The cause of hyperthyroidism is still not clear.Thyroid stimulating hormone receptor(TSHR) gene is one of the hot topic genes in the etiology of hyperthyroidism.In this review paper,the progress of correlation between TSHR gene and hyperthyroidism was summarized.Results suggested that TSHR gene germline mutations could cause familial non-autoimmune autosomal dominant hyperthyroidism and persistent sporadic congenital non-autoimmune hyperthyroidism.In addition,TSHR gene mutation may also undermine the stability of the TSHR and then become the autoantigens to make producing TSHR antibodies.Which can stimulate thyroid follicular to secrete excessive thyroid hormone and then cause Graves' disease.However,the relationship between TSHR gene and the pathogenesis of Graves' disease still needs further study.

Due to the restriction of the specific situation in China and the concrete conditions of universities,Problem-based learning teaching method failed to gain its popularity in medical education in China.In the era of information globalization,the web-based teaching method relying on the network and taking the PBL as the dominant has many advantages and there is nothing comparable to this.To establish a network of PBL platform in the area of medical education will provide medical education with a new chapter.

Objective To investigate the expression of interleukin-37 (IL-37) in placenta tissue and its relationship with the pathogenesis of severe preeclampsia. Methods All the patients were recruited in Qilu Hospital of Shangdong University from November 2012 to November 2013. Among them, thirty patients with severe preeclampsia were assigned to the preeclampsia group, and thirty-one healthy pregnant women were assigned to the control group. Immunohistochemistry of SP was used to detect the IL-37 protein expression in placenta tissue of the two groups. The expression level of IL-37 in placenta tissue of the two groups was detected by western blot. Besides, reverse transcription(RT)-PCR was used to detect the expression of IL-37 mRNA. The correlation between the expression of IL-37 mRNA and the delivery gestational age, body mass index(BMI)was analyzed. Results (1) IL-37 were detected in the placenta of both the preeclampsia group and the control group, and the expression site mainly located in the syncytiotrophoblast, with a small amount in cytotrophoblast.(2)The expression levels of IL-37 protein in the preeclampsia group and the control group were 0.59 ± 0.39 and 0.88 ± 0.22, respectively. The IL-37 mRNA levels in the preeclampsia group and the control group were 0.55 ± 0.17 and 1.11 ± 0.21, respectively. Both decreased significantly when compared to the control group (P<0.05). (3) Significant correlation between the expression of IL-37 mRNA and the delivery gestational weeks(r=0.209, P>0.05) was seen neither in the preeclampsia group nor in the control group(r=-0.053, P>0.05). In the severe preeclampsia group, the pregnant women′s BMI had no significant correlation with IL-37 mRNA expression of placenta tissue(r=0.102, P>0.05), neither did the control group(r=-0.115, P>0.05). Conclusion IL-37 expression is significantly lower in severe preeclampsia placenta tissue than that in the normal pregnant women, which may play a protective role in the course of severe preeclampsia.

Objective To investigate the expression of growth arrest-specific protein 6 (Gas6) in the placenta and decidua tissues and its relationship with the pathogenesis of preeclampsia. Methods All the patients were recruited in Qilu Hospital of Shangdong University from October 2013 to June 2014. Among them, thirty-two women with early-onset severe preeclampsia who received cesarean section were assigned to the preeclampsia group, and thirty healthy pregnant women who received cesarean section were defined as the control group. Blood glucose, blood lipids, platelet count, D-dimer levels and other clinical indicators of the two groups were detected. Immunohistochemistry of SP was conducted to identify the localization of Gas6 protein in the placenta and decidua tissues. And reverse transcription (RT)-PCR was performed for quantitative analysis of Gas6 RNA expression in placentas. The correlations between placental Gas6 mRNA levels with clinical indicators were analyzed. Results (1) The gestational age at delivery, blood pressure, serum albumin, platelet count and birth weight of fetuses showed statistically significant differences between the two groups(P<0.05). (2) The Gas6 protein expressed in the cytoplasm and nucleus of the syncytiotrophoblasts and decidual cells in the placenta and decidual tissues of the two groups. (3) The Gas6 mRNA expression elevated significantly in the placenta of preeclampsia group (0.60 ± 0.38) when compared to that of the control group (0.34±0.22;P<0.05). (4) The expression of Gas6 mRNA was positively related with body mass index, diastolic blood pressure, systolic blood pressure, free fatty acids and creatinine (P<0.05), while it was negatively associated with serum albumin(P<0.05). Conclusion The high expression of Gas6 in the placenta and decidua tissues may be related to the pathogenesis of severe preeclampsia.

Objective To approach the reasons and influence factors about sudden deafness of nurs-es in the operating room. Methods We investigated the psychologic status and etiological factors of nurs-es in operating room through questionnaires designed by ourselves about general work pressure and sudden deafness correlative reasons. Results The total score of pressure was 21.486,among which rush work and check and examination,worrying about mistakes and accidents, pricking wound were the main reasons re-suiting in sudden deafness for the operating room nurses. Conclusions Enhancement of psychological nursing, health education and working environment improvement can lessen the anxiety emotion of nurses who have sudden deafness and has considerable effect to promote recovery.

Objective To investigate significance of interferon-γ/interleukin-4(IFN-γ/IL-4) and macrophages in uterus in early embryo loss (or resorption), and to elucidate the anti-abortive effect and the immunological modulation at maternal-fetal interface with quercetin and bornvl acetate. Methods Lipopolysaccharide (LPS)(0.10μg/mouse)was injected via tail vein in order to induce abortion in 7-day-gestation mice which received quercetin and bornvl acetate at days 4-7 of gestation. Levels of IFN-γ and IL-4 in uterus lysate supernatant were measured using enzyme-linked immuno-absorbent assay (ELISA), and uterine macrophages of each group ( n =10) were detected by immunohistochemistry. Results The amount of macrophages was much higher in the uteri of LPS-induced abortion mice than that in control mice. The abortion rate of mouse declined to certain level. The therapy of quercetin combined with bornyl acetate reversed LPS-induced abortion. Conclusion The increase of IFN-γ/IL-4 and the amount of macrophages in the LPS-treated mouse uterus is associated with the embryo loss, and quercetin and bornyl acetate have the anti-abortive effect through modulation of maternal-fetal interface immunity balance.

Objective To investigate spatial memory ability of intraperitoneal injection of resveratrol in a mice model of chronic constriction injury of sciatic nerve(CCI).Methods Forty-four C57BL/6 mice were divided randomly into 4 groups:sham group (n=14),CCI group (n=14),resveratrol pre-treatment group (i.p.resveratrol 100 mg/kg 30 minutes before CCI model,n=8) and resveratrol post-treatment group (i.p.resveratrol 100 mg/kg 14 days after CCI model,n =8).CCI group,resveratrol pre-treatment group and resveratrol post-treatment group were operated with the model of neuropathic pain induced by chronic constriction injury of sciatic nerve.In shamoperated controls,an identical surgical procedure was performed,except that the sciatic nerve was not ligated.This was accomplished by using intellicage for mice by newbehavior to record their spatial memory after surgery.Results (l) Resveratrol pre-treatment group showed improved spatial memory ability compared with sham group and CCI group during day 17-21 (17 d:(55.80±7.66) ％,(51.20±7.94) ％ ; 18 d:(60.20±3.89) ％,(49.80±8.61) ％ ; 19 d:(62.20±7.25) ％,(51.20±6.83) ％ ;20 d:(63.00±9.69) ％,(48.40±8.84) ％ ;21 d:(56.80±7.52) ％,(47.20±4.54) ％)(P＜0.05),compared with CCI group.(2)From day 26,the spatial memory damage was observed in mice with CCI (26 d:(37.50±5.50)％,(51.80±9.01)％;27 d:(37.25±4.19)％,(51.20±5.76)％;28 d:(42.25± 3.50) ％,(52.80± 7.52) ％) (P＜ 0.05),compared with sham group.And this damage could be reversed by resveratrol,which was injected when the chronic pain was stable (26 d (46.60± 5.27) ％,27 d (54.00± 7.31) ％,28 d (52.60±4.39)％),compared with CCI group(P＜0.05).Conclusion Chronic constriction injury of sciatic nerve mice due to spatial memory impairment can be improved by resveratrol.

Objective To explore the imaging differences of vertebral multiple myeloma(VMM)and vertebral osteolytic metastasis on CT. Methods Review the imaging signs of 32 patients with VMM and 52 patients with vertebral osteolytic metastasis,then record and finally statistical analysis was carried out.Results Compare to 1 67 vertebras involved in 52 cases of vertebral metastasis,the patents with VMM had 220 vertebras involved.The incidence of the multiple small circular type of bone destruction in VMM was 42.66%(93/218),which was higher than that in vertebral metastasis 0.00% (0/165)(χ2 =92.963,P =0.000).The incidence of the irregular shape type of bone destruction in VMM was 23.39% (5 1/218),while it was higher in patients with vertebral metastasis 45.45%(75/165)(χ2 =20.704,P=0.000).It was also found that the incidence of the fragmentary type of bone destruction and the involvement of the unilateral pedicle in VMM were lower than that in patients with vertebral metastasis 8.7% (19/218 )& 27.27% (45/165)(χ2 =23.238,P =0.000), 6.82% (1 5/220)& 1 7.96% (30/1 67)(χ2 =1 1.477,P =0.001).The incidence of the crest protrusion type of bone destruction in patients with VMM was 16.06% (35/218),however it was 9.10% (15/165)(χ2 =4.013,P =0.045)in vertebral osteolytic metastasis. Conclusion The imaging features of VMM and vertebral osteolytic metastasis had certain characteristic.And they can be differentiated from each other,combining with clinical traits.

Objective Curcumin and MS-275,an inhibitor of histone deacetylase (HDAC),are promising anti-tumor agents. The aim of present study was to investigate the mechanisms of apoptosis induced by combined use of MS-275 in low dosage and curcumin in prostate cancer cell line DU145. Methods MTT assay was used to evaluate the lethal effect on DU145 cells by solitary use of MS-275 and or combined with curcumin. The changes in cell life cycle was detected by flow cytometry. The expressions of the survival signaling pathways were determined by Western blotting. Results Solitary application of MS-275 or curcumin may inhibit the growth of DU145 cells in a time and dose-dependent manner. The combination of MS-275 (1?mol/L) and curcumin (20?mol/L) exhibited obvious cytotoxic effect on cell viability,which was only 45.9% 48h after the combined treatment. Cell cycle assay showed that the combination of MS-275 and curcumin resulted in obvious appearance of sub-G1 phase in DU145 cells,implying that the cell apoptosis had been induced. The results of Western blotting showed that after treatment of MS-275 or curcumin singly,the phosphorylation level of Akt and ERK kinase declined slightly,however,when MS-275 and curcumin were used together,there appeared a prominent inhibitory effect on Akt and ERK kinase,indicated by a sharp decline of their phosphorylation level,and at the same time,the level of cleaved PARP,a hallmark of apoptosis,was increased in DU145 cells. Conclusion Combined use of MS-275 and curcumin may exert a synergistic cytotoxic effect on the viability of DU145 cells,and exhibit an inhibitory activity on Akt and ERK kinases to induce apoptosis.

Objective To investigate the clinical significance of platelet activation markers CD62p and PAC-1 in patients with hypertension and coronary heart diease.Methods To select patients who were in the Second Affiliated Hospital of Dalian Medical University between January 2012 and September 2012,42 patients with hypertension,46 patients with coronary heart disease.Flow cytometry was used to test the positive percentage of the platelet surface activation markers CD62p and PAC-1 .To observe the difference among hypertension group,coronary heart disease group and health control group;hyper-tension and coronary heart disease group.Results The positive percentage of platelet activation markers CD62p and PAC-1 in hypertension (36.36±9.62,7.18±8.20)%,coronary heart disease group (42.74±14.60,8.81±12.53)% showed sta-tistically significant differences (t=4.150~5.853,P<0.01)compared with healthy control group (26.82±9.13 ,1.09± 1.05)%.The positive percentage of CD62p in coronary heart disease group (42.74±14.60)% was also higher than that of hypertension (36.36±9.62)%,and the difference between them was of statistical significance (t=2.444,P<0.05).Con-clusion The hypertensive patients and coronary heart disease were in pre-thrombotic state,the activation of platelet increase significantly.Molecular markers should be measured in hypertensive patients and coronary heart disease for prevention and treatment of thrombotic disease complication.