Objective To investigate the effect of levothyroxine tablets on subclinical hypothyroidism in pregnancy.Methods One hundred and twenty patients with the subclinical hypothyroidism in hospital were divided into four groups,subclinical hypothyroidism + TPOAb (+) treatment group (39 cases),subclinical hypothyroidism + TPOAb(+) untreated group (15 cases),subclinical hypothyroidism + TPOAb (-) treatment group(26 cases) and subclinical hypothyroidism + TPOAb (-) untreated group (40 cases).Patients in the treatment groups were administrated with levothyroxine tablets.Results The levels of thyroid stimulating hormone(TSH) in subclinical hypothyroidism and TPOAb(+) treatment group were significantly lower(16-20 weeks and 28-32 weeks) at after treatment,which was also lower than that in B group(t =5.671,6.661,P ＜ 0.001).Compared with the untreated group,there was a significant difference in terms of average gestational age,fetal weight ((39.3 ± 1.6) weeks vs.(37.9 ± 1.4) weeks ; (3524 ± 562) g vs.(3101 ± 351) g,t =4.561,7.834,P ＜ 0.001) between A and B groups.In B group,premature birth,gestational hypertension,incidence of placental abruption were significantly higher than that in A group (26.67％ and 2.56％,x2 =7.490,P ＜ 0.001 ; 5.13％ and 40.00％,x2 =10.438,P ＜ 0.001 ; 0 and 13.33％,x2 =5.400,P =0.020).In C group after 16 weeks of treatment,TSH levels at (16-20) weeks and (28-32) weeks were significantly decreased.Compared with the D group,the differences were statistically significant (t =4.980 and 5.432,both P ＜ 0.001).There was no significant difference in C group and D group in terms of pregnancy outcome (P ＞ 0.05).Conclusion Patients with gestational subclinical hypothyroidism such as mergers TPOAb(+) should be treated in time.Prompt treatment can significantly reduce the incidence of adverse pregnancy outcomes,but if patient with TPOAb(-),It is recommended not to conduct any treatment.

OBJECTIVE: To investigate the expression of insulin receptor substrate-1 (IRS-1) and phosphorylation of tyrosine in androgen sterilized rats (ASRs) and the effects of Bushen Huoxue Huayu Recipe (BHHR), a compound Chinese herbal medicine for tonifying kidney and activating blood, on the ASRs, and to analyze the possible mechanism. METHODS: ASR models were established by means of testosterone injected subcutaneously at the age of 9 days. The model rats were randomly divided into BHHR group (n=15) and untreated group (n=15); the rats in normal group (n=15) were injected with oil. The rats in the BHHR group were treated with BHHR for 30 days, and the rats in model group and normal group were treated with distilled water for 30 days. Body weight and area under the curve (AUC) of insulin were measured after treatment. Expression of IRS-1 and phosphorylation of tyrosine in adipose tissue in ASRs were analysed by immunohistochemical method. RESULTS: The body weight and insulin AUC in the untreated group were increased and more than those in the BHHR group and the normal control group (P<0.05). Expression of IRS-1 and phosphorylation of tyrosine in normal group were significantly higher than those in the untreated group (P<0.05), and those in BHHR group were improved and significantly different from those in the untreated group (P<0.05). CONCLUSION: BHHR can increase the expression of IRS-1 and phosphorylation of tyrosine in adipose tissue in IR rats, which may be one of its mechanisms in improving insulin sensitivity of the target tissues.

Objective To investigate the relationship between HBV DNA load with the serological markers(HB-M)HBsAg, HBeAg,HBeAb,HBcAb in the persons infected by chronic hepatitis B virus (HBV)in Lanzhou.Methods The real-time fluores-cent quantitative PCR was used to detect the HBV DNA load and the double antibody sandwich chemiluminesent immunoassay was used to measure the serum HBsAg,HbeAg,HbeAb and HbcAb levels in 724 cases of HBVinfection.Results The HBsAg level was positively correlated with the HBV DNA load in chronic HBV infection in Lanzhou area(r=0.342,P <0.05),there was an ob-vious positive correlation between HBeAg and HBV DNA load(r=0.463,P <0.05),the HBeAb level and HBV DNA load had the negative correlation (r=-0.227,P =0.001),the HBcAb level and HBV DNA load had no significantly correlation (r=-0.062, P =0.366).Conclusion There is obvious positive correlation between HBV DNA load with HBsAg,HBeAg in chronic HBV infec-tion in Lanzhou area,which indicating that the observation by combining HBsAg and HBeAg with HBV DNA can judge the infec-tious degree of the patients more accurately.

Objective To investigate the correlations on hepatitis B virus (HBV) preS1‐antigen (pre‐S1Ag) with HBV‐DNA , HBV markers(HBV M) and liver function in the patients with hepatitis B .Methods The markers ,preS1‐Ag ,HBV‐DNA and liver function were determined by CLIA and PCR in 905 patients with hepatitis B (HBV infection group ) and 100 healthy persons (healthy control group) .Results Among 905 samples ,the positive rates of preS1‐Ag and HBV DNA were 68 .51% (620/905) and 67 .96% (615/905) ,there was no statistically significant difference between them (χ2 =30 .064 ,P>0 .05);the positive rates of pre‐S1Ag in 570 patients with HBeAg positive were 85 .08% (485/570) ,which was significantly higher than 40 .30% (135/335) in 335 patients with HBeAg negative ,the difference was statistically significant (χ2 =108 .881 ,P<0 .01) .The abnormal rates of ALT and AST in the Pre‐S1 Ag positive and negative groups were 53 .22% ,25 .96% and 51 .29% ,32 .98% ,respectively ,the differences be‐tween them were statistically significant (χ2ALT =53 .148 ,P<0 .001 ,χ2AST =66 .635 ,P<0 .001) .Conclusion Pre‐S1Ag is a reliable index of the HBV infection and duplication and is highly correlated with HBV‐DNA positive ,which is important supplement and strengthening and can provide more timely and reliable experiment basis for guiding the clinical treatment .

This article introduces two medical records of children's influenza A (H1N1). The first case is a child of influenza A (H1N1) complicated with pneumonia and it is differentiated as warm-heat syndrome. The treatment methods are dispelling wind and relieving exterior syndrome, clearing heat in qi level and removing heat at first, and then followed by dispersing lung-qi and clearing away heat pathogen, relieving cough and dissipating phlegm. The second case is a child of influenza A (H1N1) complicated with pneumonia, hypokalemia and exacerbation of primary nephrotic syndrome. The syndrome belongs to wet-heat from the beginning, so the treatment is promoting urination and eliminating turbidity, clearing heat and detoxicating, and combined with antiviral oseltamivir. The syndrome is phlegm-heat obstructing in the lung in the second phase of the disease, and the treatment is removing heat-phlegm, dispersing lung-qi and relieving cough.

Objective To analyse the clinical features of patients with gastroesophageal reflux disease(GERD)who had scores＜12 using reflux diagnostic questionnaires(RDQ).Methods A comparative and retrospective study was carried out in 148 GERD patients.Among whom 22 patients had low RDQ score(＜12)and 126 patients had high RDQ score(≥12).The differences in heart burn,substantial chest pain,regurgitation,severity and frequency of food reflux between two groups were compared.Nevertheless,the atypical symptoms such as chest distress.abnormal sensation of regurgitation or food reflux was significantly lower in patients with RDQ＜12 than those with RDQ≥accounted for 60.28%of the total RDQ score,whereas the heart burn,regurgitation and food reflux atypical symptom of chest distress was found in 13 patients(59.09%),abnormal sensation of throat in 8 patients(36.36%).cough and asthma in 3 patients(13.63%),headache in 5 patients(22.72%),belching in 9 patients(40.90%),aypnia in 8 patients(36.36%),and anxiety in 6 patients(27.27%).Conclusion RDQ is insensitive to those who have chest pain with no obvious symptom of heart burn,regurgitation or food reflux as well as those with atypical symptom beyond the RDQ.

Objective To investigate the value and clinical significance of CD4+CD25+ regulatory T cells (Treg) ,inteleukin‐18 , interferon‐γand transforming growth factor‐βin patients with hepatitis B virus (HBV) infection .Methods A total of 175 patients with HBV infection were divided into chronic type B hepatitis (CHB) group and chronic asympotomatic HBV carrier (ASC) group , which were further divided into hepatitis B e antigen (HBeAg) positive and negative groups .CD4+ CD25+ Treg ,cytokines levels and liver function were measured .Healthy subjects were enrolled into control group .Results Proportion of CD4+CD25+ Treg were without significant difference among healthy controls ,HBeAg(+ ) and HBeAg(-) ASC groups ,and HBeAg(+ ) and HBeAg(-) CHB groups (P>0 .05) .Compared with control group ,cytokines levels were significant higer in CHB and ASC group (P<0 .05) . CD4+CD25+ Treg level was significant positive correlation to alanine aminotransferase and ratio of aspartate aminotransferase to plateles in HBeAg(+ )ASC group (P<0 .05) .Conclusion CD4+CD25 + Treg and related cytokines could play important roles in the course of CHB ,while CD4+CD25+ Treg expressing might be correlated with inflammatory degree of hepatitis .

Objective To explore the differences in clinical and laboratory parameters between elderly and non-elderly patients with acute lymphoblastic leukemia (ALL).Poor prognostic factors in elderly patients were explored to guide the individualized treatment.Methods Two hundred and seventy-nine ALL patients were divided into two groups:elderly group with their age more than 60 years (60-79 years) and nonelderly group with their age less than 60 years (14-59 years).The differences in clinical and laboratory parameters,abnormal molecular genetics on related genes,including IKZF1,PAX5,NOTCH1,PHF6,SH2B3,LEF1,and JAK1,as well as the correlations with treatment response and clinical outcome were compared between the two groups.Results Males accounted for a smaller part in elderly group [42.9 ％ (21/49) vs.61.7 ％ (142/230),P =0.015].The percentage of B cell lineage ALL (B-ALL),Philadelphia chromosome positive (Ph+) and CD33 positive rate were higher in elderly group compared with those in non-elderly group [87.8 ％ (43/49) vs.70.4 ％ (162/230),P=0.009;47.8 ％ (22/49) vs.27.4 ％ (58/230),P=0.007;56.8 ％ (21/49) vs.39.0 ％ (64/230),P =0.049,respectively].While both lymphodenopathy and total complete remission (CR) rate gained the upper hand in non-elderly group [38.9 ％ (81/230) vs.20.0 ％ (9/49),P=0.016;91.3 ％ (178/195) vs.68.3 ％ (28/41),P＜ 0.001,respectively].Moreover,elderly group had lower 3-month,6-month,12-month and 24-month overall survival (OS) rates (64.6 ％ vs.84.4 ％,P=0.001;50.0 ％ vs.73.8 ％,P=0.001;29.2 ％ vs.52.4 ％,P=0.003;6.2 ％ vs.26.2 ％,P=0.003,respectively) than those of non-elderly group.No significant differences in mutation rates of PAX5,NOTCH1,PHF6,SH2B3,LEF1 and JAK1 were found (all P ＞ 0.05).Conclusions Compared with non-elderly ALL patients,elderly ones harbor their intrinsic characteristics which might give rise to inferior outcomes.As a consequence,more attention should be poured into treating this particular group of ALL patients to improve their prognosis.

Objective To investigate the changes and clinical correlation of IL-4 in patients with HBV infection.Methods Sixty cases with chronic asymptomatic HBV carriers,60 cases with chronic hepatitis B,60 cases with liver cirrhosis,60 cases with hepato-cellular carcinoma and 50 healthy controls were collected for serum.ELISA was used for detection of cytokine IL-4 levels;The a-mount of HBV DNA was measured by fluorescence quantitative PCR;Liver function was tested by automatic biochemical analyzer. Results Compared with the healthy controls[(1.64±0.17)ng/mL],IL-4 levels of patients with CHB,LC and HCC were signifi-cantly increased[(4.18±0.48),(4.71±0.42),(3.62±0.31)ng/mL,P <0.05].LC group have the highest IL-4 levels,while ASC was the lowest.Compared with the ASC group,IL-4 levels of patients with CHB,LC and HCC were significantly increased(P <0.05).Compared with the HCC group,IL-4 levels of patients with LC were significantly increased(P <0.05).IL-4 level was posi-tively correlated with TBIL levels in LC patients(r=0.529,P <0.01),while the IL-4 level was positively correlated with ALT and TBIL level in HCC patients(r=0.263,0.323,P <0.05).Conclusion IL-4 may play an important role in chronic HBV infection, the levels of IL-4 can be used as an important indicator to assess the severity of chronic hepatitis B.

Objective Accurate measurement of aldosterone is critical in the diagnosis of primary aldosteronism. We compared the harmonization of three assays including isotope dilution liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) and two chemiluminescence immunoassays (CLIAs:system A and system B) for the aldosterone measurement. Methods A total of 45 plasma samples, 4 quality control materials, 5 lyophilized bovine serums, and 3 fresh frozen human serum pools were measured by three assays respectively. Based on CLSI EP15-A3 rule, the precision was assessed by coefficient of variance. Deming regression and Bland&Altman plots was performed for method comparison, and correlation coefficient was calculated for concordance (CCC). Results All three methods met the performance criteria based on desirable biological variation for precision (<7.35％). System A showed a relevantly good correlation and comparability with ID-LC/MS/MS (R2=0.985, CCC=0.967), while System B showed relevantly bad correlations and comparability with both System A (R2=0.538, CCC=0.605) and ID-LC/MS/MS (R2=0.547, CCC=0.528).. However, the average relevant bias of two CLIAs exceeded the bias requirement derived from biological variation (18.60％). Conclusion Significant differences were found in the measurement of plasma aldosterone using ID-LC-MS/MS and two CLIAs, which urges the establishment of traceability hierarchy and improvement of reagents' specificity for standardization of aldosterone measurement in clinical settings.