Objective To investigate the changes of serum thyroid hormone in elder patients with type 2 diabetes mellitus and its chnical significance.Methods A total of 436 elder patients with type 2 diabetes mellitus (elder diabetes mellitus group) and 312 cases without diabetes mellitus (control group)were underwent thyroid ultrasound.For all of the patients,clinical data including fasting plasma glucose (FPG),hemoglobin A1c (HbA1c),serum lipid were tested.Serum thyroid hormone such as total triio dothyronine (TT3),total thyroxine (TT4),free triio dothyronine (FT3),free thyroxine (FT4),thyrotrophin (TSH),antithyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) were measured simultaneously.The patients were divided into 3 groups according to the level of HbA1c:HbA1c ＜ 7.5％ group(132 cases),HbA1c 7.5％-9.0％ group(211 cases) and HbA1c ＞ 9.0％ group(93 cases).And they were also divided into 4 groups according to the level of duration:duration ≤ 1 year group (65 cases),1 year ＜ duration ≤ 5 years group(133 cases),5 years ＜ duration≤ 10 years group(195 cases) and duration ＞ 10 years group (43 cases).The levels of thyroid function and thyroid ultrasound were compared among different groups.Results The incidence of abnormal structure of thyroid was 19.7％ (86/436) and the incidence of hypothyroidism and sub-clinical hypothyroidism was higher than the incidence of hyperthyroidism and sub-clinical hyperthyroidism [14.4％ (63/436) vs.5.3％ (23/436)] in elder diabetes mellitus group,and there was significant difference(P＜ 0.05).Compared with that in control group,TT3,FT3 was decreased [(1.27 ± 0.20) nmol/L vs.(1.60 ± 0.34) nmol/L,(3.71 ± 0.49) pmol/L vs.(4.45 ± 0.62)pmol/L],TGAb,TPOAb and thyroid gland volume was increased [(74.73 ±41.25) kU/L vs.(40.05 ± 18.28) kU/L,(87.46 ± 36.81) kU/L vs.(42.39 ± 20.84) kU/L,(17.1 ± 3.0) ml vs.(13.7 ± 2.5) ml],the ratio of thyroid swelling and thyroid nodule was increased [17.66％(77/436) vs.4.17％(13/312),59.86％ (261/436) vs.29.49％ (92/312)],and there was significant difference (P ＜ 0.05).While the levels of HbA 1c increased,the levels of TT3 and TSH decreased simultaneously.The level of FT3 in HbA1c ＞ 9.0％ group was lower than that in HbA1c ＜ 7.5 ％ group and HbA1c 7.5 ％-9.0％ group [(3.46 ± 0.39) pmol/L vs.(3.73 ± 0.47),(3.75 ± 0.49) pmol/L] (P ＜ 0.05),the ratio of thyroid swelling,thyroid nodule and abnormal thyroid echo in HbA1c ＞ 9.0％ group was higher than that in HbA1c ＜ 7.5％ group and HbA1c 7.5％-9.0％ group [36.6％ (34/93) vs.11.4％ (15/132),13.3％ (28/211);90.3％ (84/93) vs.50.0％ (66/132),52.6％ (111/211) ;45.2％(42/93) vs.12.9％(17/132),15.2％(32/211)],and there was significant difference (P ＜0.05).When the duration of diabetes increased,the levels of TT3,FT3 decreased and the levels of TSH,TGAb increased simultaneously.Conclusions It is common that elder patients with type 2 diabetes mellitus always follow with thyroid dysfunction,which should be checked out and followed up.The levels of thyroid function are important for assessing the glucose metabolism in elder patients with type 2 diabetes mellitus.

Objective: To observe the therapeutic results of Acupuncture and Tuina combining with laxative suppository in treating constipation caused by antisychotic drugs. Methods: 240 patients were randomly divided into Group A, B, C, and D, 60 in each group. Group A were treated with Acupuncture and Tuina combining with laxative suppository, Group B with Acupuncture, Group C with Tuina and Group D with laxative suppository. Results: The effective rate in Group A was 98.3%, Group B 95.0%, Group C 91.7% and Group D 60.0%. Univariate χ2 was used for analysis. There were significant differences among the 4 groups. Group A was compared with Group B and C (P＜0.05) and compared with D (P＜0.01). The efficacy time( (-χ)± S) was 2.41 ± 1.87h in Group A, 2.47 ± 1.89h in Group B,9.81 ± 6.12h in Group C and 15.13 ± 6.17h in Group D. The t-test was used for analysis. The efficacy time was significant different in Group A and B (P＜0.05), significant different in Group A and C (P＜0.05), marked different in Group A and D (P＜0.01) and no significant different in Group B and C (P＞0.05). Conclusion: Acupuncture and Tuina were effective, yet Acupuncture and Tuina combined with laxative suppository were more effective, and induce quick defecation.

[Objective]To evaluate the efficacy of topical use of 1 g/L tacrolimus eye drops in the treatment of ocular alkali burns.[Methods]A prospective study was performed to evaluate the efficacy of 1 g/L tacrolimus eye drops in the treatment of 12 patients with ocular alkali burns admittedin Zhongshan Ophthalmic Center of Sun Yat-sen University between May 23,2016 and Jan-uary 18,2017. The patients were treated for 1 ~ 18 weeks,with an average of 8.91 ± 5.56 weeks.The degree of ocular alkali burns was evaluated according to Roper-Hall classification system. In this group of patients,there were 2 cases of gradeⅡburns,5 cases of gradeⅢburns and 5 cases of gradeⅣburns. Each patient was given 1 g/L tacrolimus eye drops 2 times a day after admission. The slit lamp microscope and corneal fluorescein sodium staining examination were performed before and 1th week,2nd week,3rd week, 4th week,6th week,8th week respectively after performing topical tacrolimus treatment. Photos were taken to keep records to dynami-cally observe the epithelial repair and anterior segment lesions. Adobe Photoshop CS6 image processing software was used to calculate the area of corneal epithelium repair. The therapeutic effect was evaluated according to the corneal epithelial repair ,visual acuity and complications. The statistical analysis was carried out by SPSS 19.0 software.[Results]4 cases reached good prognosis ,including 2 cases of gradeⅡ and 2 cases of gradeⅢ burns,the corneal epithelium healed and the visual acuity was greater than 0.3. 5 cases had guarded prognosis,including 3 cases of gradeⅢand 2 cases of gradeⅣburns,corneal epithelium healed in 2 cases,corneal epi-thelial repair rate was greater than 50%in 3 cases,in which corneal neovascularization or corneal conjunctiva occurred,and the visu-al acuity was less than 0.3. 3 cases of gradeⅣ burns had poor prognosis:1 had corneal perforation,1 had long term corneal ulcer, and 1 had secondary glaucoma. In 12 cases,the corneal epithelial healing rate reached 99% in 50% patients,and the healing rate was greater than 50%in 75%patients. The visual acuity of 33.3%patients increased by more than three lines,and 66.6%cases had complications. The main factors affecting the prognosis are:The degree of corneal and corneal limbal burns,complication and corneal epithelial repair rate.[Conclusion]1 g/L tacrolimus eye drops can reduce the inflammatory reaction of ocular alkali burns ,reduce the incidence of glaucoma,promote corneal ulcer healing and corneal epithelial repair,and reduce complications caused by corneal lim-bal burns.

OBJECTIVE:To investigate the status quo and tendency of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015. METHODS:The prescriptions of breast cancer patients in 11 hospitals of Zhe-jiang province were analyzed retrospectively in respects of consumption sum,DDDs,DDC,etc. RESULTS:The consumption sum of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015 increased from 2530192.33 yuan to 6201691.54 yuan,and its proportion in total consumption sum increased from 13.93％ to 17.40％,showing in-creasing tendency. The anastrozole always took up the first place in the list of consumption sum. Tamoxifen,anastrozole and letro-zole took up the top 3 places in the list of DDDs. Goserelin took up the first place in the list of DDC. CONCLUSIONS:The pre-scription amount and consumptionsum of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015 show year-on-year growth trend;and those drugs which are safe,effective,economical and convenient predomi-nate in clinic.

ObjectiveTo evaluate the effects of exercise training on bone histomorphometry of ovariectomized rats.Methods46 SD rats were randomly divided into the normal control group (group A), ovariectomized group (group B) , estrogen supplement group (group C) and exercise training group (group D). The rats of group A had a sham operation, while that of other groups was ovariectomized. 3 months after operation, the rats had been treated for 3 months. The rats of group C were given estradiol, and the rats of group D were trained by exercise. The tibia sections were studied by histomorphometric analysis.ResultsThe values of the trabeclar area, trabeclar area%, trabeclar perimeter and trabeclar number of group D were significantly higher than that of group B. The values of the trabeclar separation, osteoclast number/mm2 and osteoclast number/mm of group D were the least in all groups, which had been ovariectomized. The values of the labeled perimeter % mineral apposition rate, bone formation rate of group D were superior to that of all groups.ConclusionThe exercise training can increase bone mass of ovariectomized rats, which had double effects of promoting bone formation and restraining bone absorption.

Objective:To explore therapeutic effect of esmolol hydrochloride combined amlodipine on patients with hyper-tension complicated aortic dissection (AD) and its influence on patient's blood pressure (BP) and heart rate (HR) .Meth-ods:A total of 110 patients with hypertension complicated AD were randomly and equally divided into amlodipine group and combined treatment group (received amlodipine and esmolol) .Results:Compared with before treatment , after treat-ment 0. 5 ,1. 5 and 7h ,there were significant reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both groups ,P<0.01 ,on 7h after treatment ,SBP level of combined treatment group significantly reduced than that of amlodipine group [(101.5 ± 7.8) mmHg vs .(123.4 ± 10.2) mmHg ,P<0.01];on 0.5 ,1.5 and 7h after treatment ,HR and rate pressure product (RPP) of combined treatment group significantly reduced than those of amlodipine group , P<0. 01 all. Compared with amlodipine group after treatment , there were significant rise in standard-reaching rates of BP (56.36% vs .87.27% ) ,HR (38.18% vs .92.73% ) and BP+HR (25.45% vs .81.82% ) in combined treatment group , P<0.01 all. Conclusion:Esmolol combined amlodipine can control blood pressure and heart rate rapidly ,safely and effec-tively in patients with hypertension complicated aortic dissection .

Objective To investigate the value of the hippocampal subfield's MRI T2 signal intensity in evaluating the effect of the hydrochloric donepezil for mild cognitive impairment(MCI).Methods 20 MCI patients with hydrochloric donepezil (treatment group) and 20 patients with placebo (control group) were scanned by MRI using FSE-T2 sequence.The margin of hippocampal subfields was outlined manually for each side to measure the MRI T2 signal intensity.The relationship between hippocampal MRI T2 signal intensity and MMSE scores was analyzed in the treatment group.Results Before the treatment, there was no significant difference of the MRI T2 signal intensity between groups.After the treatment, the MRI T2 signal intensity in the bilateral head of the treatment group was significantly decreased compared with the control group(P<0.05).There was an inverse relationship between the MRI T2 signal intensity of the bilateral hippocampal head and MMSE scores in the treatment group(P<0.05).Conclusion The MRI T2 signal intensity in the bilateral hippocampal head could be regarded as a valuable marker in making clinical diagnosis and evaluating the effect of the treatment for MCI in its early stage.

Objective To apply the MRI T2 signal intensity of hippocampal subfield in patients with amnestic mild cognitive impairment (aMCI) as early imageology. Methods From October, 2014 to August, 2015, 20 aMCI patients accepted cognitive training (training group), 20 aMCI patients accepted speech communication (speech group), and 20 age-and gender-matched healthy old people (control group) were scanned with MRI using FSE-T2 sequence. The margin of hippocampal subfields were outlined manually for each side to measure the T2 sig-nal intensity. The correlation between hippocampal T2 signal intensity and the scores of Mini-Mental State Examinatlon (MMSE) was ana-lyzed in the training group. Results Before treatment, T2 signal intensity in the bilateral hippocampal head was significantly high in the aM-CI patients compared with that in the control group (P<0.05). After treatment, T2 signal intensity in left hippocampal head decreased in the training group compared with that in the speech group (P<0.05), similar to the control group (P>0.05). There was negative correlation be-tween left hippocampal head's T2 signal intensity and the scores of MMSE in the training group before and after treatment (r=-0.61, r=-0.54, P<0.05). Conclusion The T2 signal intensity in left hippocampal head may respond to the cognitive function in patients with aMCI in the early stage, that could be used for diagnosis and evaluation in clinic.

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire;sleep information were collected via the Brief Infant Sleep Questionnaire (BISQ);Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86%(59/116) were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91%of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03%of children over one year old. The frequency of night waking was signiifcantly different between children under one year old and children over one year old (P<0.01). The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was signiifcantly different (Z=4.35, P<0.001). In children over one year old, the more frequent night waking, the lowered MDI scores (F=3.98, P=0.024). The waking duration was negatively correlated with MDI scores in children over one year old (r=-0.26, P=0.035). Neither night waking duration nor night waking frequency had signiifcant correlation with MDI scores in children under one year old. Multivariable linear regression conifrmed that night waking was an independent inlfuential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.

Objective To explore the security of exosome derived from human umbilical cord mesenchymal stem cell(huc-MSC-exosome)as a kind of biological product on clinical application.Methods huc-MSC-exosome were separated by ultea centrifuge. CD9 and CD63 expression of huc-MSC-exosome were tested by Western-blot.Nanoparticle analysis was used to detect the size and concentration of huc-MSC-exosome.Hemolytic experiment,systemic anaphylaxis and blood routine test were used to verify the self-safety of huc-MSC-exosome.Results huc-MSC-exosome expressed specific markers of exosome,CD9 and CD63.Moreover,huc-MSC-exosome cannot result in hemolysis,systemic anaphylaxis reaction and abnormality of blood routine test.Conclusion Exosome derived from human umbilical cord mesenchymal stem cell has general signs of exosomes and possesses the certainly security,which may provide the experimental evidence for huc-MSC-exosome clinical application.