In 2016, American Association of Clinical Endocrinologists(AACE) published the guidelines for obesity and defined obesity as an adiposity-based chronic disease and obesity should be managed according to the obesity-related complications (16 complications are listed). Obesity intervention should be transferred from the purpose of weight loss to the intervention of metabolic disorder and its complications. The diagnosis and intervention of obesity in this guideline is sub- classified focus on the gender, region, and combined diseases, which is with more practical and scientific significances. This interpretation is expected to help the professional medical staffs to understand the new strategy in obesity therapy and to combine with the real world and clinical experience. New suggestions should put forward and improve the theories.

Hyperthyroidism with periodic paralysis is common in clinic,the curative effect of peroral drugs on it is not satisfactory. In order to evaluate the treatment of 131 I for periodic paralysis in patients with hyperthyroidism, fouty two patients with hyperthyroidism complicated with periodic paralysis were put on p.o. 5.0 9.0 mCi 131 I Na treatment and the remission rate of periodic paralysis was observed.The total effective rate was over 95%. It can be concluded that 131 I could be used as a routine therapy for periodic paralysis in most patients with hyperthyroidism for its safety and efficiency.

Metabolic syndrome, whose incidence is higher than that we have thought, has done great harm to people's health. This review is to introduce the recent advance in the defination,epidemiology,etiology,major risk factors,clinical diagnosis and treatment, etc . of metabolic syndrome.

The new protein suppressors of cytokine signaling(SOCS) as negative regulators of signaling pathways involve in the cellular actions of many cytokines, including leptin. It regulates intracellular signal transduction cascades such as the JAK STAT pathway. SOCS is now evident of leptin resistance and has close relation with obesity. We reviewed the structure and function of SOCS 3 and the mechanism in leptin signaling pathway,providing data for the potential effect of SOCS 3 in the treatment of obesity.

Obesity has been widely accepted as a metabolic disease and its occurrence is closely related to the genetics, environment, and inflammation. Up to now, body mass index is still regarded as the standard diagnostic criterion for obesity. It has not been revised for decades and could not meet the needs of clinical diagnosis and demands for specific treatment at present. In 2013, the concept of metabolic obesity was introduced at the American Diabetes Association ( ADA) annual conference, and it was further proposed that obesity should be classified according to the metabolic status and its related complications at the 2014 American Association of Clinical Endocrinologists ( AACE) annual conference. This means that scientists and clinicians have realized that the etiology of obesity may vary with different outcomes, the treatment should be focused on the metabolic regulation, not merely on weight loss. With years of clinical practice and research in obesity, we have observed and treated numerous obese patients, and we have found that obesity has a lot of phenotypes and clinical features which are related to the metabolic status. Based on our clinical findings, combined with the experience of Chinese traditional medicine, we now propose a new clinical classification and diagnosis of obesity based on individuals′ metabolic status, which, we believe, can facilitate clinicians′practice. Based on the metabolic status and skin features of obese patients, obesity is divided into metabolic healthy obesity (‘white obesity’) and metabolic unhealthy obesity. Then, the latter is further divided into three groups including high metabolic obesity (‘red obesity’ ) , low metabolic obesity (‘yellow obesity’ ) , and severe metabolic disorder with inflammation obesity (‘black obesity’ ) . If we also consider to add normal weight metabolic obesity to this classification, there should be five types of obesity to be classified as presented. We wish this proposed classification of obesity can play a valuable role in enabling clinicians to have a better understanding of obesity in relation to its metabolism, and to develop individualized treatment according to the metabolic status of the patient. As a result, we may finally achieve the desired outcomes through making appropriate diagnosis and treatments.

The rat model of obesity was induced by high fat diet and in situ hybridization was performed with oligonucleotide probes.The results showed that expressions of leptin receptor mRNA and neuropeptide Y mRNA were significantly increased, suggesting that these increments might be related to leptin resistance.

OBJECTIVE:To establish the quality standard for Maikang mixture. METHODS:TLC was used for the qualitative identification of Paeonia lactiflora,Angelica sinensis,Ligusticum chuanxiong,Astragalus membranaceus,Schisandra chinensis and Ophiopogon japonicus. HPLC was used for the content determination of schisandrin:the column was Kromasil C18 with mobile phase of methanol-water (60∶40,V/V) at a flow rate of 1.0 ml/min,detection wavelength was 254 nm,column temperature was 40 ℃,and the infection volume was 20 μl. RESULTS:P. lactiflora,A. sinensis,L. chuanxiong,A. membranaceus,S. chinensis and O. japonicus showed clear spots and well separated. The linear range of schisandrin was 1-50 μg/ml (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 97.01%-98.58%(RSD=0.56%,n=6). CONCLU-SIONS:The established standard can be used for the quality control of Maikang mixture.

Objective To induce the site-directed mutation of human cardiac troponin I (cTnI) gene, express the mutant in E. coli, and to study the effects of the mutation on the prokaryotic expression of cTnI. Methods The cDNA encoding cTnI was cloned with RT-PCR from the total RNA extracted from human myocardium tissues. A pair of primers was designed and, after the mutations were induced at the second and the fourth codons, inserted into prokaryotic vector pET-28c (+) and transform the recombinant to BL21 (DE3) bacteria. After purified with Ni-NTA resin, the histidine-tagged fusion protein expressed by IPTG-induced was identified by Western blotting and the expression yield of cTnI protein was investigated. Results The expression of the recombinant carrying processed cTnI cDNA was stronger than that in control group. Conclusion cDNA encoding cTnI was successfully cloned. The recombinant with mutations can be more efficient expressed in E. coli. The cTnI protein can be purified to near homogeneity.

Objective To validate the theraputic efficacy of percutaneous ethanol injection(PEI) for hyperparathyroidism caused by parathyroid adenoma.Methods One case of parathyroid adenoma underwent PEI whose diagnosis was comfirmed by biopsy. The 22 gauge needle was punctured into the adenoma under CT guidance and ethanol was injected into the lesion at multiple points. Results The CT images obtained 6 months after 2 times of CT guided PEI revealed that the volume of the adenoma decreased markedly together obviously with decrease of enhancement after the injection of contrast media. The level of serum parathyroid hormone, calcium and phosphorous returned normal 2 days to 12 months after the management. The clinical manifestations improved markedly.Conclusions CT guided PEI is a minimally invasive and highly effective theraputic modality for hyperparathyroidism. It can serve as an important supplement to surgery.

Objective To investigate the effect of ketamine on learning and memory function of adult rats after injection of ketamine at early development stage. Methods Twelve rats born in a week were randomly divided into ketamine anesthesia group(Ket group)and normal saline control group(Ns group).Rats in Ket group were intraperitoneally injected with 50 mg/kg ketamine,and those in Ns group were administrated with same amount of normal saline.After eight weeks,Morris water maze test was adopted to explore the latency in place navigation and spatial probe ability.The sections of hippocampus were obtained,and immunohistochemical staining was employed to detect the expression of Bax and Bcl-2.Results In Morris water maze test,the latency in place navigation of Ket group Was significantly longer than that of Ns group(P<0.05),and the spatial probe ability significantly decreased(P<0.05).It Was revealed by immunohistochemical staining that the expression of Bax in Ket group was significantly higher than that in Ns group,while there was no significant difference in the expression of Bcl-2 between these two groups. Conclusion Application of ketamine in neonatal rats may result in learning and memory impairment in adulthood,and the underlying mechanism may correlate to the apoptosis of neuron in hippocampus region.