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6 g/L β-alanine with a product/catalyst (P/C) ratio of 5.9 g/g and a conversion > 99%. These results showed that reshaping the protonation conformation of PanD can efficiently relieve mechanism-based inactivation and boost catalytic stability. © 2020 Wiley Periodicals, Inc.INTRODUCTION The management of patients with Graves' orbitopathy (GO) and severe dysthyroid optic neuropathy (DON), refractory to corticosteroid therapy and radiation therapy is a major challenge. As T cells infiltrate in orbital tissues plays a central role in the pathogenesis of GO, the administration of rabbit anti-thymocyte globulin (rATG) may be considered as a potential new method of therapy. CASE PRESENTATION We present a case of the woman with 25-years history of Graves-Basedow disease, treated with subtotal strumectomy, two courses of radioiodine therapy, who developed severe DON during glucocorticoid therapy according to EUGOGO protocol for GO with a prompt application of orbital radiotherapy and ineffective re-administration of glucocorticoid methylprednisolone. The patient received an experimental therapy with rATG (two doses of 1.5 mg/kg). DuP-697 in vitro The clinical improvement in GO was noted at 6-week examination after rATG administration. The improvement in GO and DON, confirmed by pattern visual evoked potentials (PVEP), continued a year after administration, in parallel to the normalization of CD4/CD8 ratio of peripheral blood T lymphocytes. CONCLUSIONS Thymoglobulin may be useful in the management of severe steroid-resistant GO with dysthyroid optic neuropathy. The effectiveness of this new therapy requires a larger number of observations.Synchronous existence of medullary and papillary thyroid carcinoma is an extremely rare occurrence; however, it has been previously reported. Nonetheless, such coexistence combined with the absence of primary tumor lesions of either of the two carcinomas has never been reported. In our case, a 34-year old male is found to have medullary thyroid carcinoma of unknown primary origin as well as papillary thyroid carcinoma.BACKGROUND Thyroid dysgenesis (TD) is the main cause of congenital hypothyroidism (CH) affecting nearly 1 in 2000 newborn worldwide as the most common neonatal endocrine disorder. Paired box gene 8 (PAX8), expressed during all stages of thyroid follicular cell, plays a key role in thyroid morphogenesis by a complex regulatory network. In conclusion, the genetic mechanism of PAX8 mutant in TD is still ambiguity, therefore, more research are needed for further study. METHODS Blood samples were collected from 289 TD patients in Shandong Province, China. Genetic DNA was extracted from peripheral blood. All the exons of PAX8 along with their exon-intro boundaries were amplified by PCR and analyzed by Sanger sequencing. RESULTS We identified three novel PAX8 nonsense mutations in three patients by sequence analysis of PAX8 Patient 1 (c.C285G p.Y95X), Patient 2 (c.T747G p.Y249X) and Patient 3 (c.C786A p.Y262X). All the three patients carrying PAX8 variants have obvious clinical phenotype of thyroid anomaly, such as hypoplasia and athyreosis. CONCLUSION We conducted the largest PAX8 mutation screening so far in TD patients for the first time worldwide. Three presumably pathogenic PAX8 mutations were detected in 289 TD cases for the first time, showing the mutation rate of PAX8 is 1.04% in Chinese TD patients. In addition, our study expands the gene mutation spectrum of TD.OBJECTIVE This study aims to determine the effects of mitochondrial dysfunction on energy metabolism of granulosa cells (GCs) and oocyte's competence in polycystic ovary syndrome (PCOS). METHODS A total of 158 patients who underwent controlled ovarian hyperstimulation (COH) were enrolled. The clinical outcomes of patients with and without PCOS under in vitro fertilization-embryo transfer (IVF-ET) were compared. Human primary GCs were exposed to mitochondrial and glycolysis inhibitors. Then, the related indicators of mitochondrial activity and glycometabolism were compared with controls. The viability of GCs after mitochondrial inhibitors was also determined. RESULTS In PCOS patients, the number of retrieved oocytes significantly increased, but the high-quality embryos, available embryos and high quality blastocyst formation obviously decreased (P less then 0.05). Furthermore, the mitochondrial membrane potential, ATP content, mtDNA copy number, and HIF-1α mRNA and protein levels in GCs decreased, while the levels of reactive oxygen species increased (P less then 0.05). Mitochondrial inhibitors reduced the mitochondrial function, but increased the HIF-1α, GLUT1, LDHA and PFKP gene expression. Glucose consumption gradually increased at 24, 48 and 72 hours of GC culture after CCCP treatment, and the viability of cells tested by CCK-8 increased (P less then 0.05). CONCLUSION GCs are dependent on mitochondrial respiration and glycolysis for energy provision. Mitochondrial dysfunction accompanied by abnormal glycolysis were observed in PCOS patients, which affect the switch of energy metabolic to glycolytic. The failure of transformation to glycolysis and low HIF-1α expression in GCs during the development of follicles might be correlated to the low oocyte competence of PCOS.OBJECTIVE To detect the levels of Osteoprotegerin (OPG) and 25-hydroxyvitamin D[25(OH)D], as well as the expression of Bone Sialoprotein (BSP) mRNA, in the peripheral blood of patients with newly diagnosed T2DM under different bone mass conditions, and to explore the role and significance in the development process of T2DM combined with Osteoporosis (OP). METHODS A total of 225 patients hospitalized in Endocrinology Department and General Department from May 2017 to May 2018 were enrolled and grouped into 5 groups the pure T2DM group ( group A, 45 patients), the bone mass reduction group (group B, 45 patients), the T2DM+ bone mass reduction group (group C, 45 patients), the OP group (group D, 45 patients), and the T2DM+OP group (group E, 45 patients); meanwhile, age/age-matched healthy subjects undergoing physical examination in our hospital were collected as the normal control group (group NC,45 cases). Logistic regression analysis was used to analyze the influencing factors of bone mass in patients with T2DM.
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