[Summary] A total of 1 510 subjects undergoing physical examination in the Central Hospital of Xuzhou were included in this study. According to the level of TSH, the subjects were divided into low TSH group(0. 30-0. 99 mIU/L,n=351), moderate TSH group(1. 00-1. 89 mIU/L, n=703), and high TSH group(1. 90-4. 80 mIU/L, n=456). Analysis of variance and linear regression were used for data analysis. The results showed that systolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , triglyceride ( TG) , and high-density lipoprotein cholesterol( HDL-C) revealed significant differences among 3 group(P<0. 05 or P<0. 01). In the univariate linear regression model, serumTSHwithinthereferencerangewasnegativelyassociatedwithSBPandDBP(P<0.05orP<0.01),and positively associated with TG and HDL-C (P<0. 05 or P<0. 01). However, the correlations disappeared after adjustment for gender, age, body mass index, fasting plasma glucose ( FPG ) , and TG. In the multiple linear regression model, a significant negative correlation of TSH with SBP and FPG was found in males(P<0. 05).

Objective To evaluate the effects of clinical pathway combined with transitional care implemented by specialty nurses on patients with coronary heart disease after PCI (percutaneous coronary intervention) therapy. Methods Totally 124 patients after PCI were divided into the experimental group and the control group with random digit table. Patients in the control group received routine education and follow- up during hospitalization and discharge period. The experimental group received clinical pathway combined with transitional care implemented by specialty nurses based on routine education. The level of patients′knowledge, attitude, practice and risk factors were compared between the two groups 6 and 12 months after discharge. Results There were 55 patients in each group completed the research ultimately. The Coronary Heart Disease Knowledge Questionnaire in the experimental group scored (57.61 ±8.77), (81.27±6.88) and (88.47±6.10),while the control group scored (59.71±7.32),(68.61±7.12) and (76.85±7.70), after repeated measurement analysis of variance, F=74.71, 14.52, P<0.01. The scores of General Self- Efficacy Scale (GSES) and Coronary Artery Disease Self- Efficacy Scale (CSMS) between two groups at three time points showed statistical significance, F=5.40, 14.52, P<0.05 or 0.01. The risk factors of coronary heart disease such as total cholesterol, triacylglycerol, hemoglobin A1c, body mass index, systolic pressure and diastolic pressure were statistically different between two groups except for high density lipoprotein cholesterol and low density lipoprotein cholesterol, F=5.82, 20.32, 4.14, 4.15, 4.99, 7.15, P<0.05 or 0.01. Conclusions Clinical pathway combined with transitional care implemented by specialty nurses can improve the knowledge-attitude- practice level of patients, help to control the risk factors of coronary heart disease. It is an effective heart rehabilitation model for patients after PCI.

BACKGROUND:Currently, there are a lot of studies addressing oral microflora variation in patients wearing fixed orthodontic appliance. OBJECTIVE:To determine the changes in Streptococcus mutans, Lactobacil us and oral health in teenagers wearing metal orthodontic appliances. METHODS:Twenty-three who were subjected to fixed metal orthodontic appliances as testing group and 18 adolescent volunteers with no oral diseases served as controls. We col ected saliva samples from al the participants immediately, 90 days and 180 days after fixed metal orthodontic treatment to detect changes in Streptococcus mutans and Lactobacil us, which can lead to dental caries, and other oral parameters, including gingival index and oral hygiene index. RESULTS AND CONCLUSION:In the control group, there were no difference in Streptococcus mutans, Lactobacil us, gingival index and oral hygiene index at three time points. In the testing group, the hazard levels of Streptococcus mutans and Lactobacil us were significantly increased at 90 and 180 days than immediately after fixed metal orthodontic treatment (P<0.05), as wel as the gingival index at 90 days and oral hygiene index at 180 days became worse (P<0.05). At 180 days after fixed metal orthodontic treatment, the hazard levels of Streptococcus mutans and Lactobacil us, gingival index and oral hygiene index were severer in the testing group than the control group (P<0.05). These findings indicate that the fixed metal orthodontic appliance could lead to increasing of Streptococcus mutans and Lactobacil us, and reduce oral health status badly.

Objective To investigate the differences of the working memory tasks' performance between the patients with no neurological syphilis disease and the health controls (HC).Methods 2-back test of N-back task paradigm were applied to measure the performances of working memory.A total of 30 patients with syphilis disease were compared with 35 gender-,age-,years of education-matched healthy persons,then compared the accurate rate and reaction time on the tasks between the two groups.Results Participants with anxiety or depression had to be excluded.The results showed that patients impaired on working memory task.The accurate rate and reaction time of the working memory of the patients was worse than that of the healthy persons ((65.31 ± 8.78) ％ vs (71.00 ±9.64)％ ;(1521.14 ±290.57)ms vs (1296.08 ±253.20)ms respectively) (t=-2.472,P=0.016;t=3.337,P =0.001 respectively).The study indicated the reaction time of the working memory for the patients was negative correlation to the age of final diagnosis (r =-0.362,P =0.049).Conclusion The patients with no neurological syphilis disease show impairment on working memory.This probably because treponema pallidum injures the central nervous system.

Objective To evaluate the perioperative management and therapeutic efficacy of procedure for prolapse and hemorrhoids (PPH) in elderly patients with serious hemorrhoids. Methods The clinical data of 52 elderly patients (aged 60 years or over) with serious hemorrhoids treated by PPH from March 2005 to November 2007 were analyzed restrospectively. Results All the operations were successfully completed. The average operation time was (15.3±3.2) min, the average blood loss was (15±1.7) ml and the average hospitalization time was (4.5±2.6) days.Patients were followed for 1-20 months with (14.2±2.4) months for average. The follow-up rate was 92.3%(48/52). Complications included urinary retention in 18 cases(37.5%), anastomotic bleedings in 2 cases (4.2%), postoperative pain of anus in 4 cases (8.4%), recurrence in 1 case (2.1%),hypoglycemia in 1 case(2.1%), and 1 case (2.1%)was found stricture in rectum at 2 months after the procedure and no case developed rectovaginal fistula. Conclusions Old age is not the contraindication for PPH treatment of the serious hemorrhoids. Proper perioperative management may decrease the postoperative complications and improve the life quality of the patients.

Objective To know the effects of psychological intervention on elder patients with coro-nary heart disease when combined with depression and anxiety. Methods Divided 73 elder patients with coronary heart disease into the control group(35 cases) and the psychological intervention group(38 cases) randomly. Routine treatment and nursing cares were used in the control group, while the psychological in-tervention group was used in the psychological intervention group in addition. Evaluated the mental status between the two groups by SAS and SDS at the beginning of the research and three weeks later. Time in hospital and general clinical medical effects were analyzed in the end of research. Results There were no significant difference between the two groups about SAS and SDS scores at the beginning, while the later scores in the control group were significant higher than those of in the psychological intervention group. The period in hospital in the control group was longer than in the intervention group, the general medical effects was bet-ter in the intervention group than in the control group. Coneinsions Psychological intervention for elder patients with coronary heart disease when combined with depression and anxiety is a kind of ef-fective mode, which can improve the medical effects.

Recombinant AAV serotype 8 (rAAV8) vector is new and promising for gene delivery,which transduces muscular and hepatic cells highly efficiently. The transduction varies with the administration routes. It was observed that the rAAV8 virus injected intraperitoneally had been delivered to many different tissues through the blood circulation and resulted in extensive and prolonged gene expression. The interest gene (human coagulation factor Ⅸ) has been highly expressed via the rAAV8 vector injected intraperitoneally into mice at the dose of 5?1010 gc/ mouse. Considerable expression was detected in mouse plasma at two weeks after the administration. Expression peak up to 1 000% level compared to the UCRP occurred between 1~2 months after administration, and then the expression declined gradually but obvious expression persisted at 4 months post administration. APTT test proved the clotting activity of the recombinant hFⅨ in mouse plasma. Immunohistochemical assay showed that the human coagulation factor has been expressed significantly in several organs including liver, kidney, heart and muscles (abdominal and hindleg). These suggest that the rAAV8 virus injected intraperitoneally has been delivered via blood circulation and transduced different cells of multi-organs, and the product of the gene mediated by the rAAV8 vector is biologically active.

Objective To explore the correlation of the gene polymorphism of the two single nucleotide polymorphisms(SNPs)rs1443434andrs925489onforkheadboxEl(FOXE1)withthehighnormalthyroidstimulating hormone ( TSH) level in Chinese Han population. Methods 1 400 subjects with normal serum TSH and thyroid peroxidase antibody(TPOAb) levels were included. According to TSH or TPOAb levels, the subjects were divided into high normal TSH group(H-TSH group,n=195) and normal TSH control group(TSH control group,n=1 205) or high normal TPOAb group ( H-TPOAb group, n=711 ) and low normal TPOAb group ( L-TPOAb group, n=689 ) , respectively. The genotypes on the two SNPs of all the subjects were performed by whole-genome genotyping chips. Results There were significant differences in rs925489 genotypic distributions and allele frequencies between H-TSH group and TSH control group(both P<0. 05). The genotype TT and allele T in H-TSH group were significantly higher than those in TSH control group(89. 75% vs 83. 15%, 94. 62% vs 91. 29%). The normal TSH levels were positively associated with rs925489 genotypic distributions after adjustment for sex, age, and high density lipoprotein cholesterol(P<0. 01). There were no significant differences in rs1443434 genotypic distributions and allele frequencies between two TSH groups or two TPOAb groups. Conclusion FOXE1 rs925489 gene polymorphism may be correlated with the high normal TSH level in Chinese Han population.

Objective To explore the expression and role of LAT 1 in mouse uterus on early placenta formation on day 8 of pregnancy (D8).Methods One hundred and twenty 6-8-week old SPF female Kunming mice were used in this study.Immunohistochemistry was applied to determine the localization of LAT 1 protein in the mouse uterus on D8 of preg-nancy.The ectoplacental cones (EPCs) were dissected out from D8.5 uterus, and then cultured in vitro with different con-centrations of BCH (2-aminobicyclo-(2,2,1)-heptane-2-carboxylic acid, specific antagonist of LAT1) and L-leucine ( substrate of LAT1) to determine the role of LAT1 during the EPC attachment and outgrowth .Results LAT1 protein was highly expressed in secondary decidual zone and also positively expressed in the mouse uterus on D 8.As a specific antago-nist of LAT1, BCH significantly suppressed the ectoplacental cone outgrowth , whereas L-leucine showed no significant effect on it.Conclusions LAT1 is expressed in the mouse uterus during early placenta formation and promotes ectoplacen -tal cone outgrowth , suggesting that LAT1 may promote the trophoblast invasion into maternal decidual tissue , and partici-pates in the early formation of placenta .

Objective: To summarize the different cardiac shunt presentation in right heart contrast echocardiography and to clarify its clinical value for diagnosing the patients with congenital heart disease (CHD).
Methods: We retrospectively analyzed 102 patients who received right heart contrast echocardiography in our hospital from 2006 to 2014. The contrast media was the hand-vibrated mixture of 9 ml 50% glucose solution with 1 ml air.
Results: There were 49/102 patients with abnormal blood shunt detected including 8 patients of atrial septal defect (ASD) with right to left or dual shunt, 7 of ASD with left to right shunt, 9 of patent foramen ovale (PFO) with functional right to left shunt, 13 of patent ductus arteriosus (PDA) combining pulmonary arterial hypertension, 3 of pulmonary arteriovenous ifstula (PAVF), 9 patients with persistent left superior vena cava (PLSVC) and 8 of them drain to coronary vein sinus, 1 drain to left atrium.
Conclusion: Right heart contrast echocardiography may simply and effectively detect abnormal blood shunt in patients combining pulmonary arterial hypertension and improve the diagnostic accuracy of CHD.