It has been 50 years since the discovery of thyrotropin receptor autoantibody (TRAb). Advances in the knowledge of thyrotropin receptor ( TSHR) structure and function, combined with the elucidation of TSHR signaling and TSHR-autoantibody interaction have greatly facilitated our understanding of TRAb and their clinical applications. Measurement of TRAb activity plays an important role in the diagnosis of Graves' disease ( GD) and Graves' opthalmopathy. It has also been well recognized that TRAb is an effective predictor of GD relapse or remission after antithyroid drug and radioactive iodine treatment. TRAb test is of particular help in pregnant women and lactating mothers with recent iodine load, where radioactive iodine or technetium tests are contraindicated. In addition, it is useful in the diagnosis and differential diagnosis of fetal and neonatal hyperthyroidism as well as some rare forms of thyrotoxicosis in clinical practice. Accumulating evidence also indicates the possible correlation between thyroid cancer occurring in GD patients with positive TRAb and adverse outcomes. However, further innovation and standardization of TRAb tests are required to help pave the way for clinical applications.

Objective: To optimize the formulation of Ketanning dispersible tablet.Methods: The Ketanning dispersible tablet was prepared by using wet granules.The formulation and preparation technology was optimized by using orthogonal design which took the situation of granules,appearance of taablets,the disintegrating time and the tensile strength as indices.Results: The optimized formulation contained,10%MCC,10% PVPP is inner,10% PVPP is outer,1% magnesium stearate.The tensile strength,the disintegrating time were 70N and 3min respectively.Conclusion: It is successful to prepare immediate release tablet.The optimized formulation is rational and stable,the tablet could be released quickly.

Objective To investigate the curative effect and safety of microinvasive percutaneous nephrolithotomy (MPCNL) and ureteroscope lithotripsy (URSL) in treatment of children′s (≤6 years old) middle and upper segment ureteral calculi. Methods Eighty children (≤6 years old) with middle and upper segment ureteral calculi were selected, and they were divided into observation group and control group according to random number table method with 40 cases each. The children of observation group were treated with MPCNL, and the children of control group were treated with URSL. The operation time, hospitalization time, calculi clearance rate of the first phase, decline situation of the postoperative hemoglobin and hematocrit and complication were compared between 2 groups. Results The operation time and hospitalization time in observation group were significantly shorter than those in control group:(45.43 ± 9.76) min vs. (68.32 ± 11.28) min and (8.12 ± 1.03) d vs. (13.45 ± 2.34) d, the calculi clearance rate of the first phase was significantly higher than that in control group: 100.0% (40/40) vs. 62.5%(25/40), the incidence of complication was significantly lower than that in control group:20.0%(8/40) vs. 60.0% (24/40), and there were statistical differences (P<0.05). There were no statistical differences in the decline situation of the postoperative hemoglobin and hematocrit between 2 groups (P>0.05). Conclusions The MPCNL in treatment of children′s middle and upper segment ureteral calculi has short operation time, high calculi clearance rate of the first phase, and low incidence of perioperative complication. Compared with URSL, the URSL is safe and efficient, and it is worthy of clinical application.

BACKGROUND:Studies have shown that percutaneous vertebroplasty is a better method to repair osteoporotic vertebral compression fractures, but there are stil less specific schemes of transpedicular approach. Whether unipedicular or bipedicular approach is preferred is stil controversial. OBJECTIVE:To compare the clinical efficacy of percutaneous verterbroplastyviaunipedicular and bipedicular approach on osteoporotic vertebral compression fractures. METHODS:Totaly 118 patients with osteoporotic vertebral compression fractures who had been admitted at the Department of Orthopedics, the First People's Hospital of Kashi from June 2010 to June 2013 and folowed up over 1 year were enroled and randomly divided into unipedicular and bipedicular groups, with 59 in each group. These two groups were compared in terms of bone cement volume, bone cement leakage, kyphosis correction, vertebral height restoration, visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score, and postoperative complications. RESULTS AND CONCLUSION: The cement leakage rate was lower in the unipedicular group (34%) than the bipedicular group (37.3%), but there was no significant difference (P=0.701 > 0.05). The kyphosis correction and scoliosis correction had no statistical significance between the two groups (P > 0.05). The mean vertebral height was improved significantly in both two groups at 1 year after operation (P < 0.05), but there was no difference between the two groups before and after operation (P > 0.05). There were also no significant differences between the two groups in terms of visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score before and after operation, but these indexes were al improved significantly in each group at 1 year after operation than before operation (P < 0.05). The bone cement amount of the unipedicular group was lower than that of the bipedicular group (P=0.001 < 0.05), and the operation time was also shorter in the unipedicular group than the bipedicular group (P=0.000 < 0.05). No serious complications occurred in the two groups. These findings indicate that percutaneous verterbroplasty via unipedicular and bipedicular approach has good analgesic and repair outcomes in patients with osteoporotic vertebral compression fractures, and the unipedicular approach is better than the bipedicular approach in the folowing aspects: less bone cement volume, lower cement leakage and shorter operation time.

Objective:To explore value of pulsed wave (PW) and tissue synchronization imaging (TSI) evaluate cardi-ac systolic synchronization in patients with ischemic cardiomyopathy (ICM) .Methods:A total of 50 ICM patients were enrolled as ICM group and 35 healthy volunteers without organic heart disease were regarded as healthy control group ,PW was used to measure mitral diastolic blood flow duration/RR interval (LVFT/RR) to evaluate synchroni-zation of left atrial and left ventricular synchronization ;interventricular mechanical delay (IVMD) was measured to evaluate left and right ventricular synchronization ;TSI software was used to measure mitral annular mean systolic peak velocity (LV-Sm) ,systolic time to peak (Ts) and Ts standard deviation (Ts-SD) of all segments in order to e-valuate left ventricular systolic synchronization .Results:Compared with healthy control group ,there were signifi-cant reductions in LVFT/RR [ (44.74 ± 1.58)% vs .(41.08 ± 4.65)% ] and LV-Sm [ (9.72 ± 0.53) ms vs .(4.09 ± 1.06) ms] ,and significant rise in IVMD [ (15.51 ± 5.52) ms vs .(41.96 ± 4.20) ms] and Ts-SD [ (16.47 ± 4.16) ms vs .(34.13 ± 11.68) ms] in ICM group , P<0.01 all;Ts of anterior wall ,inferior wall et .6 positions were significantly longer ,and its synchronization significantly reduced , P<0. 05 all ,percentages of the most de-layed systolic part of left ventricle were no significant differences between two groups (P> 0.05) .Conclusion:Compared with healthy control group ,left ventricular total systolic function ,left atrial&ventricular ,left&right ventricular synchronization and systolic synchronization within left ventricular significantly reduce in ICM patients .

Objective To study the prevalence of thyroid disease in pregnant women living in both excess and sufficient water iodine area of in Jiangsu Province,and to establish an epidemiological database of thyroid disorders among pregnant women in different water iodine area in Jiangsu Province in order to guide our clinical practise.Methods Fengxian and Suining of Xuzhou were selected as excess and sufficient water iodine region.All the 439 pregnant women within the first trimester were enrolled in our study.The name,age,and previous history were recorded on questionnaire.The samples of fasting blood were obtained.Serum parameters such as free triiodothyronine ( FT3 ),free thyroxine ( FT4 ),total thyroxine ( TT4 ),thyrotropic stimulating hormone ( TSH ),and thyroid peroxidase (TPOAb) were measured by electrochemiluminescence assay.The data of the eligible 396 subjects were stored and analyzed by Epidata after excluding subjects with previous thyroid dysfuncion,renal disease,heart disease,and pregnancy-induced hypertension syndrome.Results Among the 396 subjects,197 women ( 49.7％ ) had thyroid disorders. The prevalence of hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism,hypothyroxinaemia,and thyroid autoimmunity were 0.5％,6.3％,3.3％,29.3％,9.3％,and 1.0％,respectively.The prevalence of subclinical hypothyroidism was significantly higher in excess water iodine region (32.4％) than that in sufficient water iodine area ( 19.6％ ),while the prevalence of other types of thyroid diseases such as subclinical hyperthyroidism,hyperthyroidism,hypothyroidism,hypothyroxinaemia,and TPOAbpositive cases in either excess or sufficient water iodine regions was not different.Conclusions Subclinical hyperthyridism,hypothyroxinaemia,and subclinical hypothyroidism are the main thyroid disorders in pregnant women in both excess and sufficient water iodine area.The prevalence of subclinical hypothyroidism increases obviously in excess water iodine region,indicating the relationship between thyroid disease and high iodine intake.

OBJECTIVETo observe the efficacy on primary osteoporosis treated with spreading moxibustion for warming yang and activating blood circulation so as to provide the effective clinical therapeutic methods for osteoporosis.

METHODSSixty cases of primary osteoporosis were randomized into a spreading moxibustion group (30 cases) and a calcium tablet group (30 cases). In the calcium tablet group, caltrate was prescribed for oral administration, 600 mg per day. In the spreading moxibustion group, on the basis of the treatment as the calcium tablet group, the spreading moxibustion was applied at Dazhui (GV 14) to Yaoshu (GV 2) for warming yang and activating blood circulation. The duration of treatment was 12 weeks. Visual analogue scale (VAS) score, TCM clinical symptom score and bone mineral density (BMD) were observed and compared before and after treatment in the patients between the two groups.

RESULTSVAS scores were reduced apparently after treatment in the two groups (both P < 0.01) and the results in the spreading moxibustion group were obviously superior to that in the calcium tablet group (2.36 +/- 0.43 vs 4.52 +/- 0.35, P < 0.01). BMD were all increased in the two groups (P < 0.05, P < 0.01) and the results in the spreading moxibustion group were superior to those in the calcium tablet group (both P < 0.05). The total clinical effective rate was 86.67% (26/30) in the spreading moxibustion group, apparently better than 63.33% (19/30) in the calcium tablet group (P < 0.05). TCM clinical symptom scores after treatment were all reduced apparently in the two groups (both P < 0.01), and the result in the spreading moxibustion group was obviously superior to that in the calcium tablet group (4.72 +/- 1.90 vs 6.82 +/- 2.30, P < 0.01). The total effective rate of TCM symptoms was 93.33% (28/30) in the spreading moxibustion group, apparently better than 70.00% (21/30) in the calcium tablet group (P < 0.05).

CONCLUSIONThe combined therapy of spreading moxibustion for warming yang and activating blood circulation and the oral administration of caltrate apparently relieves pain and TCM clinical symptoms, improves BMD in the patients of osteoporosis and achieves definite clinical efficacy in the patients of osteoporosis.

Aged ; Blood Circulation ; Bone Density ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Osteoporosis ; physiopathology ; therapy ; Yang Deficiency ; physiopathology ; therapy

Adult ; Choristoma ; Humans ; Male ; Mediastinal Cyst ; Neck ; pathology ; Thymus Gland ; pathology

Objective To investigate the causes of re-fractures of non fracture vertebral body after percutaneous kyphoplasty (PKP).Methods 512 patients (618 vertebral bodies) treated with PKP because of osteoporosis VCFs were recruited from June 2010 to June 2014.There were 107 males (121 vertebral bodies) and 405 females (497 vertebral bodies) with the mean age of 70.38±7.59 years old (51 to 91 years).There were 406 single segment fracture and 106 double segment fractures cases,and the fracture segments were T4 to L5.The T value of the patients' bone mineral density (BMD) was from-1.0 to-5.2 SD.The clinic characteristics of all the patients including age,sex,body weight,body height,body mass index (BMI),BMD score of the spine,volume of bone cement,restoration rate of anterior/middle vertebral height,postoperative complications (pulmonary embolism,bone cement leakage,nerve injury),and treated vertebral level were analyzed.Results 52 patients (10.16％,52/512) experienced refractures of non fracture vertebral body after kyphoplasty,and 4 experienced re-fracture of the fracture vertebral body after kyphoplasty.The average age of the 52 patients was 71.88±7.74 years old,meanwhile,the ratio of female was 94.23％ (49/52),the mean T value of BMD-4.03±0.60 SD,the ratio of initial double segment fractures 51.92％ (27/52).In addition,among the 456 cases with no fracture,the average age was 70.21±7.56 years,the ratio of female was 77.19％ (352/456);the mean T value of BMD was-2.89±0.55 SD;the ratio of initial double segment fractures was 17.32％(79/456).The data above (age,T value of BMD and initial double segment fractures) were all with statistical significant differences.Whereas the BMI,volume of bone cement,intervertebral disc leakage and restoration rate of anterior/middle vertebral height had no significant difference between the two groups.Furthermore,in the re-fracture of non fracture vertebral body group,32 cases (61.54％,32/52) were nonadjacent fractures,and 20 (38.46％,20/52) were adjacent fractures.Conclusion Osteoporosis degree,female and initial double segment fractures were major risk factors in the development of re-fracture of non fracture vertebral body after PKP.

Chief physician zhou Mei-sheng, a famous expert of acupuncture and moxibustion in our country, has made outstanding contribution to development of cause of acupuncture and moxibustion in over half a century, including paying attention to practice, concentrating attention on clinical study and creation of acupuncture and moxibustion instruments; being at good summarization, workers with original view, resolving doubts, medical skill and medical ethics passing on to later generations; believing moxibustion able to treat AIDS. In recent over 20 years, he devotes study on acupuncture and moxibustion for treatment of difficult and complicated diseases and writes books to expound a theory.
Acupuncture Therapy ; China ; History, 20th Century ; History, 21st Century ; Moxibustion