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.

Objective:To explore the value of uterine volume, ovarian volume (OV), endometrial thickness (ET) combined with ovarian hemodynamics in polycystic ovarian syndrome (PCOS).Methods:Fifty-three patients with PCOS diagnosed in the Third Affiliated Hospital of Wenzhou Medical University from October 2017 to October 2019 were selected as observation group and 53 healthy women of child bearing age who underwent physical examination at the same time were selected as control group. Patients with PCOS were divided into groups according to their different menopause times and ovalution statusafter ovulation promotion. The uterine volume, OV, ET, peak ovarian systolic velocity (PSV), ovarian artery resistance index (RI), and ovarian artery pulsation index (PI) was measured and recorded by transvaginal color Doppler ultrasound and compared between observation group and control group; and the above indicators in PCOS patients before and after chorionic gonadotrophin injection and 7 d after ovulation were compared.Results:Before treatment, the value of uterine volume, RI and PI of the observation group were lower than those of the control group: (30.28 ± 11.37) cm 3 vs. (38.41 ± 13.02) cm 3, 0.31 ± 0.04 vs. 0.73 ± 0.09, 0.86 ± 0.24 vs. 1.16 ± 0.32, the OV, ET, and PSV were higher than those of the control group: (15.04 ± 3.06) cm 3 vs. (6.35 ± 1.32) cm 3, (1.32 ± 0.41) mm vs. (0.64 ± 0.16) mm, (12.27 ± 2.83) cm/s vs. (9.37 ± 1.53) cm/s, and the differences were statistically significant ( P<0.05). Before treatment, the uterine volume and OV of PCOS patients had no significant differences in different menopause groups ( P>0.05). In menopause 10 - 15 d group, menopause 16 - 30 d group, menopause 31 -90 d group, and menopause>90 d group, the ET and PSV were gradually higher, the RI and PI were gradually lower, and the differences were statistically significant ( P<0.05). After ovulation promotion among 53 PCOS patients, 48 patients succeeded in ovulation promotion and 5 patients failed. On the day of chorionic gonadotrophin injection and mid luteal phase,the OV, ET and PSV in the successful ovulation induction group were lower than those in the failed ovulation induction group, and the uterine volume, RI and PI were higher than those in the failed ovulation induction group, and the differences were statistically significant ( P<0.05). In the successful ovulation induction group, the ET, RI, PI onthe day of chorionic gonadotrophin injection were lower than those onmid luteal phase, PSV was higher than that on mid luteal phase, and the differences were statistically significant ( P<0.05). Receiver operating characteristic (ROC)curveanalysis showed that that the area under the curve(AUC) of the value of uterine volume, OV, ET, and ovarian hemodynamic indicators joint examinationfor PCOS was 0.897 (95% CI 0.795 - 0.968), with a sensitivity of 95.0%, and a specificity of 80.2%, and all were higher than that of the single examination ( P<0.05). Conclusions:The value of uterine volume, OV, ET combined with ovarian hemodynamics are beneficial to observe the ovarian function of PCOS patients and the developmental potential of the basal layer of the endometrium, and have good application value for the evaluation of PCOS patients and guidance of clinical diagnosis and treatment.

Purpose To evaluate the application value of rapid exchange method in transnasal intestinal obstruction catheterization. Materials and Methods Fifty-eight patients with adhesive intestinal obstruction underwent transnasal catheterization under X-ray fluoroscopy, of which 31 cases were treated with rapid exchange catheterization method (group A) and the other 27 cases with traditional catheterization method (group B), success rate, operation time and complications were compared between the two groups. Results Catheterization success rate of group A and group B were 96.77%(30/31) and 77.78%(21/27) respectively, which was significantly higher in group A than in group B (χ2=4.907, P<0.05);operation time of group A and group B were (28.2±12.3) min and (25.4±15.7) min respectively, and the difference between them was not statistically significant (t=1.219, P>0.05); no operation associated injury occurred in group A and only one case in group B (3.70%) resulted in bilateral nasal edema with a small amount of bleeding because the operating time was too long, complication rate between the two groups was also not statistically significant (P>0.05). Conclusion Rapid exchange method can improve the success rate of transnasal intestinal obstruction catheterization, but the operation time and complications are comparative to those of the conventional method.

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.

The relationship between the dental occlusion and temporomandibular disorders (TMDs)has been one of the most controversial topics in the dental community.In a large epidemiological cross-sectional survey-the Study of Health in Pomerania (Germany)-associations between 1 5 occlusion-related variables and TMD signs or symptoms were found.In other investigations,additional occlusal variables were i-dentified.However,statistical associations do not prove causality.By using Hill's nine criteria of causation,it becomes apparent that the evi-dence of a causal relationship is weak.Only bruxism,loss of posterior support and unilateral posterior crossbite show some consistency across studies.On the other hand,several reported occlusal features appear to be the consequence of TMDs,not their cause.Above all,however, biological plausibility for an occlusal aetiology is often difficult to establish,because TMDs are much more common among women than men. Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either,because the a-melioration may be due to the change of the appliance-induced intermaxillary relationship.In addition,symptoms often abate even in the ab-sence of therapy.Although patients with a TMD history might have a specific risk for developing TMD signs,it appears more rewarding to fo-cus on non-occlusal features that are known to have a potential for the predisposition,initiation or perpetuation of TMDs.

Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ)condyle-fossa position with normal and abnormal function are still contentious issues.Clinical opinions can be strong,but support in most published data (mostly univariate)is problematic.Distribution overlap,low sensitivity and specificity are a common basis to reject any useful prediction value.Notwithstanding,a relationship of form with function is a basic tenet of biology.These are multifactor problems,but the questions mostly have not been analysed as such.This review moves the question forward by focusing on TMjoint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint.Multifactor analysis allows the data to speak for itself and reduces bias.Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated,backed up by stepwise logistic regression.Explained vari-ance,R2 ,predicting normals from pooled TMJ patients was 32.6%,sensitivity 67.9%,specificity 85.7%;37% versus disc displacement with reduction;and 28.8% versus disc displacement without reduction.Significant osseous organisational differences between TMjoints with clicking and locking suggest that this is not necessarily a single disease continuum.However,a subset of joints with clicking contained char-acteristics of joints with locking that might contribute to symptom progression versus resistance.Moderately strong models confirm there is a relationship between TMJ osseous organisation and function,but it should not be overstated.More than one model of normals and of TMde-rangement organisation is revealed.The implications to clinical decision-making are discussed.

Oral rehabilitation restores form and function and impacts on general health.Teeth provide a discriminating sense of touch and directional specificity for occlusal perception,management of food with mastication and swallowing,and awareness of its texture and hard-ness.Peripheral feedback for control of jaw muscles includes the enamel-dentine-pulp complex and mechanoreceptors in the periodontal tis-sues.The implications of feedback from periodontal and other intra-oral mechanoreceptors as well as changes in central representation are significant for function and adaptation to oral rehabilitation.With implants,in the absence of the periodontium and periodontal mechanore-ceptor feedback,fine motor control of mastication is reduced,but patients are still able to function adequately.Further,there is no signifi-cant difference in function with full-arch fixed prostheses on teeth in comparison with implants.Predictable implant outcomes depend on bone support.Optimum restoration design appears to be significant for bone remodelling and bone strains around implants with occlusal loading. Finite element analysis data confirmed load concentrations at the coronal bone around the upper section of the implant where bone loss is com-monly observed clinically.Load concentration increased with steeper cusp inclination and broader occlusal table and decreased with central fossa loading and narrower occlusal table size.It is recommended that occlusal design should follow a narrow occlusal table,with central fossa loading in intercuspal contact and low cusp inclination to minimise lateral loading in function and parafunction.Acknowledging these features should address potential problems associated with the occlusion in implant therapy.

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