Venous thrombotic disease is a serious disease,which impact on health and life-threatening.Pulmonary embolism and deep-vein thrombosis are the two components of a single disease called venous thromboembolism in obstetrics and gynecology.but it can be difficult to diagnose because clinical symptoms and signs are non-specific or absent in early venous thrombus embolism (VTE).It has great value that how to use the most economic,simple,efficient method for screened high-risk groups,timely and accurate laboratory diagnosis of VTE.

The clinical data and ultrasound findings of 185 patients with thyroid nodules undergoing thyroidectomy from June to December 2015 were retrospectively reviewed.Postoperative pathology confirmed malignant thyroid nodules in 86 cases and benign nodules in 99 cases.The ultrasonographic findings showed that there were significant differences in obscure boundary [51％ (44/86) vs.16％ (16/99)],hypoecho [(95％ (82/86) vs.27％ (27/99)],internal micro-calcification [63％ (54/86) vs.21％ (21/99)] and lymph node enlargement [33％ (28/86) vs.5％ (5/99)] between malignant and benign nodules (all P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of thyroid imaging reporting and data system (TI-RADS) in differentiation of malignant and benign thyroid nodules were 77％ (66/86),86％ (85/99),83％ (66/80),81％ (85/105) and 82％ (151/185),respectively.The positive rates of thyroid globulin antibody(TGAb) and thyroid peroxydase antibody (TPO-Ab) in malignant nodules [6％ (5/79) and 25％ (20/79)] were significantly higher than those in benign nodules [0 (0/94) and 12％ (11/94)] (both P ＜0.05).There was no significant difference in free T3 (FT3),free T4 (FT4) and TSH between the two groups [(4.91-± 0.78) vs.(4.93-± 1.98) pmol/L,(13.57 ±2.22) vs.(13.58 ±2.17)pmol/Land(1.78±1.40) vs.(1.88±2.36)mU/L] (allP＞0.05).The results indicate that TI-RADS grading and thyroid immunity index are valuable for differential diagnosis of thyroid nodules.

The initiation and development of diabetic chronic complications is associated not only with the level of blood glucose,but also with the glucose fluctuation.The damage in large artery and microvessel may be caused by glucose fluctuation.There are two causes which induce glucose fluctuation in clinical:one is postprandial hyperglyceamia with not well controlled,the other is hypoglycemia causes by unsuitable therapy.A lot of effective new types of substances were applicated in clinical,such as ?-glucosidase inhibitor,glinide-insulin secretagogus,fast-acting and long-acting insulin analogues.With these new powerful tools,there is possibility to treat diabetes more correctly and safely,and control the blood glucose in a stable and good level.

Laryngopharyngeal reflux (LPR) is gaining extensive attention in recent years because of the high incidence. But because of the complex symptoms and signs, there exist no diagnostic consensus. In this paper, the available objective diagnostic methods so far are reviewed, in the purpose of discussing the approach of objective and accurate diagnosis of LPR.
Humans ; Laryngopharyngeal Reflux ; diagnosis

Objective:To choose a best method of estimating the amount of blood loss after cesarean deliveryby comparing of three methods,to analyze the related factors of the amount of the blood loss more than 500ml after cesarean section.Methods:We collected the clinical data of the patients who were accepted cesarean delivery and treated in our hospital between January 2014 and December 2014.We estimate the amount of blood loss by different methods(including visually estimated,hematocrit (HCT) change and formula).Based on the formula method as the gold standard,we analyze the risk factors of the patients whose blood loss were more than 500 ml.Results:Among the 583 patients,using the method of visually estimated,there were 23 cases whose blood loss were more than 500 ml(3.95％),using the method of formula,there were 133 cases whose blood loss were more than 500 ml (22.81％),using the method of HCT change,there were 116 cases whose blood loss were more than 500 ml(19.90％).The incidence of patients whose blood loss were more than 500 ml between HCT change and formula method showed no significant difference(P ＞ 0.05),but the incidence by visually estimated method was less than the two other methods (P ＜ 0.05).We found the value of HCT change was a statistically significant positive correlation with the amount of blood loss more than 500ml.When the blood loss was more than 500 ml,the accuracy and sensitiveness of HCT method were significantly higher than those of visually estimated method(76.69％,87.93％ vs 12.78％,73.91％,respectively).Abnormal labor,uterine leiomyoma,placental factors,and macrosomia were risk factors of cases whose blood loss more than 500ml.Conclusions:HCT method is similar in accessing the blood loss after cesarean section with formula method,especially in the cases whose blood loss was more than 500 ml;HCT method is more convenient than formula method,and more accurate than visually estimated method.HCT method can be used as the standard for estimating blood loss initially,and formula method should be used as the method for estimating the blood loss accurately.Patients with macrosomia and abnormal labor are more likely to occur massive hemorrhage after cesarean section.

Objective To explore the curative effect of bisoprolol fumarate combined with wenxin granule for patients with heart failure complicated with premature ventricular.Methods 132 patients with heart failure and premature ventricular complexes were enrolled in our hospital from January 2013 to January 2016,and which patients divided into two groups,bisoprolol fumarate group (Group BF,n =66) accepted bisoprolol fumarate treatment (5 mg/time,1 times/day),and bisoprolol fumarate combined with wenxin granule group (Group BW n =66) adopted wenxin granule (9 g/time,3 times/day) based on the patients in Group BF.After 4 weeks treatment,the curative effect of all patients were evaluated with electrocardiogram monitor and cardiac ultrasound examination,and the plasma NT-proBNP concentration and hemorheology indexes were analyzed compared with pre-treatment.Results The recovery of ventricular function in Group BW was better significantly than that patients in Group BF from the cardiac ultrasound examination (P ＜ 0.05);The total relieved effective of clinical symptom,premature ventricular complexes and heart failure in Group BW were more remarkable than those in Group BF,and which difference from them was significance (P ＜ 0.05);The blood viscosity,plasma viscosity,plasma fibrinogen and plasma NT-proBNP concentration in patients with Group BW were significantly lower than those Group BF (P ＜ 0.05).Conclusions The clinical curative effect of bisoprolol fumarate combined with Wenxin Granule for heart failure complicated with premature ventricular was more remarkable compare with bisoprolol fumarate single treatment,and which possessed the relative safety.

Objective To evaluate application effectiveness of quality control circle (QCC)in increasing the face mask wearing rate of hospitalized pulmonary tuberculosis (TB)patients.Methods Nine nurses in department of tu-berculosis formed a ‘circle’,the theme of ‘improving the face mask wearing rate of hospitalized pulmonary TB pa-tients’was established,rectification measures were formulated and implemented,face mask wearing rates of pa-tients before and after implementing QCC activities were analyzed statistically.Results The face mask wearing rate of hospitalized pulmonary TB patients after implementing QCC activities was higher than that before implementing QCC activities (87.50% [147/168]vs 65.54%[116/177],P <0.05).The abilities of every ‘circle member’have been improved in the following aspects:problem-solving skills,sense of responsibility,communication skills,self-confidence,team working,enthusiasm,quality-control techniques,and cooperation abilities,the total average score increased from 23.78 before implementing QCC to 33.78 after implementing QCC.Conclusion QCC activities can not only improve the face mask wearing rate of hospitalized pulmonary TB patients,but also enhance circle mem-bers’quality-control skills and team spirit.

OBJECTIVE: To investigate the function of activator protein-1 (AP-1) in proliferation and collagen synthesis of cardiac fibroblasts (CFs) in neonatal rats induced by tumor necrosis factor-alpha (TNF-alpha), and to explore the mechanism of Qiangxin Decoction (QXD), a compound traditional Chinese herbal medicine, in reversing cardiac fibrosis. METHODS: CFs derived from neonatal rats were cultured with enzymatic dissociation, and fibrosis of the CFs was induced by TNF-alpha. The CFs were divided into normal control group, untreated group, 5% QXD-containing serum group, 10% QXD-containing serum group and 20% QXD-containing serum group. After 24-hour culture of QXD-containing serum, AP-1 mRNA was detected by real-time fluorescent quantitative polymerase chain reaction; proliferation and collagen synthesis of CFs were assayed by thiazolyl blue assay (MTT) and measured by hydroxyproline respectively, in order to determine the effect of different dosage decoction on the proliferation and collagen synthesis of CFs. RESULTS: After 24-hour stimulation of TNF-alpha in CFs, compared with those in normal control group, the expression of AP-1 mRNA and cardiac fibroblast proliferation and collagen synthesis increased significantly (P<0.05). However, Qiangxin Decoction could reduce the expression of AP-1 mRNA and decreased the proliferation and collagen synthesis of CFs significantly (P<0.05). CONCLUSION: Qiangxin Decoction can inhibit proliferation and collagen synthesis of CFs induced by TNF-alpha, and reverse cardiac fibrosis, which may be related to its down-regulation of the expression of AP-1.

Objective To assess the efficacy and safety of autologous drainage blood reinfusion in total knee arthroplasty(TKA). Methods Computers were used to search the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and VIP. The randomized controlled trials (RCTs) of autologous drainage blood reinfusion and vacuum suction without reinfusion after TKA were collected. And the results were analyzed by using the software RevMan5.1. Results Eight RCTs met the criteria for meta-analysis. Use of autologous drainage blood reinfusion significantly reduced the average amount of units of homologous blood transfusion, the length of hospital stay, and the number of patients requiring homologous blood transfusion. The rates of DVT formation and incision infection did not differ significantly between the two groups. Conclusions Autologous drainage blood reinfusion is a safe, effective procedure with less blood transfusion and medical cost. It can lower volume of allogeneic blood transfusion , shorten length of hospital stay, and avoid occurrence of complications.

The incidence of malnutrition among patients with chronic kidney disease (CKD) constantly increases despite the development of health care and dialysis techniques.New nutritional targets for CKD patients upon maintenance treatment have been developed.Before dialysis,evidences have shown that a long-term nutritional care plan,with a control of protein intake,can effectively correct metabolic disorders including proteinuria and acidosis.During the maintenance dialysis,the optimal protein and energy intakes have been recently challenged.The new classification of nutritional disorders in CKD patients may help the easily identification of protein-energy wasting.