Objective To investigate the effect of levothyrocine-thyroxine 4 (L-T4) replacement therapy on cognitive status in elderly patients with subclinical hypothyroidism (SCH).Methods One hundred and twenty elderly patients with SCH were selected and treated with thyroid hormone replacement therapy for 6 months.The thyroid functions and cognitive impairments were tested for all the subjects before and after the therapy.Results After 6 months of thyroid hormone replacement therapy,the level of thyrotropic hormone was significantly lower than that of before herapy((15.21 ± 1.78) mU/L vs.(3.46 ± 0.37) mU/L,t =6.417,P =0.0083));The neuropsyehological test performance in patients with hypothyroidism showed statistically significant improvements in clock drawing test,iconic memory,block design,complex graphics recall and delayed recall,trail making A,word list learningl,recall and recognize,forward and backward digital span,verbal fluency,and digital symbol from WAIS-RC ((8.74 ± 1.08) vs.(9.63 ± 1.32),(6.14 ± 1.03) vs.(8.47 ± 1.38),(30.36 ± 7.27) vs.(36.42 ±8.54),(13.71 ± 1.05) vs.(14.87 ± 1.38),(11.21 ± 1.13) vs.(13.56 ±1.34),(11.36 ± 1.27)vs.(13.06 ±1.47),(5.27 ±0.84) vs.(6.54 ±1.03),(63.13 ±12.09)vs.(54.63 ±10.07),(3.64 ± 1.07)vs.(4.91 ±1.32),(5.27 ±0.84) vs.(6.54±1.03),(8.52±1.16) vs.(9.83 ±0.96),(8.01 ± 0.83) vs.(8.94 ± 1.08),(4.04 ±0.57)vs.(5.37 ±0.75),(11.21 ± 1.03) vs.(13.43 ± 1.23),(33.46 ± 8.72) vs.(38.06 ± 9.58),t =13.907,11.027,12.093,16.374,10.361,11.536,8.794,-10.617,9.601,8.794,17.814,7.913,12.415,13.992,10.128 respectively,P =0.028,0.039,0.036,0.029,0.042,0.040,0.048,0.042,0.045,0.048,0.027,0.048,0.038,0.032,0.041 respectively).Conclusion The treatment of thyroid hormone for the edlerly patients with SCH has positive effects on theimprovement of mild cognitive impairment.

The changes of serum amino acid metabolism of rat following partial (69%) hepatectomy were investigated by measuring twenty amino acids in sera from blood collected from hepatic vein, portal vein, inferior vena cava and abdominal aorta 72 hours following surgical intervention. The results were as follows:1. The total concentrations of amino acids in sera obtained from above mentioned blood vessels were significantly elevated, especially in that from portal vein.2. The total amount of amino acid released from splanchnic organs accunted for 87% of the total amount of amino acid uptaken by regenerating liver. Both total amounts were significantly increased.3. The enhanccd essential amino acid uptaken by regenerating liver resulted in significant decrease of molar ratio of essential to nonessential amino acids in aortic serum.4. The molar ratio of the branched chain amino acids, valine, leucine and isoleucine, to the aromatic amino acids, phenylalanine and tyrosine in aortic serum was significantly declined, this was due to increased release of tyrosine by splanchnic organs and decreased uptake of this amino acid by regenerating liver.5. The uptake of branched chain amino acids by peripheral tissues was significantly inhibited and their uptake by regenerating liver was significantly increased. Thus, the regenerating liver was well supplied with branched chain amino acids.6. The release of alanine by splanchnic organs was significantly increased and its uptake by liver was simultaneously increased. Therefore, abundant raw matererial was supplied for glyconeogenesis to meet the energy need for rapidly proliferating hepatocytes.

Attention Deficit Disorder with Hyperactivity ; diagnosis ; etiology ; therapy ; Child ; China ; Diagnosis, Differential ; Humans ; Time Factors

Objective To study the clinical effect of Zhenqifuzheng granule combined with Tegafur gimeracil oteracil potassium capsule in treating advanced carcinoma of gastric cardia in aged patients.Methods 52 cases of aged patients with advanced carcinoma of gastric cardia were randomly divided into the observation group and the control group.The observation group was treated with zhenqi fuzheng granule combined with tegafur gimeracil oteracil potassium capsule,and the control group was given Tegafur gimeracil oteracil potassium capsule only.The curative effect,adverse reaction and cellular immune function were evaluated after two treatment cycles.Results There was no statistically significant difference in the objective efficacy rate between observation (46.2％) and control group (50.0％) (P＞0.05).The rate of adverse reaction was higher in the control group than in observation group (P＜0.05).The rate of gastrointestinal adverse reactions in the control group was 50.0％,but 15.4％ in observation group.The rate of bone marrow suppression was 26.9％ in control group,but 11.5％ in observation group.The cellular immune function was better in observation group than in the control group (P＜0.05).Conclusions Zhenqifuzheng granule can improve immune function and reduce toxic side effects when combined with Tegafur gimeracil oteracil potassim capsule in treating advanced carcinoma of gastric cardia in aged patients.

Although the history of Interventional Radiology is no longer than 50 years,interventional techniques have been dramatically developed. Interventional radiologists have been responsible for much of the medical innovations and development of the minimally invasive procedures that are commonplace today to treat many complicated diseases as physicians. But the education backgrounds of interventional radiologist in China are different. Therefore,we should be aware that the job of an interventional radiologist is totally different from that of a diagnostic radiologist. It is very important to train interventional radiologists for improving their clinical thinking and clinical competence. Herein,we propose our suggestions on how to improve the clinical thinking and clinical competence of interventional radiologists. In this paper we also systemically introduce the accurate and proper treatment procedures which should be strictly followed in clinical work and,meanwhile,the perioperative patients care is emphasized.

The endoluminal stenting is popular for more than two decades,even in China,encouraging achievements also are getting around the recent dacade.Endoluminal stents are not only applicated for all kinds of vascular stenosis,and nonvascular stenosis such as biliary tract,esophagus,trachea etc,but also are utilized gradually in the interventional treatment of cerebral ischemia and hemorrage in the recent years,especially for aortic aneurysm.There would still have a long way to go in China for further development in basic research,standardized procedure,and normalized followed-up.The main target for all the interventional radiologists in the foreseen future is how to develop new stents with independent knowlege property right and to expand the stents usage reasonably.

Objective To evaluate the clinical results of transjugular intrahepatic portosystemic shunt(TIPS)creation with 8 mm diameter covered stent-graft. Methods Ninteen concecutive patients with portal hypertension underwent TIPS creation with 8 mm diameter covered stent-graft for variceal bleeding and/or refractory ascites. Evaluation of the results through observing the improvement of clinical symptom and periodic follow up was carried out. Results Technical success achieved in all patients reaching 100% without related complications. Median follow-up was 13.5 months(ranged, 2.7 - 28 months). One case(1/19,5.3%)showed aggravation of hepatoencephalopathy and 2 others(2/19, 10.5%)revealed rebleeding. The primary patency rate was 100%(16/16)after 6 months, and 87.5%(7/8)after 12 months. Improvement or resolved rate of ascites was 66.7% (12/18). Conclusion TIPS creation with 8 mm diameter covered stent-graft can degrade the incidence of hepatic encephalopathy, improve the rate of TIPS patency and keeping the effective shunt flow.

Objective To explore the effect of interventional ward to the development of interventional radiology.Methods Investigation of the first class of the third grade hospitals in northeast region of China for the development status of interventional radiology in 2005 through questionnaires was undertaken.The hospitals were divided into two groups according to setting up interventional ward or not,together with comparative studies of number of doctors,sorts of interventional techniques and number of cases.Results Altogether 52 3rd grade,1st class hospitals have established interventional therapy,including with ward of 29(55.8%)and no ward of 23(44.2%);furthermore the average numbers of doctors in the forementioned two kinds of hospitals were 4.8 ? 1.7 vs 2.8 ? 1.5(P

Objective To study the expression changes and patterns of nucleic acid and their derivative metabolism,processing and transport-related genes in rat liver regeneration(LR) at transcriptional level. Methods The related genes were obtained by online data collection and literature review,and gene expression patterns in rat regenerated liver were checked by Rat Genome 230 2.0 array.LR-related genes were identified through the comparison of discrepancles in gene expression between partial hepatectomy(PH) and sham operation(SO) groups. Results 240 genes were determined to be related with liver regeneration.The number of initially expressive genes in the forepart of liver regeneration(0.5-4 hours after PH),prophase(6-12 hours after PH),metaphase(16-66 hours after PH),anaphase(72-168 hours after PH) were 65,14,150,11 respectively and the total expression numbers were 133,87,627,169 respeitirely.There were 6,5,22 and 9 expression patterns.Frequencies of up-regulation and down-regulation were 768 and 248.mRNA catabolism in prophase and metaphase,DNA recombination,modification and transcript,mRNA processing and transport in prophase,metaphase and anaphase,and nucleotides and their derivatives metabolism,as well as DNA replication,packaging and catabolism during the whole LR,were enhanced.Conclusion LR-related genes were mainly triggered in the forepart of liver regeneration,and funclioned at different phases.

Objective To evaluate the factors which might affect the successful reopening of occluded subclavian artery. Methods During the period of Jan. 1998-March 2007, endovascular stent placement was performed in 20 patients with occluded subclavian artery, including 12 males and 8 females, aged 17-74 years (mean 53 years). The procedures were carried out by using super-slippery guide wire via anterograde or bilateral access. Results Successful reopening of occluded subclavian artery was obtained in 14 cases and the treatment ended in failure in 6 cases. In 14 patients with successful results, the mean length of diseased artery was 3.00 cm and the mean course of disease was 9.83 months, which were 2.13 cm and 27.6 months respectively in 6 cases of failure. The successful reopening rate was 80% in arthrosclerosis cases, while it was 50% in aorto-arteritis obliterans. The successful reopening rate was 100% in those cases whose occluded artery showing a sharp stump, while the successful reopening rate was 33% in those cases whose occluded artery showing a round stump, with a statistically significant difference between the two (P< 0.05). The successful rate in cases performed via anterograde access was 65%, and it was only 43% in cases performed via bilateral access. Conclusion The etiology, the duration of disease and the shape of stump bear a close relationship to the successful reopening rate, while no obvious correlation exists between the length of diseased artery and the reopening rate. Higher reopening rate can be achieved when the procedure is performed via anterograde access.