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.

[Summary] Thyroid nodules are a common clinical problem, the majority of which are regarded as benign nodules by initial fine-needle aspiration biopsy(FNAB) or ultrasound characteristics. Given the low false negative rate of ultrasound-guided FNAB cytology and the higher yield of missed malignancies based upon nodule sonographic pattern, a routine sonographic surveillance is recommended to the thyroid nodules with benign cytology. If there are any sonographic evidence of growth or development of new suspicious sonographic features, the FNAB could be repeated. Treatment for benign thyroid nodules includes medications, percutaneous ethanol injection, thermal ablation and surgery. In order to avoid over-treatment, the potential harm and benefits of any intervention should be assessed.

The mechanisms underlying the therapeutic effects of exercise on obesity and type 2 diabetes remained unknown until irisin,a novel hormone secreted from muscle tissue,was identified.Irisin increases total energy expenditure,reduces body weight,and mitigates diet-induced insulin resistance,thus improving glycemic control.Interestingly,the concentration of irisin increases significantly after endurance exercise,suggesting there is an association between exercise and metabolism.Given its antiobesity and antidiabetic effects,irisin has been postulated to serve as an injectable treatment for metabolic disease including obesity and type 2 diabetes.

BACKGROUND: Now, the current study has not yet confirmed two treatment methods of the proximal femoral nail antirotation and total hip arthroplasty for treating intertrochanteric fractures in the elderly, which method has more advantages, and there is no clear conclusion at present. OBJECTIVE: To systematical y compare the repair effect of proximal femoral nail antirotation and total hip arthroplasty for treatment of intertrochanteric fractures in the elderly. METHODS: We searched the related literatures from 2011 to 2015 on Wanfang database, PubMed, MEDLINE and Embase database by computer. We retrieved the journals in China by hand and col ected randomized control ed trials on proximal femoral nail antirotation and total hip arthroplasty in the treatment of intertrochanteric fractures in the elderly. Intraoperative blood loss, operation time, hospitalization time, ambulation time after operation, and Harris score were selected as evaluation indexes. Data were analyzed using RevMan 5.2 software. RESULTS AND CONCLUSION: Final y, 7 Chinese literatures were included, with 811 patients. The results of meta analysis showed that the hospitalization time and ambulation time after operation were significantly shorter in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01), which reduced the pain of patients. Operation time and intraoperative blood loss were poorer in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01). No significant difference in Harris hip score was detected between the two groups (P > 0.05). These results confirmed that the internal fixation of proximal femoral nail antirotation in minimal y invasive therapy when reducing operation time and blood loss has a certain advantage. The total hip arthroplasty can make the recovery of hip function earlier, al ow early weight-bearing walking, reduce the patients’ bedridden time and reduce the complications in bed. Thus, the clinicians in the practical work should choose the appropriate therapy with considering the patient’s condition, damage degree, fracture type, and financial capability.

BACKGROUND:Autophagy can occur in chondrocytes under the low supply of nutrients. Different from necrosis and apoptosis, autophagy can make chondrocytes survive in insufficient supply of nutrients, which may be an important mechanism for the self-protection of chondrocytes. OBJECTIVE: To review the mechanism and effect of autophagy gene to protect the articular cartilage and inhibit osteoarthritis. METHODS:A computer-based search was perform in CNKI, Wanfang, PubMed to retrieve articles addressing autophagy gene and osteoarthritis published from January 2000 to January 2015. The keywords were autophagy, osteoarthritis, articular cartilage, chondrocytes in Chinese and autophagy, osteoarthritis, beclin1, LC3 in English. Totaly 269 articles were initialy searched, and finaly, 38 articles were included in result analysis. RESULTS AND CONCLUSION:Apoptosis of damaged chondrocytes is the main mechanism of articular cartilage degeneration, which can further develop into osteoarthritis. The damage and death of cels is one of the important mechanisms of cartilage degeneration, thus, to prevent damaged chondrocyte apoptosis may help cartilage repair, thus aleviating the progression of osteoarthritis. Autophagy can inhibit damaged chondrocyte apoptosis, which changes the limitations of traditional treatments for osteoarthritis. However, the current research on autophagy genes associated with osteoarthritis is stil at the primary stage, and further studies are needed on how to induce authopagy pathway in the cartilage, how to do the signal transduction and how to have an effect on the survival of chondrocytes.

Objective To investigate the survival rate, voiding, sexual function after nerve-sparing surgery with extended systematic extraperitoneal lateral lymphadenectomy in lower rectal cancer. Methods Three hundreds and ninety-two cases with advanced lower rectal cancer who underwent nerve-sparing surgery with radical dissection from 1996 to 2000 were reviewed. Among them,173 cases only cleared in abdominal cavity,219 cases coupled with extraperitoneal lateral lymphadenectomy. Results The metastatic rate of lateral lymph node was 17.8%(39/219),the rate of non-modal foci of metastatic disease in lateral out of the abdominal cavity was 5.9%(13/219).Local recurrence rate, the abdominal cavity group was 16.2%(28/173); the coupled group was 9.6%(21/219), P

Objective To discuss the quality of life in the postoperative patients with aortic valve replacement (AVR) and related influencing factors .Methods The changes of preoperative and postoperative survival quality in 102 cases of AVR surgery were assessed by using the SF‐36 scale ,and the Logistic regression was used to analyze the impact of age ,effective valve orifice area and prosthetic valve on the quality of life .Results Five patients died during follow‐up .The relative baseline survey after postopera‐tive 1 year showed that the quality of life of patients was significantly improved ,the Logistic regression analysis revealed that a lar‐ger effective orifice area(EOA) and biological valve replacement could have higher health scale scores ,and showed a positive corre‐lation .Conclusion The quality of life in the postoperative patients with AVR is affected by the valve type and EOA of prosthetic valve .

The potential effect of donor CD4+ CD25+ regulatory T ceLls on the suppression of rejection for allogenetic islet transplantation in vivo was investigated. CD4+ CD25+ regulatory T cells were generated by magnetic activated cell sorting and were ailogeneically transfered with islet transplantation in streptozotocin-induced diabetic BALB/cByJ mice. The results showed that allogeneic CD4+ CD25+ regulatory T cells prolong islet graft survival and normoglycemia in transplanted allogeneic diabetic mice.

The article reviewed the update to thyroidology from January 20ll,introducing the recent progress in the diagnosis and treatment of thyroid nodules,thyroid cancers,and Graves ophthalmopathy.Meanwhile several guidelines related to thyroid diseases published during this period were also evaluated.

Objective To elucidate the effect of multi-kinase inhibitor sorafenib on anaplastic thyroid carcinoma cells in the presence or absence of metformin.Methods SW1736 and C643 cells were treated with sorafenib in the presence or absence of metformin for various periods of time.Cell viability was detected by MTT.Cell cycle and cell apoptosis were measured by flow cytometry.Caspase-3 activity was detected by colorimetric kit.Western blot was used to analyze pERK phosphorylation and cyclinD1 expression.Results Sorafenib inhibited the growth of anaplastic thyroid carcinoma cells and induced cell cycle arrest and cell apoptosis.The EC50 of sorafenib in SW1736 and C643 was 3.68 μmol/L and 4.87 μmol/L respectively.After sorafenib ± metformin treatment,the caspase3 activity was 131.5 ％ and 278.0％ (P＜0.01) in SW1736 cells,127.2％ and 196.6％ (P＜0.01) in C643 cells.On the molecular level,sorafenib inhibited the phosphorylation of ERK and decreased the expression of cyclinD1.Metformin amplified the growth inhibitory effect of sorafenib on anaplastic thyroid carcinoma cells.The cell viability was 0.76 ± 0.17 and 0.30 ± 0.04 (P＜0.01) in SW1736 cells,0.72 ± 0.09 and 0.34 ± 0.10 (P＜0.001) in C643 cells after 2.5 μmol/L sorafenib without or with 5 mmol/L metformin treatment.Conclusions The combination of sorafenib and metformin may be a potent strategy for the treatment of anaplastic thyroid carcinoma and other advanced cancers.