Objective To investigate the changes and the significances of pregnant women with hypothyroidism companied with gestational diabetes mellitus.Methods 76 cases of hypothyroidism and subclinical hypothyroidism companied with gestational diabetes mellitus pregnant women admitted to our department from Sept 2014 to Mar 2016 were selected as the observation group.According to the levels of FT3,FT4 and TSH,the observation group were divided into two group(A group and B group).Cobas e601 was used to examine TSH and PT,APTT,TT,FIB and ATⅢ were determined with ACL-TOP.PLT,MPV and PDW were determined by Sysmex2000i.Results FIB (3.98±1.74 g/L),MPV (10.18±1.53 fl)and PDW (15.03％±1.54％)in A group were significant higher than those in B group (3.91±1.62 g/L,9.37±1.48 fl,14.41％± 1.35％％) and the control group (3.47±1.43 g/L,8.96±1.42 fl,13.67％±1.26％).FIB,MPV and PDW in B group was higher than those in the control group.PT (12.26±1.41 s,12.21±1.39 s) and APTT (31.80±8.72 s,30.43±8.54 s) in A group and Bgroup were higher than those in the control group (12.13 ± 1.32 s,29.24± 8.37 s).Otherwise,AT Ⅲ (78.47％± 10.36％,79.58％ ± 10.22％) in A group and B group was significant lower than that in the control group (86.56％±8.86％).There were distinct difference (t=3.072～6.153,P＜0.05).Conclusion The disorder of blood coagulation existed in pregnant women with hypothyroidism companied with gestational diabetes mellitus.Early diagnosis and intervention can reduce the occurrence of thrombotic disease and cardiovascular disease.

BACKGROUND: There are no effective treatments for spinal cord injury. Transplantation of olfactory ensheathing cells (OECs) has achieved great progress in repairing spinal cord injury. OBJECTIVE: To observe the effect of OECs transplantation on pathological and ultrastructural alterations of spinal cord, and the role in spinal cord injury developing.METHODS: A total of 60 SD rats were randomly divided into blank, model, transplantation and DF12 groups, with 15 animals in each group. The entire vertebral plate of T_(10), and partial vertebral plate of T_9 and T_(11) of blank group were cut open, and gelatin sponge was used for hemostasis. In the model group, the spinal cord was excised. In the transplantation and DF12 groups, OECs and DF12 culture solution were injected following spinal cord excision. The incision was sutured. Two rats from each group were anesthetized 1, 3, 7, 14, 28, 42, and 56 days following injury, and injured areas were observed by light microscopy and electron microscopy. RESULTS AND CONCLUSION: Following spinal cord injury, pathological and ultrastructural changes occurred, such as hemorrhage, edema, degeneration, necrosis, cavitation, gliacyte proliferation and nerve fiber regeneration. OECs transplantation attenuated neuronal and nerve fiber necrosis, relieved degree of pathological reaction, protected injured neurons, prevented gliacyte proliferation and increased nerve fiber regeneration. Results show that OECs transplantation ameliorated pathological reactions and promoted spinal cord injury repair.

Objective To compare the mental health among students of the Han,Y i,Ham,Dai,Lahu and Wa nationalities in Pu 'er Health school and provide the basis for mental health education of minorities.Methods A total of 2894 students of grade one and two,which are the Han,Yi,Hani,Dai,Lahu and Wa nationalities of Puer health school in Yunnan Provinc,were tested with SCL-90.And then an analysis was carried out by the characteristics among different nationalities on mental health.Results ①The psychological problem's ratio of minorities in Health school students was 40.3％.Detection rate of psychological problems in descending order is Wa 48 (55.8％),Dai 75 (41.4％),Yi 258 (41.0％),Hani,182 (40.2％),Han 557 (39.1％) and Lahu 46 (38.3％).The factor scores in descending order were obsessive-compulsive (38.6％),interpersonal sensitivity (33.2％),phobic anxiety (27.5％),hostility (25.3％),depression (23.6％),anxiety (22.4％),paranoid ideation (21.9％),psychotism (17.4％) and somatization (13.7％).②The ratio of psychological problems among different nationalities had shown significant differences (P＜0.05,P＜0.01) except for hostility factor.③In SCL-90,the scores of minority medical school students were all higher than those in the national youth norm.There existed significant differences among the most factor scores of SCL-90 (P＜0.01,P＜0.05).④The mental health of Wa was the worst.While,the mental health of Yi and Lahu were better than other ethnic groups.Conclusion The mental health of minorities medical school students is not optimistic.Therefore,the mental health education should be strengthened in the minority medical school students.

Objective To study the effect of field long march comprehensive training on freshmen' mental quality and mental health in military university. Methods Mental quality questionnaire for army men (MQQA), symptom checklist 90 (SCL-90), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and trait anxiety inventory (TAI) were carried out on 330 freshmen at various stages on their military training. All data were analyzed by paired-sample t test. Results ①As compared with pre-training, all SCL-90 factor scores except depression factor decreased significantly (P<0.05); compared to barracks military training, recruits revealed a decrease (P<0.05) in all SCL-90 factors except factors on fear, paranoia and mental disorder. ②The scores of SDS and SAS displayed a“V”shape as they decreased after the early rise at the course of military training. After the barracks military training, SAS and SDS scored high (P<0.01);Compared with pre-training, TAI scores dropped significantly (P<0.01) after field long march; compared with post barracks military traning results, SAS, SDS and TAI scores of recruits after field long march decreased significantly (P<0.05). ③After barracks military training and field long march comprehensive training, recuits' mental quality factors scored no significant distinction (P>0.05). Conclusion Filed long march effectively improved mental health of military university recruits and relived their anxiety as well as depression.

Objective To explore the mental health and its relationship with mental quality of training logistic soldiers in field.Methods Symptom Checklist 90(SCL-90) and Mental Quality Questionnaire for armymen (MQQA) were employed to evaluate the mental health and mental quality of 230 training logistic soldiers in field,and then an analysis was carried out on the characteristics of the training logistic soldiers on mental health and its relationship with mental quality.Results ①The psychological problem's ratio of training soldiers was 21.3％,and the ratio of the male(22.8％) was significantly higher than that of the female(15.2％) (x2 =8.64,P=0.00).In SCL-90,the scores of somatization (1.46 ± 0.63),hostility (1.49 ± 0.75) and psychotism (1.43 ±0.68) were all higher in training soldiers than the army norm.The factor scores of somatization (1.49 ± 0.66)and psychotism(1.46 ± 0.72) in the male training soldiers were considerably higher than those of the male soldiers norm (P ＜ 0.05),but not in the female(P ＞ 0.05).②There existed a significantly negative correlation between the factor scores of the mental quality and that of SCL-90 (P ＜ 0.05,P ＜ 0.01).③The SCL-90 scores existed clear differences in obsessive-compulsive,interpersonal sensitivity,depression,hostility and paranoid ideation among different mental quality groups (P ＜ 0.05).Conclusion The mental health of training logistic soldiers is poor.The mental health is closely related to the mental quality.Therefore,the mental health education and mental quality training should be strengthened to the training logistic soldiers.

Objective To explore the effects of group psychological training on mental health of military students and field soldiers.Methods A total of 60 students and 48 soldiers received group psychological quality training and studied a textbook Mental Quality Training for armymen for 3 months.Mental Quality Questionnaire for Amymen (MQQA),Symptom CheckList 90 (SCL-90),Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS) and State-Trait Anxiety Inventory(STAI) were employed to evaluate mental health and psychological quality of subject before and after the training.All the data were analyzed by independent-samples t test.Results (1) The difference in MQQA score of field soldiers before and after training was significantly larger than that of military students in loyalty and general score,and lower in willpower((-16.58 ± 7.75) vs.(-1.75 ± 8.68),(-27.74 ± 28.74) vs.(-12.57 ± 30.96),P ＜ 0.05).(2) The SCL-90 difference of field soldiers between before and after training was significantly larger than that of military students in hostility and phobic anxiety((0.26 ±0.47) vs.(0.07 ± 0.24),(0.13 ± 0.40) vs.(0.02 ± 0.13),P ＜ 0.05).(3) The difference in emotion score of field soldiers between before and after training was significantly larger than that of military students in SAS,SDS,SAI,TAI and STAI (P ＜ 0.01).Conclusion The effects of group psychological quality training on field soldier group are better than that of military students,which is helpful to improve mental quality and mental health,as well as to relax anxiety and depression of soldiers.

Objective To explore the mental quality developmental characteristics of cadets majored in military science and technology.Methods Mental Quality Questionnaire for army men (MQQA) and Symptom Checklist 90(SCL-90) were employed to evaluate 1771 cadets majored in science and technology,comparing mental quality differences related to gender,age,length of military service,grade and education level,etc.Results ① MQQA scores of cadets for aptitude (68.67±9.45),loyalty(75.98±8.97),bravery (68.46±9.12),self-confidence (65.72±6.61),willpower(67.7±8.33) and total score(345.90±37.79) were significantly higher than those of the army norm and the young army norm(P＜0.01).②There was significant age difference (P＜0.01) in MQQA scores.And the total score gradually increased with age.③There was significant length of military service difference (P＜ 0.01),and the total score decreased at the beginning 3 years and then increased later.④There was significant grade difference (P＜0.01) in MQQA scores.The scores of Grade One were significantly lower than those of Grade Two and Grade Four,but higher than those of Grade Three(P＜0.01) ; the scores of Grade Three were significantly lower than those of Grade Two and Grade Four(P＜0.01).⑤ There was significant education level difference (P＜ 0.01),and the scores of junior college students were significantly higher than those of undergraduates,graduate students and training students (P＜0.01) ; loyalty score of undergraduates was significantly higher than that of graduate students (P＜0.05) ; willpower score of graduate students was significantly lower than that of undergraduates and post-work training students (P＜0.05).Conclusion Cadets majored in science and technology have good mental quality,which is significantly influenced by age,length of military service,grade and level of education.

Objective To explore the mental health status and characteristics of professional degree postgraduates.Methods 326 professional degree postgraduates from 3 universities were selected as subjects by cluster sampling.Symptom checklist 90 (SCL-90) was applied to assess psychological health of the postgraduates in order.Results 1) The positive rate of psychological symptom screening was 11.11％.The detection rate of psychological problems from high to low was:obsessive-compulsion,interpersonal sensitivity,depression,hostility,somatization,paranoid ideation,anxiety,phobic anxiety and psychoticism.2) Excluding the factors of phobic anxiety,there was significant age difference in each factor score and total score of SCL-90 (P＜0.05).The somatization,interpersonal sensitivity,anxiety,hostility,paranoid ideation,psychoticism factor scores and total score of the "≥30 years" group was significantly higher than those of "≤24 years"and the "25-29 years" group (P＜0.05),the depression factor scores of "≥ 30 years" was significantly higher than the "≤24 years" group (P＜0.01).3) The scores of somatizations (P=0.038) and obsessive-compulsive factors (P=0.043) of doctoral students were significantly higher than those of master students.4) In different grades,there were significant differences in the scores of obsessive-compulsives,depression,anxiety,hostility,paranoid ideation factor scores and SCL-90 total score (P＜0.05).The factor scores and total score of the Grade Three were significantly higher than those of the first grade (P＜0.05),and the scores of hostilities,paranoid ideation factors and total score were significantly higher than those of the second grade (P＜0.05).5) Excluding phobic anxiety,the factor scores and total score of SCL-90 in the "peace and tranquility" group were significantly lower than those of "quarrel" group (P＜0.05).6) Except for somatization and paranoia ideation,the factor scores and total score of SCL-90 of caring group were significantly lower than those non-caring group (P＜0.05).Conclusion The psychological health of graduate students of professional degree varies with age,educational level and grade,and is influenced by collective atmosphere and mentor attitude.The differences in the characteristics of the crowd should be taken into full consideration in the mental health education of colleges and universities,and the educational model should be explored,the educational goals,contents and forms should be refined to improve the mental health level of the population.

Objective To investigate early diagnosis and treatment of Paget disease of breast. Methods The clinicopathological data of 26 cases of breast Paget disease in the First Affiliated Hospital of Wenzhou Medical University from January 1995 to June 2018 was analyzed. Results The main clinical manifestation of 26 patients was eczema like papillae in 19 cases (73.1%), and associated with nipple discharge in 9 cases (34.6% ) and breast mass in 6 cases (23.1% ). The diagnosis of this disease was based on curettage cytology in 4 cases (15.4% ), biopsy in 8 cases (30.8% ), and needle aspiration cytology or post resection pathological examination in 14 cases (53.8% ). Paget disease consisted of simple papillary Paget disease in 3 cases (11.5%), ductal carcinoma in 18 cases (69.2%) and invasive ductal carcinoma in 5 cases (19.2%). Pathological TNM staging was 0 stage in 19 cases (73.1%), stageⅠin 3 cases (11.5%), stageⅡin 2 cases (7.7%), stageⅢin 2 cases (7.7%) and no stage inⅣcase. In this group, 2 cases underwent radical mastectomy, 18 cases underwent modified radical mastectomy, 4 cases underwent simple mastectomy, and 2 cases underwent mastectomy combined with low axillary lymph node dissection and intraoperative rapid frozen examination. Fourteen patients received adjuvant chemotherapy with CEF(cyclophosphamide + pharmorubicin + tegafur)/EC (pharmorubicin + cyclophosphamide) + T(docetaxel) or TP(docetaxel + cis- platinum)regiment after operation, 2 cases were treated with trastuzumab targeted therapy and 5 cases with adjuvant radiotherapy. Twenty-five of 26 patients were followed up for 8-108 months except one patient lost in follow-up. The 5-year survival rate was 96.0% (24/25), and the 10-year survival rate was 52.0% (13/25). Conclusions The diagnosis of Paget disease of the breast depends on cytology or pathology, and multidisciplinary treatment based on surgery is judged of by tumor stage and coincident other types of breast cancer and axillary lymph node involvement.

Objective:To explore the risk factors of surgical site infection after posterior lumbar interbody fusion and internal fixation in elderly patients with lumbar degenerative diseases.Methods:The clinical data of elderly patients who underwent posterior lumbar interbody fusion and internal fixation for degenerative diseases of lumbar spine in Department of Orthopedics, Shanxi Bethune Hospital from January 2019 to December 2021 were retrospectively analyzed.Eighteen elderly patients with postoperative incision infection were included into the infection group, and according to the ratio of 1∶3, 54 elderly patients without incision infection during the same period were randomly selected and included in the non-infection group.The general data of patients, surgical related data and perioperative laboratory indexes were compared between groups using univariate analysis.The screened out indicators with close correlation with incision infection and with significantly statistical significance were included in binary Logistic regression analysis.Risk factors related to postoperative incision infection were analyzed by receiver operating characteristic curve(ROC).The quantitative data of risk factors related to postoperative incision infection were selected for receiver operating characteristic curve(ROC)analysis.Results:When comparing the infected versus non-infected groups, the operative time was(197.1±39.5)min vs.(171.4±37.2)min, preoperative lymphoid count was(1.6±0.5)×10 9/L vs.(1.9±0.6)×10 9/L, and postoperative neutrophil count was[(7.2(6.2-9.5)×10 9/L vs.6.3(4.8-7.2)×10 9/L], percentage of neutrophils(82.5±8.8), % vs.(71.1±6.7), percentage of lymphocytes(1.1±0.6)×10 9/L vs.(1.7±0.7)×10 9/L, percentage of lymphocytes(11.0±5.6)% vs.(19.8±6.0)%, number of neutrophils vs.Lymphocyte count ratio(NLR)[8.5(5.2-15.0) vs.3.6(2.6-4.9)]and serum albumin concentration(31.4±2.5)g/L vs.(33.3±2.4)g/L, all P<0.05).Logistic regression analysis showed that diabetes mellitus( OR=6.649, 95% CI: 1.233-35.853), operation time( OR=1.025, 95% CI: 1.004-1.047), and percentage of postoperative neutrophils( OR=1.261, 95% CI: 1.125-1.414)were independent risk factors of incision infection after posterior interbody fusion and internal fixation in patients with lumbar degenerative diseases(all P<0.05).ROC analysis showed that the area under the curve of operation time was 0.680, and the cut-off value was 177.5 min.The area under the curve of the percentage of neutrophils after operation was 0.841, and the cut-off value was 78.85%. Conclusions:In patients with posterior interbody fusion and internal fixation for lumbar degenerative diseases complicated with diabetes, long operation time, and increased percentage of neutrophils after surgery can independently increase the risk of incision infection.