Objective To investigate the changes and the significances of pregnant women with hypothyroidism companied with gestational diabetes mellitus.Methods 76 cases of hypothyroidism and subclinical hypothyroidism companied with gestational diabetes mellitus pregnant women admitted to our department from Sept 2014 to Mar 2016 were selected as the observation group.According to the levels of FT3,FT4 and TSH,the observation group were divided into two group(A group and B group).Cobas e601 was used to examine TSH and PT,APTT,TT,FIB and ATⅢ were determined with ACL-TOP.PLT,MPV and PDW were determined by Sysmex2000i.Results FIB (3.98±1.74 g/L),MPV (10.18±1.53 fl)and PDW (15.03％±1.54％)in A group were significant higher than those in B group (3.91±1.62 g/L,9.37±1.48 fl,14.41％± 1.35％％) and the control group (3.47±1.43 g/L,8.96±1.42 fl,13.67％±1.26％).FIB,MPV and PDW in B group was higher than those in the control group.PT (12.26±1.41 s,12.21±1.39 s) and APTT (31.80±8.72 s,30.43±8.54 s) in A group and Bgroup were higher than those in the control group (12.13 ± 1.32 s,29.24± 8.37 s).Otherwise,AT Ⅲ (78.47％± 10.36％,79.58％ ± 10.22％) in A group and B group was significant lower than that in the control group (86.56％±8.86％).There were distinct difference (t=3.072～6.153,P＜0.05).Conclusion The disorder of blood coagulation existed in pregnant women with hypothyroidism companied with gestational diabetes mellitus.Early diagnosis and intervention can reduce the occurrence of thrombotic disease and cardiovascular disease.

OBJECTIVE:To carry out the cost-effectiveness analysis of treating child bronchopneumonia with cefazolin,cefatrizine,cefataxime and cefuroxime METHODS:Using retrospective study and cost-effectiveness analysis,the costs of tre_atment of children with bronchopneumonia were calculated and pharmacoeconomically evaluated RESULTS:The costs of cefazolin,cefatrizine,cefuroxime and cefataxime in treatment of child bronchopneumonia were RMB 512 84,725 42,796 28 and 734 16 yuan and the cost-effectiveness ratios were 93 68,475 83,517 30 and 412 28 respectively CONCLUSION:In comparison with cefatrizine,cefuroxime and cefataxime,cefazolin is the most inexpensive one However,in evaluating the therapeutic cost of a drug, we should consider its therapeutic efficacy and course

Objective To evaluate the performance parameters of the PET instrument, which has been used for years in our hospital, assuring the stability of image quality and performance parameters. Methods NEMA NU 2-1994 Standards was used as reference for performance measurement of PET, which were published by National Electrical Manufacturers Association(NEMA). The NEMA standard cylinder model, 18F radiation source, and 18F and 68Ge columniform radiation source were used. Results Projects for performance measurement and daily quality control were drawn up. Conclusion This project provides a reference and methods for the performance measurement of PET instrument and daily quality control. It better ensures the stability of image quality and performance parameters of the PET instrument.

Objective To develop a sensitive, simple, and accurate method for the determination of shionone in rat plasma after ig administration of Asteris Radix petroleum ether extract (RAPE). Methods The separation was achieved by HPLC on a RP18 column (150 mm × 3.9 mm, 5μm) with a mobile phase composed of acetotitrile-0.05% phosphoric acid water (98: 2) at a flow rate of 1.0 mL/min. UV Detector was set at 200 nm and friedelin was chosen as an internal standard. Results The linear range of the standard curves was (0.3443-22.0) μg/mL with the correlation coefficient of 0.9968. The intra- and inter-day precisions were all below 10% and the relative error was -3.5%-1.1%.Conclusion The developed method can be successfully applied to the pharmacokinetic study. After ig administration of RAPE, T1/2(ka) is (33.09 ± 7.32) min and T1/2(ke) is (84.95 ± 22.34) min.

Objective To evaluate the quality of life(QOL)of postpartum women within six months after delivery in Pudong New Area in Shanghai.Methods From January 1st to June 30th in 2011,435 postpartum women,discharged from Children and Women's Health Care Hospital in Pudong New Area,Gaoqiao Community Health Service Center and Lujiazui Community Health Service Center in Pudong New Area,were investigated by SF 36 questionaire including eight items [physical functioning (PF),role limitations due to physical problems (RP),bodily pain (BP),general health (GH),vitality (VT),social functioning (SF),role limitations due to emotional problems (RE) and mental health (MH)] and divided into three subgroups according to the duration after delivery (8-42,43-119 and 120 180 d).The SF-36 scores were compared with the control (baseline data of 25 to 36-year-old young women in Pudong New Area) or within the three groups.Statistical methods,such as t-test and analysis of variance,were applied.Results (1) The tota lscore and the scores of the seven items in SF-36 were lower than those of control (total score:74.2±11.7 vs 80.5,PF:79.0±19.0 vs 94.6,RP:47.5±12.2 vs 85.7,BP:74.0±18.7 vs 78.4,GH:73.9±13.1 vs 71.0,VT:69.8±16.2 vs 75.0,SF:78.3±20.1 vs 86.9,RE:63.4±21.7 vs 83.5,t=-11.225,-17.105,-18.914,-4.893,3.688,-6.642,-8.881 and-10.076,all P＜0.05) and no significant difference was found in MH score between the postpartum women and the control (78.3±15.0 vs 77.8,t=0.629,P＞0.05).Compared the SF-36 scores in three subgroups (8 42,43-119 and 120 180 d postpartum),the differences on PF score(73.0±19.1,86.3± 17.1,89.1±12.9),RP score(32.4±18.6,57.7±19.1,79.9±12.0),BP score(70.7±18.0,75.6±19.0,81.6±17.3),SF score(76.3±19.6,78.2±21.7,83.9±19.3),RE score(58.5±12.9,71.4± 18.3,70.1± 19.5) and SF-36 total score (72.2± 11.1,76.1± 12.8,78.0± 11.1) were all significant (F=37.744,60.640,13.137,5.185,4.577 and 10.548,allP＜0.05).The PF,VT,RE and total score of postpartum women at 120-180 days after delivery were still lower than those of the control group(t=-4.174,-2.353,-3.341 and-2.166,all P＜0.05).Conclusions The QOL of postpartum women within six months after delivery is not good enough.Up to 120-180 days after delivery,the QOL remains.More efforts should be made to improve the QOL of postpartum women by the whole society.

OBJECTIVE To implement the automatic management of medical equipment.METHODS Based on the platform of net,three layers of C/S were applied with database technology to realize one-time importation of the basic information and current information,it made the information function of quantity evaluation,quantity determination,schedule formation,automatic alarm,apparatus distribution list,statistical inquiry,collection analysis,and information feedback coming to true.RESULTS By using one year,the application of management information system of medical equipment could meet the requirement in scientific and standardized supply,and standard,application and management of medical equipment.CONCLUSIONS It can be able to improve the system efficiency,reduce the labor and mistakes,and also achieve the aim that cannot be done by manual labor.

Objective To explore the clinical, therapeutic and genetic features of IVD gene in late-onset non-classical isovaleric aciduria. Methods One boy and two girls presented with intractable vomiting were admitted. Urine organic acids and blood acylcarnitines proifles were analyzed. Isovaleric aciduria was diagnosed and conifrmed by IVD gene analysis. The patients were treated with leucine-restricted diet and the supplements of L-carnitine and glycine. Results Three patients had recurrent vomiting, drowsiness, odor of sweaty feet and metabolic acidosis from the age of 1 to 2 years. All of them had normal intelligence and leukopenia. One had oligocythemia. The blood isovalerylcarnitines (4.6 to 8.2μmol/L) and urine isovalerylglycines (36.1 to 1783.56 mmol/mmol creatinine) were elevated. Six mutations were found in their IVD gene. Four mutations (c.157C>T, c.214G>A, c.1183C>G and c.1208A>G) were reported. Two (c.1039G>A and c.1076A>G) were novel. The patients completely recovered after treatment with protein-restricted diet and the supplements of L-carnitine and glycine. Currently, they were aged 19 months to 14 years with normal physical and psychomotor development. Conclusions The clinical features of late-onset non-classical isovaleric aciduria are complex. It is onset in infants and young children and characteristic of recurrent vomiting and metabolic acidosis, which can be diagnosed by the blood acylcarnitine spectrum, urine organic acid analysis, and conifrmed by genetic analysis. L-carnitine supplement and diet intervention has signiifcant effects.

Objective:To explore the surgical technique and therapeutic effect of flap wrapping repair of soft tissue defect after digit degloving injury with free arm medial perforator flap.Methods:From October 2009 to December 2020, 15 patients with soft tissue defect after digit degloving injury were repaired with free arm medial perforator flaps. The patients were 9 males and 6 females aged 22 to 50 years old, with an average of 32 years old. Injury mechanism: 13 cases of machine strangulation and 2 cases of machine crushing. Plane of sleeve avulsion injury: at the distal metacarpophalangeal joint of thumb in 2 cases, at the middle and distal segment of single finger of 2nd to 5th fingers in 4 cases, and at distal metacarpophalangeal joint of 2nd to 5th fingers in 9 cases. Seven cases were in left hand and 8 in right hand. Emergency surgery was performed in 2 cases and scheduled surgery in 13 cases. The flap was designed in a shape of a long strip, and the size of the flap was 5.0 cm×2.5 cm-14.0 cm×3.5 cm. During the operation, the artery of the flap pedicle was anastomosed with the palmar digital proper artery or common digital artery of the recipient digit, the subcutaneous vein or the companion vein of the artery was anastomosed with the dorsal or palmar digital subcutaneous vein, and the medial brachial cutaneous nerve carried in the flap was anastomosed with the stump of palmar digital proper nerve. All the donor sites were directly sutured. After the surgery, follow-up visits were conducted regularly at outpatient clinic, or via telephone and WeChat review or by home visit. The flap appearance, sensation and function recovery of digital joints were observed together with the patient satisfaction. Results:All flaps survived successfully after surgery. Six patients with degloving defect of the whole digit had encountered poor wound healing caused by distal phalangeal necrosis. The second stage stump trimming was performed to keep the digit to the distal end of the middle segment. Two cases of thumb and 2 cases of middle finger suffered further burning and worn tears at 7-9 months after surgery and self-healed. The follow-up period was 6-28 (average 16) months. The flap was soft without bloating. The sensation recovered to S 2-S 3. The shape of fingers was good, and no secondary flap surgery was necessary. The overall movement of interphalangeal joints was poor. According to the evaluation standard of Michigan hand function questionnaire, 15 patients achieved very satisfactory with the overall appearance and function of hands. The linear scars at donor site were hidden without complications such as tenderness and contraction. Conclusion:The free medial perforator flap of the arm is easy to design and thin, hence does not affect the shape of a digit. So, it is ideal for the repair of soft tissue defect after digit degloving injury.

Objective: To analyze serologic surveillance indicators during pregnancy among syphilis-infected women who delivered in 2013 in East China. Methods: Data were from national 'Information System of Prevention of Mother-to-child Transmission of HIV, syphilis and HBV Management’ and in total 5 206 syphilis-infected pregnant women who delivered in 2013 and in East China were involved in the analysis. Information on demographic characters, laboratory tests, and treatment regimens were collected. The maternal non-treponemal testing surveillance and titer distribution were described and compare the proportions between pregnant women receiving standard testing and non-standard testing, taking baseline testing and testing before delivery or at the third trimester. Multivariate logistic regression model was analyzed using maternal titer control as dependent variable, using prior history of syphilis infection, syphilis stages, titer, gestational weeks of treatment initiation and treatment regimens as independent variables in 3 940 pregnant women with both baseline testing results and testing results before delivery or at the third trimester. Results: The ages of the 5 206 syphilis infected pregnant women were (28.1±5.8) years old. The numbers of women received penicillin treatment, other treatment regimens and no treatment were 2 967 (57.0%), 281 (5.4%), and 1 958 (37.6%), respectively. The number of women with maternal seroconversion, 4-fold or greater titer decline, or titer increase were 349 (6.7%), 251 (4.8%) and 28 (0.5%). Multivariate analysis results showed that compared with pregnant women with prior history of syphilis, the OR(95%CI) for maternal titer control was 1.49 (1.18-1.88) among those with syphilis-infection history. Compared with pregnant women initiated treatment at 28 gestational weeks or before, the OR (95%CI) for maternal titer control was 4.09 (3.19-5.24) among those who initiated treatment after 28 gestational weeks. Compared with pregnant women initiated treatment at 28 gestational weeks or before, the OR (95%CI) for maternal titer control was 4.09 (3.19-5.24) among those who initiated treatment after 28 gestational weeks or received no treatment. Compared with pregnant women received penicillin treatment, the OR (95%CI) for maternal titer control among those received non-penicillin treatment and those received no treatment were 2.35 (1.46-3.76) and 1.55 (1.13-2.12), respectively. Conclusion In East China, the proportion of women achieved seroconversion or 4-fold or greater titer decline during pregnancy was very low. Pregnant women with no prior history of syphilis infection, early maternal initiation of treatment, and penicillin treatment were more likely to reach maternal titer control.

Objective:To explore the of short-term psychodynamic psychotherapy on anxiety and depression of gout patients and its influence on well-being index, family function and compliance.Methods:60 gout patients were selected from June 2018 to December 2019 in the outpatient department of rheumatism and immunity department of Dongguan Kanghua Hospital by prospective case-control study. They were randomly divided into control group and treatment group, 30 cases respectively. Both groups were given gout related clinical treatment and routine nursing, and the treatment group was given short-term dynamic orientation psychotherapy. The treatment compliance, the psychological status, well-being index and blood uric acid (UA) level of the two groups were compared before intervention, immediately after intervention and 3 months after intervention.Results:The scores of Patient Health Questionnaire-9 (PHQ-9) and the generalized anxiety disorder 7-item scale (GAD-7) in the two groups were gradually decreased immediately and 3 months after intervention ( P<0.05), and the scores of well-being index were gradually increased ( P<0.05); Compared with the control group, the scores of PHQ-9 and GAD-7 in the treatment group decreased more significantly ( P<0.05), and the score of well-being index increased more significantly ( P<0.05); The scores of communication, behavior control and total function of family function in the treatment group decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), and were significantly lower than those in the control group ( P<0.05); The level of serum UA in the two groups decreased gradually immediately after intervention and 3 months after intervention ( P<0.05), but there was no significant difference in UA level at each time point between the two groups. The treatment compliance of the treatment group was significantly better than that of the control group ( P<0.05). Conclusions:The short-term dynamic orientation psychotherapy for gout patients has obvious effect in improving the state of anxiety and depression, improving the index of well-being, family function and treatment compliance.