Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer.The original ATC guidelines were published by American Thyroid Association in 2012.The guidelines recommend that once the diagnosis of ATC has been verified,rapid evaluation and establishment of treatment goals are imperative,and a multidisciplinary management is required.Radical surgical resection and high doses of external beam radiotherapy are important factors associated with prolonged survival.

[Summary ] Accumulating evidence showed the associations between subclinical hyperthyroidism or subclinical hypothyroidism and adverse health outcomes. The related guidelines could be very helpful in making treatment decisions. However, even within the reference range, thyroid function is associated with adverse health outcomes, such as atrial fibrillation, coronary artery disease, osteoporosis, and dyslipidemia. Also, there is limitation to use TSH value as intervention threshold by the influence of age and other diseases. In this regard, a grading system is proposed to diagnose thyroid dysfunction, and risk stratification according to individual TSH values and comorbidities would be constructed to evaluate the utility of treatment.

[Summary] Epidemiologic evidence favors strong correlations between low thyrotropin(TSH) and high bone turnover, low bone mineral density ( BMD), and high fracture risk in hyperthyroid patients. Even subclinical hyperthyroidism, in which TSH is low and thyroid hormones are normal, is associated with osteopenia and osteoporosis. These evidences indicate that action of TSH on bone metabolism is independent of thyroid hormones and thus support the theory of the pituitary-bone axis. TSH plays its osteoprotective effect by binding TSH receptor on osteoclasts and inhibiting TNF-α expression. Physicians should screen the BMD in patients with overt and subclinical hyperthyroidism, especially the elderly, and make early diagnosis and better management for the underlying osteopenia and osteoporosis.

It has been well known that testosterone is the only connection between testis and bone as it plays an important role in skeletal growth and bone mass accrual.In the past few years,studies showed that factors other than testosterone could also be responsible for bone health.The Leydig cells in the testis produce insulin-like 3 and express cytochrome P450 2R1 (CYP2R1) gene which encodes the major enzyme involved in 25-hydroxylation of vitamin D.The understanding of the crosstalk between testis and bone could contribute to defining an improved clinical approach to the biochemical diagnosis and therapeutic management of hypogonadism and male osteoporosis.

Calorie restriction has been in use since 1900s as a therapy for obesity and type 2 diabetes. There are many modifications and progress in the forms, indications, effects, and safety of calorie restriction following a history over 100 years. However, controversies also arise such as the effect between intermittent calorie restriction vs daily calorie restriction, low fat diet vs low carbohydrate diet and low calorie diet. Therefore, more evidence-based data from high quality studies as RCT trials are needed for determining the optimal individualized calorie restriction regimen. Furthermore, calorie restriction mimetics is recently becoming an exciting research field for scientists and companies.

Objective To explore the clinical effect of one new type of short section pedicle of vertebral arch nail system(internal fixation system by nail-stick) on patients with thoracolumbar fracture.Methods 68 patients with thoracolumbar fracture were selected.Internal fixation system by nail-stick was used on the patients with thoracolumbar fracture,the clinical effect was observed.Results After following up for six to eighteen months,the vertebral height was measured by X-ray.The anterior edge height of the vertebral was 47% before operation and 94% after operation,the posterior edge height of the vertebral was 76% before operation and 97% after operation,there was significant difference between preoperation and post operation(P<0.01).All the cases with AF intemal fixation system had better clinical effect,18 cases had satisfactory effect.Except that the neurological deficits of 4 cases had not been improved,those of the other cases all had been impreved at some degree.Conclusion Thoracolumbar fracture should be treated early,AF imtermal fixation system has significant effect on the thoracolumbar fracture,the skilled performance is important during the operation,and contraindications of internal fixation system by nail-stick should be noticed.

Objective To explore curative effect of emergency treatment measures on ST segment elevation acute myocardial infarction.Methods A total of 142 cases of acute ST segment elevation myocardial infarction were received the thrombolytic therapy,percutaneous coronary intervention ( PCI) ,emergency coronary artery bypass graft-ing treatment.Results A total of 20 cases were received pre hospital thrombolysis,percutaneous coronary interven-tion ( PCI) therapy in 86 cases,32 cases of pre hospital thrombolysis combined with emergency PCI operation,4 cases of emergency coronary artery bypass graft surgery.The one year survival rates were 94.7%, 98.8%, 96.8%, 100.0%,respectively.Conclusion The prehospital diagnosis of acute myocardial infarction with ST segment eleva-tion is helpful for reducing recanalization time,and initialing the hospital treatment,so as to effectively simprove cardi-ac function and postoperative survival rate,which is worthy of clinical reference.

Caloric restriction has been practiced over 500 years as a method for increasing both the length and quality of life.Experimental work confirming the success of this approac h in animals has accumulated in the last 100 years.Since 2000,emerging evidence in humans has shown that caloric restriction can delay the onset of age related diseases including reduced risk of obesity,diabetes,cardiovascular disease,cancer,and neurodegenerative disorders.The mechanisms and clinical applications have been extensively studied.

The link between Hashimoto's thyroiditis(HT) and papillary thyroid cancer(PTC) has long been a topic of controversy.Some authors suggested that these two disorders are positively correlated,whereas others reported no relationship.Here we summarized the studies made in investigating the correlation between HT and PTC,and analyzed the nature of the correlation between HT and PTC based on biomolecular mechanisms.

Control of body weight is a hot topic.It is considered as the cornerstone for the management of patients with obesity and type 2 diabetes based on the effect of improving blood glucose,lipid profile,blood pressure,and insulin sensitivity.The strategies for weight loss include diet restriction,exercise,medicine,and bariatric surgery.In the present article the relationship between caloric restriction and weight loss was reviewed,focusing on the hot topics as to what extent weight loss could be achieved,the maintenance of ideal body weight,the risk factor of weight regain,and weight loss in particulas populations like obese children,adolescents,and older adults.