HIFU is a new technology of noninvasive tumorectomy, which take use of thermal effects, mechanical effects and cavitation effects, etc. Currently, One of the difficulties in clinical application is how to determine energy dose of HIFU and resulted biological change. This paper expounds the factors such as sound intensity, irradiation duration, treatment depth, sound environment,etc. ,which affect energy input and therapeutic efficiency in HIFU treatment.

In view of the possibility for serious adverse outcomes for mother and fetus associated with maternal thyroid dysfunctions during pregnancy,many experts have recommended conducting routine thyroid function screening in pregnancy,but guidelines from different academic communities have given varied recommendations.The aim of this review is to discuss the significance of thyroid function screening in pregnancy and evaluate efficiency of the case-finding strategy vs.the universal screening strategy.

Objective To evaluate the association between maternal thyroid diseases in the first trimester of pregnancy and obstetric complications.Methods A total of 2 517 pregnant women from 10 hospitals in Shenyang during the first 12 weeks of gestation were enrolled in this study.All sera obtained from pregnant women were measured for thyroid-stimulating hormone (TSH),free thyroxine ( FT4 ),and thyroid peroxidase antibody (TPOAb).Collected items include obstetric outcomes and complications.Results Serum TSH above 2.5 mlU/L during the first trimester of pregnancy increased the rate of spontaneous abortion ( 8.69％ vs 6.38％,P =0.048 ),even if subclinical hypothyroidism (9.50％ vs 6.38％,P =0.009).TSH above the gestational special reference range,passive smoking,and over 30 years were independent factors for increasing the rate of spontaneous abortion.Hyperthyroidism and hypothyroidism with drug treatment to maintain normal thyroid function during pregnancy reduced the incidence of spontaneous abortion.Increased or decreased levels of serum TSH and TPOAb(+) were not related with other obstetric complications.Conclusion Serum TSH above the gestational special reference range during the first trimester of pregnancy is a risk factor of spontaneous abortion; maintaining TSH within the normal range by treating hyperthyroidism or hypothyroidism may reduce spontaneous abortion rate.

Objective To explore the prevalence of anemia,iron deficiency and iron deficient anemia (IDA),and to identify their risk factors in 3 to 6 months infants in Dongcheng District of Beijing.Methods All the 845 infants aged 3 to 6 months who received bacille calmette guerin (BCG) vaccine during December 2010 and October 2011 in Hepingli Hospital of Beijing were invited to complete the investigation.Data (months,gender,birth weight,birth height,etc) were collected through a questionnaire survey.Infants were tested for hemoglobin (Hb),mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration (MCHC),serum ferritin (SF) and zinc protoporphyrin (ZPP) and mothers underwent measurement for Hb,SF and serum iron (SI).Descriptive epidemiology and non-conditional logistic regression model were used to analyze the prevalence of nutritional anemia.Results The prevalence of anemia,iron deficiency and IDA was 12.06％,7.38％ and 2.11％,respectively.Non-conditional logistic regression analysis showed that the associated factor of anemia in infants was month age (vs.3-4 months age group,4-5 months age group:odds ratio (OR) =0.496,95％ confidence interval (CI) 0.272-0.905 ; 5-6 months age group:OR =0.494,95％ CI 0.234-1.043).The factors associated with iron deficiency were month age (vs.3-4 months age group,4-5 months age group:OR =0.539,95％ CI 0.266-1.088 ; 5-6 months age group:OR =0.334,95％ CI 0.125-0.891) and time of first breast-feeding (vs.the first day,the second day:OR =2.359,95％ CI 1.191-4.675; the third day:OR =1.154,95％ CI 0.450-2.963).Conclusions Our data show that iron nutrition in 3 to 6 months-old infants in Dongcheng District of Beijing was in good situation.The influencing factors of iron nutrition in infants may be month age and the time of first breast feeding.

AIM To study the influence of indapamide(Ind) on pharmacokinetics of telmisartan(Tel) and observe the difference between male and female rats. METHODS Wistar rats were divided into Tel and Tel+Ind groups, each group containing 8 female and 8 male rats, and were ig administered a single dose of either Tel 3.6 mg·kg-1 or Tel 3.6 mg·kg-1+Ind 0.135 mg·kg-1, respectively. Blood samples were collected at intervals over 96 h after administration. The Tel concentrations in plasma were determined by high performance liquid chromatography with fluorescence detector. The Tel concentration-time curves were simulated by 3p97 software and the pharmacokinetic parameters were calculated. RESULTS Whatever in female or male rats, there were no significant differences in the main pharmacokinetic parameters of Tel between Tel and Tel+Ind groups. However, females had higher values for area under the concentration-time curve and maximum plasma concentration than males, but lower values for total clearance in both Tel and Tel+Ind groups. CONCLUSION Ind has no significant influences on the pharmacokinetics of Tel. However, pharmacokinetics of Tel is significant different between male and female rats.

Objective To investigate the value of elasticity score and elasticity strain ratio (SR) in predicting the central lymph nodes metastasis of papillary thyroid microcarcinoma (PTMC). Methods This study conducted a retrospective analysis of ultrasonography ifndings of 236 thyroid lesions from 208 patients. All of them underwent surgery in Ruijin Hospital of Shanghai Jiao Tong University from June 2012 to March 2013. Totally 82 PTMC from 82 patients were included in this study. Among them 12 patients with 12 PTMC had central lymph nodes metastasis. The elasticity score and SR were compared between metastasis and non-metastasis groups, and the receiver operating characteristic (ROC) curve of SR was calculated. Results The differences of PTMC elasticity score between two groups showed no statistical signiifcance (χ2=5.00, P=0.08). The average SR of the group with central lymph nodes metastasis is 2.44±0.61, which is higher than the group without lymph nodes metastasis whose average SR is 1.67±0.42. Differences are statistically signiifcant (t=5.5, P=0.00). The area under curve of SR-ROC curve was 0.847. Using 2.01 as cutoff of SR, the sensitivity, speciifcity, accuracy of predicting central lymph nodes metastasis was 83.3%, 81.4%, 78.6%respectively. Conclusion The SR but not elasticity score could be a meaningful indicator for predicting lymph nodes metastasis.

Objective To evaluate quantitative coronary angiography (QCA) measurement of culprit vessel fixed stenosis in acute ST segment elevation myocardial infarction (STEMI) emergency interventional thrombus aspiration.Methods One hundred and sixty-fore cases of STEMI patients accepting emergency interventional operation and thrombus aspiration treatment were choosed from September 2012 to October 2013 in the First Affiliated Hospital of Wenzhou Medical University.Thrombus Aspiration measuring vessel was carried after criminals using fixed stenosis rate QCA methods.Results The vascular stenosis rate was more than 50％ in 69.5％ of the male patients,vascular stenosis rate was more than 70％ in 40.2％ of the female patients,the anterior descending branch of the rami anterior descendens(LAD) (54.75％ ± 29.72％,n=76),Left circumflex artery (LCX) (55.25％ ± 32.23％,n =20),arteriae coronaria dextra (RCA) (56.40％ ± 29.76％,n =68).There was no difference between LAD,LCX and RCA (F=6.036,0.955,0.055;P＞0.05).Conclusion The most majority of serious vascular stenosis patients have acute STEMI.

Objective To investigate the pathogenesis of small cell lung cancer ( SCLC) and to ex-plore the expression of cell cycle related kinase ( CCRK) in SCLC and its clinical significance.Methods Reverse transcription polymerase chain reaction ( RT-PCR) and Western blot were performed to examine ex-pression of CCRK in SCLC and normal tissues.Results The expressions of gene [(0.51 ±0.11)IU/L] and protein [(0.61 ±0.13)IU/L] of CCRK in SCLC tissues were significantly higher than normal tissues [(0.30 ±0.08)IU/L, (0.34 ±0.09)IU/L] ( P <0.05).The expression of CCRK was closely correlated with the clinical curative effect ( P <0.05 ) rather than the clinical stages ( P >0.05 ) .Conclusions The expressions of gene and protein of CCRK in SCLC tissues were significantly higher than normal tissues. CCRK promoted the occurrence and progress of SCLC.Chem can restrain effectually the excessive expres-sion of CCRK.The expressions of gene and protein of CCRK in the different clinical curative effect group had significant difference.

AIM:To investigate the effect of caspase-8 small hairpin RNA ( shRNA) on attenuating apoptosis of human mesenchymal stem cells ( hMSCs ) .METHODS: Two recombinant plasmids for over-expression of caspase-8 shRNA, pAd-Cap8 shRNA1 and pAd-Cap8 shRNA2, were constructed.Caspase-8 mRNA was determined in pAd-Cap8 shRNA-transfected human HEK293 cells by Q-PCR.The screened pAd-Cap8 shRNA was used to construct the recombinant adenovirus plasmid , which was linearized and transfected into HEK 293 cells for packaging and amplification of the recombi-nant adenovirus rAd-Cap8 shRNA.The expression of caspase-8 at mRNA and protein levels was determined by Q-PCR and Western blotting .Annexin V/PI staining and determination of caspase-8 activity were performed to assess apoptosis of hM-SCs under the conditions of serum deprivation and hypoxia .The mRNA expression of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin-like growth factor 1 (IGF-1), Bcl-2 and Bcl-xL was analyzed by Q-PCR.RESULTS:The pAd-Cap8 shRNA, which efficiently inhibited caspase-8 expression, was screened by Q-PCR.The recombinant adenovirus plasmid for caspase-8 shRNA was constructed and used to package and amplify the recombinant ad-enovirus ( rAd)-Cap8 shRNA successfully .rAd-Cap8 shRNA-mediated caspase-8 shRNA markedly inhibited caspase-8 ex-pression in hMSCs .Over-expression of caspase-8 shRNA by infection of rAd-Cap8 shRNA also efficiently decreased the ap-optotic rate and caspase-8 activity in hMSCs under the conditions of serum deprivation and hypoxia , with up-regulation of the mRNA expression of HGF, IGF-1 and Bcl-2.CONCLUSION:Caspase-8 shRNA attenuates hMSC apoptosis under the conditions of serum deprivation and hypoxia .

Objective To study of zoledronic acid in the treatment of multiple myeloma bone dis-ease clinical effect and detection of serum macrophage inflammatory protein (MIP)changes of primary mye-loma (mm)in patients with serum macrophage inflammatory protein levels and multiple myeloma bone dis-ease curative effect.Methods 48 cases of multiple myeloma bone disease patients were treated with VTD regimen chemotherapy were randomly and equally divided into two groups,one group (group A)chemother-apy intermission applied zoledronic acid 4 mg per month 1 time,treatment 2 course of treatment,observa-tion of curative effect and adverse reaction,another group (B group)declined to azole phosphonic acid treatment.Results Group of pain Solution of 16 cases were markedly effective,effective in 4 cases,4 ca-ses were ineffective,efficiency 83.3%.B group bone pain relieved markedly effective in 12 cases,effective in 4 cases,8 cases were ineffective,have efficiency 66.7%.A compared to the B,the curative effect was obvious (P <0.05).By enzyme linked immunosorbent assay for the detection of the patients with a,levels of peripheral serum MIP-1a and MIP-1 beta B two groups before and after treatment.Conclusions zole-dronic acid in the treatment of multiple myeloma bone disease effectively,can significantly improve the qual-ity of life in patients with MM patients serum MIP-1a and MIP-1 beta level and multiple myeloma tumor bone disease curative effect is negative correlation,used for evaluating the effect The reference index.