Mannitol is a kind of major marine bio-products with important biological activities. It is not only used in injection as raw material, but also used with other medicine as supplemental composition. Simultaneously, it is used for synthesis of a series of derivative medicines. The specific application of mannitol as raw materials and excipient was reviewed in detail. And the synthetic methods, properties and medical application of every derivative medicine were introduced.

Thyroid hormones play major roles in the regulation of a wide range of metabolie and physiologic processes.Serum thyroid-stimulating hormone( TSH ) concentration,a sensitive barometer of thyroid function,shows significant individual difference in which genetic variation is a major factor.After using traditional genetic linkage studies and candidate gene association studies to explore the suseeptibility genes of serum TSH,many progresses have been made and new susceptibility genes have been identified by genome-wide association study (GWAS).In this review,we focus on the susceptibility genes of serum TSH levels and also the future prospect that may be obtained from these studies.

Objective To establish an objective animal experimental model for the experimental study of clinical bone defect,detect the BMP-2 activity in bone defect area,and observe the early healing situation of rabbit radial fracture.Methods A total of 72 New Zealand rabbits [weight/ each:(2.8 ±0.2)kg] were randomly divided into four experimental groups A,B,C,and D (18/each) with corresponding 0.5 cm,1.5 cm,2.0 cm,and 3.0 cm bone defect models abolished,respectively,in the middle of the rabbit left radius.By the time of modeling,all the bone segments were retained and a small amount of bone adjacent tissues were taken as E specimens of control group.Modeling time was recorded as 0 week,and six animals of each group were killed in 1 W,3 W,4 W later.Then the bone defect surrounding tissues were taken to check BMP-2 content by Western-blot detection,and the bone-healing situation was observed at different time.Results BMP-2 composition showed a significant increase in secretory volume of each group's bone defect area tissues after modeling one week,compared with E specimens of control group (P ＜ 0.05).BMP-2 composition secretion capacity even reached its peak in the third week four groups (A,B,C,D)increased by 556.1％,385.9％,272.2％,171.2％ respectively.and BMP-2 content reduced apparently in the fourth week than before(P ＜ 0.05).At the same time,BMP-2 content decreased with the addition of bone defect length(P ＜ 0.05).Also a correlation was shown between bone healing and time with the bone defect length.Conclusions A comparable rabbit radial bone defect model was successfully established.These objective animal models,which are closer to clinical reality,provide the theoretical basis of animal experiments to explore the mechanism of human fracture healing.

Objective: To report a newly designed method for treating supracondylar fracture of the humerus,and to inquire into the problems of cubitus varus deformity and joint stiff.Methods:Based on a review of anatomy,a new method which called tension band with sphenoid-shaped osteotomy through posterior approach was designed and applied for 46 cases of patients in clinic.The clinical effect was compared with effect of crossing Kirchner's wire.Results:The tension band with sphenoid-shaped osteotomy was a better method and can abide by anatomical and biomechanical principles.After follow-up for 12-36 months,curative effect was estimated as follow:30 cases were excellent,14 cases good and 2 cases poor according to Home's evaluation.Conclusions:It is a better methods in treating supracondylar fracture of the humerus following advantages including simple,reliable fixation and early mobilization etc.

The emerging technologies change rapidly in the medical field, refresh the medical ethical scenari-os, brought some medical ethical blind spot.Therefore, building the platform of academic research, making use of the new media, MOOC and“flipped classroom”, inheriting the native“The Spirits of A Great Physician” in tradi-tional Chinese medicine and western medicine, life ethics education and sublation of new exploration, the ideolog-ical and moral education for medical students is expected to be improved in China.

Objective To assess the efficacy and safety of emergency transcatheter arterial embolization in the management of intractable postpartum hemorrhage. Methods Twenty-five patients with intractable postpartum hemorrhage were undertaken superselective catheterization into the bilateral internal iliac arteries or uterial arteries to find the causes and sites of bleeding through DSA and then followed by arterial embolization with gelfoam particles. Result All of the 25 patients with obstetrical bleeding were successfully controlled by TAE, the procedure lasted for 25 - 60 min, (mean 42.5 ? 4.6 min); with both catheterization and bleeding halt successful rates of 100%. Comparison of hemoglobin and heartbeat before and after the procedure showed significance(t = 29.49, P

Objective To investigate the surgical indicatin and outcome of recurrent gastric carcinoma.Methods Review the clinical data of 56 cases with recurrent gastric carcinoma underwent reoperation from 1990 to 2000.The operative indication, surgical method and complications were analized.Results In 25 cases the recurrent tumor were resected (44.6%),in 10 cases adjacent organs were resected.NO operative motality was observed.Conclusions More aggressive radical resection of the gastric cancer is the key to prevent recurrence.Laparotomy should be performed without delay once there is a suspicion of recurrence.

Objective To study the rule of lower-cervical lymphatic metastasis in thoracic esophageal carcinoma,and make evaluation about the reasonable extent of lymphadenectomy. Methods One hundred and eight cases of thoracic esophageal carcinoma through chromatic ultrasound and CT before operation were divided into different groups selectively,while three fields lymphadenectomy (3-FL) was adopted in 31 cases,and two fields lymphadenctomy (2-FL) was adopted in 77 cases. Results The rate of lower-cervical lymphatic metastasis was 87.1%(27/31) through chromatic ultrasound and CT,and that was 25.0%(27/108) before the two up-mentioned examinations (P<0.05). In all cases, the rate of lower-cervical lymphatic metastasis in the upper pectoral esophageal carcinoma was 47.6% (10/21),that in the middle pectoral esophageal carcinoma was 21.3%(13161),and that in the middle and lower pectoral esophageal carcinoma was 19.5%(17187) ,P<0.05. Through 3-FL, the rate of lower--cervical lymphatic metastasis in the upper pectoral esophageal eareinoma was 57.1%(12/21), that in the middle pectoral esophageal carcinoma was 23.0%(14/61), and that in the middle and lower pectoral esophageal carcinoma was 21.8%(19/87), P<0.05. Conclusions The regionality metastasis is the main fashion in thoracic esophageal carcinoma with lower-cervical lymphatic metastasis. It is feasible to judge lower-cervical lymphatic metastasis through chromatic ultrasound and CT before operation.The 3-FL of the upper pectoral esophageal carcinoma is recommended. The 3-FL is selectable in the middle and lower pectoral esophageal carcinoma according to the result of chromatic ultrasound and CT.

Objective To investigate the damage mechanism of fluetuant high glucose on the INS-1 cells (pancreatic β-cell lines).Methods The cells were divided into five groups:the control groups (A group:5.5 mmol/L of glucose),the continuing high glucose group (B group:16.7 mmoL/L of glucose),the fluctuant glucose group ( C group:16.7 mmol/L of glucose for cultivation for 2 h,then the concentration changed to 5.5 mmol/L for cultivation for 3 h,which was repeated 3 times per day;the ceils were kept in the medium containing 5.5 mmol/L of glucose during night time for 9 h),the continuing high glucose plus NAC ( 1.0 mmo/L) group ( D group),the fluctuant glucose plus NAC group ( E group).The intracellular reactive oxygen species (ROS) was observed by the flow cytometry.The activity of glucose-6-phosphate dehydrogenase (G6PD) was estimated by the tetrazolium linked cytochemical method.Results 72 h after intervention,the levels of ROSwere 37.77±2.31,86.97±7.97,124.27±10.04,60.92±2.61 and 51.47±3.36,respectively,in A～E group;the activities of G6PD were 1.25±0.03,1.09±0.02,1.03±0.01,1.12±0.02 and 1.21±0.01,respectively;the levels of NADPH were (0.123±0.003) mmol/mg prot,(0.112±0.004) mmoL/mg prot,(0.099±0.002 ) mmol/mg prot,( 0.116±0.005 ) mmol/mg prot and ( 0.120±0.002) mmol/mg prot,respectively.The level of ROS in the cells of the fluctuant glucose group were significantly higher than that in the continuing high glucose group ( P ＜ 0.01 ).The G6PD activity and NADPH was significantly lower in fluctuant high glucose group than those in the continuing high glucose group (P ＜0.01 ).NAC co-cultivation decreased the extent of cell's change.Conclusions Exposure of INS-1 to high glucose lead to increased oxidative stress, possible mechanism included decreased G6PD activity and subsequent imbalance between oxidation and reduction.

Objective To study the relationship between VEGF-C,CD34 expression and thyroid papillary tumor tissue by combining assays of VEGF-C and CD34 in thyroid tumor tissue.Methods The expression of VEGF-C and CD34 were dectected by immunohistochemistry in 61 cases(thyroid papillary cancer 38.thyroid adenoma 23).Results VEGF-C level in thyroid papillary cancer(38.24±19.58)were significantly hisher than that in thyroid adenoma(16.49±9.25,P<0.01);CD34 in thyroid papillary cancer (23.68 ±9.07)/HP were higher than that in thyroid adenoma(18.70±6.34,t=4.9889,P<0.01).We found a significant relationship between the VEGF-C expression and cancerometastasis or tumor size(P<0.01;P<0.05).There was also a relationship between the CD34 expression and cancerometastasis or tumor size or age (P<0.01 or P<0.05).There Was positive relationship between the expression of VEGF-C and CD34(r=0.46.P<0.01).Conclusion It is suggested that combined detections of VEGF-C and CD34 may have important reference value on the differential diagnosis between thyroid papillary tumor tissue.