***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction : Fine needle aspiration ( FNA ) has been adopted as a simple and cost effective technique for cytologic studies of thyroid nodules . The recently introduced fine needle nonaspiration ( FNNA ) technique , however , is cl aim ed to be superior because it provides specimens with larger number of cells and better preserved cytomorphology and architecture of thyroid papillae and follicles . In this study , we compare the efficacy of the two methods . Material s and Methods : Two hundred patients with thyroid nodules , 1–4 cm in size , were recruited .  FNA and FNNA techniques were applied to each patient . In a single-blind setting , all specimens were examined by a single cytopathologist . The specimens were scored ( 0 , 1 , or 2 ) on the basis of background blood or clot , number of obtained cells , preserved architecture of papillae and follicles , and cellular degeneration . Nonparameteric methods were then used to compare the scores of the two techniques . Results : Two hundred patients ( 162 female , 38 male ) were entered into the study . Specimens from 43 patients were inadequate . In the remaining 157 patients , no statistically significant difference was seen between FNNA and FNA average scores in each parameter ( p>0.05 ) . Conclusion : We concluded that FNNA is not superior to FNA in the cytopathologic studies of thyroid nodules Medullary thyroid cancer ( MTC ) shares biochemical features with other neuroendocrine tumors but the particular characteristics are largely unexplored . We investigated the biochemical neuroendocrine profile of MTC and whether specific markers could be useful in follow-up . In addition to the st and ard tumor marker calcitonin , plasma carcino-embryonic antigen ( CEA ) , plasma catecholamines , ( platelet ) serotonin , chromogranin A , tryptase , and urinary markers of catecholamine , histamine , and serotonin metabolism were prospect ively determined in 46 patients with histologically proven MTC . Patients were divided according to the stage of disease : group 1 , no evidence ; group 2 , stable disease ( SD ) ; and group 3 , progressive disease ( PD ) .  Plasma dopamine was increased in the majority of the patients with SD and PD ; however it did not correlate with extent of disease . Elevated plasma platelet levels of serotonin were only present in patients with multiple endocrine neoplasia 2 with SD or PD but did not differ between those groups . Histamine metabolites were elevated in 20 % of patients with SD and PD . In addition to plasma calcitonin , only CEA and chromogranin A could differentiate between stable and progressive MTC . MTCs are capable of synthesizing catecholamines , serotonin , and histamine metabolites underscoring that MTCs have metabolic characteristics in common with other neuroendocrine tumors . Thus far , clinical usefulness and relevance seems limited . The most useful markers in the follow-up of MTC are plasma calcitonin and CEA The present study was conducted to investigate the histological changes and wound healing effect of aqueous extract of Elaeagnus angustifolia . After creating full-thickness skin wounds on the back of 45 male Sprague-Dawley rats they were r and omly divided into three groups . Treated group received the extract , positive control group were treated with mupirocin ointment 2 % and control group did not receive any treatment .  Wound healing rates were calculated on days 3 , 5 , 8 , 10 , 12 and 15 post-wounding and the wound tissues were harvested at 5 , 10 , and 15 days for histological analysis and hydroxyproline content measurement . The results indicated a significant increase in the percentage of wound contraction and hydroxyproline content in the treated group comparing to the control and positive control groups . A significant increase in the assigned histological scores was observed at 10 and 15 days in the treated and positive control groups compared to the control group . The results demonstrate that aqueous extract of Elaeagnus angustifolia accelerates cutaneous wound healing , and its effect may be due to the increased re-epithelialization and collagen deposition in wound and so it can be considered as a therapeutic agent for wound healing Arsenic trioxide is now considered the st and ard agent in treatment of refractory cases of acute promyelocytic leukemia ( APL ) . This drug is also shown to have anti-angiogenesis effect against APL cells in vitro . This study evaluated clinical efficacy and anti-angiogenesis effect of arsenic trioxide in 17 new cases of APL .  Arsenic trioxide was given in a dosage of 0.15 mg kg−1 and remission rate , survival rate , toxicities and effect on vascular density of bone marrow was studied . The bone marrow vascular density was examined using immunohistochemistry for von Willebr and Factor ( vWF ) and CD31 markers . Bone marrow vascular density was determined by calculating mean vessel number in 3 hot spot , high power microscopic fields . Bone marrow vascular density was reduced as identified by anti-vWF immunohistochemical staining ( Mean before treatment = 201.6 mm−2 ± 20.4 ( SEM ) , mean after treatment = 109.4 ± 17.2 ( SEM ) , p < 0.001 ) and anti-CD31 immunostaining ( mean before treatment = 199.17 mm−2 ± 21.5 ( SEM ) , mean after treatment = 99.5 mm−2 ± 22.1 ( SEM ) , p < 0.05 ) . Treatment efficacy results showed 100 % complete remission rate after median of 30 days and 72 % survival rate after median 860 days of follow-up . Main toxicities included hyper-leukocytosis , hepatic toxicity and APL differentiation syndrome . The results imply that arsenic trioxide is an effective anti-leukemia and anti-angiogenesis agent in new cases of APL 
    Output:
    
Conclusion Citrate was suggested as the first most significant biomarker and lactate as the second one .