Nutritional anemia is mainly including the iron deficiency anemia and the megaloblastic anemia.The highlights of the two kinds of nutritional anemia on the differential diagnosis are compared associated with the clinical practice,and the commonly used treatment protocol at present are briefly expounded.

[Summary] With the rapid development of endoscopic thyroidectomy for its advantages of hidden incision and good cosmetic effects, it becomes a significant issue to reduce surgical adverse effects.Recurrent laryngeal nerve ( RLN) injury is among the most important complications and is paid much attention to by clinical researchers.Reasons leading to RLN injury include accidental injury, ligation and intraoperative blood loss. An appropriate way to expose RLN, skilled operation performance, precise anatomy, individualized operation scheme and intraoperative neuromonitoring can prevent RLN injury.

Objective To observe the curative effects of metformin combined with cyproterone therapy on polycystic ovary syndrome(PCOS). Methods Ninety diagnosed PCOS patients were treated. The serum luteinizing hormone(LH), luteinizing hormone and follicule stimulating hormone(LH/FSH) ratio and T, waist hip ratio(WHR) of the patients before therapy were compared with using merformin combined with- cyproterone three cycles. Results A significant reduction(P<0.05 or P<0.01) in LH,LH/FSH,T and WHR of patients after the therapy was observed. Menses became regular after the therapy, and ache and hirsutism mitigated. Conclusion Metformin com- bined with cyproterone is a perfect means to treat polycystic ovary syndrome(PCOS).

ObjectiveTo analyze the results of implementing the tutorial system for medical interns, and to put forward some suggestions. MethodsThe medical interns and the doetors selected as tutors were asked to do questionnaires to study the tutorial system's feasibility and effectiveness. Simultaneously, we adopted the Objective Structured Clinical Examination ( OSCE ) to assess its process and resuits. Results74.3％ of the students and 75.5％ of the doctors think that they need the tutorial system,73.2％of the students think that this system can train better clinical skills,67.9％ of the doetors think that they can review the knowledge learned through teaching. Implemented after one year, students' OSCE scores are improved. ConclusionTutorial system for medical interns has achieved preliminary success, and the preparatory work and related-system building need to be further improved.

Objective To investigate the effect of batroxobin on the plasma levels of endothelin (ET) and calcitonin gene-related peptide(CGRP) in patients with acute cerebral infarction(ACI). Methods 60 patients with ACI were randomly divided into therapy group(n = 30) and control group(n = 30),500 ml of 5% GS plus 1.0g ramme of Troxerutin was intravenously dripped par day and ticlopidine 250mg/day in the control group. Based on the control group therapy,Batroxobin was intravenously dripped with 10U on the 1st day and 5U on the 3rd and 5th day for seven days. The plasma levels of ET and CGRP were detected pre and post treatment by radioimmunoassay. Results Plasma levels of ET and CGRP in batroxobin therapy group post treatment ( 81.25±27.38 ) ; ( 44. 13±13.30) ng/L were significantly different from those pre treatment(109. 83±38.24) ; (24. 73±13.59) ng/L (all P＜0. 01 ) ,and were also significantly different from those post treatment in the control group(98.07±30. 39) ; (37.02±12. 41 )ng/L (all P＜0. 01 ). Conclusion Batroxobin can accommodate the equilibration between ET and CGRP, and protect brain cell and blood vessel endothelial cell.

Objective To investigate the levels of IL-33 in the lung induced by Aspergillus fumigatus (A.fumigatus) exposure in bronchial asthmatic rats and the effects of dexamethasone.Methods Twenty-four Wistar rats were randomly and equally divided into group A (normal control),group B (asthma group),group C (A.fumigatus-exposed group),and group D (dexamethasone-treated group).B,C and D group were sensitized and challenged with ovalbumin (OVA) to establish asthmatic models.Then,group C and D were given A.fumigatus spores intranasally.Group D was pre-treated with dexamethasone during ovalbumin challenge.Group A was sensitized and challenged intranasally with normal saline as control.Airway hyperresponsiveness,eosinophils percentage and serum IgE levels were measured to confirm the establishment of asthmatic model.Expression of IL-33 in the lung were quantified by ELISA and qRT-PCR.Lung tissues and blood were plated on the potato dextrose agar (PDA) medium and cultivated for 24 h to measure the number of colony.Results Eosinophils percentage in bronchoalveolar lavage fluid (BALF),IgE levels in serum and IL-33 levels in the lung in group B and C were much more higher than in group A (P＜0.05),and the increasing range in group C was more obvious than group B.However,the changes of sRaw values in these groups had no statistical significance.Esosinophils percentage in BALF and IL-33 levels in the lung were significantly decreased (P＜0.05),and IgE levels in serum was slightly decreased (P＞0.05) in group D when compared with group C,but the ratio of A.fumigatus colonization in the lung was higher than group C.Conclusions Dexamethasone can inhibit the expression of IL-33 in the lung induced by A.fumigatus exposure in an asthmatic rat,but it also increases the risk of fungal colonization in the airway.Anti-IL-33 antibody treatment needs further research.

Objective To explore influence of antibiotics and Jiuyi Dan combined with incision-thread-drawing procedure on perianal abscess patients' level of activin A (ACTA) and C-reactive protein (CRP).Methods120 cases of perianal abscess patients in our hospital during March 2015 to December 2016 Coloproctology were selected, they were divided into the experiment group and the control group by random number method.All of patients were taken incision-thread-drawing procedure.Then the experimental group were given nine one antibiotics and Jiuyi Dan, the control group were given antibiotics.The cure rate, 6months after the recurrence rate, average healing time of the wound, and wound edema rate of two groups were observed.Levels of ACTA and CRP expression levels of two groups of patients before and after operation were analyzed.ResultsPatients in the experimental group cure rate was 96.7% higher than that of the control group (P<0.05), the recurrence rate of patients in the experimental group than in the control group, the difference was not statistically significant;the patients in the experimental group the average healing time was (20.67±3.22) d shorter than the average healing time of patients in the control group (29.48±3.15) d, patients in the experimental group wound edema rate of 5% was significantly lower than in the control group 20% (P<0.05);3D ACTA, the expression level of CRP was significantly higher than the preoperative 7 d levels after operation in the two groups (P<0.05);after 7d, the expression level of the two groups of patients with ACTA and CRP were significantly lower than the preoperative level of expression of 7d (P<0.05), experimental group levels of ACTA were significantly lower than the control group, the difference was statistically significant (P<0.05);postoperative 14d patients, ACTA levels of two groups were significantly lower than the levels before operation (P<0.05).ConclusionPerianal abscess can be treated effectively and patients levels of Acta and CRP were obviously dereased by Jiuyi Dan combined with incision-thread-drawing procedure combined, postoperative inflammatory reaction could be importantly alleviated, it was worth clinical promotion.

Lymphoid malignancies represent a heterogeneous group of malignancies with differing patterns of behaviour and response to treatment.Anaemia is common in patients with lymphoid malignancies and negatively impacts on quality of life and treatment outcomes and survival.We discuss the diagnosis and management of anaemia in patients with lymphoid malignancies.

Inhibition of tumor neovascularization (angiogenesis) has become one of the novel therapeutic strategies for tumor, and natural inhibitor of angiogenesis has been highlighted in this field. Thrombospondin-1 (TSP-1), as an important extracellular matrix component which can influence endothelial cell adhesion, migration, and proliferation, is reported to be a potent inhibitor of angiogenesis in vivo. It will be valuable to use its active peptides or small fragments from TSP-1 in antiangiogenesis therapy.