In view of the possibility for serious adverse outcomes for mother and fetus associated with maternal thyroid dysfunctions during pregnancy,many experts have recommended conducting routine thyroid function screening in pregnancy,but guidelines from different academic communities have given varied recommendations.The aim of this review is to discuss the significance of thyroid function screening in pregnancy and evaluate efficiency of the case-finding strategy vs.the universal screening strategy.

Medical science is the science about human.Humanistic attribute is one of the essence attributes of medicine.Since modern times,under the effect of the western biomedical modes,people have gradually neglected humanistic attribute,social responsibilities of medical workers and their humanistic care for patients,which results in a series of problems in current medical research and medical practice.The return of humanistic spirit is not only the essential requirement of the essence attribute of medicine,but also the calling from the development of modern medical science.Reconstruction of the humanistic spirit is the common responsibility for contemporary medical workers.Meanwhile,the cultivation of the medical students who have great humanistic quality should be the significant mission for the contemporary medical education.

AIM To study protective effect of [D-Ala~2, D-Leu~5]-enkephalin (DADLE) against hydrogen peroxide (H_2O_2) induced myocardial cell injury and its possible mechanisms. METHODS Myocardial cells were isolated from neonatal rats and cultured for 48 h. Then the cells were randomly assigned into normal control, H_2O_2（200 μmol·L~(-1)）, H_2O_2+DADLE(1 μmol·L~(-1)), H_2O_2+DADLE +naltrindole(10 μmol·L~(-1)) and H_2O_2+DADLE +U0126(10 nmol·L~(-1)) groups and cultured for another 48 h.[~3H]TdR incorporation assay and flow cytometry were used to measure the cell proliferation and apoptosis rate. The lactate dehydrogenase (LDH) activities in culture supernatant measured by using LDH activity kit. The superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in cells were measured with xanthine oxidase method and color reaction of thiobarbituric acid, respectively. The expressions of extracellular signal-regulated kinase (ERK) and phosphorylated-ERK (p-ERK) were observed with Western blot. RESULTS ① Compared with normal control group, the incorporation of [~3H]TdR in myocardial cells of H_2O_2 group was significantly lower, apoptosis rate was higher, LDH activity and MDA content in cells were higher, while SOD activity in cells was lower. In addition, the ratio of IA_( p-ERK) /IA_( ERK) was decreased. ② Compared with H_2O_2 group, the incorporation of ［3H］TdR in H_2O_2+DADLE group was significantly higher, apoptosis rate was lower, LDH activity and MDA content in cells decreased, while SOD activity increased significantly. The ratio of IA_( p-ERK) /IA_( ERK) was increased. ③ δ-Opioid receptor antagonist naltrindole and ERK antagonist U0126 inhibited this effect of DADLE on the above index changes induced by H_2O_2. CONCLUSION The δ-opioid receptor has protective effect against H_2O_2-induced myocardial cell injury, and its possible mechanism may be related to its promotion of antioxide capacity and ERK phosphorylation.

Objective To investigate the potential effects of Lactobacillus acidophilus strain L6 on prevention and treatment of Helicobacter pylori (H. pylori) infection in animal models. Methods A total of 200 hundred C57BL/6 mice were used in the study. ① Sixty mice were divided into control group (infected with H. pylori) and prevention group (previously treated with L6 and followed by infection with H. pylori) with 30 each. The incidence of H. pylori infection was compared between two groups.② Sixty mice were divided into control group (infected with H. pylori) and treatment group (infected with H. pylori for 4 weeks and followed by treatment with L6) with 30 each. Thechanges of H. pylori infection was compared between tow groups. ③ Eighty mice previously infected with H. pylori were orally administrated with L6 in the water supply over a period of 9 months. Of which, 40 H. pylori negative mice were either continuously or discontinuously treated with L6. The re-infection of H. pylori was compared between two groups. The H. pylori infection, gastric mucosal inflammatory and serum anti-H. pylori-lgG titer was measured by using urea breath test, histopathology and ELISA, respectively. Results The positive rate of H. pylori infection was 100% in control group and 20% in prevention group (pre-treated with L6 for 1 week). Whereas there was no H. pylori infection in the rest mice of prevention group pre-treated with L6 for 2 or 4 weeks. There was significant difference in H. pylori infection between two groups (P<0. 05).The serum anti-H. pylori IgG titer was lower in treatment group than in control group (P<0. 05).The reinfection of H. pylori in mice continuously treated with L6 was significantly lower than those discontiously treated with L6 (P<0. 05). Conclusions Preventively feeding L6 can significantly reduce the H. pylori infection in C57BL/6 mice, whereas the inhibition of H. pylori re-infection can also be achieved with long-term administration of L6.

Objective To investigate the effect of hyperbaric oxygen ( HBO) preconditioning on activation of plasma protein C in a rat model of asphyxial cardiac arrest?resuscitation. Methods A total of 105 adult male Sprague?Dawley rats, aged 70-90 days, weighing 260-320 g, were randomly divided into 3 groups: cardiac arrest group ( group CA, n=5) , cardiac arrest?resuscitation group ( group CA∕R, n=50) , and hyperbaric oxygen preconditioning group ( group H, n=50 ) . Cardiac arrest was induced by campling the endotracheal tube at the end of expiration. The animals underwent HBO preconditioning once a day for 3 consecutive days before cardiac arrest was induced in group H. The rats were placed in the HBO chamber, 10 min later the pressure was increased at a constant rate until the hyperbaric oxygen reached 2 atmosphere absolute, and maintained at this level for 45 min, after the oxygen concentration>95%, and then the pressure was decreased at a constant rate ( within 20 min) until the normal pressure was reached. The rats underwent no resuscitation in group CA. Five rats were selected from CA∕R and H groups at 3, 6, 12 and 24 h after restoration of spontaneous circulation, and at 30 min of cardiac arrest in group CA, and blood samples were taken from the abdominal aorta for determination of the plasma activated protein C ( APC) concentrations. The time from asphyxia to cardiac arrest, time for spontaneous regular cardiac rhythm, and successful resuscitation were recorded. Results Compared with group CA, the plasma APC concentrations were significantly decreased at each time point after restoration of spontaneous circulation in CA∕R and H groups ( P<0.05) . Compared with group CA∕R, the time from asphyxia to cardiac arrest was significantly prolonged, the time for spontaneous regular cardiac rhythm was shortened, the success rate of resuscitation was increased, and the plasma APC concentrations were increased at each time point after restoration of spontaneous circulation in group H ( P<0. 05 ) . Conclusion HBO preconditioning can promote activation of plasma protein C after resuscitation in a rat model of asphyxial cardiac arrest, and is helpful in improving hypercoagulation.

Objective To explore the influencing factors of glycemic variability in 217 cases of hospitalized patients with type 2 diabetes. Meth-ods A total of 217 cases of hospitalized patients with type 2 diabetes,whom received continuous glucose monitoring from January 2013 to Janu-ary 2016,were enrolled for the study. The evaluation variables of glycemic variability included mean amplitude of glycemic excursion(MAGE) and standard deviation of blood glucose(SDBG). Results The difference of glycemic variability was compared by gender,age,diabetic duration, HbA1c,BMI. The values of MAGE and SDBG in females were higher than those in males(P<0.05). There was no significant difference between various age groups and various diabetic duration. The level of glycemic variability increased gradually with the extension of HbA 1c(P<0.05). The level of glycemic variability increased gradually with the extension of body mass index(BMI)(P<0.05). Logistic regression analysis showed that gender(OR=0.67,P=0.02),HbA1c(OR=0.8,P=0.02),diastolic blood pressure(OR=0.9,P=0.03),triglycerides(OR=4.6,P=0.007),cholesterol(OR=0.6,P=0.007). HDL-C(OR=0.09,P=0.006)were significant influencing factors of glycemic variability in hospital-ized patients with type 2 diabetes. Conclusion Gender,HbA1c,BMI,and blood fat are significant influencing factors of glycemic variability while age and duration are not related to the glycemic variability in hospitalized patients with type 2 diabetes.

Objective To analyze the synergistic effects between H.pyloriinfection and non-steroidal anti-inflammatory drugs use in peptic ulcer patients and upper gastrointestinal bleeding patients induced by peptic ulcer.Methods The peptic ulcer group consisted of 803 peptic ulcer patients,208 patients with gastrointestinal hemorrhage,and they were compared with 2 061 patients with non-peptic ulcer.Results H.pyloriinfection and NSAIDs use could increase the risk of peptic ulcer,and NSAIDs use in coordination with H.pyloriinfection in gastric ulcer morbility,but it's not significant coordination in the duodenal ulcer mortility.Pure NSAIDs use could increase the risk of bleeding gastric and duodenal ulcer,but pure H.pyloriinfection didn't increase the risk of bleeding peptic ulcer obviously,but the risk of bleeding peptic ulcer was not different in the patients of occasional,frequent and long-term NSAIDs use.Conclusion Detection of H.pyloriin the patients with long-term NSAIDs use is necessary,and eradication is needed in the patients infected with H.pylori.The NSAIDs use in peptic ulcer patients complicated with upper gastrointestinal bleeding should be payed attention and given timely treatment.

Objective:To study on the levels of CXCL8 and its receptors (CXCR1 and CXCR2) in peripheral blood neutrophils of the patients with chronic hepatitis B.Methods:The neutrophils were isolated and purified by neutrophil isolation medium,and the loads of HBV-DNA in neutrophils were detected by PCR,and the levels of HBeAg in serum were measured by ELISA.The patients were divided into different groups according to the detective results so that the expressions of CXCL8 and its receptors ( CXCR1,CXCR2) in neutrophils were detected by the methods of streptavidin-biotin complex ( SABC ) immunocytochemistry stain.Results:The data of SABC immunocytochemical stain showed that the positive color of CXCL8 was mainly located in the cytoplasm of PMNs.However,the most positive color of CXCR1and CXCR2 was mainly expressed in the cytoplasm and cell membrane.Interestingly,the deeper immune coloring of CXCL8 and CXCR1, and relatively shallow immune coloring of CXCR2 were explored in the group with positive of HBeAg.The similar detective results also had been found in the cases with positive of HBV DNA in neutrophils.Compared with the normal control group,the levels of CXCL8 and CXCR1 in the patients were significantly increased ( P<0.05) ,but the differences were too small to be statistically significant in the level of CXCR2 (P>0.05).Conclusion:After neutrophils occult infected by HBV,not only the secretion of CXCL8 can be promoted, but also the expression of CXCR1 will be further increased.The data of immunohistochemical staining have been shown that the color degree of CXCL8 and its receptors ( CXCR1, CXCR2 ) are positive correlation to the level of HBeAg and the loads of HBV DNA.More PMNs can be chemotactic attraction to lesion so as to participate in the local inflammatory injury and tissue repair via the interactive pathway of the high expression of CXCR1 on surface of neutrophils with CXCL8.

Objective To evaluate the association between maternal thyroid diseases in the first trimester of pregnancy and obstetric complications.Methods A total of 2 517 pregnant women from 10 hospitals in Shenyang during the first 12 weeks of gestation were enrolled in this study.All sera obtained from pregnant women were measured for thyroid-stimulating hormone (TSH),free thyroxine ( FT4 ),and thyroid peroxidase antibody (TPOAb).Collected items include obstetric outcomes and complications.Results Serum TSH above 2.5 mlU/L during the first trimester of pregnancy increased the rate of spontaneous abortion ( 8.69％ vs 6.38％,P =0.048 ),even if subclinical hypothyroidism (9.50％ vs 6.38％,P =0.009).TSH above the gestational special reference range,passive smoking,and over 30 years were independent factors for increasing the rate of spontaneous abortion.Hyperthyroidism and hypothyroidism with drug treatment to maintain normal thyroid function during pregnancy reduced the incidence of spontaneous abortion.Increased or decreased levels of serum TSH and TPOAb(+) were not related with other obstetric complications.Conclusion Serum TSH above the gestational special reference range during the first trimester of pregnancy is a risk factor of spontaneous abortion; maintaining TSH within the normal range by treating hyperthyroidism or hypothyroidism may reduce spontaneous abortion rate.

Objective To observe the effect of ephedrine on the expression of eotaxin in human bronchial epithelial cells (16HBE) stimulated by tumor necrosis factor‐α(TNF‐α) and to explore the mechanism of Chinese medicine ephedra in treating asthma .Methods The in vitro cultured 16HBE were randomly divided into the control group ,TNF‐αstimulation group(TNF‐α20 ng/mL) and TNF‐αplus ephedrine group (TNF‐α20 ng/mL plus ephedrine 300 μg/mL) .Three complex holes in each group were set to culture for 18 h ,the eotaxin mRNA expression was measured by real time fluorescent quantified PCR and protein level was detected by immunocytochemical stain and Western blot .The eotaxin concentration in cells culture supernatant was quantified by ELISA .Results Compared with the the control group ,the expression level of eotaxin mRNA and protein ,and the concentration of eotaxin in cell culture supernatant in the TNF‐α stimulation group were increased obviously ,there being statisticaly significant difference between them(P<0 .01);however ,all above these parameters in the TNF‐αplus ephedrine group showed decreased obvi‐ously as compared with the TNF‐αgroup ,the difference between them was statistically significant (P<0 .01) .Conclusion Ephed‐rine can inhibit the expression and secretion of eotaxin in TNF‐α induced 16HBE inflammatory model ,which may be one of the mechanisms of Chinese medicine ephedra in treating asthma .