Iodine is an essential trace element for growth and development of fetus. More and more surveys currently show that the urinary iodine level of pregnant women is between 100 - 149 μg/L, which is lower than the level recommended by the World Health Organization (WHO). Under this level of iodine nutrition, different investigations have shown different effects on thyroid function of pregnant women, and the impact on growth and development of the fetus requires long-term objective evaluation. At present, there are three aspects: development, intelligence quotient (IQ), and psychological behavior. There are not many studies on comprehensive evaluation. This article combs the related published research to provide a reference for further clarifying the influence of iodine nutrition level during pregnancy on thyroid function of pregnant women and the growth and development of their offspring.

Objective To evaluate the clinical value of cardiovascular function in patients with type 2 diabetes mellitus by wave intensity and tissue Doppler imaging.Methods According to the course of disease,30 patients with type 2 diabetes mellitus were divided in to two groups:T2DM group 1,the course of disease between 1 year to 5 years; T2DM group 2,the course of disease was longer than 5 years.30healthy volunteers were considered as control group.The parameters of accelerating wave intensity(W1),decelerating wave intensity(W2),negative area(NA),time interval between the R-wave of ECG and the first peak(R-W1),the first and second peaks (W1-W2),elasticity modulus (Ep),stiffness index (β),arterial compliance(AC),pulse wave velocity(PWVβ) and intima media thickness (IMT) were calculated by wave intensity.The left ventricular ejection fraction (LVEF),left ventricular ejection time (LVET),early diastolic peak speed (E),late diastolic peak velocity (A),E / A and isovolumic relaxation time(IVRT) were detected by two dimensional echocardiography.Mitral annular early diastolic peak speeds (Em),late diastolic peak velocity (Am) and Em / Am were detected by tissue Doppler imaging.Then three groups data were recorded and compared.Results Compared with the control group,β,PWVβ,Ep in T2DM group increased significantly(P ＜0.01 or P ＜0.05),while AC decreased(P ＜0.05).IMT in T2DM group 2 was thicker significantly than the control group(P ＜0.01).PWVβ,Ep,IMT in T2DM group 2 were significantly higher than those of T2DM group 1 (P ＜0.05).W2 in T2DM group 2 was significantly higher than those of T2DM group 1 and the control group(P ＜0.01 or P ＜0.05).E/A,Em and Em/Am in T2DM group were significantly lower than those of the control group (P ＜0.05 or P ＜0.01).Compared with T2DM group 1,Em in T2DM group 2 decreased significantly(P ＜0.05).In T2DM group,there were positive correlation between IMT and Ep,β,PWVβ (r =0.48,r =0.385,r =0.478,P ＜0.05 or P ＜0.01),positive correlation between Em and E (r =0.404,P ＜0.05) ;positive correlation between Em/Am and E/Em,E/A (r =0.602,r =0.559,P ＜0.01) ; negative correlation between Em and IVRT (r =-0.653,P ＜0.01);positive correlation between W1 and LVEF (r =0.627,P ＜0.01); positive correlation between W1-W2 and lVET (r =0.847,P ＜ 0.01) ; no correlation between W2 and E/A,E/Em,Em/Am,IVRT(P ＞0.05).Conclusions The elasticity of carotid artery and the diastolic function of left ventricular decreased in T2DM patients,while the systolic function of left ventricular was normal.

Objective To evaluate the function and synchronization of left atrial in patients with chronic heart failure(CHF) by real-time three dimensional echocardiography (RT-3DE).MethodsThirty healthy controls and thirty-two patients with CHF were studied.The CHF were divided into group CHF1 with the normal of left ventricular filling pressure and group CHF2 with the elevated of that.From the volume-time curve of RT-3DE workstation,the maximum volume (LAVmax),the minimum volume (LAVmin),the volume before contraction (LAVp) of left atrial were acquired.Accordingly,the total,passive and active ejection fraction could be calculated.The synchronization parameters derived from RT3DE were the dispersion and maximum difference of time to minimum volume for left atrial segments (Tmsv- 16-SD,Tmsv 12-SD,Tmsv-6-SD,Tmsv- 16-Dif,Tmsv 12-Dif,Tmsv-6 Dif).The index of volume and time were corrected by the body surface area and interval of R-R,respectively.The correlation were analysed in them.Results ① All the index of volume before and after correction were gradually increasing from control to CHF2 group,but the LATEF,LAPEF and LAAEF were just the reverse,with all parameters had significant difference among total groups( P ＜0.01 ).②The synchronization parameters were significantly higher from control to CHF2 group( P ＜0.01 ).Comparing between two groups,no significant difference of the synchronization parameters were found between CHF1 group and CHF2 group ( P ＞ 0.05),except Tmsv-16-SD％ and Tmsv-16-Dif％ ( P ＜0.01 ).③The Tmsv-16-SD％ and Tmsv-16-Dif％ had a positive correlation with the index of volume and a negative correlation with the ejection fraction.The most significantly correlation parameters was LAVmaxI,with r =0.75 and P ＜0.01.ConclusionsThe function of left atrium are reduced in patients of CHF,there are dyssynchronization.The higher of the filling pressure of left ventricle,the lager of the dyssynchronization of left atrium.RT-3DE may paly important roles in the evaluation of function and synchronization of left atrium.

Objective To evaluate the effect of angiotensin Ⅱ ( Ang Ⅱ ),angiotensin- (1-7) [ Ang- ( 1-7 ) ],and co-action of Ang Ⅱ and Ang-( 1-7 ) on β cell insulin signaling pathway.Methods Mouse pancreatic β cell line NIT-1 was incubated with( 1 )0,10-7,10-6,10-s,10-4 mol/L concentrations of Ang Ⅱ for 24 h ; ( 2 )0,10-7,10-6,10 -5,10-4 mol/L concentrations of Ang- ( 1-7 ) for 24 h; ( 3 ) co-administration of Ang Ⅱ and Ang- ( 1-7 ) was divided into control,10-5mol/L Ang Ⅱ,10-6mol/L Ang-( 1-7 ),10-5mol/L Ang Ⅱ + 10-6mol/L Ang-( 1-7 ) group.Tyrosine phosphorylation of insulin receptor β subunit(IR-β-Tyr) and serine phophorylation of protein kinase B(Akt-Ser) were detected by Western blot.ResultsInsulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation was significantly decreased in Ang Ⅱ 10-5 and 10-4 mol/L group; no significant changes in insulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation were detected between Ang-( 1-7 ) treatment groups and control; Ang-( 1-7 ) blocked the inhibitory effect of Ang Ⅱ on Akt-Ser phosphorylation,yet exerted no effect on Ang Ⅱ-induced IR-β-Tyr phosphorylation inhibition.Conclusion Ang Ⅱ significantly inhibits insulin signaling pathway in β cell; Ang-( 1-7 ) reverts the inhibitory effect of Ang Ⅱ on insulin-stimulated Akt-Ser phosphorylation in β cell.

AIM: To detect the expression level of telomere regulating factor tankyrase and its clinical significance in the origin and development of gastric adenocarcinoma. METHODS: Quantitative Real-time PCR was used to measure the expression of tankyrase mRNA in cancerous and normal adjacent tissues from 16 patients with gastric adenocarcinoma. Immunohistochemistry was used to detect tankyrase protein expressions in 37 gastric adenocarcinoma samples and 13 normal controls. RESULTS: The expression of tankyrase mRNA in gastric adenocarcinoma [median 1.44?10~ -2, range (3.88?10~ -5)-0.4847] was significantly higher than that in normal adjacent mucosa [median 1.0134?10~ -2, range 0-(4.933?10~ -2)] (P

Objective: To investigate anxiety and depression among young acne patients, to provide a reference for the comprehensive treatment and to improve the quality of life of the patients. Methods: Totally 157 students with acne of a major skin disease (acne group) and 157 healthy subjects (control group) selected from 244 and 297 students with and without acne were evaluated with the Zung’s Depression Self-rating Scale (SDS) and the Zung’s Anxiety Self-rating Scale(SAS). The SDS and SAS scores at different levels of sex and disease state were compared between two groups. Results: The positive detection rate of depression symptoms and anxiety symptoms in acne group was 59.20% and 69.40%,respectively, and the combined detection rate of anxiety and depression symptoms was 52.90%; the detection rate of depression symptoms and anxiety symptoms in control gruop was 32.50% and 25.50%,respectively, with anxiety and depression symptoms accounted for 20.40%, the differences were statistically significant(χ2=22.63, 60.81, 35.69, P<0.01). Compared with acne group, there were higher SDS and SAS scores in acne group(Z=5.95, 9.16, P<0.01). In the acne group, the SDS and SAS scores of males were higher than females. There were significant differences in the SDS and SAS scores of the samples with different incidence(H=55.67, 43.83, P<0.01). Conclusion Students with acne are more likely to suffer from depression and anxiety. Compared with healthy population, moderate and severe acne patients have more serious depression and anxiety symptoms. It is suggested that the medical staff in school should take appropriate psychological intervention and treatment to facilitate the comprehensive rehabilitation of the young students with acne.

Objective To explore the clinical features,genetic causes and prognosis of intellectual disability with epilepsy(ID-E)in children.Methods The data of unknown causes of ID-E children(n=40)who were identified in Department of Pediatrics,Xiangya Hospital of Central South University from March 2015 to March 2016 were respectively analyzed,and follow-up studies were performed to investigate the epilepsy control and intellectual deve-lopment.Results Forty unexplained ID-E included 25(62.5％)male,and 34(85.0％)cases were severe intellectual disability patients.The onset age of epilepsy was 0.16 to 8.00 years old,median age was 1.5 years old.Twenty cases(50.0％)had slow electroencephalogram background,and 22 cases(55.0％)had focal spikes.Ten cases(25.0％)had abnormal cranial images,with brain dysplasia or atrophy.Follow-up lasted from 0.58 to 1.58 years,and 19 cases(47.5％)had seizure control.Twenty-five cases(62.5％)had used at least 2 anti-epilepsy drugs during follow-up,and 19 cases(47.5％)had drug refractory epilepsy.Improvement of mental or motor development in epilepsy controlled group and the uncontrolled group were 12 cases(63.2％)and 2 cases(9.5％).There were separately 8 cases(8/40 cases,20.0％)and 3 cases(3/16 cases,18.8％)diagnosed respectively by whole genome-wide analysis of copy number variants(CNVs)and gene-panel whose CNVs test findings were negative.Conclusions ID-E patients of unknown causes have the following clinical features:they were mostly found in male patients with severe intellectual disability,and drug refractory epilepsy patients have rather high percentage;well controlling of epilepsy is useful for improvement of mental and motor development.Genetic analysis is significant for control and prognosis of ID-E patients,and genome-wide CNVs have high positive rates which can be used as first-tier test to detect genetic etiology of ID-E of unknown cause.

Objective: To investigate the clinical effect of percutaneous transhepatic bile duct drainage guided by ultrasound. Methods: From June 2016 to June 2018, 100 patients with obstructive jaundice in Lishui Central Hospital were treated with ultrasound-guided percutaneous transhepatic bile duct drainage.The success rate and postoperative complications of the patients were analyzed. Results: Among 100 cases, 98 cases were successful, 2 cases failed, and the failure rate was 2%.The success rate of one-time catheterization in 0.5-2.0 cm patients with intrahepatic bile duct diameter(98.91%) was significantly higher than that in intrahepatic bile duct diameter 0.3-0.4 cm patients(87.50%), compared with two different diameter puncture catheterization, the difference was statistically significant(χ²=12.369, P<0.05). All 98 cases with successful puncture were followed up after operation (P<0.05), and there was no statistically significant difference between the two groups(P<0.05). The drainage tube was removed in 2 cases, bile duct infection was found in 2 cases, the remaining patients were unobstructed, and there were no obvious complications. Conclusion Ultrasound-guided percutaneous transhepatic catheterization and drainage for the treatment of obstructive jaundice caused by malignant tumor is simple, reliable, safe and effective, and has a certain clinical value.It is worthy of popularizing and application.

Objective: To evaluate the clinical value of three-dimensional ultrasound VOCAL technique in evaluating gastric emptying function in children with functional dyspepsia (FD). Methods: Seventy-one children with FD who were treated in Wenzhou Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2018 to June 2018 were enrolled as the study subjects (observation group), and 71 normal children without FD were selected as controls (control group). The gastric emptying, antral pyloric systolic contraction frequency and distal gastric contraction movement in different time groups were analyzed, and GET1/2 and 2h gastric residual situation before and after treatment in the observation group were compared. Results: The GET1/2 of the observation group was (60.2±12.69)min, and the gastric emptying rate of the observation group was (61.9±12.2)min and (72.0±12.3)min at 90min and 120min, which were significantly better than those of the control group, and the differences were statistically significant (t=19.092, 15.092, 14.882, P=0.016, 0.024, 0.033). The frequency of antral pyloric systolic contraction, gastric antrum contraction frequency and gastric antrum contraction amplitude were (1.1±0.7)times/min, (2.9±0.8)times/min, (1.0±0.6)cm, respectively.Compared with the control group, the differences were statistically significant (t=16.092, 21.224, 8.092, all P<0.05). In the observation group of 71 children: GET1/2 before treatment and after treatment were (68.1±11.8)min, (54.2±9.8)min, respectively.The gastric residual at 2h after treatment was (31.2±8.0)%, (22.1±7.0)%, respectively.The GET1/2 and 2h gastric residual rate of the children were significantly lower than before treatment, and the differences were statistically significant (t=18.983, 21.004, all P<0.05). Conclusion Three-dimensional ultrasound VOCAL technology can be used as an evaluation standard for FD in children.

Objective:To investigate the efficacy of salbutamol combined with budesonide aerosol inhalation in the treatment of patients with acute attack of bronchial asthma and its influence on serum inflammatory factors.Methods:From January 2017 to December 2018, 78 patients with acute attack of bronchial asthma in Zhejiang Xin'an International Hospital were selected, and they were divided into combined group and control group according to the random number table method, with 39 cases in each group.The control group was treated with routine western medicine, and the combined group was treated with salbutamol and budesonide aerosol inhalation on the basis of the control group.The two groups were treated for 2 weeks.The changes of vital capacity(VC), forced expiratory volume in one second(FEV 1) and peak expiratory flow(PEF) were compared before and after treatment.The changes of serum high mobility group protein 1(HMGB1), C-reactive protein(CRP) and tumor necrosis factor-alpha(TNF-α) were measured before and after treatment. Results:The total effective rate of the combined group was 87.18%(34/39), which was higher than 68.57%(24/39) of the control group, the difference was statistically significant(χ 2=5.791, P<0.05). The values of VC, FEV 1 and PEF between the two groups before treatment had no statistically significant differences( t=0.588, 0.892, 0.371, all P>0.05), which in the two groups after treatment were all increased(the combined group: t=16.045, 7.193, 6.667; the control group: t=7.834, 8.354, 4.262, all P<0.05). The values of VC, FEV 1 and PEF in the combined group after treatment were higher than those in the control group ( t=6.591, 9.615, 11.383, all P<0.05). The levels of HMGB1, CRP and TNF-α in the two groups before treatment had no statistically significant differences( t=0.306, 0.669, 0.371, all P>0.05), which in the two groups after treatment were all decreased (the combined group: t=10.235, 16.992, 12.371; the control group: t=4.763, 15.663, 13.115, all P<0.05). The levels of HMGB1, CRP and TNF-α in the combined group were lower than those in the control group after treatment( t=6.591, 3.559, 8.307, all P<0.05). Conclusion:Salbutamol combined with budesonide aerosol inhalation in the treatment of acute attack of bronchial asthma has better effect, which can effectively improve the lung function of patients, inhibit the release of inflammatory factors, and with high safety.