In 2016, American Association of Clinical Endocrinologists(AACE) published the guidelines for obesity and defined obesity as an adiposity-based chronic disease and obesity should be managed according to the obesity-related complications (16 complications are listed). Obesity intervention should be transferred from the purpose of weight loss to the intervention of metabolic disorder and its complications. The diagnosis and intervention of obesity in this guideline is sub- classified focus on the gender, region, and combined diseases, which is with more practical and scientific significances. This interpretation is expected to help the professional medical staffs to understand the new strategy in obesity therapy and to combine with the real world and clinical experience. New suggestions should put forward and improve the theories.

Hyperthyroidism with periodic paralysis is common in clinic,the curative effect of peroral drugs on it is not satisfactory. In order to evaluate the treatment of 131 I for periodic paralysis in patients with hyperthyroidism, fouty two patients with hyperthyroidism complicated with periodic paralysis were put on p.o. 5.0 9.0 mCi 131 I Na treatment and the remission rate of periodic paralysis was observed.The total effective rate was over 95%. It can be concluded that 131 I could be used as a routine therapy for periodic paralysis in most patients with hyperthyroidism for its safety and efficiency.

Metabolic syndrome, whose incidence is higher than that we have thought, has done great harm to people's health. This review is to introduce the recent advance in the defination,epidemiology,etiology,major risk factors,clinical diagnosis and treatment, etc . of metabolic syndrome.

The rat model of obesity was induced by high fat diet and in situ hybridization was performed with oligonucleotide probes.The results showed that expressions of leptin receptor mRNA and neuropeptide Y mRNA were significantly increased, suggesting that these increments might be related to leptin resistance.

Obesity has been widely accepted as a metabolic disease and its occurrence is closely related to the genetics, environment, and inflammation. Up to now, body mass index is still regarded as the standard diagnostic criterion for obesity. It has not been revised for decades and could not meet the needs of clinical diagnosis and demands for specific treatment at present. In 2013, the concept of metabolic obesity was introduced at the American Diabetes Association ( ADA) annual conference, and it was further proposed that obesity should be classified according to the metabolic status and its related complications at the 2014 American Association of Clinical Endocrinologists ( AACE) annual conference. This means that scientists and clinicians have realized that the etiology of obesity may vary with different outcomes, the treatment should be focused on the metabolic regulation, not merely on weight loss. With years of clinical practice and research in obesity, we have observed and treated numerous obese patients, and we have found that obesity has a lot of phenotypes and clinical features which are related to the metabolic status. Based on our clinical findings, combined with the experience of Chinese traditional medicine, we now propose a new clinical classification and diagnosis of obesity based on individuals′ metabolic status, which, we believe, can facilitate clinicians′practice. Based on the metabolic status and skin features of obese patients, obesity is divided into metabolic healthy obesity (‘white obesity’) and metabolic unhealthy obesity. Then, the latter is further divided into three groups including high metabolic obesity (‘red obesity’ ) , low metabolic obesity (‘yellow obesity’ ) , and severe metabolic disorder with inflammation obesity (‘black obesity’ ) . If we also consider to add normal weight metabolic obesity to this classification, there should be five types of obesity to be classified as presented. We wish this proposed classification of obesity can play a valuable role in enabling clinicians to have a better understanding of obesity in relation to its metabolism, and to develop individualized treatment according to the metabolic status of the patient. As a result, we may finally achieve the desired outcomes through making appropriate diagnosis and treatments.

The new protein suppressors of cytokine signaling(SOCS) as negative regulators of signaling pathways involve in the cellular actions of many cytokines, including leptin. It regulates intracellular signal transduction cascades such as the JAK STAT pathway. SOCS is now evident of leptin resistance and has close relation with obesity. We reviewed the structure and function of SOCS 3 and the mechanism in leptin signaling pathway,providing data for the potential effect of SOCS 3 in the treatment of obesity.

Objective To investigate the effect of ketamine on learning and memory function of adult rats after injection of ketamine at early development stage. Methods Twelve rats born in a week were randomly divided into ketamine anesthesia group(Ket group)and normal saline control group(Ns group).Rats in Ket group were intraperitoneally injected with 50 mg/kg ketamine,and those in Ns group were administrated with same amount of normal saline.After eight weeks,Morris water maze test was adopted to explore the latency in place navigation and spatial probe ability.The sections of hippocampus were obtained,and immunohistochemical staining was employed to detect the expression of Bax and Bcl-2.Results In Morris water maze test,the latency in place navigation of Ket group Was significantly longer than that of Ns group(P<0.05),and the spatial probe ability significantly decreased(P<0.05).It Was revealed by immunohistochemical staining that the expression of Bax in Ket group was significantly higher than that in Ns group,while there was no significant difference in the expression of Bcl-2 between these two groups. Conclusion Application of ketamine in neonatal rats may result in learning and memory impairment in adulthood,and the underlying mechanism may correlate to the apoptosis of neuron in hippocampus region.

Artificial intelligence (AI) is among the forefront science in recent years. The rapid development of intelligent medicine based on AI, a new concept in the medical field, has resulted in a large impact on traditional medicine. AI poses a great opportunity and also many challenges for clinical physicians. Recently, researches in the development and application of AI are increasingly published in the field of endocrinology, such as the diagnosis and prediction of diabetes and its complications, the optimizing treatment and blood glucose management, the development of artificial pancreas, the diagnosis and treatment of obesity, the prognosis of bariatric surgery, osteoporosis and fracture prediction, bone age analysis, non-invasive assessment of liver steatosis and fibrosis, diagnosis of acromegaly, pathological diagnosis of thyroid and pituitary tumors. Nevertheless, the clinical applications of AI for medicine are still at an initial stage. With the rapid development of AI, we are expecting that it will play a pivotal role in the field of endocrinology and metabolism in the future. This is a new era for medical community to embrace new technology. Only with the properly dealing with the innovation of AI, a win-win result could be achieved.

OBJECTIVE:To explore the influential factors for plasma concentration of paliperidone palmitate injection for pa-tients with schizophrenia. METHODS:37 schizophrenia patients who used Paliperidone palmitate injection and took plasma concentra-tion monitoring in Wuxi Mental Health Center from Sept. 2012 to Jun. 2015 was selected,the results were statistically analyzed,and the influential factors were preliminary explored. RESULTS:Totally 37 times were conducted for the plasma concentration monitoring for paliperidone with the average plasma concentration of(17.72±13.46)ng/ml,and 24 times(accounting for 64.86%)in the range of(10-60 ng/ml);the average plasma concentration of male patients was lower than that of female patients,the difference was statisti-cally significant(P<0.05);there was no significant difference in the average plasma concentration among different ages(P>0.05);there was also no significant difference in plasma concentration/dose ratio in patients with different daily dose(P>0.05);the average plasma concentration of patients with combination treatment was higher than that of single drug,the difference was statistically signifi-cant(P<0.05);and there was no significant difference in the average plasma concentration of relieved patients and ineffective treat-ment patients(P>0.05). CONCLUSIONS:The plasma concentration of paliperidone palmitate is affected by age,combination treat-ment and other factors,clinic can optimize the therapeutic regimen based on monitoring results of plasma concentration and patients’ symptoms to promote the rational drug use.

Objective To induce the site-directed mutation of human cardiac troponin I (cTnI) gene, express the mutant in E. coli, and to study the effects of the mutation on the prokaryotic expression of cTnI. Methods The cDNA encoding cTnI was cloned with RT-PCR from the total RNA extracted from human myocardium tissues. A pair of primers was designed and, after the mutations were induced at the second and the fourth codons, inserted into prokaryotic vector pET-28c (+) and transform the recombinant to BL21 (DE3) bacteria. After purified with Ni-NTA resin, the histidine-tagged fusion protein expressed by IPTG-induced was identified by Western blotting and the expression yield of cTnI protein was investigated. Results The expression of the recombinant carrying processed cTnI cDNA was stronger than that in control group. Conclusion cDNA encoding cTnI was successfully cloned. The recombinant with mutations can be more efficient expressed in E. coli. The cTnI protein can be purified to near homogeneity.