Thyroid autoantibodies (TAA) in euthyroid women were associated with several adverse pregnancy outcomes,such as miscarriage,preterm birth.Maternal TAA frequently results in transient mild elevation of serum TSH above the normal reference value in women during pregnancy and in infants born in the first month of life,and may affect neuropsychological development of their offspring.The cause is still unclear.Medical interventions on TAA involve levothyroxine or selenium supplementation. The article reviews the effects of maternal thyroid autoantibodies on pregnancy outcomes,as well as on neonatal thyroid status,and neuropsychological development of the fetus and neonate,and summarizes therapeutic strategies used to intervene maternal thyroid autoimmunity.

Surgery is now still the first choice for treatment of thyroid cancer.Long-term post-operative follow-up and thyroid hormone treatment are of great importance in reducing recurrence,early detection of metastases or recurrence,and improving patients' quality of life.This article reviews the recent advancement in post-operative follow-up and hormone treatment in thyroid cancer patients.

Objective To assess the prevalence,development and prognosis of thyroid disorders in adult healthy subjects aged over 60 years.Methods We performed a cross-sectional study in 1999 and a 5-year follow-up study in 2004.A total of 102 men and 147 women aged 60 to 88 years from rural communities in north China were studied.Serum thyrotropin(TSH),thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)were determined by an immunochemiluminometry assay in all participants.Free triiodothyronine(FT_3)and free thyroxine(FT_4)were determined in subjects with abnormal TSH results.Results We dropped the reference range for TSH into 0.28~4.75 mU/L.The prevalence of thyroid dysfunction,positive TPOAb and TgAb was 10.84%,12.85%and 11.65%,respectively.six newly diagnosed patients were found in the follow-up study,3 cases(all women)with hypothyroidism and 3(all men)with hyperthyroidism.Conclusion The high prevalence of thyroid dysfunction in the elderly indicates screening is necessary.Most elderly patients with subclinical dysfunction can recover spontaneously.The strategy should be focused on whether we monitor these patients.

OBJECTIVE:To investigate the effects of mannitol combined with dexamethasone on related indexes of patients with infectious brain edema.METHODS:A total of 120 patients with infectious cerebral edema were divided into control group (60 cases) and observation group (60 cases) according to therapy plan.Control group was given Furosemide injection 20 mg+20％ Mannitol injection 1 g/(kg,time)+0.9％ Sodium chloride injection 10 mL intravenously,every 6 h,3 days later adjusting drug dose according to the disease condition of patients.Observation group was given Dexamethasone injection 10-20 mg+20％ Mannitol injection 1 g/(kg·time)+ 0.9％ Sodium chloride injection 10 mL intravenously,every 6 h,3 days later adjusting drug dose according to the disease condition of patients.A treatment course lasted for 7 d,and both groups were treated for 2 courses of treatment.The levels of NO,IL-1 and TNF-α,mortality and the occurrence of sequelae before and after treatment as well as the occurrence of ADR were observed in 2 groups.RESULTS:Before treatment,there was no statistical significance in the levels of NO,IL-1 or TNF-α between 2 groups (P＞0.05).After treatment,the levels of NO,IL-1 and TNF-α in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).The incidence of mortality,sequelae and ADR in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:Mannitol combined with dexamethasone can reduce inflammatory factor level,the incidence of sequelae and mortality,without increasing the incidence of ADR.

Objective To investigate the expression of proteinase active receptor 2(PAR2)protein in hepatocellular carcino-ma(HCC)and portal vessel tumor thrombosis(PVTT)to evaluate its clinical value.Methods Immunofluorescence,RT-PCR and Western blot were used to examine the expression of PAR2 protein in cancer tissue,tumor thrombosis and cancer-adjacent normal tissue from 21 patients with HCC.Results The expression pattern of PAR2 protein was different cancer tissue and cancer-adjacent normal tissue.PAR2 labeling index was significantly higher in cancer tissue and PVTT than cancer-adjacent normal tissue(P <0.05).Although PAR2 labeling index was lower in cancer tissue than in tumor thrombosis,no statistical significance was observed in PAR2 labeling index between them(P >0.05).Conclusion PAR2 is over-expressed in HCC and PVTT.PAR2 expression is re-lated with the development and progression of HCC.

Objective:To study the expression and correlation of tumor-associated macrophages(TAM) and CCL5 in ganstric cancer.Methods:48 cases patients with completed clinical and pathological data of gastric cancer paraffin block specimens were select-ed.Cancer tissues and adjacent tissues were used as control,using SP immunohistochemical method to detect CD68 and CCL5 in gastric cancer tissues and adjacent tissues,and using the Spearman correlation statistics statistical methods for the correlation.Results:CD68 and CCL5 showed positive expression in gastric cancer tissue,significantly higher than those in the adjacent tissues(P<0.01),CD68 and CCL5 were related with gastric cancer invasion depth, lymph node metastasis, TNM stage and tumor differentiation ( P<0.001 ) . There was positive relation between the expression of CD68 and CCL5 in gastric cancer(P<0.01,r=0.759).Conclusion: CD68 and CCL5 played a driving role to the invasion and metastasis of gastric cancer occurrence,suggesting that the secretion CCL5 by TAM may promote the invasion and metastasis of gastric cancer.

BACKGROUND:Immunotherapy with autologous immune cel s has been developed as a major adjuvant therapy for malignant tumors, but its mechanism of action has not been elucidated. OBJECTIVE:To investigate the relationship between cytokine-induced kil er cel secretion and apoptosis in human liver cancer stem cel s. METHODS:Human liver cancer stem cel s, HepG2 cel s, were isolated and enriched using serum-free suspension method. The peripheral blood mononuclear cel s from patients with liver cancer were induced byγ-interferon, CD3 monoclonal antibody and recombinant human interleukin-2 to form kil er cel s. Passage 1 liver cancer stem cel s were divided into control group (culture alone) and experimental group (co-culture of cytokines-induced kil er cel s and human liver cancer stem cel s). At 48 hours after culture, apoptosis in human liver cancer stem cel s was detected using flow cytometry, and expression of caspase-3 mRNA and protein was detected using RT-PCR and western blot, respectively. RESULTS AND CONCLUSION:The apoptotic rate in the control group was significantly lower than that in the experimental group (P<0.05). The expressions of caspase-3 at mRNA and protein levels were both higher in the experimental group than the control group (P<0.05). Experimental findings show that cytokines-induced kil er cel s can significantly promote apoptosis in human liver cancer stem cel s, and up-regulate the caspase-3 mRNA and protein expressions dramatical y.

Objective To investigate the association of serum leptin (LEP) levels during the first postpartum year with the occurrence of postpartum thyroiditis (PPT).Methods Fifty-seven PPT patients consisted of 34 with overt PPT and 23 subclinical PPT.37 healthy postpartum women were used as controls.Serum samples were obtained at 4 postpartum date points,i.e.3-days and 3,6,12-months postpartum.LEP level was determined by radioimmunoassav.Results Compared with control women,PPT patients were maintaining significantly higher levels of LEP and LEP/body mass index (BMI) ratio during the first postpartum year.There was no significant difference in serum LEP level or LEP/BMI ratio between overt PPT and subclinical PPT groups.In PPT patients,LEP and LEP/BMI ratio were negatively correlated with serum TSH,and positively correlated with serum FT4 and FT3.Conclusion Sustained high levels of serum LEP after delivery may favor the occurrence of PPT.Further studies are needed to clarify the specific role played by LEP in PPT.

A total of 1 870 patients who had undergone thyroidectomy were investigated.The mean TSH level in patients with differentiated thyroid cancer (DTC) was significantly higher than that in patients with benign thyroid nodules[(1.95±1.69 vs 1.40±1.98)mIU/L,P＜0.01].DTC patients who had lymphatic metastasis or the diameter of tumor more than 10 mm had higher serum TSH level.Serum thyrotropin is an independent risk predictor for DTC.

ObjectiveTo investigate the cumulative incidence of persistent hypothyroidism in patients who were diagnosed as postpartum thyroiditis ( PPT),and to determine the factors associated with the development of persistent hypothyroidism in those patients.MethodsThe present study was performed as the continuous study followed by the former epidemiological survey on PPT,in which 58 patients with PPT (35 overt PPT and 23 subclinical PPT) were diagnosed.The 58 patients were followed up at 12th month postpartum,and then for every 6 months until 24 months postpartum.Fasting blood samples were taken for testing serum TSH,thyroid peroxidase antibody ( TPOAb),and thyroglobulin antibody ( TgAb ).Free T3 ( FT3 ),free T4 ( FT4 ),and TSH receptor antibody ( TRAh ) were detected if TSH was abnormal.50 healthy postpartum women were used as control group.ResultsOf the total 58 PPT patients,91,4％ ( n =53 ) were successfully followed.Five patients with overt PPT and 6 patients with subclinical PPT developed persistent hypothyroidism,and the cumulative incidence of persistent hypothyroidism in the studied PPT patients was 20.8％.Among 15 PPT patients who had a classical biphasic course (a thyrotoxic phase followed by a hypothyroid phase),persistent hypothyroidism was seen in 26.7％ (n =4 ).Among 11 PPT patients with hypothyroidism only,persistent hypothyroidism was seen in 63.6％ ( n =7).On the contrary,none of the patients with thyrotoxicosis only had persistent hypothyroidism.All of the patients who developed persistent hypothyrodism had a higher TSH levels than 4.8 mU/L at 6th month postpartum.Before delivery,TSH levels of the patients developed persistent hypothyroidism were significantly higher than those of the patients with transient hypothyroidism,and this was the case at the 12th month postpartum ( all P＜0.01 ).PPT patients maintained a relatively higher rate of thyroid autoantibodies.The positive rate of TPOAb at the 12th,18th,and 24th month postpartum was 56.6％,50.9％,and 52.8％,respectively; and the positive rate of TgAb being 35.8％,30.2％,and 30.2％,respectively.Both the positive rate and titer of TPOAb in patients with overt PPT were higher than those in patients with subclinical PPT at the 18th and 24th month postpartum (P＜0.05).Conclusions 20.8％ patients with PPT developed persistent hypothyroidism at the 24th month postpartum.Whether a patient with PPT would develop persistent hypothyroidism depends on his clinical feature and TSH level.