Objective To evaluate the therapeutic efficacy of YunKe and prednisone on moderate and severe thyroid associated ophthalmopathy(TAO).Methods 1 08 hyperthyroidism patients with moderately severe TAO were randomly divided into YunKe group,hormone group and the control group.All of the patients were given anti -thyroid medication(ATD)treatment.By thyroid hormone level upper limit every times higher than normal for a sulfhydryl imidazole 5mg/day to calculate daily dosage,based on thyroid hormone level adjusted a sulfhydryl imidazole dose every two weeks,make thyroid hormone levels in the normal range.YunKe set:intravenous push note YunKe per day A +B agent four groups (including cloud 20mg),each treatment medicine for five days in A row,interval of 25 days to the next period of treatment,medication six procedures.Hormone group:oral prednisone for 6 months,monthly dose in the order 1 mg·kg -1 ·d -1 ,0.75mg·kg -1 ·d -1 ,0.5mg·kg -1 ·d -1 ,0.25mg·kg -1 ·d -1 ,0.1 25mg·kg -1 ·d -1 , 0.062 5mg·kg -1 ·d -1 ,1 time a day,took at 8 o'clock in the morning.The control group treated ATD.Before and 6 months after treatment,all of the patients were checked the TNF -αand TRab,CT scan to measure degree of exophthalmus.Six months after treatment,respectively,on the basis of TAO classification (NOSPECS)and TNF -α, TRab level changes to determine the efficacy of treatment.Data entry Excel 2003 statistical software,used SPSS 1 9.0 statistical software to analyze data.Non parametric tests of three groups of data with Kruskal Wallis test.Not matching the two independent samples nonparametric test with the Mann -Whitney test,with P <0.05 for the difference was statistically significant.Results The markedly effective rate,effective rate and ineffective rate of YunKe group were 36.1 %,47.2% and 1 6.7% respectively,which of the hormone group were 20.0%,37.1 % and 42.9%,which of the control group were 1 3.9%,22.2% and 63.9%.The efficacy among the three groups had statistically significant differences (Kruskal -Wallis χ2 =1 0.736,P =0.005 ).The lighter exophthalmos,tge curative effect was better (Mann -Whitney Z =-4.599,P <0.001 ).The changes of TNF alpha,TRab levels among the three groups had significant differences(YunKe group,the TNF alpha,TRab levels markedly reduced 75.0% and 80.6%,respectively, which of the hormone group were 37.1 % and 34.3%,which of the control group were 1 9.4% and 27.8%,TNF χ2 =23.527,P <0.001 ;TRab χ2 =23.831 ,P <0.001 ).Conclusion The therapeutic efficacy of YunKeon TAO is better than prednisone,but the long -term effect deserves more investigation.

Objective To evaluate the clinical efficacy of Jianpi pill in the treatment of leucocytopenia induced by anti -thyroid drug.Methods According to the digital table,195 Graves hyperthyroidism patients with leucocytopenia induced by anti -thyroid drug were randomly divided into the observation group(100 cases)and the control group(95 cases).The observation group was given Jianpi pill treatment,while the control group adopted the combination therapy of batilol tablets,leucogen tablets,vitamin B4 tablets.The facial color,whether or not limb weak-ness,whether or not palpitations after strenuous exercise in the two groups were observed.The number of white blood cells and the number of neutrophils in the two groups were observed.3 months later,the curative effect of the two groups was determined according to the degree of cure.Results The total effective rates of the control group and the observation group were 52.63% and 85.00% respectively,the difference was statistically significant between the two groups(χ2 =23.96,P <0.01 ).The disappear infection rates of the control group and the observation group were 25.00% and 69.05% respectively,the difference was statistically significant between the two groups (χ2 =15.93, P <0.01 ).The total effective rates of mild,moderate,severe leucocytopenia were 95.56%,87.50%,46.67%respectively,the difference was statistically significant between mild and severe leucocytopenia (χ2 =16.00,P <0.01),and the difference was statistically significant between moderate and severe leucocytopenia(χ2 =7.94,P <0.01).The excellence rates of mild,moderate,severe leucocytopenia were 48.89%,40.00% and 48.89% respec-tively,the difference was statistically significant between mild and severe leucocytopenia(χ2 =5.92,P <0.01),and the difference was not statistically significant between moderate and severe leucocytopenia(χ2 =2.41,P >0.05).The incidence rates of dry mouth,hyperactive bowel sounds and liver damage,constipation and diarrhea in the control group were 4.21%,2.10% and 1.05% respectively,and the incidence rates of dry mouth,hyperactive bowel sounds and liver damage in the observation group were 3.00% and 1.00% respectively,there was no significant difference in adverse reactions between the two groups(P >0.05).Conclusion The curative effect of Jianpi pill in the treatment of Graves hyperthyroidism patients with leucocytopenia induced by anti -thyroid drug is sure,and it is superior to the combination therapy of batilol tablets,leucogen tablets,vitamin B4 tablets.

Objective To investigate the features and influence factors of cardiac function in preterm infants.Methods One hundred and eleven preterm infants were divided into three groups according to the gestational age which was 28-31+6,32-33+6 and 34-36+6 weeks respectively.Fifty term-birth infants at gestational age of 37-41+6 weeks were taken as control group.The cardiac function was examined by SonoSite 180 PLUS color Doppler ultrasonic diagnostic apparatus.The parameters of cardiac function included heart rate,peak flow rate of aorta valve orifice (AV),peak flow rate of pulmonary artery valve orifice (PV),cardiac output (CO),stroke volume (SV),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),the ratio of early (E) and late (A) diastolic velocities of mitral and tricuspid valves (MVE/A,TVE/A).Within one week after delivery,the cardiac function was examined,and the cardiac function of preterm infants with different gestational age were compared.Another 162 preterm infants were divided into four groups according to the time at examination as 12 h-,24 h-,72 h-and 1 week-28 d.The influence factors of cardiac function were determined by multi-factor linear regression analysis.Results The AV,PV,CO,LVEDV,LVESV and SV increased with the increasing of gestational age.MVE/A (1.13±0.17,1.14±0.18,1.13±0.18) and TVE/A (0.90±0.16,0.90±0.13,0.90±0.15) of 28-31+6,32-33+6 and 34-36+6 weeks group were higher than those of control group (1.28±0.17 and 1.04±0.20),respectively (P＜0.05).PV of 72 h-group and 1 week-28 d group were higher than that of 12 h-group [(79.60±11.22) cm/s and (78.86±13.64) cm/s vs (72.61±8.56) cm/s](P＜0.05).The heart rate of 1 week-28 d group was higher than that of other three groups (P＜0.05).Both CO and SV were positively related to body weight and gestational age (r=0.55 and 0.36,0.61and 0.52,respectively,P＜0.05).Conclusions The left ventricular pump function increases with the increasing of gestational age,while the diastolic function of left and right ventricle of preterm infants does not change significantly in the first month of life.The PV of preterm infants significantly increases 72 h after delivery.The body weight and gestational age are important influence factors of cardiac function in preterm infants.

Objective To investigate the dynamic change and correlation of the pulmonary ventilative function, mechanic and cardiac function in the term infants. Methods Twenty hundred term infants were divided into A 、B 、C and D groups by age which was 0 ～ 24 h, ～ 72 h, ～ 1 w and 28 d respectively. The lung ventilative and mechanical function were measured respectively by using techniques of tidal breathing flow-volume loop(TBFVL)and the single occlusion. The Master screen Paed-lung function devices of Germanic JAEGER Co. was be used in this study. The parameter of pulmonary function including minute volume(MV) ,tidal volume (TV), respiratory system compliance(Crs) and respiratory system resistance (Rrs). The cardiac function were measured by using SonoSite 180 PLUS color Doppler ultrasonic diagnostic apparatus. The main parameter of cardiac function including cardiac output(CO) and stroke volume(SV). Results The TV of A, B ,C and D group were 20. 2 ± 3.78,21. 1 ± 3.71,22. 3 ± 4. 48 and 23. 9 ±4.90 (ml)respectively, the TV of C and D group were higher than that of A group, and the TV of D group was higher than that of B group (P ＜ 0. 05).There were no significantly difference of Crs, Rrs among A, B, C and D group(P ＞ 0. 05). The CO of A,B,C and D group were 0.93 ±0. 23,0.93 ±0.23,1.02 ±0.21 and 1.08 ±0.27 (L/min) ,the CO of D group was higher than that of A and B groups (P ＜ 0. 05). The CO was negative correlation with Rrs (r = - 0. 16,P ＜ 0. 05) and positive correlation with MV、 TV、 Crs (r was 0. 50、 0. 54、0. 13 respectively, P ＜ 0. 05).Conclusion The lung ventilative function is mature gradually with increasing age. The cardiac output has been obviously improved for postnatal 1 week in the term infants. The pulmonary ventilative function and mechanic parameter are important effective factors of cardiac function.

Objective To reveal inpatient service utilization and medical burden in disease-caused poor rural families,for policy references.Methods By means of convenience sampling method,face-toface interview was made to inpatients from such families in Miyi County of Sichuan Province,Binhai County of Jiangsu Province and Xingtai County of Hebei Province.Results Totally 453 effective questionnaires were collected,with an effective rate of 96.7％.Respondents feature low income and fund raising capability,while 75.3％ of them pay their inpatient costs out-of-pocket,17.7％ pay with loans from others and 7.1％ pay by financial assistance from relatives;but they tend to go to higher level hospitals and have higher financial burdens for diseases.Conclusions Rural hospitalization resources should be optimized and integrated,levels of the New Rural Cooperative Medical System be improved,the catastrophic health care system be perfected and the health insurance coverage be gradually expanded for the low-income and marginalized population.

Objective To summarize and analyze the epidemiological and clinical characteristics of patients with subacute thyroiditis(SAT),so as to provide a basis for prevention and treatment.Methods The epidemiological and clinical data of 1 865 patients with SAT,who were treated in the Shandong Institute of Prevention and Control for Endemic Disease in 2015-2006,were collected.The SAT patients' sex,age,urban and rural areas,occupation and time of onset distributions,summary onset clinical manifestations,laboratory findings,treatment and outcome were analyzed retrospectively.Results The average age of the 1 865 patients with SAT was 42.16 years old,the youngest was 9 years old,and the oldest was 74 years old.Most of the patients were 21-50 years old,which was accounted for 62.36％ (1 163/1 865),and most of the patients were female,which was accounted for 83.70％ (1 561/1 865).Most of the patients lived in rural areas,which was accounted for 60.54％ (1 129/1 865).Most patients were onset in January,accounted for 20.48％ (382/1 865),and the least in July,accounted for 1.77％ (33/1865).For the clinical classification,the moderate type and the light type were the largest part with 1 716 cases,accounted for 92.01％,while the severe type was 149 cases,accounted for 7.99％.The clinical manifestations were as follows:the neck discomfort in 1 701 cases,accounted for 91.21％;neck pain,sore throat and palpitate in 1 439 cases,1 351 cases and 1 341 cases,accounted for 77.16％,72.44％ and 71.90％,respectively.Laboratory test results were as following:1 865 cases of thyroid 131I absorption rate reduced(100％);1 396 cases of thyroid nodules increased(74.85％);532 cases of FT3 and FT4 significantly increased,while TSH significandy decreased (28.53 ％);949 cases of FT3 and FT4 increased,while TSH decreased (50.88％);53 cases of FT3 and FT4 decreased,while TSH increased (2.84％);331 cases of FT3,FT4 and TSH in the normal range(17.75％).The thyroid 13I absorption rate significantly increased and thyroid nodules significantly reduced with treatment,the difference was statistically significant (t =-34.93,133.2,all P ＜ 0.001).1 813 patients were cured,while 52 cases arised hypothyroidism.Conclusion Majority of SAT patients are young women.The peak of the incidence of SAT lies in autumn and winter.The proportion of the moderate type is the highest.Early diagnosis and treatment is the key to improve the prognosis of patients with SAT.

OBJECTIVE To offer better cleaning and less rusted medical instrument,prevent hand injuries,and the incidence of nosocomial infection among healthcare professionals.METHODS Two methods were used in two operating rooms for comparison.A multi-enzyme rinse liquid,the Ruhof rinse liquid was used in the test group.The traditional method was used in the control group.The cleaning level of these two groups were observed.RESULTS The group using Ruhof rinse liquid was much cleaner than the group without using it(P

Objective To explore the relationship between job stressors,montal health and intention to quit of pediatric nurses by comparing with nurses in internal medicine department. Methods Job stressors, mental health,intention to quit of pediatric nurses and their relationship were investigated among nurses in above mentioned wards from three third-level and first-class hospitals by using questionnaires. Results The scores of some factors of job stressors and nine factors of SCL- 90 of pediatric nurses were much higher than those of internal medicine nurses. There was a significantly positive correlation between some factors of job stressors, mental health and intention to quit of pediatric nurses. Conclusions Working pressure is a factor of low mental health level and intention to quit of pediatric nurses. Effective management strategies should be imple-mented to protect the mental health of pediatric nurses and decrease the loss of nurses.

Objective To evaluate the immunogenicity of group A and C meningococcal polysaccharides conjugates using different proteins as carriers. Methods Heat-labile enterotoxin B subunit (LTB)pentamer form was expressed in E. coli. The target protein was identified and purified by cation-exchange chromatography. Then biological activity of rLTB was tested using GM1-ELISA. GCMP was conjugated to rLTB with the chemical method (ADH). Furthermore, the mice were immunized with GAMp-TT/GCMP-TT conjugates and GAMP-TT/GCMP-rLTB conjugates via peritoneal. Finally the anti-polysaccharide antibody was detected. Results The GAMP-TT/GCMP-rLTB conjugate elicits remarkably higher serum antibodies in mice than GAMP-TT/GCMP-TT conjugate. Conclusion These results indicated that polysaccharide conjugates using different proteins as carriers were superior to those using only one protein as carrier.