Objective:To study the metabolism of high density lipoprotein cholesterol ( HDL-C ) and apolipoprotein A-Ⅰ( ApoA-Ⅰ) in different thyroid function status during pregnancy. Methods:This study re-cruited thirty cases of euthyroid, with nineteen cases of subclinical hypothyroid and eight cases of subclini-cal hyperthyroid pregnancy. The concentrations of fasting serum HDL-C and ApoA-Ⅰwere detected and ana-lyzed from 9-12, 14-17, 23-26, and 37-40 gestational weeks. Friedman repeated measures ANOVA on ranks was adopted to analyze the changes of serum HDL-C and ApoA-Ⅰat different stages. General line-ar model ( GLM) was adopted to analyze the differences of serum HDL-C and ApoA-Ⅰin different thyroid function status during pregnancy. Results:There were no significant differences of maternal serum HDL-C among different stages (χ2 =5. 428,P=0. 143,χ2 =2. 027,P=0. 567,χ2 =2. 885,P=0. 410). There were significant differences of serum ApoA-Ⅰduring euthyroid and subclinical hypothyroid pregnancies (χ2 =46. 343, P<0. 001,χ2 =35. 984, P<0. 001), and no significant difference during subclinical hyperthy-roid pregnancy (χ2 =6. 750, P=0. 080). There were significant differences of serum HDL-C and ApoA-Ⅰbetween euthyroid and subclinical hyperthyroid pregnancies (P=0. 025,P=0. 027), and no significant differences between euthyroid and subclinical hypothyroid pregnancies (P=0. 378,P=0. 549). Conclu-sion:Subclinical hyperthyroidism affected the metabolism of maternal serum HDL-C and ApoA-Ⅰ, which could affect the fetal growth and development. Subclinical hypothyroidism ( after treatment with drugs) had no obvious effect on the metabolism of maternal serum HDL-C and ApoA-Ⅰ.

Congenital hypertrophic pyloric stenosis(CHPS)is a common gastrointestinal congenital mal-formation in neonate and small infants.Pyloromyotomy is an effective method for treatment of CHPS,including several methods.Traditional open pyloromyotomy for the patient's body injury is serious,such as accident of an-esthesia,postoperative infection,skin scar;laparoscopic pyloromyotomy can cause the pylorus muscle incision uncomplete,invasive operation damage,etc.Endoscopic pyloromyotomy for neonatal has some advantages:a lit-tle injury,no scars,simple operation,less complications,quicker recovery of feeding.Endoscopic mucosal pyloro-myotomy may be a new method of treatment,needing further exploration and research.

Objective To study the clinical value of exposure of recurrent laryngeal nerve in thyroid operation for the prevention of recurrent laryngeal nerve injury. Methods A total of 90 patients received thyroid operation in our hospital from April 2012 to August 2014 were enrolled and randomly divided into observation group(n=45) and control group(n=45) according to whether the recurrent laryngeal nerve were exposed during operation. The patients in observation group received thyroid operation with recurrent laryngeal nerve exposure, and the patients in control group received conventional thyroid operation. Then recurrent laryngeal nerve injury situation and operation situa-tion were compared. Results Recurrent laryngeal nerve injury symptoms were less in the observation group (2. 22%) compared with that of the control group (15. 56%) with a statistically singnificant difference(P<0. 05). The operation time of observation group (54. 45 ± 6. 62) min was longer than that of the control group (41. 29 ± 5. 82) min with a statistically singnificant difference (P<0. 05). The recovery time of observation group (5. 85 ± 0. 85) d was shorter than that of the control group (8. 02 ± 1. 12) d, with a statistically singnificant differ-ence (P<0. 05). There was no significant difference in bleeding volume during operation,postoperative drainage volume and drainage dura-tion between two groups(P>0. 05). Conclusion Exposure of recurrent laryngeal nerve in thyroid operation is helpful to prevent recurrent laryngeal nerve injury,which reduce the damage recovery time,although it will extend the operation time,does not increase bleeding and drainage volume.

Objective To explore the efficacy and safety of different doses of budesonide mixed suspension atomization inhalation in children with post infectious cough,and provide reference for the rational use of budesonide.Methods One hundred and twenty children with post infectious cough aged 2-14 years old were selected and divided into three groups by random digits table method (40 cases in each group).Control group was treated with 4 mg once montelukast sodium chewable tablets for 2-5 years old children,or 5 mg once for 6-14 years old children.Low-dose group was treated 2 times/d with a dose of 0.5 mg budesonide mixed suspension diluted in normal saline to 4 ml based on control group and high-dose group was treated 2 times/d with a dose of 1.0 mg budesonide mixed suspension diluted in normal saline to 4 ml based on control group.The outcome of curative effects were recorded and analyzed after 7 days of treatment.Results The total efficacy rate was 70.0％(28/40),52.5％(21/40),35.0％(14/40) in high-dose group,low-dose group and control group after 3 days of treatment,and there was significant difference between high-dose group and control group (P＜ 0.01).The total efficacy rate was 92.5％(37/40),90.0％(36/40),72.5％ (29/40) in high-dose group,low-dose group and control group after 7 days of treatment,and there was no significant difference(P ＞ 0.025).Few adverse events associated with inhaled corticosteroids,such as thrush,sore throat,hoarseness were observed in three groups.Conclusions Budesonide mixed suspension atomization inhalation alleviates symptom of post infectious cough significantly with no obvious side effects,even in high-dose group which has a more outstanding efficacy.Therefore,this therapy is valuable in clinical application.

Objective To evaluate the diagnostic accuracy of 4 μg/mL vancomycin screening plate (4VA)for vancomycin-non-susceptible Staphylococcus aureus.Methods The diagnosis trials on 4VA for vancomycin-non-susceptible Staphylococcus aureus were searched in the databases such as PubMed(1 966 to Aug.2013),The Cochrane Library(the second phase of 2013),ISI Web of Knowledge(1 980 to Aug.2013),CNKI (1 964 to Aug.2013),VIP (1 989 to Aug.2013)and Wanfang(1 998 to Aug.2013),mean-while the manual.Two reviewers evaluated the quality of the included trials according to the quality assessment of diagnostic accu-racy studies,and then meta-analysis was performed using Meta-Disc 1.4 software.Results A total of 3 trials involving 974 partici-pants were included.The results of meta-analysis showed that the weighted sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio,were 0.805 [95%CI (0.047 to 0.563)],0.921 [95%CI (0.901 to 0.938)],10.804 [95%CI (5.5 1 1 to 21.181)],0.1 62 [95%CI (0.71 to 1.0)]and 69.721 [95%CI (1 1.740 to 414.06)]respectively.Conclusion 4VA for vancomycin-non-susceptible Staphylococcus aureus has a very high specificity and sensitivity,so 4VA could be used to creening plate (4VA)for vancomycin-non-susceptible Staphylococcus aureus in clinic.

Objective To compare the therapeutic effect in two kinds of inhalation in infant asthmatic bronchitis.Methods Two hundred and twelve asthmatic bronchitis children were randomly divided into group A (103 cases) and group B (109 cases).The children in two groups were treated with conventional therapy,including antibiotics,fluids and other treatment.The children in group A were given budesonide 1 mg,terbutaline 5 mg plus 0.9％ sodium chlorine in 2 ml,with oxygen driven inhalation therapy,2-4 times/d.The children in group B were given albuterol sulfate inhalation aerosol 1-4 spray/times,4-6 times/d,inhaled fluticasone quantitative aerosol spray 1-2 spray/times,2 times/d,15 s/times.The course of two groups was 5-7 d.The therapeutic effect was compared.Results The total effective rate in group A and group B were 92.2 ％ (95/103) and 97.2 ％ (106/109),there was no significant difference (x2 =2.73,P ＞ 0.05).The relieve time of cough,gasping and wheezing,hospital stay in group B were shorter than those in group A [(12.00 ± 2.75) h vs.(29.00 ± 1.25) h,(10.00 ± 1.45) h vs.(31.00 ± 2.75) h,(13.00 ± 1.55) h vs.(33.00 ± 2.33) h,(7.20 ± 0.65) d vs.(8.70 ± 1.35) d],the cost of hospitalization in group B was lower than that in group A [(2.00 ± 0.30) thousand Yuan vs.(2.50 ± 0.55) thousand Yuan],there were significant differences(P ＜ 0.05).Conclusions The albuterol inhalation solution combined with fluticasone has the advantages of rapid efficacy,short course,low cost,easy to accept and adjust.It is worth to spread in primary hospital.

Purpose:Expression of MEK-1 was studied by regulating ?V integrin and E-cadherin on MCF-7 breast cancer cells.Methods:Using cell transfected techniques site-mutated genes were inserted into MCF-7 cells and made MCF-7 cells containing MEK-1-GFP,Ala 222 MEK-1-GFP,Asp 222 MEK-1-GFP ,respectively. These cells were tested with immunoblot analysis and immunofluoresence technique to determined the change of MEK-1 expression and location of MEK-1 in cells.Results:Deactivated Ala 222 MEK-1-GFP inhibited the activity of MAPK,active Asp 222 MEK-1-GFP increased the activity of MAPK. Ala 222 MEK-1-GFP increased the expression of E-cadherin,did not increase the expression of ?V integrin and inhibited FAK phosphorylation. MEK-1-GFP and Asp 222 MEK-1-GFP did not affect the expression of E-cadherin ,but upregulated the expression of ?V integrin,increased FAK phosphorylation.Conclusions:MEK-1 regulated the expression of ?V integrin and E-cadherin,FAK is the key factor that induced signal pathway of ?V integrin. It is possible that MEK-1 regulated FAK phosphorglation by regulating expression of ?V integrin and E-cadherin.

Rectal cancer is a common malignant tumor in the gastrointestinal system.For the patients with resectable but high-risk rectal cancer,neoadjuvant and adjuvant chemoradiation plus surgery may improve local control.Compared to adjuvant chemoradiation,neoadjuvant chemoradiation showed the advantage of sphincter preservation.When the goal of preoperative chemoradiation was sphincter preservation,conventional radiotherapy was recommended.Through the analysis of the patients with 5-year survivals,the radiation had a similar impact on the survival as the chemotherapy alone for the patients with the intermediate risk factors.The impact on local control need to be further investigated before recommending chemotherapy alone for those subset patients.Advances in preoperative irradiation,postoperative irradiation and the comparison of preoperative irradiation with postoperative irradiation are also reviewed in this article.

Objective To analyze and compare the effect of early minimally invasive surgical treatment and conventional treatment for patients with severe acute pancreatitis.Methods According to the including criteria,eight randomized-controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed and analyzed by using Revman 4.2 software.Results Compared with conventional treatment,early minimally invasive surgical treatment was associated with a significantly lower incidence of mortality(RR=0.35,95%CI:0.20～0.63,P

OBJECTIVE: To evaluate the effect of Eucommiae ulmoides on the microstructural and ultrastructural change of femur and lumber vertebrae in ovariectomized rats.METHODS: 80 4-month-old female SD rats were randomized to 4 groups: sham operation group,model group,alfacalcidol group,E.ulmoides group.In the sham operation group,the abdominal cavities of the rats were cut open to expose ovaries before being sutured.However,the rats in the other 3 groups were ovariectomized bilaterally.At 10 days after operation the rats were administered intragastrically with corresponding drug.After 3 months,femur and lumber vertebrae were dissected and fixed in 4% glutaral for 3 days,then decalcified in 4% EDTA for 4 weeks,and then the structure of femur and lumber vertebrae was observed under light microscope and transmission electron microscope(TEM).RESULTS: Observed under light microscope,the femur and lumber vertebrae were full of fat in the ovariectomized rats and in which the density of bone trabecula decreased significantly;however,in alfacalcidol-treated rats and E.ulmoides-treated rats,the amount of fat decreased markedly while the density and thickness of bone trabecula increased.Observed under TEM,in the ovariectomized rats,rough endoplasmic reticulum(RER),cytolysosome and mitochondrial were plentiful inside osteoclasts in femur and lumber vertebrae,partial osteoblasts atrophied,the amount of RER and other cellular organ decreased significantly and apoptosis appeared for partial cells;however,in alfacalcidol-treated group and E.ulmoicdes-treated group,the above changes improved significantly.CONCLUSION:E.ulmoides has remarkable beneficial effect on osteoporosis in ovariectomized rats.The mechanism might be attributed to its inhibition on the synthesis of fat and the activity of osteoclasts,promotion on the activity of osteoblasts and inhibition on the apoptosis.