Objective To investigate the effect of nano carbon tracer for protecting parathyroid function in the surgery of thyroid cancer.Methods A total of 178 patients with thyroid cancer admitted in our hospital from Jun.2014 to Mar.2016 were collected and divided into the control group and the observation group according to the random number table method,89 cases in each group.The control group received routine surgery,while the observation group received nanocarbon suspension during surgery.The levels of serum parathyroid hormone and serum calcium in the 2 groups were measured at 3 days after surgery,and the patients with low parathyroid hormone,normal parathyroid hormone and low calcium were counted.Results The rate of ormal serum calcium in the observation group was 91.01％(81/89),significantly higher than 67.42％(60/89) in the control group (P＜ 0.05).The rate of normal parathyroid hormone in observation group was 94.38％ (84/89),significantly higher than 64.04％ (57/89) in the control group (P＜0.05).Conclusion The nano carbon tracer is helpful for protection of parathyroid function in the surgery of thyroid cancer.

Totally 1 360 pregnant women during the first trimesters (4-12 weeks) who visited Ningbo University Affiliated Hospital and Ningbo Jiangbei Maternal Health Hospital from February 2010 to October 2011,and 216 non-pregnant healthy women,who contemporaneous by visited the hospital,were enrolled in this study.The thyroid screening was made by determining urinary iodine and serum free thyroxine,free triiodothyronine,total thyroxine,total triiodothyronine,thyrotropin,and thyroid peroxidase antibody (TPOAb).The median concentration of urinary iodine in the pregnant women was not different from that of non-pregnant women (P＞0.05) ; 1 360 pregnant women were screened,268 (19.71％) of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody.29(13.43％) of non-pregnant women were identified to suffer from thyroid disorders or with positive thyroid autoantibody.There was significant difference between the 2 groups (x2 =4.40,P＜0.05).Prevalence of thyroid dysfunction may increase during early pregnancy.The screening for thyroid function and autoantibody should be recommended in that period.

Objective To analyze risk factors for the perioperative complications and death following hip fracture in the elderly. Methods The present study included 1352 elderly patients (≥65 years) who had received hip fracture surgery from January 2010 to June 2015 in Huadong hospital affiliated to Fudan University. Their clinical data were analyzed to determine risk factors for perioperative complications and death. Results Factors significantly affecting the perioperative complications included gender, preoperative serum albumin, ASA grade (≥Ⅲ), cardiac functional grade (≥Ⅲ), respiratory system disease and blood transfusion. Factors significantly affecting the death included preoperative serum albumin, ASA grade (≥Ⅲ), cardiac functional grade (≥Ⅲ) and blood transfusion. Multivariate Logistic regression analysis revealed that the independent risk factors for perioperative complications included gender (B=-0.686, P=0.019), preoperative serum albumin (B=-0.808, P=0.006), cardiac functional grade (≥Ⅲ, B=1.181, P=0.004), blood transfusion (B=0.890, P=0.004) and respiratory system disease (B=3.118, P=0.000);while the independent risk factors for death included preoperative serum albumin (B=-2.516, P=0.000) and blood transfusion (B=1.396, P=0.010). Conclusions In elderly patients undergoing hip fracture surgery, the independent risk factors for perioperative complications included gender, preoperative serum albumin, cardiac functional grade, blood transfusion and respiratory system disease, while the independent risk factors for death included preoperative serum albumin and blood transfusion. Perioperative risk assessment and prevention are the keys of better prognosis.

Objective:To observe the effects of electroacupuncture(EA)on sleep electroencephalogram(EEG)and event-related potential(ERP)in patients with somatoform disorders(SFD). Methods:Seventy-five SFD patients were recruited as an EA group to receive EA at Shenting(GV24)and Baihui(GV20)once daily,30 min each time,with 6 straight days as a treatment course,and 4 courses were conducted at 1-day intervals.Before treatment,patients underwent a survey using a physical symptom checklist on their primary symptoms.Before and after treatment,their sleep EEG was monitored using Quisi,and the ERP mismatch negativity(MMN)and P300 were detected.The Quisi sleep EEG and ERP were also examined among 40 normal volunteers as the normal group data. Results:During the trial,13 cases were removed from the EA group due to incomplete data,and 62 cases were finally included for statistical analyses.Of the 62 SFD patients,the main disturbing symptoms were cognitive impairments,sleep disorders,respiratory symptoms,digestive symptoms,five-sense organ problems,and cardiovascular symptoms in order.Before treatment,the EA group had increased MMN and P300 latencies and decreased amplitudes compared with the normal control group(P<0.01 or P<0.05);according to Quisi,the EA group also had reduced total sleep time(TST),shorter rapid eye movement sleep(REM)latency(RL)and REM time(RT),smaller number of REM period(NRP),extended sleep latency(SL),longer awaking time(AT),lower sleep efficiency(SE),larger percent of non-rapid eye movement sleep(NREM)stage 1(S1)and smaller percent of NREM stage 2(S2),and the percent of slow wave sleep(SWS),i.e.NREM stage 3(S3)plus stage 4(S4),also went down,all presenting significant differences between groups(P<0.01 or P<0.05).After 4 courses of treatment,the MMN and P300 latencies were reduced,and their amplitudes became larger in the EA group compared with the baseline(P<0.05);they had insignificant differences compared with the normal control group(P>0.05).Quisi showed that the TST and RL increased,and the SL and AT decreased in the EA group,and the predominant change in sleep architecture was reduced S1 percent,increased S2,and improved SE,all showing significant intra-group differences(P<0.01 or P<0.05);however,the intra-group difference in the NRP was statistically insignificant(P>0.05).Except the TST,RT,S1 percent,and SWS,there was no statistical significance in comparing the other Quisi parameters(including RL,NRP,SL,AT,SE,and S2 percent)between the two groups(P>0.05). Conclusion:SFD patients have a variety of clinical symptoms,and most of them show abnormal sleep EEG and ERP;EA can correct abnormal sleep EEG parameters and the MMN and P300 of ERP in SFD patients.

To investigate the relationship between serum retinol-binding protein 4(RBP4) and gestational diabetes mellitus (GDM) in Chinese Han pregnant women.195 (23-42 years) pregnant women were recruited (July 2005 to December 2007) from the Department of Gynecology and Obstetric in Ruijin Hospital during their visiting for routine prenatal examination.99 subjects belonged to GDM group,and 96 belonged to the group with normal glucose tolerance (NGT).65 non-pregnant healthy women served as control.Serum RBP4 was measured using sandwich enzyme linked immunosorbent assay (ELISA).Pregnant women had higher level of serum RBP4 than that of non-pregnant control.The concentration of serum RBP4 was significantly increased in GDM group as compared with NGT group[(43.04±1.85 vs 33.84±2.17) rag/L,P<0.01].Multiple stepwise regression analysis showed that triglycerides and homeostasis assessment for insulin resistance (HOMA-IR) were independent variables of RBP4 (r2 =0.165) in pregnant women.The results suggest that serum RBP4 level is significantly increased in pregnant women.Women with GDM had even higher RBP4 level than that of normal pregnant women,and RBP4 levele was positively correlated with triglycerides and HOMA-IR.

OBJECTIVE：To evaluate the efficacy and safety of admi nistration of doxazosin mesylate in mild to moderate essential hypertension.METHODS　In the trial,43 patients meeting the creteria of enlistment after 2-week wash-out periods are randomized into two groups in term of double- blind manner,22 cases for doxazosin mesylate group,21 cases for Terazosin hydroc hloride group.The patients will recept the scheduled medication intervention and blood pressure measure in order to assess the efficacy of antihypertension.Phys ical examnation, electrocardiogram,hematological and urinary test will be perfor med for monitoring the adverse events according to the trial protocol.RE SULTS：The rate of effectiveness of doxazosin mesylate for hypertension controling is 86.4%.No severe adverse events such as the cardiovascular disorder s appear in the 6-week trial except for the mild,toleratable headache in one pat ient.Doxazosin mesylate does not interfere with the hepatic and renal metabolism and impair their functions.CONCLUSIONS：Doxazosin mesylate adim inistration is effective and safe in mild to moderate essential hypertension.

Objective To investigate the intervention effect of 1,25(OH)2D3 on serum level of parathyroid hormone,bone metabolic markers and muscle strength in the community elderly with low bone mass.Methods A total of 132 residents aged 60 years and over from Shanghai communities diagnosed as osteopenia or osteoporosis were enrolled and treated with 0.5 μg/d calcitriol for 3 months.Serum levels of parameters in blood biochemistry and bone metabolic markers were determined by Cobas Diagnosis System of Roche before and after treatment,and the handgrip strength of both left and right hands were measured at the same time.Results The average age of 132 patients was(66.1 ± 6.3) years,4 cases (all female) terminated their medication in advance,and 128 patients completed the treatment for three months.The baseline serum levels of 25 (OH)D and PTH were 19.6 ± 7.9 μg/L and 41.0 μg/L respectively.According to the median value of serum PTH before treatment,patients were divided into the two groups:the high PTH group and the low PTH group.Compared with the low PTH group,the serum levels of 25OHD and serum calcium were decreased in the high PTH group[(17.1 ± 7.0) μg/L vs.(22.1 ± 8.2) μg/L,2.4 mmol/L vs.2.5 mmol/L,P＜0.05].After 3 months of intervention,serum levels of creatinine,urine calcium and left handgrip were significantly elevated[(68.2 ± 13.8) μmol/L vs.(65.2 ± 13.4) μmol/L,(5.9 ± 2.8)mmol/24 h vs.(4.4 ± 2.0) mmol/24 h,23.8 kg vs.21.0 kg,all P ＜0.05],while serum levels of PTH,eGFR,phosphorus were significantly decreased[35.5 ng/L vs.42.0 ng/L,(87.0 ± 17.0) ml/min vs.(93.1±17.9) ml/min,1.2 mmol/L vs.1.3 mmol/L,all P＜0.05).There was a significant negative correlation between serum 25(OH)D and PTH before treatment(r=-0.312,P＜0.05),but the negative correlation between them was no longer significant after 3 months of treatment (r =0.042,P ＞ 0.05).A multivariate logistic regression analysis revealed that the increment of left handgrip strength greater than 25％ (OR =0.138,95％ CI:-0.002-8.383),the increment of serum calcium levels(OR =2.578,95％CI:1.0345-8.693)and age(OR =0.103,95％CI:0.035-0.345) were significantly correlated with the decrement of serum PTH levels greater than 30 ％ after three months of treatment.Conclusions Vitamin D diminution or deficiency is common in the elderly.The shortterm treatment of calcitriol can obviously reduce serum PTH,inhibit bone absorption and increase muscle strength.The effect of calcitriol on serum PTH is closely related to promoting calcium absorption and improving handgrip strength.

The management of drug clinical trial institutions from the risk management point of view is investigated. According to the technology of risk assessment in risk management, taking the project audit as an example, basing on the basic procedures of risk identification, risk assessment and risk control, making 8 risk factors into the table of risk management for project approval of clinical trial in order to initially establish a risk management of drug clinical trial institutions. In this way, the management quality of project for drug clinical trials will be probably improved, so that the risk incidence rate will be effectively reduced in the later phase of clinical trial.

Objective: To understand the relationship between medication during pregnancy and single live preterm birth of infant in women of childbearing age in Shaanxi province. Methods: A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women selected through multi stage stratified random sampling in Shaanxi during 2010 to 2013. Qualitative datum was described by percentage and measurement datum was described by mean±standard deviation. Logistic regression analysis was done to evaluate the relationship between medication during pregnancy and preterm birth of infant. Results: The overall incidence rate of premature birth was 2.7% in Shaanxi. Among the 28 841 mothers participating in this study, the proportion of medication use at any time during pregnancy was 15.8%, and the most commonly used drug was cold medicine (5.9%). After adjusting all confounding factors, the multivariable logistic regression analysis results showed that taking hormone medicine (OR=2.23, 95%CI: 1.19-4.18), antihypertensive medicine (OR=7.74, 95%CI: 4.28-13.95) and other medicines (OR=2.15, 95%CI: 1.60-2.89) during early pregnancy were the risk factors for preterm delivery, the risk was 2.23 times, 7.74 times and 2.15 times higher compared with those taking no these medicines. Conclusion Using hormone medicine, antihypertensive medicine and other medicines during pregnancy increased the risk for preterm delivery in women of childbearing age in Shaanxi.

Objective: To investigate the relationship between maternal disease in early pregnancy of women of childbearing age and congenital heart disease of neonates. Methods: A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women during 2010-2013 in Shaanxi province. Propensity score (PS) matched (1∶1) analysis was used to match participants with diseases to those without disease in early pregnancy. Through the control of the confounders step by step, a logistic regression model was established to evaluate the ORs of congenital heart disease according to the independent variable of maternal disease. Results: A total of 28 680 pairs of mothers and infants were included in this study, the proportion of the women with disease in early pregnancy was 20.25% (5 807). After PS matching, 5 436 pairs were matched. After adjusting all confounding factors, the multivariable logistic regression analysis results showed that maternal disease (OR=1.86, 95%CI: 1.23-2.81), especially cold (OR=2.19, 95%CI: 1.46-3.28), gynecological disease (OR=4.74, 95%CI: 2.03-11.09) and diabetes (OR=14.00, 95%CI: 1.64-119.21), in early pregnancy were the risk factors for congenital heart disease of neonate. Conclusion In women of childbearing age, disease in early pregnancy, especially cold, gynecological disease and diabetes, can increase the risk of congenital heart disease in neonates.