Objective To analyze the relationship between the urine iodine level in different pregnant periods of women and the thyroid function .Methods The pregnant women were randomly sampled in Foshan city and 490 cases were selected as the research subjects ,including 170 cases of early stage pregnancy ,162 cases of middle stage pregnancy and 158 cases of late stage pregnancy . According to the thyroid function ,490 subjects were divided into the normal thyroid function group and the abnormal thyroid func‐tion group .Results 140 cases(88 .61% ) in the late stage pregnancy had normal thyroid function ,which were less than 166 cases (97 .65% ) in the early stage pregnancy and 157 cases (96 .91% ) in the middle stage pregnancy ;the constituent ratio of urine iodine < 100 μg/L in the early stage pregnancy was 19 .88% (33/166) in the normal thyroid function ,which was lower than 75 .00%(3/5) in the abnormal thyroid function group .The constituent ratio of urine iodine 100 - 300 μg/L in the early stage pregnancy group was 56 .0% (93/166) ,which was higher than 0 .0% (0/4) in the of abnormal thyroid function group .Conclusion It is neces‐sary to conduct the urinary iodine monitoring in early pregnant woman ,moreover it is suggested that the thyroid function detection will be conducted in the pregnant women with urine iodine < 100 μg/L and urine iodine 100 - 300 μg/L .

Objective To observe the effect of plasma exchange (PE) on patients with thrombotic throbocytopenic purpura (TTP) . Methods Eight patients received PE and drugs treatment (including glucocorticoid and anti-platelet drugs) . The other 7 patients were only treated with glucocorticoid and anti-platelet drugs. PE was performed with fresh-frozen plasma every other day, and median of PE treatment was 4 times(2 to 6 times) . Average exchanged volume of plasma was (2316?28. 3) ml. Results The survival rate of the patients with PE treatment was significantly higher than that of the patients only with drugs (75% vs 14. 3% ) . Within 12-72 h after the plasma treatment, neurological and psychiatric symptoms ameliorated. After 4 times of PE treatment, hematocrit and platelet increased gradually, and fever, novel petechia, purpura and jaundice were not observed again in the survival patients. When the PE treatment finished, 2 cases relapsed and received PE treatment again. Conclusion PE is an effective therapy for TTP.

Objective To investigate the effect of bumetanide pretreatment on focal cerebral ischemiareperfusion(I/R) injury in rats.Methods One hundred and five male SD rats weighing 250-300 g were randomly divided into 3 groups (n =35 each ):sham operation group(group S),focal cerebral I/R group (group I/R) and bumetanide pretreatment group (group B).Focal cerebral I/R was induced by occluding the fight middle cerebral artery with a nylon thread with a rounded tip which was inserted into internal carotid artery and advanced cranically until resistance was met in groups I/R and B.In group B bumetanide 30 mg/kg was injected iv at 10 min before ischemia.Neurologic function was assessed and scored-neurologic deficit scores (0 =no deficit,4 =unable to move).The animals were sacrificed at 3,24 and 48 h of reperfusion and their brains were immediately removed for determination of cerebral water content and expression of Na+ -K+ -2Cl- cotransporter 1 (NKCC1).The infarct size was measured at 24 h of reperfusion.Results Focal cerebral I/R significantly increased neurelogic deficit scores,NKCC1 expression,cerebral water content and infarct size in group I/R as compared with group S.Bumetanide pretreatment significantly attenuated cerebral focal I/R-induced increase in neurologic deficit scores,NKCC1 expression and cerebral water content in group B as compared with group I/R.There was no significant difference in infarct size between groups I/R and B.Conclusion Bumetanide pretreatment can reduce focal cerebral I/R injury in rats,and down-regulation of NKCC1 expression is involved in the mechanism.

Objective To study clinical characteristics,causes of misdignosis and diagnostic and therapeutic methods for primary hyperparathyroidism (PHPT).Methods Retrospective analysis was done for 51 patients of PHPT,47 confirmed by biopsy after surgical operation and 4 without operation diagnosed based on their serum levels of calcium,alkaline phosphatase ( ALP),intact parathyroid hormone ( iPTH ),and computed tomography (CT) or 99mtechnetium sestamibi (99mTcMIB1) imaging at the First Affiliated Hospital of Sun Yat-sen University,Guangzhou during June 1997 to November 2010.Results Bone-related complications were the most common clinical manifestation,accounting for 51％ (26/51 ) of the cases,and adenoma,a benign,enlarged and hyperactive parathyroid gland,in 34 of 47 cases ( 72％ ).In orthotopic lesions,the right inferior was affected in 19 of 46 cases (41％),followed by the left inferior in 13 cases (28％),while 5 of 51 cases (10％) with ectopic parathyroid gland.PHPT was easily misdiagnosed as urolithiasis,rheumatic disease,primary osteoporosis,etc,accounting for 92％ of the cases in our study.Preoperative serum levels of calcium,ALP and iPTH in the patients varied with their clinical type and pathological classification,the highest in patients with urolithiasis-bone-related complications [ (3.22 ±0.35) mmol/L,(1455 ± 1091 ) U/L and (1669 ± 515 ) ng/L,respectively ] and in patients with parathyroid carcinoma [ (3.46 ± 0.40) mmol/L,( 1410 ± 426) U/L and ( 1861 ± 768) ng/L,respectively ].Sensibility of preoperative localization diagnosis using ultrasonography,CT and 99mTcMIBI was 88％ (35/40),97％ (30/31) and 97％ (31/32),respectively.Conclusions PHPT is frequently misdiagnosed as other diseases.Measurement of serum calcium should be included in routine physical examinations,supplemented with measurement of serum ALP and iPTH,as well as medical imaging,which can help avoid misdiagnosis.CT combined with 99mTcMIBI imaging can improve accuracy of preoperative localization diagnosis.

Objective To evaluate the effect of ulinastatin on the expression of aquaporin-4 (AQP4) during focal cerebral ischemia-reperfusion (I/R) in rats.Methods One hundred and thirty-five male adult SpragueDawley rats,weighing 230-280 g,were randomly divided into 3 groups (n =45 each):sham operation group (S group),I/R group and ulinastatin group (group U).The rats were anesthetized with intraperitoneal 10％ chloral hydrate 3.5 ml/kg.Focal cerebral ischemia was induced by 2 h middle cerebral artery occlusion followed by 24 repeffusion.In U group,ulinastatin 100000 U/kg was injected immediately after beginning of reperfusion,while the equal volume of normal saline was injected in S and I/R groups.The rats were sacrificed at 6,24 and 48 h of repeffusion and brains were removed for determination of infract volume (by TTC),brain water content and expression of AQP4 (by immunohistochemistry) in brain tissues.Results Compared with S group,the infarct volume and brain water content were significantly increased,and the expression of AQP4 was up-regulated at each time point in I/R and U groups (P ＜ 0.05).Compared with I/R group,the infarct volume and brain water content were significantly decreased,and the expression of AQP4 was down-regulated at each time point in U group (P ＜0.05).Conclusion The mechanism by which ulinastatin mitigates focal cerebral I/R injury is related to down-regulation of AQP4 expression in brain tissues.

Objective To explore the safety and efficacy of loop ileostomy and Hartmann operation in gerontal patients with obstructive carcinoma of sigmoid and high rectum. Methods sixty-two gerontal patients with obstructive carcinoma of sigmoid and high rectum from April 2008 to April 2013 were randomly divided into loop ileostomy group and Hartmann group.The operation time , length of stay and postoperative complications in the two groups were analyzed. Results The time of absolute diet in loop ileostomy group was shorter than that in Hartmann group in Stage I operation (P < 0.05). The time of operation, absolute diet, and length of stay in loop ileostomy group were shorter than that in Hartmann group in Stage II operation (P < 0.05). Conclusion The application of loop iloostomy in gerontal patients with obstructive carcinoma of sigmoid and high rectum was safe and effective.

Objective To investigate the reliability and validity of a novel hand-held dynamometer, OE-210, for muscles strength of low-er extremities. Methods From March 1st to August 30th, 2016, 38 young adults were tested the muscle strength of quadriceps and ham-strings with OE-210 dynamometer by 2 rators, and were retested by one of the raters three days later. The isokinetic test was also conducted on all the subjects one day afterwards. The intraclass correlation coefficient (ICC) of OE-210 test results and the Pearson's correlation coeffi-cient between results of OE-210 and isokinetic test were calculated. Results The ICC of test-retest were 0.718 to 0.924, and the ICC of in-ter-rater were 0.784 to 0.870. The correlation between muscle performance measured with 2 tools were significant (P<0.001), that was light to medium on quadriceps (r=0.270-0.413), and strong on hamstrings (r=0.582-0.668). Conclusion OE-210 dynamometer was reliable for muscle strength measurement on quadriceps and hamstrings, and the conditions for valid application need further research.

Objective To investigate the expressions and clinical significanees of suppressors of cytokine signaling-1 (SOCS-1) and SOCS-3 in myocardium of patients with sudden cardiac death (SCD). Method This study included myocardial autopsy specimens of 24 patients admitted between 2005 and 2006. Of them, 9 cases had the findings of autopsy examination consistent with coronary atberosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 patients died of acute myocardial infarction (MI group) and 8 patients died of traffic accidents and trauma The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of non-MI and con-trol group were detected by using RT-PCR. The levels of SOCS-1 protein and SOCS-3 protein were detected by us-ing immunohistochemistry. Statistical analysis were performed by using SPSS version 13.0 software and the data were processed with ANOVA test. Results The expressions of SOCS-1 mRNA and SOCS-3 mRNA in non-MI and MI groups were were significantly higher than those in control group (0. 788±0. 101) and (0. 741±0.111) vs.(0.436±0.044) (P <0.01); (0.841±0.092) and (0.776±0.070) vs.(0.454±0.076), P <0.01, re-spectively). The antibody-positive cells of SOCS-1 protein in myocardium of non-MI group and MI group were significantly higher than those in myoeardium of control group (320.00±48.48) and (347.14±70.88) vs.(42.50±10.35) (P < 0.01), respectively. The antibody-positive cells of SOCS-3 protein in myoeardium of non-MI group and MI group were significantly higher than those in myocardium of control group (381.11±59.25) vs.(40.00±10.69), (P < 0.01)and (332.86±111.91) vs. (40.00±10.69), (P =0.001). Conclusions The expressions of SOCS rnRNA and SOCS-3 mRNA in myoeardium of patients with SCD from coronary diseases are significantly increased contributing to the pathogenesis of SCD.

Objective A previously reported female diagnosed with type A insulin resistance syndrome bearing a heterozygous missense mutation of R1174W in the insulin receptor gene was followed for 7 years since the age of 16 years. Methods Five-hour oral glucose tolerance tests (OGTT) were done on baseline, the 3rd, 6th and 7th year respectively, with serum insulin and C-peptide measured at the same time points. Areas under of curve (AUC) of glucose, insulin and C-peptide were compared between the years.Acute insulin response (AIR) was determined at baseline and the 7th year. The dose response were insulin secretion rates at each time point during OGTT being plotted over the corresponding glucose levels, and the slopes of which quantified the insulin secretion responding to glucose. Results The follow up data showed that the glucose metabolism of the subject did not deteriorate over time with yearly glycosylated hemoglobin A1c (HbAlc) being normal (4.6%-5.5%), and hyperinsulinemic hypoglycemia was a persistent phenomenon observed at 4-5 hours post-load. The fasting and AUCs of serum insulin and C-peptide tended to decline without simultaneously increase of those of plasma glucose. The AIR decreased by 56% as compared to baseline. The dose response curves shifted downward as years went by. Conclusions It supports that with the alleviation of physiological insulin resistance after puberty, the gross hyperinsulinemia tends to ameliorate, and β-cell secretion does not deteriorate over time as glucose homeostasis maintains.

The Mycobacterium chelonae/abscessus (M.chelonae/abscessus) complex belongs to the rapidly growing genus Mycobacterium (RGM).It is one of the most important pathogenic members of Mycobacterium leading to nosocomial infections and outbreaks.It includes members of M.chelonae,M.immnunogenum,M.abscessus,M.massiliense,and M.bolletii.In order to investigate the epidemiological characteristics of the M.chelonae/abscessus complex in China and to conduct the molecular methods for species identification of M.chelonae/abscessus,we collected clinical M.chelonae/abscessus complex strains identified by phenotypic tests.Members were verified by sequencing of 16S rRNA,Species and subspecies were identified by hsp65 and rpoB PCR RFLP methods.In total,27 clinical specimens were identified as Mycobacterium chelonae/abscessus complex by phenotypic tests.16s rRNA gene sequence analysis of all 27 clinical samples shared over 99.7％ similarity with M.chelonae and M.abscessus.Species identification with hsp65 PCR-RFLP and rpoB PCR-RFLP revealed that 18 specimens were M.abscessus and 4 were M.absecces.The remaining 5 samples displayed a pattern that failed to match any previously reported pattern.Thus,this might represent a novel species that is part of the Mycobacterium chelonae/abscessus complex.We identified that a majority of the chronic lung infection in China is caused by the M.chelonae/abscessus complex.Specifically,the M.abscessus species might be the most infectious,while other species in the complex can still cause infection.Interestingly,there may be a novel or previously unidentified species that is a part of the complex.Finally,we show that species identification can be carried out more accurately by combined use of hsp65 and rpoB PCR-RFLP.