Antithyroid drugs(ATD)is the main treatment for hyperthyroidism and its adverse reactions have been much concerned by physicians. Methimazole(MMI)and propylthiouracil(PTU)are the two common antitithyroid drugs used currently. Generally, the ATD are safe and effective, though their clinical adverse reactions are also relatively common. The toxic effects include liver damage and leukocytopenia, antineutrophil cytoplasmic antibody-associated pulmonary small-vessel vasculitis, hypoglycemia, allergic reactions, muscle impairment,and so on. They are usually reversible and disappear spontaneously when the drug is discontinued. However,the serious rare side effects can also occur and there may have potentially deadly threatening effects which need to be cautious for the clinicians. MMI is usually preferred over PTU because it has significantly fewer side effects. And unlike the dose-dependent side effects of MMI, there has no significant correlation between adverse reaction and drug dosage in using PTU. Moreover, PTU has more severe hepatotoxity than MMI, even fatal liver impairment and liver failure. The risk of liver damage from PTU is an important concern, particularly in children. For this reason, MMI is the first choice for treating children with hyperthyroidism.

无创性磁刺激技术在中枢神经功能检测和神经肌肉功能恢复的应用是康复医学工程研究的一个新热点。文章对磁刺激的发生发展 ,物理原理 ,特性 ,磁刺激与标准电刺激的差别 ,外周磁刺激技术的多信道磁刺激对电刺激模拟等最新发展 ,以及临床上磁刺激在神经肌肉功能恢复的作用作了全面介绍。

Objective: To investigate the factors affecting the development of malnutrition among the elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the prevention of malnutrition among the elderly patients with T2DM. Methods: Elderly T2DM patients at ages of 60 years and older admitted to Hangzhou First People's Hospital affiliated to Zhejiang University School of Medicine from June 2022 to June 2023 were recruited. Patients' demographics, number of medicines administered and comorbidities were collected using questionnaire surveys, and glycosylated hemoglobin (HbA1c), serum albumin (ALB) and hemoglobin levels were collected from medical records. The nutrition status was assessed with the new version of the Mini Nutritional Assessment Short Form (MNA-SF). Factors affecting the development of malnutrition were among the elderly T2DM patients identified using a multivariable logistic regression model. Results: A total of 382 elderly T2DM patients were enrolled, including 226 men (59.16%) and 156 women (40.84%) and with a mean age of (70.06±8.41) years. The prevalence of malnutrition was 22.25% among participants. Multivariable logistic regression analysis identified age (70 to 79 years, OR=1.261, 95%CI: 1.007-1.158; 80 years and older, OR=3.285, 95%CI: 1.618-6.662), three and more types of comorbidities (OR=2.790, 95%CI: 1.254-5.191), use of multiple medicines (OR=3.501, 95%CI: 1.841-6.658), sleep disorders (OR=1.613, 95%CI: 1.120-2.322), regular exercises (OR=0.280, 95%CI: 0.115-0.614), serum ALB of 35 g/L and greater (OR=0.272, 95%CI: 0.102-0.560) and HbA1c of 7% and higher (OR=2.914, 95%CI: 1.445-5.881) as factors affecting the development of malnutrition among elderly patients with T2DM. Conclusions The risk of malnutrition is associated with age, types of comorbidities, use of multiple medicines, sleep disorders, regular exercise, HbA1c and ALB among the elderly patients with T2DM. Periodical nutrition screening and intensified health education are recommended for T2DM patients.

Objective To investigate the efficacy and safety of local immune regulation therapy of thyroid disease.Methods Totally 110 patients with confirmed diagnosis of autoimmune thyroid disease were recruited.All patients received thyroid local immune regulation therapy with glucocorticoids 1~3 courses of treatment and followed up for 2~3 years,each being taken good care of during the whole observation.Results About 94.0% of the patients had significantly improved their subjective symptoms,such as pain,fatigue,and lethargy.About 67.7% of the cases had reached normal or markedly improved thyroid function after thyroid local immune regulation therapy.About 92.0% of the volumes of thyroid were reduced.Serum antithyroperoxidase antibody levels were decreased from(338.2?43.2)mU/L to(266.9?42.2)mU/L(P

Health appropriate technologies are applied nationwide in our country and have produced good results. But the informatization of health appropriate technologies lags behind and is still at a preliminary stage.As the network of Zhejiang basic health appropriate technologies has been estabished,this paper discusses some issues related with the informatization of health appropriate technologies.

Objective To investigate the diagnosis value of the cytological examination of the cerebrospinal fluid of central nervous system leukemia.Methods Adopting cell smear centrifugal machine to collect the cerebrospinal fluid cells,the cells were stained and examinated under the microscope.Results Fifty-nine children with different type of leukemia had been examinated by 438 times by cerebrospinal fluid.The positive rates of the cases and samples were 15.3% and 8.7%,respectively.Conclusion The cytological examination of cerebrospinal fluid is especially valuable for the early diagnosis ,therapy and relapse of central nervous system leukemia of monitoring.

Objective: To observe the therapeutic efficacy of tuina plus cupping on chronic fatigue syndrome (CFS). Methods: A total of 100 CFS patients meeting the inclusion criteria were randomly divided into a treatment group and a control group according to the random number table in the sequence of visit, with 50 patients in each group. The treatment group was treated with tuina plus cupping therapy, 3 times a week. The control group was given oral tablets of wild American ginseng lozenges. After 3 months of treatment, the score of fatigue questionnaire scale (FS-14) was observed and the efficacy was evaluated. Results: The total effective rate was 92.0％ in the treatment group, versus 76.0％ in the control group and the difference between the two groups was statistically significant (P<0.05). After treatment, the FS-14 scores of the two groups decreased, and the intra-group differences were statistically significant (both P<0.05). The change of FS-14 score after treatment in the treatment group was more significant than that in the control group (P<0.05). Conclusion: Tuina plus cupping is effective for CFS, and can improve fatigue symptoms significantly.

Idiosyncratic adverse drug reactions (IDR) induce severe medical complications or even death in patients. Alert structure in drugs can be metabolized as reactive metabolite (RM) in the bodies, which is one of the major factors to induce IDR. Structure modification and avoidance of alert structure in the drug candidates is an efficient method for reducing toxicity risks in drug design. This review briefly summarized the recent development of the methodologies for structure optimization strategy to reduce the toxicity risks of drug candidates. These methods include blocking metabolic site, altering metabolic pathway, reducing activity, bioisosterism, and prodrug.
Binding Sites ; Cytochrome P-450 Enzyme System ; metabolism ; Drug Design ; Drug Discovery ; methods ; Drug Recalls ; Drug-Related Side Effects and Adverse Reactions ; prevention & control ; Humans ; Structure-Activity Relationship

Objective To evaluate the efficacy and safety of Shuangyi Qushi Tongluo Capsules (SQTC) for the treatment of knee osteoarthritis (KOA).Methods A multi-center,randomized,parallel-controlled trial was carried out in 240 cases of KOA patients.The patients were divided into trial group (N =120) and control group (N =120),which was given SQTC,Xianlinggubao capsules respectively for 8 weeks.Before treatment,and 2,4 and 8 weeks after treatment,we recorded the scores of clinical symptoms and traditional Chinese medical syndromes,Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores and knee function scores.After treatment,the clinical efficacy and adverse reaction were observed.Results (1) After treatment for 8 weeks,the clinical efficacy of the trial group was superior to that of the control group (P ＜ 0.05).(2) The trial group had better effect on improving the visual analogue scale (VAS) scores of knee pain,VAS scores of limitation of motion and time for morning stiffness than the control group after treatment for 8 weeks(P ＜ 0.05 or P ＜ 0.01).(3) After treatment for 4 and 8 weeks,the trial group had better effect on improving scores of traditional Chinese medical syndromes,WOMAC scores and Japanese Orthopedic Association(JOA) scores than the control group (P ＜ 0.05 or P ＜ 0.01).(4) Before and after treatment,the results of blood,urine and stool routine examination,liver and kidney function,and electrocardiography showed no significant changes.Conclusion SQTC are effective and safe in treating KOA,and can start an effect shortly.

The status quo of American informatics nurses investigated 4 times by US HIMSS from 2004 to 2014 was analyzed.The following characteristics of American informatics nurses were summarized in terms of their educa-tion level, income, qualification authentication, occupation satisfaction, work experience and duties, including high education level and interdisciplinary background, high income and occupation satisfaction, necessary clinical background, and systematic professional development, which may provide reference for nursing staff in China to have a better understanding of informatics nurse.