Objective To investigate the variation of thyroid hormone therapy in patients with hypothyroidism before,during and postpartum pregnancy.Methods Thirty-eight patients who suffered from hypothyroidism and had successful pregnancy were collected.Among them,15 cases of hypothyroidism were caused by autoimmune thyroiditis caused,11 cases were induced by thyroid surgery; in 131I treatment induced hypothyroidism were 5 cases,7 patients had unclear reason pregnancy clinical thyroid dysfunctions.Thirty-eight cases of non-pregnant patients with hypothyroidism were also collected as the control group.They achieved efficacy standards by levothyroxine (L-T4) treatment and dose variation of L-T4 was statistically analyzed.Results There was a significant difference before pregnancy,postpartum and different periods of pregnancy.L-T4 dose had a significant increase after pregnancy.At 10-12 weeks,16-18 weeks,22-24 weeks,26-30 weeks,34-36 weeks respectively,L-T4 dose was significantly increasing compared with before pregnancy and postpartum 3 months((110.51 ± 10.42),(113.81 ± 21.04),(108.32 ± 21.01),(105.58 ±21.54),(105.89±10.24),(84.42 ±10.45) and (86.43 ±10.29) μg/L,F=15.631,P＜0.001),but between before and pregnancy postpartum,there was not significantly difference (P ＞ 0.05).Among the various stages of pregnancy,there was also no significant difference; In the patients with hypothyroidism due to thyroid surgery and 131I therapy,L-T4 dose were significantly higher than autoimmune thyroiditis and patients with no clear reason(before,during and after pregnancy,F =4.98,5.15,5.04,P ＜ 0.001).Conclusion Patients with hypothyroidism during pregnancy should increased therapeutic dose of thyroid hormone with average about 30％-40％ of the original dose,and in postpartum,levels before pregnancy could resume.High doses of L-T4 treatment should be taken in patients with hypothyroidism after 131I therapy and after thyroid surgeries.

Through decades of innovation and transcendence,foreign medical universities consistently promoted integration of medicine and humanities and carried out curriculum and teaching reform.Both the ideas and measures are advanced and worthy study.Currently,the development of medical humanities education in China is confronted with difficulties.Medical students need to promote their humanistic quality urgently.The study explored the effective measures to innovate and transcend by analyzing the advancement of foreign medical humanities education and problems of medical humanities education in China.

Currently, the widespread use of new media challenges ideological and political education among the medical students. The study explores the effects on medical students' values by new media on the basis of analyzing its characteristics, including communication space, information, subject and route. In addition, the study analyzes the mode's theoretical construction and practical op-eration from these aspects:the mode's connotation, operation mechanism, the characteristics and prac-tical application.

Acupuncture and moxibustion is classified as category of alternative medicine and has been incorporated into the public medical institution in Oman. There are two public hospitals which have set up acupuncture and moxibustion service at present, but only in outpatient department regions. Private clinics of traditional Chinese medicine are not uncommon, and the local government is constantly improving the management policy on it now. The musculoskeletal system diseases are predominant diseases treated by acupuncture and moxibustion, and obesity female is mostly common. Compared with other Arabian countries, Oman is more inclusive to foreign culture and the local government attaches great importance to acupuncture and moxibustion, so there is much better development space for acupuncture and moxibustion in Oman.

BACKGROUND:Doubld-action hemiarthroplasty and total hip arthroplasty are reliable methods to treat intertrochanteric fracture of femur in the elderly, but which is better remains controversial in the clinic. OBJECTIVE:To observe the practical effect of prosthetic replacement with different methods in treatment of intertrochanteric fracture of femur in the elderly, and to assess the clinical value. METHODS:A total of 54 elderly patients with intertrochanteric fracture of femur at the age of over 65 years old were randomly assigned to two groups. In the observation group (n=27), patients underwent graded cement double-action arthroplasty. In the control group (n=27), patients received cementless total hip arthroplasty. They were folowed up for 2 years. Harris scores were recorded in the two groups so as to assess the therapeutic effects. Folow-up recurrence rate, adverse events and host response to materials were analyzed. RESULTS AND CONCLUSION: The therapeutic effects were similar between the observation and control groups (89%, 81%;P > 0.05), but recurrence rate of 2-year folow-up was significantly lower in the observation group than in the control group (4%, 30%;P < 0.05). Moreover, dislocation, acetabular wear and loosening were not found. Results indicate that the midterm effects were similar between graded cement double-action arthroplasty and total hip arthroplasty in treatment of intertrochanteric fracture in the elderly, but graded cement double-action arthroplasty significantly decreases the recurrence rate.

BACKGROUND:General anesthesia or continuous epidural anesthesia can be commonly selected for lower limb joint surgery in the elderly. The effect of epidural anesthesia is precise, and can be easily controled. The effect of muscle relaxation is good. However, the time of anesthesia induction is relatively long, and it is not ideal in the control of pain in the visceral peritoneum reflection region. Moreover, circulatory system interference can be greatly affected by lumbar anesthesia. OBJECTIVE:To evaluate the effects of combined spinal-epidural anesthesia with ropicavaine in elderly patients undergoing lower limb arthroplasty. METHODS: Ninety patients undergoing lower limb arthroplasty admitted to Heze Municipal Hospital from September 2013 to November 2014 were chosen and were equaly and randomly assigned to two groups, including 52 cases of knee replacement and 38 cases of hip replacement. Patients in the control group received continuous epidural anesthesia. Patients in the observation group received combined spinal-epidural anesthesia with ropicavaine. Vital signs, onset time of anesthesia, drug consumption, analgesic effect and postoperative side effects were observed and compared in both groups. RESULTS AND CONCLUSION:Heart rate, pulse, and arterial oxygen saturation were significantly lower in the control group than in the observation group. Vital signs in the observation group were more stable, and the significant difference was detected between the two groups (P < 0.05). Onset time of anesthesia and drug consumption were significantly better in the observation group than in the control group, showing very significant differences between the two groups (P < 0.01). The excelent and good rate of analgesic effects was lower in the control group (67%) than in the observation group (89%), which showed significant differences between the two groups (P < 0.05). In the control group, vomiting appeared in 10 cases and dyspnea appeared in 4 cases, with an incidence of side effect of 31%. In the observation group, vomiting appeared in 3 cases and dyspnea in 2 cases, with the incidence of side effects of 11%. The incidence of side effect was significantly higher in the control group than in the observation group (P< 0.05). These data indicate that combined spinal-epidural anesthesia with ropicavaine showed good analgesic effect in elderly patients receiving lower limb arthroplasty. The onset time of anesthesia was short. Drug consumption was low. The incidence of side effects was low.

Resveratrol is a polyphenol phytoalexin presents in a variety of plant species.Many studies have shown that resveratrol exerts neuroprotective effects.This article reviewes the neuroprotective mechanisms of resveratrol in cerebral ischemia from the aspects of antiapoptosis,antioxidant and antiinflammatory.