Objective To investigate effect on patients with chronic heart failure complicated with euthyroid sick syndrome(ESS) who had given small dose of levothyroxine sodium that based on the routine anti heart failure therapy.Methods 70 patients with chronic cardiac insufficiency and ESS were randomly divided into control group and treatment group,the control group patients were given routine anti heart failure treatment,while the treatment group plus levothyroxine sodium tablets for 1year.Observe and compare the relevant examination and laboratory indexes of 2 groups before and after treatment,follow up the number of vascular events about 2 groups within 1year.Results The 6 minutes walk test [ Respectively:(383.0 ± 48.7 ) m,(339.3 ± 37.8 ) m ],NYHA heart function classification[ Respectively:(2.7 ± 0.4)grade,(3.2 ±0.5) grade],LVEF[ Respectively:(40.87 ± 8.18)％,(35.38 ± 7.35 ) ％ ],BNP [ Respectively:( 197.74 ± 20.58 ) ng/L,( 302.01 ± 10.15 ) ng/L ] water of the treatment group [Respectively:(317.0 ± 36.6)m,(323.4 ± 44.8)m,(3.5 ± 0.5) grade,(3.5 ± 0.3) grade,(33.18 ± 7.29)％,(34.74 ± 9.81 ) ％,( 369.75 ± 21.15 ) ng/L,(345.56 ± 18.65 ) ng/L] and the control group were better than before treatment.The treatment group was more significant,the two groups after treatment had a significant difference ( t=2.974,3.698,9.136,7.476,all P ＜ 0.05 ),the number of cardiovascular events of the treatment group was decreased within 1 year,compared with the control group the difference was statistically significant (x2 = 4.96,P ＜ 0.05 ).Conclusion In the treatment of conventional heart failure therapy combined with a small dose of levothyroxine sodium therapy on chronic heart failure patients can improve the patients' quality of life,reduce medical costs.

The article reviewed the function of general practitioners in Beijing Jiaotong University Health Service Center, which was transitioned from sole curative service to both curative and preventive services. The article also discussed the role as gatekeeper for health system played by practitioners in university health service centers.

OBJECTIVE:To provide optimal therapeutic scheme for patients with acne vulgaris. METHODS: By a single-blind randomized controlled method,a total of 122 patients with acne vulgaris were assigned to one of the following 3 groups: tazarotene cream group(n=42),Water chlorine tincture group(n=38) and combined treatment group(n=42). The curative efficacy was observed after treatment for 8 consecutive weeks. RESULTS: The number of skin lesions in all the 3 groups reduced as the course of treatment increased,and there were significant differences across the 3 groups after 8-week treatment as compared with before treatment (P0.05). CONCLUSION: Tazarotene cream is effective for non-inflammatory acne. The superior efficacy of water chlorine tincture as compared with tazarotene for patients with impetigo might be related to the antibacterial action of chloramphenicol. Tazarotene cream combined with local application of 0.5% water chlorine tincture is effective for inflammatory acne.

Objective To utilize air pressure for slimming. Methods The external counterpulsation was taken as the master, the non-motivity of which was utilized to develop special air pressure slimming unit based on the structure of human body and physiological characteristics. Results The air pressure slimming unit could work on the existing external counterpulsation with desirable results. Conclusion The air pressure slimming unit can be used not only on the existing external counterpulsation, but on other pneumatically operated equipment with control circuit. As aerobics, the working mode of air pressure slimming unit is a kind of long time and passive aerobic exercise with fixed position, frequency and mode. It is safe and the curative effect is reliable.

Objective:To explore the risk factors of recurrence after laparoscopic myomectomy and provide references for clinical prevention and treatment.Methods:The clinical data of 216 patients who underwent laparoscopic myomectomy in Ningjin County People′s Hospital from June 2016 to December 2018 were analyzed retrospectively. The recurrence rate at 12 months after the operation was followed up, and the risk factors influencing the recurrence after laparoscopic myomectomy were screened by univariate analysis and multivariate Logistic regression model.Results:After followed up for 12 months after the operation, 24 cases had recurrence, with a recurrence rate of 11.11%(24/216). Univariate analysis showed that the recurrence after laparoscopic myomectomy was significantly correlated with surgical age, age at menarche, number of fibroids, uterine size, and gonadrotropin releasing hormone agonist (GnRH-a) treatment after the operation ( P<0.05), but was not significantly correlated with body mass index, fibroid size, fibroid type, and pregnancy after the operation ( P>0.05). Multivariate Logistic regression analysis showed that surgical age ≥ 35 years old ( OR=1.289, 95% CI 1.013-1.641), age at menarche <13 years old ( OR=1.765, 95% CI 1.167 - 2.669), and number of fibroids ≥ 2 ( OR=2.487, 95% CI 1.442 - 4.288) were independent risk factors for recurrence after laparoscopic myomectomy ( P<0.05), while GnRH-a treatment after the operation ( OR = 0.696, 95% CI 0.510-0.951) was its protective factor ( P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of surgical age ≥ 35 years old, menarche age <13 years old, and number of fibroids ≥ 2 for predicting recurrence after laparoscopic myomectomy was 0.641 (95% CI 0.573 - 0.705), 0.719 (95% CI 0.654 - 0.778) and 0.622 (95% CI 0.554 - 0.687), and age at menarche had the greatest diagnostic efficiency. Conclusions:Surgical age ≥ 35 years old, age at menarche <13 years old, and number of fibroids ≥ 2 are independent risk factors for recurrence after laparoscopic myomectomy. Intraoperative ultrasound and postoperative GnRH-a treatment can help reduce the risk of postoperative recurrence.

Objective To explore the pathological mechanism of brain function and structure in young patients with major depressive disorder by diffusion tensor imaging(DTI)and resting state functional magnetic resonance imaging(fMRI).Methods Sixteen participants diagnosed with major depression (MD) and 16 healthy age and gender-matched controls(HC) were recruited. Resting state fMRI and DTI brain scans were performed on all participants. A voxel-based method (VBM) was used to analyze the DTI datasets, and regional homogeneity (ReHo) approach was applied to preprocess the fMRI datasets. The value of fractional anisotropy (FA) and ReHo maps were obtained in the whole brain.Results FA values in the MD group were significantly lower than those of the healthy controls in the white matter of the left middle temporal gyrus, right middle frontal gyrus, left medial frontal gyrus, right precentral gyrus, left angular gyrus, left fusiform gyrus, left superior temporal gyrus, right middle temporal gyrus, right sub-gyral, left insula, and left pyramis (P＜0.01). ReHo in the MD group decreased in the left superior frontal gyrus, right superior frontal gyrus, left middle frontal gyrus, right middle frontal gyrus, left medial frontal gyrus, right medial frontal gyrus, left paracentral lobule, right paracentral lobule, right inferior parietal lobule, left postcentral gyrus, right postcentral gyrus, left middle occipital gyrus, left lingual gyrus, right putamen, right cingulate gyrus, right cuneus, left superior temporal gyrus, and right middle temporal gyrus (P＜0.01). Conclusion Abnormality of brain white microstructure and function exist widely in young patients with major depressive disorder. Abnormal connection of structures and function between the brain areas may be the key reason for the depression.

Applying combined PBL and traditional teaching method to medical chemistry experimental teaching.Questionnaire and course examination were used to evaluate teaching ef-fect.The conclusion was that PBL teaching method was more helpful and effective than that of single traditional teaching method.

Objective To investigate the effect of hyperoxia on growth of type Ⅱ alveolar epithelial cells (AECⅡ).MethodsLungs of fetal rats at 19 days of pregnancy were collected,and AEC Ⅱ was isolated and cultured by differential adherence method.Cells were randomly divided into air group and hyperoxia group.In air group,cells were cultured in 5％ CO2 incubator.And cells in hyperoxia group were cultured in 5％ CO2+95％ O2 incubator.The growth,activity,cell cycle,cell apoptosis of AEC Ⅱ were observed at 2,4,6 and 8 days of culture.The interaction between different time and groups were analyzed by ANOVA of factorial design.Comparison of means was done by two-sample independent t test and one-way analysis of variance.Bonferroni correction was used during the comparisons.Results(1) Cell growth situation:in hyperoxia group,cell number was decreased from2 hto 8 h [(7.29±0.43)×105/ml,(2.68±0.37)×105/ml,(0.23±0.10)×105/ml and (0.00±0.00) × 105/ml],and lower than those in air group [(10.41 ± 0.24) × 105/ml,(27.90±1.91) × 105/ml,(27.12±0.85) ×105/ml and (26.29±1.59) × 105/ml](t=10.992,38.912,94.166and 49.696,P=0.000 respectively). (2) Cell activity:the living cells ratio in hyperoxia group at 2 d[(79.00±0.71) ％],4 d [(52.80±1.14)％] and 6 d [(31.60±1.52)％] was lower than those [(97.00±0.71)％,(97.20±0.84)％ and (95.00±0.71)％] ir air group (t=31.213,70.519 and 84.722,P=0.000 respectively).(3) Cell cycle:the cell ratios of G1 phase and S phase in hyperoxia group at day 4 [(66.82±1.20) ％ and (27.31±1.16) ％] and day 6 [(70.22±1.27) ％ and (30.31±1.40) ％] were significantly higher than that at day 2 and that in air group (P＜0.05 respectively).(4) Cell apoptosis:in hyperoxia group,the cell ratio of Annexin-V+/PI- subgroup at 4 h was the highest [(23.89 ± 0.52)％],followed by those at day 2 and 6 [(21.32 ± 0.43)％ and (1.47 ±0.61)％].While the cell ratio of Annexin-V+/PI+ was the highest at 6 h [(53.92± 1.64)％],followed by those at 4 h and 2 h [(45.03±1.01)％ and (12.17±0.60)％],which were all different with those in air group(P＜0.05 respectively).ConclusionsHyperoxia might inhibit cell activity and cell cycle of AEC Ⅱ and promote apoptosis.

The statistics of purified protein derivative (PPD) test and chest radiograph of freshmen at a university from 2007 to 2010 were collected and examined.The result showed 25 tuberculosis cases (a prevalence rate of 0.18％) and 1 790 cases (13.40％) with strong positive PPD.After giving informed consents,the students with strong positive result and no abnormality on chest radiograph were divided into two groups.The treatment group (n =814) received precautionary anti-tuberculosis treatment while the nontreatment group (n =976) had no treatment.And 34 tuberculosis cases were found during four years in school (0.25％).Except for freshmen in 2008,the prevalence rate of the strong positive PPD groups much higher than that of the positive and negative groups and the difference had statistic significance between the groups (x2 =23.20,10.58,18.80,P ＜ 0.05).Therefore PPD test and chest radiograph are two main methods for an early diagnosis of tuberculosis among freshmen.Adopting precautionary anti-tuberculosis treatment for students with strong positive PPD and regular physical examinations are effective measures for tuberculosis control at universities.

Objective Self-management was adopted to intervene patients with breast cancer during chemotherapy in order to know about its effects on breast cancer patients′medical compliance behavior. Methods Samples were 154 breast cancer patients undergoing chemotherapy after surgery in breast surgery of the first affiliated hospital of Zhengzhou university. They accepted the docetaxel and cyclophosphamide (TC) program of chemotherapy. Patients were divided into two groups by random number table, one group as control group(80 patients) and the other group as experimental group (74 patients). Different nursing care were conducted during the two groups, the control group patients given routine nursing care, the experimental group patients given routine nursing care and self-management. The medical behavior compliance and upper extremities edema incidence for the two groups of patient were surveyed after the intervention and then evaluate the effect of the intervention. SPSS (version 17.0) was used to carry out statistical analysis. Results The total score of medical compliance behavior, the experimental group was (18.36±1.30) points, the control group was (16.70±1.57) points, the experimental group was higher than the control group, and there was statistically significant difference between two groups(t=7.093, P<0.05).The experimental group scores were higher than the control group in the functional exercise compliance (4.33±0.77 vs. 3.55±0.90), prevent or reduce the edema compliance (4.41± 0.61 vs. 3.84±0.88), PICC or venous access port of regular maintenance compliance (4.62±0.52 vs. 4.33± 0.57)(t=5.704,4.594,3.268,P<0.05);There were statistically significant differences between two groups (t=5.704,4.594,3.268,P < 0.05). There was no statistically significant difference between two groups (P >0.05) in scores of chemotherapy compliance on time.The influence of self-management on the incidence of upper extremities edema was as follow: The upper extremities edema incidence in control patients was 23.68% (18/76) which was higher than 11.11% (8/72) in the experimental group (χ2=4.036, P < 0.05). Conclusions Given self- management intervention for breast cancer patients with postoperative chemotherapy, the medical behavior compliance was increased, and the incidence of upper extremities edema was decreased.