Objective To evaluate the association between preoperative serum thyroglobulin concentration and aggressive behavior of papillary thyroid cancer(PTC).Methods A total of 334 PTC patients diagnosed by surgical pathology treated in our hospital from Jan.2013 to Dec.2017 were retrospectively reviewed.Patients were divided into two groups according to Tg levels and clinicopathological characteristics between the two groups were compared.Binary logistic regression analysis was conducted to evaluate the factors influencing extrathyroidal extension and lymph node metastasis of PTC.Results High level of preoperative serum Tg was signifcantly associated with old age,multifocality,larger maximum tumor size,more frequent extrathyroidal extension,lymph node metastasis,and advanced T and TNM stage(P＜0.05).Maximum tumor diameter ＞2 cm(P=0.031) and preoperative serum Tg level ＞17.21 ng/ml(P=0.028) were independent risk factors for extrathyroidal extension.Maximum tumor diameter ＞2 cm(P=0.007) and preoperative serum Tg levels ＞25.40 ng/ml (P=0.016) were independent risk factors for lymph node metastasis,whereas female was a significant protective predictive factor(P＜0.001).Conclusion Preoperative serum Tg levels may serve as an independent risk marker for extrathyroidal extension and lymph node metastasis of PTC,and partly contributes to predict aggressive behavior of PTC.

Objective: To determine the change of gene expressions in human perirenal adipose tissue (PAT) and oblique abdomen subcutaneous adipose tissue (SAT) of overweight and obese subjects. Methods: Ninety-seven patients, including 35 overweight/obese patients and 62 non-obese patients, who underwent renal surgery were included. The clinical data and various gene expressions in PAT and SAT of two groups were analyzed. Results: Body mass index, waist circumference, systolic blood pressure, resting heart rate, fasting blood glucose, and serum creatinine were significantly higher in overweight/obese patients than those in non-obese patients(P<0.05 or P<0.01). Compared with non-obese patients, PAT adipocytes showed bigger, and the expressions of uncoupling protein-1 (UCP1) mRNA and protein were markedly lower in overweight/obese patients. The mRNA expressions of CIDEA and adiponectin in PAT of overweight/obese patients were significantly lower, while leptin, monocyte chemotactic protein 1, interleukin (IL)-6, and IL-10 mRNA expressions were significantly higher. There were no significant differences in the related gene expressions of SAT between the two groups. Conclusions Different parts of adipose tissue reveal various characteristics, and play different roles in the occurrence and development of obesity. UCP1 expression is decreased in PAT of overweight/obese patients, with the changes of adipocytokine expressions. (Chin J Endocrinol Metab, 2018, 34: 567-572)

OBJECTIVETo compare the difference in the clinical efficacy on post-stroke upper limb spasmodic hemiplegia between the combined therapy ofneedling technique and Bobath technology and simple Bobath technology.

METHODSSixty patients were randomized into an observation group and a control group, 30 cases in each one. The usual medication of neurological internal medicine was used in the two groups. In the control group, Bobath facilitation technology was applied to the rehabilitation training. In the observation group, on the basis of the treatment as the control group,needling technique was used to stimulate Zhongfu (LU 1), Tianfu (LU 3), Chize (LU 5), Quchi (LI 11), Jianshi (PC 5) and Daling (PC 7). The treatment was given once a day; 5 treatments made one session and totally 4-week treatment was required in the two groups. The modified Ashworth scale, the modified Fugle-Meyer assessment (FMA) and the Barthel index (BI) were adopted to evaluate the muscular tension, the upper limb motor function and the activities of daily living (ADL) before and after treatment in the two groups. The clinical efficacy was compared between the two groups.

RESULTSCompared with those before treatment, the modified Ashworth scale, Fugl-Meyer score and BI score were all improved after treatment in the two groups (all<0.01). The results in the observation group were better than those in the control group (all<0.01). The total clinical effective rate was 93.3% (28/30) in the observation group and was 80.0% (24/30) in the control group. The efficacy in the observation group was better than that in the control group (<0.05).

CONCLUSIONSTheneedling technique combined with Bobath therapy achieve the superior efficacy on post-stroke upper limb spasmodic hemiplegia as compared with the simple application Bobath therapy. This combined treatment effectively relieve spasmodic state and improve the upper limb motor function and the activities of daily living.

's acupuncture school in Gansu,represented byand,is of great influence in China.'s acupuncture school originated from(Inner Canon of Yellow Emperor) and(Classic of Questioning),and shaped aroundDynasty andDynasty. Professorhas formed a unique "'s acupuncture" diagnosis and treatment system by inheritance and innovation. He clinically paid attention to basic training,obtainingand keeping spirit,as well as syndrome differentiation,reinforcing and reducing. Also,he took the priority the pressing hand with bilaterally needle manipulation. Besides,he thought important simplicity,innovation and acupoints selecting according to time. We inherited's acupuncture from his family,teachers'techniques,international communication,college and university education and scientific research. In this article we prescribe the development,the inheritance and the protection measures of's acupuncture school in terms of its origination,academic thought,and inheritance research,etc.,so as to provide references for further study and inheritance.

Objective To measure the endogenous metabolites in synovial tissues of rheumatoid arthritis (RA) rabbits with cold syndrome;To investigate the specificity mechanisms of heat-reinforcing needling for RA. Methods A total of forty healthy purple blue rabbits were randomly allocated to normal group, model group, reinforcing-reducing needling group (RRN), twirling-reinforcing needling group (TRN) and heat-reinforcing needling group (HRN) 8 rabbits in each group. Arthritis rabbits cold model was made with ovalbumin and freezing. Except for normal groupand model group, RRN was given acupuncture of reinforcing-reducing needling at Zusanli (ST36), TRN was given acupuncture of twirling-reinforcing needling at Zusanli (ST36), HRN was administrated acupuncture of heat-reinforcing needling at Zusanli (ST36), once a day and retaining 30 min, a total of seven days. Fresh synovial tissues of rabbits knee joints were extracted after the intervention, then GC-Q/TOF-MS technology were employed to evaluate metabolic profiles. Results The synovial tissues metabolites of TCA cycle, carbohydrate and fatty acid metabolism in model group mainly increased compared with normal group (P<0.05); The synovial tissues metabolites of various kinds above-mentioned decreased compared with model group in all intervention of acupuncture group (P<0.05), and the metabolites of TCA cycle and carbohydrate metabolism in HRN were obviously less than that of RRN and TRN (P<0.05). Conclusion The specificity of heat-reinforcing needling for RA manifests in regulation of TCA cycle and carbohydrate metabolism.

Objective To investigate the regulating effect of heat reinforcing acupuncture manipulation on body energy metabolism enzymes in rheumatoid arthritis (RA) and preliminarily explain the mechanism of heat-producing action of heat reinforcing acupuncture manipulation. Method Forty chinchilla rabbits were randomized into normal, model, equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups. A model of cold syndrome-type RA was made by ovalbumin induction and exposure to low temperature in the other four groups not including the normal group. From two days after successful model making, the normal and model groups were grabbed and fastened (bound) by the same way as for the acupuncture groups, 30 min once daily. The equal reinforcement and reduction group received even reinforcing-reducing method;the twirling reinforcement group, twirling reinforcement method;the heat reinforcing group, heat reinforcing acupuncture manipulation. The needle was manipulated for 1 min and retained for 30 min once daily, for a total of seven days. The RA rabbit knee joint circumference was measured and the inflammation score was recorded according to synovial histopathological sections before and after treatment. After the completion of intervention, the rabbits were sacrificed and the articular synovium was rapidly separated for frozen sections. Articular synovium lactate dehydrogenase (LDH), succinate dehydrogenase (SDH) and cytochrome oxidase (CCO) activities were measured by histochemical staining. Result After acupuncture intervention, the RA rabbit knee joint circumference was shortened in all the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups, but the shortening effect on the RA rabbit knee joint circumference was better in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05);the inflammation score recorded according to the RA rabbit synovial histopathological sections was also decreased more in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Synovial LDH integral optical density, total positive area and area percentage were significantly higher in the model group than in the normal group (P<0.05), and significantly lower in the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups than in the model group(P<0.05) and also in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Rabbit synovial SDH and CCO activities were significantly higher in the model group than in the normal group (P<0.05). Rabbit synovial SDH and CCO integral optical density, total positive area and area percentage were significantly higher in the equal reinforcement and reduction, twirling reinforcement, and heat reinforcing acupuncture manipulation groups than in the model group (P<0.05) and also in the heat reinforcing acupuncture manipulation group than in the equal reinforcement and reduction and twirling reinforcement method groups (P<0.05). Conclusion Heat reinforcing acupuncture manipulation has a definite therapeutic effect on RA and can increase SDH and CCO activities to enhance aerobic metabolism and produce more local energy in a rabbit model of RA. That may be the mechanism by which heat reinforcing acupuncture manipulation produces heat.

Objective To evaluate the myocardial protective effects of Histidine-TryptophanKetoglutarate (HTK) solution on infants with tetralogy of fallot in cardiac operation through comparison with St.Thomas Ⅱ cardioplegia(STH) and HTK cardioplegia in the operation of tetralogy of fallot.Methods Forty infants with tetralogy of fallot(TOF) were enrolled in this study.Their age ranged from 7 to 35 months,and body mass from 5.3 to 9.5 kg.The infants were randomly divided into HTK (n =20) group and STH (n =20) group who received HTK or STH solution respectively.Then 3 ml blood sample were got at 1,2,4,8,24 and 48 h after the opening of ascending aorta.The serum levels of cardiac troponin Ⅰ(cTnI),creatine kinase(CK) and creatine kinase MB(CK-MB) were measured.Results There was significant difference between two groups in terms of the level of cTnI at different time (F(inner group)=49.94,P＜0.001;F(between group) =10.23,P＜0.001;F (across group) =28.49,P＜0.001),and the level of cTnI in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK at different time (F(inner group) =58.85,P＜0.001;F(between group) =16.43,P＜0.001;F(across group)=18.32,P＜0.001),and the level of CK in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK-MB at different time (F(inner group)=34.51,P ＜0.001;F(between group)=11.03,P＜0.001;F(across group)=10.28,P＜0.001),and the level of CK-MB in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P ＜0.05).Conclusion HTK is more valid than STK for improving the ability of anti ischemia of myocardium and cardiac function,reducing arrhythmia and ischemia reperfusion injury on infants with TOF in cardiopulmonary bypass.

The clinical data of patients with hypoparathyroidism accompanied by elevated and normal muscle enzymes were analyzed retrospectively.The results showed that there were no differences in age,gender,pathogenesis,etiology,and parathormone level between groups with elevated muscle enzyme and normal muscle enzyme.Serum calcium concentration in the group with normal muscle enzyme was within normal range.Serum calcium concentration in the group with elevated muscle enzyme was significantly lower than that in the group with normal muscle enzyme (P＜0.01).As the serum calcium concentration rose,the elevated enzyme level gradually returned to normal range,suggesting that the decrease of serum calcium concentration resulted in the elevated muscle enzyme levels in patients with hypoparathyroidism.

[Summary] The relationship between the state of cognition and hypertension in 155 type 2 diabetic patients was studied.The results showed that significant difference in the state of cognition was found in patients with or without hypertension,so as to those with poorly or well controlled hypertension (P＜0.05).Systolic blood pressure,pulse pressure,mean arterial blood pressure,and duration of hypertension were negatively correlated with multiple cognitive domains,suggesting that proper control of blood pressure may have a protective effect on cognitive function in type 2 diabetic patients.

Objective To explore the relation between glucose fluctuation state and diabetic chronic compli-cations in type 2 diabetes mellitus. Methods 169 cases with type 2 diabetes mellitus were divided into two groups: 78 cases with constant high glucose(group Ⅰ) and 91 cases with glucose fluctuation state( group Ⅱ ). The clinical data such as fasting plasma glucose(FBG) ,fasting blood insulin(FINS) ,fasting blood C peptide,2 hours postprandial plasma glucose (2hPG) ,2 hours postprandial blood insuline (2hINS) ,2 hours postprandial blood C peptide, glycosy-lated hemoglobin A1c (HbA1c), and blood pressure (BP), body mass index ( BMI ), urinary albumin excretion rote (UAER) ,triglyeeride(TG) ,total cholesterol(TC) ,high density lipoprotein cholesterol(HDL-C) ,low density lipopro-tein cholesterol(LDL-C) were measured. Results 2hPG in group Ⅱ was much higher than that in group Ⅰ (P<0.01) ,but 2 hours postprandial blood insuline and 2 hours postprandial blood C peptide in group Ⅱ were much lower than those in group Ⅰ (P<0.01). The incidence of diabetic chronic complications was higher in group Ⅱ compared with that in group Ⅰ (P<0.01). Conclusion These findings suggest that glucose fluctuation state with type 2 dia-betes mellitus had increased diabetic chronic complications.