Objective To explore the value of ultrasound in assessment of treatment effect of diffuse toxic goiter.Methods 80 diffuse toxic goiter patients with 131I therapy were selected as research subjects.Before and after treatment,the serum thyroid hormone levels were detected and thyroids were checked by ultrasound.Results Before and after treatment,the FT3 levels were positively correlated with blood flow area ratio and flow grade (r =0.472,0.593,all P ＜ 0.05).After treatment,the thyroid weight,peak systolic velocity(PSV) and end diastolic velocity (EDV) [(12.89 ± 7.86) g,(32.24 ± 21.85) cm/s,(12.36 ± 19.22) cm/s] were significantly lower than those of before treatment [(30.12 ± 17.24) g,(68.58 ± 34.25) cm/s,(28.03 ± 21.24) cm/s] (t =11.265,4.762,3.672,all P ＜ 0.05).Before and after treatment,the RI and PI showed no significant difference(all P ＞ 0.05).The difference of thyroid blood flow grade before and after treatment was statistically significant (x2 =98.959,P =0.000),the proportion of flow grade class Ⅲ before treatment was higher(80.0％),while the proportion of flow grade class Ⅰ after treatment was higher(60.0％).After treatment,the FT3 and FT4 levels [(6.88 ± 4.14)pmol/L,(17.23 ± 7.35)pmol/L]were significantly lower than those of before treatment [(18.79 ± 6.45) pmol/L,(56.47 ± 22.97) pmol/L] (t =17.243,13.254,all P ＜ 0.05).The TSH level [(11.52 ± 8.27) mU/L] was significantly higher than that of before treatment[(0.01 ± 0.00)] mU/L (t =3.365,P ＜ 0.05).After treatment,the thyroid weight,PSV and EDV of cure group[(9.34 ±2.36) g,(20.13 ± 8.59) cm/s,(9.13 ± 5.34cmn/s)] were lower than those of non-cure group [(18.78 ± 8.76) g,(52.32 ± 13.24) cm/s,(17.24 ± 8.34crn/s)] (t =9.143,8.793,5.232,all P ＜ 0.05).The differences of RI and PI in the cure group and non-cure group were not statistically significant (all P ＞ 0.05).Conclusion Ultrasound has a better role in the evaluation effect of 131I therapy for diffuse toxic goiter.

Patients with primary liver cancer are always associated with hypersplenism .The traditional treatment of hypersplenism is splenectomy .With the development of interventional imaging ,partial splenic emboli-zation has been used extensively in clinical practice .Hepatocellular carcinoma with hypersplenism patients by par-tial splenic embolization can obviously improve the blood , reduce the complications of portal hypertension .PSE combined with other treatment can prolong the survival of patients with hepatocellular carcinoma .In this paper ,the clinical application of PSE is reviewed .

Objective Uterine epithelial cells were isolated from pregnant mice and cultured in vitro , and exam-ined the effect of CD82 on the expression of integrin αV,β3, E-cadherin and β-catenin in the cells.Methods The uter-ine epithelial cells were primarily isolated from pregnant mouse uterus .The recombinant adenovirus containing mouse CD 82 gene which had been constructed in our lab infected the uterine epithelial cells .Immunocytochemistry was used to detect the protein expressions of integrin αV,β3, E-cadherin and β-catenin in the uterine epithelial cells , which were infected with CD82 adenovirus or not .Results 1.The purity of primary cultured cells was (93.2 ±0.6)%.2.The transfection efficiency of CD82 recombinant adenovirus was ( 92 ±4.5 )%.The adenoviral particles carrying CD 82 gene indeed ex-pressed CD82 gene and protein in the primary uterine epithelial cells after 24 hours or 48 hours.3.The uterine epithelial cells of pregnant mice on d4 expressed integrin αV, β3, E-cadherin and β-catenin.4.In contrast to the control group, when CD82 adenovirus infected cells , the uterine epithelial cells of pregnant mice on d 4 increased the expression of integrinαV,β3 and β-catenin protein, had no significant changes of E-cadherin.Conclusions CD82 may have effect on the ex-pression of integrin αV,β3 and β-catenin in mouse uterine epithelial cells before implantation .

Objective:To study the health equity and explore the influencing factors of health inequities among those insured in New Rural Cooperative Medical System and to provide theoretical and factual basis for improvement of medical insurance system through .Method:Using concentration index decomposition to explore the sources of inequity in health outcomes and the degree of horizontal inequity in health outcomes .Results:Economical level leads that the concentration indexes of two week prevalence favor the poor , i.e.the worse the health outcome of the rich is.Economical level leads that the concentration indexes of chronic disease prevalence and self -reported health defective rate favor the rich , i.e.the worse the health outcome of the poor is .Conclusion:Economic level is the primary factors affecting two weeks prevalence , age, culture level, the employment situation is the factors al-leviate health outcomes unfair .Increase people′s economic level and cultural level , improve the situation of em-ployment is important to the health equity .

Objective To evaluate the efficacy and safety for cervical ripening by double-balloon catheter among full-term pregnancy women underwent labor induction.Methods It was a prospective nonrandomly controlled research.Totally 128 singleton-pregnancy women in full-term who had to undergo labor induction because of pregnancy complications or comorbidities from August 2011 to April 2013 in Peking University First Hospital were selected as study subjects.Participants were allocated to preinduction cervical ripening with either a double-balloon catheter (66 participants,study group) or prostaglandin vaginal insert (62 participants,control group).Compare the efficacy for cervical ripening and adverse reactions between the two groups.Results The efficacy for cervical ripening (Bishop scores improved by ≥ 2) had no significant differences between study and control groups [82％ (54/66) compared with 81％ (50/ 62),P＞0.05].The time interval between intervention and parturiency was significantly higher in the doubleballoon catheter group than in the prostaglandin vaginal insert group [(24.2±8.5) compared with (14.5±8.0) hours,P＜0.05].The proportion of women who achieved parturiency within 12 hours was significantly lower in the double-balloon catheter group than that in the control group [9％ (6/66) compared with 21％ (13/62),P＜0.05].The cesarean section rate showed no significant differences [41％ (27/66) compared with 43％(27/62),P＞0.05].The prevalence of intrauterine infection demonstrated by clinical diagnosis was significantly higher in the double-balloon catheter group [11％ (7/66) compared with 6％ (4/62),P＜O.05].The double-balloon catheter group had significantly lower rates of contraction overfrequency [0(0/66) compared with 42％ (26/62),P＜0.05],hyperthermia [3％ (2/66) compared with 19％ (12/62),P＜0.05],fetal heart rate abnormalities before removing the device or drug [5％ (3/66) compared with 19％ (12/62),P＜0.05],as well as precipitate labour [2％ (1/66) compared with 16％ (10/62),P＜0.05].Conclusions The efficacy of a double-balloon transcervieal catheter is similar to that of a prostaglandin vaginal insert.However,the double-balloon catheter cannot significantly reduce the cesarean section rate while it increases the risk of intrauterine infection.The materual and fetal safety of transcervical catheter is superior to the prostaglandin vaginal insert.In cases of oligohydramnios,fetal growth restriction,pregnancy complicated with asthma,hypertension and scar uterine are in favor of a balloon catheter using for cervical ripening on account of high risk of using prostaglandin.

Objective The pathogenesis of T2DM has not been elucidated.This study aimed to explore the association of FXR gene polymorphisms with the risk of T2DM in Eastern China population. Methods We collected 467 cases in the Health Examination Center of our hospital from January 2011 to December 2012.Ligase detection reaction was performed to test the genotypes in 240 T2DM patients and 227 controls.Unconditioned logistic regression analysis was used to explore the association of FXR gene polymorphisms with the risk of T2DM in different genetic models, after adjusting for age, sex, smoking and drinking status. Results Compared with AA genotype, GG significantly increased the risk of T2DM (P=0.017), while GA+GG approached marginal significance in association with T2DM (P=0.049) in rs1030454.For rs10860598, GA reduced the incidence of T2DM (P=0.025) compared with AA genotype, while GA+GG had marginal significance with T2DM (P=0.049).For rs11110411, CT or CT+CC could reduce the risk of T2DM compared with TT with P value of 0.016 and 0.024 respectively.Compared with AA, GA or GA+GG in rs17030270 was negative with the risk of T2DM with P value of 0.018 and 0.032 respectively. Conclusion FXR gene polymorphisms are associated with the risk of T2DM in northern Chinese Han population and the variation of FXR gene may play a role in the pathogenesis of T2DM.

Objective To study the abnormal alteration of regions in bipolar depression patients,so as to investigate its pathophysiologic mecha?nism. Methods Regional homogeneity(ReHo)technology of resting?state functional magnetic resonance imaging were used to compare 24 bipolar depression patients and 28 healthy controls. Results Compared to the healthy controls,the bipolar depression patients exhibited significantly higher ReHo value in the bilateral superior frontal gyrus,the bilateral middle frontal gyrus,the bilateral medial frontal cortex,the bilateral supplementary motor area,the left paracentral lobule and the left precentral gyrus(all P<0.001). Conclusion The abnormal function in the bilateral superior frontal gyrus,the bilateral middle frontal gyrus,the bilateral medial frontal cortex,the bilateral supplementary motor area,the left paracentral lobule and the left precentral gyrus may associate with the mechanism of pathophysiology in bipolar depression.

Objective:To find the discrepancies caused by HLA B gene variants in HLA B antigen homozygotes which were typed again by DNA method.Methods:75 blood samples assigned HLA B homozygotes by serology were typed and detected HLA B expression variants by PCR SSP.Results:The 12 samples had been assigned the second alleles by DNA method in 75 HLA B homozygotes by serology.One out of 12 samples was identified expression variant by PCR SSP.The null allele was caused by the insertion of an extra cytosine at the beginning of exon 4.Conclusion:HLA B gene typing by PCR SSP will be the use of supplement to serology.The expression variant detection by PCR SSP will improve accuracy for tissue typing and benefit clinical application.

Objectives To analysis the main characteristics and changes of the internal death in pediatric intensive care unit (PICU) in the past five years. Methods The clinical data of 330 death cases in PICU internal medicine were retrospectively analyzed from January 2008 to December 2012. Results The mortality rate in PICU dropped from 5.85%to 3.96% from 2008 to 2012. Among 330 death cases, 136 cases (41.2%) were infants, 73 cases (22.1%) were toddlers, 51 cases (15.45%) were preschoolers, and 70 cases (21.21%) were school-age and adolescence. In different years, the differences of distribution of death in different age groups were statistical significance (χ2=6.90, P=0.009). In all years, the infant had the highest death rate. As the time progresses, the death rate of the infant and young children decreases, while the death rate of the school-age and adolescence increases. Among the diseases caused death, the cardiovascular disease was the most common disease (33.94%), followed by hematologic malignancy (31.52%). The difference of distribution of the diseases caused death in different age group was statistically significant (P<0.01). The cardiovascular disease was main cause of death in infant, and the hematologic malignancy was the main cause of death in other three age groups. Within 24 h admission, the pediatric critical illness score (PCIS) had been assessed, 67.49% was critical and 15.48%was extremely critical. The hospitalization time was negatively correlated with PCIS (r=-0.313, P<0.001). Conclusions In the past five years, the mortality in PICU declined year by year. Cardiovascular disease in infancy and hematologic malignancy in non infancy are the leading cause of death in children. Admission in critical or extremely critical condition is the reason of early death in hospital.