Severe aplastic anaemia is a marrow failure syndrome characterized by pancytopenia and hypocellular bone marrow.Immunosuppressive therapy(IST)consisting of antithymocyte or antilymphocyte globulin (ATG) and cyclosporine has been recommended for children lacking HLA-matched sibling donor.For children unresponsive to initial immunosuppressive therapy or those who relapsed after first immunosuppressive therapy,they can choose repeat course of immunosuppressive therapy,allogeneic hernatopoietic stem cell transplantation,new drugs or clinical trials.And the prognosis has been greatly improved in recent years,dueing to the development of allogeneic hematopoietic stem cell transplantation and the application of new drugs such as eltrombopag.This article reviews researches advance in different therapies for children with relapsed or refractory severe aplastic anaemia,aimed at guaiding treatment methods.

Thyroid-associated ophthalmopathy(TAO)is an organ specific autoimmune disorder affecting the life quality of patients.Glucocorticoids have been applied for many years in the treatment of TAO,though the side effects are the major concern.Recently,intravenous methylprednisolone pulse therapy is a novel and effective method for TAO treatment.Nevertheless this new strategy needs to be modified,and attention should be paid to the indications and contraindications in order to prevent liver damage when high dose methylprednisolone is applied.

The second part of (2008 edition)includes iodine deficiency disease,thyroditis and thyroid nodule.This guideline reaffirms the epidemic characteristics,the prevention and the management of iodine deficiency disease.It identifies the measurement of iodine nutritional status and the necessity of iodinized salt.It emphasizes the regular diagnosis and treatment of subacute and chronic thyroiditis,and also mentions the advancement on differential diagnosis and rational therapy of thyroid nodules.In addition,it gives some advices on the management of thyroid nodules in two special groups(pregnant women and children).

Taking the characteristics of Indian students into account,teaching quality can be improved by these means:thorough preparation before class,various application for teaching,mutual and interactive communication and inspiration.

Objective To introduce the surgical technique and results of total mesorectal excision (TME) for rectal cancer. Methods　Reviews.Results　As a result of TME, local recurrence rates have declined from 20%-30% to 3%-8%, 5-year survival rate have risen to 75%, and the rates of sphincter preservation have risen too.Conclusion　Total mesorectal excision reduces the local recurrence rates and raise the survival figures after excision of rectal cancer. Patients have a high quality of life.

Neovascularization is the main cause of the vision loss of the patients sufferring from proliferative diabetic retinopathy,retinopathy of prematurity and age-related macular degeneration.It is proved that collagen and elastin in the extracellular matrix contribute to the choroidal and retinal neovascularization in vitro and in vivo.Among the extracellular matrix-related adhesion molecules,integrin α5β1 could enhance the cell adhesion and hyperplasy,while its inhibitors could restrain the choroidal and retinal neovascularization in vivo,so are the inhibitors of the integrin α V β3 and α V β5.Selectins and intercellular adhesion molecule-1 mainly affect the neovascularization as the medium between the endothelial cells and the leucocytes.It is demonstrated that the extracellular matrix degradationrelated serine proteinases (mainly urokinase-type plasminogen activator ) /matrix metalloproteinases (mainly MMP-2 and MMP-9)also could induce the choroidal and retinal neovascularization in vitro and in vivo.Furthermore,type-1 plasminogen activator inhibitor and tissue inhibitor of metalloproteinase could prevent that and the further study of the extracellular matrix-related molecules would bring out new insights and methods for the precaution and treatement of the ocular neovascularization.

Urinary and sexual dysfunction is common complication after surgical treatment for rectal cancer patients,and many studies were carried out for these complications.This article reviewed the literatures on clinical research of urogenital function after operations of rectal cancer.

Antithyroid drugs(ATD)is the main treatment for hyperthyroidism and its adverse reactions have been much concerned by physicians. Methimazole(MMI)and propylthiouracil(PTU)are the two common antitithyroid drugs used currently. Generally, the ATD are safe and effective, though their clinical adverse reactions are also relatively common. The toxic effects include liver damage and leukocytopenia, antineutrophil cytoplasmic antibody-associated pulmonary small-vessel vasculitis, hypoglycemia, allergic reactions, muscle impairment,and so on. They are usually reversible and disappear spontaneously when the drug is discontinued. However,the serious rare side effects can also occur and there may have potentially deadly threatening effects which need to be cautious for the clinicians. MMI is usually preferred over PTU because it has significantly fewer side effects. And unlike the dose-dependent side effects of MMI, there has no significant correlation between adverse reaction and drug dosage in using PTU. Moreover, PTU has more severe hepatotoxity than MMI, even fatal liver impairment and liver failure. The risk of liver damage from PTU is an important concern, particularly in children. For this reason, MMI is the first choice for treating children with hyperthyroidism.

Fine-needle aspiration biopsy is the mainstay of preoperative diagnosis of thyroid cancer which is the most common type of endocrine malignancy.However,some aspirates yield indeterminate cytology and there is no clear recommendation for the management on these situations.The use of emerging molecular markers such as BRAF、RET、PAX8/PPARγ will likely improve the diagnosis of malignancy in thyroid nodules and facilitate more individualized therapeutic options and postoperative management.Some markers have been extensively characterized and introduced into clinical practice.

Objective To compare the clearing effect between combination use of mosapride and polyethylene glycol (PEG) and polyethylene glycol only for colonoscopy preparation of patients with constipation caused by functional diseases.Methods A total of 212 adult patients who underwent colonoscopy examination were recruited to this randomized single blinded controlled study.Patients in control group received 3 liters of PEG only,whereas patients of experimental group received 10mg mosapride 30min before 3liter PEG.The patients were surveyed for the tendency of constipation.Experimental variables including time of first defecation and completion of bowel cleansing,defecation frequency,and degree of discomfort during colonoscopy preparation were recorded.Results The times of first defecation and completion of bowel cleansing of experimental group were shorter than those of control group ( P ＜ 0.05 ),but there were no significant differences in defecation frequency,the degree of discomfort and the bowel cleansing quality between 2 groups ( P ＞ 0.05 ).The percentages of patients with constipation in control and experimental groups were 26.61％ and 26.67％,respectively.The defecation frequency and the degree of discomfort of constipative patients were similar in both groups ( P ＞ 0.05 ).The time of first defecation and time of completion of bowel cleansing of constipative patients in experimental group were shorter than those in control group ( P ＜ 0.05 ).The bowel cleansing quality of constipative patients in experimental group was better than that of control group ( P ＜ 0.05 ).There was no difference in defecation frequency and adverse reaction between 2 groups (P ＜ 0.05).Conclusion Combination of mosapride and PEG for colonoscopy preparations of patients with functional constipation tends to shorten times of first defecation and completion of bowel cleansing,and to increase the bowel cleansing quality.