Hashimoto’s thyroiditis (HT) is strictly related to a cellular immune response with lymphatic infiltration of the thyroid gland by T and B cells, as well as a humoral immune response leading to specific antibody production. The synchronous appearance of HT and papillary thyroid cancer (PTC) indicates an immunological link between the two entities. In this article, we provide a review of the etiology of HT and the potential immunological mechanism of HT coexistent with PTC, which will provide references for new ideas for clinical diagnosis and treatment of HT coexistent with PTC in the future.

Objective: To summarize the existed problems and the relationship between the medical insurance and basic medical insurance policy, to find more reasonable payment mode to adjust with the medical insurance policy. Methods: On the basis of the endowment insurance implement experience, explore the payment mode of medical insurance. Results: It is very necessary to set the payment period of the basic medical insurance.

Objective To assess and compare the efficacy and safety of ecabet sodium-based quadruple therapy versus bismuth-based quadruple therapy for Helicobacter pylori (Hp) eradication.Methods A multicenter,randomized,positive controlled clinical trial was carried out.The object of the study were chronic gastritis patients at 8 hospitals in Xi'an,Beijing,Shanghai and Guangzhou from June 2009 to June 2011.All patients were divided into treatment group and control group.In treatment group,patients received ecabet sodium-based quadruple therapy (two times per day,omeprazole magnesium 20 mg,amoxicillin 1000 mg,clarithromycin 500 mg and ecabet sodium 1.0 g each time for 10 days.In control group,patients were assigned to receive bismuth-based quadruple therapy (two times per day; omeprazole magnesium 20 mg,amoxicillin 1000 mg,clarithromycin 500 mg and bismuth potassium citrate 220 mg each time) for 10 days.The Hp eradication was determined by 13C or 14C urea breath test at the 38th day after the treatment and the eradication rate was calculated.Side effects were recorded and analyzed.The data were analyzed by chi square test and Fisher's exact test.Results A total of 311 patients were recruited,and 155 patients were allatted in treatment group and 156 in control group.The per-protocol (PP) analysis indicated that the eradication rates of treatment group arid control group were 75.71％(106/140) and 77.37％(106/137) respectively,and there was no significant difference x2 =0.106,P=0.745).The intention-to-treat (ITT) analysis indicated that the eradication rates of treatment group and control group were 68.39％ (106/155) and 67.95％ (106/156) respectively,and there was no significant difference x2 =0.007,P=0.934).The side effects rates of treatment group and control group were 20.00％ (31/155) and 25.64％(40/156) respectively,and the difference was not statistically significant (Fisher's exact test,P=0.280).No serious side effect was observed in two groups.Conclusion The efficacy and safety of ecabet sodium-based quadruple therapy for Hp eradication in chronic gastritis patients may be the same as bismuth-based quadruple therapy.

BACKGROUNDSlp2 gene is one of the differential expression genes in lung cancer tissues and normal controls, the aim of this study is to observe the effects of antisense Slp2 gene on growth and proliferation in lung cancer cell lines.

METHODSTotal RNAs were extracted from 4 lung cancer cell lines (A549, GLC-82, NCI-H446, NCI-H460), Slp2 gene expressions were detected at mRNA level by reverse transcription-polymerase chain reaction (RT-PCR); antisense Slp2 gene plasmid was constructed and transfected into GLC-82, NCI-H446 and NCI-H460 cells with lipofectinmin. The expressions of Slp2 gene were analyzed by RT-PCR in these cells before and after transfection; Flow cytometry, MTT assay and soft agar culture were used to investigate the effects of antisense Slp2 gene transfection on DNA content changes in cell cycle, proliferation and colony formation ability of these cells.

RESULTSSlp2 gene was positive expressed in A549, GLC-82, NCI-H446 and NCI-H460 cell lines. The proliferation of GLC-82, NCI-H446 and NCI-H460 cells were inhibited by antisense Slp2 gene conspicuously. The flow cytometry experiments showed accumulation of transfected cells in G2-phase, for one time concomitant appearance of apoptotic cells of sub-G1 (hypodiploid) DNA content was observed in transfected NCI-H446 cell. Dramatic inhibition of colony formation in soft agar was observed in those transfected lung cancer cell lines.

CONCLUSIONSThe results suggest that Slp2 gene might be a key gene in lung cancer cell growth and proliferation.

Abortifacient Agents, Steroidal ; administration & dosage ; Abortion, Induced ; methods ; Androgen Antagonists ; administration & dosage ; Contraceptives, Oral ; administration & dosage ; Female ; Fertilization in Vitro ; methods ; Gonadotropin-Releasing Hormone ; administration & dosage ; analogs & derivatives ; Hormone Replacement Therapy ; methods ; Hormones ; administration & dosage ; Humans ; Mifepristone ; administration & dosage ; Norpregnenes ; administration & dosage ; Pregnancy

Objective:To investigate the clinicopathological characteristics of papillary thyroid microcarcinoma in the isthmus (PTMCI) and the independent risk factors of central lymph node metastasis.Methods:58 consecutive patients with PTMCI admitted from Jan. 2016 to Dec. 2018 (isthmus group) were retrospectively analyzed, including 15 males and 43 females,age (42.93±12.69) years old; According to the specific location of papillary thyroid microcarcinoma (PTMC) in isthmus, PTMCI were subdivided into the right PTMCI and the left PT-MCI 67 patients with a single PTMC located in the unilateral lobe were randomly selected as a control (lobe group) , including 13 cases of male and 54 cases of female, age (47.18±11.34) years old. Index included the patient’s age, gender, tumor diameter, TPOAb, aspect ratio, microcalcification, capsular invasion, lymph node metastasis, surgical methods, operation method, and scope of lymph node dissection. SPSS 21.0 software was used for statistical analysis. The quantitative data of normal distribution was expressed as ± s,and the difference between the two groups was compared by chi-square test.The risk factors of CLNM of the isthmus group were analyzed with univariate chi-square test and multivariate Logistic regression analysis.The difference was statistically significant if P<0.05. Results:Compared with PTMC, PTMCI showed a higher rate of capsule invasion ( P=0.003) ,lymph node metastasis ( P=0.049) ,lymph node metastasis in central region ( P=0.033) ,and surgical methods between the two groups were statistically significant ( P<0.05) ;But PTMCI was significantly lower than PTMC in aspect ratio>1 ( P<0.05) . Univariate analysis showed that capsule invasion ( P=0.001) and microcalcification ( P=0.012) were risk factors for PTMCI lymph node metastasis. Multivariate Logistic regression analysis showed that capsule invasion ( P=0.016) and microcalcification ( P=0.046) were independent risk factors for central lymph node metastasis in PTMCI. Conclusions:Compared with PTMC,PTMCI indicates a higher rate of capsular invasion,lymph node metastasis in prelaryngeal and central lymph node;Compared with PTMC, PTMCI indicates a lower rate of aspect ratio>1; Capsule invasion and microcalcification are independent risk factors for central lymph node metastasis in PTMCI. For patients with the right PTMCI or the left PTMCI and also without capsular invasion and calcification,ipsilateral central lymph node dissection should be considered.