Objective To analyze the clinical effect of comprehensive intervention on bone loss in postmenopausal women, and to provide reference for the prevention of osteoporosis in postmenopausal women .Methods 152 cases of postmenopausal bone mass in our hospital from March 2014 to March 2015 were selected as the research object, all patients were randomly divided into intervention group and control group,76 cases in each group.The control group was treated with HRT hormone replacement therapy and calcium supplement treatment , the intervention group based on the treatment in control group by alendronate treatment,supplemented by health guidance, two patients were treated for 1 years.Comparison of two groups of patients before and after treatment, N (N-MID), osteocalcin, procollagen type I amino terminal peptide (PINP), beta crosslinking degradation products (β-CTX), alkaline phosphatase (ALP), bone mineral density L2-L4 (BMD), E2, Serum Osteocalcin (sOC) and calcitonin (CT), parathyroid hormone (PTH), the incidence rate of fracture, osteoporosis, adverse drug reaction.Results There were no significant differences in BMD (L2-L4),β-CTX, N-MID, PINP, ALP and sOC between the two groups; After one year of treatment, BMD and sOC of the two groups were significantly higher than those before treatment (P<0.05), and the levels of β-CTX, N-MID, PINP and ALP were significantly decreased (P<0.05), and the difference between the two groups was statistically significant (P<0.05).There was no significant difference in E2, PTH and CT between the two groups before treatment.After one year of treatment, the above indexes of the two groups were significantly higher than those before treatment (P<0.05), and there was no statistically significant difference between the two groups.In the comprehensive intervention group, one patient ( 1.32%) was diagnosed as osteoporosis and two cases (2.63%) fractured after one year of treatment,In the control group, 11 cases (14.47%) were osteoporosis, 9 cases%). The fracture rate and osteoporosis rate in the intervention group were significantly lower than those in the control group (P<0.05).In the course of treatment,six patients in the comprehensive intervention group had adverse drug reactions, and the alendronate dosage decreased by half,and no adverse drug reaction was found in the control group.Conclusion hormone,Caltrate,alendronate and health guidance comprehensive intervention program to improve the hormone level in patients with osteopenia, bone reconstruction of women physical level and promote the bone tissue of patients with anti absorption to enhance the role of postmenopausal bone balance favorable development, for postmenopausal bone loss in women with a high clinical value.

Objective:To explore the clinical effect of multidisciplinary cooperation model in the prevention of acquired dysphagia in ICU.Methods:A multidisciplinary team was set up to collect 118 patients in Neurosurgery ICU of our hospital as the research object. The patients were divided into the experimental group and the control group, 59 cases in each group. The control group implemented the routine nursing measures of ICU, and the experimental group implemented the multidisciplinary cooperative nursing mode. The incidence of ICU acquired swallowing disorders (ICU-ASD) and complications of the two groups were compared.Results:There was no significant difference between the two groups in the incidence of swallowing dysfunction 24 hours after tracheal extubation ( P>0.05). The incidence of swallowing dysfunction 48 hours and 72 hours after tracheal extubation in the control group was 11.86% (7/59) and 16.95% (10/59) respectively, while the test group was 1.69% (1/59) and 3.39% (2/59) respectively. The difference was statistically significant ( χ 2values were 4.827 to 7.230, P< 0.05 or 0.01); the incidence of aspiration, aspiration pneumonia and malnutrition in the control group were 11.86% (7/59), 10.17% (6/59) and 8.47% (5/59), respectively, while the test group were 1.69% (1/59), 0 and 0, respectively, with statistically significant difference ( χ 2value was 4.827, P< 0.05). Conclusion:Multidisciplinary cooperation model can effectively prevent the incidence of ICU-ASD, and ultimately reduce the incidence of complications.

Objective:To analyze the relationship between thyroid function, iodine nutrition level and thyroid autoantibodies in pregnant women.Methods:In 2016, pregnant women were selected from different water iodine areas in Tianjin. A disposable urine sample of 25 ml was collected to determine urine iodine, and 3 ml of intravenous non-anticoagulated blood was collected to determine serum thyroid hormones and thyroid autoantibodies. Chemiluminescence immunoassay was used to determine the thyroid function indexes [free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid-stimulating hormone (TSH)], thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody (TgAb) levels in pregnant women. According to serum TSH and FT 4 levels, pregnant women were divided into the euthyroidism group and subclinical hypothyroidism group(referred to as hypothyroidism). Urine iodine arsenic-cerium catalytic spectrophotometry was used to detect the urine iodine level of pregnant women. The correlation between urinary iodine levels and thyroid function indexes of the two groups of pregnant women was analyzed, and single factor and multivariate logistic regression were used to analyze the influencing factors of hypothyroidism. Results:There were 798 pregnant women in the euthyroidism group and 28 pregnant women in the hypothyroidism group. The hypothyroidism detection rate was 3.39% (28/826). In the euthyroidism group and hypothyroidism group, 43.73% (349/798) and 46.43% (13/28) of pregnant women had urine iodine levels < 150 μg/L, respectively. There was no correlation between urine iodine level and serum TSH ( r = 0.038, P > 0.05), and a positive correlation with serum FT 4 ( r = 0.077, P < 0.05). The differences between the euthyroidism group and the hypothyroidism group in the median (interquartile range) of TPOAb and TgAb were statistically significant ( Z = - 3.986, - 3.411, P < 0.05). After logistic regression analysis, TPOAb was a risk factor for hypothyroidism ( OR = 3.428, 95% CI: 1.131 - 10.388). Conclusions:Urine iodine and thyroid autoantibodies should be screened as routine examination items before or during pregnancy. Correct iodine deficiency in time, avoid blindly excessive iodine supplement, and reduce the occurrence of subclinical hypothyroidism in pregnant women, so as to reduce the adverse effects on mothers and their offspring.

Objective To investigate the risk actors of postpartum hemorrhage of cesarean section,in order to provide the basis for the prevention of hemorrhage after cesarean section.Methods A case-control study was conducted in 100 cases with postpartum hemorrhage of cesarean section and 200 cases without bleeding of cesarean section.The clinical data were compared and analyzed.The single factor and multiple factors of the Logistic analysis was used to analyze the risk factors of postpartum hemorrhage of cesarean section.Results Fetal macrosomia (OR =3.678,95％ CI:1.456-5.345),placenta adhesion (OR =4.264,95％ CI:1.556-5.646),placenta praevia (OR =2.754,95％ CI:1.754-5.456),multifetal pregnancy (OR =3.964,95％ CI:1.274-4.453) were the risk factors of postpartum hemorrhage after cesarean section.Conclusion Evaluation of the above risk factors before cesarean section was important for prevention of postpartum hemorrhage.

ObjectiveTo evaluate the effect of facial fat tissue grafting and remodeling with SMAS suspension in facial rejuvenation.MethodsThe treatment process of 12 patients with facial fat tissue grafting and SMAS-suspended rhytidectomy were reviewed retrospectively,the surgical operative procedure and treatment results of facial liposuction and autologous fat grafting with SMAS-suspended rhytidectomy were analyzed and evaluated.Results12 patients underwent facial liposuction,SMAS-suspended rhytidectomy and autologous free fat tissue grafting and remodeling.All the followed-up cases obtained good results without complications.ConclusionsCombined surgery of facial fat tissue remodel with SMAS-suspended rhytidectomy not only corrects the soft tissue laxity,but also modifies the faical volume loss.It solves the aging problems in different angles through soft tissue lift and volume restoration.It is a relatively ideal surgical method of facialplasty for those aged patients.

Objective To investigate the role of SHBG in PCOS. Methods Three hundred and ten PCOS patients were divided into the low-SHBG group , the normal-SHBG group , and 95 healthy women were enrolled in the healthy control group. Results (1) In the low SHBG group, the incidences of IR and MS were higher than those in the the normal SHBG group and the healthy control group (P < 0.05); (2) In the low SHBG group, DHEAS was significantly higher than that in the normal SHBG group (P < 0.05); (3) In the low SHBG group, FINS, HOMA-IR, TG, TC/HDL, TG/HDL, LDL/HDL were significantly higher than those in the normal SHBG group and the healthy control group , but HDL was significantly lower than that in the normal SHBG group (P < 0.05); (4) SHBG was positively correlated with HDL, but was negatively correlated with FPG, FINS, HOMA-IR, TG, TC/HDL, TG/HDL, LDL/HDL. Conclusions Uner the low SHBG level, PCOS patients have high levels of DHEAS, and SHBG may be a risk factor for MS, IR and dislipidemia.

Objective To explore the relationship between PAH-DNA adducts and CYP1A1,GSTM1 gene polymorphisms and lymphoma.Methods PAH-DNA adducts from bone marrow of lymphoma patients and control cases were determined by competitive ELISA.The genotypes of both CYP1A1 and GSTM1 were detected by PCR-based restriction fragment length polymorphisms (PCR-RELP).Results The level of PAH-DNA adducts in lymphoma patients [(2 498±1 250) pg/ml] was significantly higher than that in control [(1 882±797) pg/ml] (t =0.006,P ＜ 0.05).CYP1A1 mutant genotype and GSTM1 null genotype had increased risk of lymphoma,with OR being 1.36 (95 ％ CI 0.56-3.31,P ＞ 0.05),4.03 (95 ％ CI 1.51-10.76,P ＜ 0.05),respectively.GSTM1 null genotype individuals with PAH-DNA level higher (or equal) than 2 200 pg/ml had increased risk of lymphoma.Conclusions The content of PAH-DNA adducts and the occurrence of lymphoma may have a certain correlation.GSTM1 null genotype may be linked to lymphoma and increase the risk.

Objective To investigate the association between arsenic(+3 oxidation state) methyltransferase (AS3MT) genetic polymorphism and susceptibility to endemic arsenism.Methods Polymerase chain reactionrestriction fragment length polymorphism-single strand conformation polymorphism(PCR-RFLP-SSCP) technology was performed to detect mutations of AS3MT gene intron 8 and exon 9 in genome DNA of the 79 cases and 110 controls.PCR products with abnormal band forms were further sequenced to find the types and sites of mutation.Chi-square test and multivariate Logistic analyses were conducted.Results The incidence of the 9149 base mutation(A→C) in AS3MT gene intron 8(AS3MT-9149) in case group(19.0％,15/79) was lower than that in control group (23.6％,26/110).The incidence of the codon 287 mutation(ATG→AT/CG) in AS3MT gene exon 9(AS3MT-287)in case group(10.1％,8/79) was lower than that in control group (11.8％,13/110).However,statistical analysis indicated no significant difference in both mutations between two groups[AS3MT-9149:odds ratio(OR) =0.59,95％ confidence interval(CI):0.26-1.31,P =0.195; AS3MT-287:OR =0.85,95％ CI:0.32-230,P =0.751].Conclusions There are no significant association between the genetic polymorphisms of AS3MT-9149,AS3MT-287 and the susceptibility to endemic arsenism.Similarly,due to small sample amount,we can not exclude the possibility that these gene polymorphisms are related to susceptibility to endemic arsenism.

Objective To evaluate the hematological toxicity of craniospinal irradiation,and determine the short-term clinical efficacy and prognostic factors in medulloblastoma.Methods Eightseven patients who underwent craniospinal irradiation were retrospectively analyzed with respect to the changes in hematology during craniospinal irradiation.The effect of sex,age,tumor location,interval between surgery and radiation,interval time during radiation and radiation sequence on survival were also studied.Results The 1,2,3-year overall survival (OS) and progress-free survival (PFS) rate were 95.0％,92.4％,84.9％ and 93.7％,89.8％,80.8％,respectively.The incidence of 2-3 grade leucopenia was 90.8％,while the incidence of 1-2 grade thrombocytopenia was 70.1％,and the incidence of 3 grade thrombocytopenia was 1.1％.The incidence of 1-2 grade hemoglobin reduction was 16.1％.No patient had grade 3-4 hemoglobin reduction.Kaplan-Meier analysis shows that more favorable prognoses in terms of 3-year PFS were evident for 0-1 grade thrombocytopenia compared with 2-4 grade thrombocytopenia (x2 =3.936,P ＜ 0.05).And 3-year PFS and 3-year OS were evident for 0 grade hemoglobin reduction compared with 1-4 grade hemoglobin reduction (x2 =10.269,9.336,P ＜ 0.05).The 3-year PFS between interval time during radiation ＜ 3 days and ≥ 3 days was 84.6％ and 68.6％ (x2 =4.413,P ＜ 0.05).Conclusions Hematological toxicity during craniospinal irradiation and the interval time during radiation were prognostic factors.

Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs).Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively.Twenty-two males and 9 females had an average age of 18 years (range 3-60 years).Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR).Median total radiation dose was 53.9 Gy (48.6-60 Gy).The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing.Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs.Results The median time of follow-up was 51 months.At the endpoint of the follow-up period,7 patients experienced tumor recurrence:5 had a local recurrence (LR) and 2 had both LR and distant recurrence.Six patients died,4 of which had cases of pediatric infratentorial anaplastic EPs.The three and five-year progress-free survival (PFS) were 80.6％ and 75.9％.Overall survival (OS) at three-year and five-year were 83.9％ and 76.2％,respectively.Univariate analysis showed a more favorable prognoses in terms of three-year PFS,five-year PFS and OS for GTR compared to STR (x2 =4.685,6.311,4.238,P ＜ 0.05).Besides,a more favourable univariate outcome in terms of five-year PFS was evident in patients when the total radiotherapy dose was ＞ 55 Gy compared to ≤55 Gy (x2 =4.210,P ＜ 0.05),and no severe radiotherapy complications occurred.Conclusions Surgery is the major treatment method,while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients.Surgical resection and radiotherapy dose were relevant to prognosis.