Objective The purpose of this research is to calculate the prevalence of thyroid dysfunction during pregnancy and to discuss the relationship between gestational thyroid diseases and pregnancy outcomes.Methods There were 3 745 pregnant women who took antenatal care at Sun Yat-sen Memorial Hospital,Sun Yat-sen University were chosen as the research objects during March 2012 to February 2014.All of them were given close monitoring and tracking till the termination of pregnancy.These subjects took thyroid function testing (TT4,FT4,TSH,thyroid peroxidase antibody),if the result was abnormal,they were followed up periodically.Results The prevalence of overt hyperthyroidism is 1.90％,1.20％ for subclinical hyperthyroidism,1.17％ for hypothyroidism,6.78％ for subclinical hypothyroidism,and 3.82％ for isolated hypothyroxinemia.Compared with normal thyroid function group,the morbidity of placental abruption increased in overt hyperthyroidism group (5.8％ vs 1.0％,P＜ 0.01) ; the incidence of gestational diabetes mellitus was increased in subclinical hyperthyroidism group (37.5 ％ vs 16.6％,P＜0.01) ; and the morbidity of preterm birth increased in subclinical hypothyroidism group (14.3％ vs 7.7％,P =0.002).Conclusion Gestational thyroid diseases may increase the incidence of adverse pregnancy outcomes ; such as placental abruption,gestational diabetes mellitus,and premature birth.

Objective To establish the method of measuring quercetin content in semen cuscutae(SC) and to explore its in- vivo pharmacokinetics features.Methods The rapid and sensitive HPLC- UV method was adopted with carbamazepine acting as internal standard. After the extract of SC was given, serum samples of rats were collected and measured on C18 reverse- phase chromatographic column after liquid- liquid extract. Results The linear range of calibration curve were 0.05～ 9? g/mL (r=0.9998). The method showed good precision and recoveries for serum with 86.65～ 99.07% , and extracting recoveries 79.91～ 84.56% .The limit of detection(LOD) as 0.05? g/mL. Conclusion The pharmacokinetic process of quercetin in vivo manifestated an opening two- compartment model with t1/2(Ab)=0.13h, t1/2(? )=0.19h, t1/2(? ) =1.22h, tmax=0.333h. The results may provide evidence of safety and effectiveness for clinical use of SC.

Aim To study the mechanism of anti-tumor effect of PHⅡ-7 to K562 and K562/A02 cells.Methods The effects of individual and combined doxorubicin on K562 and K562/A02 cells were observed by MTT assay.The coefficient of drug interaction was used to analyse the synergistic effect of PHⅡ-7,obtaining the RNA from the cells stimulated by PHⅡ-7 with different doses to analyse the MDR1 gene expression level.Finally,the cumulation of doxorubicin was observed in K562 and K562/A02 cells after being coped with PHⅡ-7.Results PH Ⅱ-7 had anti-tumor effect with IC50 of (1.37?0.37) ?mol?L-1;(1.48?0.34) ?mol?L-1 for K562 and K562/A02,respectively.It could potentiate the anti-tumor effect of dororubicin with CDI of 0.22 and 0.09 for K562 and K562/A02,respectively.PHⅡ-7 could synergistically inhibit the proliferation of K562 and K562/A02 cells.The decrease of MDR1 expression level depended on the increase of dose of PHⅡ-7 acting on cells.PHⅡ-7 could also develop the cumulation of doxorubicin in cells.Conclusion PHⅡ-7 is not only a Cytotoxinic drug but also can synergistically inhibit the proliferation of K562 and K562/A02 cells with the decrease of MDR1 expression level,especially in K562/A02 cells.

Objective To understand the characteristics and distribution of injury related deaths in residents aged ≥60 years in Jing'an district of Shanghai and provide evidence for the prevention of injury and effective intervention in this population.Methods According to the data from diseases surveillance and death-reporting system in Jing'an during 1975-2014,the causes of 5 199 injury related deaths were analyzed.Results The average injury related mortality in the elderly aged ≥60 years in Jing'an was 159.37/100 000 during this period.The injury related mortality increased with age.Fall was the first cause of injury related death,accounting for 53.30％.The characteristics and distribution of injury related deaths varied with age and gender.Conclusion Injury has become an important cause affecting the health of the elderly.It is necessary to conducted targeted injury prevention and control in the elderly in communities.

Objective:To investigate the value and influence factors of preoperative and intraoperative localization of ectopic hyperparathyroidism (EHPT).Methods:Results of 99mTc-sestamibi ( 99mTc-MIBI), neck ultrasound, contrast CT and intraoperative local venous parathyroid hormone (IOLVPTH) were retrospectively analyzed in 205 patients with primary hyperparathyroidism (PHPT) suspected of EHPT. Results:Incidence of EHPT was 16.6% (34 cases), and 36 ectopic lesions were detected. The proportion of EHPT in antero-superior mediastinum, intrathyroidal, in the retropharyngeal region, in carotid sheath, in the prevertebral region and intrapericardial were 44.1% (15 cases), 29.4% (10 cases), 11.8% (4 cases), 5.9% (2 cases), 5.9% (2 cases) and 2.9% (1 cases), respectively. Contrast CT was the most sensitive (86.1%, 31 lesions/36 lesions) for EHPT, followed by 99mTc-MIBI (66.7%, 24 lesions/36 lesions), IOLVPTH monitoring (61.8%, 21 lesions/34 lesions) and neck ultrasound (55.6%, 20 lesions/36 lesions). Contrast CT was most sensitive,100% in detecting deep-located EHPT lesions, whereas IOLVPTH had advantages in detecting intrathyroidal EHPT lesions, with a sensitivity of 100.0%.The combined use of 99mTc-MIBI and neck ultrasound showed a sensitivity of 77.8% in the localization of EHPT. Conclusions:Contrast CT is highly sensitive in the localization of EHPT. The combined use of preoperative imaging and IOLVPTH monitoring helps to higher localization for EHPT.

Objective To investigate the intervention effect of Xuanfuhua decoction on mice with nonalcoholic steatohepatitis (NASH) induced by high-fat, high-fructose, and high-cholesterol diet. Methods A total of 32 male C57/BL6J mice were randomly divided into normal group, model group, Xuanfuhua decoction group, and obeticholic acid group, with 8 mice in each group. Since week 24 of modeling using high-fat, high-fructose, and high-cholesterol diet, each group was given the corresponding drug for intervention at a dose of 14.19 g/kg by gavage for the Xuanfuhua decoction group and 10 mg/kg by gavage for the obeticholic acid group and a volume of 20 mL/kg for gavage, once a day for 6 consecutive weeks. HE staining, oil red O staining, Sirius Red staining, and Masson staining were used to observe the pathological changes, lipid deposition, and collagen deposition of liver tissue; related kits were used to measure the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and glucose, as well as the content of TG and hydroxyproline (Hyp) in liver tissue; quantitative real-time PCR was used to measure the expression of genes associated with lipid metabolism, inflammation, and fibrosis in liver tissue; immunohistochemical staining was used to observe the positive expression of F4/80 and α-SMA in liver tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Compared with the normal group, the model group had significant increases in body weight, liver wet weight, and serum levels of AST, ALT, TC, TG, LDL-C and glucose (all P < 0.01). HE staining showed hepatocyte steatosis, a large number of fat vacuoles, hepatocyte ballooning degeneration, and inflammatory cell infiltration in liver tissue of the mice in the model group, and the model group had a significant increase in NAFLD activity score (NAS) compared with the normal group ( P < 0.01). Oil red O staining showed the deposition of a large number of red lipid droplets with different sizes in hepatocytes of the mice in the model group, and compared with the normal group, the model group had significant increases in the area percentage of oil red O staining and the content of TG in the liver ( P < 0.01). Sirius Red staining and Masson staining showed significant collagen fiber hyperplasia in the perisinusoidal area, the central vein, and the portal area in the model group, and the model group had a significant increase in the content of Hyp in liver tissue compared with the normal group ( P < 0.05). Compared with the model group, the Xuanfuhua decoction group had significant reductions in the serum levels of AST, ALT, TC, TG, LDL-C, and glucose (all P < 0.05), significant improvements in hepatic steatosis, inflammatory infiltration, lipid droplet deposition, and collagen fiber hyperplasia, and significant reductions in NAS score, area percentage of oil red O staining, and content of TG and Hyp in the liver (all P < 0.05). Compared with the normal group, the model group had significant increases in the mRNA expression levels of lipid metabolism-related genes (SREBP-1c, FASN, SCD-1, PPAR-γ, and CD36), inflammation-related genes (F4/80, TNF-α, CCL2, and CD11b), and the fibrosis-related gene α-SMA (all P < 0.05), and immunohistochemical staining showed significant increases in the positive expression of F4/80 and α-SMA ( P < 0.01). Compared with the model group, the Xuanfuhua decoction group had significant reductions in the mRNA expression levels of SREBP-1c, FASN, SCD-1, PPAR-γ, CD36, F4/80, TNF-α, CCL2, CD11b, and α-SMA in liver tissue (all P < 0.05), and immunohistochemical staining showed significant reductions in the positive expression of F4/80 and α-SMA ( P < 0.01). Conclusion Xuanfuhua decoction has a good intervention effect on mice with NASH induced by high fat, high fructose, and high-cholesterol diet and can significantly inhibit hepatic lipid deposition, inflammatory response, and liver fibrosis.

ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.