Thyroid hormones play important roles in growth, development, and metabolism of various cells and tissues. It has been assumed for a long time that thyroid hormones are lipophilic and enter cells by passive diffusion, but it has become increasingly clear that cellular uptake and efflux of thyroid hormones are mediated by transporters. The discovery of these thyroid hormone transporters will lead to a better understanding of the tissuespecific regulation of thyroid hormones.

Neuroblastoma is one of the solid tumors in children which easily metastasizes to bone.It causes radiographic appearance of osteoclastic reactions after bone metastases.In the process,neuroblastoma cells,osteoblasts and bone stromal cells secrete a series of related factors to promote bone metastases.In this paper,the progress of the mechanism in bone destruction caused by neuroblastoma is reviewed.

Objective To evaluate the efficacy of chaihu shugan san plus polyene phosphatidylcholine for non-alcoholic fatty liver disease(NAFLD).Methods Ninety patients with NAFLD were randomly divided into 3groups(each n=30):polyene phosphatidylcholine group(Group A),chaihu shugan san group(Group B),and chaihu shugan san plus polyene phosphatidylcholine group(Group C).The clinical symptom scores,biochemistry index (ALT,AST,GGT,TBIL,TC,TG,HLD-C,LDL-C),and B ultrasound examination were measured.Results There were significant differences in clinical symptom scores,ALT,AST,GGT,TBIL,TC,TG,and LDL-C between before and after treatment in the three groups(P＜0.05).After treatment,the clinical symptom scores,ALT,AST,TBIL,and LDL-C in Group C were significantly lower than those in Group A and Group B(P＜0.05).There were similar effects on TC and TG between Group B and Groop C,which were better than those in Group A(P＜0.05).Conclusion The efficacy of combined treatment of chaihu shugan san and polyene phosphatidylcholine was better than that of merely chaihu shugan san or tiopronin.

Objective To explore the possibility of finding pulmonary embolish by CT scan. Methods 20 cases of patients with pulmonary embolism comfirmed by CTA were selected. The CT scan was compared with the enhance film in the same level of contrast observation site. Results 12 cases found in plain site with the CTA form show abnormal density within the same lumen shadow. Indirect signs of bronchial artery dilatation except plain and outside the CTA showed no difference. Conclusion Pulmonary embolism in the carefully observed before enhanced large artery can be found within the thrombus.

“The guideline for the diagnosis and management of thyroid diseases during pregnancy and postpartum in China” written by Chinese Society of Endocrinology and Chinese Society of Perinatal Medicine is now formally published.This guideline was written following the principles of “based on the national conditions,evidencebased medicine,being innovative and realistic,and resource sharing”.It is modeled on the guideline issued by American Thyroid Association in 2011,joining the research of domestic scholars and combining with the actual situation of domestic clinical work and maternal and child health.This guideline contains 11 chapters,taking question terms and recommendation terms in the model,and a total of 68 problem terms and 57 recommendation terms.This paper deeply discusses the problems about the diagnosis and treatment of subclinical hypothyroidism during pregnancy,as well as the importance of establishing gestation-specific TSH reference interval.

Objective To investigate the effect of problem-based learning(PBL) combined with traditional teaching in the teaching of electrocardiogram (ECG) diagnosis. Methods Totally 80 2011 grade clinical medicine students were enrolled and randomly divided into study group and regular group. Traditional teaching method was implemented in regular group while PBL com-bined with traditional teaching was applied in study group. Effect was observed;measurement data were analyzed by independent samples t test and were expressed as mean ± standard deviation x±s;enumeration data were analyzed by χ2 test. P<0.05 signifies statistical differences. Results Satisfaction degree of students towards teachers was 95.0%(38/40) in study group and was 80.0%(32/40) in regular group with statistical significances between two groups(P=0.001). Satisfaction degree of students towards teaching method was 100 . 0%( 40/40 ) in study group and was 87 . 5%(35/40) in regular group with statistical significances between two groups (P=0.000). Operating skills, theoretical knowledge and ECG analysis capabilities scores were significantly higher in study group than in regular group with statistical differences(P=0.012, P=0.021, P=0.016). Conclusions Implementing PBL teaching combined with traditional teaching can achieve significantly better teaching effect than traditional teaching, therefore it is worthy of application and promotion.

OBJECTIVE: To clarify the pathogens in plateau hospital-acquired pulmonary infection and their antimicrobial susceptibility so as to provide scientific basis for clinical first-line treatment in the rational use of antibacterial drugs. METHODS: The bacteriological culture and drug susceptibility experiment on sputum and bronchial douche fluid collected from 1 396 patients with hospital-acquired pulmonary infection in our hospital from 2004 to 2006 as well as the filed medical records were analyzed retrospectively. RESULTS: 789 positive bacteria were isolated, of which, 77.82% (614/789) were gram-negative bacilli (GNB), with Klebsiella spp showing the highest percentage, accounting for 53.91% (331/614); 21.04% (166/789) were gram-positive bacteria, with staph showing the highest percentage, accounting for 46.99% (78/789).Most of the GNB were sensitive to imipenem, sulbactam/cefoperazone, then to aminoglycosides. The susceptibility rate of Gram-positive bacteria to vancomycin was 90.36%. CONCLUSION: Gram-negative bacilli were the main hospital infection pathogens, which were sensitive to imipenem, sulbactam/cefoperazone but highly resistant to ceftazidime, which calls for attention in the clinic.

hypothyroidism is a common subclinical disease in endocrinology. Its diagnosis is based on an elevated serum TSH but normal FT 4 levels. The adverse outcome of subclinical hypothyroidism is progressing to overt hypothyroidism with an increased risk for atherosclerosis and myocardial infarction . Two factors may affect the development of overt hypothyroidism: the levels of serum TSH and thyroid autoantibodies and both factors have additional effects on the outcome. The benefits of treatment with T 4for preventing the development of overt hypothyroidism is not yet certain; subclinical hypothyroidism is a strong indicator of risk for atherosclerosis and myocardial infarction, just like other known major risk fators such as hypercholestrolemia, hypertension, smoking and diabetes (odds ratio for aortic atherosclerosis 1.9; odds ratio for myocardial infarction 3.1). The treatment with T 4 for the patients could reduce the levels of serum cholesterol. The effects of subclinical hypothyroidism in pregnant women on the IQ of their children have been widely focused. According to the results from a published epidemiological study, the normal reference values of TSH, thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) detected by immunochemiluminesence assay (ICMA) method and the cut-off values of TPOAb and TgAb associated with thyroid diseases have been proposed.

Objective To observe the clinical efficacy ofShenqi Unguent on sub-clinical hypothyroidism patients with qi-deficiency constitution.Methods A total of 60 patients were randomly divided into treatment group and control group. The treatment group took the traditional Chinese medicine ofShenqi Unguent, while the control group took euthyrox orally for 6 months. Changes of carotid intima-media thickness (CIMT), thyroid function (FT3, FT4, TSH, TG-Ab, TPO-Ab), and TCM syndrome integral before and after treatment of the two groups were observed. Results After treatment, the TCM syndrome integrals of the treatment group were significantly improved, compared with the control group (P<0.01). Similarly, CIMT of the treatment group were obviously increased, compared with the control group (P<0.05). Meanwhile, levels of serum TG-Ab and TPO-Ab were distinctly reduced than that of the control group (P<0.01).ConclusionShenqi Unguent has marked clinical efficacy on sub-clinical hypothyroidism patients with qi-deficiency constitution.

[Summary] The incidence of thyroid cancer in China is increasing rapidly, at an annual percentage change (APC)of 20. 1%, while the APC of mortality of thyroid cancer is only 1. 6%, which is defined asoverdiagnosis by the experts of tumor field. This tendency is due to the over-screening for thyroid nodules and cancers with high resolution of B ultrasound equipments. The prevalence of latent thyroid cancer is 11. 5% in human-being as found by the autopsy. However, the prognosis of the majority of patients is good. The clinical doctors and health-care department of government in China should take actions to deal with the tendency of over-screening andoverdiagnosisfor thyroid nodules and cancers.