Metabolic syndrome is on the rise in China. An improved understanding of the criteria for the diagnosis of this syndrome will lead to important questions for the population in China. The progression of this syndrome to type 2 diabetes mellitus(DM) is a dreaded outcome that may be prevented. Once DM is established,knowledge of the current therapeutic approaches is required.

The endocrine system with the normal aging is characterized by a progressive loss of reserve capacity,resulting in a decreased ability to adapt to environmental demands.This loss of homeostatic regulation reflects important alterations in hormonal synthesis,metabolism,and action.However,these changes may have no significant clinical manifestations,especially under non-stress conditions.This review discusses the endocrine system in the elderly in general.

Thyroid cancer is the most common endocrine gland malignanct tumor. Numerous studies have found that the content of peripheral blood circulating RNA in various cancer types is aberrantly expressed, which could be a potential biological diagnostic marker and therapeutic target. Tissue-speciifc messenger RNA has a dysregulated expression and may be used for the diagnosis and residual/metastatic detection of thyroid cancer. Recent studies have showed that non-coding RNA (ncRNA) could act as oncogene or tumor suppressor gene in bacteria, fungi and mam-mals. It plays a regulatory role in occurrence and development of tumors and stably exists in peripheral blood. It is hopeful that it will become a new marker for diagnosis of tumors. This review introduces some latest research progress on circulating RNA associated with thyroid cancer; and emphatically discuss the role of mRNA, microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA) in thyroid tumorigenesis and metastasis.

Objective To speculate the contents changes and clinical significance of heme oxygenase-1(HO-1) and unconjugated bilirubin (UCB) in the patients with acute cerebral infarction.Methods HO-1 and UCB in blood serum were measured in these patients with acute cerebral infarction(ACI) and control group at one day, third day,and sixth day after the onset by ELISA and oxidation of vanadate. Results The content of HO-1 and UCB in serum decreased step by step at the first day, third day, and sixth day after the onset. The level of HO-1 displayed a positive correlation with the UCB in serum in the first day after the onset (r=0.645, P

Objective To investigate the potential association among urinary albumin excretion rate(U_(AER)), 24h ambulatory blood pressure(ABP) and erythrocyte sodium-lithium countertransport(SLC) in non-insulin dependent diabetes mellitus (NIDDM). Methods U_(AER), SLC were determined with radioimmunoassay and modified method of Canessa respectively, and 24h ABP profiles were recorded in 69 NIDDM subjects. Results NIDDM patients with increased U_(AER) had higher prevalence of hypertension and higher prevalence of abnormal circadian rhythm of blood pressure. Blood pressure(BP), particularly nighttime systolic BP was also significantly increased. U_(AER) was positively correlated to mean nighttime BP, mean daytime and 24h systolic BP, while inversely related to day-night dip in systolic BP. However, there was no significant difference in SLC between NIDDM subjects with and without increased U_(AER). Futhermore, neither U_(AER) nor all ABP indices were correlated to SLC. Conclusion Close association exists among diabetic nephropathy and increased BP and abnormal diumal BP rhythm, while either SLC and U_(AER) or SLC and BP is significantly correleted. Increased rate of SLC is not likely a marker for diabetic nephropathy in NIDDM, and it seems not to be involved in the pathogenesis of diabetic hypertension.

Objective In order to select appropriate size of embolizing granules and to achieve complete embolization and good therapeutic effect, the diameters of thyroid arteries in Graves disease was measured. Methods Multiple slides of embolized thyroid tissues from superior pole, body and inferior pole of resected thyroid glands were made. After being embeded and stained, diameters of arteries in various parts of thyroid glands were measured with microscope calipers (Olympus). Results Average diameter capillary network of the thyroid body gland adjacent to superior, infreior artery was 0. 12-0. 25 mm, and the smallest one was 0. 04-0. 11 mm. The diameter of isthmus was 0. 130. 15 mm. The average diameter of superior and inferior artery was 2- 5. 5 mm and 3. 0- 3. 75 mm measured by using interventional angiography Conclusion According to the diameters of arteries which were measured, complete embolization and good therapeutic effect can be achieved.

Objective To study the pathological morphology of thyroid specimen after thyroid arteries embolization. In order to select appropriate size of embolizing granules, the diameters of thyroid arteries in Graves' disease were measured. Methods Multiple slides of embolized thyroid tissues from superior pole, body and inferior pole of the resected thyroid glands were made. After being embedded and stained, pathological morphology was observed and diameters of arteries in various parts of thyroid glands were measured under microscopy. Results Pathological examination of thyroid glands showed that superior and inferior thyroid arteries and most of their branches were embolized with ischemic necrosis and fibrosis in the embolized thyroid tissue. Follicular epithelium appeared as flat or cubic shapes with colloid reduction. Average diameter of main branches of superior artery was 440～550?m and that of inferior artery was 300～375?m. The diameters of capillary network in the thyroid body was 120～250?m, and the non embolized ones was 40～110?m. The diameter of isthmus was 130～150?m. Conclusions Pathological morphology of Graves' disease after thyroid arteries embolization showed that the excretion of thyroid glands would be decreased and equivalents to subtotal thyroidectomy.

Objective To study clinical characteristics,causes of misdignosis and diagnostic and therapeutic methods for primary hyperparathyroidism (PHPT).Methods Retrospective analysis was done for 51 patients of PHPT,47 confirmed by biopsy after surgical operation and 4 without operation diagnosed based on their serum levels of calcium,alkaline phosphatase ( ALP),intact parathyroid hormone ( iPTH ),and computed tomography (CT) or 99mtechnetium sestamibi (99mTcMIB1) imaging at the First Affiliated Hospital of Sun Yat-sen University,Guangzhou during June 1997 to November 2010.Results Bone-related complications were the most common clinical manifestation,accounting for 51％ (26/51 ) of the cases,and adenoma,a benign,enlarged and hyperactive parathyroid gland,in 34 of 47 cases ( 72％ ).In orthotopic lesions,the right inferior was affected in 19 of 46 cases (41％),followed by the left inferior in 13 cases (28％),while 5 of 51 cases (10％) with ectopic parathyroid gland.PHPT was easily misdiagnosed as urolithiasis,rheumatic disease,primary osteoporosis,etc,accounting for 92％ of the cases in our study.Preoperative serum levels of calcium,ALP and iPTH in the patients varied with their clinical type and pathological classification,the highest in patients with urolithiasis-bone-related complications [ (3.22 ±0.35) mmol/L,(1455 ± 1091 ) U/L and (1669 ± 515 ) ng/L,respectively ] and in patients with parathyroid carcinoma [ (3.46 ± 0.40) mmol/L,( 1410 ± 426) U/L and ( 1861 ± 768) ng/L,respectively ].Sensibility of preoperative localization diagnosis using ultrasonography,CT and 99mTcMIBI was 88％ (35/40),97％ (30/31) and 97％ (31/32),respectively.Conclusions PHPT is frequently misdiagnosed as other diseases.Measurement of serum calcium should be included in routine physical examinations,supplemented with measurement of serum ALP and iPTH,as well as medical imaging,which can help avoid misdiagnosis.CT combined with 99mTcMIBI imaging can improve accuracy of preoperative localization diagnosis.

We analyzed the minus of present medical education,basing on questionnaires of 1773 medical students,including the students' participation rates in lectures of multiple fields and their demands on future lectures.We gave some pieces of advice to solve the problems as well as some references to boost our lectures.

Objective A previously reported female diagnosed with type A insulin resistance syndrome bearing a heterozygous missense mutation of R1174W in the insulin receptor gene was followed for 7 years since the age of 16 years. Methods Five-hour oral glucose tolerance tests (OGTT) were done on baseline, the 3rd, 6th and 7th year respectively, with serum insulin and C-peptide measured at the same time points. Areas under of curve (AUC) of glucose, insulin and C-peptide were compared between the years.Acute insulin response (AIR) was determined at baseline and the 7th year. The dose response were insulin secretion rates at each time point during OGTT being plotted over the corresponding glucose levels, and the slopes of which quantified the insulin secretion responding to glucose. Results The follow up data showed that the glucose metabolism of the subject did not deteriorate over time with yearly glycosylated hemoglobin A1c (HbAlc) being normal (4.6%-5.5%), and hyperinsulinemic hypoglycemia was a persistent phenomenon observed at 4-5 hours post-load. The fasting and AUCs of serum insulin and C-peptide tended to decline without simultaneously increase of those of plasma glucose. The AIR decreased by 56% as compared to baseline. The dose response curves shifted downward as years went by. Conclusions It supports that with the alleviation of physiological insulin resistance after puberty, the gross hyperinsulinemia tends to ameliorate, and β-cell secretion does not deteriorate over time as glucose homeostasis maintains.