[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.

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.

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: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.

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.

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.

Objective To observe the effect of Zhibo Dihuang Pill(ZDP) on leptin-induced idiopathic central precocious puberty(ICPP) in mice.Methods Eighteen BALB/c female mice aged 18 months were randomized into 6 groups: normal group,model group,high-and low-dose ZDP groups(at the dose of 101.4 and 50.7 g?kg-1?d-1 respectively),and megestrol acetate(3.9 mg?kg-1?d-1)group and gonadotropin releasing hormone analogues(GnRH-A) group(at the first dose of 1573.5 ?g/kg,the second and the third dose of 1180 ?g/kg,once every other day).Except the normal group,the mice in other groups received intraperitoneal injection of leptin 20mg/kg to establish ICPP model.After treatment,the vaginal opening,body weight,uterus weight and ovaries weight as well as the serum levels of luteinizing hormone(LH),estrogen(E2) were detected.Meanwhile,the uterus index and ovaries index were also examined.Results High-dose ZDP had an inhibition on the advance of vaginal opening induced by leptin after modeling for 4~6 days(P0.05).Conclusion The therapeutic effect of ZDP for ICPP is probably related with the inhibition of the advance of hypothalamic-pituitary-gonad axis activation.

Objective To investigate the influence of hypoxia on leptin expression in serum,CSF and brain tissue of C57BL/6J mice.Methods C57BL/6J mice were divided into 3 groups:the normal control,24-hour hypoxia group and 48-hour hypoxia group.The latter two groups exposed to hypoxia in the man-made auto pressure and hypoxia control cabin(XQ-I).Radioimmunoassay was used to detect the leptin level.Results The leptin level in the serum,CSF and brain tissue of mice exposed to hypoxia were higher than that of normal control,but no difference was found between 24-hour hypoxia group and 48-hour hypoxia group.Conclusion Hypoxia probably induces the increasing of leptin expression in fat tissue,as well as in the central nervous system.