Objective:To investigate the predictive value of early thyroid function changes on the efficacy of patients with Graves′ disease (GD) after 131I therapy. Methods:Data of patients with GD (59 males, 214 females; age (37.4±11.4) years) who underwent single therapy of 131I in Tianjin Medical University General Hospital from November 2017 to January 2019 were retrospectively analyzed. Symptoms, signs and laboratory tests (serum free triiodothyronine (FT 3) and serum free thyroxine (FT 4)) of patients were observed to assess the efficacy of 131I treatment. Efficacy was divided into complete remission (CR), partial remission (PR), non-remission (NR) or relapse. The changes of thyroid function (ΔFT 3=FT 3 before treatment-FT 3 after treatment)/FT 3 before treatment×100%; ΔFT 4=FT 4 before treatment-FT 4 after treatment)/FT 4 before treatment×100%) 1 month after 131I therapy in each efficacy group and differences among them were compared by using independent-sample t test, χ2 test, one-way analysis of variance and the least significant difference t test. ROC curves were drawn to analyze the predictive values of early thyroid function changes on the efficacy of 131I treatment for GD. Logistic regression analyses were performed to identify the influencing factors for the efficacy of 131I therapy. Results:CR rate and total effective rate of 273 GD patients after single therapy of 131I were 67.03%(183/273) and 92.67%(253/273), respectively. After 1 month, CR rate of euthyroidism group ( n=95) was significantly higher than that of hyperthyroidism group ( n=178; 81.05%(77/95) vs 59.55%(106/178); χ2=4.60, P=0.032). ΔFT 3 and ΔFT 4 at the first month were statistically significant and decreased sequentially in the CR group ( n=183), PR group ( n=70), NR or relapse groups ( n=20; F values: 15.40, 12.54, both P<0.001). ROC curve analysis showed that patients with ΔFT 3≥73.64% and (or) ΔFT 4≥59.03% had a higher probability of achieving CR, with sensitivities of 84.3% and 86.7%, and specificities of 62.6% and 62.6%, respectively. Logistic regression analysis showed that 24 h radioactive iodine uptake (odds ratio ( OR)=1.095, 95% CI: 1.031-1.139), dose of 131I given per gram of thyroid tissue ( OR=1.562, 95% CI: 1.321-1.694), ΔFT 3 ( OR=1.354, 95% CI: 1.295-1.482), ΔFT 4 ( OR=1.498, 95% CI: 1.384-1.608) were factors affecting the outcome of patients with GD treated with 131I treatment (all P<0.05). Conclusion:Effects of 131I treatment can be predicted based on the change of the thyroid function at the first month after 131I treatment in patients with GD.

With the widespread use of electrical equipment, cognitive functions such as working memory (WM) could be severely affected when people are exposed to 50 Hz electromagnetic fields (EMF) for long term. However, the effects of EMF exposure on WM and its neural mechanism remain unclear. In the present paper, 15 rats were randomly assigned to three groups, and exposed to an EMF environment at 50 Hz and 2 mT for a different duration: 0 days (control group), 24 days (experimental group I), and 48 days (experimental group II). Then, their WM function was assessed by the T-maze task. Besides, their local field potential (LFP) in the media prefrontal cortex (mPFC) was recorded by the in vivo multichannel electrophysiological recording system to study the power spectral density (PSD) of θ and γ oscillations and the phase-amplitude coupling (PAC) intensity of θ-γ oscillations during the T-maze task. The results showed that the PSD of θ and γ oscillations decreased in experimental groups I and II, and the PAC intensity between θ and high-frequency γ (hγ) decreased significantly compared to the control group. The number of days needed to meet the task criterion was more in experimental groups I and II than that of control group. The results indicate that long-term exposure to EMF could impair WM function. The possible reason may be the impaired communication between different rhythmic oscillations caused by a decrease in θ-hγ PAC intensity. This paper demonstrates the negative effects of EMF on WM and reveals the potential neural mechanisms from the changes of PAC intensity, which provides important support for further investigation of the biological effects of EMF and its mechanisms.
Humans ; Rats ; Animals ; Memory, Short-Term/physiology* ; Electromagnetic Fields/adverse effects* ; Prefrontal Cortex ; Cognition

Objective To investigate the risk factors of atrial fibrillation (AF) in hyperthyroidism patients.Methods The clinical data of 557 patients with hyperthyroidism receiving 131I treatment from January 2015 to May 2018 were enrolled in the study.There were 50 cases with AF and 507 patients without AF before the treatment.Univariate and multivariate logistic regression were applied to analyze the risk factors of AF in hyperthyroidism patients.Results Compareded to non-AF patients,AF patients had older age [(59.1±10.6) vs.(41.9±13.7) years,t=6.75,P＜0.01],more males[42.0％(21/50] vs.19.7％(100/507),x2=14.11,P＜0.01],longer duration of hyperthyroidism [66.0 (6.8,120.0) vs.12.0(3.0,72.0) months,Z=2.83,P=0.02],higher prevalence of coronary artery disease [16.0％(8/50) vs.2.6％(13/507)] and hypertension[30.0％(15/50) vs.9.3％(47 / 507)],higher serum creatinine (SCr) [51.5(46.0,64.3) vs.42.0(35.0,51.0) μmol / L,Z=4.62,P＜0.01],serum uric acid (SUA) [(360.6±90.3) vs.(313.4±80.3)μmol/L,t=3.76,P＜0.01]and gamma-glutamy transpeptidase (GGT)[72.1 (38.0,97.0)vs.42.2(17.0,48.8) U/L,Z=4.97,P＜0.01] and total bilirubin (TBIL) (21.3±8.8) vs.(13.8±7.7) U/L,t=5.26,P＜0.01],direct bilirubin(DBIL)[12.6(7.9,17.4) vs.5.5(4.1,7.9)μmol/L,Z=6.62,P=0.00)]and lower blood platelet (PLT) [(188.5±60.8) × 109/L vs.(241.0±65.1)× 109/L,t=4.52,P＜0.01].And there were no significant differences in thyroid hormone level and thyroid autoimmune antibody levels.Univariate and multivariate analysis showed that the age (OR=1.23,95％CI:1.09-1.38,P＜0.01),SUA (OR=1.01,95％CI:1.00-1.20,P=-0.05),DBIL (OR=1.65,95％CI:1.01-2.72,P=0.05),GGT (OR=1.04,95％CI:1.01-1.08,P=0.01) were risk factors for AF in patients with hyperthyroidism.Conclusion Older age,abnormal serum SUA,DBIL and GGT are risk factors for atrial fibrillation in patients with hyperthyroidism,to timely control hyperthyroid and to give symptomatic treatment for those patients are necessary.

Objective To summarize the characteristics and management of pregnancy complicated with aortic dissection, and to explore the reasonable diagnosis and treatment plan. Methods The clinical data of 10 patients of pregnancy complicated with aortic dissection in Wuhan Tongji Hospital from January 2011 to June 2017 were collected. Their age was 25.2 (21-29) years. Results In the 10 patients, the majority (8 patients) were primipara, and most of them were in the late stages of pregnancy (5 patients) and puerperal (4 patients). Among them, 1 patient had gestational hypertension, and the blood pressure of the left and right upper extremities was significantly abnormal (initial blood pressure: left upper limb blood pressure: 90/60 mm Hg, right upper limb blood pressure: 150/90 mm Hg). The major clinical manifestations were severe chest and back pain which happened suddenly, with D-dimmer and C-creative protein increased which may be associated with inflammatory reaction. All patients were diagnosed by thoracoabdominal aortic CTA, including 5 patients of Stanford type A dissection and 5 patients of Stanford type B dissection. In the 10 patients, 1 patient refused surgery and eventually died of aortic rupture with the death of fetus before birth. And the remaining 9 patients underwent surgical treatment, 3 patients of endovascular graft exclusion for thoracic aortic stent graft, 2 patients underwent Bentall operation, 1 patient with Bentall + total aortic arch replacement + vascular thoracic aortic stent graft, 1 patient with Bentall operation combined with endovascular graft exclusion for thoracic aortic stent graft, 1 patient with Bentall + coronary artery bypass grafting, 1 patient of thoracoabdominal aortic vascular replacement. Among them, 1 patient underwent endovascular graft exclusion for thoracic aortic stent graft died of severe postoperative infection, and the remaining 8 patients were discharged from hospital. Nine patients were single birth, among them 5 newborn patients had severe asphyxia, 4 patients had mild asphyxia. Finally, 3 neonates died of severe complications, and the remaining 6 survived. Conclusion The ratio of pregnancy with Stanford type A aortic dissection is far higher than in the general population, the possibility of fetal intrauterine asphyxia is larger, but through active and effective surgical and perioperative treatment, we can effectively save the life of mother and fetus.

Objective To analyze the effect of self efficiency,social support and coping style on the psychological resilience.Methods A total of 386 patients with cerebral infarction in a grade 3A hospital of Tangshan City were served as the subjects.The resilience scale,self efficiency scale,social support scale and medical coping questionnaire were taken as the survey tools.The Pearson correlation analysis,multiple linear regression model and structure equation model(SEM) were applied.Results The resilience score was (59.72 ±12.17) points,the resilience was positively correlated with the self efficiency,social support,facing coping style and avoidance coping style(P＜0.01),and negatively correlated with the surrender coping style(P＜0.01).The total efficiency coefficients of self efficiency sensation,subjective support,facing coping style and surrender coping style for affecting the resilience were 0.720,0.264,0.121 and-0.092 respectively.Conclusion Self efficiency,social support and coping style have significant influences on the psychological resilience.

Objective To estimate the effect of blastocysts morphological score on pregnancy outcomes and neonate′s condition in vitrified-warmed single-blastocyst transfer cycles. Methods A retrospective analysis of 586 cycles of vitrified-warmed single-blastocyst transfer from Mar. 2010 to Feb.2016 was performed and the influ-ence of day of vitrification,inner cell mass(ICM)and trophectoderm(TE)scores on pregnancy outcomes and neo-nate′s condition were observed. Results There were no significant differences in clinical pregnancy rate,birth weight and sex ration of newborn between different vitrification day,ICM score and TE score.The day of vitrifica-tion and ICM score can significantly influence pregnancy loss rate,and were the two primary predictors of pregnan-cy loss rate. Vitrification day,ICM score and TE score exerted significant influence on live birth rate(P < 0.05) and TE score was the primary factor of live birth rate. Conclusions Day 5 vitrified blastocysts with higher quality of ICM and TE can provide high live birth rate and low pregnancy loss rate,but it could not predict the weight and gender of the newborn.

Objective:To investigate efficacy of modified expander in the treatment of non-extraction patients with Angel Ⅰ maloccul-sion.Methods:1 4 Angel Ⅰcases aged 1 0 -1 4 years treated by non-extraction and fixed rapid expander.Jaw bones of the cases were laser scanned before(T1 )and after treatment(T2).The differences of arch width and length between T1 and T2 were analyzed.The In-dex of treatment complexity,outcome and need(ICON)was used to assess the pre-treatment and post-treatment study models.Data were statistically analysed with SPSS1 3.0 software.Results:The arch width increased significantly from T1 to T2.Good occlusal rela-tionship and soft tissue profiles were achieved in all cases.All cases were evaluated as greatly improved by ICON.Conclusion:AngelⅠ malocclusion can be treated successfully by increasing arch width with fixed rapid expander technique without tooth extraction.

Objective Liver dysfunction is a common complication of hyperthyroidism [ mainly Graves’ disease(GD)], that may restrict the choice as well as affect the ultimate outcome of treatment. The purpose of this study was to describe the clinical and biochemical patterns in patients suffering from Graves’ disease and liver dysfunction and to determine influential factors. Methods A total of 1 928 patients received radioactive iodine, 131 I treatment. Before 131 I therapy, 24 h radioactive iodine uptake of thyroid(24 h RAIU), serum free triiodothyronine (FT3 ), free thyroxine( FT4 ), sensitive thyroid-stimulating hormone( sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroglobulin antibody(TgAb), anti-thyroid peroxidase antibody(TPOAb), and serum hepatic function parameters etc were performed. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ2 test, logistic regression, and Pearson bivariate correlation. Results Ages, the course of Graves’ disease, the weight of thyroid, FT4 , TPOAb, and TRAb in Graves’ disease patients complicated with liver dysfunction were higher than those in patients with normal hepatic function, as shown in table 1. The influential factors including age, course of Graves’ disease, heart rate, weight of thyroid, FT4, 24 h RAIU, TgAb, TPOAb, and TRAb. 24 h RAIU were the protecting factors. Age, course of Graves’ disease, heart rate, weight of thyroid, FT4 , TRAb, and TPOAb were the risk factors. Conclusion The risk of liver dysfunction in patients with Graves’ disease was increased in the following cases: age over 45 years, heart rate above 90 bpm, weight of thyroid more than 35 g, course of Graves’ disease longer than 3 years, FT4 greater than 70. 5 pmol/ L, TPOAb above 360 IU/ ml, and TRAb above 15 IU/ L. In these coses 131 I therapy will be recommended.

Objective To identify clinical features of papillary thyroid microcarcinoma(PTMC) according to patients' age.Methods Seventy-eight patients with PTMC were divided into 2 groups according to age:≥45 years and ＜45 years.The clinical data were retrospectively analyzed.Results The average preoperative thyroglobulin (Tg)level in ＜45 years group was apparently higher than that in ≥45 years group[(138.61 ± 91.87 vs 80.20 ± 85.00) μg/L,P＜0.01].The average tumor size in ＜45 years group was apparently larger than that in ≥45 years group [(0.64 ± 0.24 vs 0.45 ± 0.25) cm,P＜0.01].There were more patients with multiple cancer foci in ＜45 years group than in ≥45 years group (73.53％ vs 45.45％,P＜0.05).And there were more patients with cancer in bilateral lobes in ＜45 years group than that in ≥45 years group(44.12％ vs 18.18％,P＜0.05).There were no significant differences in preoperative thyroid stimulating hormone level,preoperative thyroglobulin antibody (TgAb)level,incidence of capsular invasion of cancer,neck lymph nodes involvement,distant metastasis,and backgrounds of benign thyroid diseases between two groups (all P＞0.05).Conclusion The patients with PTMCs had different clinical features according to age.Hence,clinicians should consider an individualized treatment according to age in order to achieve better therapeutic efficacy.

Among several intraoral distalizing devices,the pendulum appliance is one of the most commonly used noncompliance appli-ances.It is widely used to correct Class Ⅱ molar relationship.More healthy teeth can be preserved with the using of pendulum appliance in the tooth extraction of borderline cases.The pendulum appliance was modified and used in clinic.Long-term observasion showed that the modified pendulum appliace is effective in orthodontic treatment.