Objective:To investigate the effects of persistent isolated hypothyroxinemia in the first and second trimester of pregnancy on complications and adverse outcomes of pregnancy.Methods:A retrospective analysis was conducted in 784 pregnant women including 111 cases of persistent isolated hypothyroxinemia in the first and second trimester of pregnancy and 673 pregnant women with normal thyroid function as control group. All women were registered and delivered in the Department of Obstetrics of our hospital from April 2016 to April 2017. The complications and adverse outcomes of pregnancy in the two groups were analyzed.Results:Age, body weight before pregnancy, body mass index(BMI), 1 h plasma glucose and 2 h plasma glucose during oral glucose tolerance test in persistent isolated hypothyroxinemia group were higher than those in control group( P<0.05), with increased incidence of anemia during pregnancy( P<0.05). However, there were no significant differences in the incidences of gestational diabetes mellitus and gestational hypertension between the two groups( P>0.05). No significant statistical differences were found in macrosomia, stillbirth, neonatal malformation, postpartum hemorrhage, acute delivery, premature delivery, fetal intrauterine development delay, and small full-term infants between the two groups( P>0.05). Logistic regression analysis showed that age( OR=1.1, 95% CI 1.0-1.1, P=0.002) and pre-pregnancy body weight( OR=1.0, 95% CI 1.0-1.1, P=0.046) were risk factors for the occurrence of persistent isolated hypothyroxinemia in the first and second trimesters of pregnancy. Persistent isolated hypothyroxinemia in the first and second trimesters was associated with anemia during pregnancy( OR=1.9, 95% CI 1.1-3.2, P=0.024). Conclusions:Pregnant women who are older and heavier before pregnancy should pay more attention to their thyroid function. Pregnant women with persistent isolated hypothyroxinemia in the first and second trimesters should be concerned for anemia.

目的 探讨难治性高血压患者的临床特点.方法 纳入2012年1月～2013年12月于我院内分泌代谢科就诊的高血压患者320例,依据难治性高血压的诊断标准将其分为高血压组269例和难治性高血压组51例.收集两组患者的临床资料并进行比较分析.结果 难治性高血压患者占总高血压患者的15.9％ (51/320).难治性高血压组患者病程长于高血压组,收缩压(SBP)、舒张压(DBP)及醛固酮水平均高于高血压组(P＜0.05),而两组患者性别、年龄、体重指数(BMI)、心率、QT间期、血钾、血钠、二氧化碳结合力比较,差异均无统计学意义(P＞0.05).难治性高血压组使用可乐定、α-受体阻滞剂、螺内酯、氢氯噻嗪、吲达帕胺、血管紧张素受体Ⅱ阻断剂(ARB)及钙离子拮抗剂(CCB)患者比例均高于高血压组(P＜0.05),而两组间使用β-受体阻滞剂和血管紧张素转化酶抑制剂(ACEI)患者比例比较差异均无统计学意义(P＞0.05).难治性高血压组合并糖尿病、冠心病、慢性肾脏病、高尿酸血症、肾上腺CT见腺瘤改变患者比例及颈动脉内膜厚度高于高血压组(P＜0.05),而两组间合并血脂异常、脑卒中患者比例比较差异均无统计学意义(P＞0.05).结论 难治性高血压患者占总高血压患者的比例较高,且常合并多种心血管危险因素及心脏、肾脏、肾上腺疾病.

目的 研究临床免疫检验质量控制相关性举措对检验所得结果可靠性、准确性的影响.方法 以2016年5月-2017年5月我院收治的、接受免疫检验的120例患者为本次观察对象,按照研究需求将他们随机分成对照组(血液检测行常规质控)、实验组(血液检测采取严格质量控制),比较不同组患者其临床效果情况.结果 两组检验质量问题发生几率方面,研究组(0.0％)与对照组(6.7％)相比更具优势;临床效果获得情况方面,研究组(96.7％)与对照组(78.3％)相比更具优势(P<0.05).结论 落实临床免疫检验质量控制的相关措施,可提高检验结果的准确性、降低问题发生率、保证结果的可靠性.

Objective To observe the different expression of interleukin(IL)-13 ,IL-18 and tumor necrosis factor(TNF)αin my-coplasma pneumoniae pneumoni achildren with different clinical symptoms ,and explore the value of serum IL-13 ,IL-18 and TNF-αon clinical diagnosis ,judgement of disease ,clinical treatment of mycoplasma pneumoniae pneumonia in children .Methods A total of 120 children with mycoplasma pneumoniae pneumonia cases(observation group) and 60 cases of healthy children(control group) during June to October in 2016 in our hospital were recruited as objects in this research .The levels of serum IL-13 ,IL-18 and TNF-αwere compared between patients in acute phase and convalescence ,between patients with mild illness and severe illness ,between patients with wheezing and without wheezing ,between patients with pulmonary fibrosis and without pulmonary fibrosis ,between children with mycoplasma pneumoniae pneumonia and healthy children .Results The expression of serum IL-13 ,IL-18 and TNF-αin all children with mycoplasma pneumoniae pneumonia were significantly higher than those of healthy children (P<0 .05) .Acute phase and convalescence ,severe illness with mild condition ,with breathing and are not associated with breathing ,changes in sample with pulmonary fibrosis and pulmonary fibrosis change of mycoplasma pneumoniae pneumonia in children with serum IL-13 ,IL-18 and the expression level of TNF-αcomparative has significant difference ,and the former is higher than the latter(P<0 .05) .Conclu-sion Serum IL-13 ,IL-18 and TNF-αparticipate in the condition of mycoplasma pneumoniae pneumonia development process ,they are important reference indexes of clinical diagnosis ,illness conditions determination and treatment of mycoplasma pneumoniae pneumonia .

目的:讨论血清检验指标改变对甲亢性肝病患者的价值.方法:抽选2012年4月-2015年4月来笔者所在医院治疗甲亢性肝病和普通甲亢患者共90例,根据肝功能情况,分为试验组(肝功能异常)和对照组(肝功能正常),各45例.对比两组患者的并发症发生率、肝功能、血清检验指标.结果:试验组患者与对照组患者并发症发生率分别为86.7%、42.2%,试验组高于对照组,差异有统计学意义(P<0.05).同时检测出试验组患者的肝功能五项指标,谷草/谷丙转氨酶(AST)、胆红素(DBIL)、碱性磷酸酶(ALP)、总胆汁酸(TBA)、谷氨酸转肽酶(GGT)与促甲状腺激素(TSH)、游离T3(FT3)、游离T4(FT4)、三碘甲状原氨酸(TT3)、总甲状腺素(TT4)的水平均高于对照组(P<0.05).结论:甲亢性肝病患者体内分泌高水平甲状腺素,影响正常体能代谢,易造成消瘦、腹泻、多汗、黄疸等并发症.对患者早诊断、早治疗,可避免发生不可逆肝损伤.

<正>甘草为多年生草本植物,甘草(Glycyrrhiza uralensis Fisch)的根及根茎,具有补中益气、祛痰止咳、缓急止痛、解毒、调和诸药等功效。甘草的活性成分包括三萜皂苷和多种黄酮等。其中,异甘草素(2,2,4-三羟基查耳酮,isoliquiritigenin)是从甘草根的水解产物中分解出的一种黄酮类成分,属于羟基查耳酮类化合物。除了甘草,异甘草素也存在于在其他植物如红芪、黄芪、串果藤等中。异甘草素为黄色

目的 通过审查门诊处方,分析不合理各类情况,为临床合理用药提供参考.方法 随机抽取我院2010年4月～7月门诊处方5539张,进行回顾性审核,对其中不合理处方重点分析.结果 不合理处方335张,占抽查处方总数的6.05%.结论 我院门诊处方基本合理,但尚有问题存在;提高处方质量及加强审核处方仍是必要的.

静脉药物配置中心(pharmacyi ntravenousa dmixtureservice,pivas)是参照GMP标准,在规定的洁净条件下,由药学和护理专业人员按照操作规程,对静脉药物进行集中配置,提供安全有效静脉药物的一种新的药品配置流程和工作模式,是现代药学的重要组成部分。本文将结合我院配置中心的的实际工作经验,就pivas实际工作中的体会和问题做探讨。

目的 了解我院普外科手术患者抗菌药物预防使用情况,促进临床抗菌药物的合理应用.方法 回顾性调查普外科于2006年1-3月间住院患者的病历,包括患者的基本情况、手术类型、抗菌药物的选择、给药途径、疗程和费用等,并与指南比较和进行分析.结果 468例手术患者,年龄16个月到90岁(中位数:47岁).其中,清洁手术111例(占23.7%),清洁-污染手术220例(占47.0%),污染手术137例(占29.3%).头孢菌素类是所有手术患者使用最广泛的抗菌药物,其次为硝基咪唑类、喹诺酮类和林可霉素类.存在的不合理用药,主要为围手术期给药时机不当、术后用药时间过长及药物选择、用药频度、溶媒不当等.结论 医院应通过规范围手术期的用药期、限制清洁手术的抗菌药物使用等措施,促使抗菌药物预防使用的有效、安全和经济.

OBJECTIVE:An LC-MS method was developed for the determination of thioctic acid in human plasma.MET-HODS:The chromatographic separation was carried out on Zorbax SB C18 column with the mobile phase consisting of methanol-acetonitrile-0.1% glacial acetic acid(adjusted pH to 4.0 with ammonia)(55∶10∶35) at a flow rate of 0.3mL·min-1.Naproxen was used as internal standard.Column temperature was 40℃.SIM was used for determination of thioctic acid in human plasma.Ion mass spectral(m/z) of 205.0 was selected for thioctic acid and 229.3 for naproxen.RESULTS:The linear range of thioctic acid was 0.01～10μg·mL-1(r=0.999 9).The method recovery was within 97.61%～106.31%.The intra-day and inter-day RSD of thioctic acid(high,medium and low concentrations) were all less than 4%.CONCLUSION:The method is sensitive,accurate and reproducible,and suitable for the determination of thioctic acid in human plasma and its pharmacokinetic and bioavailability study.