The outstanding progress in the molecular basis of thyroid carcinoma has offered a tool for the development of new drugs,mainly tyrosine kinase inhibitors (TKIs).A number of TKIs are now being applied to the treatment of thyroid carcinomas.Recent clinical trials of TKIs in patients with advanced thyroid cancer have shown some promising preliminary results.This review summarizes the most relevant achievements in the field and the challenges we are facing.

Objective To explore the efficacy and safety of the donepezil hydrochloride in the treatment of post-stroke aphasia.Methods 60 patients with post-stroke aphasia were divided randomly into donepezil hydrochloride group (30 cases) and control group (30 cases).Trail group patients were received 5 mg per time,and once a day for oral administration of 2 weeks.From the third week they were received 10 mg per time,once a day,for continuous 10 weeks,and finally implemented four weeks washout period.The control group patients were received conventional treatment of neurology.The language function of patients were assessed with the Western Aphasia Battery (WAB) and the adverse reactions after treatment were evaluated by Treatment Emergent Symptom Scale (TESS).Assessments were implemented at the three time points,the start of trail,12 weeks,a washout period of 4 weeks.Results After 12 weeks of treatment,the AQ,PQ,CQ scores of WAB in the experimental group were (91.35±8.14),(32.74±8.12),(91.53±7.89).After 4-week washout period,they were (94.69±5.21),(33.70±4.94),(93.33±5.59) respectively.After the trail for 12 and 16 weeks,the score of each WAB item in the trail group was significantly higher than that before treatment.Compared with the control group,there was significant difference between the two groups(P＜0.01).The trail group had no significant adverse reactions.Conclusion Donepezil hydrochloride in the early treatment of post-stroke aphasia is safe,effective and the therapeutic effect is stable.

Objective To investigate the clinical efficacy of Qingzhuo Qudu Pills combined with acupuncture in treating chronic nonbacterial prostatitis and to explore the possible molecular mechanism. Methods A total of 160 cases of chronic nonbacterial prostatitis were randomly divided into western medicine group, Chinese medicine group, acupuncture group and combined group, 40 cases in each group. The western medicine group was given Tamsulosin and Celecoxib tablets orally, Chinese medicine group was given Qingzhuo Qudu Pills, acupuncture group were given acupuncture, and the combined group were given Qingzhuo Qudu Pills plus acupuncture. Treatment period covered 30 days. Before and after treatment, the clinical efficiency of the four groups was assessed by the US National Institutes of Health chronic prostatitis symptom index ( NIH-CPSI) scores, and routine prostatic fluid examiantion and drug safety assessment were also carried out. Results ( 1) The total effective rate was 69.23%, 84.62%, 74.36% and 92.50% in the western medicine group, Chinese medicine group, acupuncture group and combined group, respectively; the combined group had the best clinical efficiency ( P<0.05) , and then came Chinese medicine group ( P<0.05) , but the difference between acupuncture group and western medicine group was insignificant (P>0.05). (2) After treatment, the total scores and scores of each item of NIH-CPSI were decreased in the four groups ( P<0.05 compared with those before treatment) , and the improvement of general symptoms, the quality of life, pain and urination in the combined group was superior to that in the other 3 groups ( P<0.05) . ( 3) After treatment, levels of tumor necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1β) were decreased to various degrees (P<0.05 or P<0.01 compared with those before treatment), and the decrease in the combined group was superior to that in the other 3 groups (P<0.05). (4) The blood, urine and stool routine examination, electrocardiography, hepatic and renal function of the 4 groups stayed normal before and after treatment, and no adverse reaction was present in the 160 cases. Conclusion Qingzhuo Qudu Pills combined with acupuncture is safe and effective in treating chronic non-bacterial prostatitis through relieving symptoms and reducing the degrees of prostatitis. Cytokines may play an important role in the pathogenesis and treatment of chronic prostatitis.

Objective To investigate the correlation between serum C-reactive protein (CRP) level and carotid atherosclerotic plaque calcification in patients with ischemic stroke or transient ischemic attack (TIA).Methods The patients with non-cardiogenic ischemic stroke or TIA in anterior circulation performed head and neck vascular CTA at 1-6 months from the time of onset were enrolled prospectively.The demographic and clinical data were collected and serum CRP levels were detected.Univariate and multivariate logistic regression analyses were used to determine the correlation between the serum CRP level and the carotid atherosclerotic plaque calcification.Results A total of 165 patients were enrolled.Their age was 62.4± 10.6years,male patients accotnted for 66.7％;113 patients (68.5％)had carotid atherosclerotic plaque calcification (calcification group),52 (31.5％) did not have carotid atherosclerotic plaque calcification (non-calcification group).The age of the calcification group (median,interquartlle;66 [58-73] years vs.58 [51-66] years;Z=-3.738,P＜0.001) and CRP levels (1.9 [0.5-3.8] mg/L vs.0.0 [0.0-2.2] mg/L;Z =-4.126,P ＜ 0.001) were significantly higher than those of the non-calcification group.There were no significant differences in other baseline clinical data between the two groups.Multivariate logistic regression analysis showed that age (odds ratio 1.063,95％ confidence interval 1.024-1.104;P =0.001) and CRP levels (odds ratio 1.209,95％ confidence interval 1.030-1.419;P=0.020) were still significantly correlated with the plaque calcification after adjusting for other confounding factors.Conclucions Carotid plaque calcification was correlated with older age and increased serum CRP level in patients with ischemic stroke or TIA.

Objective To observe the effects of bisphenol A (BPA) on the reproductive function in F1 mice. Methods Pregnancy mice were divided into four groups randomly. From the beginning of pregnance,the mice in experimental groups were given BPA with 30,120,360 mg?kg-1?d-1 until the new mice were born. The mice in control group were given the same volume of corn oil. When the young mice were 30 d, the sperm malformation rate,the activities of lactic acid dehydrogenase(LDH) and glucose-6-phosphate dehydrogenase(G-6-PD) of testicle,the organ coefficient, the histopatholgical changes of testicle in male mice were examined. Results The form of the epithelial cells of seminiferous tubules was disordered. The number of mature spermatozoa was decreased. This changes were more and more with the increase of BPA dose. Compared with control group,organ coefficients in low and large dose groups reduced,LDH activity and G-6-PD activity in middle and large dose groups decreased,LDH activity in low dose group increased. The sperm malformation rates in experimental groups increased as the increase of BPA dose, the differences were remarkable(P

OBJECTIVE:To optimize the extraction process for the preparation of Paeonia lactiflora formula granules and establish an HPLC method for the determination of Paeoniflorin in the samples.METHODS:The optimum water extraction process was selected by the L9(34)orthogonal design and the content of Paeoniflorin in formula granules was analyzed by HPLC.The HPLC assay was performed on a crosmosil C18-MS-II(250mm? 4.6mm,5? m)column.The mobile phase was employed by using acetonitrile-0.1% phosphoric acid(14∶ 86).The detection wavelength was set at 230 nm and the system was operated at 25℃.RESULTS:The optimum extraction conditions were to reflux for 3 times with 12 fold water and each time for one hour.The extraction rate of Paeoniflorin was 85.7% and the dried extraction yield was 34.4%.The peak area had a good linearity with the concentration of Paeoniflorin and the linear range was 0.128～ 0.640? g(r=0.999 8).The average recovery was 100.76% and RSD was 1.26%.CONCLUSION:The preparation process of Paeonia lactiflora formula granules was stable and feasible.The HPLC method for quality control was accurate and suitable.

Objective To study the effect of integrated the respiratory function exercise on promoting lung cancer patients'rapid recovery of function .Methods From September 2014 to September 2016,113 patients with lung cancer were selected in the research .According to the law of random numbers ,they were divided into two groups . The observation group (60 cases) was given the general primary care combined with integrated respiratory function exercise.The control group (53 cases) was given the general basic nursing intervention .Then,the incidence rate of complications and related indicators after operation were compared between the two groups .Results The incidence rate of complications of the observation group was 3.33％,which was significantly lower than 22.64％ of the control group (χ2 =9.369,P<0.05).The related indicators after surgery had statistically significant differences between the two groups (t=3.420,3.811,19.993,all P<0.05).The negative emotional relief score of the observation group [(90.29 ±2.39) points] had statistically significant difference compared with that of the control group [(90.29 ± 2.39)points](t=11.025,P<0.05).The nursing satisfaction rate of the observation group was 96.7％ (58/60), which of the control group was 66.7％(40/60),the difference was statistically significant (χ2 =7.120,P<0.05). Conclusion For patients with lung cancer ,clinical comprehensive respiratory function exercise intervention has rapid rehabilitation after surgery and can improve quality of life of the patients .

Objective To explore the influence of whole-course individualized nursing intervention on treatment compliance among intractable epilepsy children with ketogenic diet therapy.Methods 80 intractable epilepsy patients with ketogenic diet therapy were divided into the control group and the experimental group with 40 cases in each group.The routine nursing was given to the control group.On basis of routine nursing,whole-course individualized nursing intervention was given to the experimental group.The investigation was carried out before and after intervention in two groups by using self-designed questionnaire.The treatment compliance and therapeutic effect were compared between two groups.Results The treatment compliance and therapeutic effect were significantly alleviated in the experimental group compared with the control group in the third,sixth and twelfth months.Conclusions The whole-course individualized nursing intervention can improve the parental awareness of the disease,enhance their confidence and determination to adhere to the treatment,improve their treatment compliance,thereby improve the effect of treatment.

Objective To investigate clinical characteristics,quality of life,and psychological factors in functional dyspepsia (FD) patients with weight loss.Methods A multi-center and prospective investigation was conducted (Clinical trial registration number:ChiCTR-TRC-12001968) which recruited 1341 consecutive FD outpatients from three Guangdong hospitals according to Rome Ⅲ criteria between June and September in 2012.Of these,1057 patients with complete information were divided into group A as having weight loss more than 5％ (n =207) and group B as having weight loss less than 5％ (n =850).Nepean Dyspepsia Index-symptom checklist,appetite,Hamilton Rating Scale of Anxiety/Depression (HAMA/HAMD),Pittsburgh Sleep Quality Index (PSQI),Nepean Dyspepsia Index-quality of life,direct medical costs were used to compare the differences between the two groups.Results There were no significant differences in total scores of NDI-symptom checklist,the severity or bothersome items between two groups (t =-1.301、-0.918、0.138,P =0.193、0.359、0.890),but significant differences were observed in the frequence item and the rating of appetite as poor or very poor between two groups (t =-2.122,P =0.035 ;x2 =35.448,P =0.000 ;x2 =35.274,P =0.000).Significant differences were observed in the incidence of anxiety and depression and total scores of PSQI between the two groups (x2 =73.939,P =0.000;x2 =47.046,P =0.000 ; t =-4.904,P =0.000).Subscales scores of NDI-quality of life in group B were all significantly higher than those in group A (t =5.348、2.569、5.809、4.704,P =0.000、0.010、0.000、0.000).There were significant differences in the frequency of care-seeking and direct medical costs between the two groups (t =-4.860、-3.011,P =0.000、0.003).The frequency of gastroscopic examinations in group A was slightly higher than that in group B (t =-1.505,P =0.133).Conclusion FD patients with weight loss is not rare,and most of them have psychological disorders,loss of appetite and sleep disturbance.Moreover,care-seeking are more frequent,direct medical costs are more expensive,and impairment as assessed by NDI-QOL is more severe.Therefore,we should pay more attention to FD with weight loss in clinical setting.

Objective To discuss the effect of mirtazapine in depressive functional dyspepsia patients with weight loss (FD-WL).Methods As a randomized and controlled trial,seventy-two FD patients with weight loss and depression were randomly divided into mirtazapine group(n=24),paroxetine group(n=23) and conventional group(n=25),and all patients were treated for 8 weeks.The Nepean Dyspepsia Index (NDI)-symptom checklist,the Hamilton Rating Scale of Depression (HAMD),body weight were assessed before the treatment and after 2,4,6,8 week.Results (1) After 2-week treatment,the scores of NDI-symptom checklist and HAMD in mirtazapine group were significantly lower than that in paroxetine group and conventional group.After 4-week,6-week and 8-week treatment,the score of HAMD in mirtazapine group((13.34±1.52),(11.65±1.56),(10.15±1.36)) and paroxetine group((13.65±1.81),(11.34±1.21),(9.58±1.41))was significantly lower than that in conventional group((18.15±1.61),(17.20±2.14),(15.30±1.56)) (all P<0.05).But there was no statistically difference between mirtazapine group and paroxetine group (P>0.05).(2) After 6-week and 8-week treatment,the body weight in mirtazapine group((53.17±6.46)kg,(53.55±6.52)kg)was significantly higher compared with that in paroxetine group((49.47±5.72)kg,(49.57±5.81)kg)and conventional group((48.69±5.60)kg,(48.68±5.65)kg)(all P<0.05).After 8-week treatment,patients in mirtazapine group experienced a weight gain of(3.34±1.82)kg.Conclusion Mirtazapine not only can significantly improve dyspepsia symptoms and depressive scoring,but also can increase body weight.