Necessity of treating subclinical hypothyroidism in early pregnant women

目的评估早孕妇女亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)对妊娠结局的影响及药物治疗的必要性。方法收集18 243例在厦门大学附属第一医院产前检查直至分娩的病例,诊断标准为妊娠10~12周产前检查时TT4与FT4正常而TSH≥2.5 m IU/L为SCH,甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)≥34 U/L为阳性。根据TSH的升高程度不同、TPOAb情况、能否遵医嘱按时按量服用L-T4使TSH控制在正常范围内进行分组:2.5 m IU/L≤TSH≤5.0 m IU/L且TPOAb阳性且能遵医嘱者为A组,不能遵医嘱者为B组;TSH>5 m IU/L且TPOAb阳性且能遵医嘱者为C组,不能遵医嘱者为D组;2.5 m IU/L≤TSH≤5.0 m IU/L且TPOAb阴性且能遵医嘱者为F组,不能遵医嘱者为G组;TSH>5 m IU/L且TPOAb阴性且能遵医嘱者为H组,不能遵医嘱者为K组。并随机抽取200例同期甲状腺功能正常的病例作为对照组(E组),回顾分析早孕妇女甲状腺功能异常的发生率、SCH对妊娠结局的影响、早孕妇女SCH行左旋甲状腺素片(L-T4)替代治疗的剂量及影响因素。结果早孕妇女SCH检出率为5.20%,甲状腺功能正常率为79.00%。A组早产3.31%(8/242)、妊娠期高血压7.02%(17/242)、胎儿生长受限7.02%(17/242)、出生低体质量儿6.61%(16/242)的发生率均低于B组的8.79%(8/91)、14.29%(13/91)、15.38(14/91)、14.29(13/91)(P均 5 m IU / L,TPOAb was positive and had good compliance; Group D: TSH and TPOAb as Group C but not have good compliance; Group F: 2. 5 m IU / L≤TSH≤5. 0 m IU / L,TPOAb was negative and had good compliance; Group G: as Group F,but not have good compliance; Group H: TSH > 5 m IU / L,TPOAb was negative and had good compliance; Group K: as Group H,but not have good compliance. Randomly selected 200 cases with normal thyroid function at the same period as the control group( Group E). Retrospective analysis the occurrence rate of thyroid gland dysfunction,the influence of SCH to pregnancy outcome,the doses and influencing factors of replacement therapy by L-T4 to SCH of early pregnant women. Results Relevance ratio of SCH in early pregnant women was5. 20%,the ratio of normal thyroid function was 79. 00%. In group A,premature birth 3. 31%( 8 /242),gestational hypertension 7. 02%( 17 /242),fetal growth restriction 7. 02%( 17 /242),low birth weight infant 6. 61%( 16 /242),were lower than that in group B 8. 79%( 8 /91),14. 29%( 13 /91),15. 38( 14 /91),14. 29( 13 /91) respectively( P < 0. 05). In group C,spontaneous abortion 3. 31%( 6 /181),premature birth 3. 89%( 7 /181),gestational hypertension 8. 29%( 15 /181),gestational diabetes mellitus 3. 89%( 7 /181),fetal growth restriction 7. 73%( 14 /181),low birth weight infant 6. 63%( 12 /181),were lower than that in group D 11. 54%( 6 /52),11. 54%( 6 /52),19. 23%( 10 /52),11. 54%( 6 /52),17. 31( 9 /52),15. 38( 8 /52)( P < 0. 05). No significant statistical difference were found in multiple comparison of the above six indexes of group A,B,C. And just the same as the multiple comparison of group F,G,H,K,E. When TSH reach the standard,the dosage of L-T4 in group A and C had significant difference [( 0. 757 ± 0. 378 vs. 1. 106 ± 0. 454) μg / kg,t = 8. 39,P < 0. 001]. There were also significant differences of group F compared with group H[( 0. 443 ± 0. 198 vs. 0. 813 ± 0. 378) μg/kg,t = 8. 22,P < 0. 001],group( A + F) compared with group( C + H) [( 0. 634 ± 0. 358 and 1. 017 ±0. 427) μg / kg,t = 11. 77,P < 0. 001],group A compared with group F [( 0. 757 ± 0. 378 vs. 0. 443 ± 0. 198) μg / kg,t = 9. 85,P < 0. 001 ],group C compared with group H [( 1. 106 ± 0. 45 vs. 0. 813 ± 0. 378) μg / kg,t = 5. 59,P < 0. 001],group( A + C) compared with group( F + H) [( 0. 932 ±0. 463 vs. 0. 693 ± 0. 388) μg / kg,t = 6. 53,P < 0. 001]. Conclusion The early pregnant women with SCH and TPOAb positive could increase the occurrence rate of spontaneous abortion,premature birth,gestational hypertension,gestational diabetes mellitus,fetal growth restriction and low birth weight infant. The early intervening treatment of L-T4 could efficiently decrease the adverse event occurrence ratio of pregnant woman with SCH and positive TPOAb,but no effect for that with SCH and TPOAb negative. The TSH level and condition of TPOAb could affect the replacement therapy dosage of early pregnancy with SCH

服务业:演变、国际比较及其启示

世界服务业发展的一般轨迹表明:工业化后期,服务业比重逐步增加并最终占据绝对优势,社会经济进入所谓的“服务社会”。与国际水平比较,我国服务业发展明显处于滞后状态。政府应将现代服务业发展放到突出位置,采取积极有效措施,改善政策环境,促进服务业市场化的发展。优先发展生产者服务业,应根植于信息化之中,立足于经济网络之上,并使其与工业的发展形成互补。同时进行服务业技术创新,促使高新技术不断在现代服务业进行创新和实现突破,进行人力资源的深度开发,建立服务业集群区,这是中国现代服务业发展路径的必然选择

Spatial sampling method for crop acreage based on remote sensing in hilly area in Minhou County,Fujian Province

以福建闽侯县作为研究区,采用传统抽样(简单随机抽样、系统抽样、分层抽样); 、空间抽样(空间随机抽样、空间系统抽样、空间分层抽样)等方法对研究区农作物种植面积进行样本抽选、总体推算及误差估计,结果表明: 1 500; m*1 500; m格网为最优抽样单元尺寸,空间分层抽样方法的相对误差为3.86%,变异系数为6.03%,抽样成本为6.03,抽样效率高.与传统抽样方法相比,空间; 抽样方法显著减少样本容量,节约调查成本.Traditional sampling methods of simple random sampling,systematic; sampling,stratified sampling,and spatial sampling methods of spatial; random sampling,spatial system sampling and spatial stratified sampling; were applied to conduct sample extraction,population extrapolation and; error estimation in crop acreage in Minhou County. The results showed; that spatial stratified sampling had the highest sampling efficiency; with 1 500 m*1 500 m square grid as the optimal sampling unit size. And; relative error,variation coefficient and sampling cost was 3.86%,6.03%; and 6.03,respectively. Compared to traditional sampling method,spatial; sampling method significantly reduced sampling size and saved cost.全国统计科学研究项

Economy in Vietnam and Other Southeast Asian Countries: Different Colors

最近,不少观点认为,越南正面对的困难是由世界经济不利因素造成的。这种说法在一定程度上是正确的,但同样处于如此不利背景下,东南亚地区其他国家的经济状况仍然有所改善并迅猛发展,基本与越南经济黯淡的现状相反。本文将综述作为东盟成员的越南及东南亚其他国家经济出现不同的特点。一、证券市场将越南证券市场指数(VnIndEX)与东南亚

ApoE基因多态性与动脉粥样硬化性脑梗死的相关性研究

目的分析ApoE基因与血脂和颈动脉粥样硬化程度的关系,进一步探讨ApoE基因与动脉粥样硬化性脑梗死的相关性。方法采用病例-对照研究的方法,收集厦门大学附属第一医院神经内科的95例缺血性脑卒中和65例非缺血性脑卒中住院患者。检测患者的ApoE基因型、血脂及颈动脉粥样硬化程度。结果与E2/E3比较,基因型E3/E3、E3/E4可能是缺血性脑卒中的保护因素;缺血性和非缺血性脑卒中患者在血浆TC、LDL-C、ApoB含量比较上均为E3/E4> E3/E3>E2/E3,且2组血浆LDL-C浓度在E3/E4与E2/E3、E3/E3比较中差异有统计学意义(P<0. 05); LDL-C、ApoB与2组颈动脉粥样硬化斑块程度有关,是其危险因素;与基因型E2/E3比较,E3/E4在有斑块组中较无斑块组比例高。结论基因型E3/E3、E3/E4可能是缺血性脑卒中的保护因素。基因型E3/E4可能是导致患者颈动脉粥样斑块形成的危险因素,基因型E3/E4通过影响患者的血浆LDL-C水平进一步导致动脉粥样硬化斑块的形成,但与动脉粥样硬化性脑梗死的相关性研究有待更大的样本量更进一步的研究

福建省闽侯县区域农作物种植面积的空间抽样方案

基于国产GF-1号卫星影像农作物空间分布数据,以正方形网格作为抽样单元形状,综合应用遥感技术、空间抽样方法、模拟退火算法及空间自相关理论,对福建省闽侯县农作物种植面积进行估算.结果表明:根据全局自相关指数Moran’s I及其显著性指标Z Score,选取1 500 m×1 500 m作为最优单元尺寸;对研究区进行剖分,构建抽样框,对比空间随机抽样、空间系统抽样及空间分层抽样的抽样结果,空间分层抽样方法的样本容量为37,相对误差为3.86%,抽样效率最高;运用模拟退火优化算法规划野外调查的最优路径,确定空间抽样调查方案.全国统计科学研究资助项目(2015LZ18

Study on Solid-State Circular Dichroism Spectroscopy and Its Application to Chiral M(II) Schiff Base Complexes

结合课题组近期的相关研究,对固体CD光谱在手性配合物研究中的应用,特别是手性样品固体CD光谱的测试方法进行了概述,通过对四对手性席夫碱M(II)(M=Ni、Cu)配合物的固体和溶液CD光谱进行比较研究,发现配合物的手性构型在固液相中保持一致,但其固液CD光谱之间存在不同程度的差异,可能是由于相应配合物在固体和溶液相中的四面体扭曲或构象的微妙不同所致.An account on the application of solid-state CD on chiral metal complexes is briefly reviewed. Special focus is on the methods to record solid-state CD spectra of chiral solid sample, and then we switch to the comparison between solid-state and solution CD spectra of four pairs of chiral M(II) (M = Ni, Cu) Schiff base complexes. The solid-state CD spectra reveal that the chiral complexes mantain the same handeness found in solution states. But it is notable that there are some differences between the solid-state and solution CD spectra for the selective chiral complexes, which may be ascribed to some subtle tetrahedral distortion or conformational distinctions of the complexes between the two states.国家自然科学基金(20171037);; 南京大学配位化学国家重点实验室基金;; 厦门大学科技创新项目(B类,2003XDYY39)资

综合化学新实验——手性席夫碱Ni(Ⅱ)络合物的合成与表征

本实验属于化学系综合化学实验,其构思来自手性络合物的立体选择性合成。学生可通过本实验从实践和理论上探讨手性配体在立体选择性合成手性络合物中的作用并掌握对手性络合物组成和结构的各种表征方法特别是CD光谱方法

Study on solid-state circular dichroism spectroscopy and its application to chiral M(II) Schiff base complexes

An account on the application of solid-state CD on chiral metal complexes is briefly reviewed. Special focus is on the methods to record solid-state CD spectra of chiral solid sample, and then we switch to the comparison between solid-state and solution CD spectra of four pairs of chiral M(II) (M = Ni, Cu) Schiff base complexes. The solid-state CD spectra reveal that the chiral complexes maintain the same handeness found in solution states. But it is notable that there are some differences between the solid-state and solution CD spectra for the selective chiral complexes, which may be ascribed to some subtle tetrahedral distortion or conformational distinctions of the complexes between the two states

中药沐足结合护理干预治疗护理人员下肢静脉曲张的效果观察

目的探讨中药沐足结合护理干预在下肢静脉曲张护士中的应用效果。方法选取某三甲综合性医院患有下肢静脉曲张的临床护士60例为研究对象,应用随机数字表法分为两组,各30例。两组研究对象均行基础护理,对照组采用医用的循序减压弹力袜进行治疗,观察组实施中药沐足结合护理干预措施。2个月后比较两组患者疗效。结果观察组研究对象静脉曲张恢复总有效率高于对照组,观察组研究对象经过3个疗程的治疗,痊愈12例,显效l3例,有效4例;对照组分别为痊愈5例,显效8例,有效9例;观察组、对照组临床治愈率和总有效率分别为40.00%、96.67%和16.67%、73.33%。差异有统计学意义(P<0.05)。结论中药沐足结合护理干预可以改善下肢静脉曲张的临床症状。福建中医药大学2016年临床专项校管课题(XB2016085