Objective To examine the effect of metformin on serum thyrotropin (TSH) level in diabetic patients with subclinical hypothyroidism (SCH).Methods The long-term effects of metformin on thyroid axis hormones were assessed in 55 diabetic patients with primary SCH who were untreated with L-T4(study group),as well as in 31 diabetic patients with normal thyroid function (control group).According to using metformin or not,patients of study group were divided into the metformin group (group 1,n =28),and the non-metformin group(group 2,n =27).Serum TSH levels were compared between baseline and follow-up in patients receiving metformin treatment.Results After 30 weeks of metformin administration,a significant TSH decrease(t =2.91,P ＜ 0.05) was observed in group 1 [from(6.98 ± 1.92) to(2.44 ± 0.61) mIU/L].After stopping metformin therapy,the level of TSH at 52 weeks fol low-up was back to the baseline level [(6.99 ± 1.76) mIU/L,P ＞ 0.05].There was no significant difference in TSH level between baseline and after 30 weeks follow-up in group 2[(6.01 ± 1.63) mIU/L vs(6.21 ± 1.71) mIU/L,P ＞0.05].At the end of 30 weeks follow-up,no significant differences were found in body mass index and thyroid func tion in both metformin group and non-metformin group.In control group,metformin administration for 30 weeks had no effect on TSH level(P ＞ 0.05).Conclusion Metformin administration influences TSH without change of FT4 level in type 2 diabetic patients with primary SCH.

Objective:To evaluate the therapeutical effects of diplopore puncture of tympanum and intratympanic administration(DPTIA) on patients with acute secretory otitis media(ASOM).Method:One hundred and forty -one cases with ASOM were divided into two groups randomly,with 69 cases(80 ears) in group A(experimental group) and 72 cases(84 ears) in group B(control group).Group A was treated with DPTIA combined with medication, group B was treated with haplopore puncture of tympanum combined with medication. All patients accepted 1 to 3 courses of treament,and were observed during the period of treatment and 3 months after treatment.Result:The factors (including gender, age, side of ailing ear, course of disease, air-bone gap in the pure tone average,and acoustic immitance type in ailing ear) which may impact the prognosis were matched in two groups prior treatment(P＞0.05). While there was a significant difference in the cure rate and the total effective rate respectively between two groups after treatment(P＜0.05).No adverse reaction or complication was seen.Conclusion:DPTIA is a safe, reliable and effective way to manage patients with ASOM.

Objective To analyze the suspicious results of serum HBV DNA by fluorescence quantitative PCR and develop appropriate countermeasures in order to improve the quality of detection of HBV DNA.Methods Blood samples of patients from the First Affiliated Hospital of Wenzhou Medical College from 2008 to 2011 were analyzed for HBV DNA by fluorescence quantitative PCR.1969 cases of suspicious results,judged by the rule of review the results of serum HBV DNA combined with the historical results,PCR amplification curve,HBV serum markers and clinical diagnosis,were analyzed and redetected by using of two different reagents,careHBV PCR Kit and careHBV PCR Kit V2,at the same time.The consistency and inconsistency ratio of the results were evaluated.Both the reasons of inconsistent and the undetected rates of careHBV PCR Kit were analyzed.The two reasons for the inconsistent results included the reagent related factors,e.g,showing no amplification curve caused by the false negative and abnormal low efficiency of amplification curve,and the non reagent related factors such as operating pollution and other sample factors.Results There were 115 154 blood samples were detected for HBV from 2008 to 2011 and 1969 samples (1.71％) with suspicious results were redetected.The consistency and inconsistency results were 1588 (80.65％) and 381 (19.35％),respectively.Every year from 2008 to 2011,the percentage of the inconsistent results caused by the reagent related factors were 18.87％,20.23％,51.33％ and 59.57％ respectively,which showed an increasing trend,and the percentage of inconsistent results caused by the nonreagent related factors were 81.13％,79.77％,48.67％ and 40.43％ respectively,which showed a declining trend year by year.The undetected rates of careHBV PCR Kit were 2.49％,4.08％,10.09％ and 14.47％ respectively,showing an increasing trend.Conclusions The redetection for the specimens with the suspicious results by using of different reagents can avoid the blind detection of HBV DNA and reduce the experimental error.All the clinical samples for quantitative HBV DNA including the mutations of HBV gene can be measured accurately and effectively,which is helpful to hepatitis B patients for antiviral therapy.

AIM: To provide a basis for appraising quality standard of Baohe Pill (Fructus Gataegi, Massa medicata fermentata, Rhizoma pinelliae, Pericapium citr reticulatae, Fructus forsythiae, Semen raphani, Fructus Mordei germinatus, Poria) inclusive of its RP-HPLC fingerprint chromatogram. METHODS: The chromatographic column was Kromasil C_ 18 column (4.6 mm?250 mm, i.d, 5-?m particle size). The mobile phase was 0.5% solution of ammonium dihydrogen phosphate (NH_4H_2PO_4), and the flow rate was 0.8 mL/min with UV detector at 214 nm. RESULTS: The RP-HPLC fingerprint chromatogram of Baohe Pill was established. In the experiment, for precision and repeatability, the RSD of each area of common peak was less than 3%. CONCLUSION: This method is simple and reliable.

0.05). ②Among 30 pilots with abnormal vestibular functions,19 were permanently grounded and 11 were permitted to return their flying station. 36 pilots returned to fly in 45 cases with normal vestibular functions. The permanently grounded rate had significant differences between the two groups with normal and abnormal vestibular functions. (P

Background:The diagnostic accuracy of APRI and FIB-4 for liver fibrosis in patients with chronic hepatitis B is nothigh,especially for significant liver fibrosis (F≥2). Noninvasive diagnosis for liver fibrosis has become a research hotspot;and the diagnostic value of APRI combined with FIB-4 is not clear. Aims:To investigate the diagnostic value ofAPRI combined with FIB-4 for significant liver fibrosis in patients with chronic hepatitis B. Methods:A total of 171patients with chronic hepatitis B from January 2011 to October 2016 at General Hospital of Xinjiang Military Region wereenrolled. Liver biochemical indices,routine blood test and liver biopsy pathology were performed. APRI and FIB-4 werecalculated,ROC curve was drawn,and cutoff value of APRI and FIB-4 for diagnosing significant liver fibrosis wasdetermined,and mode of APRI combined with FIB-4 for diagnosing significant liver fibrosis was established. Results:Withthe increase in degree of liver fibrosis,APRI and FIB-4 were gradually increased (P < 0. 05). Area under ROC curve(AUC)for APRI and FIB-4 were 0. 812 and 0. 770,respectively. The sensitivity of FIB-4 for diagnosing significant liverfibrosis was higher than that of APRI. Sensitivity,specificity,negative predictive value,positive predictive value,andaccuracy of APRI combined with FIB-4 for diagnosing significant liver fibrosis were superior to APRI or FIB-4 used alone;and the specificity,accuracy of mode 2 were superior to mode 1. Conclusions:APRI combined with FIB-4 can increasethe accuracy for diagnosing significant liver fibrosis.

OBJECTIVE: To sum up the experiences of diagnosis, treatment and medical evaluation of head and neck tumors in aircrew. METHOD: Sixty-seven cases of pilot patients with head and neck tumors in our hospital since September in 1979 to July in 2009 were retrospective analyzed in the study. RESULT: Among 44 aircrew with benign head and neck tumors there were 37 cases continued their flying jobs and 7 cases were permanently grounded; whereas in 23 aircrew with malignant tumors there were 6 cases qualified for flight and 17 patients unqualified. CONCLUSION Benign or malignant of the head and neck neoplasm in the pilots are not the exclusive basis for their medical assessment. Tumor nature, location, efficacy of treatment and the impact on the function of their body should be considered as making the flight medical evaluation for the aircrew with head and neck tumors. Early diagnosis and treatment of head and neck tumors in aircrew are very important for reducing the rate of grounded.
Adult ; Aviation ; Female ; Head and Neck Neoplasms ; diagnosis ; epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVE: To evaluate the therapeutical effects of diplopore puncture of tympanum and intratympanic administration (DPTIA) on patients with acute secretory otitis media (ASOM). METHOD: One hundred and forty-one cases with ASOM were divided into two groups randomly, with 69 cases (80 ears) in group A (experimental group) and 72 cases (84 ears) in group B (control group). Group A was treated with DPTIA combined with medication, group B was treated with haplopore puncture of tympanum combined with medication. All patients accepted 1 to 3 courses of treatment, and were observed during the period of treatment and 3 months after treatment. RESULT: The factors (including gender, age, side of ailing ear, course of disease, air-bone gap in the pure tone average, and acoustic immittance type in ailing ear) which may impact the prognosis were matched in two groups prior treatment (P>0.05). While there was a significant difference in the cure rate and the total effective rate respectively between two groups after treatment (P<0.05). No adverse reaction or complication was seen. CONCLUSION DPTIA is a safe, reliable and effective way to manage patients with ASOM.
Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ear, Middle ; Female ; Humans ; Male ; Middle Aged ; Otitis Media with Effusion ; therapy ; Punctures ; Young Adult

OBJECTIVE: To sum up the experiences of diagnosis, treatment and medical evaluation of sinusitis and nasal polyp in aircrew. METHOD: Ninety three aircrew with sinusitis and nasal polyp were included in the study. RESULT: There were 11 cases with acute sinusitis and 82 cases with chronic sinusitis and nasal polyp. Of the 82 cases, there were 46 cases in class I (including 39 cases with symptoms and signs on ground in Ia, 7 cases only with signs in Ib), 36 cases in class II (no symptoms on ground but with symptoms of secondary barotraumas in flight, including 14 cases with secondary barosinusitis in IIa, 13 cases with secondary barotrauma in IIb, 9 cases with secondary barosinusitis and barotrauma in IIc ). Of the 82 cases, there were 24 cases in 1 stage of type I, 38 cases in 2 stage of type I, 7 cases in 3 stage of type I, 2 cases in 1 stage of type II, 6 cases in 2 stage of type II, 3 cases in 3 stage of type II, 2 cases in type III. Eighty four cases continued their flying jobs and 9 cases were permanently grounded. CONCLUSION Flying safe can be endangered by sinusitis and nasal polyp alone or with its secondary barotraumas. Chronic sinusitis and nasal polyp complicated with barotraumas are important causation for medical grounding. The aircrew with sinusitis and nasal polyp will be allowed to continue their flying jobs only after getting well curative effect and normal gas pressures of ear and nasal sinus.
Adolescent ; Adult ; Barotrauma ; complications ; diagnosis ; therapy ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; complications ; diagnosis ; therapy ; Sinusitis ; complications ; diagnosis ; therapy ; Young Adult

Objective:To investigate the role of conjunctival impression cytology in the diagnosis of Sj?gren's syndrome (SS) and the immunological factors influencing conjunctival lesions.Methods:A total of 57 patients complaining about dry eye were collected, including 38 patients with primary Sj?gren's syndrome (pSS) and 19 patients with non-SS. Conjunctival impression cytology tests were performed for all patients, and they were scored by the Nelson method. Thirty-one patients with SS underwent serological tests such as autoantibodies, immunoglobulins, and complement. The correlation between the relevant data was compared using the t test and the rank sum test. Results:The Nelson grade ≥2 is the positive cut-off value for the diagnosis of SS. The sensitivity was 68.4%, and the specificity was 89.5%, and the area under the receiver operating characteristic curve (ROC) was 0.767. In patients with SS, there was statistical correlation between the results of conjunctival impression cytology and antinuclear antibody (ANA) ( χ2=4.664, P=0.031), anti-SSA antibody ( χ2=8.58, P<0.01), anti-SSB antibody ( χ2=6.13, P=0.013), anti-SSA-52 antibody ( χ2=6.48, P=0.011), immunoglobulin (Ig)G ( t=-4.344, P<0.01) and rheumatoid factor (RF) ( U=25.0, P<0.01). Conclusion:Con-junctival impression cytology has certain value in the diagnosis of SS and can be used to evaluate conjunctival lesions in SS. Serum ANA, anti-SSA antibody, anti-SSB antibody, anti-SSA-52 antibody, IgG, and RF levels are significantly associated with the degree of conjunctival lesions, and can be considered as an indirect evidence of conjunctival involvement in SS.