Objective To explore the significance of thyroid function determination at the first and second trimesters of pregnan‐cy .Methods Electrochemiluminescence immunoassay was used to detect the levels of TSH ,FT3 and FT4 in first trimester women (T1 group) ,second trimester women (T2 group) and non‐pregnant women (control group) ,respectively .And the results were an‐alyzed .Results There were significant difference in the levels of TSH ,FT3 and FT4 between T1 group and control group (P<0 .05) .The total prevalence rate of thyroid diseases in pregnant women was 28 .85% ,which was significantly higher than that in control group(15 .00% ) ,P<0 .05 .Hypothyroidism and subclinical hypothyroidism were the main forms of thyroid dysfunction in pregnant women .Conclusion The determination of thyroid function at the first and second trimesters of pregnancy will benefit pre‐natal and post‐natal care .

Objective To explore the mental state of family members of neurosis patients, and to observe the effect of psychological intervention on these people. Methods The families of neurosis patients were randomly divided into experimental group (psychological intervention) and control group (no psychological intervention). Group or individual psychological consultations were performed in experimental group, and the intervention effect was evaluated with self-rating anxiety scale (SAS) scores method and was compared between experimental group and control group. Results The SAS score was 38.84?5.34 before psychological intervention and 29.43?2.99 after psychological intervention, respectively, and it had significant differences between before and after psychological intervention treatment, but no significant difference in control group. The effect of psychological intervention was correlated with age, education condition, occupation and habitation. Conclusion Mental problems exists in the family members of neurosis inpatients, and the psychological intervention can improve their psychological obstacle and ease anxiety, which benefits not only to the relatives' health but also to the neurosis patients' therapy and restoration.

Objective:To study the mesiodistal teeth size and the relationship between upper and lower teeth dimension of normal occlusion from Han Chinese in Xi'an. Methods: 52 males and 55 females with normal occlusion were selected. The mesiodistal width of each tooth was measured using a vernier gauge caliper. Statistical analysis was performed. Results: For the 107 cases with normal occlusion, the mean and standard deviation of the teeth size were calculated. There were significant differences between males and females in maxillary incisors, canines, first molar and mandibular canines, premolars. The normal range was obtained for the anterior and overall tooth size ratio(anterior ratio:78.32?3.01 overall ratio:91.10?2.27); and the regression equation that was used to quantify the tooth size discrepancies was expressed according to the significant correlation between the upper and lower tooth (r anterior=0.754, rtotal=0.851). Conclusion: There is a relationship between upper and lower teeth dimension. Sex difference should be considered when tooth size was used in clinic.

Objective To analyze the problems in the diagnosis of Coats disease and its main causes of misdiagnosis. Methods The clinical data of a group of patients with Coats diseases who had undergone indirect ophthalmoscopy, ocular fundus photography, fundus fluorescein angiography (FFA) and follow-up examination were retrospectively analyzed. The main causes of misdiagnosis were analyzed via reviewing the images of FFA and revising or confirming the initial diagnosis of Coats diseases according to the main features of abnormal dilation of retinal capillary vessels. Result In 68 patients (75 eyes), there were 45 cases whose initial diagnosis was Coats disease while the final diagnosis was not, in whom the final diagnosis was old retinal vein occlusion in 21, retinal vasculitis in 9, diabetic retinopathy in 3, old posterior uveitis in 3, congenital retinoschisis in 3, and proliferative vitreoretinopathy, familial exudative vitreoretinopathy, racemose hemangioma, old rhegmatogenous retinal detachment, macular epiretinal membrane, and idiopathic juxtafoveal telangiectasis in 1, respectively. There were 23 patients who was diagnosed as Coats disease in the final diagnosis but not the initial one. The initial diagnosis was old posterior uveitis in 6 patients, retinal vasculitis in 5, exudative age-related macular degeneration in 4, retinal main arterial tumor in 2, retinal angioma in 3, intraocular tumor in 2, and central serous chorioretinopathy in 1. Conclusions There are many problems in the clinical diagnosis of Coats disease. The main reason of misdiagnosis is that the clinicians can not comprehensively master the core of the definition of Coats disease and its clinical characters.

OBJECTIVE:To develop a HPLC method for the assaying of the principal agent in oxiracetam sodium chloride injection.METHODS:The separation was performed on Intersil CN-3column;the mobile phase was a mixture of acetonitri_ le-water(6∶94)with detection wavelength at214nm,flow rate at0.6ml/min and sample size at5?l under room temperature. RESULTS:The linear correlation of oxiracetam was observed over the concentrations of0.5625to288?g/ml(r=0.9999).The average recovery was99.95%(RSD=1.36%).CONCLUSION:The method is accurate,convenient specific and repro-ducible,and suitable for the determination and quality control of Oxiracetam.

Objective To evaluate the visual results,surgical technique and safety of secondary intraocular lens (IOL) implantation in aphakic eyes following vitrectomy and lensectomy for complicated ocular trauma or retinal detachment. [WT5”HZ]Methods The clinical records of 32 cases (32 eyes),received these surgeries during November 1996 and December 1999,were reviewed retrospectively.During the secondary operation,intraocular infusion through the pars plana was performend and the type of IOL was chosen based on the integrity of lens capsule. [WT5”HZ]Results The study included 30 eyes suffering from trauma (foreign bodies in 15 eyes,penetrating injury with traumatic endophthalmitis and with vitreous hemorrhage in 6 eyes respectively,blunt trauma with lens dislocation in 3 eyes),and 2 eyes with primary retinal detachment.Those eyes all received vitrectomy,lensectomy,and/or removal of foreign bodies and corneal suture.The interval of two operations ranged from 1 to 16 months with an average of 6.8?3.7 months.Posterior chamber IOL was implanted in the ciliary sulcus in 25 eyes with a whole or 2/3 of lens capsule,trans scleral suture fixation of IOL in 5 eyes,anterior chamber IOL and IOL with artificial iris in one eye respectively.Silicone oil was removed in 5 eyes during the secondary operation.Post operative visual improvement was achieved in 29 eyes.Main complications were corneal edema and low intraocular pressure after operation. [WT5”HZ]Conclusion Intraocular infusion and proper IOL implantation during the secondary operation following vitrectomy can provide selected aphakic eyes with better visual recovery.

Objective To observe the preventive effects of 2.5% sodium bicarbonate solution on the patients who had upper respiratory tract infection caused by fungal with hormone treatment.Methods 36 patients of systemic lupus erythematosus,polymyositis/dermatomyositis were randomly divided into two groups:observer group with glucocorticoid treatment and using 2.5% sodium bicarbonate solution to clean the mouth,and control group only with glucocorticoid treatment.After 7 days,we observed the rate of fungal infection of the two groups.Results There was significant diffience on the rate of fungal infection between observer group and control group(P0.05).Conclusion Using 2.5% sodium bicarbonate solution to clean the mouth can effectively prevent the patients who has upper respiratory tract infection caused by fungal with hormone treatment and decrease the rate of fungal infection.

Alzheimer disease (AD) is a significant threat on health in elderly people.Many traditional Chinese herbs and their prescriptions show fairly good effect in treatment of AD.We review the results on treatment of AD from three aspects of AD' s pathogenesis, in which the natural herbs were mainly used, and present the way to the problem to be solved.

The original meaning of Portfolio is briefcase, generally translated as study archives in our country, with learners as the center, through the process of goal setting, feedback learning, self-reflection, steps, to show yourself and target revision form of process evaluation with learners as the center, to continuously promote the personal comprehensive ability through reflective learning progress. Portfolio, introduced in clinical admissions bilingual teaching, through six aspects such as individual learning, classroom display, clinical teaching, practice process and result display and target changes, and through the learning process assessment (fuzzy comprehensive evaluation method) and professional knowledge assessment (mini) method evaluating the clinical practice, evaluates Portfolio, in order to improve the medical students' clinical thinking and their comprehensive ability of lifelong learning,and promote the medical students' all-round development.

Objective To investigate the diagnostic value of D-dimer age-adjusted threshold in elderly patients with Pulmonary thromboembolism(PTE).Methods Collected patients older than 50 years of suspected PTE,who visited Yan′an People′s Hospital and the Hospital Affiliated to Yan′an University from June 2015 to September 2016,using the revised Geneva criteria for clinical probability assessment firstly.The low-risk group was excluded from the study;the patients with moderate-to-high risk were performed D-dimer detection and CTPA.All patients determined both by D-dimer age-adjusted thresholds and traditional thresholds,comparing the diagnostic efficacy of the two methods subsequently.Results 163 patients were diagnosed with PTE by CTPA among the 549 subjects,the positive rate was 29.69％.The diagnostic sensitivity of plasma D-dimer was 83.44％,78.53％,the specificity was 17.88％,31.61％ respectively,the missed diagnosis rate was 16.56％,21.47％,respectively.The misdiagnosis rates were 82.12％ and 68.39％,respectively,and the Younden index was 0.013 2 and 0.101 4 respectively.All subjects were divided into four groups according to age:50-60 years,60-70 years,70-80 years,and equal or greater than 80 years age group.Compared with the traditional threshold,the misdiagnosis rates of the four groups of age-adjusted thresholds decreased by 4.00％,15.70％,21.36％ and 17.39％,respectively and the specificity was increased by 1.23,1.65,2.56 and 3.00 times,respectively.Conclusion The diagnostic accuracy of the age-corrected threshold is higher than the traditional threshold;combined with clinical practice,the optimal threshold is determined by the ROC curve,the clinician can serve as a reference.