In recent years,with the criterion and scaling up of newborn screening work,not only the rates of neonatal congenital hypothyroidism screening increased year by year but also more and more neonatal hyperthyrotropinemia children have been found.How to correctly understand the neonatal hyperthyrotropinemia is still one of the problems in the clinical work.This article will review the causes,diagnosis,prognosis and treatment principles of hyperthyrotropinemia.

Objective To evaluate the effects of dopamine (DA) alone or DA plus norepinephrine (NE) on hemodynamics, tissue oxygenation, acid-base balance and renal function during orthotopic liver transplantation (OLT).Methods Thirty ASA IE or IV patients undergoing OLT were randomly divided into 2 groups of 15 patients each. In group A DA was continuously infused during operation. The initial infusion rate was 1-3 ?g?kg-1 ?min-1 . The rate was then adjusted to MAP between 60-80 mmHg. While in group B DA and NE were continuously infused. The initial infusion rate of DA was 1-3 (?g?kg-1?min-1 and that of NE 0.03 ?g?kg-1?min-1 . Both rates were adjusted to MAP between 60-80 mm Hg but the maximal DA infusion rate was 5 ?g?kg-1?min-1 . Anesthesia was induced with midazolam, propofol, fentanyl and vecuronium and maintained with isoflurane inhalation, continuous propofol infusion and intermittent i.v. boluses of fentanyl, midazolam and pipecuronium. Radial artery was cannulated and S-G catheter was placed via right internal jugular vein. Hemodynamic variables such as MAP, CVP, PAP, PCWP, SVRI, PVRI, blood gases, mixed venous blood O2 saturation (SvO2), blood lactate, Cr and BUN were measured and O2 delivery (DO2 ) and O2 consumption (VO2 ) were calculated and recorded after induction and before surgery (T1 baseline), 60 min after operation was started (T2), at 60 min anhepatic phase (T3) and 60 min neohepatic phase (T4 ) and at the end of operation ( T5). Results There were no significant differences between the two groups with respect to age, sex, body weight, duration of operation and types of surgery. MAP and HR were quite stable in both groups. CVP, MPAP, PCWP, cardiac output (CO) and CI were significantly decreased while SVR and SVRI were increased during anhepatic phase (T3 ) in both groups ( P

Objective:To evaluate the effect of fire needle with regulating respiration by mu point treatment and regulating zang by shu point treatment on humid-heat type of rheumatoid arthritis(RA).Methods:120 patients with RA were randomly divided into two groups:the treatment group received fire needle with regulating respiration by mu point treatment and regulating zang by shu point treatment,the control group were administrated with Dichronic tablets.The changes of rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C reactive protein(CRP),immune globulin and the indexes of swelling,aching,morning stiffness of joints were observed.Results:After treatment,the curative effect rate in the treatment group was higher than that in the control group(P

Objective To evaluate the serum Level of B-natriure peptide(BNP)in elderly patients with Left Ventricular dysfunction and to determine the correlation between the BNPand hemodynamic Variable.Methods According to New York Heart Association(NYHA)class.51 patients with Left Ventricular dysfunction and 28 without Left Ventricular dysfunction(control group)were measured.BNP Levels were obtained,Left ventricular ejection fraction(LVEF)was assessed by echocardiography,center vein pressure(CVP)was determined in NYHA Class Ⅲ-Ⅳ groups.Results BNP were (39.32?5.51)ng/L in control group,respectively(265.94?63.13)ng/L in NYHA ClassⅡgroup(n=18),(569.93?109.17)ng/L 、CVP was(9.67?1.23)cmH_2O in NYHA class Ⅲ group,(2 764.33?1 020.53)、CVP was(19.61?4.57)cmH_2O in NYHA class Ⅳ.The difference of BNP and CVP in groups were scegnificant(all P

Objective To evaluate characteristics of hematopoietic and immunologic reconstitution in mixed cord blood transplantation. Methods Single, 2 human HLA-haploidentical or HLA-mismatched cord blood units were transplanted into sublethally irradiated severe combined immunodeficiency (SCID) mice, respectively. The characteristics of engraftment, multilineage hematopoiesis and immunologic reconstitution among the three guoups were compared. Results Single or 2 cord blood units could engraft SCID mice and reconstitute human hematopoiesis and immunologic functions. No significant differences in engrafting rate were observed. Cord blood cells were apt to differentiate into NK cells and B lymphocytes. One or 2 cord blood units could be implanted in SCID mice simultaneously as shown by HLA-DQB1 gene detection. The cord blood containing more hematopoietic progenitor cells and higher colony forming potentiality was apt to engraft. Moreover, in less HLA disparity group, 2 cord blood units were prone to engraft simultaneously. Conclusions Co-transplantation of two cord blood units can reconstitute hematopoietic and immunologic functions in SCID mice. However, imbalance in multilineage differentiation existed.

Objective To investigate the clinical efficacy of Bushen Tongdu Capsule for treating patients with rheumatoid arthritis (RA, TCM syndrome of kidney-deficiency with cold). Methods Totally 71 RA patients were randomly divided into treatment group (36 cases) that was treated with Bushen Tongdu Capsule and control group (35 cases) that was treated with tripterygium glycosides tablet. Both groups were treated for 12 weeks. The signs and symptoms, the state of illness, and laboratory index were observed before and after treatment. Results The total effective rate was 72.22% (26/36) in the treatment group, and 62.86% (22/35) in the control group, without statistical significance (P>0.05). After treatment, simplified disease activity index, TCM syndrome integrals, tender joint count, swollen joint count, overall evaluation from patients, overall disease evaluation from doctors, rest pain, morning stiffness time, average hands grip strength, 20 m walking time, healthy condition questionnaire score, and C-reactive protein were significantly improved in both groups (P<0.01, P<0.05). Compared with control group, TCM syndrome integrals changed more significantly, with statistical significance (P <0.05). Conclusion Bushen Tongdu Capsule can relieve symptoms and signs of RA patients (TCM syndrome of kidney-deficiency with cold) effectively.

Objective To evaluate the diagnostic value of multi-slice CTA(MSCTA) in cerebral aneurysms.Methods 15 patients with cerebral aneurysms were undergone MSCTA,of which,DSA were performed in 5 cases,and Gnglielmi detachable coil were performed in 2 cases . The images of 15 patients were processed with maximum intensity projection ( MIP ) , volume rendering ( VR ) and multiple planar reconstruction ( MPR ) .Results 16 cerebral aneurysms in 15 patients were found by MSCTA , the location of aneurysms was in the vertebral artery in 2,in the cerebral arterial circle in 5,in the anterior cerebral artery in 5 ,and in the middle cerebral artery in 3.DSA displayed 4 cerebral aneurysms in 5. 3D-CTA imaging and MPR combined with original transect images and multi-angle observation wereof great advantageous for diagnosis. The position, size and width of the fundus of cerebral aneurysms in 5 patients displayed by CTA wereaccordant with the results of DSA.Conclusion MSCTA can display cerebral aneurysms clearly. 3D-CTA combined with MPR and original images can make diagnosis more accurate and objective, and provide valuable information for surgery or interventional therapy.

Objective To evaluate the risk clinic factors of severe community-acquired pneumonia in older adults,and to provide examples for its clinic application.Methods Sixty-four case patients who were admitted for a diagnosis of severe community-acquired pneumonia in older adults in Beijing Haidian Hospital from January 2013 to July 2015 were selected as observation group.One hundred cases patients also admitted for a diagnosis of community-acquired pneumonia were selected as control group.Within 24 h of admission,the clinical data were collected,medical history were collected,and the serum biochemistry,coagulation index fibrin degradation product,D-dimer and inflammatory factor procalcitonin were detected.The data were analyzed by univariate analysis,and logistic regression analysis was used to analyze the variables with significant difference in single factor analysis.Results Single factor analysis showed that the percentage of severe pneumonia with central nervous system disorders,severe pneumonia with aspiration,severe pneumonia with two or more comorbidities,aspiration and severe pneumonia with bedridden patient in observation group were obviously higher than the control group,the difference between two groups have remarkable statistical significance((82.21％ (53/64) vs.32％(32/100),60.93％(39/64) vs.1％(1/100),(84.37％,54/64) vs.54％(54/100),90.62％(58/ 64) vs.28％ (28/100),59.37％ (38/64) vs.11％ (11/100);P＜0.01 or P＜0.05).The mortality of observation group was higher than the control group,the difference between two groups have remarkable statistical significance(56.62％ (36/64)] vs.3％ (3/100),P=0.001).Albumin of severe pneumonia was obviously lower than the control group,the difference between two groups have remarkable statistical significance ((27.79 ±8.53) g/L vs.(33.66±9.63) g/L,P=0.011).Fibrin degradation product of severe pneumonia was obviously lower than the control group,the difference between two groups have remarkable statistical significance ((i0.98 ± ± 1.32) ng/L vs.(3.61±0.98) ng/L,P=0.002).D-dimer of severe pneumonia was obviously higher than the control group,the difference between two groups have remarkable statistical significance ((2.68± 0.56) mg/L vs.(0.42±0.12) mg/L,P=0.001).Procalcitonin of severe pneumonia was obviously higher than the control group,the difference between two groups have remarkable statistical significance ((1.63±0.32) ng/L vs.(0.13 ± ±0.21) ng/L,P =0.015).The result of multiple factors logistic regression analysis showed the aspiration,hypoproteinemia,D-dimer were severe community-acquired pneumonia in older adults's independent risks (OR =1.782,1.208,1.356,P＜0.05).Conclusion Aspiration,hypoproteinemia,D-dimer are the factors of risking suffering severe community-acquired pneumonia in older adults.D-dimer could be the detection index of severe community-acquired pneumonia in older adults.

Objective To explore the indications, superiority and surgical technique of periareolar approach in the management of benign breast diseases. Methods 132 patients with benign breast disease (91 cases of Fibroadenoma, 12 cases of limited gland hyperplasia, 8 cases of cyst, 2 cases of benign phyllodes tumor and 6 cases of male gynecomastia) underwent operation through areolar incision. Results All patients were followed up for 1-10 months. 107 cases were satisfied with their treatment,19 cases were not quite satisfied with the relatively long incision, and 6 cases were not satisfied with the front incision. The one-month-later reexamination showed that 117 cases feel good and 15 cases had partial numbness of the nipple (15/132, 11.36%). All but two patients wound healing delayed because of local hematoma (2/132, 1.52%). Neither necrosis nor infection was found. Conclusions With the advantages of fewer complications and cosmetic effect, periareolar approach can be applied in management of various benign breast diseases. Factors such as indications, anatomical layer, postoperative molding, appropriate drainage, pressure dressing should be taken into consideration for the success of operation.

OBJECTIVE To study and evaluate the value of the antibiotic-neutralized culture bottle applied by manual operations.METHODS A total of 711 blood samples were collected from clinical high fever patients in Qingdao Central Hospital from 2002 to 2005.To compare the bacteria detected rates,cultural time and bacteria types in 399 samples cultured in manual blood-culture bottles with those in 312 samples cultured in antibiotic-neutralized culture bottles applied by manual operations.RESULTS The bacteria detected rates were 10.28% in manual blood-culture bottles and 20.83% in antibiotic-neutralized culture bottles applied by manual operations.There was significant difference between both of them(P72h were no statistical difference between manual blood-culture bottles and antibiotic-neutralized culture bottles.Twenty species of bacteria were detected in manual blood-culture bottles and 29 species of bacteria in antibiotic-neutralized culture bottles applied by manual operations.CONCLUSIONS The bacteria detected rate and species of bacteria were more obviously raised in antibiotic-neutralized culture bottles applied by manual operations than in manual blood-culture bottles.