The second part of (2008 edition)includes iodine deficiency disease,thyroditis and thyroid nodule.This guideline reaffirms the epidemic characteristics,the prevention and the management of iodine deficiency disease.It identifies the measurement of iodine nutritional status and the necessity of iodinized salt.It emphasizes the regular diagnosis and treatment of subacute and chronic thyroiditis,and also mentions the advancement on differential diagnosis and rational therapy of thyroid nodules.In addition,it gives some advices on the management of thyroid nodules in two special groups(pregnant women and children).

Thyroid-associated ophthalmopathy(TAO)is an organ specific autoimmune disorder affecting the life quality of patients.Glucocorticoids have been applied for many years in the treatment of TAO,though the side effects are the major concern.Recently,intravenous methylprednisolone pulse therapy is a novel and effective method for TAO treatment.Nevertheless this new strategy needs to be modified,and attention should be paid to the indications and contraindications in order to prevent liver damage when high dose methylprednisolone is applied.

Severe aplastic anaemia is a marrow failure syndrome characterized by pancytopenia and hypocellular bone marrow.Immunosuppressive therapy(IST)consisting of antithymocyte or antilymphocyte globulin (ATG) and cyclosporine has been recommended for children lacking HLA-matched sibling donor.For children unresponsive to initial immunosuppressive therapy or those who relapsed after first immunosuppressive therapy,they can choose repeat course of immunosuppressive therapy,allogeneic hernatopoietic stem cell transplantation,new drugs or clinical trials.And the prognosis has been greatly improved in recent years,dueing to the development of allogeneic hematopoietic stem cell transplantation and the application of new drugs such as eltrombopag.This article reviews researches advance in different therapies for children with relapsed or refractory severe aplastic anaemia,aimed at guaiding treatment methods.

Taking the characteristics of Indian students into account,teaching quality can be improved by these means:thorough preparation before class,various application for teaching,mutual and interactive communication and inspiration.

Objective To introduce the surgical technique and results of total mesorectal excision (TME) for rectal cancer. Methods　Reviews.Results　As a result of TME, local recurrence rates have declined from 20%-30% to 3%-8%, 5-year survival rate have risen to 75%, and the rates of sphincter preservation have risen too.Conclusion　Total mesorectal excision reduces the local recurrence rates and raise the survival figures after excision of rectal cancer. Patients have a high quality of life.

Objective To study the chemical constituents from the fungal fruiting bodies of Ganoderma sinense.Methods Individual constituents,isolated and repeatedly purified on silica gel and Sephadex LH-20 column chromatography,were identified by physicochemical constants and structurally elucidated by spectral methods.Results Four compounds were isolated and identified as: sinensoic acid(1),cerebroside D(2),poke-weed cerebroside(3),hemisceramide(4).Conclusion Compound 1 is a new compound,others are isolated from the fungus of Ganoderma for the first time.

Objective:To study the effect of sertraline plus cognitive behavior therapy in treatment of panic disorder Method:14 outpatients with panic disorder according to crteria of CCMD-2-R were collected as our sample All of them were given sertraline 50 mg/d for 6 months in addition to cognitive behavior therapy The clinical effect was assessed at the end of 1 month,3 months and 6 months Results:At the end of 1 month,3 patients were assessed as markedly improved,9 as improved At the time of 3 months,10 patients were assessed as markedly improved,2 as improved At the end of 6 months,12 markedly improved,2 improved There were 3 patients had mild side effects,which faded with time Conclusion:Sertraline plus cognitive behavior therapy has good effect in treatment of panic disorder with good compliance and little side effect

Insulin deficiency is a key factor involved in the pathogenesis of diabetes. Apoptosis is one of the reasons for the lose of islets. The whole process of apoptosis is quite complex. This article summarizes the role of several factors such as glucose, free fatty acid, GLP-1, and in the islets apoptosis.

Exendin-4,a peptide analogue of glucagon-like peptide-1(GLP-1),is presently in clinical trials as a therapy for type 2 diabetes mellitus.Exendin-4 selectively acts on GLP-1 receptors,which are coupled to the cAMP nucleotide second messenger pathway to enhance the survival and plasticity of neurons in the brain.Exendin-4 has potent effects on homeostasis of Ca2+,on multiple targets to block apoptotic signaling pathways,and on neuronal proliferation and differentiation.It has also been demonstrated to possess properties against oxidative stress and excitotoxicity.In this review the functions of exendin-4 on central nerve system and the potentia therapeutic effects on neurodegenerative diseases will be involved.

[Summary] Epidemiologic evidence favors strong correlations between low thyrotropin(TSH) and high bone turnover, low bone mineral density ( BMD), and high fracture risk in hyperthyroid patients. Even subclinical hyperthyroidism, in which TSH is low and thyroid hormones are normal, is associated with osteopenia and osteoporosis. These evidences indicate that action of TSH on bone metabolism is independent of thyroid hormones and thus support the theory of the pituitary-bone axis. TSH plays its osteoprotective effect by binding TSH receptor on osteoclasts and inhibiting TNF-α expression. Physicians should screen the BMD in patients with overt and subclinical hyperthyroidism, especially the elderly, and make early diagnosis and better management for the underlying osteopenia and osteoporosis.