Thyroid cancer is one of the most common tumors of the endocrine system, characterized by high morbidity and low mortality. Thyroid stimulating hormone (TSH) is an important factor in the development of thyroid cancer. TSH suppression therapy is widely used in clinical practice to reduce recurrence and metastasis through long-term strict monitoring and control of postoperative TSH level in patients with differentiated thyroid cancer (DTC). However, the specific mechanism of the effect played by TSH in the proliferation and progression of DTC has not been clarified. The current researches focus on classifying the relation between TSH and the onset risk, adverse clinicopathological factors and prognosis of DTC, and the applicable scope of TSH suppression therapy and targeted TSH receptor (TSHR) therapy. This article reviews the relation between TSH and DTC and the latest research progress of TSH suppression therapy and TSHR targeted therapy.

Objective:To investigate the epidemic situation of drinking water-borne endemic fluorosis in Henan Province, evaluate the effectiveness of prevention and control measures, and provide a basis for formulating further prevention and control policies.Methods:From April to November 2021, a census of all diseased villages registered in 112 drinking water-borne endemic fluorosis counties (cities, districts, hereinafter referred to as counties) of 17 provincial-level cities and 9 provincial-level counties (cities) in Henan Province was conducted to collect the basic information of diseased counties and villages. The content of fluoride in drinking water and the prevalence of dental fluorosis in children aged 8 - 12 years old were measured on a village by village basis.Results:By the end of 2021, drinking water-borne endemic fluorosis was prevalent in 112 diseased counties in Henan Province, involving 17 450 diseased villages. Among them, 17 433 villages had implemented measures to reduce fluoride and improve water quality, with a water improvement rate of 99.90% (17 433/17 450). There were 14 920 villages with qualified water, and the qualified rate of water fluoride was 85.50% (14 920/17 450). There were a total of 4 232 water improvement projects in all diseased villages, with a normal operation rate of 97.09% (4 109/4 232) and a qualified rate of 93.03% (3 937/4 232) for water fluoride in the projects. The total detection rate of dental fluorosis in children in the province was 9.64% (39 391/408 584), with moderate to severe dental fluorosis accounted for 8.08% (3 182/39 391), the dental fluorosis index was 0.18. The prevalence of fluorosis was negative.Conclusions:In 2021, the prevalence of drinking water-borne endemic fluorosis is widespread in Henan Province, and measures to reduce fluoride and improve water quality in diseased villages have been basically implemented. However, the fluoride content of water in some villages still does not meet the standard, and some water improvement projects cannot operate normally throughout the year. In the future, it is necessary to address the above issues one by one and consolidate the achievements in prevention and control of drinking water-borne endemic fluorosis.

Objective:To learn about the progress of prevention and control of drinking-water-borne endemic arsenic poisoning in Henan Province, and provide scientific basis for achieving the goal of eliminating high arsenic hazards as scheduled.Methods:From July to August 2019, in accordance with the requirements of the National Monitoring Program for Drinking-water-borne Endemic Arsenic Poisoning, a general survey was carried out in 26 high-arsenic villages in 6 counties of Henan Province to investigate the water improvement situation and the operation of water improvement projects, and the arsenic content in drinking water of households was measured, meanwhile, the arsenic poisoning status of permanent residents in high-arsenic villages was investigated.Results:All 26 villages with high arsenic content in the province had undergone water improvement, with a water improvement rate of 100.00%. A total of 18 water improvement projects were investigated in 26 high-arsenic villages, all of which were operating normally. Twenty-six water samples were collected, and the arsenic content in the household water was < 0.01 mg/L, which met the sanitary standards for drinking water. No patient of endemic arsenic poisoning was found during the survey.Conclusion:In Henan Province, the drinking-water-borne endemic arsenic poisoning has been effectively controlled, and the prevention and control achievements should continue to be consolidated in the future.

Objective:To master the provincial-level quality assessment of the self-inspection projects for control and evaluation of drinking water-borne endemic fluorosis in the counties (cities, districts) of Henan Province, so as to ensure the quality of self-inspection.Methods:Totally 30 counties (cities, districts) with drinking water-borne endemic fluorosis in Henan Province were selected as project counties (cities, districts), using consulting and checking data, on-site investigation and review, the implementation of self-inspection projects were audited. The water improvement and the water fluorine content, and the prevalence of dental fluorosis in children aged 8-12 were investigated in villages with drinking water-borne endemic fluorosis, and the provincial-level quality assessment of the self-inspection projects was carried out.Results:A total of 99 villages with drinking water-borne endemic fluorosis in 30 counties (cities, districts) were investigated, and all 30 counties (cities, districts) completed the investigation task of self-inspection projects. A total of 99 water samples were collected, and there were 23 counties (cities, districts) with the same results of county (city, district) self-inspection and provincial-level review of water fluorine, accounting for 76.67%; a total of 5 815 children aged 8-12 were investigated, there were 18 counties (cities, districts) with the same results of county (city, district) self-inspection and provincial-level review of dental fluorosis detection rate, accounting for 60.00%.Conclusions:The self-inspection projects of control and evaluation of drinking water-borne endemic fluorosis at the county (city, district) level in Henan Province are completed well. Most of the self-inspection projects are consistent with the provincial-level review results, but the disease diagnosis ability of grass-roots professional personnel and the detection technical level of laboratory technician in some counties (cities, districts) need to be improved.

Objective:To investigate the expression of RASAL3 in intrahepatic cholangiocarcinoma (iCCA) and the mechanism of promoting iCCA development.Methods:Tumor and paracancerous tissues were collected from 185 iCCA patients, the expression of RASAL3 was detected by immunohistochemistry, RT-qPCR and Western blot. The expression of RASAL3 and FXYD6 mRNA and protein in human cholangiocarcinoma cell line and human bile duct epithelial cells were detected with RT-qPCR and Western blot, the cell proliferation was detected with CCK-8 assay, and the activity of Na +-K +-ATPase was also detected. Results:RASAL3 was highly expressed in cholangiocarcinoma tissues and cell lines; Survival analysis showed that RASAL3 overexpression was associated with poor prognosis of cholangiocarcinoma( P<0.05) and knockdown of RASAL3 inhibits the proliferation of cholangiocarcinoma cells; Silencing RASAL3 decreases the expression of FXYD6 inhibiting the activity of Na +-K +-ATPase. Conclusion:RASAL3 is up-regulated in human cholangiocarcinoma, which can promote the occurrence and development of cholangiocarcinoma by activating FXYD6 and affecting Na +-K +-ATPase activity.

Objective:To understand the status of drinking water-borne endemic fluorosis in Henan Province, so as to provide scientific basis for improving prevention and control strategies.Methods:Ten counties (districts, referred to as counties) were selected from drinking water-borne endemic fluorosis areas of Henan Province in 2018. Three villages in each project county were selected according to the disease status of mild, moderate and severe conditions, and the operation status of water improvement projects, water fluoride content and dental fluorosis among children aged 8 to 12 years in each diseased village were monitored.Results:Totally 30 villages were surveyed, all of which were in the water improvement projects; a total of 25 water improvement projects were monitored, all of them were in normal operation, and the water fluoride exceeding standard rate was 28.00% (7/25), the qualified rate of water fluoride in the water improvement projects was 72.00% (18/25). Among them, 21 villages were in normal operation and the water fluoride in the water improvement projects met national standard. In which the detection rate of dental fluorosis among children aged 8 to 12 years was 36.71% (606/1 651), the index of dental fluorosis was 0.74, and the epidemic intensity was extremely mild. Water fluoride of water improvement projects in 9 villages exceeded the national standard, where the detection rate of dental fluorosis among children aged 8 to 12 years was 43.57% (261/599), the index of dental fluorosis was 0.78, and the epidemic intensity was extremely mild. The detection rate of dental fluorosis among children in the villages where the water fluoride of water improvement projects exceeded the national standard was higher than that in the villages where the water fluoride of water improvement projects met the national standard (χ 2=8.752, P < 0.01). Conclusions:The excessive fluorine content in the water of water improvement projects is still serious, and the epidemic is still severe. It is necessary to strengthen the scientific demonstration of the water improvement project construction and the project acceptance upon completion, so as to prevent unqualified projects from being put into use. We will carry out regular water quality monitoring and promptly rectify projects with water quality exceeding the standards.

Objective:To understand the prevention and control progress of drinking water-borne endemic fluorosis in Henan Province, to evaluate the effects of prevention and control measures, and provide a basis for adjusting prevention and control strategies.Methods:In 2019, a general survey was conducted in all registered drinking water-borne endemic fluorosis villages in Henan Province to monitor the basic conditions of water improvement, the fluoride content of drinking water and the prevalence of dental fluorosis in children aged 8-12 years. The control compliance (water fluoride content qualified and the detection rate of dental fluorosis of children ≤30%) status of the villages was analyzed, and calculate the compliance rate.Results:A total of 17 504 drinking water-borne endemic fluorosis villages were monitored, among them, 17 352 villages with water improvement and 152 villages without water improvement, with a water improvement rate of 99.1%. Among the 3 685 water improvement projects constructed, 3 448 were in normal operation, and the normal operation rate was 93.6%. There were 13 526 villages with qualified drinking water fluoride content, and the qualified rate of water fluorine was 77.3%; the actual beneficiary population was 11 011 000, and the population benefit rate was 90.1%. The qualified rate of water fluoride in the villages with and without water improvement was 77.9% (13 512/17 352) and 9.2% (14/152), respectively; the qualified rate of water fluoride in the villages with water improvement was significantly higher than that in the villages without water improvement (χ 2=400.58, P < 0.05). A total of 498 527 children of 8 to 12 years old were examined, 68 972 cases of dental fluorosis were detected, the detection rate of dental fluorosis was 13.84%, and the dental fluorosis index was 0.3. The number of villages meeting the control standard was 12 488, and the compliance rate was 71.3%. Conclusions:In Henan Province, the water improvement projects in the drinking water-borne endemic fluorosis areas have been basically implemented, and the disease has been effectively controlled. However, there is still a certain gap with the target of the "13th Five-Year Plan on National Prevention and Control of Endemic Diseases", and timely rectification is needed to ensure the effectiveness of the water improvement projects.

Objective: To investigate the association between the frequency and filling rate of lateral canals and the sealing quality in the apical third roots of the permanent teeth with failed endodontic treatments, so as to explore the failure factors of root canal therapy. Methods: Clinical records of the permanent teeth with failed endodontic treatments were collected from the Department of Endodontics, Capital Medical University School of Stomatology during a period of 2 years. The teeth were diagnosed as chronic apical periodontitis and then undergone endodontic microsurgery. The sealing quality of the apical root canal was observed by means of periapical radiographs. The surgical treatments were performed and the resected root apices were collected. The samples were scanned by micro-computed tomography and the 3D volume rendered images of the resected root apices were reconstructed. Moreover, the frequency and the filling rate of lateral canals in the apical third roots were calculated. The potential relationship between tooth position and the presence of lateral canals was evaluated. Results: Totally 89 teeth with 89 root apices met the inclusion criteria and were included in the present study. The rate of correct-filling, underfilling and overfilling was 40% (36/89), 32% (28/89), and 28% (25/89), respectively, examined by periapical radiographs. Amongst all of the 89 samples, lateral canals were found in 44 samples. The incidence of apices with lateral canals was 49% (44/89). Furthermore, 3 out of 44 samples were fully filled with material in the lateral canals, and the rest 41 samples showed no filling materials. The filling rate of the lateral canals was 7% (3/44). However, no significant difference was detected between the tooth position and the presence of lateral canals (P>0.05). Conclusions The sealing quality of the apical third roots in permanent teeth with failed endodontic treatments was not good enough. The incidence of apices with lateral canals was high, but the filling rate of the canals was low. Further studies are needed to explore the relationship between lateral canals and the failure of endodontic treatment.

Objective To compare the effects and cost of peripheral intravenous catheter (PIV) and peripherally inserted central catheter (PICC) on very low birth weight infants (VLBWI).Methods From July 2013 to August 2015,95 VLBWI with PICC (PICC group) and 90 VLBWI with PIV (PIV group) admitted to the Neonatal Intensive Care Unit (NICU) of Changzhi Maternal and Child Care Hospital were included in the analysis.The two groups were compared in body mass increase,average length of hospital stay,incidence of catheter-related complications,and care cost and effect.Results The body mass increase per weak was higher in the PICC group than in the PIV group,with statistically significant difference (P ＜ 0.05).The average length of hospital stay in the PICC group was shorter than that in the PIV group [(48.2 ± 5.2) d vs.(53.2 ± 8.1) d,P ＜ 0.05].The incidence of catheter-related complications was lower in the PICC group than in the PIV group (35.4％ vs.44.9％),including phlebitis (PICC group,21 person-times;PIV group,169 person-times),liquid leakage or exosmose (PICC group,2 person-times;PIV group,185 person-times),and catheter prolapse (PICC group,3 person-times;PIV group,145 person-times) with statistically significant differences (all P ＜ 0.05),and catheter blockage (PICC group,7 person-times;PIV group,84 person-times) and other complications such as venous embolism and infection (PICC group,1 person-time;PIV group,3 person-times) with no statistically significant differences (all P ＞ 0.05).The average monthly cost in the PICC group (1 951.5 yuan) was lower than that in the PIV group (2 008.5 yuan),and the cost of single insertion in the PICC group (1 691.5 yuan) was higher than that in the PIV group (129.9 yuan),the cost-effectiveness was better in the PICC group than in the PIV group (30.22 vs.36.45).Conclusions For VLBWI,PICC can reduce the times of venous puncture,the incidence of complications,and promote body mass increase.However,the monthly cost was similar between the two groups in this study,possibly because of the short-time of this study.The advantages in cost-effectiveness of PICC may become more prominent when the catheter dwelling time extends.

OBJECTIVETo compare the efficacy and toxicity of the chemotherapeutic regimen containing pirarubicin and mitoxantrone on the treatment of relapsed or refractory acute myeloid leukemia (AML) in adults.

METHODSIn this open prospective multicentre study, we randomly assigned patients with relapsed or refractory AML to receive TAE regimen (pirarubicin+cytarabine+etoposide) versus MAE regimen (mitoxantrone + cytarabine + etoposide). The efficacy and toxicity were compared between the two groups.

RESULTS56 patients entered this clinical trial. The complete remission (CR) rate on TAE arm was 79.0% versus 55.6% on MAE arm with the overall response (OR) rates of 86.8% versus 88.9%, respectively. The CR was higher on TAE arm (P=0.035) but with no significant difference between the two groups regarding the overall response (OR) rate. The regimens were well tolerated in both groups. Hematologic and non-hematologic toxicity were similar except relatively lower the mean dosage of G-CSF, red blood cells and platelets transfusion on TAE arm. No significant differences were seen between the two groups regarding the overall survival and relapse free survival rates.

CONCLUSIONTAE regimen might be an effective salvage therapy in patients with relapsed or refractory AML.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Dactinomycin ; administration & dosage ; Doxorubicin ; administration & dosage ; analogs & derivatives ; Etoposide ; administration & dosage ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Methotrexate ; administration & dosage ; Prospective Studies ; Recurrence ; Remission Induction