Objective To elucidate the effect of multi-kinase inhibitor sorafenib on anaplastic thyroid carcinoma cells in the presence or absence of metformin.Methods SW1736 and C643 cells were treated with sorafenib in the presence or absence of metformin for various periods of time.Cell viability was detected by MTT.Cell cycle and cell apoptosis were measured by flow cytometry.Caspase-3 activity was detected by colorimetric kit.Western blot was used to analyze pERK phosphorylation and cyclinD1 expression.Results Sorafenib inhibited the growth of anaplastic thyroid carcinoma cells and induced cell cycle arrest and cell apoptosis.The EC50 of sorafenib in SW1736 and C643 was 3.68 μmol/L and 4.87 μmol/L respectively.After sorafenib ± metformin treatment,the caspase3 activity was 131.5 ％ and 278.0％ (P＜0.01) in SW1736 cells,127.2％ and 196.6％ (P＜0.01) in C643 cells.On the molecular level,sorafenib inhibited the phosphorylation of ERK and decreased the expression of cyclinD1.Metformin amplified the growth inhibitory effect of sorafenib on anaplastic thyroid carcinoma cells.The cell viability was 0.76 ± 0.17 and 0.30 ± 0.04 (P＜0.01) in SW1736 cells,0.72 ± 0.09 and 0.34 ± 0.10 (P＜0.001) in C643 cells after 2.5 μmol/L sorafenib without or with 5 mmol/L metformin treatment.Conclusions The combination of sorafenib and metformin may be a potent strategy for the treatment of anaplastic thyroid carcinoma and other advanced cancers.

AIM:The polysaccharides of Hedyotis difusa Willd of different sources were extracted and its content and composition of the polysaccharide was analyzed. METHODS: The microwave was employed for the aqueous extract of Hedyotis difusa Willd and the content of total sugar was determined by phenol-sulfur test,the monosaccharides composition was determined by HPLC with pre-column derivatization. RESULTS: The polysaccharide obtained from the samples of Guangdong Province had the highest content.The analytic data showed that the composition of monosaccharides in hydrolytic polysaccharides of Hedyotis difusa Willd were mannose,glucose,galactose,arabinose and rhamnose,the average content of polysaccharides was 9.82%. CONCLUSION: The HPLC method with pre-column derivatization is appropriate for the analysis of monosaccharide composition of Hedyotis difusa Willd polysaccharides and the method is simple,quick and accurate.

Objective To investigate the diagnostic value of multi -modal MRI for prostate cancer .Methods The multi modalitymagnetic resonance data of 43 patients with prostatic diseases were retrospectively analyzed ,selected biopsy or operation pathology results as the control ,analyzed their unenhanced MRI ,DWI,MRS and DCE -MRI. Results (1)In 43 patients,29 cases were diagnosed by biopsy of prostate cancer .37 cancer lesions were found,and 28 cancer lesions showed obviously low signal intensity in T 2WI.(2)The mean ADC value of the cancer lesions and normal areas were (0.69 ±0.09) ×10 -3 mm2/s and (1.31 ±0.18) ×10-3 mm2/s,there was significant difference in ADC value between the two groups (t=21.06,P<0.01);(3) The mean Cho +Cre/Cit value of the cancer lesions and normal areas were (2.67 ±1.58) and (0.74 ±0.28),there was significant difference in ADC value between the two groups (t=7.34,P<0.01);(4)32 rapidly ascending and slowly descending type ROI's,4 flat type ROI's and 1 rising type ROI's were founded in cancer lesions .Conclusion Multi-modal MRI can further provide the blood perfusion of prostate cancer ,water molecule diffusion and microcirculation state ,metabolism and biochemical composi-tion change information .The combination of T2WI,DWI,MRS and DCE-MRI can improve the diagnostic efficiency for the detection of prostate cancer prominently .

[Summary] Lifestyle intervention is one of the important strategies for the prevention of type 2 diabetes. Recently, caloric restriction regimen has become a hot topic as one of the cornerstone of lifestyle intervention. The alternate day fasting regimen is simple, and increases the patient compliance. Both daily calorie restriction and alternate day fasting regimen can reduce body-weight significantly in pre-diabetes subjects, and reduce the visceral fat mass and the fasting insulin levels, and improve the insulin sensitivity, as well as maintain the lean mass, though the effect on fasting blood glucose was not significant. Nevertheless, the most recent studies have demonstrated that daily calorie restriction,in particular, alternate day fasting regimens can be effective in individuals with pre-diebates in order to prevent type 2 diabetes.

Lithium carbonate is a fundamental drug used in the management of acute mania and prophylaxis of bipolar disorders.It has been found that some patients on lithium carbonate therapy developed hypothyroidism.Therefore,this medication becomes a second-line choice for the treatment of patients with hyperthyoidism,though no standardized protocol has been approved.It remains worthwhile to investigate the efficacy and safety profiles of lithium carbonate in the management of hyperthyroidism.

Objective To investigate the effect of 17β-estradiol on the proliferation of thyroid stem/ progenitor cells.Methods In thyroid stem/progenitor cells derived from nodular goiters,the effects of 17 β-estradiol on thyrosphere formation,estrogen receptor (ER) expression,cyclin D1 expression,and mitogen activated protein kinase (MPAK) pathway were analysed by BrdU ELISA,conventional and realtime PCR,immunofluorensence staining,and Western blot.Results 17β-estradiol induced thyrosphere formation and proliferation of thyroid stem/ progenitor cells.ER-α and ER-β were expressed in thyroid stem and progenitor cells with higher mRNA expression level of ER-α compared to differentiated thyrocytes (8.85-±0.81 vs 1.10 ±0.35,P＜0.01).Stimulation by 1 mmol/L 17β-estradiol increased cyclin D1 mRNA expression and ERK phosphorylation levels,which was blocked by an ER antagonist,ICI 182780.Conclusion Estrogen stimulated the growth of stem cells derived from thyroid nodules via estrogen receptor,suggesting the relevance of increased thyroid stem cell proliferation with higher prevalence of thyroid nodules in women.

Objective To express and purify Chlamydial protease-like activity factor(CPAF)from Chlamydophila pneumoniae,for investigating the effect of its recombinant protein GST-CPAF in inducing human monocytic cells to secrete proinflammatory cytokines and cell apoptosis.Methods The recom-bination expression plasmid pGEX6p-2/CPAF from Chlamydophila pneumoniae was transformed into E.coli.The recombination GST-CPAF was expressed after induction by IPTG,and purified by a agarose gel FF.Human monocytic cells were stimulated by the GST-CPAF to test the production of tumor necrosis factor a(TNF-α)and interleukin-6(IL- 6)by ELISA.Inhibition of cells proliferation with GST-CPAF was assessed by MTT.The THP-1 cell apoptosis stimulated by GST-CPAF was detected by Hoechst33258 fluorescence staining,DNA fragmentation analysis and cell apeptosis was detested bv Annexin V-FITC-propidiuum iodide (PI)staining.Results The recombination protein GST-CPAF was successfully expressed with high level in E.coli,and stimulated human monocytic cells to produce proinflammatory cytokines including TNF-α and IL-6 in a dose-and time-dependent manner.Otherwise,the GST-CPAF inhibited the growth of human monocytic cell in a dose-dependent manner.Apoptosis with nuclear chromatin fragmentation as well as cell shrinkage was observed by fluorescent staining and microscopy,DNA ladders in apoptosis cells were detected after 24 h with the GST-CPAF.Conclusion The GST-CPAF from Chlamydophila pneumoniae can induce the secretion of proinflammatory cytokines TNF-α and IL-6 by human monocytic cells,and inhibited the proliferation of THP-1 cell and apoptosis in vitro.

Continuing medical education refers to the completion of basic medical education for inservice education,which is to guarantee the sustainable development of physicians in clinical and scientific research ability,and is the essential means to safeguard and improve the level of medical treatment.Traditional continuing medical education is given priority to the form of regularly organize workshops,so it has some limitations to oral and maxillofacial surgery.MOOC teaching is a kind of large-scale open new online teaching mode.This study provides an overview of the MOOC development,characteristics and development situation in the medical teaching.The necessity and feasibility of MOOC based teaching protocol in oral and maxillofacial surgery continuing medical education has been discussed.And curriculum transformation,construction of education model and possible challenges have also been analyzed and discussed in this paper.

Objective To evaluate the safety of Renaissance spine robot assisted system in spinal injury.Methods From March 2014 to May 2016,38 patients with spinal disease received spinal surgery assisted by spine robot system.They were 20 males and 18 females,with an average age of 42 years (range,from 12 to 69 years).There were 10 lumbar fractures,8 thoracic fractures and 20 spinal deformities.Pedicle screw implantation was conducted in 30 patients (PS group) and percutaneous vertebroplasty in 8 (PV group).One side was chosen randomly to use Mazor spine robot assisted system (assisted group) and the opposite side the conventional method (non-assisted group).The anteroposterior and lateral X-rays and CT scan of the lumbar and/or thoracic spine were performed in all patients after surgery.The precision of pedicle screws implantation in PS group was evaluated by the Abul-Kasimhierarchy grading system;location of the puncture trajectory,time used for puncture and radiation exposure time in PV group were evaluated.Results 208 pedicle screws were implanted in PS group,including 120 lumbar ones and 88 thoracic ones.For lumbar pedicle screw implantation,the excellent to good rate was 95.0％ (57/60) in the assisted group,significantly higher than that in the non-assisted group (80.0％,48/60) (P ＜ 0.05).For thoracic pedicle screw implantation,the excellent to good rate was 95.5％ (42/44) in the assisted group,significantly higher than that in the non-assisted group (77.3％,34/44) (P ＜ 0.05).There were 24 puncture trajectories in 8 patients in PV group,showing no pedicle penetration or cement leaking in any case.The mean time used for puncture was 5.5 ± 1.4 min in the assisted group,significantly shorter than that in the non-assisted group (17.8 ± 7.5 min) (P ＜ 0.05);the X-ray exposure time was 14.0 ± 4.0 s in the assisted group,significantly shorter than that in the non-assisted group (22.4 ± 6.0 s) (P ＜ 0.05).Conclusions Renaissance spine robot-assisted system deserves more clinical application,because in spinal surgery it can make pedicle screw implantation more precise and safer,and can reduce operation time and X-ray exposure time in percutaneous vertebroplasty.

Objective:To explore the effects of traditional Chinese medicine nursing protocols for type 2 diabetes mellitus on the level of frailty and self-management in patients with type 2 diabetes mellitus, so as to provide new ideas for intervention of diabetic frailty and improvement of self-management.Methods:From January 2021 to June 2021, the 100 patients with type 2 diabetes mellitus in the department of Endocrinology of the First Affiliated Hospital of Anhui University of Chinese Medicine were treated with the traditional Chinese medicine nursing protocols for type 2 diabetes mellitus issued by the State Administration of Traditional Chinese Medicine using the quasi experimental research method. General information questionnaire, Tilburg Frailty Indicator(TFI), Summary of Diabetes Self-Care Activities (SDSCA), Chinese-Diabetes Management Self-Efficacy Scale(C-DMSES) and the effect evaluation scale of traditional Chinese medicine nursing protocols for diabetes mellitus (type 2 diabetes mellitus) were investigated on 1 to 2 days after admission, at discharge, 3 months after discharge and were analyzed by t test, analysis of variance, SNK test. Results:The TFI scores of patients were (4.90 ± 2.44), (3.89 ± 1.99), (3.43 ± 2.22) points, the SDSCA scores were (41.31 ± 14.30), (57.90 ± 12.73), (52.33 ± 12.71) points, the C-DMSES scores were (128.99 ± 32.18), (154.69 ± 25.43), (141.27 ± 27.86) points, the effect scores of traditional Chinese medicine nursing protocols for type 2 diabetes mellitus were (13.40 ± 6.02), (6.98 ± 5.04), (5.01 ± 3.96) points at 1-2 days after admission, discharge, and 3 months after discharge, there were statistically significant differences among different time periods ( F values were 11.14-72.50, all P<0.05). The fasting blood glucose and 2-hour postprandial blood glucose of patients were (9.28 ± 3.51), (7.16 ± 1.66), (7.24 ± 1.76) mmol/L and (14.93 ± 4.22), (10.28 ± 4.83), (10.30 ± 2.25) mmol/L at 1-2 days after admission, discharge and 3 months after discharge, and the differences were statistically significant ( F = 21.02, 37.55, both P<0.05). Conclusions:The implementation of traditional Chinese medicine nursing protocols for type 2 diabetes mellitus can delay the degree of frailty of type 2 diabetes mellitus, improve the level of self-management of patients, help patients control blood glucose, with good traditional Chinese medicine nursing effect, worthy of clinical application.