As an important postsurgical adjuvant treatment for DTC, radioactive iodine (RAI) is administered to eliminate residual thyroid tissue as well as the potentially persistent or distant metastatic lesions.It plays a significant role in reducing disease recurrence and tumor-related mortality.The major challenge at present in RAI treatment decision-making is how to achieve optimum clinical outcome with minimal radiation exposure.ATA guidelines recommends a postsurgical recurrence-risk adapted approach to RAI treatment management based on the clinicopathological features.However, RAI therapy is not beneficial to all DTC patients.The potential benefits from RAI therapy in DTC patients with different risk stratification have attracted much attention, and are reviewed in this article in order to provide more evidence-based basis for clinical decision-making.

Recently, the morbidity of differentiated thyroid carcinoma (DTC) has increased annually. American Thyroid Association (ATA) published the management guidelines for patients with thyroid nodules and DTC in 2006 in order to standardize their management. The ATA guidelines was updated for the ifrst time in 2009 and its renewed version was completed in 2015 based on the considerable progress that had been made in the ifelds such as diagnostic assessment and management of thyroid nodules, surgery and radioactive iodine therapy for DTC in recent years. This article tried to interpret the updated contents about radioactive iodine therapy for DTC in 2015 version of the guidelines.

Objective To explore the efficacy of glutathione (GSH ) combined with early nursing intervention for treating neo‐natal jaundice ,and to investigate its influence on serum malondialdehyde (MDA ) ,superoxides dismutase(SOD) and glutathione‐Px (GSH‐Px) levels .Methods Sixty‐eight cases of neonatal jaundice were chosen and randomly divided into the observation group (n=34) and conventional group (n= 34) .Contemporaneous 20 full term healthy neonates were selected as the healthy control group .The observation group was added with GSH and early nursing intervention on the basis of the conventional group .Serum to‐tal bilirubin(TBIL) ,direct bilirubin(DBIL) ,MDA ,SOD and GSH‐Px levels were detected before and after treatment .Results The total effective rate in the observation group was 91 .2% ,which was significantly higher than 73 .5% in the conventional group(P<0 .05);compared with before treatment ,serum TBIL and DBIL levels after treatment in the two group were significantly decreased (P<0 .01) ,moreover the levels of TBIL and DBIL after treatment in the observation group were significantly lower than those in the conventional group(P<0 .01) .The serum MDA level before treatment in both groups were significantly higher than that in the healthy control group(P<0 .01) ,while serum SOD and GSH‐Px levels in the two groups were significantly lower than those in the healthy control group(P<0 .01);after treatment ,serum MDA level in both groups were significantly decreased (P<0 .01 or P<0 .05) ,while serum SOD and GSH‐Px levels in the two group were significantly increased (P<0 .01 or 0 .05);compared with the conventional group ,decrease of serum MDA level in the observation group was more significant (P<0 .05) and serum GSH‐Px level was markedly increased(P<0 .05) .Conclusion GSH combined with early nursing intervention has better effect in the treatment of neotatal jaundice and effectively reduces the levels of serum TBIL ,DBIL and MDA ,and increases the levels of SOD and GSH‐Px , which has positive clinical significance .

Objective To investigate the expression of Chemerin in cervical intraepithelial neoplasia(CIN) and cervical cancer and its relation with clinicopathological characteristics.Methods The expression of Chemerin was determined with enzyme-linked immunosorbent assay (ELISA) in 35 cervical cancer cases,20 cervical intraepithelial neoplasia cases and 20 normal persons.The association of serum level of Chemerin with clinicopathological charactersistics was analyzed.Results The level of Chemerin was the highest in cervical cancer cases [(2113.35 ± 198.64) ng/L],higher in CIN [(1562.78 ± 158.65) ng/L],and low in normal persons [(946.36 ± 113.57) ng/L],showing significant difference among three groups.The serum level of Chemerin in cervical cancer were positively correlated with Federation International of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis (P ＜ 0.05).Serum Chemerin levels were increased with clinical FIGO stage and showed significantly positive correlation with FIGO stage (rs =0.92,P =O.000).Conclusions The expression of Chemerin in patients with cervical carcinoma is increased.Chemerin may be used as reference indicator to predict its progression in cervical carcinoma.

Objective To study the adverse effects on periodontal tissues caused by crownless roots in elderly people with osteoporosis. Methods Totally 60 12?week SD rats(30 male and 30 female)were randomly divided into the control group(10 male and 10 female sham?operated rats)and the osteoporosis group(20 male and 20 female castrated rats). After 12 weeks,the bone mineral density of right femora was measured by dual energy X?ray for all rats to confirm osteoporosis. The right molar crown was pinched off with haemostatic forceps and the molar root was retained. The 10 con?trol rats and the 20 experimental rats were sacrificed respectively at postoperative 2 and 4 weeks. The periodontal tissues of right molar were sampled and the morphology of the parodontium and the alveolar bone was observed by haematoxylin and eosin(HE)staining and the expression of tumour necrosis factor?alpha(TNF?α)and inducible nitric oxide synthase?2(NOS2)was detected by immunohistochemical staining and real time fluores?cent quantitative PCR(qRT?PCR). Results The HE slices indicated that the periodontal tissues in the osteoporosis group were significantly im?paired compared to the control group as the structure of parodontium loosened. Bone impairment aggravated over time. TNF?αstaining showed as a few claybank spots on the parodontium in the control group,while the staining colour was darkened in the osteoporosis group. The expression of TNF?αmRNA was significantly higher in the osteoporosis group than in the control group(P<0.05). The result of NOS2 was contrary to that of TNF?α. The differences in TNF?αand NOS2 were not statistically significant at 2 and 4 weeks(P>0.05). Conclusion The crownless roots in rats with os?teoporosis cause adverse effects of periodontal tissues as the roots accelerate absorption of the surrounding alveolar tissues. It is indicated that crown?less roots in elderly people with osteoporosis should be removed as soon as possible.

Sphincter of Oddi dysfunction(SOD) is grouped under the functional gastrointestinal diseases.Due to lack of typical symptoms and signs,the diagnosis of SOD is difficult.The proposal to classify SOD significantly improves diagnosis and has important clinical significance in selecting treatment.This paper reviews the researches on classification,recent progress in diagnosis and treatment of SOD.

AIM: To study the protective effects of intravenous (iv) CGRP on myocardial injury in rat. METHODS: Establish a rat myocardial ischemic injury model by subcutaneous injection of single dose of isoproterenol (ISO), and treat the model with single dose of iv CGRP. Two hours later, serum CK, LDH, MDA and SOD levels were measured, MDA and SOD in myocardial tissue were tested, and myocardial tissue structures were observed. RESULTS:(1) Serum MDA and tissue MDA levels increased significantly and serum SOD and tissue SOD decreased significantly in injury group, in the CGRP treated group, the above changes were reversed (P

Objective To investigate the effectiveness of glucocorticoids in the treatment of granulomatous lobular mastitis (GLM), and to discuss the optimal stage to add glucocorticoids during the treatment. Methods Twenty-four patients having received the core needle biopsy were involved. Ten cases with the explicit pathological diagnosis received the glucocorticoids therapy following the subtotal excision after remission. Pathological diagnoses of the rest 14 patients were undefined. For these 14 patients, simple partial excisions were given and the postoperative pathological diagnoses were presented as the GLM. Of all the 14 patients who accepted the surgical treatment firstly, 8 patients received the postoperative glucocorticoids adjuvant therapy. For the rest 6 patients, steroid hormone therapy was not used after surgery, and they were followed up postoperatively. All patients' clinical and pathological information were collected and analyzed. Results All patients were followed up for 6-36 months (average 18) by the outpatient service. Of all the 10 patients who received the glucocorticoids therapy before surgery, only 1 patient of them got the GLM recurrence. For the 8 patients who received the postoperative glucocorticoids treatment, only 1 patient got the recurrence. For the 6 patients who received simple partial excision, the recurrence of the GLM may be up to 3. There was no statistical difference between the two groups who both received the 05). But compared with the pure surgery treatment, the difference was obviously (P<0.05). Conclusions The clinical presentation and imaging performance of GLM are unspecific, so the diagnosis of the GLM is difficult. There is no consensus regarding the optimal treatment for GLM. The glucocorticoids therapy may be necessary preoperatively or postoperatively. For the patient with clear preoperative biopsy diagnosis, preoperative glucocorticoids adjuvant chemotherapy followed by the wide excision may be an effective method.

Objective To investigate the relationship between the initial change of Tg and clinical outcome in DTC patients with pulmonary metastases after 131I treatment.Methods A total of 47 DTC patients (13 males,34 females;average age (41.6±16.3) years) with pulmonary metastases from January 2008 to June 2014 were retrospectively analyzed.Patients were divided into 3 groups according to the variation of Tg: G1 with a declined (more than 50％) Tg;G2 with a declined (less than 50％) Tg or an increased (less than 10％) Tg;G3 with an increased (more than 10％) Tg.The median follow-up time was 1 501 d.Clinical outcomes were divided into remission,stable disease and progressive disease according to the serum test and imaging results.Data analysis was performed by χ2 test and Fisher exact test.Results The percentage of G1,G2,G3 patients was 44.7％(21/47),40.4％(19/47),and 14.9％(7/47) respectively.Results of follow-up showed 19.0％(4/21) patients achieved remission and 81.0％(17/21) with stable disease in G1.There were 2/19 with remission,12/19 with stable disease and 5/19 with progression disease in G2.All patients (7/7) had progressive disease in G3.The clinical outcome was related to the variation of Tg after 131I treatment (Fisher exact test,P<0.01).Conclusions Initial Tg after 131I treatment could be a predictor to the outcome of patients.The increased Tg level indicates a high possibility of 131I refractory disease.

Background and purpose:Radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) is a big challenge in the management of thyroid cancer. Sorafenib and lenvatinib are the 2 tyrosine kinase inhibitors (TKIs) recently approved by FDA, which could not be affordable for most of the Chinese patients. This pilot study aimed to evaluate the short term effcacy and safety of apatinib, a Chinese domestic TKI targeted vascular endothelial growth factor receptor (VEGFR), in advanced RAIR-DTC.Methods:Ten patients who were identiifed as progressive RAIR-DTC were enrolled in this study. Patients received oral apatinib 750 mg once daily. Both thyroglobulin (Tg) and/or Tg antibody (TgAb) levels were monitored every 2 weeks after the treatment. Computed tomography (CT) was per-formed every 4 weeks after apatinib treatment to evaluate the response according to response evaluation criteria in solid tumor version 1.1 (RECIST 1.1). Within 8 weeks after apatinib treatment, therapeutic response was evaluated in terms of Tg, a sensitive biochemical tumor marker for DTC, and RECIST 1.1 assessment. Meanwhile, the adverse events (AE) were monitored during the therapy.Results:The Tg levels declined after the ifrst 2 weeks of apatinib treatment, and a mean decline rate of 68% could be observed in 8 patients with Tg available for evaluation after 8 weeks, which repre-sented a biochemical partial response. Eighteen target lesions (TL) of 10 patients were evaluated and followed up. The diameter of TL began to decrease after 4 weeks, and a mean decline of 40% could be observed after 8 weeks’ apatinib treatment. A total of 9 patients (9/10) achieved partial response according to RECIST 1.1 criteria and 1 patient with stable disease, with 90% objective response rate and 100% disease control rate. The most common AE beyond grade 3 included hand-foot-skin reactions, hypertension and hypocalcemia, which accounted for 50%, 30% and 20% of the cases, respectively. No severe AE related to apatinib was observed during the treatment.Conclusion:A safe and rapid response and high partial response rate in terms of biochemistry, RECIST 1.1 could be observed in RAIR-DTC patients within 8 weeks of apatinib treatment.