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.

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).

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.

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.

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.

Streptococcus pneumoniae is a common infectious pathogen in children and the main cause of death in children under 5 years of age.It can lead to non-invasive pneumococcal diseases such as sinusitis and otitis media, as well as invasive pneumococcal diseases(IPD) such as meningitis, sepsis and pneumonia.IPD is a serious infectious disease in children, with high morbidity and mortality.However, the incidence of IPD in children varies significantly among different ages, genders and regions.Penicillin used to be the first choice for the treatment of IPD.With the widespread use of antibiotics in clinical practice, the problem of drug resistance of Streptococcus pneumoniae continues to increase.The situation of antibiotic resistance of Streptococcus pneumoniae in China has been very serious, and some data show that the multiple drug resistance rate of Streptococcus pneumoniae is as high as 88.7%.As a result, streptococcus pneumococcal vaccines have emerged as the primary means of reducing the incidence of IPD, in addition, it is effective in reducing the spread of drug-resistant strains.This article reviews the epidemiological characteristics, pathogenesis, common invasive pneumococcal disease in children, laboratory diagnosis, treatment and prevention of IPD in children.

Biotech is currently the fastest growing sector in drug industry. Globally biotech products generated revenues of $55bn in 2004, in a total drug market worth $550bn. The USA is the primary market of biotech products, being the source of approximately half of sales in 2004. About 55% of biopharmaceuticals’ sales in 2004 came from the five leading products (Erythropoietin,Interferon,Human insulin,G-CSF,Rituximab).Great progress has been made in the biotech market of China over the last few years. About 60%~70% of recombinant protein biopharmaceuticals are expressed in mammalian cells in USA and EU, while most recombinant protein biopharmaceuticals are expressed in E.coli in China. Most biopharmaceuticals expressed in mammalian cell can’t be manufactured in China. The biotech industry comprise numerous, mostly small organizations. These organizations typically employ less than 100 people. Most biotech companies have never brought a product to market before they disappear. Therefore, it is very important for biotech companies to make an appropriate development strategy.

Physicians often encounter patients with both hyperthyroidism and pregnancy in clinical practice. Proper treatment will help a lot for both mother and fetus. However, whether propranolol could be applied routinely in the medical therapy other than antithyroid drugs is not regularly mentioned in text book, because there were few literatures reporting its side effects including miscarrage, intrauterine growth retardation, bradycardia, respiratory depression, hypoglycemia, and hyperbilirubinemia. Animal experiments revealed bradycardia after propranolol administration, and respiratory depression after birth due to blockage of β receptors in the lungs. Nevertheless, this drug has been considered safe in pregnant hyperthyroid women according to long-term experience, as no malformation has been demonstrated in the offsprings, and it helps a lot in hyperemesis gravidarum as well. Specialists also recommend short-term use like a few weeks before antithyroid drugs set in action and during thyroid storm, in order to avoid potential side effects. It is suggested that less than routine-dose of the drug be administered before labor, as the plasma drug concentration in the neonate would elevate after birth. As for lactating mother, it's safe to take regular dose of the drug because only extremely low dose will be taken by the neonate through milk.

Objective　To observe the effects of epithelial growth factor (EGF) and basic fibroblast growth factor (bFGF) on wound healing of the penetration keratoplasty (PKP) with autograft in rabbits. Methods　After the establishment of penetrating keratic autograft model on 24 rabbits, they were equally divided into EGF-, bFGF-, EGF+bFGF-treated and control groups. The wound healing of all the animals were observed with healing intensity, liquid scintillation counter, AgNORs staining, VG staining and transmission electron microscopy. Results　①EGF, bFGF, and EGF+bFGF increased the limiting pressure of the wounds and the 3H-TdR incorporation. ②The fibroblast cells and its secreting proliferative collagen in both the bFGF group and EGF+bFGF group were more well-arranged. Conclusion　①EGF, bFGF, EGF+bFGF can obviously elevate the intensity of wound healing after PKP and enhance the synthesis of DNA. ②The effect of this agent combination is just as the same as bFGF applied alone 14 d after the operation. ③bFGF can improve the quality of wound healing after PKP.

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.