Hypertriglyceridemia is one of the clinical manifestations of hypothyroidism.Besides regulating thyroid hormone axis,thyroid stimulating hormone (TSH) also has the effect on up-regulated expression of inflammatory cytokines.Synthesis of inflammatory factors can promote the expression of apolipoprotein B48 (ApoB48) in intestinal mucosal epithelial cells,suggesting that TSH may up-regulate the expression of ApoB48 by inducing inflammation; while theoratically,low-level of thyroid hormones can inhibit the synthesis of ApoB48.At the same time,since ApoB48 is the important cause of hypertriglyceridemia,there is a contradiction that it is difficult to explain the clinical phenomenon of hypertriglyceridemia induced by hypothyroidism.Therefore,hypothyroidism may affect the expression of ApoB48 by high level of TSH and low level of thyroid hormones,leading to hypertriglyceridemia.

Objective: To study the effect of simulating scene method in teaching neurology.Method:Simulating scene method in teaching neurology of noviciate,the student and teacher joint evaluation and comparison with controlled group were applied.Results: According to students' evaluation,simulating scene method can improved students' leaning interest,clinical performing skill and clinical thinking,which had significant difference compared with that of controlled group.According to teachers'evaluation,simulating scene method could improve students'leaning attitude and elevate the clinical performing mark,which was also significantly different compared with controlled group.Conclusions:Simulating scene method can improved students' clinical performing skill and teaching effect.

Objective To explore the indications, intraoperative problems and management of its complications of the microendoscopic discectomy (MED) in the treatment of lumbar intervertebral disc herni-ation through posterior approach. Methods 242 cases of lumbar disc herniation treated by MED were re-viewed retrospectively from March 2000 to March 2002. Of the 242 cases, there were 171 males and 71 fe-males aged from 19 to 71 years with an average of 34 years. Among them, the lesions were located at single level in 193, double levels in 46, and three levels in three. All of 242 patients were examined with CT, 48 of which were performed MR. Results 205 herniated discs of the single level were removed, 36 of the double levels, and one of the three levels. It was average 2.2 days for the patients to get off bed ranging from 24 hours to 6 days. Postoperative hospitalization was from 3 to 12 days with an average of 5.2 days. Among the intraoperative complications, dural tear happened in four, nerve root injury in two, and mistakes of localiza-tion in one. While in postoperative complications, there was discitis in one which happened at three weeks postoperatively, and was cured with antibiotics and ambulation for five months. All incision healed in one stage, except one suffered from superficial infection and healed by dress changing. All cases were followed up for 2 to 15 months with an average of 6 months. The average period for the patients retuning to daily life was 3.6 weeks, and 52.4% of the patients restored to previous work. According to Macnab's evaluation sys-tem for clinical outcomes, the results showed excellent in 183, good in 44, fair in 13 and poor in two, so the rate of excellent and good was 94%. However, there were two cases converted to open operation because of compressive neurological dysfunction. Conclusion Appropriate control of indications and skillful surgical technique are the key points to decrease the complication, and to improve the curative effect.

Objective To elucidate the effect of multi-kinase inhibitor sorafenib on anaplastic thyroid carcinoma cells in the presence or absence of metformin.Methods SW1736 and C643 cells were treated with sorafenib in the presence or absence of metformin for various periods of time.Cell viability was detected by MTT.Cell cycle and cell apoptosis were measured by flow cytometry.Caspase-3 activity was detected by colorimetric kit.Western blot was used to analyze pERK phosphorylation and cyclinD1 expression.Results Sorafenib inhibited the growth of anaplastic thyroid carcinoma cells and induced cell cycle arrest and cell apoptosis.The EC50 of sorafenib in SW1736 and C643 was 3.68 μmol/L and 4.87 μmol/L respectively.After sorafenib ± metformin treatment,the caspase3 activity was 131.5 ％ and 278.0％ (P＜0.01) in SW1736 cells,127.2％ and 196.6％ (P＜0.01) in C643 cells.On the molecular level,sorafenib inhibited the phosphorylation of ERK and decreased the expression of cyclinD1.Metformin amplified the growth inhibitory effect of sorafenib on anaplastic thyroid carcinoma cells.The cell viability was 0.76 ± 0.17 and 0.30 ± 0.04 (P＜0.01) in SW1736 cells,0.72 ± 0.09 and 0.34 ± 0.10 (P＜0.001) in C643 cells after 2.5 μmol/L sorafenib without or with 5 mmol/L metformin treatment.Conclusions The combination of sorafenib and metformin may be a potent strategy for the treatment of anaplastic thyroid carcinoma and other advanced cancers.

Objective To investigate the effects of Sangju Qingjie Decoction on the ventilator-induced lung injury in rats.Methods Thirty-six healthy male SD rats of both sexes,weighing 300-350 g,were randomly divided into 3 groups(n =12 each):control group(group C); mechanical ventilation group(group V)and Sangju Qingjie Decoction group(group SJ).The animals were anesthetized with intraperitoneal 3％ urethane 1.4 g/kg and tracheostomized.The femoral artery and vein were cannulated for blood sampling and drug administration.The animals were mechanically ventilated for 2.5 h(VT =40 ml/kg,RR 40 bpm,I:E =1:1,FiO2 21％).Ingroup SJ,Sangju Qingjie Decoction 300 g was injected into the stomach through a gastric tube once a day for 10 consecutive days,and mechanical ventilation was performed 2 h after the last injection.While in groups V and C,the equal volume of normal saline was given instead of Sangju Qingjie Decoction.Arterial blood samples were collected before ventilation,at the end of ventilation,and at 30 min after ventilation(T0-2)for blood gas analysis.Respiratory index(RI)and oxygenation index(OI)were calculated.The animals were then sacrificed and the lungs were removed for microscopic examination and determination of the content of TNF-α,IL-6 and IL-10 and W/D lung weight ratio.Results Compared with group C,RI at T1,2,the content of TNF-o,IL-6 and IL-10 and W/D ratio were significantly increased,and OI was significantly decreased at T1.2 in groups V and SJ(P ＜ 0.05).Compared with group V,RI at T1,2,the content of TNF-α and IL-6 and W/D ratio were significantly decreased,and OI at T1,2 and the content of IL-10 were significantly increased in group SJ(P ＜ 0.05).The pathological damage was attenuated in group SJ compared with group V.Conclusion Sangju Qingjie Decoction can attenuate the ventilator-induced lung injury through inhibition of inflammatory response in rats.

OBJECTIVE:To study the antipyretic and analgesic effects of Compound tuniuxi sirup.METHODS:Fever was induced by dry yeast in SD rats,then divided the rats into high-dose(33.12g/kg),medium-dose(16.56g/kg),low-dose(8.28g/kg)and control,aspirin group,observed the antipyretic effect;The mice were divided into high-dose(47.84g/kg),medium-dose(23.92g/kg),low-dose(11.96g/kg)and control,aspirin group,then were investigated with hot plate and acetic acid induced body twist.RESULTS:Compound tuniuxi sirup can markedly inhibit the fever in the model anmals 1 hour later,the effect of the high,medium groups are similar to aspirin;and could increase the pain threshold obviously(the low-dose group is obviously in 1.5h～2h(P

[Summary] To determine how endocrinologists in China access and treat patients with Graves' orbitopathy (GO) and gain insight on how to make the management of this disease more uniform and standardized in the context that management of GO continues to be challenging.Based on the questionnaire used in the European survey on GO,a questionnaire in Chinese was drafted and circulated to the members of Chinese Society of Endocrinology (CSE).There were a total of 124 valid responders.The majority (94.4％) of the responders believe that a muhidisciplinary approaches for GO management is valuable.Over 80％ of the participants advocated the evaluation of exophthalmometry,vision,visual fields by perimetry,eye movements,fundoscopy,TSH receptor antibodies,thyroid function,and ultrasound.Steroids were preferred as the first-line therapy by 92.7％ of responders,among them,59.7％ choose intravenous route.The treatment strategy for GO with intravenous glucocorticoids therapy still remains debated.Antithyroid drugs were the most common choice (72.6％) for first-line therapy of thyrotoxicosis.Treatment options for GO were very similar among Chinese,Latin-American,and European responders,though radioactive iodine and surgical treatment were more often indicated in China.The appropriate treatment of the patient with GO is controversial even amongst thyroid specialists.Further training of clinicians,easier access of patients to specialist multidisciplinary centres,and the publication of practice guidelines may help improving the management of this condition in China.

Objective To investigate the effect of 17β-estradiol on the proliferation of thyroid stem/ progenitor cells.Methods In thyroid stem/progenitor cells derived from nodular goiters,the effects of 17 β-estradiol on thyrosphere formation,estrogen receptor (ER) expression,cyclin D1 expression,and mitogen activated protein kinase (MPAK) pathway were analysed by BrdU ELISA,conventional and realtime PCR,immunofluorensence staining,and Western blot.Results 17β-estradiol induced thyrosphere formation and proliferation of thyroid stem/ progenitor cells.ER-α and ER-β were expressed in thyroid stem and progenitor cells with higher mRNA expression level of ER-α compared to differentiated thyrocytes (8.85-±0.81 vs 1.10 ±0.35,P＜0.01).Stimulation by 1 mmol/L 17β-estradiol increased cyclin D1 mRNA expression and ERK phosphorylation levels,which was blocked by an ER antagonist,ICI 182780.Conclusion Estrogen stimulated the growth of stem cells derived from thyroid nodules via estrogen receptor,suggesting the relevance of increased thyroid stem cell proliferation with higher prevalence of thyroid nodules in women.

Rutin,a flavonoid found in fruits and vegetables,is a potential anticancer compound with strong anti-cancer activity.Therefore,electrochemical sensor was developed for the detection of rutin.In this study,CoWO4 nanosheets were synthesized via a hydrothermal method,and porous carbon(PC)was prepared via high-temperature pyrolysis.Successful preparation of the materials was confirmed,and character-ization was performed by transmission electron microscopy,scanning electron microscopy,and X-ray photoelectron spectroscopy.A mixture of PC and CoWO4 nanosheets was used as an electrode modifier to fabricate the electrochemical sensor for the electrochemical determination of rutin.The 3D CoWO4 nanosheets exhibited high electrocatalytic activity and good stability.PC has a high surface-to-volume ratio and superior conductivity.Moreover,the hydrophobicity of PC allows large amounts of rutin to be adsorbed,thereby increasing the concentration of rutin at the electrode surface.Owing to the syn-ergistic effect of the 3D CoWO4 nanosheets and PC,the developed electrochemical sensor was employed to quantitively determine rutin with high stability and sensitivity.The sensor showed a good linear range(5-5000 ng/mL)with a detection limit of O.45 ng/mL.The developed sensor was successfully applied to the determination of rutin in crushed tablets and human serum samples.