Thyroid carcinoma is the most frequent endocrine cancer,and most are found in women.Different pathologic types of thyroid carcinoma has different biologic behaviors,and onset is hidden,which results in difficults to diagnose the early thyroid carcinoma.With the development of the molecular biology,more researches are focus on thyroid carcinoma in recent years.This article reviews the tumor markers,oncogene and gene therapy of thyroid carcinoma.

Objective]To research and explore the characteristic of medicine in Treatise on Febrile Diseases. [Methods]Combine with the doctors of past dynasties, relevant annotations of the treatment of cough notes in Treatise on Febrile Diseases,and my own learning experience,analyze the characteristic of medicine of Zhongjing treating cough in Treatise on Febrile Diseases.[Results]Its characteristics are summed up in three points.Pay attention to the thought of the simultaneous dispersion and descending, and conform to lung qi.Pay attention to the drugs of the lung channel,especially the application of Ephedra and its compatibility with other drugs.Pay attention to“reinforcing earth to generate metal”and protect stomach qi. [Conclusion]The research of this paper is beneficial to broaden the clinical treatment of cough ideas,expand the clinical application of the classical prescription,deepen the understanding of Zhang Zhongjing's academic thought.

OBJECTIVE:To investigate the revenue and expenditure in PIVAS of our hospital,and to provide data for the es-tablishment and operation of PIVAS in other hospitals. METHODS:A statistics was undertaken for the revenue and expenditure of PIVAS in 2014,and partial influential factors were analyzed comprehensively. RESULTS:In 2014,under the premise of only long-term doctor's advice for the morning,760611 groups of intravenouse drugs had been administered in PIVAS of our hospital. The revenue was about 2197439 yuan and the expenditure was about 1872598 yuan;the cost of human resource was the main cost part,which took 77.92%. CONCLUSIONS:The revenue of PIVAS almost covers the cost of pharmacy in our hospital at pres-ent;the data of cost-effectiveness can be reference for other hospitals.

OBJECTIVE:To observe the protection effects of Metformin combined with Calcitriol on renal functiou and retina in patients with type 2 diabetes. METHODS:80 patients with type 2 diabetes with early diabetic nephropathy and mild-to-moderate non proliferative retinopathy were randomly divided into control group(40 cases)and observation group(40 cases). Control group received Metformin hydrochloride tablet with initial dose of 0.5 g,twice a day during a meal,increased 0.5 g every week,then gradually increased to 2 g every day;observation group additionally received Calcitriol soft capsule,0.25 μg/times,once a day. The treatment lasted and followed-up for 6 months. Efficacy of retinopathy,blood glucose levels [2 h postprandial blood glucose (2 h PG),blood glucose (FPG)],renal function indexes [urinary albumin-to-creatinine ratio (ACR),urinary albumin excretion rate (UAER),proteinuria (Pr)],vision and visual field defects,fundus angiography before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than in control group,and the difference was statistically significant(P<0.05). Before treatment,there were no significant differences in the 2 h PG,FPG,ACR,UAER,Pr,vision and visual field defects between 2 groups (P>0.05). After treatment,2 h PG, FPG were significantly lower than before;ACR,Pr,UAER,average value of visual field defects,fundus angiography and bleed-ing area were significantly lower than before,and observation group was lower than control group;vision was significantly higher than before,and observation group was higher than control group. The differences were statistically significant (P<0.05). There was respectively 1 patient showed slight adverse reactions in both groups. CONCLUSIONS:Metformin combined with Calcitriol has certain protection effect on the renal function and retina in patients with type 2 diabetes,it can reduce 2 h PG,FPG,ACR, Pr,UAER,average value of visual field defects,fundus angiography and bleeding area of patients and improve vision,with small adverse reactions and high safety.

Objective To understand the status quo of continuing medical education in different levels of hospitals in primary health technical personnel,and provide suggestions for the development of continuing medical education.Methods Questionnaire survey,Statistical analysis and Interview.Results Health technical personne of medical institutions at all levels in primary health technical personnel were generally more emphasis on continuing medical education,but the management system,input and the need are different in the different levels of hospital.Continuing medical education in the basic level hospitals is much lower than the high level hospitals.Conclusions We should strengthen the transformation of continuing education mode,put forward the practical development strategy,improve the level of medical education,and narrow the gap between different levels of hospitals,so as to achieve the purpose of common progress.

Objective To investigate the therapeutic effect of astragalus injection onβcells apoptosis of type 1 diabetes mice. Methods 32 mice were randomly divided into a control group, a diabetes group, a small dose group and a large dose group of astraglus. Except the control group, mice in the other 3 groups received intraperitoneal injection of STZ in order to induce diabetic mellitus. Then one week after injection of STZ, mice in the small dose group and the large dose group of astraglus were given 30, 60 g/(kg?d) doses of astragalus injection, while the other 2 groups were injected into an equal volume saline for 4 weeks. Serum NO, inducible nitric oxide synthase (iNOS) and insulin levels were detected by enzyme linked immunosorbent assay method, and apoptosis was measured by using a TUNEL assay. Results Compared with the diabetes group, the serum NO (25.81 ± 2.09μmol/L, 18.84 ± 3.95μmol/L vs. 30.34 ± 2.53μmol/L) and iNOS (21.38 ± 4.48μmol/L, 17.00 ± 3.05μmol/L vs. 26.62 ± 2.48μmol/L) levels were significantly reduced in the small dose group and the large dose group of astragalus (P<0.05);But the insulin levels (312.19 ± 66.91 pmol/L, 330.14 ± 56.06 pmol/L vs. 273.56 ± 43.54 pmol/L) and apoptosis ofβcells (23.00%± 16.58%, 27.38%± 18.79%vs. 31.25%± 18.19%) were not significant different among the experimental groups (P>0.05). Conclusion Astragalus injection can reduce the iNOS activity and NO production, but can not effectively decreasingβcells apoptosis.

Objective To know the current state of environment pollution in the surrounding of the smelteries of gold and silver with indigenous method and provide a reference for the environment pollution control. Methods The occupational and environmental hygiene investigation were conducted during Apr.-Jul.,2000,the level of arsenic in the samples collected from the surrounding of the smelteries was determined. Results Primitive gold-silver smelting had such problems as backward production processes,the irrational distribution of enterprises,no treatment of “the three wastes” and serious harm to the ecological environment. The concentrations of both arsenic and lead in the environmental medium were heavily over the standard limits and some patients with chronic arsenic poisoning were found among the local residents. Conclusion Primitive gold-silver smelting may produce serious environmental pollution which can induce the health impacts of the local people.

Objective To investigate the effect of combination therapy of Gabapentin and Cobamamide in treatment of painful diabetic neuropathy (PDN).Methods A total of 96 patients with type 2 diabetes (T2DM) and PDN were enrolled in this study and randomly divided into control group (Con,n=32),Cobamamide group,(n=32),and Gabapentin+Cobamamide group,(n=32).FPG and HbA1c were actively controlled in each group.Con group was treated with vitamin B1.Clinical and biochemical data of all the subjects were collected.The degree of pain was assessed by visual analogue scale (VAS).The changes of median nerve,peroneal nerve motor nerve conduction velocity (MNCV),and sensory nerve conduction velocity (SNCV) were evaluated by EMG assessment.The assessment of sleep quality was done by Pittsburgh sleep quality index scale (PSQI).Results There was no significant differences of baseline MNCV,SNCV and the degree of pain among the three groups (P>0.05).After treatment,all the above index were improved in both Cobamamide group and Gabapentin+Cobamamide group.MNCV and SNCV were higher in Gabapentin+Cobamamide group than in Cobamamide group (P<0.05).There were no significantly improvement of MNCV and SNCV in Con group (P>0.05).Conclusion The combination therapy of Gabapentin and adenosine cobalt amine could reduce pain,improve nerve conduction velocity,and improve the quality of sleep.

Objective To explore the effect of microRNAs 224 and 21 on human glioma stem cells survival and the possible molecular mechanisms.Methods qPCR was used to detect the dysregulated expression of microRNAs in malignant glioma samples, human GBM stem cells, artificially established GBM stem cell lines and human tissues.Caspase 3/7 assay, Annexin V apoptosis/fluorescence assay were performed to determine the effect of miR-21 or miR-224 mimics and inhibitor on cell apoptosis.Living cells count was used to assess miR-21 or miR-224 mimics and inhibitor on cell growth.TargetScan was used to explore potential targets of miR-21 and miR-224, and dual luciferase reporter assay was used to identify whether the 3’UTR of Caspase 3, Caspase 9 and Bim mRNA was a binding target of miR-21 or miR-224.Western blot was used to detect the expression of Caspase 3, Caspase 9 and Bim protein after transfection of miR-21 or miR-224 mimics or inhibitors.Results miR-21 and miR-224 are strongly upregulated in GSC samples, multiple GBM human tumor specimens, and GBM neurosphere stem cell lines ( P<0.05 ) .Caspase 3/7 assay and Annexin V apoptosis/fluorescence assay results showed that miR-224 and miR-21 regulated GSC apoptosis.Living cells count results demonstrated that miR-224 and miR-21 regulated GSC growth.miR-224 and miR-21 regulate pro-apoptotic gene expression by directly targeting Caspase 3, Caspase 9, and Bim 3’-UTRs. Conclusion These results indicate that miR-224 and miR-21 are important physiologic drivers of GSC resistance to apoptosis, providing new points of therapeutic leverage against these treatment-resistant cells.

Objective To explore the differential diagnostic significance of clone analysis for multicentric occurrence (MO) and intrahepatic metastasis (IM) in hepatocellular carcinomas (HCCs).Methods Loss of heterozygosity (LOH) and microsatellite instability (MSI) were analyzed by microsatellite polymorphism test and the integration sites of HBV were assessed by Southern blot in each nodule of the HCCs. The clonalities were then compared between each nodule of the same patient and the diagnosis of MO or IM was concluded. Finally, the results based on clonality analysis were compared with those according to clinicopathological and imaging data. Results According to the results of LOH and MSI in 79 nodules and nontumorous tissue from 35 cases of mutiple HCCs, 5 (14.3%)and 29 cases (82.9 %) were divided into MO and IM, respectively. Both MO and IM presented simultaneously in 1 patient (2.9%). The integration sites of HBV could be analyzed in 77 nodules from 34 multiple HCCs. Among them, 6 (17. 6%) and 27 cases (79.4%) were divided into MO and IM, respectively. Both MO and IM presented simultaneously in 1 patient (2.9%). The classification results of microsatellite polymorphism test and HBV integration sites analysis demonstrated a significant positive correlation (rs = 0.909, P＜0.001). Nevertheless, neither the classification of microsatellite polymorphism test nor that of HBV integrate sites analysis was correlated with the discrimination according to clinicopathologic and imaging data (rs=0. 133, P=0. 468, rs =0. 262, P=0. 155, respectively). Recurrence in patients in the MO group occurred significantly later than that in IM cases who were diagnosed by clonality analyses (P=0. 001). Conclusion The clonality analysis based on the results of LOH and MSI or assessments of HBV integrate sites is useful for the differential diagnosis of MO and IM and their treatment and prognosis.