The prevalence of thyroid nodules, especially differentiated thyroid cancer, has increased during the past decades. With the consideration of increasing prevalence of the disease, American Thyroid Association (ATA) updated the guidelines for adult patients with thyroid nodules and differentiated thyroid cancer in 2015. The aim of the new guidelines was to minimize potential harm from overtreatment in majority of patients at low risk for disease-specific mortality and morbidity while appropriately treat and monitor those patients at higher risk. The updates of surgery-related contents in new ATA guidelines are interpreted in this article.

Objective To discuss the value of thyroglobulin (TG) in diagnosis and treatment of differentiated thyroid cancer (DTC) patients. Methods Literatures on measurement and clinical application of serum TG were reviewed. Results Immunometric assay (IMA) was adopted by most clinical lab.TG antibody (TG-Ab) should be measured in the same sample of DTC patient.TG detection before operation is of less value in confirming diagnosis of DTC, but is helpful in differential diagnosis of histopathological type of DTC.TG detection after operation is very important in patients who had undergone total thyroidectomy.Monitoring TG after thyroid hormone withdrawal or recombinant human TSH stimulation is more sensitive to identify tumor recurrence. Conclusion Monitoring TG after total thyroidectomy has great value in follow-up of DTC patients.

Objective To investigate the relationship between nuclear transcription factor-?B (NF-?B) and the preterm delivery (PRD) associated with intraamniotic infection (IAI) and the related mechanisms. Methods A total of 45 pregnant mice (gestation for 15 d) were divided into three groups (n=15 in each group): lipopolysaccharide (LPS) group, pyrrolidine dithiocarbamate (PDTC) plus LPS group, and saline group. The delivery time of the mice administered intravenously with the above in each group was observed after intravenous administration. The other 15 pregnant mice were also divided into 3 groups (n=5 in each group). At 16 h after administration, these mice were sacrificed for the detection of TNF-? and IL-8 levels in the plancenta by immunohistochemistry. Results The gestation time of group administered with LPS was longer than that of the group administered with LPS plus PDTC, but the expression levels of TNF-? and IL-8 were lower than those of the group administered with LPS plus PDTC. Conclusion NF-?B may participate in PRD associated with IAI through modulating the expressions of some cytokines.

Objective To investigate the relationship between auditory event-related potentials to an oddball task and age in healthy adults,in order to provide the basis for the clinical diagnosis of age-related cognitive diseases.Methods 90 subjects were examined by auditory event-related potentials to an oddball task,and divided into normal young adults,middle-aged and elderly groups (n =30,each group).We measured the wave latencies and amplitude of P50,N100 and P200 wave recorded at the Cz points,and those of N200 and P300 wave at the Pz point.The correlations of the above indicators with age were analyzed.Results The reaction times were (519.33±33.65) ms in youth group,(521.52±39.81) ms in middle age group and (531.46±43.26) ms in elderly group.There were no statistically differences in reaction times among the 3 groups(F=1.89,P=0.107).Compared with the youth group,P50 amplitudes were increased [(2.03±0.31) μV vs.(1.83±0.23) μV,t=2.17,P＝ 0.032],P300 latencies were prolonged [(343.17 ± 30.70) ms vs.(323.54 ± 24.56) ms,t=2.23,P=0.028],P300 amplitudes were decreased [(13.88±3.15) μV vs.(15.62± 2.12) μV,t=2.35,P＝0.018] in the middlc-aged group.Compared with the middle-aged group,the elderly group showed that P50 amplitudes were increased [(2.39±0.40) μV vs.(2.03±0.31) μV,t =4.73,P=0.000],N200latencies were prolonged [(222.16±29.40) ms vs.(206.04±28.98) ms,t=2.12,P=0.039],P300 latencies were prolonged and amplitudes were decreased [(373.83 ± 45.90)ms vs.(343.17±30.70)ms,t=5.12,P=0.000; (10.68±4.16)μV vs.(13.88±3.15) μV,t=4.95,P=0.000].Other waves had no significant differences in latencies and amplitudes among the three groups (all P＞ 0.05).In all subjects,P50 amplitudes and P300 latencies showed positively correlated with age.The average increments of P50 amplitudes and P300 latencies in normal young adults,middle-aged and elderly groups were 0.008 V/year,0.012 V/year and 0.016 V/year,and 0.917 ms/year,1.148 ms/year and 1.715 ms/year respectively.Conclusions In healthy adults,P50 amplitude and P300 latency of auditory event-related potentials are related with age.P50 amplitude and P300 latency are gradually increased or prolonged along with age,with accelerated changes in the elderly.

Objective To assess clinic value of esophageal stent placement in the benign and malignant esophageal strictures,and the influence of stents selection on curative effect. Method 36 cases of esophageal strictures, 5 cases of benign strictures,31cases of malignant strictures,including 4 cases with esophagotracheal fistula and 3 cases with esophagomediastrinal fistula. 26 domestic Nickel-Titanium alloy memorial netlike stents and 14 membrane-covered stents were used for the treatment. All patients were treated by placing esophageal stent perorally under fluoroscopic guidance. Results 40 stents were planced successfully in 36 cases, only one case showed membrane covered stent migrating. Symptoms of dysphagia were considerably relieved after stent insertion. The total effective rate was 97.2%. Conclusion The esophageal stent is an effective and safe treatment for benign and malignant esophageal stenosis: The nutritive condition and the quality of life of patients are improved, which is favourable for tumor further treatment. Appropriate stent selection can keep esophageal patent rate and decrease sliding rate.

Objective To observe the clinical value and the effect of interventional treatment on obstructive jaundice. Methods 24 patients with obstructive jaundice, including 21 cases of malignant biliary obstruction and 3 cases of chololithiasis post operative biliary stricture of bile duct, were treated after percutaneous transhepatic biliary moulding, 6 cases with percutaneous transhepatic cholangic drainage(PTCD), 18 cases with insertion of biliary stents, 13 net-type stents and 5 Z-type stents were used, according to the patient's state and financial condition. Results The total technical success rate was 100%. After 7～15 days of interventional treatment, the total serum bilirubin level declined from (454 93?64 52)?mol/L to (66 94?8 45)?mol/L, transaminase declined from (265 67?30 09)u/L to (56 21?8 73)u/L. There was very significantly difference (P

Abstract: Objective To explore the effect of optimal intervention on occupational stress in front-line workers of electronic manufacturing industry. Methods A total of 257 front-line workers in an electronic manufacturing industry were selected as the research subjects using the judgment sampling method. On the basis of the previous three-level prevention intervention model on occupational stress in labor-intensive enterprise workers，a two-year optimized "333" model of three-level prevention intervention on occupational stress was implemented in the research subjects. The pre-intervention and post-intervention occupational stress levels of job demand-control（JDC）and effort-reward imbalance（ERI）model in workers at this enterprise were evaluated using the Simple Job Stress Questionnaire and the ERI Questionnaire. Results Compared with those before intervention，the scores of job requirements dimension of JDC model，giving and intrinsic input dimensions of ERI model decreased after intervention（all P<0.01）；the scores of social support dimension of JDC model and that of return dimension of ERI model increased（all P<0.05），and the detection rates of occupational stress of both JDC and ERI models decreased （26.1% vs 10.1%，21.0% vs 8.9 % ，all P<0.01）. Conclusion Optimizing the "333" intervention mode for three-level prevention intervention of occupational stress can effectively alleviate the occupational stress levels of front-line workers in electronic manufacturing enterprises.

Objective To investigate the method and effect of laparoscopic splenectomy(LS) using the Endo-Cutter and the LapDisc.Methods Laparoscopic splenectomy(LS) using the Endo-Cutter and the LapDisc was performed in 12 patients,including 7 patients with hematopathy and 5 patients with benign tumors.The laparoscopic procedure was performed with the surgeon's left hand through the LapDisc.With the left hand providing safe retraction,a harmonic scalpel was used to incise the splenorenal ligament and the splenogastric ligament.After the spleen was mobilized,a vascular stapler(Endo-Cutter) was used to divide the splenic hilum.The spleen was delivered out of the abdominal cavity through the hand-assisted incision.Results All the LS were successfully completed and no conversion to open surgery was needed.The operating time was 35~120 min(mean,80 min),the blood loss during operation was 40~200 ml(mean,127 ml),and the hospital stay,3~6 d(mean,4.5 d).Follow-up in the 12 patients for 6 months found no complications. Conclusions Laparoscopic splenectomy using the Endo-Cutter and the LapDisc is safe and effective.

Objective: To explore the effects of multivitamin and mineral supplements on self-evaluation of mood and health status in healthy volunteers.Methods:149 healthy volunteers took multi-nutrient supplements or placeboes for 8 weeks, and self-evaluation of mood and health status was evaluated by Profile of Mood States and 36-item short-form health survey.Results:Self-comparing POMS scores, active group's scores of vigor were significantly increased, from 14.2? 4.6 to 15.5 ? 4.9(t=2.74,P37)were significantly improved. But the placebo group and young volunteers were not significantly improved. Conclusion: The intervention of multivitamin and mineral supplements can improve elderly healthy persons' mood and healthy status.

The incidence of papillary thyroid carcinoma (PTC) has been increasing in the past decades.The overall survival (OS) of most PTC patients is satisfied,however,recurrence is not rare.Surgical management is the basic treatment for PTC.The first step of surgery includes gland resection and lymph node dissection of central compartment.Several controversies remain in the indications and range of surgery.In this article,the progress of gland management,lymph node dissection in central compartment and complications in PTC/papillary thyroid microcarcinoma were reviewed.