RESUMO
Objective:To investigate the relationship between thyroid stimulating hormone (TSH) level and thyroid peroxidase antibody (TPOAb) status in the first trimester on pregnancy outcomes.Methods:A total of 2 095 pregnant women with complete clinical data from department of pregnancy endocrinology or department of obstetrics in Dongying People′s Hospital from January 1, 2018 to November 31, 2019.According to the TSH level detected before 12 + 6 weeks of gestation, all pregnant women were divided into normal TSH (0.1 μIU/ml≤TSH< 2.5 μIU/ml), high TSH (2.5 μIU/ml≤TSH≤4.0 μIU/ml), sub-clinical hypothyroidism during gestation (4.0 μIU/ml<TSH<10.0 μIU/ml). According to negative and positive of TPOAb, they were divided into group A [TSH normal + TPOAb (-) group, n=1 523], group B [TSH normal + TPOAb (+ ) group, n=185], group C [high TSH + TPOAb (-) group, n=234], group D [high TSH + TPOAb (+ ) group, n=47], group E [subclinical hypothyroidism + TPOAb (-) group, n=70], and group F [subclinical hypothyroidism + TPOAb (+ ) group, n=36]. Taking group A as the control, the differences of pregnancy complications and pregnancy outcomes between the groups were compared, and the correlation between TSH and TPO antibodies and pregnancy complications and pregnancy outcomes was analyzed by multivariate logistic regression. Results:There was a significant difference in the number of gestational diabetes cases among pregnant women ( P<0.05). Further compared with control group A, group F had the highest percentage (55.6% vs 20.5%). There was a statistical difference in the distribution of preterm delivery among pregnant women in each group ( P<0.05), and the percentage of preterm delivery in group D and group F were increased. There was no statistically significant difference in pregnancy complications and adverse pregnancy outcomes between the other groups and the control group ( P>0.05). Multivariate logistic regression analysis of gestational diabetes mellitus and preterm delivery showed that the risk of gestational diabetes mellitus was significantly increased in group F compared with the control group. Age, gestational status, and TPOAb positivity were risk factors for gestational diabetes. The risk of premature birth in group D, group E and group F was higher than that in the control group [odds ratio ( OR)>1]. Age and TPOAb positivity were risk factors for preterm delivery in pregnant women ( OR>1, P<0.05). Conclusions:TPOAb positive in early pregnancy combined with subclinical hypothyroidism in pregnancy will increase the risk of gestational diabetes, while TPOAb positive in early pregnancy combined with TSH on the high side or subclinical hypothyroidism in pregnancy will increase the risk of premature delivery, so the management of such pregnant women should be strengthened and active treatment should be given if necessary.
RESUMO
Aspirin is a non-steroidal anti -inflammatory drug,has good antipyretic and analgesic effects , but also inhibits platelet aggregation and antithrombotic effects ,commonly used in clinical coronary heart disease and cerebrovascular disease in first grade , two grade prevention .The need to pay attention to the medication time , interaction,the risk of bleeding ,medication use in special populations in the process ,to ensure the reasonable clinical medication of aspirin .This review summarizes the research progress of aspirin prophylaxis .
RESUMO
Objective To explore the effect of four-element teaching design model based on comprehensive learning in teaching of basic nursing in vocational nursing students. Methods Ninety-six nursing students at Taizhou Vocational and Technical College in Zhejiang Province were selected as the study subjects. Ninety-six nursing students were divided into the experimental group and the control group with 48 nursing students in each. The experimental group used four-element teaching design model for teaching, and the control group adopted traditional teaching methods.The testing results and evaluation of nursing students for this curriculum were compared. Results The theoretical assessment and skill assessment of nursing students in the experimental group were 82.09±8.05 and 90.65±4.93 respectively, and in the control group were 76.30±10.20, 85.33±6.01. The difference was statistically significant (t =3.06,4.74, P<0.01). The scores of curriculum setting, teaching methods, assessment methods, and teaching effects in the experimental group were evaluated as 35.08±3.64, 42.06±4.75, 18.15±1.60, 40.35±6.20, in the control group were 29.63 ± 4.65, 36.02 ± 6.20, 14.04 ± 2.69, 36.35 ± 6.56. The difference was statistically significant (t=3.07-9.09, P<0.01). Conclusion The four-element teaching design model based on comprehensive learning can improve the students′ learning initiative and teaching effect of basic nursing, promote the coordinated development of nursing students'professional knowledge, skills and professional ability.
RESUMO
Objective: To observe the pharmaceutical care for type 2 diabetes patients with hypertension.Methods: Totally 160 cases of type 2 diabetes patients with hypertension were divided into the control group (80 cases) and the observation group (80 cases).The observation group was given pharmaceutical care, and the control group was without pharmaceutical care.The indices of FPG, 2hPG, blood pressure, medication compliance and adverse drug reactions were analyzed.Results: After the treatment, FPG and 2hPG in both groups decreased significantly when compared with those before the admission (P0.05).Conclusion: Pharmaceutical care for type 2 diabetes patients with hypertension shows significant curative effect, which can effectively reduce blood sugar, improve blood pressure and increase medication compliance.
RESUMO
Objective To investigate the effect of vitamin D (VD) on gastric cancer and its underlying mechanisms by detecting serum VD levels in gastric cancer patients and the expression of vitamin D receptor (VDR) in gastric tumor.Methods Serum VD levels was detected by enzyme linked immunosorbent assay,VRD expression of tumor tissue and normal mucosa were detected by immunohistochemistry.At the same time,relationships of VDR expression and the prognosis of the patients were analyzed.Results The serum levels of VD of gastric cancer patients were lower than that of healthy people (P＜0.05),and they were negatively related to the degree of cell differentiation significantly (P＜0.001).VDR expression in gastric tumor tissue significantly decreased compared to that of the normal mucosa (P＜0.05).A significant correlation was found between the VDR expression and the differentiation grade of the carcinoma,with well differentiated carcinoma having the highest level of VDR expression (P＜0.05).For patients with gastric cancer,those with positive VDR expression had significant longer progression-free survival (PFS) and overall survival (OS) than the patients with negative VDR expression (P＜0.05).Conclusions VD may be a protecting factor of gastric cancer.VDR can be regarded as a marker of differentiation of gastric cancer and served as an effective prognostic factor in patients with postoperative gastric cancer.
RESUMO
Objective To clarify the effect of iodine intake on serum thyroglobulin (Tg). Methods A 5-year prospective study was conducted in the 3 different iodine intake areas in China [Panshan (miht deficiency) ,Zhangwu (more than adequate) and Huanghua (excess)]. A total of 3 099 people with normal serum levels of Tg in 1999 were followed and 2 448 of these participants were feasible to be observed in 2004 and included in the present study. The serum levels of Tg, thyraglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb) and TSH, thyroid volume, family and personal histories of thyroid diseases were measured and inquried. The general linear model (GLM) was used to explore the determinants of Tg. Results Among the study population at baseline, serum Tg were significantly different in three areas [7.5 (4.4-13. 1) μg/L at Panshan, 6.8 (3.6-11.2)μg/L at Huanghua, 5.9 (3.2-10.7) μg/L at Zhangwu, P<0.01]. They were associated with age, sex and the rate of positive TgAb, abnormal thyroid volume, abnormal TSH and positive personal history of thyroid diseases, in order to control the effects of confounding factors, the data from 1856 subjects with thyroid-related indexes all in normal range and without personal history of thyroid diseases were analyzed to clarify the effect of iodine intake on Tg. The serum Tg among three areas were significantly different in both 1999 and 2004, they were all increased in 5 years with significant augment (△ Tg) among the three areas[3.1 (-0.2-8.0) μg/L at Panshan, 3.5 (0.5-9.0)μg/L at Huanghua vs 2. 5(0.3-6.1) μg/L at Zhangwu,P<0.01]. The GLM analysis revealed that age, Tg and TSH levels at baseline were the determinants of △Tg in addition to iodine intake. Conclusion Iodine intake is a dominant determinant of serum Tg. Age and TSH should also be considered while indicating iodine intake by serum Tg.
RESUMO
Objective To probe a simple, safe, and minimally invnsive method to treat ectopic pregnancy with preservation of the organs. Methods Superselective catheterization of uterine artery through cannulation of right femoral artery was achieved in 56 patients with ectopic pregnancy. Location of the lesions involved, feeding arteries, and active bleeding were observed on angiography. 150 mg of methylamine neopterin diluted in 100 ml of saline water was infused slowly into the target artery. Small gelatin spongy particles with size of 0.5 mm in diameter were used to embelize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Results Suporselective uterine arterial infusion and embolization were successfully performed in all 56 patients without any related complications. Active bleeding in the peritoneum in 33 cases ceased soon after embolization. The embryos in 13 patients were confirmed to have died by ultrasound two days after the procedure. Beta-HCG value dropped to below 5 U/L within two to twelve days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Histerosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 11 patients. Conclusions Superselective uterine arterial infusion and embolization is a minimally invasive procedure, which can be used to effectively treat ectopic pregnancy by disabling the ectopic embryo and embelizing leaking arteries with the advantages of preserving the fallopian tubes.
RESUMO
Objective To analyze the significance of urinary type Ⅰ collagen cross-linked N-telopeptides (uNTX) for the prognosis and response to therapy of bone metastatic neoplasms.Methods The subjects were divided into 3 groups: A,B and C.The levels of uNTX were measured by enzymatic immunoassay kit,and the activity of serum alkaline phosphatases(AKP) and calcium concentration were measured simultanuously.Results uNTX levels positively correlated with bone metastatic neoplasms,and were markedly high in the patients with extensive bone collagen breakdown.Conclusions uNTX is more sensitive than the activity of serum AKP and plasma calcium concentration for bone metastasis of neoplasms,so it is significant in differentiating and monitoring bone metastatic neoplasms.The measurement of uNTX is an early objective methods for evaluation of prognostic response to therapy of bone metastatic neoplasms.
RESUMO
<p><b>OBJECTIVE</b>To investigate the prevalence of thyroid diseases in a community which did not use iodized salt.</p><p><b>METHODS</b>The survey was conducted in Panshan, Liaoning Province. 1 103 inhabitants aged 14 years or more attended the examinations, which included questionnaire, physical examination and serum analysis. Iodine in the urine and thyroid B ultrasound examination were also conducted.</p><p><b>RESULTS</b>The prevalence of overt hyperthyroidism and hypothyroidism was 16.3 per thousand and 2.7 per thousand, respectively. Subclinical hyperthyroidism and hypothyroidism were detected in 37.2 per thousand and 9.1 per thousand of the subjects, respectively. Serum autoantibodies to thyroid were detected in 10.9% of the entire population. The prevalence of goiter was 20.7% (diffuse goiter 16.8% and nodular goiter 3.9%).</p><p><b>CONCLUSION</b>In the iodine deficient areas, perhaps autoimmununization is not only related to the development of goiter but is also the main cause of subclinical hyperthyroidism and hypothyroidism.</p>
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autoanticorpos , China , Epidemiologia , Bócio , Epidemiologia , Inquéritos Epidemiológicos , Hipertireoidismo , Epidemiologia , Hipotireoidismo , Epidemiologia , Iodo , Urina , Prevalência , Características de Residência , Cloreto de Sódio na Dieta , Doenças da Glândula Tireoide , Epidemiologia , Alergia e Imunologia , Metabolismo , Nódulo da Glândula Tireoide , EpidemiologiaRESUMO
0 05) The progression free median duration of responsive patients was 7.1 months in Oxa CF 5 Fu group and 5.4 months in control ( P