Objective To discuss the influence of gestational hypothyroxinemia to the pregnancy outcomes and fetus development,and find the evidence of hormone replacement therapy.Methods The clinical data of 1141 gravida admitted from Nov.2014 to Oct.2015 were retrospectively analyzed,including the data of systematic antenatal examination,all the data of pregnancy,the materials of delivery,the last ultrasound examination,production status and the thyroid stimulating hormone (TSH) of the newborn etc.,to find the difference of related index.Results Of the 1141 gravida with integral data,200 had past history of thyroid disease,189 showed below normal of free thyroxine (FT4) and 752 were normal ones.The 189 gravida with normal TSH but lower FT4 were divided into group A (0-5％ lower than the normal FT4 value,n=60),group B (5％-10％ lower than the normal FT4 value,n=40) and group C (10％ and above lower than the normal FT4 value,n=89).The ones with both normal TSH and FT4 value served as control group.Compared to the control group,the higher premature delivery rate,incidence of gestational diabetes mellitus and cesarean delivery rate (P＜0.05) were found in group C,and more gravida in group B had a history of hypertension and dyslipidemia during pregnancy (P＜0.05).The cesarean delivery rate of group B and C were higher than group A.Meanwhile,the rate of group B was higher than control group (P＞0.05).At delivery,the maternal weight,BMI,diastolic pressure,and head circumference of fetus in the last ultrasound examination were higher in group C than in control group (P＜0.01),but the gestational weeks of the newborn were shorter in group C (38.55 ± 1.86 weeks) than in control group (39.14 ± 1.57 weeks,P＜0.01).The 189 gravida with lower FT4 were divided into two groups according to the thyroid peroxidase antibody (TPOAb) level.The head circumference of fetus in the last ultrasound examination was higher in TPOAb(+) group than in TPOAb(-) group (45.99 ± 62.36cm vs.33.23 ± 2.08cm,P＜0.01).Conclusions The influence of gestational hypothyroxinemia to pregnancy outcomes and fetus development cannot be ignored,especially for the pregnant women with lower FT4 value (10％ and above lower than the normal) or with positive TPOAb.It is suggested to take the thyroid function test in the early stage of pregnancy for those pregnant women mentioned above.

Aim To compare the effects of the non-peptide angiotensin Ⅱ receptor type Ⅰ antagonist,Losartan,and the active vascular peptide,calcitonin gene-related peptide(CGRP),on the proliferation of vascular smooth muscle cells induced by angiotensin Ⅱ,and to explore the mechanism of depressor effect of Losartan and CGRP in vivo.Methods MTT,Thymidine incorporation and flow cytometry,were used to determine the ability of proliferation of VSMC induced by angiotensin Ⅱ in the presence or absence of Losartan or CGRP,Western blotting was used to determine the activity of ERK1/2.Results Losartan or CGRP inhibited the viability,DNA synthesis,cell proliferation index,and the activity of ERK1/2 in a dose-dependent manner.Conclusion Losartan or CGRP significantly inhibits the proliferation of VSMC induced by angiotensin Ⅱ;the inhibitory effect of CGRP is stronger than that of Losartan.The signaling path way is involved in ERK1/2.

Objective To compare percutaneous suturing with sponge forceps and open suturing for repair of acute closed Achilles ruptures.Methods From March 2011 to June 2014,40 patients with acute closed Achilles rupture were enrolled in this study and randomized into 2 equal groups (n =20) which were subjected to percutaneous suturing with sponge forceps or open suturing.The operative time,incisive length,blood loss,wound healing,hospitalization time and complications were compared between the 2 groups.Their ankle functions were evaluated at postoperative 3,6,and 12 months according to American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores.Results The operative time (median,60.0 min),hospitalization time (median,8.5 d) and incisive length (median,8.0 cm) in the open suturing group were significantly greater than those in the sponge forceps group (32.5 min,7.0 d and 1.5 cm) (P ＜ 0.05).The blood loss (15.1 ± 13.7 mL) in the sponge forceps group was significantly less than in the open suturing group (54.2 ± 33.9 mL) (P ＜ 0.05).The open suturing group received an average follow-up of 16.8 months (from 12 to 23 months),witnessed superficial skin infection in 3 cases,and obtained AOFAS scores of 91.2 ± 5.1,95.2 ± 2.8 and 97.8 ± 1.6 at 3,6,and 12 months postoperatively.The sponge forceps group received an average follow-up of 15.6 months (from 12 to 24 months),witnessed wound healing in all cases,and obtained AOFAS scores of 90.6 ±5.3,94.I ±2.6 and 97.0 ±2.6 at 3,6,and 12 months postoperatively.The sponge forceps group obtained insignificantly lower AOFAS scores than the open suturing group (P ＞ 0.05).No injury to the sural nerve or tendon rerupture happened in either group.Conclusions In treatment of acute closed Achilles ruptures,compared with open suturing,percutaneous suturing with sponge forceps may be relatively easier without using special equipment,and additionally,may lead to lower incidence of incision complications and better short-term efficacy.

Objectives To evaluate the lung function in patients of severe secondary hyperparathyroidism caused by uremia and to analyze related factors.Methods The pulmonary function of 70 patients with uremia ( 40 patients with severe secondary hyperparathyroidism, 30 MHD patients without SHPT) and 30 healthy people was determined.Correlative analysis was performed between parameters such as pulmonary function indexes and clinical or laboratory parameters. Results Lung function was significantly different between patients with uremia and healthy subjects(P<0.05, respectively). A number of lung function indicators were negatively correlated with iPTH,C reactive protein( CRP) ,dialysis age but were positively correlated with hemoglobin (Hb) and albumin(Alb) (P <0.05).Conclusion Patients with SHPT show impaired lung function.IPTH, dialysis age, Hb, Alb and CRP can be used as important indicators of lung function.

Aim To explore the effect of receptor component protein(RCP)in the signal transduction of vascular smooth muscle cell(VSMC)proliferation induced by static pressure.Methods The mouse-derived vascular smooth muscle cell line(A10VSMC)was employed in the experiment.Cells were exposed to static pressure,and MTT assay was used to detect the cell viability.Western blot was used to determine the expressions of PCNA,RCP and p-Akt,RCP mRNA was tested by RT-PCR,and co-immunoprecipitation was used to test the interaction between RCP and G proteins.Results The cell viability,expressions of PCNA and RCP increased with the elevation of static pressure and reached their peaks at 120 mmHg,and after 6 hours they got a plateau.The static pressure significantly increased the level of p-Akt,meanwhile,the binding of RCP and Gαs significantly decreased.However,the binding of RCP and Gβ increased in response to static pressure after stimuli of static pressure,but Gγ was obscure.Conclusion Static pressure can induce VSMC proliferation and expression of RCP,which may involve G protein signal transduction model.

Objective To observe the effect of vancomycin-loaded calcium sulfate for one-stage treatment of chronic osteomyelitis.Methods A retrospective case series study was made on 26 patients with chronic osteomyelitis treated from January 2014 to April 2016.There were 23 males and 3 females,with a mean age of 35.8 years (range,16-90 years).After focus debridement of osteomyelitis,the cavities were filled with vancomycin-loaded calcium sulfate and systemic antibiotics were used.Meanwhile,gentamicin was added to patients showing unclear pathogens.Three patients underwent flap transfer surgery simultaneously due to the inadequate soft tissue coverage.Wound healing,local redness and swelling,sinus recurrence,recovery of osteomyelitis and repair of bone defect were detected after operation.Results All patients were followed up for 6-30 months (mean,19.5 months).Primary healing was achieved in all patients.One patient experienced wound exudate and was effectively managed by dressing change,one patient experienced inadequate local soft tissue coverage and was effectively managed by a second flap transfer surgery,and one patient remained wound unhealing after two surgeries and was cured by infected bone resection using the Masquelet induced membrane technique.Follow-up showed local bone defect was repaired in all patients without bone infection recurrence.Conclusions For patients with chronic osteomyelitis,one-stage surgery with vancomycin-loaded calcium sulfate can control infection with simultaneous repair of bone defect.Therefore,the procedure is a simple and effective method and worthy of clinical practice.

Objective To observe the effects of 630 nm red light and 460 nm blue light emitting diode irradiation on the healing of skin wounds in Japanese big-ear white rabbits. Methods The skin wound model was established with 8 Japanese big-ear white rabbits. Three parts of vulnus in each rabbit were used:two parts of vulnus were irradiated vertically by red and blue LED light,respectively(15 min/time),and the distance between lights and wounds was 15 cm;the 3part of the wound was used as a control. On the 21day of the wounds exposure to light,the number of healing wounds and the percentage of healing area were recorded and the treatment effect of these two light sources was compared. HE staining was used to analyze the newborn tissue structure. Masson staining was used to observe the proliferation of skin collagen fibers. Immuohistochemical staining was used to analyze fibroblast growth factor(FGF),epidermal growth factor(EGF),endothelial growth factor(CD31),proliferating cell nuclear antigen(Ki-67),and inflammatory cytokines(CD68)infiltration in the skin. Results The healing rate in the red light,blue light,and control groups was 50.0%(4/8),25.0%(2/8),and 12.5%(1/8),respectively. Since the 12day after modeling,the healing area percentage in the red light group was significantly higher than those in the blue light and control groups(P<0.05,P<0.01). On the 21day after modeling,the skin thickness of the red light group was(2.95±0.34)mm,which was significantly higher than that in control group [(2.52±0.42)mm;F=3.182,P=0.016)]. The average optical density of collagen fibers was 0.15±0.03 in red light group,which was significantly higher than that of the blue light group(0.09±0.01;F=7.316,P=0.012)and control(0.07±0.01;F=7.316,P=0.003). The results of immunohistochemistry showed the expression levels of EGF,FGF,CD31 antigen,and Ki-67 in the red light group were significantly higher than those in the blue light and control groups,whereas the CD68 expression was significantly lower(P<0.05 or P<0.01). Conclusion LED red light irradiation can promote the healing of skin wounds in Japanese big-ear white rabbits,which may be achieved by the effect of red light irradiation in stimulating the proliferation of skin epidermal cells,vascular endothelial cells,and fiberous tissue.

Objective To evaluate the efficacy of Ganoderma lucidum preparation on the behaviors,biochemistry,and autoimmunity parameters of mouse models of APP/PS-1 double transgenic Alzheimer's disease(AD).Methods A total of 44 4-month-old APP/PS-1 double transgenic AD mice were randomly divided into AD model group,Aricept group,Ganoderma lucidum middle-dose(LZ-M)group,and Ganoderma lucidum high-dose(LZ-H)group,with 11 mice in each group.In addition,10 4-month-old C57BL/6 mice were used as the control group.Water maze test was conducted to observe the behavior changes,and the protein expressions in brain tissues were detected by Western blot analysis.The autoimmune indicators were detected by indirect immunofluorescence method.Results In the navigation experiment,the time of finding the platform was gradually shortened since the 2day in the control,LZ-H,and LZ-M groups,and the time of searching the platform in the AD model group gradually increased.On the 5day,the time of finding platform was significantly shorter in control group (t=5.607,P=0.000) and LZ-H group(t=2.750,P=0.010)than AD model group.In the space exploration experiment,the number of crossing the target platform(t=2.452,P=0.025)and the residence time in the target quadrant(t=2.530,P=0.020)in AD model group mice was significantly smaller/shorter than those in control group;in addition,the number of crossing the target platform in the AD model group was significantly smaller than that in LZ-H group(t=2.317,P=0.030)and LZ-M group(t=2.443,P=0.030),while the residence time in target quadrant decreased significantly(t=2.770,P=0.020)compared with LZ-H group;the number of crossing through the target platform quadrant(t=2.493,P=0.022)and residence time in the target quadrant(t=2.683,P=0.015)in LZ-H group were significantly higher than in Aricept group.Western blot analysis showed that the expression of ApoA1 in the brain tissues of mice in LZ-H and LZ-M groups were significantly higher than those in AD model group(P<0.01,P<0.05);Aβ-40 expression in LZ-H group was significantly lower than that in AD model group(P<0.05);the expressions of Syt1,ApoE,and ABCA1 in brain tissues of mice in LZ-H group were significantly higher than those in model group(P<0.01,P<0.05).The plasma IgG level in Aricept group(t=30.945,P=0.000),LZ-M group(t=25.639,P=0.000)and LZ-H group(t=4.689,P=0.001)were significantly higher than that in the control group.Conclusion Ganoderma lucidum preparation can improve behavior disorders of AD model mice,promote the expressions of ApoA1,ApoE and Syt1,inhibit the expression of Aβ-40 protein,and improve the autoimmune function.

Objective To investigate the risk factors of hyperbilirubinemia in late preterm infants. Methods The clinical data of 815 late preterm infants (449 males and 366 females) from 25 hospitals in Beijing were collected from October 2015 to April 2016, including 340 cases(41.7％) with hyperbilirubinemia (hyperbilirubinemia group), and 475 cases without hyperbilirubinemia (control group). The clinical data of two groups were compared, and the maternal factors influencing hyperbilirubinemia in late preterm infants were analyzed with logistic regression. Results There were no significant differences in gender ratio (M:F 1.39 vs. 1.12, t=1.811,P=0.172)and birth weight[(2502.6±439.6)g vs. (2470.2±402.9)g,χ2=2.330,P=0.127)]between two groups. The incidence rates of hyperbilirubinemia in infants of 34 wks, 35 wks and 36 wks of gestational age were 22.9％(87/174), 35％(119/300) and 42.1％(143/341) respectively (χ2=1.218,P=0.544). The multivariate logistic regression analysis indicated that the maternal age(OR=1.044,95％ CI:1.010-1.080,P=0.011)was independent risk factor and multiple births(OR=1.365,95％CI:0.989-1.883,P=0.048), premature rupture of membranes(OR=2.350,95％ CI:1.440-3.833,P=0.001), cesarean section(OR=1.540,95％CI:0.588-4.031,P=0.014)were risk factors for hyperbilirubinemia in late preterm infants. Conclusions The incidence of hyperbilirubinemia in late preterm infants is relatively high. Maternal age, multiple births, premature rupture of membranes and cesarean section are risk maternal factors related to hyperbilirubinemia in late preterm infants.

Objective:To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods:The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group (237 cases) and the control group (722 cases) according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results:Among the 959 late-preterm babies, 530 were male and 429 were female.Two hundred and thirty-seven cases (24.7%) developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases (81 cases, 8.4%), followed by transient tachypnea (65 cases, 6.8%), amniotic fluid aspiration (51 cases, 5.3%), and respiratory distress syndrome (24 cases, 2.5%) successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups (all P>0.05). Compared with the control group, more late-preterm infants were delivered by cesarean section (73.4% vs.59.7%, χ2=14.43, P<0.001) and the 1-minute Apgar score was lower [(9.41±1.66) scores vs.(9.83±0.53) scores, t=5.40, P<0.001] in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group (66.7% vs.58.6%, χ2=4.877, P=0.027), but no difference in various complications between 2 groups was observed ( P>0.05). In the respiratory morbidity group, the most frequent complications were maternal hypertension and preeclampsia (27.8% vs.22.6%, χ2=2.728, P=0.099). There were no differences between 2 groups in gestational age, birth weight and birth length (all P>0.05). There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group (18.8% vs.14.1%, 6.3% vs.2.4%, χ2=8.960, P=0.011). The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the control group [(9.00±4.42) d vs.(6.82±4.19) d, t=6.676, P<0.001] since the infants with respiratory morbidity needed to be hospita-lized. Conclusions:Respiratory diseases occur in about 1/4 of late-preterm infants.Infants who are delivered by cesarean section and whose mothers are complicated with the maternal hypertension and preeclampsia should be monitored closely.Respiratory support should be provided for infants not appropriate for gestational age who are more likely to suffer from respiratory diseases, so that they can successfully pass through the transition period.