Objective To identify clinical features of papillary thyroid microcarcinoma(PTMC) according to patients' age.Methods Seventy-eight patients with PTMC were divided into 2 groups according to age:≥45 years and ＜45 years.The clinical data were retrospectively analyzed.Results The average preoperative thyroglobulin (Tg)level in ＜45 years group was apparently higher than that in ≥45 years group[(138.61 ± 91.87 vs 80.20 ± 85.00) μg/L,P＜0.01].The average tumor size in ＜45 years group was apparently larger than that in ≥45 years group [(0.64 ± 0.24 vs 0.45 ± 0.25) cm,P＜0.01].There were more patients with multiple cancer foci in ＜45 years group than in ≥45 years group (73.53％ vs 45.45％,P＜0.05).And there were more patients with cancer in bilateral lobes in ＜45 years group than that in ≥45 years group(44.12％ vs 18.18％,P＜0.05).There were no significant differences in preoperative thyroid stimulating hormone level,preoperative thyroglobulin antibody (TgAb)level,incidence of capsular invasion of cancer,neck lymph nodes involvement,distant metastasis,and backgrounds of benign thyroid diseases between two groups (all P＞0.05).Conclusion The patients with PTMCs had different clinical features according to age.Hence,clinicians should consider an individualized treatment according to age in order to achieve better therapeutic efficacy.

Objective To analyze the effect of self efficiency,social support and coping style on the psychological resilience.Methods A total of 386 patients with cerebral infarction in a grade 3A hospital of Tangshan City were served as the subjects.The resilience scale,self efficiency scale,social support scale and medical coping questionnaire were taken as the survey tools.The Pearson correlation analysis,multiple linear regression model and structure equation model(SEM) were applied.Results The resilience score was (59.72 ±12.17) points,the resilience was positively correlated with the self efficiency,social support,facing coping style and avoidance coping style(P＜0.01),and negatively correlated with the surrender coping style(P＜0.01).The total efficiency coefficients of self efficiency sensation,subjective support,facing coping style and surrender coping style for affecting the resilience were 0.720,0.264,0.121 and-0.092 respectively.Conclusion Self efficiency,social support and coping style have significant influences on the psychological resilience.

Objective Liver dysfunction is a common complication of hyperthyroidism [ mainly Graves’ disease(GD)], that may restrict the choice as well as affect the ultimate outcome of treatment. The purpose of this study was to describe the clinical and biochemical patterns in patients suffering from Graves’ disease and liver dysfunction and to determine influential factors. Methods A total of 1 928 patients received radioactive iodine, 131 I treatment. Before 131 I therapy, 24 h radioactive iodine uptake of thyroid(24 h RAIU), serum free triiodothyronine (FT3 ), free thyroxine( FT4 ), sensitive thyroid-stimulating hormone( sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroglobulin antibody(TgAb), anti-thyroid peroxidase antibody(TPOAb), and serum hepatic function parameters etc were performed. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ2 test, logistic regression, and Pearson bivariate correlation. Results Ages, the course of Graves’ disease, the weight of thyroid, FT4 , TPOAb, and TRAb in Graves’ disease patients complicated with liver dysfunction were higher than those in patients with normal hepatic function, as shown in table 1. The influential factors including age, course of Graves’ disease, heart rate, weight of thyroid, FT4, 24 h RAIU, TgAb, TPOAb, and TRAb. 24 h RAIU were the protecting factors. Age, course of Graves’ disease, heart rate, weight of thyroid, FT4 , TRAb, and TPOAb were the risk factors. Conclusion The risk of liver dysfunction in patients with Graves’ disease was increased in the following cases: age over 45 years, heart rate above 90 bpm, weight of thyroid more than 35 g, course of Graves’ disease longer than 3 years, FT4 greater than 70. 5 pmol/ L, TPOAb above 360 IU/ ml, and TRAb above 15 IU/ L. In these coses 131 I therapy will be recommended.

Among several intraoral distalizing devices,the pendulum appliance is one of the most commonly used noncompliance appli-ances.It is widely used to correct Class Ⅱ molar relationship.More healthy teeth can be preserved with the using of pendulum appliance in the tooth extraction of borderline cases.The pendulum appliance was modified and used in clinic.Long-term observasion showed that the modified pendulum appliace is effective in orthodontic treatment.

Objective:To investigate efficacy of modified expander in the treatment of non-extraction patients with Angel Ⅰ maloccul-sion.Methods:1 4 Angel Ⅰcases aged 1 0 -1 4 years treated by non-extraction and fixed rapid expander.Jaw bones of the cases were laser scanned before(T1 )and after treatment(T2).The differences of arch width and length between T1 and T2 were analyzed.The In-dex of treatment complexity,outcome and need(ICON)was used to assess the pre-treatment and post-treatment study models.Data were statistically analysed with SPSS1 3.0 software.Results:The arch width increased significantly from T1 to T2.Good occlusal rela-tionship and soft tissue profiles were achieved in all cases.All cases were evaluated as greatly improved by ICON.Conclusion:AngelⅠ malocclusion can be treated successfully by increasing arch width with fixed rapid expander technique without tooth extraction.

Objective To investigate the efficacy and influential factors of 131I treatment for lung metastases from DTC.Methods Fifty patients (18 males,32 females;age (40.8±13.2) years) with lung metastases from DTC who underwent 131I treatment from October 2007 to December 2012 were retrospectively analyzed.The efficacy of 131 I treatment was assessed using 131I imaging and determination of serum Tg level after 6 months.The possible factors affecting efficacy included patients' age,gender,operation method,pathological classification,the diagnostic time of pulmonary metastasis,serum Tg level at diagnosis,131I uptake pattern,characteristics of other imaging modalities,cervical lymph node metastases and extrapulmonary distant metastases (assign 1 for metastases,0 for no metastases).Univariate and multivariate analyses (Student t test,Fisher exact test and logistic regression) were performed to investigate the factors.Results The rates of complete remission,partial response and invalid of 131I treatment were 20％ (10/50),74％ (37/50) and 26％ (13/50) respectively.Univariate analysis showed that age(t =2.019,P＜0.05),gender (P =0.032),serum Tg level at diagnosis (t =2.646,P＜ 0.05),findings of other imaging modalities (P =0.039),and extrapulmonary distant metastases(P=0.023) were the factors influencing outcome of 131I treatment.Multivariate logistic regression analysis showed that the influential factors included age,serum Tg levels and extrapulmonary distant metastases.The regression equation was as follows:logit P =2.127-0.056× age-0.163×Tg level-1.280×extrapulmonary distant metastasis (x2=10.484,P＜0.001).Aged patients,a significant increase of Tg level and extrapulmonary distant metastases indicated a poor prognosis.Conclusions 131I treatment is an effective method for lung metastases from DTC.The patients with younger age,lower Tg levels,no other distant metastases had good response to 131I treatment.

ObjectiveTo explore the influence of antipsychotics combined with skill traning on quality of life and social function of patients with schizophrenia at recovery.Methods80 patients with schizophrenia were randomly divided into study group (n=40, antipsychotics plus skill training)and control group (n﹦40, only antipsychotics) for 1-year treatment. At pre-treatment and end of treatment, both groups were assessed with Positiveand and Negative Symptom Scale (PANSS), Generic Quality Of Life Inventory-74 (GQOLI-74) and Social Disability Screening Schedue(SDSS) respectively to evaluate their effects, quality of life and social funtion.ResultsAfter 1-year treatment, the general scores of PANSS and each factors in both groups decreased significantly compared with the baseline(P<0.05～0.01), and the significant difference was found between two groups(P<0.01). Improvement of each factor score of FAD(except factor of the material life) and SDSS in study group were more better than those in control group(P<0.05～0.01).ConclusionTreatment with antipsychotics plus skill traning is helpful to release the mental syndrome, improve quality of life and social funtion, and facilitate the recovery of the patients with schizophrenia at recovery.

Objective To investigate the incidence and correlative factors of metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE).Methods A total of 116 SLE patients and 115 controls were enrolled into the study.The incidence of MS,SLE disease activity index(SLEDAI) of patients with SLE combined with MS (MS-SLE) and patients without MS (n-MS-SLE),lupus characteristics,cumulative glucocorticoids,administration dose of glucocorticoids and hydroxychloroquine were compared between SLE group and the control group.Results The incidence of MS of SLE group was obviously higher than that of the control ( 34.48％ vs 14.78％,P ＜ 0.05 ).The ratios of patients with lower HDL-C,higher TG and higher blood pressure in SLE group ( 50.86％,56.03％,46.55％ ) were higher than those in the controls ( 34.78％,16.52％,20.00％,all P ＜ 0.05 ).MS-SLE group had significantly higher mean waist circumference,BMI,systolic blood pressure and diastolic blood pressure and lower HDL-C than n-MS-SLE group (all P ＜0.05 ).No significant difference was found regarding duration of disease,renal involvement,ESR,C-reactive protein,high-sensitivity C-reactive protein,SLEDAI,cumulative and current glucocorticoids use in MS-SLE group and n-MS-SLE group.The ratio of patients taking hydroxychloroquine in n-MS-SLE group was higher than that of MS-SLE group (46.05％ vs 15.00％,P＜0.05).Conclusions Patients with SLE has a higher incidence rate of MS.Hydroxychloroquine may reduce their MS incidence.

Objective To investigate the risk factors of atrial fibrillation (AF) in hyperthyroidism patients.Methods The clinical data of 557 patients with hyperthyroidism receiving 131I treatment from January 2015 to May 2018 were enrolled in the study.There were 50 cases with AF and 507 patients without AF before the treatment.Univariate and multivariate logistic regression were applied to analyze the risk factors of AF in hyperthyroidism patients.Results Compareded to non-AF patients,AF patients had older age [(59.1±10.6) vs.(41.9±13.7) years,t=6.75,P＜0.01],more males[42.0％(21/50] vs.19.7％(100/507),x2=14.11,P＜0.01],longer duration of hyperthyroidism [66.0 (6.8,120.0) vs.12.0(3.0,72.0) months,Z=2.83,P=0.02],higher prevalence of coronary artery disease [16.0％(8/50) vs.2.6％(13/507)] and hypertension[30.0％(15/50) vs.9.3％(47 / 507)],higher serum creatinine (SCr) [51.5(46.0,64.3) vs.42.0(35.0,51.0) μmol / L,Z=4.62,P＜0.01],serum uric acid (SUA) [(360.6±90.3) vs.(313.4±80.3)μmol/L,t=3.76,P＜0.01]and gamma-glutamy transpeptidase (GGT)[72.1 (38.0,97.0)vs.42.2(17.0,48.8) U/L,Z=4.97,P＜0.01] and total bilirubin (TBIL) (21.3±8.8) vs.(13.8±7.7) U/L,t=5.26,P＜0.01],direct bilirubin(DBIL)[12.6(7.9,17.4) vs.5.5(4.1,7.9)μmol/L,Z=6.62,P=0.00)]and lower blood platelet (PLT) [(188.5±60.8) × 109/L vs.(241.0±65.1)× 109/L,t=4.52,P＜0.01].And there were no significant differences in thyroid hormone level and thyroid autoimmune antibody levels.Univariate and multivariate analysis showed that the age (OR=1.23,95％CI:1.09-1.38,P＜0.01),SUA (OR=1.01,95％CI:1.00-1.20,P=-0.05),DBIL (OR=1.65,95％CI:1.01-2.72,P=0.05),GGT (OR=1.04,95％CI:1.01-1.08,P=0.01) were risk factors for AF in patients with hyperthyroidism.Conclusion Older age,abnormal serum SUA,DBIL and GGT are risk factors for atrial fibrillation in patients with hyperthyroidism,to timely control hyperthyroid and to give symptomatic treatment for those patients are necessary.

Objective:To investigate the predictive value of early thyroid function changes on the efficacy of patients with Graves′ disease (GD) after 131I therapy. Methods:Data of patients with GD (59 males, 214 females; age (37.4±11.4) years) who underwent single therapy of 131I in Tianjin Medical University General Hospital from November 2017 to January 2019 were retrospectively analyzed. Symptoms, signs and laboratory tests (serum free triiodothyronine (FT 3) and serum free thyroxine (FT 4)) of patients were observed to assess the efficacy of 131I treatment. Efficacy was divided into complete remission (CR), partial remission (PR), non-remission (NR) or relapse. The changes of thyroid function (ΔFT 3=FT 3 before treatment-FT 3 after treatment)/FT 3 before treatment×100%; ΔFT 4=FT 4 before treatment-FT 4 after treatment)/FT 4 before treatment×100%) 1 month after 131I therapy in each efficacy group and differences among them were compared by using independent-sample t test, χ2 test, one-way analysis of variance and the least significant difference t test. ROC curves were drawn to analyze the predictive values of early thyroid function changes on the efficacy of 131I treatment for GD. Logistic regression analyses were performed to identify the influencing factors for the efficacy of 131I therapy. Results:CR rate and total effective rate of 273 GD patients after single therapy of 131I were 67.03%(183/273) and 92.67%(253/273), respectively. After 1 month, CR rate of euthyroidism group ( n=95) was significantly higher than that of hyperthyroidism group ( n=178; 81.05%(77/95) vs 59.55%(106/178); χ2=4.60, P=0.032). ΔFT 3 and ΔFT 4 at the first month were statistically significant and decreased sequentially in the CR group ( n=183), PR group ( n=70), NR or relapse groups ( n=20; F values: 15.40, 12.54, both P<0.001). ROC curve analysis showed that patients with ΔFT 3≥73.64% and (or) ΔFT 4≥59.03% had a higher probability of achieving CR, with sensitivities of 84.3% and 86.7%, and specificities of 62.6% and 62.6%, respectively. Logistic regression analysis showed that 24 h radioactive iodine uptake (odds ratio ( OR)=1.095, 95% CI: 1.031-1.139), dose of 131I given per gram of thyroid tissue ( OR=1.562, 95% CI: 1.321-1.694), ΔFT 3 ( OR=1.354, 95% CI: 1.295-1.482), ΔFT 4 ( OR=1.498, 95% CI: 1.384-1.608) were factors affecting the outcome of patients with GD treated with 131I treatment (all P<0.05). Conclusion:Effects of 131I treatment can be predicted based on the change of the thyroid function at the first month after 131I treatment in patients with GD.