Objective To compare the clinical performance of the self-etching and the phosphoric acid etching adhesive system for restoration of non-carious Class V restorations for a period of two years.Methods There were 37 patients with at least one pairs of similar-sized non-carious cervical lesions participated in the study.120 restorations were placed by one operator,of which 60 with phosphoric acid etching adhesive system(Spectrum TPH,Prime& Bond)and 60 with self-etch(Clearfil AP-X,SE Bond).The restorations were evaluated by ?2 statistics at the baseline,6th,12th and 24th month according to the modified Ryge"s USPHS criteria.Results At two years,106 teeth were reviewed in 33 patients.The retention rates for self-etching adhesive system were 89% and for phosphoric acid etching adhesive system 77%.The percentage of the retention rates of both adhesive systems was not found to be different when calculating the failure rates.No cases in both adhesive systems showed slight marginal discoloration problems.Some cases for each adhesive system had slight color change after the same period.Conclusions The performance of both adhesive systems is excellent during this two-year clinical trial.The self-etch adhesive system exhibites slightly better coloar match than the phosphoric acid etching system.

Objective To evaluate the variables which can be used as prognostic factors in predicting the outcome of Graves disease(GD)after treatment with antithyroid drugs.Methods We performed a retrospective audit of 204 patients with newly diagnosed Graves disease consecutively at the Ruijin Hospital.Results Overall,110 patients(53.9%)were considered to be treatment failures.Age at the time of diagnosis was(31.0±12.2)years in the successful group and(36.3±14.0)years in the failure group.Free T3(FT3)was(25.60±9.52)pmol/L and(19.16±6.38)pmol/L in the failure and the successful group(P=0.001).FT3 to FT4 ratio and thyrotrophin recptor antibody(TRAb)levels were higher in the failure group(P=0.001).Logistic regression analysis showed that thyroid size,FT3 to FT4 ratio and TRAb at the time of diagnosis were associated with failure outcome.The patients reached euthyroid state at 3,6,9 and 12 months respectively and in the failure group the patients with continued thyrotropin suppression were more than those in the successful group(P=0.001).Conclusions Graves disease patients with large thyroid size,high levels of TRAb and FT3 to FT4 ratio before drug treatment are more likely to fail to respond to antithyroid drug treatment.We also found that patients with continuing thyrotropin suppression and attainmen of euthyroid state in the course of treatment had low remission rate and prolonged therapy.

Objective To explore the mechanism of persistent thyrotropin suppression in euthyroid patients with Graves′ disease after antithyroid drugs (ATD) treatment. Methods A prospective clinical study was performed in 122 patients with newly diagnosed Graves′ disease. All the patients were treated with 30 mg methimazole or 300 mg propylthiouracil daily, to whom L-T4was added, aiming at normalizing FT3 and FT4 but avoiding elevated TSH level. When the patients were clinically and biochemically euthyroid for at least 3 months, their blood levels of thyroid hormones, TSH, TSH receptor antibody(TRAb) and thyroid peroxidase antibody(TPOAb) were detected again and the cases were divided into two groups according to negative or positive TRAb. Results After treatment as long as (7.1±1.1) months, stable euthyroid status was restored for 3 months. When the patients reached the euthyroid state, 64 of them still had detectable TRAb levels, and 58 became negative TRAb. The two groups had similar levels of FT3 and FT4, but patients with positive TRAb had lower TSH level than patients with negative TRAb[0.044 mIU/L(0.001-4.163 mIU/L) vs 1.749 mIU/L(0.079-4.646 mIU/L),P＜0.01]. In addition, the TSH level was negatively correlated with TRAb level (r=-0.539, P＜0.01), and not with FT3, FT4 levels or other factors. Conclusion The present study showed that elevated TRAb level is associated with persistent suppression of TSH in patients with Graves′ disease after being rendered euthyroid. This finding may be due to the binding of TRAb to pituitary TSH receptor.

Medullary thyroid cancer (MTC) is characterized hy the secretion of calcitonin that is derived from parafollicular cells.20％-25％ of MTC are hereditary.Compared with other types of thyroid cancer,MTC is prone to recurrence,metastasis,and younger onset age.RET gene germline mutation accounts for the hereditary MTC,and somatic mutation is responsible for part of sporadic cases.A good correlation between phenotype and genotype is reported.We present in this article a case of medullary thyroid cancer patient with genetic diagnosis and treatment as well as postoperative follow-up together with RET gene screening results in her family members in order to call attention to the diagnosis and treatment of MTC.

Objective To explore the relationship between serum leptin level and the hypothalamuspituitary-gonad ( HPG) axis in female adolescents with anorexia nervosa ( AN). Methods Sixteen newly diagnosed female adolescents with AN in Shanghai and Zhejiang province were investigated, and their serum leptin, FSH, LH and body composition were measured before and after 18 weeks treatment, and their menorrhea cycles were observed. The rhythm of 24 h serum leptin secretion was studied in 4 patients with AN. Twenty-six, healthy females with normal weight and without contraceptive medication were studied as controls. Results (1) All of 16 patients had amenorrhea, 3 primary amenorrhea and 13 secondary amenorrhea. At admission LH in 14 patients and FSH in 12 patients were below the low limit of the normal reference range (1.5 U/L and 4. 6 U/L respectively), and among them 5 patiend had both 15% weight gain and significantly increased serum leptin level (P

OBJECTIVETo investigate the chemical constituents of Tibetan medicine Phyllanthus emblica.

METHODVarious chromatographic techniques were employed for isolation and purification of the constituents, and the structures were elucidated by chemical and spectral analyses.

RESULT11 compounds were isolated and identified as gallic acid (I), ellagic acid (II), 1-O-galloyl-beta-D-glucose (III), 3,6-di-O-galloyl-D-glucose (IV), chebulinic acid (V), quercetin (VI), chebulagic acid (VII), corilagin (VIII), 3-ethylgallic acid (3-ethoxy-4,5-dihydroxy-benzoic acid, IX), isostrictiniin (X), 1,6-di-O-galloyl-beta-D-glucose (XI).

CONCLUSION3-Ethylgallic acid (3-ethoxy-4,5-dihydroxy-benzoic acid) is a novel compound, and isostrictiniin was found from P. emblica for the first time.

Ellagic Acid ; chemistry ; isolation & purification ; Fruit ; chemistry ; Gallic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Phyllanthus emblica ; chemistry ; Plants, Medicinal ; chemistry ; Tibet

Objective To compare the diagnostic value of myocardial perfusion imaging (MPI) and 64 multi-slice spiral CT (64-MSCT) for coronary artery disease (CAD). Methods Fifty-two patients with suspected or known CAD were included in the study. Each patient underwent both stress and rest MPI,MSCT as well as conventional coronary angiography (CAG) within 1 month. The stress and rest MPI were scored by a 5-grade criteria (0 ～ 4) based on 17 coronary artery segments. The difference between summed stress and rest scores ＞ 1 was defined as myocardial ischemia. Stenosis in one main vessel or one main branch of the main vessel ≥50% was defined as myocardial ischemia by MSCT. CAG was used as the reference for comparison. Statistical analysis was performed using SPSS 13. 0 software. Kappa value was used to test the accordance of MPI and MSCT results. X2 test was used to evaluate the difference between MPI and MSCT results. Results The patient-based sensitivity, specificity, positive and negative predictive values and accuracy of MPI and MSCT for the diagnosis of CAD were 86.7% (26/30), 77.3% ( 17/22),83.9% (26/31), 81.0% ( 17/21), 82.7% (43/52) and 83.3% ( 25/30), 86.4% ( 19/22), 89.3%( 25/28), 79.2% ( 19/24), 84.6% (44/52), respectively. The vessel-based sensitivity, specificity, positive and negative predictive values and accuracy of MPI and MSCT were 74.5% (38/51), 81.0% (85/105 ), 65.5% (38/58), 86.7% ( 85/98), 78.8% ( 123/156 ) and 90.2% (46/51 ), 88.6% ( 93/105 ),79.3 % (46/58), 94.9% (93/98), 89.1% ( 139/156), respectively. There was no statistically significant difference between MPI and MSCT for either patient or lesion-based diagnosis (X2 =0.44, 0.21, both P ＞0.05 ). 96.0% (24/25) patients with both abnormal MPI and MSCT positive were valified by CAG while 83.3% (15/18) patients with both MPI and MSCT negative were excluded by CAG. Conclusions Both MPI and MSCT are reliable diagnostic modalities for CAD. They also provide complementary diagnostic value to each other.

Objective To separate and amplify Hantaan virus(HV)in serum of hemorrhagic fever patients with renal syndrome(HFRS)in Heilongjiang,and look for its difference from intemational standard type strain(76-118strains).Methods HVs of different phase in the 8erum of 50 HFRS patients were separated and amplified by RTnested-PCR,its products were analyzed the amplified by sequencing.Results Detectable rate of HV in the patients serum was 36.36%(8/22)in 7 days after onset,it Was 13.04%(3/23)in patients having an onset 8 days to 14 days earlier,5 cases were not detectable 15 days after onset.Comparing the sequence of HV S gene fragment,sample 1,9,18,31,37,38,44 strain had a homology of 90.24%,86.72%,89.97%,89.16%,86.45%,87.26%and 89.43%to 76-118 strains,respectively.Conclusions The positive rate is the highset in 7 days after onset.Nucleotide sequence difference exists between pathogenic strain of Heilongjiang's HV and international standard strain,indicating that not only hosts but also locations can affect HV.

Electrocardiography ; Humans ; Male ; Middle Aged ; Myocardial Bridging ; complications ; Myocardial Infarction ; etiology ; Myocardium ; pathology

[Summary]_ This is a pedigree of multiple endocrine neoplasia type 1(MEN1). The proband pursuit medical assistance because of hypertension and weakness. Adrenal cortical carcinoma with possible Cushing's syndrome was diagnosed after a series of tests. During this process, the proband was found to have hypercalcemia, and he was diagnosed as primary hyperparathyroidism. Adrenal carcinoma plus primary hyperparathyroidism suggested MEN1, which was confirmed by MEN1 gene 400_401insC mutation. Pedigree investigation found six additional patients, including one with high parathyroid hormone level and two without clinical evidence of any MEN1 diseases. The proband died of metastatic malignancy 7 months after diagnosis while the other 3 patients with clinically confirmed MEN1 tumor responded well to surgery, including one with adrenal cortical carcinoma.