Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective To investigate the clinical effect of Jiaotai Shugan decoction in adjuvant treatment of type 2 diabetes mellitus(T2DM)complicated with depression with liver qi stagnation type.Methods From June 2022 to June 2023,90 patients with T2DM complicated with depression with liver qi stagnation type treated in the Second People's Hospital of Lishui City were selected,who were randomly divided into control group and observation group,with 45 cases in each group.Both groups were treated with basic treatment of diabetes,control group was given escitalopram to improve the emotion,while observation group was further given Jiaotai Shugan decoction.After 8 weeks,the clinical effective rate were evaluated by Hamilton depression scale-24(HAMD-24)and patient health questionnaire-9(PHQ-9)scores,the levels of 5-hydroxytrytamine(5-HT),noradrenaline(NE),brain-derived neurotrophic factor(BDNF),fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG)and haemoglobinA1c(HbA1c)were detected,and adverse reactions were recorded.Results The clinical total effective rates of observation group was higher than that of control group,and the difference was statistically significant(P＜0.05).8 weeks after treatment,HAMD-24 and PHQ-9 scores of observation group were lower than those of control group(P＜0.01).The levels of 5-HT,NE and BDNF of observation group were higher than those of control group(P＜0.01).The levels of FPG,2hPG and HbA1c in observation group were lower than those in control group(P＜0.01);There was no significant difference in adverse reactions between two groups(P＞0.05).Conclusion Modified Jiaotai Shugan decoction is effective in treating T2DM complicated with depression with liver qi stagnation type,can reduce HAMD-24 and PHQ-9 scores,increase the levels of 5-HT,NE,BDNF,and reduce the levels of FPG,2hPG,HbA1c.There was no obvious adverse reactions.

Objective To explore the diagnostic value of contrast-enhanced ultrasound combined with tumor markers in benign and malignant ovarian tumors.Methods The clinical data of 100 patients with ovarian tumors treated in our hospital from May 2016 to May 2017 were analyzed retrospectively.The parameters of contrast-enhanced ultrasonography (CEUS) for benign and malignant ovarian tumors were analyzed.The levels of tumor markers were measured and the ultrasound imaging was analyzed.Analysis of the detection rate of benign and malignant ovarian tumors by contrast-enhanced ultrasound alone or in combination with tumor markers.Results Compared with benign ovarian tumors,ovarian malignant tumors have the characteristics of uneven enhancement,early onset and peak time of contrast enhancement,and higher rate of enhancement (P ＜ 0.05);compared with benign ovarian tumors,serum CA125 and CA199 levels in patients with ovarian malignant tumors were higher,with significant difference (P ＜ 0.05).The detection rates of contrast-enhanced ultrasound combined with tumor markers were higher than those of ultrasound or tumor markers alone,and were in accordance with pathological criteria.Conclusions The application of combined contrast-enhanced ultrasound and tumor markers in the diagnosis of ovarian benign and malignant tumors has a high detection rate,can significantly improve the accuracy of clinical detection,and provide a strong basis for treatment.

OBJECTIVETo explore the differences in the clinical therapeutic effects on xerophthalmia of and deficiency between the needling technique (the combined reinforcing technique to induce warm sensation) and the reinforcing needing technique achieved by rotating needle.

METHODSA total of 54 patients of xerophthalmia were randomized into an observation group (28 cases) and a control group (26 cases). In both of the groups, the main acupoints included Cuanzu (BL 2), Sizhukong (TE 23), Taiyang (EX-HN 5) and Fengchi (GB 20); the combined acupoints were Danzhong (CV 17), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3). In the observation group, the needling technique was used and in the control group, the reinforcing needing technique achieved by rotating needle was adopted. The treatment was given once every day. 10 treatments made one course and 2 courses were required. Before and after treatment, the score of eye symptoms, tear secretion and the breakup time of tear film were observed in the two groups. The clinical therapeutic effects were compared between the two groups after treatment and in 4-week follow-up after treatment separately.

RESULTSAfter treatment, the total effective rate was 92.9% (26/28) in the observation group and was 80.8% (21/26) in the control group, without significant difference in comparison (>0.05). In 4-week follow-up after treatment, the total effective rate was 85.7% (24/28) in the observation group and was 61.5% (16/26) in the control group, indicating the significant difference in comparison (<0.05). After treatment, the differences were significant in the score of eye symptoms, tear secretion and the breakup time of tear film as compared with those before treatment in the two groups (all <0.01). After treatment, the improvements of the score of eye symptoms, tear secretion and the breakup time of tear film in the observation group were better remarkably than those in the control group, indicating the significant differences (all <0.05).

CONCLUSIONThe needling technique achieves the significant therapeutic effects on xerophthalmia of and deficiency and the recurrence rate of the disease is low.

Objective To evaluate the effect of hydrogen on mitochondrial fusion during myocardial ischemia-reperfusion (I/R) in aged rats.Methods One hundred and fifty pathogen-free healthy male Sprague-Dawley rats,aged 18 months old,weighing 400-500 g,were divided into 5 groups (n=30 each) using a random number table:control group (group C),sham operation group (group S),group I/R,normal saline group (group NS) and hydrogen-rich saline group (group H).Group C received no treatment.The anterior descending branch was only exposed but not ligated in group S.Myocardial I/R was induced by occlusion of the anterior descending branch of the left coronary artery for 30 rmin followed by reperfusion in I/R,NS and H groups.Hydrogen-rich saline 1 ml/100 g was injected intraperitoneally at 5 min before reperfusion in group H,while normal saline 1 ml/100 g was injected intraperitoneally at 5 min before reperfusion in group NS.The rats were sacrificed at 12 and 24 h of reperfusion,and hearts were removed for examination of the pathological changes and for determination of apoptosis in cardiomyocytes (by TUNEL) and expression of Mfn1 and Mfn2 protein and mRNA in myocardial tissues (by Western blot or real-time polymerase chain reaction).The apoptosis index was calculated.Results Compared with C and S groups,the apoptosis index of cardiomyocytes was significantly increased and the expression of Mfn1 and Mfn2 protein and mRNA in myocardial tissues was down-regulated at 12 and 24 h of reperfusion in I/R,NS and H groups (P＜0.05).Compared with NS and I/R groups,the apoptosis index of cardiomyocytes was significantly decreased and the expression of Mfn1 and Mfn2 protein and mRNA in myocardial tissues was up-regulated at 12 and 24 h of reperfusion in group H (P＜0.05).The pathological changes of myocardial tissues were significantly attenuated in group H when compared with group I/R.Conclusion The mechanism by which hydrogen attenuates myocardial I/R injury is related to promoting mitochondrial fusion and inhibiting apoptosis in cardiomyocytes of aged rats.

Objectives To investigate the occipital cortex metabolite alterations in repetitive and severe neonatal hypoglycemia rats treated with sodium pyruvate and to reveal the protective role of sodium pyruvate using high resolution 1H nuclear magnetic resonance spectroscopy.Methods Thirty-six 2-dayold Sprague-Dawley rats were randomly divided into hypoglycemia group and pyruvate group with 18 rats in each group.Rats in both groups received intraperitoneal injections of insulin (40 U/kg body weight) at 2,4 and 6 days of age to induce severe hypoglycemia (blood glucose value ≤ 1.4 mmol/L).In the hypoglycemia group,2.5 hours after insulin injection,intraperitoneal injection of 50％ glucose (2 ml/kg) was administered to terminate hypoglycemia,while in the pyruvate group,50％ glucose (2 ml/kg) and sodium pyruvate solution 2.5 ml/kg (500 mg/kg) were injected.Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay was used to observe the status of injured neurons in six neonatal rats,and metabolite changes in occipital cortex of the other 12 rats were detected by 1H nuclear magnetic resonance spectroscopy.The difference between the two groups was compared by independent-samples t test.Results Neonatal rats of both groups reached severe hypoglycemia level 2.5 hours after insulin injection.Compared with hypoglycemia group,pyruvate group had fewer injured neurons (45±5 vs 113 ± 12,t=0.782,P=0.013) and lower injured index in the occipital cortex (0.15 ± 0.03 vs 0.36 ± 0.06,t=l.143,P=0.020).Pyruvate group showed significant decreases in the concentration of taurine [(13.31 ± 2.06) vs (18.44 ± 3.86) mol/kg,t=8.231],glutamine[(1.50 ± 0.24) vs (2.02 ± 0.40) mol/kg,t=3.137],glutamate[(7.04 ± 0.95) vs (9.40 ± 1.73) mol/kg,t=6.449],aspartate[(1.51 ± 0.28) vs (2.15 ± 0.58) mol/kg,t=2.561] and creatine [(6.37±0.99) vs (8.46± 1.77) mol/kg,t =4.226] in the occipital cortex (all P'＜0.017).Conclusions Simultaneous use of glucose and sodium pyruvate to terminate hypoglycemia in repetitive and severe neonatal hypoglycemia rats can effectively alleviate severe hypoglycemia-induced occipital lobe damage via regulating excitatory amino acid neurotransmitters,energy metabolism and other metabolic pathways.

Objective To investigate the assessment of multi-detector spiral CT on the cardiac function after bioprosthetic valve replacement with mitral valve preservation.Methods Thirty-five patients suitable for undergoing bioprosthetic mitral valve replacement in our hospital from May 2012 to February 2014 were randomly divided into 2 groups:group A(experimental group,intraoperative preservation of mitral valve and subvalvular structure during,n=16) and group B (control group,without intraoperative preservation of subvalvular structure of mitral valve,n=19).MDCT before operation and on postoperative 10 d was performed for evaluating the left ventricular function.Results In the comparison of preoperative MDCT,the end diastolic velocity(EDV),end systolic velocity(ESV),ejection fraction(EF) and stroke volume(SV) had no statistical difference between the group A and B.In MDCT results on postoperative 10 d,EDV,ESV and EF in the group A were 113.42±9.22)mL,(38.63±3.40)mL and (51.63±4.71) ％,which in the group B were(113.42 ± 9.22) mL,(38.63 ± 3.40) mL and (51.63 ± 4.71) ％ respectively,the difference was statistically significant(P＜0.05),but SV had no statistical difference between the two groups(P＞0.05).Conclusion The bioprosthetic valve replacement with mitral valve preservation is safe and feasible in technology,moreover effectively protects the postoperative left ventricular function.

Based on the Australian AR-DRGs, this research gathered the diagnosis related information on the first page of medical records and accomplished the computerization of data collection and analysis through the data-base of Shanghai Shenkang Hospital Development Center.According to the clinical practices, the DRGs model has been adjusted to complete the localization and a severity-based-DRGs model and grouping tool have been established for the municipal hospitals in Shanghai.

The severity of disease can be used to evaluate the current situation of patients as well as to predict the diseases outcome.In the meantime, the severity among different diseases has been more and more applied in the evaluation of the patients at hospital level.This study collected and summarized different types of international disea-ses grouping tools'characteristics and applications based on the severity of disease, and their suitability and practical values in hospital performance evaluation were compared and analyzed.

The performance evaluation is an effective method to guide the public hospitals behavior and pro-mote their sustainable development.The introduction of disease severity could make the performance evaluation sys-tem more scientific and reasonable, and encourage the hospitals to improve their technical skills and services ability. Based on the Shanghai diagnosis related groups system, a case-mix index ( CMI) was introduced and a severity score of disease was developed after the relative weight ( RW) adjustment to evaluate different types of disease severity in hospitals.The results have shown that CMI effectively reflects the patients'disease severity and the intensity of treat-ment in those hospitals taken into consideration.Therefore, the scientific indicators should be selected and the evalu-ation system should be improved thereby establishing an effective monitoring and dynamic adjustment mechanism and further developing the diagnosis related group application.