Objective To access the effectiveness of withdrawing iodized salt on correcting the iodine excess in the population living in high iodine areas.Methods Before withdrawing iodized salt,2 twons were selected from each of 5 cities with water-borne iodine excess areas in Hebei province.All the selected towns were divided into 7 groups according to their iodine content in drinking water.Two villages wereselected from each group where urine samples of children aged 8 to 10 years old were collected to investigate the change of urinary iodine content of these children before and after withdrawing iodized salt.The urinary iodine content was determined using the method for determination of ammonium persulfate digestion arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Correlation between children's urinary iodine and drinking water iodine was analyzed.Results Before and after withdrawing iodized salt,744 and 771 urine samples were collected from the examined children aged 8-10 years respectively.The overall median urinary iodine content (MUIC) of the examined children after withdrawing iodized salt (350.1 μg/L) decreased significantly than that of before withdrawing iodized salt (460.8 μg/L,U =3 127.8,P ＜ 0.05).After withdrawing iodized salt,the MUIC of the children decreased significantly in 8 of 12 villages (P ＜ 0.05).Before and after withdrawing iodized salt,the percentage of urine samples with iodine content above 300 μg/L was 76.7％ (571/744),58.5％ (451/771) respectively,with significant statistical difference (x2 =57.7,P ＜ 0.05).After withdrawing iodized salt,Children's MUIC also decreased significantly across gender and age (boys:558.5,351.6 μg/L,U =960,P ＜ 0.05; girls:522.9,355.5 μg/L,U =698,P ＜ 0.05; 8 years old:536.0,295.5 μg/L,U =529.5,P ＜ 0.01; 9 years old:386.2,323.2 μg/L,U =753.5,P ＜ 0.01; 10 years old:525.5,368.8 μg/L,U =521.5,P ＜ 0.05).The children's MUIC correlated positively with the median water iodine contert (MWIC) in the villages where they lived (r =0.951,P ＜ 0.01).Analyzed by linear regression,approximately 89％ of the variability in MUIC was associated with variability in MWIC.Conclusions Withdrawing iodized salt could only correct the iodine excess caused by consuming iodized salt in the population living in the areas with MWIC below 100 μg/L.In the areas with water iodine above 100 μg/L,intervention should be focused on seeking water with proper iodine content.

Objective The aim of this study was to investigate the application of low molecular weight heparin combined with alteplase for thrombolysis in patients with acute myocardial infarction(AMI),and to compare its thrombolysis effect with traditional anticoagulant-general heparin. Methods 35 AMI patients with alteplase intravenous thrombolytic therapy were divided into two groups,among which 15 cases in the study group were treated with 30 mg enoxaparin instant intravenous injection before thrombolysis,40 mg enoxaparin hypodermic injection 15 minutes after thrombolysis,40 mg enoxaparin hypodermic injection every 12 hours for 5 days. The other 20 cases were assigned to the control group and treated with 4 000 u(or 60 u/kg)general heparin instant intravenous injection,then pumped general heparin intravenously in the rate of 800-1 000 u/h. Meanwhile,detected coagulation convention every 3 hours and adjusted the dose of heparin according to the activated partial thromboplastin time(APTT)to keep APTT value within 1.5 to 2.0 times(50-70 s)the standard value. 48 hours later,patients in the control group was given hypodermic injection of 40 mg enoxaparin every 12 hours for 5 days. All cases were given regular treatment as guidelines recommended. Results The patency rate of infarct-related coronary artery assessed by unified clinical criteria was 86.66% and 65.00%,and the average recanalization time was(1.62±0.36)h and(1.81±0.33)h in the study and control groups,respectively. There were no significant differences on patency rate and recanalization time between the two groups(P > 0.05). One case of bleeding complication occurred in the study group(6.66%),while five cases occurred in the control group(25.00%). In the two groups,no cases appeared intracranial hemorrhage and other serious or fatal bleeding occurred. Conclusion The clinical efficacy of low molecular weight heparin was non-inferior to general heparin in AMI patients with alteplas thrombolysis. The application of low molecular weight heparin was simple and easy to operate. It can optimize the procedure of thrombolysis,reduce repetitive coagulation index monitoring and lessen clinical workload,which is worth being promoted to primary hospital and the emergency systems.

Through summarizing and analyzing the characteristics of elderly infertile people,the problems emer-ging in the assisted reproduction process and the possible ethical problems emerging in the assisted reproduction treatment of elderly patients,this paper explored how to build the ethical path which aimed at elderly pregnancy -assisted people and suitable for Reproductive Center in the First Affiliated Hospital of Xinjiang Medical University. And aiming at the possible ethical problems emerging in the process of assisted reproduction treatment of elderly pa-tients,this paper put forward that it should establish normative ethical working path,to be more convenient to fully conduct ethical supervision and examination in the process of assisted reproduction treatment of elderly patients.

Objective To summarize the efficacy of different anticoagulation methods during perioperative period of non-cardiac surgery after cardiac valve replacement and to compare the postoperative bleeding-related complications and embolization-related complications. Methods Retrospective analysis of clinical data of 56 patients who underwent non-cardiac surgery after cardiac valve replacement in our hospital from January 2016 to January 2018 was conducted. There were 27 males and 29 females, aged 19-75 (53.56±13.94) years. According to different anticoagulation methods during perioperative period, the patients were divided into a bridging group (32 patients) and a non-bridging group (24 patients). The postoperative hospital stay, the number of patients needing postoperative blood transfusions, bleeding-related complications and embolization-related complications were compared between the two groups. According to the patient’s perioperative embolization risk, each group of patients were divided into a high-risk subgroup, middle-risk subgroup, and low-risk subgroup, and the bleeding-related complications and embolization-related complications in each subgroup were compared. Results The postoperative hospital stay in the bridging group was significantly longer than that in the non-bridging group (P<0.05), but there was no significant difference in the number of patients needing postoperative blood transfusions, overall bleeding-related complications and embolization-related complications between the two groups (P>0.05). Subgroup analysis was performed according to the degree of embolization risk in the perioperative period. The incidence of bleeding-related complications of the non-bridging group in the high-risk subgroup was significantly higher than that in the high-risk subgroup of the bridging group (P<0.05). The incidence of bleeding-related complications in the bridging group was similar to that of embolization-related complications, while the rate of bleeding-related complications in the non-bridging group was 7 times higher than that of embolization-related complications. Conclusion Bridging anticoagulation increases the length of postoperative hospital stay, but for patients with high risk factors for embolization, it is more beneficial than continuing oral warfarin during the perioperative period. The incidence of bleeding-related complications associated with continued warfarin therapy is significantly higher than that of embolization-related complications, and hemostatic drugs can be given necessarily.

Objective To optimize the supercritical CO₂ extraction conditions of volatile oil from Wenjing Huoxue cataplasm. Methods On the basis of single factor investigation on the comprehensive score of extraction yield , osthole content and isoimperatorin, the effects of extraction temperature, pressure and time on the comprehensive score of extracted volatile oil were optimized by orthogonal design. Results In the single factor experiment, the factors that had a great influence on the comprehensive score of the extracted volatile oil were extraction temperature, extraction pressure and extraction time. The orthogonal experiment results showed that the extraction temperature and extraction pressure had a significant influence on the comprehensive score of volatile oil. The optimized extraction process was as follows: extraction temperature at 55 ℃, extraction pressure as 30 MPa, and extraction time as 2 h. Conclusion The extraction process optimized in this experiment is stable and feasible, which could be used for the extraction and preparation of the volatile oil.

Objective    To analyze the near-term clinical efficacy of two different surgical procedures (Sun's procedure and Debranching combined endovascular stent-graft procedure) to cure Stanford type A aortic dissection, and summarize the clinical experience to help better master the indications of the two surgical procedures. Methods     We retrospectively analyzed the clinical data of 46 patients with Stanford A aortic dissection in our hospital between September 2014 and September 2017. There were 39 males and 7 females at age of 20–74 (48.67±11.80) years. According to different surgical methods, the patients were divided into a Sun's procedure group (26 patients) and a debranching combined endovascular stent-graft procedure group (20 patients). The clinical effect of the two groups was compared. Results     The debranching combined endovascular stent-graft procedure group was significantly superior to the Sun's group in cardiopulmonary bypass (CPB) time, aortic cross clamp(ACC) time, intraoperative urine output, postoperative mechanical ventilation time, postoperative 24 h volumes of drain, CICU time, renal function recovery of postoperative 72 h and total hospital stay(P<0.05). The incidence of transient neurological damage after operation in the debranching combined endovascular stent-graft procedure group was significantly lower than that of the Sun's procedure group(P<0.05). The follow-up time ranged from 3 to 36 months. And the follow-up rate was 90.5%. One patient in the Sun's procedure group died of serious pulmonary infection postoperative 30 days. One patient in the debranching combined endovascular stent-graft group was found to have internal leakage in the early postoperative examination and   disappeared after 6 months. Sun's procedure group did not find endoleak. All patients during the follow-up time did not appear brain, coagulation disorders, stroke, paraplegia, upper limb ischemia and other complications. Conclusion     For Stanford type A aortic dissection, debranching combined surgery may have the risk of postoperative endoleak, but the overall effect is superior to Sun's operation. Therefore, debranching combined surgery should be preferred for the treatment of this type of dissection.