Thyroid-associated ophthalmopathy(TAO)is an organ specific autoimmune disorder affecting the life quality of patients.Glucocorticoids have been applied for many years in the treatment of TAO,though the side effects are the major concern.Recently,intravenous methylprednisolone pulse therapy is a novel and effective method for TAO treatment.Nevertheless this new strategy needs to be modified,and attention should be paid to the indications and contraindications in order to prevent liver damage when high dose methylprednisolone is applied.

Severe aplastic anaemia is a marrow failure syndrome characterized by pancytopenia and hypocellular bone marrow.Immunosuppressive therapy(IST)consisting of antithymocyte or antilymphocyte globulin (ATG) and cyclosporine has been recommended for children lacking HLA-matched sibling donor.For children unresponsive to initial immunosuppressive therapy or those who relapsed after first immunosuppressive therapy,they can choose repeat course of immunosuppressive therapy,allogeneic hernatopoietic stem cell transplantation,new drugs or clinical trials.And the prognosis has been greatly improved in recent years,dueing to the development of allogeneic hematopoietic stem cell transplantation and the application of new drugs such as eltrombopag.This article reviews researches advance in different therapies for children with relapsed or refractory severe aplastic anaemia,aimed at guaiding treatment methods.

The second part of (2008 edition)includes iodine deficiency disease,thyroditis and thyroid nodule.This guideline reaffirms the epidemic characteristics,the prevention and the management of iodine deficiency disease.It identifies the measurement of iodine nutritional status and the necessity of iodinized salt.It emphasizes the regular diagnosis and treatment of subacute and chronic thyroiditis,and also mentions the advancement on differential diagnosis and rational therapy of thyroid nodules.In addition,it gives some advices on the management of thyroid nodules in two special groups(pregnant women and children).

Objective To introduce the surgical technique and results of total mesorectal excision (TME) for rectal cancer. Methods　Reviews.Results　As a result of TME, local recurrence rates have declined from 20%-30% to 3%-8%, 5-year survival rate have risen to 75%, and the rates of sphincter preservation have risen too.Conclusion　Total mesorectal excision reduces the local recurrence rates and raise the survival figures after excision of rectal cancer. Patients have a high quality of life.

Taking the characteristics of Indian students into account,teaching quality can be improved by these means:thorough preparation before class,various application for teaching,mutual and interactive communication and inspiration.

Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer.The original ATC guidelines were published by American Thyroid Association in 2012.The guidelines recommend that once the diagnosis of ATC has been verified,rapid evaluation and establishment of treatment goals are imperative,and a multidisciplinary management is required.Radical surgical resection and high doses of external beam radiotherapy are important factors associated with prolonged survival.

Parathyroid carcinoma is a rare endocrine tumor.Clinical manifestations are varied with multiple organs involved,mainly due to hypercalcemia.So far the etiology and pathogenesis of parathyroid carcinoma are still unclear and preoperatively diagnosis is difficult.Technetium-99 m sestamibi scan and ultrasound can help to find the early lesions.Complete surgical resection with suspicious involved lymph nodes is the recommended treatment.Parathyroid carcinoma is insensitive to chemotherapy and radiotherapy.New immune therapy yields unsure efficacy.Therapeutic effect and prognosis mainly depend on primary surgical resection of the tumor.The disease recurs in more than 50％ of patients with poor prognosis.

Early diagnosis and timely treatment are two critical factors in reducing the cerebral damage and improving prognosis for ischemic stroke patients.The only proved effective way is to intravenously administer recombinant tissue plasminogen activator for thrombolytic therapy.However,the narrow time window restricts its application.One rapid and effective blood test,or auxiliary examinations such as computer tomography which may aid early diagnosis of ischemic stroke would contribute to treatment and intervention promptly,then take a pivotal role for the disease prognosis.Herein,the reported proteins and RNA markers are summarized and analysed in clinical application of acute ischemic stroke likewise.

Antithyroid drugs(ATD)is the main treatment for hyperthyroidism and its adverse reactions have been much concerned by physicians. Methimazole(MMI)and propylthiouracil(PTU)are the two common antitithyroid drugs used currently. Generally, the ATD are safe and effective, though their clinical adverse reactions are also relatively common. The toxic effects include liver damage and leukocytopenia, antineutrophil cytoplasmic antibody-associated pulmonary small-vessel vasculitis, hypoglycemia, allergic reactions, muscle impairment,and so on. They are usually reversible and disappear spontaneously when the drug is discontinued. However,the serious rare side effects can also occur and there may have potentially deadly threatening effects which need to be cautious for the clinicians. MMI is usually preferred over PTU because it has significantly fewer side effects. And unlike the dose-dependent side effects of MMI, there has no significant correlation between adverse reaction and drug dosage in using PTU. Moreover, PTU has more severe hepatotoxity than MMI, even fatal liver impairment and liver failure. The risk of liver damage from PTU is an important concern, particularly in children. For this reason, MMI is the first choice for treating children with hyperthyroidism.

Caloric restriction has been practiced over 500 years as a method for increasing both the length and quality of life.Experimental work confirming the success of this approac h in animals has accumulated in the last 100 years.Since 2000,emerging evidence in humans has shown that caloric restriction can delay the onset of age related diseases including reduced risk of obesity,diabetes,cardiovascular disease,cancer,and neurodegenerative disorders.The mechanisms and clinical applications have been extensively studied.