Acromegaly is an endocrine and metabolic disease with insidious onset. Delays in its diagnosis and treatment significantly increase the incidence of complications. Early detection, diagnosis, and treatment are extremely important for the prognosis of patients with acromegaly. Based on a large quantity of evidence in recent years, Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020) has standardized the diagnosis and the treatment strategies of acromegaly. In the non-surgical treatment section, according to the categories of drugs used to treat acromegaly, the indications, selection, administration, dosage and precautions of pharmaceutical treatment have been clarified with specific recommendations. It is hoped that the new consensus can further guide and standardize the clinical management of acromegaly.

Objective To explore the application value of new pre-operation auxiliary chemotherapy(NACT)in treating cervical carcinoma. Methods Two periods of chemotherapy were conducted on 53 cervical carcinoma patients;the chemotherapy projects were PVB and BIP;operation was made two weeks afterwards. Results The total effective rate of NACT was 77.4% ,26.4% of which was complete remission;50.9% of which was partial remission;local carcinoma bulk decreased significantly; the post-operation pathology indicated that there was 3.8% of uterus infiltration and 7.1% of pelvic cavity lymph node metastasis. Those patients received chemotherapy after the operation,all patients were followed up. Conclusion NACT is safe and effective for the pre-operation treatment of cervical carcinoma,which can reduce the carcinoma bulk and increase the successful rate of the operation.

Objective To investigate the curative effect of surgery,radiotherapy and photodynamic therapy combined with chemotherapy on early glottic carcinoma and prognostic factors.Methods Clinical data of 122 cases of early glottic carcinoma with Tis ~T2 N0 M0 were analyzed retrospectively.Small doses of chemotherapy applied to single drug cisplatin (according to the surface area of 50 mg/m2 ).83 patients underwent surgical treatments combined with chemotherapy,20 cases accepted radiotherapy combined with chemotherapy and 19 cases accepted photodynamic therapy combined with chemotherapy. Results The 3 and 5 years overall survival rates (overall survival,OS ) of surgery group,radiotherapy group and photodynamic group were 92.7%,93.8% and 89.5%,89.5% and 84.4% ,89.5%,respectively.The 2-year disease free survival rate (disease-freesurvival,DFS)were 87.6%,79.4%,78.6%,respectively.The 2-year local control rate(local control,LC)were 91.9%,84.4%,83.0%, respectively.27 cases suffered from tumor recurrence or metastasis,15 cases in the surgery group,3 cases in the radiotherapy group and 5 cases in the photodynamic group,among them 19 patients accepted salvage surgery.Multifactor retrospective analysis indicated anterior commissure invasion (P=0.047),clinical stage(P =0.018)and KPS score before treatment(P =0.001)were independent adverse prognostic factors for OS.Anterior commissure invasion(P=0.027)and differentiation degree(P=0.041)were adverse prognostic factors for DFS.Anterior commissure invasion was also poor prognostic features for LC(P=0.047).Conclusion Radiotherapy and photodynamic therapy combined with chemotherapy may be the first or very important treatment on early stage glottic squamous cell cancer(Tis ~T2N0M0 ).High preservation rate of laryngeal function with radiotherapy and photodynamic therapy combined with chemotherapy can significantly improved quality of life of patients.Curative effect of three groups was similar,and three kinds of curative methods achieved good effect.KPS score before treatment,glottis impair and differentiation degree were the main adverse prognostic factors for early stage glottic carcinoma.

Objective To investigate the incidence of metabolic syndrome (MS) in patients with gastric cancer, and to explore the relationship between MS and the tumor site and the influence of MS on surgical procedure and short-term outcomes of patients with gastric cancer. Methods The clinical data of 639 patients with gastric cancer who were admitted to the Affiliated Hospital of Qingdao University from January 2006 to June 2008 were retrospectively analyzed. Patients with MS were in the MS group ( n= 64) and those without MS were in the control group ( n = 575 ). The surgical and postoperative complications were reviewed and the tumor site, intraoperative conditions and short-term outcomes between the two groups were analyzed. All data were analyzed using the chi-square test or t test. Results The incidence of MS in patients with gastric cancer was 10.0% (64/639).The incidence of MS in female patients was 14.4% (27/188), which was significantly higher than 8.2% (37/451)of male patients ( χ2= 6.265, P < 0.05). The operation time of the MS group was ( 185 ± 133 ) minutes, which was significantly longer than ( 168 ± 50) minutes of the control group ( t = 2. 126, P < 0. 05 ). The number of lymph nodes dissected in the MS group was 18 ± 11, which was significantly lower than 21 ± 11 of the control group ( t = 2. 125, P < 0.05 ). The postoperative period of fever of the MS group was (3.0 ± 1.4) days, which was significantly longer than (2.5 ± 1.4) days of the control group (t = 2. 433, P < 0.05 ). The incidence of postoperative complications of the MS group was 31.3% (20/64), which was significantly higher than 14.3% (82/575) of the control group ( χ2 = 12.291, P < 0.05 ). The length of hospital stay of the MS group was ( 19 ± 11 ) days,which was significantly longer than ( 16±11 ) days of the control group ( t = 2. 141, P< 0.05 ). The mortalities of MS group and control group were 0 and 0. 5% (3/575), respectively, with no significant difference ( χ2 = 0.000,P >0.05). Condusions A low prevalence of MS is found in patients with gastric cancer. However, patients with gastric cancer complicated with MS may present with prolonged surgical procedure, reduced amount of lymph nodes dissected and increased incidence of postoperative complications, hospital stay and costs. Perioperative management of patients with gastric cancer complicated with MS should be paid more attention.

Objective To investigate the expression of fragile histidine triad (FHIT) gene in cervical carci-noma and relationship with its clinical-pathological implication. Methods The expression of FHIT was detected by immunohistochemistry SP method in 42 cases of cervical carcinoma and 13 cases of adjacent tissue. Results 47.6% (20 of 42) of cases expressed FttIT in the tumor cells,and 92.3% (12 of 13) of cases of the adjacent tissue were present. There was a significant positive correlation between cervical carcinoma and adjacent tissue(P <0.01). The positive rates of FHIT in high and middle desrees of differentiation were significantly higher than that in low degree of differentiation(54.2% vs 38.9%). Tumors with lymph node metastases(45.9%) had loss FHIT protein expression than those without metastasis(60.0%) (P <0.05). The FHIT expression between Ⅰ and Ⅱ stage,the difference was significant(55.0% vs 45.5%) (P < 0.05). Conclusion FHIT gene plays an improtant role in the occurrence and development of cervical carcinoma. It is suggested that FHIT can be a useful marker for predicting invasion and metas-tasis ability of cervical carcinoma.

Objective To analyze the relationship between the urine iodine level in different pregnant periods of women and the thyroid function .Methods The pregnant women were randomly sampled in Foshan city and 490 cases were selected as the research subjects ,including 170 cases of early stage pregnancy ,162 cases of middle stage pregnancy and 158 cases of late stage pregnancy . According to the thyroid function ,490 subjects were divided into the normal thyroid function group and the abnormal thyroid func‐tion group .Results 140 cases(88 .61% ) in the late stage pregnancy had normal thyroid function ,which were less than 166 cases (97 .65% ) in the early stage pregnancy and 157 cases (96 .91% ) in the middle stage pregnancy ;the constituent ratio of urine iodine < 100 μg/L in the early stage pregnancy was 19 .88% (33/166) in the normal thyroid function ,which was lower than 75 .00%(3/5) in the abnormal thyroid function group .The constituent ratio of urine iodine 100 - 300 μg/L in the early stage pregnancy group was 56 .0% (93/166) ,which was higher than 0 .0% (0/4) in the of abnormal thyroid function group .Conclusion It is neces‐sary to conduct the urinary iodine monitoring in early pregnant woman ,moreover it is suggested that the thyroid function detection will be conducted in the pregnant women with urine iodine < 100 μg/L and urine iodine 100 - 300 μg/L .

[Objective]To observe the guidance effect of software Minics for the operation on sacroiliac fracture.[Method]30 models of articulatio sacroiliaca were detected by X-ray and helical CT to three-reconstruction and divided into three groups randomly,each group had 10 models.The fractures of group A were fixed by K-wires screws according to direction of software Minics on data of helical CT.The fracrures of group B were fixed by K-wires screws guided by video X-ray equipment.And thoes group C were fixed by K-wires screws according to the direction X-ray and helical CT.the fixation effects were estimated by biomechanical and anatomy index.[Result]There were significant differences between groups A,B and group C on the mechanical intensity and anatomy location(P0.05).[Conclusion]Software Minics can be used for the instruction of operation on sacroiliac fracture.

Objective To assess the efficacy and safety of insulin Lispro in type 1 or type 2 diabetic patients.Methods Forty diabetic patients were assigned to receive premeal insulin Lispro plus bedtime Neutral Protamine Hagedorn(NPH)insulin for 12 weeks.The following characters were compared between before and after treatment,including fasting plasma glucose(FPG),1 h and 2 h postprandial glucose(after a standardized meal),glycosylated hemoglobin(GHbA_1c)levels,total daily insulin dose and the number of hypoglycemic episodes.Results Thirty-nine subjects fulfilled the study.After 12 weeks of Lispro treatment,the levels of FPG and 1 h and 2 h postprandial glucose were decreased significantly,being 1.12 mmol/L,2.37 mmol/L and 1.92 mmol/L respectively;GHbA_1c was decreased by 1.45%(from 8.9% to 7.5%).The dose of insulin Lispro was not changed,compared with the dose of regular human insulin at baseline.The incidence of hypoglycemia was decreased from 19.5 every week at baseline to 9.8 every week with Lispro.Conclusion Insulin Lispro is an effective agent for good glucose control with fewer hypoglycemic episodes in diabetic patients.

ObjectivesTo evaluate the therapeutic result of various management for severe radiation injury of the bowels.MethodsThe clinical presentation, diagnostic approach, managements and therapeutic effects were analysed retrospectively in 28 severe radiation therapy caused enteric injury patients. In all intestinal stricture cases, partial ileal resection was performed in 14 patients, right hemicolectomy in 1 patient, rectosigmoid resection in 3 patients. Instestinal fistulae was treated by diseased segment resection and reanastomosis in 7 patients, sigmoidostomy was undertaken in 2 patients.ResultsThere was no inhospital mortality. One case suffered from low colonic fistula,4 died of recurrence of the primary tumor.Postoperative bowel function and nutrition status significantly improved in all patients.ConclusionSurgical management combined with nutrition support is safe and effective for the treatment of severe radiation caused enteric injury.

Objective:To evaluate the psychosomatic effects of relaxation and the correlation between the effects and the personality and behavior pattern of the subject.Methods:68 medical students were involved in the study. All the subjects received relaxation training for 2 months. They were tested with Self-Rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) before and at the end of the study. They were also tested electroencephalogram (EEG), electromyography (EMG) and skin temperature at the above two time-points. The correlation between the personality and the extents of alteration in index of EEG were also studied.Results:After training, the scores of SAS and PSQI in the subjects were significantly lower than those before training. The indexes of EEG, EMG and skin temperature were improved. The extents of alteration in index of EEG were correlated positively with the N-scores of Eysenck Personality Questionnaire (EPQ), the total scores and TH-scores of Type A Behavior Pattern (TABP).Conclusion:Relaxation can improve psychosomatic states of undergraduates. The extents of alteration in index of EEG were correlated with the personality and behavior pattern of the subject.