[Summary] There is growing awareness of the importance of vitamin D beyond maintenance of musculoskeletal health.Vitamin D has been shown to have extensive biological functions,including modulating immune function,inhibiting cellular proliferation,inducing differentiation,promoting apoptosis.Vitamin D deficiency is highly prevalent in critically ill patients,and it may impact the severity of illness and contribute to lessthan-optimal outcomes.Vitamin D plays an important role in preventing the development of critical illness based on its pleiotropic actions,thus holding a profound prospective with respect to an adjunctive therapy in critically ill patients.

Objective To compare the differences of clotting laboratory indices and thromboelastogram (TEG) parameters between pregnant women with gestational diabetes mellitus (GDM ) and healthy pregnant women .Methods The detection results of clotting laboratory indices and TEG in 46 pregnant women with GDM and 49 healthy pregnant women in our hospital from June 2013 to July 2014 were retrospectively analyzed and compared .Results In the comparison of the GDM group and the control group ,the traditional clotting laboratory indices ,INR and PT had statistically significant differences(P<0 .05) .However ,other tra‐ditional clotting laboratory indices ,like APTT ,FIB ,PLT showed no statistically significant differences (P>0 .05) .The common TEG indices of R value ,K value ,Angle ,MA value and CI value were statistically different between the GDM group and control group(P<0 .05) .Conclusion TEG is more sensitive than traditional clotting detection in monitoring the prethrombotic state of pregnant women with GDM and has certain significance for guiding early clinical intervention ,alleviating or delaying complications and improving the maternal and infantile outcome .

Objective To observe the effect of budesonide inhalation joint montelukast in the treatment of children with mycoplasma pneumonia cough.Methods 176 children with mycoplasma pneumonia cough were chosen.According to the order of admission,they were divided into observation group and control group.Control group was given montelukast sodium chewable tablets treatment,the observation group was given budesonide inhalation on the basis of treatment of control group.After treatment,the efficacy,prognosis and compliance were observed.Results Before treatment,the cough scores between the two groups had no significant difference (P>0.05).After treatment, the degree of cough in the two groups were significantly improved, the cough score of the observation group from (7.4 ±2.2)points decreased to (1.5 ±0.6)points (t=24.271,P<0.05);the cough score of the control group from (7.5 ±2.3)points decreased to (5.4 ±1.8)points (t=6.745,P<0.05);and the cough score of the observation group was significantly lower than the control group,the difference was statistically significant (t =19.282,P <0.05).The total effective rate of the observation group was 93.18%,which of the control group was 73.86%,the difference was statistically significant (χ2 =3.446,P<0.05).The incidence rate of adverse reactions in the observa-tion group was 4.55%,which in the control group was 11.36%,but there was no significant difference between two groups (P>0.05).The relapse rate of the observation group was 7.95%,which was significantly lower than 18.18%of the control group, the difference between the two groups was statistically significant ( P <0.05 ) .Conclusion Budesonide inhalation joint montelukast in the treatment of mycoplasma pneumonia cough has significant effect,it has less adverse effects,good safety,and children without any discomfort,so it worthy of clinical application.

Objective To evaluate the influence of extraocular counterpulsation on ocular fundus blood vessels using high-frequency color Doppler ultrasonography. Methods Twenty-one patients with ischemic optic neuropathy were treated with extraocular counterpulsation. During treatment, the Doppler spectra were detected with high-frequency color Doppler ultrasonography. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance retinal index (RI) of central retinal artery and posterior ciliary artery were measured instantly before treatment and 1 min,5 min and 15 min after treatment. Results The instant PSV and EDV of central retinal artery and posterior ciliary artery were significantly increased (P＜0.05) after treatment, then decreased gradually. Fifteen min after treatment ,they returned to the level before treatment. Conclusions We can observe the changes of ocular fundus blood vessels noninvasively on high-frequency color Doppler ultrasonography. The method may be regarded as one of the basis for evaluating the effect of extraocular counterpulsation.

AIM:To investigate the clinical effects of traditional Chinese medicine, Si Ling San, on acute central serous chorioretinopathy (CSC).METHODS:We retrospectively analyzed the clinical data of 48 patients (48 eyes) with CSC, among whom 24 were given oral Si Ling San (as treatment group) and the other 24 did not receive any treatment (control group).The baseline and 1 or 3mo follow-up data for the best corrected visual acuity (BCVA), central macular thickness (CMT) and maximum height of subretinal fluid (SRF) were collected and then compared between the two groups.RESULTS:BCVA of the treatment group was not statistically different from the baseline level at 1mo (P>0.05), but it was significantly improved at 3mo (P<0.05).BCVA was better at 3mo than that at 1mo(P<0.05).In the control group, however, no significant improvement of BCVA was found at 1 or 3mo compared with baseline (both P>0.05).The BCVA of the two groups was not significantly different at baseline and 1 and 3mo follow-up (all P>0.05).In the treatment group CMT and SRF at 1 and 3mo were significantly lower than baseline (both P<0.05).CMT and SRF at 3mo were significantly lower than that at 1 month (both P<0.05).In the control group, CMT and SRF at 1mo were not different from baseline level (both P>0.05), while they were significantly decreased at 3mo follow-up (both P<0.05).CMT and SRF at 3mo were significantly lower than that at 1mo (both P<0.05).In addition, CMT and SRF of the treatment group at both 1 and 3mo were statistically lower than that of the control group (all P<0.05).CONCLUSION:This study preliminary suggest that oral Si Ling San has the potential to treat acute CSC.But further trials are warranted to study its role in improving the visual function, shortening the duration and reducing the recurrence of CSC.

BACKGROUND:Heparinase can induce syndecan-1 shedding from tumor cells and macrophage motion may correlate with biosynthesis regulation of heparan sulfate proteoglycan.OBJECTIVE:To investigate the effects of heparinase Ⅰ on syndecan-1 and extracelluar signal regulated kinase 2(ERK2)in human umbilical vein endothelial cells(HUVECS)with hypoxia/reoxygenation injury.METHODS:heparinase Ⅰ-precultured HUVECS were treated with hypoxia/reoxygenation.Immunohistochemistry staining,RT-PCR and western blot were applied to detect HUVECS syndecan-1 and ERK2 expression.RESULTS AND CONCLUSION:Expression of syndecan-1 and ERK2 was increased in HUVECS following hypoxia/reoxygenation treatment.Heparinase Ⅰ significantly upregulated the expression of syndecan-1 and ERK2 in HUVECS with hypoxia/reoxygenatiOn treatment.Syndecan-1 and ERK2 expression was positively related.Results show that syndecan-1 and ERK2 participate the pathophysiology of HUVECs hypoxia/reoxygenation injury Heparinase Ⅰ influences ERK2 expression by regulating syndecan-1.

AIM: To investigate the effect of hirudo and earthworm liquor extract on the expression of syndecan-1 in focal cerebral ischemia reperfusion rats and the relationship between syndecan-1 expression and cellists underlying antiinflammatory mechanism. METHODS: The MCAO models of rats were built with the intraluminal filament occlusion. Rats' brains were cut at the levels of the hippocampus as the templates. Immunohistochemistry staining and HE staining were used to facilitate the observation of the distribution and the quantities of cells with expression of syndecan-1 and the pathological change of MCAO ischemia 2 h reperfusion 4, 24, 72 h and 7 d with hirudo and earthworm liquor extract or saline treatment, respectively. RESULTS: Hirudo and earthworm liquor extract could upregulate the expression of syndecan-1 on ischemia/ reperfusion in rats' brains, especially at 72 h. The numbers of syndecan-1 cells got peak, hirudo and earthworm extract liquor could downregulate polynucleation inflammatory cells at 24 and 72 h. The expression of inflammatory cells in both hirudo and earthworm liquor extract group and saline group at 4 h was not significant. Hirudo and earthworm extract liquor downregulated the monocytic inflammation cells infiltration at 7 d. CONCLUSION: Hirudo and earthworm liquor extract can upregulate the expression of syndecan-1 on ischemia reperfusion in rats' brains. The upregulation of syndecan-1 can decrease inflammatory cell infiltrate.

Objective To explore the expression of syndecan-1 in different intervals following focal cerebral ischemia/reperfusion in rat and the relationship between syndecan-1 and inflammatory cells in the rat brain.Methods The rat model of middle cerebral artery occlusion(MACO) was performed by using the intraluminal filament occlusion for 2 h,then released.The rat brain were cut in the coronal planes at the levels of the hippocampus as the templates.The immunohistochemical staining and HE staining were used to observe the distribution and the quantity of syndecan-1 and inflammatory cell expression in the normal control group,sham operation group and the MCAO groups at 4,24,72 h and 7 d after reperfusion.Results The expression of syndecan-1 was mainly in the cortex and the subcortex in the rats of normal control group and sham operation group.The immunoreactivity of syndecan-1 in the infarcted core and perilesional infarcted zone started decreasing at 4 h after ischemia/reperfusion,reached the lowest at 24 h.The expression of syndecan-1 in the perilesional infarcted zone was up-regulated at 72 h and recovered at 7 d.The relationship between syndecan-1 and inflammatory cells was of negative correlation.Conclusion The decreasing of syndecan-1 may contribute to inflammatory response in the cerebral infarction region after focal cerebral ischemia/reperfusion.

Objective To study the risk factors for thyroid papillary carcinoma in patients aged over 65 years,and to investigate the etiology of thyroid papillary carcinoma.Methods A total of 784 patients with thyroid nodules screened by ultrasound were grouped according to different iodine intakes,gender,age,diet,smoking history and history of radiation therapy.The incidence of thyroid papillary carcinoma was compared among the different groups.Pathogenic factors for thyroid papillary carcinoma were analyzed.Results 55 patients (7.0％) were diagnosed as thyroid papillary carcinoma among 784 patients.Gender,age,iodine intake,smoking history and history of radiation therapy were the pathogenic factors for papillary thyroid carcinoma.Thyroid papillary carcinoma was common in older women,patients with high-iodine intake and patients with the history of radiation therapy.The incidence of thyroid papillary carcinoma was higher in patients with high iodine intake than with normal-iodine intake or low-iodine intake [22.8％ (31/136) vs.1.9％％ (10/517),10.7％ (14/131),x2 =75.07,P＜0.01].The incidence of thyroid papillary carcinoma was higher in female than in male elderly patients [8.0％ (49/612) vs.3.5％ (6/172),P＜0.05].The incidence of thyroid papillary carcinoma was higher in patients with the history of radiation therapy than without the history of radiation [11.6％ (14/121) vs.6.2％ (41/663),P＜0.05].Conclusions The main risk factors for thyroid papillary carcinoma are living environment,gender,age,diet,smoking history and history of radiation therapy,which are more influenced by external factors.

As one of the main members of the Rho GDI dissociation inhibitory factors,D4-GDI inhibits the dissociation of Rho protein and GDP,which is also involved in a wide range of celluar functions,such as cell contraction,adhesion,migration,proliferation and apoptosis.Recently,accumulating evidence has been suggested that D4-GDI is involved in the pathogenesis of several pulmonary diseases,such as lung cancer.Intervention of D4-GDI expression may improve the pathological changes and prognosis of these diseases.