ObjectiveTo explore the efficacy of 131 Ⅰ treatment in Graves' disease,and to analyze the related factors.MethodIn 87 patients with Graves' disease,thyroid uptake ratio( TUR ) and its effective half-life(EHL) were compared before and after 131 Ⅰ treatment.The weight of thyroid gland was evaluated with radio-imaging and type B ultrasonography.ResultThe dose of 131 Ⅰ was ( 185.2 ± 148.0 ) MBq.The TUR of tracer dose and therapeutic 131 Ⅰ dose were 76.5 ％ ±8.2％ and 73.3 ％ ±9.0％ ( t =2.451,P =0.008 ).The EHL were ( 5.2±0.7 ) and ( 5.0 ±0.8 )days,respectively ( t =1.998,P =0.023 ).After followe-up of ( 57.0 ±26.3 ) months,49 patients ( 56.3 ％ ) became euthyroid,14 ( 16.1％ )manifested delayed hypothyroidism,and 24 (27.6％)remained in hyperthyroidism.Thyroid autoantibodies were found in 34.5％ patients,of whom,the incidence of hypothyroidism was higher in patients with positive autoantibodies than those with negative ones (30.0％ vs 8.8％,x2 =6.560,P =0.009 ).ConclusionBoth TUR and EHL of therapeutic doses of 131 Ⅰ are lower than the tracer doses.Positive thyroid autoantibodies may affect the outcome of the 131 Ⅰ treatment.

Objective To explore the effect of applying phase changing theory mode on reducing depression occurrence of pregnant women after delivery. Methods 89 cases of pregnant women suffered from pre-delivery depression were separately divided into the intervention group (45 cases) and the control group (44 cases) at random.The intervention group accepted the intervention measure of the phase changing theory mode but the control group accepted the routine instruction of the nursing.The EPDS and self-designed ordinary situation questionnaire were used to investigate the two groups.The depression pre and post-delivery and general situation post-delivery were separately compared between the two groups. Results The depression degree of the pregnant women of the intervention group was evidently reduced compared with before intervention and the contemporaneous results of the control group.Postpartum recovery,ability of attending babies and developmental condition of the babies were better in the intervention group than those of the control group. Conclusions The application of the phase changing mode in nursing of parturients can reduce the occurrence of postpartum depression,so as to help them set up a healthy living manner,supply appropriate feeding and attendance for babies and improve the living quality of them.

Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.

OBJECTIVE To strengthen the management for visitors in the newborn nursery,in order to reduce the newborn hospital infection rate and enhance the hospital infection management quality in the newborn nursery.METHODS Taken the air and the object surface sampling in the newborn nursery,and the sampling derived from the hands of staff and visitors to undertake the contrast examination.RESULTS Before and after visits,the air pollution rate was over norm by increase of 58.3%,and after disinfection it declined 75.0%,after visiting,the object surface contamination rate was over norm by 56.3%,after disinfection it fell by 77.1%.Before washing-hands,the bacterial contamination rate of visitors and staff was over norm by respectively 100.0% and 68.3%,after washing,the passing rate of visitors was 92.0%,and no medical staff were over norm.CONCLUSIONS To adopt the effective management for visitors in the newborn nursery is very important to reduce the hospital infection rate in newborn nursery.

Objective To open pterygopalatine artery using autologous blood clot clogged the middle cerebral artery, resulting in cerebral infarction model of middle cerebral artery in the distal blood supply area.Methods Open PPA, ligation of ECA, embolus through CCA blood flow, rushed into the MCA distal embolus, cause infarction model. According to Bederson rating score the neural function.TTC staining to determine the infarction volume.Results Comparison of two operation models, scores were increased, and white infarcted area appears.There is no significant differences detected by statistical analysis.Conclusion Open PPA manufacturing cerebral infarction model rats of autologous blood clots could shorten the operation time, reduce the mortality rate.

Objective To investigate the incidence and risk factors of optic atrophy in cerebral palsy(CP).MethodsThe clinical dates of 872 children with CP were analyzed retrospectively.ResultsThe incidence of optic atrophy was 17.1% in CP.There was no significant difference among sexes,age and clinical types.Asphyxiation (OR=1.787,95%CI:1.225～2.608) and premature delivery (OR=2.074;95%CI:1.332～3.230) were significantly related to optic atrophy.ConclusionIn children with CP,the incidence of optic atrophy is high.Asphyxiation and premature delivery are risk factors of optic atrophy.Examination of ocular fundus should be considered as one of the routine examinations.

Objective To evaluate patient outcomes of sustained low flow oxygen inhalation therapy with humidifying and non-humidifying oxygen.Methods Randomized controlled trial (RCT) about sustained low flow oxygen therapy with humidifying and non-humidifying oxygen were searched from China National Knowledge Infrastructure (CNKI),Wanfang database,VIP database,PubMed on line.Literatures were searched from the database had been established till now.The primary outcome of the rate of unpleasant respiratory symptoms,oxygen humidification cylinder pollution as well as secondary lower respiratory tract infections were attached importance to.Two reviewers evaluated the literatures independently according to the RCT authentic assessment manual of Cochrane Collaboration.Negotiation took as the measure to attach an agreement.RevMan 5.2 was used to analyses the result of the study.Results A total of 15 met the inclusion criteria,Meta-analysis showed that humidifying and non-humidifying oxygen was not statistically significant with the rate of unpleasant respiratory symptoms (P ＞ 0.05).Non-humidifying group was better than humidity group at the rate of oxygen humidification cylinder pollution and the secondary lower respiratory symptoms (Z=2.50,2.44,P ＜ 0.05).Conclusions Low flow nasal oxygen inhalation therapy may not have to use humidifying oxygen.

Objective To explore a variety of sustainable development under the network environment of doctor-patient communication service platform in the role of reproductive medicine nursing,to improve the reproductive efficiency of medical care services in the new environment,build new doctor-patient communication platform.Methods In reproductive medicine nursing practice,based on the internet to build diversification of doctor-patient communication information service platform,such as reproductive center website,QQ group of doctor-patient communication,Wechat public service platform.Through the questionnaire survey form,understand reproductive center patients through various network platform in the query,the information,make an appointment for reproductive assisted reproduction related information and interact with staff and other aspects of the usage and satisfaction.Results Recycling effective questionnaire was 517 papers.A total of the use of network platform for the overall coverage was more than 80％ of patients,among them the most widely Wechat public platform,utilization rate was 78.1％ (400/512);60.8％ (312/513) patients think Wechat platform using the most convenient.The overall satisfaction rate for center web services platform was 89.5％ (460/514).Conclusions Online platforms provide better nursing efficiency and quality,as well as improving doctor-patient communication based on the internet environment.It provides a new way for sustainable development for nursing system in the field of reproductive medicine.

Objective To investigate the primary repair methods and efficacy of island pedicled pectoralis major muscle flap in soft tissue defect after the operation of head and neck malignant tumors .Methods From April 2011 to September 2012 ,27 patients from this hospital who underwent primary repair using island pedicled pectoralis major muscle flap after a head and neck extensive soft tissue defect were investigated ,including 11 cases of tongue cancer defect ,2 cases of parotid gland defect ,3 cases of gum cancer defect ,2 cases of oropharyngeal cancer defect ,9 cases of floor of the mouth cancer defect .Results 27 patients were safety in periop-erative ,27 cases of island pectoralis major muscle flap survived ,patients were satisfied with both the appearance and function .There was postoperative neck hematoma in 1 patient ,it was eliminated through timely remove the hematoma and hemostasis completely ;There was 1 case of removing the epidermal necrolysis skin as flap necrosis ,while it was acceptable efficacy as the muscle flap sur-vival and surface granulation repaired .Conclusion Island pectoralis major muscle flap obtains unique advantages in repairing a large area of soft tissue defect in head and neck cancer patients after operation ,such as abundant of tissue ,a constant arterial anatomy of thoracoacromial ,easy to operate ,rich blood supply ,strong resistance to infection ,high survival rate and so on .A fine surgery opera-tion is the key of island pectoralis major muscle flap survival .

ObjectiveTo observe the effects of Huatan Tongluo on the Bederson's scores,the permeability of blood-brain barrier and ultrastructure of hippocampus endothelial cells after thrombolysis in acute cerebral infarction.To provide experimental evidence for the prevention of bleeding after thrombolysis in acute cerebral infarction with Huatan Tongluo.Methods 120 SD male rats were randomly divided into sham group,model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tougluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group( each group was divided in 6h,24h,3d,7d four-phase).MCAO rats were prepared by self-embolus method.rt-PA group and Huatan Tongluo combined rt-PA groups were given rt-PA through tail vein injection and three doses of Huatan Tongluo to treat.To observe the Bederson's scores in rat on four-phase.To detect the permeability of blood-brain barrier(BBB) by the Evans Blue dye ( EB dye) and watch the ultrastructure of hippocampus endothelial cells in ischemic region by electron microscopy.Results 1.Bederson's scores:Compared with model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tongluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group significantly lower(P＜0.01 ) ; Compared with rt-PA group,Huatan Tongluo combined rt-PA medium-dose groups and high-dose groups was significantly lower(P ＜ 0.05).2.EB dye:Compared with model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tongluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group (P ＜ 0.01 ) ; Compared with rt-PA group ( 6h:( 236.72 ± 79.79 ) ng/g; 24h:(229.72 ±22.18)ng/g;3d:(163.34 ±24.45)ng/g;7d:(133.21 ±25.09)ng/g),Huatan Tongluo combined rt-PA medium-dose groups (6h:( 121.63 ± 33.27) ng/g;24h:( 153.78 ± 60.67 ) ng/g;3d:( 76.05 ± 27.11 ) ng/g;7d:(72.97 ±25.81 ) ng/g) and high-dose groups (6h:( 123.11 ±23.65) ng/g;24h:( 138.36 ±52.36)ng/g;3d:(83.00 ±32.00)ng/g;7d:(75.06 ± 13.97) ng/g) was significantly lower(P＜ 0.01 ).3.Electron microscopy:Compared with model group,treatment groups all protected the endothelial cells.In 24h,the Huatan Tongluo combined rt-PA high-dose group was best.At 3d and 7d,the Huatan Tongluo combined rt-PA medium-dose group was best.ConclusionHuatan Tongluo combined rt-PA to thrombolysis can protect the blood-brain barrier and endothelial cells of hippocampal's ischemic region.After thrombolytic,to adjust the medicine drug concentration at different time can play a better treatment results.