In this article , the hot ethical concerns related to totally endoscopic thyroidectomy have been ana-lyzed and discussed .The author considers that this procedure is consisted with the patient′s no-harm and advanta-geous ethical principles , and the patient′s privacy is well protected .However , different procedures and operative risks should be well understood by the patients before the operation .Patient′s independence should be respected .

OBJECTIVE:To study the effects and mechanism of rapamycin on invasion and metastasis of cervical cancer HeLa cell. METHODS:HeLa cells were divided into control group and rapamycin low-dose,medium-dose and high-dose groups (10, 30,100 nmol/L). After treated for 48 h,cell viability was measured by MTT assay,and inhibitory rate was calculated;migration and invasion of cell was tested by Transwell assay. The expression of matrix metalloproteinase 2(MMP-2),MMP-9,Vimentin and E-cadherin,and phosphorylation of protein kinase B (Akt),mammalian target of rapamycin (mTOR) were detected by Western blot. RESULTS:Compared with control group,the inhibition rate of cell viability was increased in rapamycin groups(P<0.01);the number of invasion and metastasis cells decreased(P<0.01);the expression of MMP-2,MMP-9 and Vimentin were decreased (P<0.01 or P<0.05);the expression of E-cadherin was enhanced(P<0.01 or P<0.05);the phosphorylation of Akt and mTOR were reduced (P<0.01). CONCLUSIONS:Rapamycin could inhibit invasion and metastasis of HeLa cell via Akt/mTOR signal pathway.

Objective To estimate the frequency of heart valvular involvement in Chinese patients with Takayasu arteritis (TAK) and its correlation with other clinical features. Methods Ninety-one patients with TAK were studied and their clinical manifestations, laboratory test, vascular images and echocardio - gra-phic findings were retrospectively reviewed. The data were compared between patients who had heart valvular involvement and those who had not. Mann-Whitney U-test or Student's t-test, Chi-squared test or Fisher's exact test were used for analysis. Results Aortic regurgitation and mitral regurgitation were both confirmed in 20 (22%) patients. Tricuspid regurgitation and pulmonary valve regurgitation were observed in 10 (11%) and 2 (2%) patients, respectively. Older age at onset, longer disease duration, hypertension and involvement of the ascending aorta were all significantly more frequent in TAK patients with aortic regurgitation (t=2.903, P<0.01; Z=-2.759, P<0.01; χ2=7.918, P<0.01; Z=-4.454, P<0.01) than those without. However, the constitutional symptoms and acute phase reactants [erythrocyte sedimentation rate (ESR) and C reactive protein (CRP)] were not statistically different between patients with and without valvular regurgitation (P>0.05). Aortic valvular pathology examination of the three TAK patients who had underwent aortic valve replacement showed no inflammatory cell infiltration. Conclusion This study has demonstrated that heart valve involvement is common in patients with TAK, mainly in the form of regurgitation, and which may be secondary to hypertension and other cardiovascular complications. We should pay more attention to the screening and treatment of heart valvular involvement in TAK patients.

Objective To investigate the effects of 25‐hydroxy vitamin D [25(OH)D] status on the pregnancy outcome in the second and third trimester pregnant women living .Methods A total of 143 pregnant women (12 -42 weeks gestational age) were participated in the study .Their serum 25(OH)D concentrations were detected by liquid chromatography‐mass spectrometry method .Finally ,vitamin D status was assessed according to sufficiency group(n= 32) ,inadequacy group(n= 49) ,insufficiency group(n=51) and deficiency group(n=11) .Retrospective analysis were adopted to follow up the pregnancy outcome of pregnant women .Results (1)The average serum 25(OH)D level was(22 .49 ± 9 .51)ng/mL in the second and third trimester of pregnancy . (2)Abortion rate were 3 .1% (1/32) in sufficient group ,2 .0% (1/49)in inadequacy group ,11 .8% (6/51) in insufficiency group , 36 .4% (4/11) in deficiency group ,fetal distress incidence were 3 .1% (1/32) ,8 .2% (4/49) ,11 .8% (6/51) ,36 .4% (4/11) in each group .Abortion ,fetal distress rate were higher in deficiency group compared with the other three groups(P<0 .05) .(3)Bacterial vaginosis incidence were 0(0/32) ,4 .1% (2/49) ,13 .7% (7/51) ,27 .3% (3/11)in each group ,deficiency group and insufficiency group were higher(P<0 .05) .(4)Otherwise ,the gestation period were (39 .48 ± 1 .44) weeks in sufficient group ,(39 .00 ± 1 .70) weeks in inadequacy group ,(38 .09 ± 2 .01) weeks in insufficiency group ,(37 .29 ± 0 .49) weeks in deficiency group ,pregnancy cycle was significantly shorter when 25(OH)D<20 .00 ng/mL (P<0 .05) .Conclusion Vitamin D deficiency in pregnant women could increase the risk of abortion ,fetal distress ,bacterial vaginosis ,and significantly shorten the gestation period .

Objective To investigate effect of folic acid combined with xin funing on CRP, HGF, IL-2,TNF-αof patients with cervical cancer caused by human papillomavirus.Methods 80 cases of cervical cancer patients were randomly divided into control group, 40 cases in the control group were given conventional chemotherapy, 40 cases in the experimental group were on the base of the control with folic acid combined with xin funing.CRP, HGF, TNF-α, IL-2 and T lymphocyte subsets were compared before and after the treatment.Results Compared with the control group, the serum CRP, HGF and TNF-αof the experiment group were lower(P<0.05), IL-2 levels was higher (P<0.05), CD4 +and CD4 +/CD8 +level were higher(P<0.05), level of CD8 +was lower(P<0.05) and the clinical effective rate were higher(P<0.05).Conclusion Folic acid combined with Xin Funing has important significance for the treatment of patients with cervical cancer.It is speculated that the mechanism may be to reduce the level of serum CRP and HGF in patients with cervical cancer, and to increase the level of IL-2, and to regulate immune cells.

Traditional Chinese medicine (TCM) is a great knowledge base that has been developed through thousands of years and has been accumulated a wealth of experience in diagnosis and treatment.TCM has advanced concepts,but lag behind the use of modern technology and means.With the progress of modern science and technology,the combination of TCM theory and moderm science and technology promotes the development of TCM engineering.TCM has been a breakthrough in diagnostic techniques and clinical treatment,especially modern TCM instruments.At present,diagnostic instruments of TCM mainly depend on pulse and tongue device,and gradually develop to four diagnostic comprehensive analysis platform.Therapeutic instruments of TCM include electroacupuncture device,meridian instrument,laser treatment device and magnetic therapy instrument.This article focuses on the current status,problems and trend on TCM diagnostic and therapeutic instruments,which mainly include diagnostic instruments,clinical treatment instruments,Chinese medical instruments.

OBJECTIVETo explore the role of the basic fibroblast growth factor (bFGF) in the directional differentiation of bone marrow mesenchymal stem cells (BMSCs) into Leydig cells.

METHODSAfter purification and identification, we inoculated the third-generation BMSCs of SD rats onto a six-orifice board and then randomly divided them into groups A (normal saline control), B (human chorionic gonadotropin [hCG] + platelet-derived growth factor [PDGF] induction), C (hCG + PDGF + 5.0 ng/ml bFGF induction), D (hCG + PDGF + 10.0 ng/ml bFGF induction), and E (hCG + PDGF + 20.0 ng/ml bFGF induction). On the 7th, 14th and 21st day of induction, we observed the morphological changes of the cells and measured the level of testosterone (T) and expression of 3 beta hydroxy steroid dehydrogenase (3β-HSD) in the supernatant by immunofluorescence staining.

RESULTSAfter induction, the BMSCs of groups B, C, D, and E exhibited microscopic features of enlarged size, inter-connection, long-shuttle or irregular shape, adherent growth, and large round nuclei, all characteristic of Leydig cells. With the prolonging of time and enhanced concentration of bFGF, gradual increases were observed in the T level and the count of 3β-HSD-positive BMSCs in the four induction groups, with statistically significant differences between group B and groups C, D, and E (P < 0.05), as well as between group C and groups D and E (P < 0.05), but not between D and E (P > 0.05).

CONCLUSIONThe bFGF has an obvious promoting effect in the in vitro induced differentiation of rat BMSCs into Leydig cells.

Animals ; Bone Marrow Cells ; cytology ; drug effects ; metabolism ; Cell Differentiation ; Cells, Cultured ; Chorionic Gonadotropin ; metabolism ; Fibroblast Growth Factor 2 ; pharmacology ; Humans ; Leydig Cells ; cytology ; Male ; Mesenchymal Stromal Cells ; cytology ; drug effects ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Testosterone ; metabolism

Objective To study the characteristics of Z-HL_(16)C cell strain mutated from the human embryonic lung fibroblasts(HL).Methods Morphology observation,chromosome cytogenetics,tumorigenesis in nude mice,and the sensitivity to virus were examined.Results As a transformed cell strain,the Z-HL_(16)C showed polygon shapes liking epithelium;the number of chromosome was sub-triploid or hyper-triploid,and the structures of 30%～40% chromosomes were abnormal.The incidence of its inoculation in nude mice was 100%,and the pathological studies proved its tumorigenesis.The cytopathic effects of many kinds of viruses were observed in Z-HL_(16)C cell strain.Conclusion The Z-HL_(16)C is one of the cancer cell strains transformed from HL cells.

Objective　To study the effects of glucose and lipid metabolism on gallstone formation. Methods　Twenty five patients with gallstones and 25 normal volunteer controls were studied from January to April in 1998. The patients were well matched the control with sex and age (1∶1). In the study, Body Mass Index (BMI) and Waist-to-Hip circumference ratio (W/H) were measured. Blood glucose, glucosylated hemoglobin (HbA1C), insulin, C peptide and all parameters of lipids were detected at fasting state. The glucose,insulin, C peptide were detected again at 2-hour after taking 75g glucose orally. Results　The result showed there was no difference on BMI and W/H between the patients and controls. HbA1C、mean fasting and 2-hour glucose concentration were not in significantly different between the two groups (P>0.05, P>0.2, P>0.1 respectively). There were 10 patients with abnormal glucose metabolism (7 with NIDDM, 3 with IGT), but only 4 controls were abnoumal (one with NIDDM, three with IGT). The difference was significant (P<0.05). Furthermore, the mean fasting and 2-hour insulin concentration of gallstone group was higher than that of the control (P<0.02, P<0.05). And the gallstone group had a higher fasting C peptide concentration than control (P<0.05). There was no statistical difference on the parameters of plasma lipid between the tow groups. Conclusion　The study suggests that diabetes mellious and hyperinsulinemia acted as an important role on gallstone formation.

Objective To explore the effect of activities of daily living (ADL) training on hemiplegia after stroke. Methods 50 stroke patients with hemiplegia were divided into treatment group (n=27), who received ADL training and physical therapy, and control group (n= 23), who only received physical therapy. They were evaluated with modified Barthel index (MBI) and the Brunnstrom classification. Results After 6 months of treatment, the score of MBI improved more in the treatment group than in the control group (P<0.05), but there was no significant difference in Brunnstrom stage (P>0.05). Conclusion ADL training can improve the recovery of ADL in hemiplegics after stroke.。