( n=56) and the intervention group ( n=57) according to the treatment time. In the control group, routine follow-up based on case-management was adopted, while in the intervention group, the follow-up based on social goals model was adopted. The intervention effect in two groups were tested by social relation quality scale.Results After intervention, the total score of social relation quality, score of family adaptability and score of family commitment were (53.60±8.86),(20.34±3.28) and (18.07±2.96), and they were all significantly higher than the scores in the control group [(49.25±9.75),(18.52±3.55),(16.22±3.21)](P<0.05). Conclusions The follow-up management based on social goals model can effectively improve the level of family adaptability and family commitment. The intervention could be one of the effective ways to implement social relational quality fin patients after TACE.