With the increasing number of complex and difficult thyroid cancer patients, the traditional medical model is difficult to solve the problem of diagnosis and treatment of patients optimally. In recent years, multidisciplinary team (MDT) model is applied clinically. For complex and difficult thyroid cancer diseases, the model can play a multidisciplinary advantage and provide more personalized and accurate diagnosis and treatment scheme for patients. The diagnosis and treatment of complex and difficult thyroid cancer involve thyroid surgery, otolaryngology, thoracic surgery, anesthesiology, endocrinology, nuclear medicine, radiotherapy, oncology, ultrasound, imaging, pathology and other disciplines. Based on the important role of MDT in diagnosis, treatment, nursing, postoperative management and clinical research of thyroid cancer, as well as the challenges and difficulties faced in implementation of MDT, the status and progress of multi-disciplinary comprehensive diagnosis and treatment of thyroid cancer will be systematically elaborated in the paper.

with PsA in Chinese Han population from Shandong Province.

Objective:To investigate the prognostic factors and pathological characteristics of mixed subtype thyroid cancer (MSTC) .Methods:Data of 41 cases of MSTC, which were confirmed by postoperative pathology, among from 24, 912 cases of thyroid cancer admitted in Mar. 2005 to Aug. 2020 in the First Medical Center of Chinese People’s Liberation Army General Hospital, were retrospectively analyzed. 37 cases underwent surgical treatment, while 4 cases only underwent puncture to confirm the pathology due to physical conditions, and no surgical treatment was performed. The tumor size, number of lesions, capsule invasion, AJCC 8th TNM staging, surgical methods, radiotherapy and chemotherapy were collected. The MSTC patients in the group were followed up to obtain the postoperative situation. SPSS 25.0 and R studio statistical software was used for data processing, and Cox single factor and multivariate regression were used to analyze independent risk factors.Results:In the 41 cases, there were 9 cases of papillary carcinoma (PTC) mixed with follicular carcinoma (FTC) , and 8 cases of mixed medullary and follicular carcinoma (MMFTC) . There were 15 cases of poorly differentiated thyroid cancer (PDTC) , 4 cases of squamous cell carcinoma of thyroid (SCCT) , and 5 cases of undifferentiated thyroid carcinoma (ATC) . The median follow-up time was 18 months, and 11 patients died during the follow-up, with a mortality rate of 26.8%. Average onset age was (51.41+15.69) years. 4 cases had postoperative recurrence during the follow-up, including 2 cases of local recurrence, and 2 cases of distant metastasis. Single factor results showed that age, degree of tumor differentiation, surgical method, radiotherapy and chemotherapy were the risk factors affecting the prognosis of patients with MSTC ( P<0.05) . Multivariate analysis showed that age at diagnosis ( P=0.007) and surgical procedure ( P=0.017) were independent risk factors for prognosis in patients with MSTC. Conclusion:Middle-aged and elderly women are at high risk for MSTC, and the degree of tumor differentiation is proportional to survival. Due to the multi-type and pleomorphic pathological findings, a reasonable treatment plan has good effects on prognosis of MSTC.

Objective To investigate the killer cell immunoglobulin-like receptor (KIR) genes, KIR2DS4 and its variant KIR1D for an association with syphilis in the comparison between syphilis patients and unrelated healthy subjects. Methods One hundred and ninety syphilis patients and 192 unrelated healthy subjects were performed to determine the KIR genotypes by PCR-SSP method. The gene frequencies of KIR2DS4 and KIR1D were analyzed for an association with syphilis in the patients and healthy people who belonged to KIR gene haplotype A. Results Of 192 healthy individuals, 187 were identified with a KIR2DS4 gene. And 91 individuals were classified as homozygous haplotype A with the percent of 48.7% (91/187) in 187 KIR2DS4 positive individuals. Of 190 syphilis patients, 181 were identified with a KIR2DS4 gene. And 89 individuals were classified as homozygous haplotype A with the percent of 49.2% (89/181) in 181 KIR2DS4 positive individuals. The frequency of KIR1D/KIR1D in syphilis patients classified as haplotype A was 16.9%, and was significantly higher than that in the control group (6.6%, P=0.032). However, there was no significant difference for the frequencies of KIR2DS4/KIR2DS4 and KIR2DS4/KIR1D between the two groups (P>0.05). Conclusion KIR1D/KIR1D might be associated with syphilis in the comparison between syphilis patients and unrelated healthy controls who were classified as homozygous haplotype A.

Objective To investigate the clinical features of SAPHO syndrome.Methods Clinical data of 22 cases of SAPHO syndrome were analysed.Results There were 7 males and 15 females among the 22 patients.The average age at onset of cutaneous and osteoarticular lesions was 45 years and 44 years, respectively.Of the 22 patients,21 had palmoplantar pustulosis and 1 had acne fulminans.Anterior chest wall (ACW) was involved in 19 patients,peripheral joints in 4 patients and sacroiliac joints in 2 patients.Osteoarticular manifestations occurred prior to the onset of skin lesions in 10 cases.after that in 9 cases,and simultaneously in 3 cases.The mean interval between the onset of cntaneous and osteoarticular lesions was 2.7 years and the longest interval was 20 years.Conclusions Middle-aged females predominate in patients with SAPHO syndrome seen in dermatological clinics.Palmoplantar pustulosis and ACW involvement are the most common clinical manifestations of SAPHO syndrome.

Objective To detect the mutations in ATP2C1 gene of 5 sporadic patients with Hailey-Hailey disease (HHD).Methods Five sporadic patients with HHD collected from the outpatient clinic setting were recruited into this study with informed consent.Blood samples were taken from all patients and 100 unrelated human controls.and DNA was extracted from these samples.Mutation scanning was carried out for ATP2C1 gene by polymerase chain reaction (PCR) and direct sequencing.Results The diagnosis of all cases was confirmed by typical clinical manifestation,cutaneous pathology and immunofluorescence pathology.Five novel mutations.including a deletion mutation (2025delG),three missence mutations (L269R,C348R,A651D) and a non-sense mutation (Q259X) were identified in these cases.No mutations were detected in any of the 100 controls.Conclusion Five novel mutations in ATP2C1 gene have been identified for Hailey-Hailey disease.

Objective To study mutations in the extracellular matrix protein 1 (ECM1) gene in a family with lipoid proteinosis (LP). Methods Bi-directional DNA sequencing was used to detect the ECM1 gene in patients with LP as well as among their parents, siblings and children. Results Sequencing from the affected individuals revealed a new compound heterozygote of missense/nonsense mutations, C220G/R476X, which were not found in the control group. The father was a carrier of the missense mutation C220G and the mother was a carrier of the nonsense mutation R476X, both on one allele. The other siblings, the patients' children and their siblings' children were carriers of either C220G or R476X mutations. Conclusion A new compound heterozygous mutation of ECM1 gene was identified in this LP family.

Objective To investigate the protective effects of purified effective component group in extract from Xiaoshuan Tongluo(CGXT)formula on chronic brain ischemia in rats.Methods CGXT 75,150,and 300 mg/kg or vehicle were ig administered daily for four weeks to rats with bilateral common carotid arteries ligation(BCCAL).From the day 24 to 28 after BCCAL,Morris water maze was performed to assess the learning and memory impairment of rats.Four weeks after BCCAL,brain gray and white matter damage were assessed.Results In Morris test,the mean escape latency of rats in the CGXT(150 and 300 mg/kg)groups was significantly shorter than that in the vehicle group.CGXT also attenuated the neuronal damage in hippocampus and cortex and reduced the pathological damage in the optic tract and corpus callosum.Conclusion CGXT could improve learning and memory impairment resulted from BCCAL in rats.These results provide the experimental basis for the clinical use of CGXT in stroke treatment and may help in investigation of multimodal therapy strategies in ischemic cerebrovascular diseases including stroke.

The continuous development and application of new technology in thyroid surgery has promoted the rapid improvement of thyroid surgery. New technology in the field of thyroid surgery has developed rapidly. The application of neural monitoring technology has enabled the thyroid surgery to enter an accurate era. Imtraoperative neuromonitoring and continuous intraoperative neuromonitoring have made the recurrent laryngeal nerve protection more secure. Nano-carbon parathyroid gland negative imaging technology could identify parathyroid gland more precise. However, when the nano-carbon was used, the injection time, position and dosage should be grasped so as to achieve the best effect of negative imaging. Endoscopic and robotic thyroid surgery could meet the demand of cosmetic. "Treatment first, beauty second" is still the principle to be strictly followed. Do not blindly expand indications and pursue endoscopic surgery. Energy surgical instruments′ update made the operation more efficient, while the instruments have some disadvantages. Thyroid surgeon must correctly understand the working principle of new energy devices and use them rationally. Through grasping the working principle and application skills of new technology in clinical work, definiting its advantages and disadvantages, adhereing to the "reasonable choice, standard application" principle, learning the pioneers′ experience, the application of new thyroid diagnosis and treatment technology could be more reasonable and safe.

Objective To investigate the association of HLA-A and -B alleles with syphilis in Shandong Han population. Methods The allele frequencies of HLA-A and -B were detected in 205 patients with syphilis and 5844 normal human controls by PCR-sequence specific oligonucleotide probe (PCR-SSOP)method. Results The patients with syphilis showed a higher frequency of HLA-A*02, B*15, B*40 alleles(all P＜0.01, Pc＜0.05) and a lower frequency of HLA-A*26 allele (P= 0.003, Pc = 0.039) than the normal human controls did. There was an increased frequency of HLA-B*15 and B*40 alleles in patients with symptomatic syphilis (both P＜0.01, Pc＜0.05), as well as an elevated frequency of HLA-A*02, 11, 29, B*15 and 40 alleles (all P＜0.01, Pc＜0.05) and a decreased frequency of HLA-A*30 and 33 in patients with asymptomatic syphilis(P=0.002, 0.026, Pc=0.001, 0.013 respectively), compared with the normal human controls. The frequency of HLA-A*30 allele was significantly higher in patients with symptomatic syphilis than in those with asymptomatic syphilis (P = 0.001, Pc = 0.013). Conclusions There seems to be an association between HLA-A*02, B* 15 and B*40 alleles and syphilis, between HLA-A*30 allele and symptomic syphilis, and between HLA-A*02, 11 and 29 alleles and asymptom1atic syphilis, in Shandong Han population.