Thyroid dysfunction is particularly common during pregnancy , which may affect pregnancy outcomes , and harm maternal and child health.Since release of 2011 pregnancy thyroid-stimulating hormont(TSH) diag-nostic guidelines by American Thyroid Association (ATA).In 2012,Endocrinology branch and Perinatal Medi-cine Branch of the Chinese Medical Association jointly issued the “pregnancy and postpartum thyroid disease di-agnosis and treatment guidelines”, it is important that each laboratory has its own reference interval for diagnosing thyroid disorders in pregnancy.This article discussed trimester-specific thyroid hormone reference of the area in where the auther live.

Objective To investigate the relevance ratio of abnormal electrocardiogram (ECG) and describe the abnormal ECG index among the residents in Keshan disease (KD) area.To assess the KD illness severity and provide comparable quantitative indicators,provide the scientific basis for elimination of KD.Methods Non probability sampling method was used,and monitoring stations with the highest incidence of KD at the county level were selected in 2012.Clinical examination and 12 lead ECG was carried out.According to The KD Diagnosis Standard (WS/T 210-2011),eight common changes in ECG of KD were scored.According to age and sex group,check the abnormal rate of ECG detection of Keshan disease,while analysed the changes of abnormal ECG index score in latent KD patients and chronic KD patients.Abnormal ECG index to determine:If there was one change,the score was 1 and the abnormal ECG index was 1.And so on,the highest score was 8.Results Totally 61 831 residents were surveyed and 9 634 were found with abnormal ECG,and the relevance ratio of abnormal ECG was 15.58％;totally 3 862 residents had eight ECG changes of KD and the relevance ratio was 6.25％;totally 508 residents were diagnosed with KD and the relevance ratio was 0.82％.The relevance ratio of abnormal ECG among all age groups was statistically different (x2 =3 065.64,P ＜ 0.05).The relevance ratio of abnormal ECG in women was higher than that of men [3.91％ (2 419/61 831) vs 2.33％ (1 443/61 831),x2 =86.30,P＜ 0.05].Abnormal ECG index score was (1.06 ± 0.25) which was not statistically different between gender [men:(1.07 ± 0.27) vs women:(1.06 ± 0.24),t =1.41,P ＞ 0.05].The abnormal ECG index score in latent KD patients was lower than that of chronic KD patients [(1.09 ± 0.30) vs (1.60 ± 0.69),t =-4.87,P ＜ 0.05].In eight ECG changes,the most check out items were T wave and/or ST segment changes (2 816).Conclusions The relevance ratio of abnormal ECG in KD area is at a higher level.The abnormal ECG index can be used to assess the KD illness severity and provide comparable quantitative indicators,in order to provide a new train of thought for the evaluation of KD elimination.

To evaluate the efficacy and accuracy of photorefractive keratectomy (PRK) for myopia and myopic astigmatism .SVS APEX excimer laser with a wave length of 193 nm(Sumit Technology Inc. Waltham, Mass, USA) was applied. 316 myopic eyes of 168 patients were treated with PRK between September, 1996 and October, 1997, and 260 eyes (84%) of 150 patients were followed for more than three months, including male 68(116 eyes, 40.1%) and female 82(144 eyes, 59.9%). The preoperative spherical equivalent refractive errors ranged from -1.25D to -10.00 (mean -4.67±1.63D), and astigmatism ranged from 0 to -2.00D (means -0.33±0.45D). We divided the patients into two groups according to the referaction: group A (from -1.25D to -5.90D) and group B(from -6.00 to -10.00D). The number of eyes in the two groups were 220 and 40 respectively. In group A, on the 10th day, 68.9% has the uncorrected visual acuity (UCVA) equal to or one line better or lower than the preoperative best corrected visual acuity (BCVA). In 1,3,6 and 12 months, 90%, 96%, 95% and 94% had the UCVA equal to or one line better or lower than the preoperative BCVA respectively. In group B, on the 10 th day, in 1,3,6 and 12 months, UCVA equal to or one line better or lower than the preoperative BCVA occurred in 35.9%, 83%, 87%, 86%, and 84% of the cases respectively. Most of the haze showed 0.5～1 grades except 3 eyes with the haze of 2 grade in 3 or 6 months and it changed to 1 and 0.5 grade respectively within one year. In 10 days and 1,3,6,12 months postoperatively, the corneal haze was noted in 32.9%, 84.8%, 62.8%,9.0% and 2.8% of the treated eyes respectively. We found that 193 nm excimer laser PRK was a predictable, safe, stable, and effective refractive surgery for correcting myopia up to -10.00D in Chinese patients, and the effect was better in myopia lower than -6.00D.

Oblective To evaluate the corneal healing of non-epuality diopter response histopathologically,immunohistochemically and ultrastructurally after excimer laser photorefractive keratectomy(PRK) with SVS APEX PLUS(Summit Technology Inc. USA) excimer laser, and the effects of corticosteroid on the healing. Methods PRK on 6 white rabbits(12 eyes) was performed on right eye of the rabbit for an attampted correction of -4.00 diopter and on left eye for an attempted correction of -8.00 diopter. The rabbits were divided into 2 groups randomly and each group included 6 eyes: Group FLM (3 rabbits, 6 eyes) and group CM (3 rabbits, 6 eyes). Fluoromethalone was given to group FLM,and chloromycetin to group CM. On 10d, 30d and 100d ,the eyes of one rabbit in each group were enucleated randomly. Half of each cornea was prepared for electron microscope observation (SEM and TEM)and the rest embedded in OCT compound for immunohistochemical study to examine Ⅲ -C and FN. Results All eyes were reepithelialized within 3d after PRK. Subepithelial corneal haze was observed on 15d,which was dominant on 30 or 60d. On 100d postoperatively,corneal hazes of 11 eyes were grades 0 or 0. 5,only 1 eye(the left eye of group CM) was denser haze (grade 1). On 3d postoperatively, one or two layers of corneal epithelial cell covered the ablation zone. On 30d after PRK,the epithelial cells showed hyperplastic changes. The cells were larger and increased from normal 5 or 6 layers to 7 or 8 layers of cells on 100d after PRK,epithelium was clear with more bright epithelium. Microplicae and microvilli were less than before. The expression of Ⅲ -C and FN in group CM was significantly more evident than that in group FLM. Conclusion The study show that despite recovery of a continuous and smooth epithelial layer and nearly normal corneal tissues on 100d after PRK,abnormalities of both epithelium and superficial stroma can be detected in the area of ablation. The ablation depth of stroma can influence the appearance of corneal haze after PRK. The microplicae and microvilli of rabbit cornea epithelium become less after PRK,which can be one of cause leading to ocular dry sensation in some patients.

Objective To describe the status of prevalence,awareness,treatment,and control of hypertension among the residents in severe historical endemic areas of Keshan Disease in Heilongjiang Province,and to provide scientific evidence for prevention and control of hypertension.Methods In December 2015,Yongjin,Yongli groups of Yongjin Village,and Fengnian,Fengtian,Fengfu groups of Fengnian Village in Fanrong Township,Fuyu County,Qiqihaer City,Heilongjiang Province were selected via the cross-sectional method.The residents aged 18 years or older were surveyed as respondents by cluster sampling.Demography,risk factors,hypertension related information were collected through questionnaire survey.Blood pressure,height and weight were measured through physical examination.Blood pressure measurement was conducted with Omron HEM-1020 electronic sphygmomanometer,the diagnostic criteria was Chinese Guidelines for Prevention and Treatment of Hypertension (revised in 2010).Results Totally 683 residents were surveyed,the valid participants were 669,the prevalence of hypertension was 49.2％ (329/669),the standardized prevalence was 37.9％,the prevalence of men [58.0％ (164/283)] was higher than that of women [42.7％ (165/386),x2 =15.103,P ＜ 0.01],the prevalence increased with increasing age (total,men,women:x2tendency =9.044,4.560,7.789,all P ＜ 0.01).The awareness of hypertensive patients was 60.8％ (200/329),the standardized awareness was 41.2％,the awareness of men [54.3％ (89/164)] was lower than that of women [67.3％ (111/165),x2 =5.836,P ＜ 0.05],the awareness of hypertensive patients increased with increasing age (total,men,women:x2tendency =3.638,2.686,2.419,all P ＜ 0.05).The treatment of hypertensive patients was 51.1％ (168/329),the treatment of men [43.9％ (72/164)] was lower than that of women [58.2％ (96/165),x2=6.711,P ＜ 0.05],the treatment of hypertensive patients increased with increasing age (total,men,women:x2tendency =4.422,2.704,3.633,all P ＜ 0.01).The control rate of hypertensive patients was 5.5％ (18/329),the control rate among the treatment was 10.7％ (18/168).Conclusions The standardized prevalence of hypertension among the residents of the severe historical endemic areas of Keshan disease in Heilongjiang Province is higher than the national average (25.2％),the standardized awareness is lower than the national average (46.5％),the treatment and the control are low.We should pay more attention to the hypertension in the severe historical endemic areas of Keshan disease.

Objective To evaluate the efficacy and accuracy of photorefractive keratectomy(PRK) for myopia and myopic astigmatism.Methods SVS APEX PLUS excimer laser with a wave length of 193nm(Summit Technology Inc.Waltham,Mass,USA) was applied.Three hundred and sixteen myopic eyes of 168 patients were treated with PRK from Suptember 1996 to October 1997,and 260 eyes(84%) of 150 patients were followed-up for more than three month,including male 68(116 eyes,40.1%) and female 82(144 eyes,59.9%).The preoperative spherical equivalent refractive errors ranged from -1.25D to -10.00D(mean -4.67D± 1.63D),and astigmatism ranged from 0 to -2.00D(mean -0.33D±0.45D). The patients were divided into two groups according to the refraction:group A(from -1.25D to -5.90D) and group B(from -6.00D to -10.00D).The number of eyes in the two groups were 220 and 40,respectively.Results In group A,After 10 days,68.9% had the uncorrected visual acuity(UCVA) equal to or one line better or lower than the preoperative best corrected visual acuity(BCVA).After 1 ,3,6 and 12 months,90%,96%,95% and 94% had the UCVA equal to or one line better or lower than the preoperative BCVA,respectively.In group B,after 10 days,1,3,6 and 12 months,UCVA equal to or one line better or lower than the preoperative BCVA occurred in 35.9%,83.0%,87.0%,86.0% and 84.0% of the patients respectively. Most of the haze showed 0.5～1 grades except 3 eyes with the haze of 2 grade at 3 or 6 months and it changed to l and 0.5 grade respectively at one year.after 10 days and 1,3,6,12 months postoperatively,the corneal haze was noted in 32.9%,84.8%,62.8%,9.0%and 2.8% of the treated eyes respectively.Conclusion We found that the 193nm excimer laser PRK is a predictable,safe,stable,and effective refractive surgery for correcting myopia up to-10.00D in Chinese patients,and the effect is better in myopia lower than -6.00D.

BACKGROUNDAs a new member of inhibitor of apoptosis protein(IAP) family,Livin,especially Livin α,is known to be involved in occurrence and development of lung cancer.Livin is an important mechanism of chemotherapy resistance of lung cancer cell.The aim of this study is to set up Livin isoform(α & β)-specific gene silencing system in SPC-A1 cells by gene transfection and RNA interference(RNAi),and to explore the different functions and value of the isoforms in enhancing chemosensitivity of SPC-A1 cells.

METHODSLivinα+β,Livinα and Livinβ specific siRNA were expressed stably in SPC-A1 cells,respectively.MTT was performed to study sensitivity of the cells to chemotherapy drugs.In vivo experiment was performed to test sensitivity of mouse bearing tumor to cisplatin after gene silencing of Livin.

RESULTSAfter silencing of Livinα+β,Livinα and Livinβ genes,sensitivity of SPC-A1 cells to many chemotherapy drugs(including cisplatin,carboplatin,cyclophosphamide and adriblastine) was markedly increased(P < 0.05).Among them,gene silencing of Livinα+β showed the strongest enhancement effect on chemosensitivity of SPC-A1 cells(P < 0.01).Animal experiment showed that tumor inhibition rate of pSilencer-Livinα+β,pSilencer-Livinα and pSilencer-Livinβ groups was 146.1%,130.7% and 110.5%,respectively.

CONCLUSIONSThe results suggest that Livin isoform,especially Livinα+β is hopeful to be a molecular target for increasing sensitivity of lung cancer cell to chemotherapy.Gene silencing may be a new means of gene therapy for non-small cell lung cancer.

Objective To investigate the effect of blood transfusion physicians for participating in clinical consultation to provide a reference for blood transfusion physicians participating in clinical practice.Methods The clinical data in 5 224 inpatients receiving blood transfusion before the blood transfusion physicians participating in clinical consultation (from January 2010 to December 2015) and after participating in clinical consultation (from January 2013 to December 2015) were retrospectively analyzed.Results The occurrence rates of blood transfusion adverse reactions before and after the blood transfusion physicians participating in clinical consultation were 2.39 ％ and 1.48 ％ respectively (x2 =5.674,P=0.021),the blood transfusion ratios of inpatients were 4.85 ％ and 3.55 ％ respectively (x2 =135.5,P＜0.01),the average allogeneic blood transfusion volumes were 0.563 U and 0.420 U (t=3.986,P=0.016),and the constituent ratios of mild,moderate andsevere anemia were 5.40％ and 0.23 ％,29.60％ and 17.90％,and 65.00％ and 81.80％ respectively (x2 =237.6,P＜0.01).Conclusion Participating in clinical consultation by the blood transfusion physicians is conducive to clinical treatment.

Objective To make a discussion on patients with acute paraquat poisoning (APP) early copeptin and ischemia modified albumin expression and its clinical significance.Methods 93 APP patients were selected as the poisoning group,the hospital clinical death as the endpoint,di-vided into survival group (48 cases)and death group(45 cases).All patients after admission in 2 h, 24 h in blood samples were 3 mL,detection of myocardial enzymes,cTnI,IMA,Copeptin.Re-sults Compared the death group and survival group,Death group of oral dose than the survival group had significant difference.While the rescue time,for the first timeof hemoperfusion and times with no difference.2h after admission Copeptin,IMA levels elevated,the death group and survival group have significant difference.24 h Copeptin,cTnI,CK,CK-MB in death group was significantly higher than the survival group(P <0.05).IMA comparison between two groups was no significance.Patients with APP oral dose was positively correlated with Copeptin;and IMA (ACB value)was negative correlation.More oral dose,Copeptin,IMA increased significantly. Copeptin was negatively correlated with IMA levels. Regression analysis, suggesting that Copeptin,IMA,cTnI,CK,CK-MB in patients with oral dose showed a linear relationship.Con-clusion There is an important significance in early diagnosis of APP myocardial injury in the early detection of IMA and Copeptin,a correlation between concentration and prognosis,which is more severe illness,its content is higher,the worse the prognosis.It has an important clinical value for evaluating prognosis.

Objective To make a discussion on patients with acute paraquat poisoning (APP) early copeptin and ischemia modified albumin expression and its clinical significance.Methods 93 APP patients were selected as the poisoning group,the hospital clinical death as the endpoint,di-vided into survival group (48 cases)and death group(45 cases).All patients after admission in 2 h, 24 h in blood samples were 3 mL,detection of myocardial enzymes,cTnI,IMA,Copeptin.Re-sults Compared the death group and survival group,Death group of oral dose than the survival group had significant difference.While the rescue time,for the first timeof hemoperfusion and times with no difference.2h after admission Copeptin,IMA levels elevated,the death group and survival group have significant difference.24 h Copeptin,cTnI,CK,CK-MB in death group was significantly higher than the survival group(P <0.05).IMA comparison between two groups was no significance.Patients with APP oral dose was positively correlated with Copeptin;and IMA (ACB value)was negative correlation.More oral dose,Copeptin,IMA increased significantly. Copeptin was negatively correlated with IMA levels. Regression analysis, suggesting that Copeptin,IMA,cTnI,CK,CK-MB in patients with oral dose showed a linear relationship.Con-clusion There is an important significance in early diagnosis of APP myocardial injury in the early detection of IMA and Copeptin,a correlation between concentration and prognosis,which is more severe illness,its content is higher,the worse the prognosis.It has an important clinical value for evaluating prognosis.