Abnormal thyroid function is high risk for pregnancy.Studies from clinical observation and animal experiments have indicated that maternal sub clinical hypothyroidism during the first gestational term may lead to impairment of brain development of offspring,and early diagnosis and effective treatment may prevent the damage.Therefore,it is suggested that screening thyroid function before gestational 8 weeks in pregnant women is initiated.The changes in thyroid function during pregnancy are related to these changes in maternal thyroid physiology can lead to confusion in the diagnosis or evaluation of thyroid abnormalities.Establishment of trimester-specific reference ranges is urgently needed.Local iodine nutritional statue and testing reagent effect the measured value of thyroid function in general population,so it is recommend that all regions and hospitals should establish their own pregnancy reference ranges.

ObjectiveTo investigate the high risk factors,etiology,diagnosis,treatment and precaution of venous thromboembolism (VTE) in pregnancy and puerperium. MethodsData of 16 cases of VTE admitted in Department of Obstetrics and Gynecology,Peking Union Medical College Hospital from January 1992 to April 2011 were analyzed retrospectively.The differences of blood routine test and coagulation function between VTE patients (study group) and normal pregnant women (control group) were compared by paired t test in this case-control study.Results All patients were diagnosed by color Doppler ultrasound or CT pulmonary artery angiography.Five cases (31.2 ％) occurred before delivery and 11 (68.8 ％) occurred during postpartum.Two cases (12.5 ％)complicated by pulmonary thromboembolism,and one of them died.Six cases (37.5％) were older than or equal to 35 years old,and 12 cases (75.0％) had gestational complications.The hematocrit in study group were lower than that in control group (0.29±0.06 vs 0.39±0.02,t=4.56,P=0.01).There was no statistical difference between the coagulation function of the two groups.After anticoagulant therapy or surgery,15 cases recovered.One pulmonary thromboembolism patients complicated with rheumatic cardiac disease remained shock after anti-coagulants was administered,then died of hemorrhage of respiratory tract after inferior vena cava filter placement. Conclusions VTE is likcly to happen in puerperium than in pregnancy.There are no good screening indicators for thromboembolism during pregnancy and puerperium.Anticoagulation is recommended to be the first line therapy.For women with high risk of thromboembolism,it is suggested to prevent actively and treat early to decrease the complications and long-term sequelea.

Objective · To evaluate the clinical characteristics of endometrial pathology in postmenopausal women with asymptomatic thickened endometrium. Methods · A retrospective review was conducted of the patients between October 2013 and October 2015 in the International Peace Maternity & Child Health Hospital. The postmenopausal women with asymptomatic thickened endometrium of 5 mm or more found by transvaginal ultrasonography were recruited. They underwent hysteroscopy and endometrial sampling to analyze the relationship between endometrial pathology and endometrial thickness. Results · A total of 257 patients were recruited. The average age was 61.3 years old, the average menopause period was 122 months, and the average endometrium thickness was 8.6 mm. The endometrial pathology included normal atrophic endometrium, endometrial polyp, submucous myoma, intrauterine adhesion, uterine septum, endometrial hyperplasia and endometrial cancer. The most common pathological type was endometrial polyp, accounting for 66.9% of the all patients and 83.9% (172/205) of all pathological types. Three cases of adenocarcinoma (1.2%) were diagnosed. There was significant difference in endometrial thickness among normal endometrium, endometrial polyp and endometrial cancer (P<0.05). The endometrium in endometrial cancer was the thickest, which was (13.20±5.38) mm averagely. There was significant difference in ages among the pathological types (P=0.004). Conclusion · There are few patients of malignancy among asymptomatic postmenopausal women with thickened endometrium. Follow-up visits were recommended to these women.

Objective To investigate the changes in cells on cell cycle,cell apoptosis and susceptibility to chemotherapeutic drugs of lung adenocarcinoma A549 cells under two dimensional (2D system) and three dimensional (3D system) culture conditions. Methods The three dimensional culture of A549 cells was carried out using rotatable culture bottle and desk-top water bath shake. Flow cytometer,in situ cell apoptosis detection kit,MTT and blood cell counter were employed to compare cell cycle,cell apoptosis and susceptibility to ADM of A549 cells under different culture conditions. Results The three dimensional culture system was confirmed to have been successful by the aid of observation under inverted and electron microscope. There were significant retardation of G_ 1 phase,lower cell apoptosis rate and decreased susceptibility to ADM in A549 cells in 3D system compared with those in 2D system. Conclusions There were remarkable differences in biological characteristics of A549 cells in two culture systems,indicating that A549 cells cultivated in 3D system simulated better solid tumor in vivo . The 3D system was very useful for further investigation of the behavior of solid tumor,so that anti-carcinoma chemotherapeutic drugs could be advantageously tested in vitro before clinical application.

Objective To analyze the hidden blood loss following primary total hip arthroplasty (THA) and put forward corresponding treatment measures.Methods A retrospective study was done on the 138 patients with hip disease managed with THA for the preliminary unilateral replacement from January 2009 to January 2011.There were 48 males and 90 females,at age range of 45-71 years (mean,62 years).The pre-and post-operative blood routine and intra-and post-operative blood loss and transfusion were analyzed and hidden blood loss during peri-operation period was evaluated.Results All the patients were trnsfused with autologous blood intra-operatively.Intra-operative blood loss was (495 ± 105) ml and postoperative drainage volume was ( 121 ±29) ml.In addition,116 patients were given red cell suspension (RCS) and blood plasma to raise the level of hemoglobin and the RCS transfusion volume was (600 ± 225) ml.The total blood loss was (1 521 ±156) ml including hidden blood loss of (822 ±96) ml (57.2％).No obvious differences were observed in the indicators between males and females.Conclusions Hidden blood loss is an important factor that affects the prognosis of the patients treated by THA.In order to secure their safety in perioperative period and benefit their recovery,assessment of the amount of bleeding in THA should fully take the hidden blood loss into consideration and prompt treatment measures should be taken to fully and effectively recover their effective circulation blood volume.

Objective To find an effective method for the treatment of mitomycin C extravasation injuries. Methods The rabbit model of mitomycin C extravasation was made and managed by different methods. The therapeutic efficacy in each group was assessed by using regression index and regression time. Results The therapeutic efficacy in ice compress group and ice compress plus amifostine group was better than that in other groups and the regression time was the shortest. There was no inflammation and necrosis in skin in ice compress group. Conclusion Ice compress, which can prevent inflammation and necrosis in skin, is one of the most effective treatment methods for mitomycin C extravasation injuries.

Objective To study the mechanism of multicellular drug resistance of pulmonary adenocarcinoma cell line A549 mediated by cell-cell adhesion. Methods We compared the sensitivity of monolayer cells (MCs) to adriamycin (ADM) with that of multicellular spheroids (MCSs) which was employed as a three dimensional cell culture model. Transmission electron microscopy was applied to observe the cellular ultrastructure. Bcl-2, Bcl-xL, and Bax expression levels were detected by flow cytometry and indirect immunofluorescent staining. Results Compared with MCs, MCSs had more than two layers of cells, more extensive and compact cell adhesion, and inlay junctions were found within them. MCSs were more resistant to ADM. At the same time, Bcl-2 and Bcl-xL expressions in MCSs were much higher. After treatment with ADM, expressions Bcl-2 and Bcl-xL increased markedly in MCSs. Conclusion MCSs could simulate the solid tumors in vivo and has multicellular drug resistance mediated by cell-cell adhesion. The possible mechanisms may be associated with the upregulation of Bcl-2 and Bcl-xL.

AIM:To investigate the effect of TSM tablet on rat's atherosclerotic model's endothelial cell and explore the mechanism of it.METHODS:Fifty Wistar rats were randomly assigned into five groups:control group,model group,Simvastatin group,TSM high group,TSM low group.All groups were fed with high fat diet and vitamin D3 except for control group to set up atherosclerosis model.After 12 weeks we detected circle endothelial cell,angiotensinⅡ and electron microscopy morphology of arteries.RESULTS:Level of circulating enthelia cell(CEC) and AngⅡin model rats were significantly higher.TSM can reduce level of the CEC and AngⅡ.Model group rat's artery endothelial cells were severely damaged under electron microscopy;rat's artery endothelial cellsin TSM group were basically intact and its internal elastic membrane was unbroken on it thickness was even,without significant lesion.CONCLUSION:TSM by reducing the number of CEC,the level of AngⅡ used for experimental atherosclerotic endothelial cell in rats has the protective effect.

ObjectiveTo investigate the clinical features and pregnant outcomes of the pregnant women with congenital adrenal hyperplasia (CAH) 21-hydroxylase deficiency (21-OHD).MethodsThe clinical features,therapies,pregnant outcomes of the pregnant women with 21-OHD were retrospectively reviewed in Peking Union Medical College Hospital,from January 2005 to April 2011.ResultsThere were 8 pregnant womenwith 21-OHD including 5siinplevirilizing patientsand 3nonclassical 21-OHD women.Eightpatientswereacceptedprogestationalandprenatalcontinuallowerglucocorticoid treatment.During the gestational period,the dosage of glucocorticoid was adjusted in one pregnancy.The serum level of 17-alpha hydroxyprogesterone (17-OHP) were elevated after pregnancy [ (70 ± 38 ) versus (24 ±23) nmol/L,P ＜ 0.05].The fertility and offspring rate of 8 patients was 8/12,the fertility and offspring rate of patients who started treatment at preadolescence was significantly increased (4/5 versus 4/7).Four patients were accepted genital reconstructive surgery ( clitorectomy,clitoroplasty,vulvoplasty) before pregnancy.The incidence of GDM was 1/8.All patients selected caesarean at from 37 +6 gestation weeks to 39+6 gestation weeks.The average newborn birth weight was (3210 ± 447 ) g,and height was (48 ±2) cm of 8 neonates,none of them was CAH.Conclusions Medical and surgical therapy provides satisfactory fertility and pregnancy outcomes for women with 21-OHD.It is safe to pregnant women with 21-OHD and their fetus in continual lower glucocorticoid treatment.The dosage of glucocorticoid should be carefully adjusted during the pregnancy individually according to serum level of 17-OHP.