Objective To investigate the heritability of Graves′ disease (GD) and to discuss its clinical significance. Methods The heritability of GD was calculated using Falconer′s formula and by investigating the GD numbers of 1968 first relatives of 526 established GD patients. Results The heritability of GD was 45%, appearantlymuchlowerthanthoseofprevious reports in China. Conclusion The onset of GD is affected by both inheritant and environmental factors, the latter seems to be predominant over the former.

ObjectiveTo evaluate intraoperative cholangiograhy during cholecystectomy for patients with preoperative benign gallbladder disease. Methods Unexpected biliary disease and anomaly found by intraoperative cholangiography in 904 cases of preoperatively diagnosed simple gallbladder stone and polypoid lesions were analyzed. Results Choledocholithiasis was found in 79 cases, anomalous pancreaticobiliary junction (APBJ)in 21, gallbladder cystic duct variations in 28, right accessory hepatic duct in 4 . Conclusions Intraoperative cholangiograhy during the process of simple cholecystectomy helps to discover preoperatively mis-diagnosed choledocholithiasis, hence to avoid secondary exploration of common bile duct which is otherwise inevitable, it may also demonstrate the anomalous pancreaticobiliary junction and bile ductal anatomic variations.

The metabolic properties of cancer cells diverge significantly from those of normal cells. Energy production in cancer cells is abnormally dependent on aerobic glycolysis. In addition,cancer cells have other metabolic characteristics,such as increasing fatty acid synthesis and glutamine metabolism. Emerging evidences show that many key enzymes in dysregulated Warburg-like glucose metabolism,fatty acid synthesis and glutaminolysis are linked to drug resistance in cancer treatment. For example, lactate dehydrogenase A contributes to paclitaxel/trastuzuma resistance in breast cancer, fatty acid synthase is linked to docetaxel/trastuzumab/adriamycin resistance in breast cancer, and glutaminolysis is linked to cisplatin resistance in gastric cancer. Therefore,targeting cellular metabolism may improve the response to cancer therapeutics,and the combination of chemotherapeutic drugs with cellular metabolism inhibitors may overcome drug resistance in cancer therapy. This review discussed the relationship between dysregulated cellular metabolism and chemotherapy resistance, and the way in which targeting of metabolic enzymes can help overcome the resistance to cancer therapy or enhance the efficacy of common therapeutic agents.

ObjectiveTo study the feasibility of laparoscopic assisted splenectomy for massive splenomegaly and devascularization in the treatment of patients with cirrhosis and portal hypertension.MethodA retrospective study was carried out on 12 patients who underwent laparoscopic assisted splenectomy and devascularization from October 2003 to January 2010.ResultsThe operation was successfully carried out in eight patients.The remaining four patients were converted to open surgery due to intra-operative bleeding.The mean operation times for the 12 patients and the 8 patients who underwent laparoscopic surgery were 350 min (range,190-470 min) and 313 min (range,190-410 min),respectively.The corresponding mean intra-operative blood losses were 1300 ml (range,200-2200 ml) and 700 ml (range,200-1700 ml),respectively.For the 8 patients who received laparoscopic surgery,flatus were passed 3-5 days after operation,and the postoperative hospitalization was 10-20 days.ConclusionsLaparoscopic assisted splenectomy for massive splenomegaly and devascularization is feasible.It is a treatment option for patients with cirrhosis and portal hypertension.

Objective To investigate the relationship between the TRAb-producing cell precursors and different clinical stages of Graves' disease.Methods Peripheral lymphocytes were infected with Epstein-Barr virus,a kind of lymphocyte precursor stimulator,and were stimulated to produce TRAb.Results Of the total wells containing Ig-producing B cell precursors,there were 34.6% and 29.1% from 2 untreated patients,30% from 1 relapsing patient and only 1.3% and 3.8% from 2 healthy controls that secreted TRAb,respectively.As for the wells containing B cell precursors from 2 remission patients with undetectable TRAb in circulation,the percentage (10.7%) of TRAb-containing wells from one was higher than that from the other (5.3%).And the latter had similar percentage of TRAb-positive wells with the controls.The isotype of TRAb in supernatants of our EBV-transformed B lymphocytes was predominantly IgM.Conclusion The frequencies of TRAb-specific precursors were different at three distinct clinical stages of the disease.

BACKGROUND: Most of the literatures only reported that there is a great difference between diabetics who have a high 24-hour urinary albumin excretion rate and those without renal damage, but there is no obvious difference between cases of microalbuminuria and those without renal damage.OBJECTIVE: To probe into the relationship between diabetic nephropathy and osteoporosis.DESIGN: A case-control study.SETTING: Department of Endocrinology, West China Hospital of Sichuan University.PARTICIPANTS: According to the diagnostic standard set by the American Diabetes Association in 1997 (fasting blood glucose ≥ 7 mmol/L,postprandial blood glucose ≥ 11.1 mmol/L), 96 diabetic patients were selected, including 56 males ＜ 60 years old and 40 females who had not entered the menopausal period, excluding the influence of age and osteoporosis caused by menopause. The average age of the subjects was (48.7±10.5)years, their duration were from one month to twenty-one years with the aver age of (7.85±2.56) years, and their general information had no significant differences.METHODS: According to the urine albumine excretion rate and renal function, the patients were divided into four groups: normal albuminuria group (n=48), microalbuminuria group (n=28), macroalbuminuria group (n=15), renal failure group (n=5). The bone mineral densities of lumbar spines (L2-4), femoral neck, Ward's triangle and trochanter were detected with Dual energy X-ray absorptiometry, and then the fasting blood glucose,2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate were compared between the patients with and without osteoporosis.MAIN OUTCOME MEASURES: The fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate, as well as the bone mineral density, were observed in all the patients.RESULTS: The L2-3 bone mineral density in the macroalbuminuria group was significantly different from that in the microalbuminuria group (P ＜ 0.05). The proximal femur bone mineral density in the microalbuminuria group was significantly different from that in the normal albuminuria group (P ＜ 0.05). The bone mineral densities of proximal femur and lumbar spine in the renal failure group were significantly decreased as compared with those in the other groups (P ＜ 0.01). The disease course,glycosylated hemoglobin A, alkaline phosphatase and body mass index were significantly different between the patients with and without osteoporosis (P ＜ 0.05).CONCLUSION: The incidence rate of osteoporosis is increased with the aggravation of nephropathy, and diabetic nephropathy may be closely correlated with the decrease of bone mineral density and the occurrence of osteoporosis.

0,most symptoms of ADR were reported for the first time with the homogeneous literature ratio being 0.The predominant outcome of severe ADR were hospitalization or delayed hospitalization course,followed by increased risk of death or patients' permanent or distinct disabling.CONCLUSION:New and severe ADR should be given close attention in the clinic to guard against severe ADR.

Objective To observe the analgesic effects of dexmedetomidine combined with dif-ferent-doses of sufentanil in patients undergoing spine surgery.Methods Sixty patients(ASA grade Ⅰor Ⅱ degree,age 18-70 years)undergoing spine surgery were randomly assigned into three groups ac-cording to PCA formulation(n =20):3 μg/kg sufentanil group (group S1),1.5 μg/kg dexmedetomi-dine+ 2 μg/kg sufentanil group (group S2 )and 1.5 μg/kg dexmedetomidine + 1 μg/kg sufentanil group (group S3).The same anesthesia method was applied among three groups.Patient-controlled intravenous analgesia pump was applied before 30 minutes prior to the end of surgery.The drugs in each group were diluted to 1 50 ml and infused by a pump at a rate of 3 ml/h with a patient-controlled analgesia (PCA)bolus of 0.5 ml and lock time of 30 minutes.VAS and Ramsay scores at 2 h(T0 ),4 h (T1 ),8 h(T2 ),12 h(T3 ),24 h(T4 )and 48 h(T5 )after surgery were estimated.Postoperative nausea and vomiting,bradyrhythmia and hypersomnia were also recorded.Results Compared with group S1, VAS of groups S2 and S3 was significantly decreased at T1-T5 (P <0.05).There were also no signifi-cant difference in the incidence of postoperative nausea and vomiting,bradyrhythmia and hypersomnia among three groups.Conclusion Dexmedetomidine of 1.5 μg/kg can significantly reduce the dosage of sufentanil on postoperative analgesia in patients undergoing spine surgery,and decrease the rate of postoperative nausea and vomiting without any bradyrhythmia and hypersomnia.

Objective To study the effects of 1,25-(OH)_2-vitamin D_3[1,25-(OH)_2D_3] on proliferation,differentiation, and secretion of osteoprotegerin and RANK ligand (RANKL)in cultured marrow mesenchymal cells of rhesus monkey (RhBMSCs). Methods Three different concentrations of 1,25-(OH)_2D_3 (10~(-12) ,10~(-10), and 10~(-8)mol/L)were added to the cultured RhBMSCs in vitro. MTT was used to observe cell proliferation and ELISA technique was used to measure the concentration of alkaline phosphatase (ALP), osteocalcin, osteoprotegerin, and RANKL. Mineralization nodus was identified via alizarin red staining. Results Under different concentration of 1,25-(OH)_2D_3, RhBMSCs proliferation were promoted within 7 days but were suppressed beyond 7 days. No significant dose-dependent manner was found. Differentiation of RhBMSCs into osteoblast was promoted by 1,25-(OH)_2D_3. The levels of ALP and osteocalcin in groups with various concentrations of 1,25-(OH)_2D_3 were higher than those of control group [ALP(ng/ml) ,7 d:31.40±1.25,26.50±0.50,28.47± 0.25 vs 13.48±0.26;10 d:33.37±0.68,35.30±1.57,33.27±0.67 vs 17.14±0.55;13 d:35.37±0.12,30.47± 0. 25 , 30. 27±1.25 vs 16.55 ± 1.13 ; osteocalcin (ng/ml), 7 d:4.47±0. 29,4.00 ±0. 60,3.73±0.78 vs 1.63± 0.55;10 d:5.63±0.57,5.17±0.15,4.30±0. 10 vs 2.17±0. 15;13 d:7.03±0.15,5.53±0.25,5.27±0.31 vs 2.23±0. 55 ; all P < 0. 05], but no typical mineralization nodus was found in either group. Secretions of osteoprotegerin and RANKL from RhBMSCs were stimulated by 1,25-(OH)_2D_3 [osteoprotegerin (pg/ml), 7 d: 72.57±0.67,68.00±1.75,64.23±0.87 vs 30. 13±1.72; 10 d:62.03±1.62,51.80±1.30,28.93±0.95 vs 18.13±1.40;13 d:65.13±0.71,62.43±2.11,44.93+1.63 vs 36.70±0.95 ;RANKL(pg/ml) ,7 d:74.33+0.61, 82.37±2.15,85.23±0.45 vs 70.83±1.71 ;10 d:83.30±0.46,86.70±0.56,88.23±0.91 vs 74.20±1.83;13 d: 81.70±1.81,81.07±0.95,84.70±1.41 vs 72.73±0.97 ;all P<0.05]. The secretion of RANKL was increased at first and then decreased, whereas the secretion of osteoprotegerin had the opposite tendency. The secretions of RANKL and osteoprotegerin were both in a dose-dependent manner. Conclusions 1,25-(OH)_2D_3 promotes differentiation of RhBMSCs into osteoblasts,resulting in increased secretions of osteoprotegerin and RANKL

Objective To observe and analyze the occurrence and related factors of pulmonary fibrosis caused by dust exposure in Shenzhen city in 2014 ,and to explore the preventive measures .Methods 64 cases of patients with pneumoconiosis from January 1st ,2014 to December 31st were selected as the study objects ,the factors affecting the development of pneumoconiosis and the re‐lated factors of complications were compared and analyzed ,the preventing measures were discussed .Results the proportion of pneumoconiosis stage Ⅱ and stage Ⅲ and the incidence of complications were increased with the working age of dust‐exposed work ,the differences were statistically significant(P<0 .05) .Compared with patients who used anti‐dust respirator and were trea‐ted in time ,the patients used common respirator and not treated in time had higher proportion of pneumoconiosis stage Ⅱ and stageⅢ and the incidence of complications ,the differences were statistically significant(P<0 .05) .The incidence of complications associ‐ated with pneumoconiosis such as tuberculosis ,pulmonary emphysema ,pulmonary heart disease were higher in patients with more than 20 working years than those with 10- <16 and 16-20 years ,the differences were statistically significant(P<0 .05) .Conclu‐sion Working years of dust‐exposed work ,personal protective measures ,timely treatment are major influence factors for the occur‐rence and development of pneumoconiosis and related complications .Strengthening the engineering and technical measures for re‐ducing dust in dust‐exposed work ,personal protection and health education ,regular physical examination are important means to prevent the occurrence and development of pulmonary fibrosis caused by dust‐exposed work .