Objective To explore the change rule of serum thyroid hormone level in senile patients. Methods Totally 2433 elderly patients in our hospital during January to August 2011 were divided into three groups by age:adult group aged(46.0± 10.8)years(n=1030),elderly group aged (69.5±6.3)years (n=848) and advanced age group aged (83.9±3.8)years (n=555).The levels of serum free triodothyronine (FT3),free thyroxine (FT4),thyroid-stimulating hormone (TSH) were determined by chemistry luminescence technique. Results The levels of serum FT3 [(4.33 ± 1.22)pmol/L,(3.96 ± 0.89) pmol/L vs.(5.08 ± 2.99) pmol/L,t=7.075,8.799,both P=0.000] and FT4 [(18.32±5.81)pmol/L,(18.58±6.71)pmol/L vs.(19.87±10.97) pmol/L,t=3.732,2.709,both P=0.000] were lower in the elderly and advanced age than in adult.The levels of serum TSH were higher in the elderly than in adult (P=0.002),while no difference was found between advanced age and adult (P=0.134)[(5.51± 17.39) mU/L in the elderly,(3.33±5.65) mU/L in adults vs.(4.53±14.37)mU/L in advanced age].There were no significant differences in the levels of serum FT3,FT4 and TSH between advanced age and the elderly (all P＞0.05).The detection rate of the decreased FT3,FT4 and TSH in elderly and advanced age were (13.3％ vs.25.8％),(2.9％vs.1.8％),(6.8％vs.12.3％),while the detection rate of increment were (3.1 ％vs.0.1％),(8.6％vs.9.9％),(18.0％vs.15.7％),respectively.The rates of declined FT3 and TSH were obviously higher in the advanced age than in the elderly (x2=39.96,15.83,all P =0.000),but the rates of declined FT4 and increased FT3 were lower in the advanced age than in the elderly (x2 =27.84,16.32,all P=0.000). Conclusions The abnormal detection rates of thyroid hormones are high in the elderly,thus due attention should be paid to thyroid function test for early diagnosis and treatment of senile thyroid disease.

Objective To investigate the anxiety condition of patients with benign paroxysmal positional vertigo (BPPV) and the relationship among the different genders, ages and education levels and anxiety.Methods The general information and a history of 58 patients diagnosed as BPPV were studied.State-trait anxiety inventory (STAI) was adopted to 58 cases of BPPV and compared with the Chinese standard norm.SPSS 19.0 software was used to analyze the data.Results There was no significant difference in trait anxiety (T-AI) score (Pm:0.539;Pf:0.924) between male and female patients with BPPV and the 1998 Chinese male and female norm.The S-AI scores were significantly higher in male and female BPPV patients than that in Chinese men and women norm scores (Pm:0.033;Pf:0.01).There was no significant difference in trait anxiety (T-AI) score (P:0.674;P:0.349;P:0.077) between patients with different genders, ages and education levels.There was significant difference in state anxiety (S-AI) score (P:0.046;P:0.02;P:0.035) between patients with different genders, ages and education levels.The anxiety degrees of BPPV in man, elderly people, higher degree of education were higher than those of in woman, young and middle-age, lower degree of education.Conclusion The patients with BPPV have anxiety condition, but there is no obvious anxiety potential in T-AI.The anxiety degree of BPPV in man, elderly people, higher degree of education was higher than those of in woman, young and middle-age, lower degree of education.Therefore, the correct psychological assessment and psychological intervention were required throughout the whole course of BPPV treatment and rehabilitation.

Objective To investigate the properties of the abilities of spontaneous counterfactual thinking(SCFT) and induced counterfactual thinking(ICFT) produced by undergraduate students with depressive symptoms.Methods Undergraduates were induced to produce SCFT after recalling a negative event and ICFT after reading a story about a traffic event.Then the undergraduates were demanded to complete the counterfactual inference test(CIT).The amount and rationality of CFT and the scores of CIT were analyzed.Results Mild depressive students(MDS) generated a higher amount of SCFT than non-depressive students(NDS),midrange depressive students and severe depressive students(SVDS)(P0.05).The rationality of SCFT generated by four groups were significantly different(P

ObjectiveTo evaluate the value of inferior petrosal sinus sampling (IPSS) in the diagnosis of adreno-corticotropic hormone ( ACTH ) dependent Cushing syndrome ( CS ) with unknown origin. MethodsIPSS was carried out for the diagnosis of 16 cases with ACTH dependent CS who had not been identified after a series of dexamethasone suppression tests and radiological examinations. The ratio of inferior petrosal sinus/peripheral ACTH was assayed.The sensitivity and specificity of diagnosis of the Cushing disease were estimated. ResultsThe inferior petrosal sinus/peripheral ACTH ratio was over 2. 0 in 13 cases. Twelve cases underwent surgery with pathological diagnosis of pituitary ACTH adenoma, 1 patient relieved after γ knife treatment. The ratio was ＜ 2.0 in 3 cases including 2 pulmonary carcinoid and one pituitary ACTH adenoma. The sensitivity and specify of IPSS for the diagnosis of Cushing disease were 13/14and 2/2 respectively.ConclusionIPSS was a safe technique with high sensitivity, specify and infrequent complications in the diagnosis of ACTH dependent Cushing disease.It had great clinical value in the differential diagnosis of ACTH dependent Cushing disease with unknown origin.

Objective:To explore the characteristic of parenting style and its relationship with self congruence in Tibet middle school students.Methods:Totally 1149 Tibet students in 2 middle schools were investigated by the Scale of EMBU (Egma Minnen av Bardndosnauppforstran)and SCCS (Self Consistency and Congruence Scale) from counties resided mainly by Tibet people.Results:The total average scores of Tibet students'self-congruence were lower than the median[(2.8 ± 0.3) < median 3].There was no significant difference between genders [(2.6 ±0.3)vs.(2.7 ±0.4),P >0.05],and the scores of self flexibility had statistical significant difference in gender [(2.9 ±0.5)vs.(2.8 ±0.5),P <0.05].The scores of parenting style in positive elements were negatively correlated with self congruence in Tibet middle school students (r =-0.20,P <0.01 ).Multi-linear regression showed that the element of maternal emotion and understanding had negative relevance with SCCS(β=-0.16,P <0.01),while the element of maternal rejection and denial had positive relevance with SCCS(β=0.16,P <0.01) .Conclusion:It indicates that the level of self-congruence is higher than median,and that parenting style might have a certain relationship with self congruence in Tibet middle school students.

BACKGROUND:The patients are suffering from peritoneal adhesions that are caused after abdominal operation. As so far, there is stil no effective drug or method that can completely prevent peritoneal adhesions. Carboxymethyl chitosan is a biocompatible and biodegradable biomedical material with anti-adhesion effects, which is an ideal biomaterial for prevention of peritoneal adhesion theoreticaly.
OBJECTIVE:To investigate the novel anti-adhesion properties of carboxymethyl chitosan anti-adhesion solution on the prevention of postsurgical adhesion in vivo in a rat model.
METHODS:Fifty-six adult male Wistar rats were randomly divided into four groups: 0.9% normal saline solution (group A), hyaluronic acid gels (group B), medical chitosan gels (group C) and carboxymethyl chitosan anti-adhesion solution (group D). The model of postoperative intestinal adhesion was established by making cecal scratches/abdominal wal defects. Al the rats were scarified after 2 or 3 weeks. Whole blood was colected by cardio-puncture, lung tissue and tissue adhesion were stripped. The incidence and degree of adhesions, histological effects, expression of transforming growth factor-β1 (TGF-β1), the amounts of hydroxyproline and white blood cels were observed.
RESULTS AND CONCLUSION:The formation of postsurgical adhesions in groups B, C and D was significantly decreased, which was lighter than that of group A (P < 0.05). Furthermore, the adhesion formation in group D was significantly decreased in comparison with group A (P < 0.01). At the same time, the levels of transforming growth factor-β1, hydroxyproline and white blood cels in group D were lighter than those of group A (P < 0.05), and the histopathological results indicated that a marked reduction in inflammatory cels and fibroblasts. Carboxymethyl chitosan anti-adhesion solution can effectively reduce the degree and incidence of postoperative adhesion, and it is becoming a promising drug delivery system in the context of postsurgical anti-adhesion.

Objective To explore the level of serum transforming growth factor-β1 (TGF-β1) in patients with prehypertension and impaired fasting blood glucose.Methods A total of 180 healthy subjects with matched age and sex was divided into 3 groups:group A (blood pressure ＜ 120/80 mmHg and fasting blood glucose ＜6.1 mmoVL),group B (prehypertension and fasting blood glucose ＜6.1 mmol/L),group C (prehypertension and 6.1 mmol/L≤ fasting blood glucose ≤7.0 mmol/L).There were 60 subjects in every group.Serum TGF-β1 was measured by Enzyme-Linked Immunosobent Assay (ELISA),fasting blood glucose,triglyceride,total cholesterol,low-density lipoprotein cholesterol ( LDL-C),high-density lipoprotein cholesterol ( HDL-C),Uric Acid ( UA),body mass index (BMI) were determined.Results The level of serum TGF-β1 in group B and C was higher in that in group A( t =2.071,and 2.147,P ＜0.05 ).The level of serum TGF-β1 was higher in group C than group B,but no significant difference was observed ( P ＞0.05).The pearson correlation analysis showed there was a significant correlation between TGF-β1 and systolic blood pressure ( r =0.279,P =0.047).Conclusions The level of serum TGF-β1 was higher in patients with prehypertention which may mediate the target organ damage caused by the prehypertention.

Objective To investigate the effects of different volumes of ropivacaine with the same solubility in supraclavicular brachial plexus block(SCBPB) under ultrasound guidance on ipsilateral diaphragmaticparalysis.Methods Seventy two patients (32 males,40 females, aged 18-65 years, of ASA Ⅰ or Ⅱ, scheduled for the right upper limb fracture internal fixation removal were randomized into group A (0.375% ropivacaine 20 ml) and group B (0.375% ropivacaine 30 ml), 36 cases in each group.The onset and duration of sensory and motor block were observed as well as complication.Diaphragmatic excursion were evaluated by M type ultrasound before and 30 min after drug injection under eupnea and forced respiration through observing diaphragmatic excursion to study diaphragmatic paralysis.Results The onset time of sensory block and maintaining time of sensory block or motor block had no significant difference between the two groups.Compared with group A,the onset time of motor block in group B was significantly shorter (P<0.05).Twelve cases (33.3%) in group A and 22 cases (61.1%) in group B respectively showed complete or partial hemidiaphragmatic paralysis 30 min after drug injection.Compared with group A, the rate of diaphragmatic paralysis in group B was significantly higher (P<0.05).Conclusion Supraclavicular brachial plexus block under ultrasound guidance with 0.375% ropivacaine 20 ml or 30 ml both can provide excellent anesthetic effect.0.375% ropivacaine 20 ml is less likely to lead to diaphragmatic paralysis.

Objective To analyze the central visual fields and the ocular fundus changes of both eyes of patients with pituitary adenoma. Methods A total of 70 cases of pituitary adenoma received the examination of static central visual fields of all liminal values by Humphrey instruments 750 cycloscope and the fundus exams by Topcon TRC 50X fundus photography before operations. Results There were 64.3% patients with decreased visual acuities, 80.7% with the defect of visual field, and 46.4% with fundus changes. The decrease of the visual acuity was the first diagnostic symptom in 45.7% patients, among whom 28.6% were misdiagnosed as ocular diseases. Conclusions The misdiagnosed cause is that the first diagnostic symptom is the decrease of visual acuity without defect of visual field accompanied by ocular diseases. To avoid the misdiagnosis and the omitter of pituitary adenoma, general examination of visual field should be carried out in the patients with decreased visual acuity and optic atrophy with unknown reason in the clinical diagnosis of ophthalmology.

Objective To investigate the effect of exercise on glucose transporter 4 (GLUT4) in adipocyte of rats with insulin resistance induced by diets. Methods Experimental rats were randomized into three groups: a control group (n=10), a model group (n=10) and an exercise group (n=10). The model and exercise groups were fed with the diets enriched with sucrose (20%,w/w), lard (10%, w/w), cholesterol (2.5%, w/w) and cholic acid (1%, w/w) to induce insulin resistance. Exercise group was subject to swim for 6 weeks. After the plasma membrane and the intracellular membrane of adipocyte were prepared and separated, GLUT4 protein was detected by Western blot analysis. The body weight, serum triglyceride and cholesterol, fasting plasma glucose and serum insulin concentration were detected at the predetermined time points. And the insulin sensitivity index was calculated. Results Western blot analysis showed that intracellular membrane GLUT4 protein in adipocyte of the rats in the model group decreased by 38.72% (P