Objective To investigate the efficacy and optimal time of levothyroxine (L-T4) treatment in pregnant rats with subclinical hypothyroidism.Methods Female adult Wistar rats were divided into six groups (n =10 per group):control,hypothyroid (H),subclinical hypothyroid (SCH),and SCH treated with L-T4 starting from the tenth,thirteenth,and seventeenth gestational day (GD10,GD13 and GD17),to restore normal thyroid hormone levels.Spatial learning was assessed in progenies by a water maze test and fEPSPs recording.Results Progenies from the SCH and H groups demonstrated significantly longer mean latency in the water maze test and a lower amplification percentage of the fEPSPs' amplitude and slope compared with the offspring of the control group.L-T4 treatment in the GD10 and GD13 groups significantly shortened mean latency and increased the amplification percentage of the fEPSPs' amplitude and slope as compared with the progeny of rats with subclinical hypothyroidism.However,L-T4 treatment in the GD17 group showed only minimal effect on spatial learning of offspring.Conclusion Maternal subclinical hypothyroidism may impair spatial learning in the offspring; L-T4 treatment started early during pregnancy may alleviate this adverse effect.

Objective:To test curriculum management effect of graduate students'clinical practice of counseling psychology.Methods:Totally 26 students [average age (24.5 ± 1.0) years] who completed 30-day interns summer were investigated with the self-made questionnaire evaluating the quality of clinical practice.Results:All students obtained promotion in practice activities,the attendance ranged from 50.0％ to 96.2％.The overall satisfaction was (3.8 ± 0.8) and the average degree of supervisors'satisfaction was (4.0 ± 0.8).There were 92.3 ％ of the students had participated more than 224 hours' practice and completed all tasks.After the interns,the students had significantly improved in all 8 aspects of professional abilities.Conclusion:In graduate education of counseling psychology,curriculum management of clinical practice may be an effective approach to improve students' clinical skills.

Objective To investigate the effect of VPA and molecular hydrogen(H2)on phenotypes of microglia treated with hypoxia. Methods Mouse hypoxic BV2 microglia were treated with VPA or H2. The levels of phenotypic markers of supernatant and cells were detected by ELISA, flow cytometry and real?time PCR,respectively. Results Hypoxia significantly increased mRNA level of M1 marker(iNOS)and reduced mRNA levels of M2 markers(CD206 and TGF?β)in BV2(P<0.05). Besides,the ratio between the mRNA levels of M1 increased(P<0.05). VPA significantly reduced protein level(CD16/32)and mRNA production(iNOS)of M1 markers in hypoxia?treated BV2(P<0.05). The ratio be?tween the mRNA levels of M1 markers and M2 markers(CD16:CD206,CD32:CD206,iNOS:CD206 and iNOS:TGF?β)were also significantly decreased(P<0.05). H2 significantly reduced both protein levels(TNF?α,CD16/32 and iNOS)and mRNA production(iNOS)of M1 markers and increased secretion of M2 marker(IL?10)in hypoxia?treated BV2(P<0.05). The ratio between the mRNA levels of M1 markers and M2 markers(CD16:CD206,iNOS:CD206 and iNOS:TGF?β)were also highly declined(P<0.05). Conclusion Hypoxia can induce microglial cells toward pro?inflammatory phenotype. Both VPA and H2 can inhibit hypoxia?induced inflammatory effect on microglia.

Objective To investigate the application effect of Problem based learning (PBL) combined with role play teaching method in the training of emergency internal medicine.Methods Totally 60 medical students were randomly divided into two groups.The students in the observation groop were trained with PBL teaching method while those in control group were trained with traditional teaching method.The practical performances of the students in both groups were evaluated by virtual experience of dealing with patients in the emergency department through the role play teaching method.The grasp of basic knowledge was assessed by writing tests.Finally all the students in the observation group answered a survey about the teaching methods.Results There was uo difference in the scores of the basic knowledge test between the two groups ( P ＞ 0.05 ).The practical ability of the observation group was much better than that of the control group in the role play practice ( P ＜ 0.05 ).Almost all the students in the observation group accept the PBL teaching method.Conelusion PBL combined with role play teaching method is effective based on the characteristics of emergency medicine.

Objective To investigate the effect of iodine excess on thyroid follicle epithelial ultrstructure and the relationship between thyroid iniury and autoimmune thyroiditis. Methods NOD.H-2h4 mice and Kunming mice were randomly divided into four groups receiving plain water,5 fold,10 fold,and 100 fold excessive iodine water.4,8 and 24 weeks after receiving iodine water,the mice were killed.After fixation with osmic acid and dual staining with uranyl chloride and citrate lead,thyroid gland ultrstructure was examined with electron microscopy.Resuits Iodine treated NOD.H-2h4 mice exhibited marked accumulation of peroxisome and secondary lysosomes,apoptosis and necrosis of thyroid epithelial cell.damage of thyroid follicles and lymphocvtic infiltration.The observed changes induced by iodine were in a dose dependent way.Conclusion The oxidative iniury on the thyroid epithelial cells induced by iodine excess might be the prerequisite for the creation of autoimmune thyroiditis.

Objective To explore whether maternal subclinical hypothyroidism gives rise to poor performance in the offspring and whether this is associated with the expression of several genes that are under the control of thyroid hormones. Methods Sixty female rats were divided into three groups ( each group n = 20): ( 1 )maternal subclinical hypothyroidism ( total thyroidectomy with T4 infusion), (2) maternal hypothyroidism ( total thyroidectomy without T4 infusion), and (3) control (sham operated). All rats were mated 10 days after the start of infusion. The infusion continued until 10 days postpartum. Pups were sacrificed at postnatal day 3, 7, and 21. The hippocampus was collected and tested for brain-derived neurotrophic factor (BDNF) and Rap1 protein expression by Western blotting and for BDNF and neural cell adhesion molecule ( NCAM ) mRNA expression by real-time polymerase chain reaction. On day 41-49, rat pups explored the Morris water maze. Time spent in the quadrant previously containing the plat form was recorded. Results The present study found decreases in BDNF mRNA (on day 3 ) and protein levels (on day 3 and 7 ) in hippocampi of pups from subclinical hypothyroidism dams (P＜0.05). No change was observed in the levels of NCAM mRNA, whereas at day 21, expression of Rap1 protein was higher than that of control offspring. In addition, pups of subclinical hypothyroidism dams showed a trend toward depression in short-term memory (P＞0.05), and long-term memory testing revealed a trend toward subclinical hypothyroidism group pups being less able to remember a fixed platform position than controls, spending less time in the proper quadrant ( P＜0. 05 ). Conclusion The long-term memory deficits of pups born to maternal subclinical hypothyroidism dams are likely related with decrease in BDNF expression as well as increase in Rap1 expression in hippocampi.

Objective To assess the risk factors of the in-hospital mortality of acute type A aortic dissection after operation. Method From January 2003 to June 2008,185 patients, 144 males and 41 females, with acute type A aortic dissection operated on were enrolled. The average age of patients was (49.46 ± 11.04 ) years old.The patients' demographics, history, clinical features, and some laboratory examinations were reviewed. Univariate and multivariate analysis followed by logistic regression analysis were carried out to identify the predictors of inhospital mortality. Results The in-hospital mortality rate was 9.1%. The results of univariate and multivariate analyses as follows: pre-operation positive neurological symptom (Univariate OR = 5.084,95%CI:1.792 -14.426, P = 0.002; Multivariate OR = 5.538,95%CI: 1.834 - 16.721, P = 0.002, respectively), hypotension (Univariate OR = 6.986,95%CI:1.510- 32.323,P =0.013; multivariate OR = 1.998,95%CI:0.315-12.679,P = 0.463, respectively) and renal failure (Univariate OR = 3.594,95%CI:1.237 - 10.438,P =0.019; Multivariate OR = 3.254,95%CI:1.034- 10.242, P= 0.044, respectively). Conclusions There are two predictors, pre-operation positive neurological symptom and renal failure, of pre-hospital mortality found in current analyses. Our results may improve the regimen made by cardiac surgeons and emergency doctors so as to help patients and their relatives to make correct decision.

Objective To analyze the effects of valproic acid(VPA),a histone deacetylase(HDAC)inhibitor,on macrophage polarization in?duced by paraquat(PQ)or lipopolysaccharide(LPS). Methods Mouse RAW264.7 cells were cultured at 37℃with 5%CO2,passaged,and then given one of the following treatments:(1)PQ;(2)PQ+VPA(classⅠandⅡa HDAC inhibitor);(3)PQ+apicidin(classⅠHDAC inhibitor);(4)PQ+MC1568(classⅡa HDAC inhibitor);(5)LPS;(6)LPS+VPA;(7)LPS+apicidin;(8)LPS+MC1568. The cells and culture supernatants were harvested after 8 h of treatment. RT?PCR,ELISA,and flow cytometry were conducted to assess the expression levels of macrophage phenotyp?ic markers. Results Both PQ and LPS skewed the macrophage functional polarity toward proinflammatory phenotype. VPA,apicidin,and MC1568 all inhibited PQ?and LPS?induced macrophages polarizing toward pro?inflammatory phenotype ,but the inhibitory effects were different in some ways. Conclusion VPA inhibits the proinflammatory function of macrophages induced by PQ and LPS ,but the effect of VPA on PQ?and LPS?induced macrophages has its own characteristics.

Data were collected through questionnaire from 505 women enrolled during early pregnancy.Based on soy intake frequency,the subjects were divided into three groups:frequent (three or more times per week),conventional ( more than twice per month but less than three times per week),and occasional ( two or fewer times per month).Serum TSH and FT4 were measured by chemiluminescence immunoassay.The urinary concentrations of two primary isoflavones (daidzein and genistein) and creatinine were further assessed in 95 subjects from the three groups.The percentages of frequent,conventional,and occasional consumers were 18.6％,62.6％,and 18.8％,respectively.No difference was found in age,medical records,family history of thyroid diseases,serum FT4,TSH,and prevalence of thyroid dysfunctions among three groups. Both urinary daidzein and genistein levels were significantly higher in the frequent consumers compared with the other two groups.No correlations were found between urinary isoflavone levels and serum FT4 or TSH.These findings suggest that dietary soy consumption during early pregnancy seems not to be associated with the development of thyroid dysfunction.

Objective To investigate the effect of treatment with levothyroxine in early maternal subclinical hypothyroidism (SCH) on the neural development of the progeny. Methods 75 thyroidectomized female Wistar rats were divided randomly into groups of hypothyroidism (CH), SCH, SCH treated with levothyroxine at embryonic day 10 (E10), E13, and E17. There were 15 sham operated controls. Body weight,thyroid function, and the development of progeny by morris water maze, immunohistochemistry, and Nissl's staining of progeny were made. Results Pups from SCH or CH group had significantly lower body weight than euthyroid group ( P＜0. 05 ). Pups from E10, E13 or E17 groups had normal body weight compared to pups of control (P＞0.05). The levels of TSH and total T4( TT4 ) of all pups were normal. The mean latencies were longer in pups from CH, SCH, and E17 group than the control (P＜0.05). The mean escape latencies did not differ between the control and E10 group pups and between the control and E13 pups (P＞0.05). There were changes in the cytoarchitecture of the barrel cortex and of the hippocampus ( toluidine blue-stained sections) in CH, SCH, and E17 pups. The barrel cortex of E10 or E13 pups was similar to that of control pups. The distribution of BrdUlabeled cells was more widespread in CH, SCH, and E17 pups than in control, E10, and E13 progeny.Conclusion Maternal SCH disturbs learning and memory performances, cytoarchitecture and cell migration of the pups. Treatment with levothyroxine in early maternal SCH before E13 improves the cell migration in the developing brain of the progeny.