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.

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).

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.

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.

Physicians often encounter patients with both hyperthyroidism and pregnancy in clinical practice. Proper treatment will help a lot for both mother and fetus. However, whether propranolol could be applied routinely in the medical therapy other than antithyroid drugs is not regularly mentioned in text book, because there were few literatures reporting its side effects including miscarrage, intrauterine growth retardation, bradycardia, respiratory depression, hypoglycemia, and hyperbilirubinemia. Animal experiments revealed bradycardia after propranolol administration, and respiratory depression after birth due to blockage of β receptors in the lungs. Nevertheless, this drug has been considered safe in pregnant hyperthyroid women according to long-term experience, as no malformation has been demonstrated in the offsprings, and it helps a lot in hyperemesis gravidarum as well. Specialists also recommend short-term use like a few weeks before antithyroid drugs set in action and during thyroid storm, in order to avoid potential side effects. It is suggested that less than routine-dose of the drug be administered before labor, as the plasma drug concentration in the neonate would elevate after birth. As for lactating mother, it's safe to take regular dose of the drug because only extremely low dose will be taken by the neonate through milk.

In the tumor microenvironment, inflammatory cells regulate intracellular signaling transduction mediated by the corresponding nuclear transcription factor by releasing inflammatory factors ,which leads to transformation of epithelial cells to mesenchymalcellsand eventually promote tumor metastasis. Because of the intimate relationship between inflammation and tumor metastasis , it would be helpful for further enhancement of effectiveness of tumor therapy if we could better understand both the biological character of tumor and the related inflammatory factors.

[Summary ] Accumulating evidence showed the associations between subclinical hyperthyroidism or subclinical hypothyroidism and adverse health outcomes. The related guidelines could be very helpful in making treatment decisions. However, even within the reference range, thyroid function is associated with adverse health outcomes, such as atrial fibrillation, coronary artery disease, osteoporosis, and dyslipidemia. Also, there is limitation to use TSH value as intervention threshold by the influence of age and other diseases. In this regard, a grading system is proposed to diagnose thyroid dysfunction, and risk stratification according to individual TSH values and comorbidities would be constructed to evaluate the utility of treatment.

Neuregulin-1 (NRG-1) can bind with its tyrosine kinase receptor via paracrine and autocrine, activate downstream pathways and perform a series of biological reactions, and reduce pressure load and improve heart function through inhibiting sympathetic nerve excitement.Recent study identified that NRG-1 can induce pluripotent stem cell differentiation;clinical trials proved that recombinant human NRG-1 can reduce level of N terminal pro brain natriuretic peptide, rehospitalization rate and onset times of heart failure.The present article made a review on research progress of NRG-1 in cardiovascular field.

Platelet -derived growth factor (PDGF)is an important factor of promoting cell growth which has a physiological role ranging from DNA synthesis,cell mitosis inducement,promotion on a variety of extracellular matrix accumulation as well as impact on the cell phenotype and growth.Studies showed that PDGF played an important role in growth and proliferation of vascular and nerve.It has a significant effect on accelerating tissue repair and promoting healing of chronic diabetic foot ulcers.