Clinical management of radioiodine-refractory differentiated thyroid cancer (RR-DTC) is extremely diffcult. Re-differentiation compounds, such as retinoids, peroxisome proliferator-activated receptor (PPAR) agonists, DNA methyltransferase inhibitors and histone deacetylase inhibitors, have been used in trials to increase iodine uptake in RR-DTC. However, data on these drugs failed to meet the initial high expectations. In recent years, targeted agents have been increasingly used in pre-clinical and clinical studies to induce re-differentiation and mediate131I therapy, and the outcomes are encouraging.

Objective To compare the clinical effect of craniotomy versus sphenotresia drainage for treatment pa?tients with hypertensive cerebral hemorrhage. Methods Retrospective analysis the patients with hypertensive cerebral hemorrhage in our hospital, and divided into the group of craniotomy(n=39) and the group of sphenotresia drainage(n=50). The operating time, hematoma clearance rate, complications after operation and intracranial pressure at 4h, 24h, 48h, 72h, 5d and 7d after operation between the two groups were record. Results The intracranial pressure in both groups are raised gradually in the 48 h after surgery and gradually declined at 48 h after surgery. The increasing amplitude in craniotomy group is less than the group of sphenotresia drainage. Between the two groups of group, different point, and between groups and the interaction of the different point difference had statistical significance (P<0.05). The hematoma clearance rate in the group of craniotomy is less than the group of sphenotresia drainage. However, the operating time and the infection rates in the group of craniotomy is greater than the group of sphenotresia drainage, the difference is statistically significant (P<0.05). Conclusion Craniotomy can increase the hematoma clearance rate, decrease intracranial pressure as well as the oc?currence of rehaemorrhagia, however, it also will prolong operation time and increase the risk of lung infection and gastro?intestinal bleeding. It is depend on the general characteristic of patients to determine which operation methods to adopt.

Objective To study the effect of arthroscopy in conjunction with minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of tibial plateau fracture.Methods 78 cases of tibial plateau fracture patients admitted during March 2011 and June 2014 were retrospectively analyzed, with 38 cases given the conven-tional open reduction treatment (group A) and 40 given arthroscopy in conjunction with MIPPO (group B).The clini-cal efficacy, Rasmussen excellent rate and good rate, and postoperative complications in both groups were then com-pared.Results The operative time showed no significant difference in both groups (p >0.05); the time of hospital-ization, the length of surgical incision and healing time of group B were significantly better than group A (p <0.05);after follow -up observation, Rasmussen excellent rate and good rate of group B were significantly higher than group A (p <0.05).Conclusion Arthroscopic in conjunction with MIPPO has the advantages of smaller surgical wound, faster recovery and fewer complications, and have good efficacy and better clinical value for the treatment of tibial plateau fractures.

Objective To investigate the effects of hypertonic saline in the treatment of children with critical hand, foot and mouth disease (HFMD).Methods The 250 pediatric patients with HFMD hospitalized from January 2011 to Januar-y 2013 in our hospital were randomized into the control group treated routinely and the experimental group treated with hyper-tonic saline on the basis of general conventional treatment .The therapeutic effect and sodium ion concentration in the children of two groups were observed and compared.Results The treatment effect of the experimental group was obviously better than that of the control group (p<0.05).Sodium ion concentration and incidence of adverse reactions in two groups before treat-ment showed no significant differences (p>0.05), while the sodium ion concentration of the experimental group was much higher than that of the control group on the 4th and 6th treatment day (p<0.05).Conclusion Hypertonic saline treatment can significantly enhance the therapeutic effect, increase the sodium ion concentration and improve the prognosis in children with critical HFMD.Therefore, hypertonic saline treatment for patients with clinical HFMD has a very important clinical sig-nificance and it is worth popularization and application.

The standardized resident training is an important and necessary way to cultivate high-quality medical talents.The goals between clinical and imaging residents in standardized training of ultrasound department are different.For clinical residents,the purpose is to understand the ultrasound images of various common diseases,combine clinical manifestation with ultrasound images,and improve the level of clinical diagnosis and treatment.For imaging residents,the goal is much higher and stricter;they need to master solid ultrasonic knowledge,independent operational and diagnostic ability,in order to provide reliable and accurate ultrasonic diagnosis.We individually design the teaching plan and methods in ultrasound department,in order to improve teaching efficiency and quality.

At present,the technology to predict the response to neoadjuvant therapy with biomakers has been widely used in clinical practice.The approaches of biomarkers detection are various,including immunohistochemistry,detection of serum biomarkers conventional blood tests,gene expression profile analysis,single nucleotide polymorphisms,miRNAs,proteomics analysis.With the development of biotechnology,the technology of biomarkers detection is expected to become effective means in assessment of adjuvant therapy,risk,prognosis and individualization in esophageal cancer treatment.

OBJECTIVE:To analysis the application status of antibiotics in perioperative patients of our hospital.METHO-DS:The use of antibiotics in 300 perioperative patients(100 with type Ⅰ incisions and 200 with type Ⅱ incisions)from June to November in 2006 were analyzed retrospectively.RESULTS:In the patients with type Ⅰ incisions,Cephalosporins took the lead on the list of DDDs,followed by Penicillin,Nitroimidazole,FQNS,and Aminoglycosides.CONCLUSION:Physicians should have an increased awareness to the rational prophylactic use of antibiotics in perioperative patients to lower the perioperative infection rate of incisions.

Objective To investigate the relationship between gestational hypothyroidism and preeclampsia.Methods A retrospective study was conducted on 1 776 patients with gestational hypothyroidism,who gave birth in the International Peace Maternity & Child Health Hospital of China Welfare Institute,Shanghai Jiaotong University School of Medicine from January 2013 to December 2014.They were divided into three groups,including Improving Group (n=1 469),Progressing Group (n=133) and Remaining Group (n=174),based on their thyroid function at the first and third trimesters.Levels of thyroid hormones in the first and third trimesters were analyzed.Incidences of preeclampsia in those patients were calculated.And the correlation between thyroid function and incidence of preeclampsia was analyzed.T-test,Mann-Whitney U test,Chi-square test,variance analysis (SNK method) and Kruskal-Wallis H test or Logistic regression were performed for statistical analysis.Results (1) There were no statistical differences in age,gravidity and parity among the three groups.The pregestational body mass index in Progressing Group was lower than that in Improving group (21.1 ±2.9 vs 21.8±2.8,P＜0.05).(2) In the first trimester,the level of thyroid stimulating hormone (TSH) in Remaining Group was higher than those in Improving and Progressing Groups [(4.21 ± 1.69) vs (3.77±.3.03) and (2.00±0.57) mU/L,F=27.635,P＜0.01],and that in Improving Group was higher than that in Progressing Group (P＜0.05).The level of free thyroxine (FT4) in Progressing Group was higher than those in Improving and Remaining Groups [(16.18±9.67) vs (14.58± 1.71) and (14.54± 1.74) pmol/L,F=16.188,P＜0.01].In the third trimester,the TSH level in Remaining Group was higher than those in Improving and Progressing Groups [(5.07±0.86) vs (2.57±0.77) and (4.31 ±0.87) mU/L,F=28.986,P＜0.01],while the TSH level in Improving Group was higher than that in Progressing Group (P＜0.05).No statistical differences in FT4 levels (in the third trimester) and positive rates of thyroid peroxidase antibody (TPOAb) Were observed in the three groups.(3) Blood pressures (including diastolic and systolic blood pressures) in the first trimester and diastolic pressures in the third trimester showed no significant differences among the three groups.Systolic pressure of Improving Group in the third trimester was lower than that of Progressing Group [(119.4± 11.9) vs (121.8± 14.2) mmHg,P＜0.05,1 mmHg=0.133 kPa].(4) The incidence of preeclampsia in Progressing Group was higher than those in Improving and Remaining Groups [7.52％ (10/133) vs 1.29％ (19/1 469) and 3.45％ (6/174),x2=26.646,P＜0.01],and the incidence in Progressing Group was higher than those in Remaining and Improving Groups (both P＜0.05).The incidence of severe preeclampsia in Progressing Group was higher than that in Improving Group [6.02％ (8/133) vs 0.41％ (6/1 469),P＜0.05].There were no significant differences in incidences of mild preeclampsia among the three groups.(5) After adjusting for age,body mass index,gravidity and parity,the risk of severe preeclampsia in Improving Group was lower than that in Remaining Group (OR=0.233,95％CI:0.057-0.946,P＜0.05).Conclusions By improving thyroid function in pregnant women with hypothyroidism,the risk of preeclampsia,especially severe preeclampsia,could be reduced,which could improve maternal and neonatal outcomes.

Over the past decade , with the rapid increase of the incidence of idiopathic membranous nephropathy (IMN) in our country, the diagnosis and treatment of IMN has been paid more and more attention.IMN is an autoimmune disease.Two important podocyte autoantigens , PLA2R and THSD7A, have been indentified sine 2009.Subsequently , serum anti-PLA2R antibody test and anti-THSD7A antibody test have also been used in clinical .Preliminary applications show that these two tests can not only help IMN diagnosis and differential diagnosis , but also help IMN prognosis.