[Comparison of the efficacy of gasless robotic surgery through transaxillary apporach and open surgery for papillary thyroid carcinoma].

Objective: To compare the efficacy of gasless robotic surgery through transaxillary approach and open surgery for papillary thyroid carcinoma (PTC). Methods: The data of patient undergoing robotic surgery through transaxillary approach and traditional open surgery for PTC at the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from November 2016 to June 2023 were retrospectively analyzed. A 1∶1 propensity score matching (PSM) was performed to balance age, sex, extent of surgery, tumor size, capsule invasion, and multifocality. Surgical data, postoperative pathological data, complications, postoperative 2-month visual analog scale (VAS) scores for aesthetics, and follow-up data were compared between the two groups. Results: A total of 728 PTC patients were included. There were 339 patients in the robotic group, among which 262 were female (77.3%) and 77 were male (22.7%), with the age of [M (Q1, Q3)] 39 (32, 46) years and a body mass index (BMI) of 22.8 (20.7, 25.0) kg/m². Meanwhile, 389 patients were in the open group, among which 290 were female (74.6%) and 99 were male (25.4%), with the age of 47 (38, 55) years and a BMI of 23.2 (21.3, 25.5) kg/m2. Further analysis after PSM (there were 264 cases in both groups) showed that in the subtotal thyroidectomy and central neck dissection (LT+CCND) subgroup, the robotic group had longer operative time, higher blood loss, and greater drainage volume compared with the open group [100 (80, 130) min vs 60 (50, 80) min; 10 (10, 20) ml vs 10 (10, 20) ml; 103 (69, 145) ml vs 75 (57, 98) ml; all P<0.001], and the central lymph node metastasis rate was higher in the robotic group [45.6% (57/125) vs 31.8% (47/148), P=0.019]. In the total thyroidectomy and central neck dissection (TT+CCND) subgroup, the robotic group also had longer operative time, higher blood loss, and greater drainage volume compared with the open group [150 (110, 180) min vs 85 (75, 100) min; 20 (10, 20) ml vs 10 (10, 20) ml; 155 (107, 206) ml vs 90 (70, 120) ml; all P<0.001]. The incidence of chest skin numbness at 3 months postoperatively was higher in the robotic group compared with the open group (12.9% vs 0, P<0.001), while there were no statistically significant differences in other postoperative complications (all P>0.05). The VAS score at 2 months postoperatively was higher in the robotic group compared with the open group [9 (9, 9) vs 8 (7, 9), P<0.001]. Three cases of contralateral lobe recurrence occurred in the open group, while there were no case of recurrence in the robotic group. The 5-year overall survival rate was 100.0% in both the robotic and open groups, and there was no statistically significant difference in the 5-year disease-free survival rate between the robotic and open groups (100.0% vs 98.6%, P=0.068). Conclusion: Gasless robotic surgery through transaxillary approach for total thyroidectomy or lobectomy in the treatment of PTC is safe, feasible, and effective, with good cosmetic outcomes and comparable efficacy to traditional surgery.

[Analysis of the complete genome characterization of 11 human astrovirus strains in Shandong Province].

Objective: To study the complete genome characterization of Human Astrovirus (HAstV) in Shandong Province. Methods: Stool samples from acute flaccid paralysis (AFP) surveillance in Shandong Province from 2020 to 2022 were collected, and HAstV nucleic acid was examined by real-time quantitative PCR (qPCR). Next-generation sequencing (NGS) was conducted for the positive samples to obtain complete genome sequences and identify the genotype. Homology comparison and phylogenetic analysis were performed by using BioEdit and Mega software. Results: A total of 667 samples were examined by qPCR, of which 14 were HAstV-positive (2.1%), including HAstV-1 (n=6), MLB1 (n=6), MLB2 (n=1), and VA2 (n=1). The complete genome sequences were obtained from 11 samples. The six HAstV-1 sequences of this study had 98.2% to 99.9% nt similarities with each other and 87.6% to 98.6% with those from other regions. The four MLB1 sequences of this study had 99.1% to 99.9% nt similarities with each other and 92.2% to 99.4% with those from other regions. The VA2 sequence of this study had 96.0% to 96.3% nt similarities with those from other regions. Phylogenetic analysis based on ORF2 region showed that the local HAstV-1 sequences were most closely related to Japanese strains, and had distinct topology with phylogenies based on ORF1a and ORF1b regions. Conclusion: The complete genome sequences of 11 HAstV strains are obtained, and the VA2 complete genome is found.

Effects of radial stress on piezoelectric ceramic tubes and transducers.

Static analysis is performed for fiber windings to quantitatively control the radial stress at the outer radius of the piezoelectric ceramic tube. The radial stress is verified both experimentally and theoretically, and the dependence of the resonant and material properties of the piezoelectric ceramic tubes on the radial stress is clarified. The resonance frequencies and dielectric loss remain relatively stable, but the relative permittivity and the short circuit elastic constant decrease with the radial stress. The variations of the increased bandwidth and decreased electromechanical coupling coefficient (k31), piezoelectric constant (d31 and g31), and mechanical quality factor (Qm) are associated with the height-to-radius ratio. The properties of three cylindrical transducers applied with various radial stress show similar change tendencies, and a difference of 0.34 MPa radial stress results in a variation of approximately 13 in the bandwidth, 14 in Qm, 15 in k31, d31, and g31, and 16 in the amplitude of the first pulse. These results suggest that the consistency of the radial stress is essential, and it should be relatively small. These findings guide the design and preparation of the enhanced transducer.

Reproductive performance, metabolism and oxidative stress profile in Chinese yellow-feathered broiler breeder hens fed multiple levels of isoleucine.

1. This experiment was conducted to evaluate the effects of dietary isoleucine (Ile) on reproductive performance and certain indices of metabolism and oxidative stress in Chinese yellow-feathered broiler breeder hens.2. A total of 600, 40-week-old Chinese yellow-feathered broiler breeder hens were fed a basal diet formulated with maize, corn gluten meal and spray-dried blood cell meal containing 3.3 g/kg Ile, or supplemented to contain 4.5, 5.7, 6.9, or 8.1 g/kg Ile for five weeks. Each dietary treatment had six replicates with 20 birds per replicate. After three weeks of receiving the trial diets, 24 eggs were collected at random from each replicate to measure egg quality. Starting after four weeks of treatment, 50 settable eggs per replicate were collected for 7 d in succession for hatching. After five weeks of being fed the treatment diets, birds were slaughtered for tissue and organ collection.3. For the overall period, laying rate, egg weight, egg mass and hatchling weight linearly (P < 0.05) and quadratically (P < 0.05) increased with dietary Ile levels. Final body weight, feed intake and relative liver weight of birds fed 3.3 g/kg Ile was lower compared to birds fed the other diets (P < 0.05). There was no effect of Ile level on egg quality (P > 0.05). Hatchling weight was linearly (P < 0.05) and quadratically increased (P < 0.05) in line with dietary supplemental Ile.4. After three weeks on the trial diets, birds fed the diet containing 3.3 g/kg Ile had decreased blood TG concentrations compared to breeders fed 6.9 or 8.1 g/kg Ile (P < 0.05). Activities of CK were significantly higher in breeders fed the 3.3 g/kg Ile diet compared to all other levels of dietary Ile after five weeks of treatment. A quadratic effect (P < 0.05) was evident for glucose at 8.1 g/kg Ile level. After five weeks of treatment, plasma TG concentrations in birds fed 3.3 g/kg Ile were significantly lower than in birds fed all other levels of Ile. Glucose concentrations in breeder hens receiving the 3.3 g/kg Ile diet were lowest and the highest concentrations were in birds fed 5.7 g/kg Ile (P < 0.05). Plasma activities of LDH were highest in breeders on the 3.3 g/kg Ile diet but were only significantly different (P < 0.05) for birds fed 5.7 g/kg Ile.5. The current study indicated that Ile deficiency decreased reproductive performance and appeared to serve as a stressor. The optimal dietary Ile for Chinese yellow-feathered broiler breeder hens in the laying period was 5.79 g/kg feed (0.75 g/d).

[Analysis of Neisseria Meningitidis carriage characteristics among healthy population in Shandong province from 2008 to 2020].

Objective: To analyze the carriage characteristics of Neisseria meningitidis (Nm) among healthy population of epidemic cerebrospinal meningitis in Shandong province. Methods: From April 2008 to April 2020, a total of 16 848 healthy population were recruited from Lixia District of Jinan City, Gaomi City of Weifang City, Jiaxiang County of Jining City, Wendeng District of Weihai City, Tancheng County of Linyi City and Linyi County of Dezhou City for the investigation.Throat swab samples were collected, Nm was isolated, cultured and identified, and Nm carrying characteristics of healthy population with different characteristics were analyzed. Results: Among the 16 848 healthy population, male accounted for 51.86% (8 737). A total of 136 Nm strains were isolated, and the carriage rate was 0.81%. Among the 136 Nm strains, serogroup B (60.29%) and ungroupable strains (23.53%) were dominant. Analysis of the Nm carriage rate, that were higher in the healthy population of Linyi (1.39%) and Jinan (1.14%), higher in 13-16 years old (1.60%) and 17-19 years old (1.10%) healthy population, and higher in male (1.02%). Conclusion: The Nm carriage rate of healthy population is relatively low in Shandong Province, and the proportion of serogroup B and ungroupable Nm is relatively high.

[Molecular epidemiological characterization of group A rotavirus in domestic sewage in Jinan from 2016 to 2018].

Objective: To understand the detection of group A rotavirus (RVA) in domestic sewage and its molecular epidemiological characteristics, and further explore the feasibility and necessity of RVA environmental surveillance. Methods: From 2016 to 2018, we collected domestic sewage samples monthly in Jinan city, and concentrated them via anion membrane adsorption-elution method. Then RNA extraction and RVA VP7 and VP4 coding region RT-PCR amplification were performed. After purification, TA cloning and sequencing, homology analysis and phylogenetic analysis were conducted on the obtained sequences. Results: RVA G gene was detected in 31 of the 36 sewage samples (86.1% detection rate); RVA P genotype was detected in 33 samples (91.7% detection rate). A total of 536 RVA sequences were obtained, of which 225 G-type sequences belonged to 6 genotypes, and the G9 accounted for 92.4% (208/225); 311 P-type sequences were obtained, which belonged to 4 genotypes. The dominant P[8] accounted for 50.1% (156/311), followed by P[4] with 41.8% (130/311). Phylogenetic analysis shows that there were multiple transmission chains circulating in the dominant genotypes G9 and P[8]. Conclusion: The genotype, homology, and phylogenetic characteristics of sequences obtained from domestic sewage in Jinan area were described, which further confirmeing that RVA environmental surveillance is not feasible but also necessary.

[Combining intraoperative ultrasound-guided irreversible electroporation with chemotherapy for treating locally advanced pancreatic cancer: a clinical report of 64 cases].

Objective: To examine the safety and clinical efficacy of ultrasound-guided irreversible electroporation (IRE) using the open surgery approach, after induction chemotherapy, in the treatment of locally advanced pancreatic cancer (LAPC) . Methods: The data of 64 LAPC patients who underwent ultrasound-guided IRE using the open surgery approach after induction chemotherapy at Department of Pancreatobiliary Surgery, Sun Yat-sen University Cancer Center from August 2015 to March 2019 were retrospectively analyzed. The study comprised of 30 males and 34 females, with median age of 58.5 years old (range: 34 to 87 years old) , were included in this study.The tumor was located in the pancreatic head and body/tail in 30 and 34 patients, respectively.The largest recorded tumor size was 6.1 cm (≤4.0 cm: n=35; >4.0 cm: n=29) .To create an electric field around the tumor, Two to six probes were parallelly inserted into each patient's tumor, based on the size of the tumor, at a distance of 2 cm apart through the transverse mesocolon in a caudal-to-cranial direction.According to the numerical sequence of patients undergoing ultrasound-guided IRE, the first 15 cases and following 49 patients were categorized as the primary and secondary treatment group, respectively.T text or χ(2) test was analyzed to the data between two groups.The study endpoints were overall survival (OS) and progression free survival (PFS) , which were investigated using Kaplan-Meier method, and their differences were compared using log-rank test. Results: The overall length of hospital stay was (8.9±2.7) days (range: 5 to 20 days) . Four patients were lost to follow-up.The study follow-up rate was 93.8%, with a median follow-up time of 29.3 months (range: 13.5 to 55.7 months) .The median OS and PFS of the entire cohort was 24.6 months (95% CI: 22.0 to 27.3 months) and 12.0 months (95%CI: 8.8 to 15.2 months) , respectively.One month after IRE, abdominal pain was significantly relieved in 95.3% of the patients (t=-28.55, P<0.01) .The rate of complications in the entire cohort was 20.3% and all were classified as grade B.Of them, pancreatic fistula, incisional infection, and upper gastrointestinal hemorrhage were observed in 7, 4, and 2 cases, respectively.The rate of complications for patients in the primary and secondary treatment groups were significantly different (10/15 vs. 6.1%) , respectively (χ(2)=26.01, P<0.01) .Further, two deaths were observed after IRE in the primary treatment group, while none was observed in the secondary treatment group. Conclusions: Ultrasound-guided IRE using the open surgery approach after induction chemotherapy is found to be safe and effective in treating patients with LAPC.However, these findings should be validated in prospective randomized trials before wide clinical application.

[Clinical analysis of 8 cases with anti-GQ1b antibody syndrome].

Objective: To investigate the clinical characterization, treatment and prognosis of anti-GQ1b antibody syndrome. Methods: The clinical data of 8 patients with positive serum anti-GQ1b antibody from the Department of Neurology of Nanjing Brain Hospital between June 2016 and July 2018 were analyzed retrospectively. Their serums were tested by immunoblotting. Relevant literatures were reviewed to investigate possible pathogenesis. Results: Of the 8 cases, 4 cases were male, 4 cases were female; their age ranged from 16 to 76 (47±21) years old. Seven of them were with acute onset, the time course of the disease ranged from 2 to 15 (7±4) days. Six cases had a history of influenza prior to the onset of the presenting symptoms. In terms of the clinical manifestations of the eight patients, two were affected with Guillain-Barre syndrome (GBS), two with Cavernous sinus syndrome, one with Miller Fisher syndrome, one with both GBS and spinal cord demyelination, one with Bulbar paralysis, and one with chronic inflammatory demyelinating polyneuropathy (CIDP). The anti-GQ1b antibody IgG in serum was positive in 6 patients, two of whom were combined with positive IgG of anti-GD1b antibody in serum. The anti-GQ1b antibody IgM in serum was positive in 1 patient, and the anti-GQ1b antibody IgM and anti-GT1b antibody IgM in cerebrospinal fluid (CSF) were both positive in the other patient. In terms of the treatment, 3 patients (3/8) received vitamin B treatment only, 2 patients (2/8) received steroid plus vitamin B treatment, 2 patients (2/8) received intravenous immunoglobulin (IVIG) plus vitamin B treatment, and 1 patient (1/8) received steroid plus IVIG treatment. During the 8-33 months' follow-up after discharge, 6 patients were significantly improved in their symptoms, one with mild diplopia, one with limbs weakness, numbness and difficulty in walking. The symptoms of one patient (case 3) fluctuated twice and recovered again after treatment. Conclusions: The disease spectrum of anti-GQ1b antibodies syndrome is broad, and main symptom is ophtalmoplegia. Immunotherapy with IVIG and steroid would be beneficial to prognosis.

[Analysis of current epidemiological and clinical characteristics for laboratory confirmed epidemic cerebrospinal meningitis cases in Shandong Province, 2007-2016].

Objective: To analyze epidemiological and clinical characteristics of laboratory confirmed epidemic cerebrospinal meningitis cases. Methods: Epidemiological and clinical informations and cerebrospinal fluid (CSF) and blood specimens of AMES (acute meningitis/encephalitis syndrome) cases were collected in the six sentinel hospitals from 2007 to 2016. neisseria meningitides (Nm) species and serogroup identification were detected by the methods of real-time fluorescent quantitative polymerase chain reaction (Real-time PCR) and bacterial culture, and epidemiological and clinical characteristics of laboratory confirmed epidemic cerebrospinal meningitis cases were analyzed. Results: 6 809 AMES cases were reported from 2007 to 2016. Total 4 422 cases were detected, and 90 cases were Nm positive. Through the methods of Real-time PCR, bacterial blood culture and CSF culture, the numbers of Nm positive cases were 90, 2 and 1 respectively. Twenty-two Nm cases were identified from 2007 to 2011 (4 cases were ungrouped), which with the highest incidence in serogroup C cases (17/18), and one cases was ungroupable Nm. Nm laboratory confirmed cases (68 cases) were increased dramatically and mainly occurred in serogroup B cases (43/67, 64.2%) from 2012 to 2016, with serogroup C cases highly decreased (5/67, 7.5%) and ungroupable Nm cases increased (13/67, 19.4%) meanwhile. Serogroup W135 and X cases were first detected at 2012 and 2014, and serogroup A remaining a low level which only detected one case at 2013. The morbidity of epidemic cerebrospinal meningitis was occured in the whole year, and mainly in winter and spring. The ratio of Nm laboratory confirmed cases to AMES cases during November to May (3.5%, 67/1 920) was higher than that during June to October (0.9%, 23/2 502) (χ(2)=34.45, P<0.001). Most Nm cases were children, students and farmers, and account for 30.0% (27/90), 31.1% (28/90), 18.9% (17/90), respectively. The majority of Nm cases were under 20 years old (60/90, 66.67%), and serogroup C cases (17/22, 77.3%) mainly occurred in over 12 years old population, while serogroup B (24/43, 55.8%) and ungroupable (6/14) cases mainly occurred in under 12 years old population. The main clinical symptoms of epidemic cerebrospinal meningitis cases were fever (78/90, 86.7%), headache (59/90, 65.6%) and vomiting (51/90, 56.7%). Misdiagnosis rate of admitting diagnosis was up to 87.8% (79/90) for the reason of atypical features in specific symptoms and blood or CSF positive index. The well-healed ratio in correct diagnosed group (7/11) was higher than that in misdiagnosed group (2.5%, 2/79) (χ(2)=40.61, P<0.001). Conclusion: The clinical symptoms of epidemic cerebrospinal meningitis cases were atypical, and the diagnosed sensitivity and accuracy would be improved by enhanced molecular biology detection. The predominant epidemic serogroup of Nm switched from serogroup C to B, and the key work was surveaylance of serogroup transition.

[Etiologic surveillance and analysis of acute meningitis and encephalitis syndrome in Jinan city in 2013-2016].

Objective: To characterize the etiology and epidemiological characteristics of the acute meningitis and encephalitis syndrome (AMES) in Jinan city in 2013-2016. Methods: The epidemiological data, clinical diagnosis, serum and cerebrospinal fluid (CSF) specimens were collected from 3 577 AMES cases in 6 sentinel hospitals in Jinan city in 2013-2016. Samples of all cases were made sero-diagnosis for Immunoglobulin (Ig) M antibody to Japanese encephalitis virus (JEV) and negative cases of JEV for enterovirus (EV), mumps virus (MuV) and herpes simplex virus (HSV) by enzyme-linked immunosorbent assay (ELISA). Virus isolation and molecular identification were performed. Positive rates were analyzed by Chi-square test. Results: In 2013-2016, the positive rates of JEV, EV, MuV and HSV were 9.0% (322/3 577 cases), 22.1% (643/2 916 cases), 9.9% (289/2 916 cases), 26.9% (783/2 916), respectively. Of these, the positive rates of JEV were 32.9% (261/794), 1.2% (14/1 175), 1.0% (8/807) and 4.9% (39/801 cases); EV: 19.5% (91/466), 35.1% (342/974 cases), 15.5% (115/743) and 13.0% (95/733); MuV: 9.2% (43/466), 14.4% (140/974), 9.0% (67/743) and 5.3% (39/733). HSV: 35.4% (165/466), 38.5% (375/974), 25.7% (191/743) and 7.1% (52/733). There were significant differences in positive rates of 4 kinds of viruses in 2013-2016 (P<0.001). A total of 81 EV strains belonging to 8 serotypes were isolated from 1 020 CSF specimens. The positive rates were 4.8% (6 cases), 13.1% (55 cases), 4.1% (7 cases) and 4.2% (13 cases) from 2013 to 2016. Coxsackievirus (CV) B5, echovirus (E) 6 and E30 accounted for 46% (37 isolates), 22% (18 isolates) and 21% (17 isolates) of all strains. Conclusion: The AMES cases in Jinan city in 2013-2016 were mainly caused by HSV, EV, MuV, JEV. CVB5, E6 and E30 were the dominant serotypes of EV associated with AMES cases in Jinan city.

Effects of dietary tryptophan levels on performance and biochemical variables of plasma and intestinal mucosa in yellow-feathered broiler breeders.

The effects of dietary tryptophan (Trp) levels on performance and biochemical variables of plasma and intestinal mucosa in broiler breeder hens were investigated in this study. A total of 780 Lingnan yellow-feathered broiler breeder hens were randomly assigned in one of five dietary treatments with six replicates per treatment (26 birds per replicate). The breeder hens were fed either the basal diet (0.11% Trp) or the basal diet supplemented to 0.15%, 0.19%, 0.23% and 0.27% Trp, from 197 to 259 days of age. Graded levels of Trp from 0.11% to 0.27% in the diet produced quadratic (p < .05) responses in laying rate, average daily egg production, and feed conversion ratio, and quadratic (p < .01) responses in total large follicle weight and average large follicle weight. An increase in fertilization rate of total eggs was observed in breeders fed 0.27% Trp, and hatchability was higher in breeders fed 0.23% and 0.27% Trp than with 0.19% Trp (p < .05). The content of uric acid N decreased with 0.15% and 0.23% dietary Trp (p < .05). The content of GSH and the GSH-to-GSSG ratio in plasma were reduced by 0.15%, 0.19% and 0.27% Trp diets (p < .05). A higher activity of GST in plasma was observed with 0.15% Trp in relation to 0.23% and 0.27% Trp (p < .05). The activity of Na+ -K+ -ATPase of plasma in birds fed 0.27% Trp was lower than in those fed 0.15% Trp and the control birds (p < .05). There were significant influences of dietary Trp levels on S6K1, B0 AT1, Nrf2, TLR4, TNF-α and IL-6 transcripts of ileal mucosa (p < .05). The optimal dietary Trp level was 0.203% or 254 mg per hen per day, for Chinese yellow-feathered broiler breeder hens aged from 197 to 259 days.

Effects of oxidative stress induced by high dosage of dietary iron ingested on intestinal damage and caecal microbiota in Chinese Yellow broilers.

The objective of this trial was to test the effects of oxidative stress induced by a high dosage of dietary iron on intestinal lesion and the microbiological compositions in caecum in Chinese Yellow broilers. A total of 450 1-day-old male chicks were randomly allotted into three groups. Supplemental iron (0, 700 and 1,400 mg/kg) was added to the basal diet resulting in three treatments containing 245, 908 and 1,651 mg/kg Fe (measured value) in diet respectively. Each treatment consisted of six replicate pens with 25 birds per pen. Jejunal enterocyte ultrastructure was observed by transmission electron microscopy. The results showed that a high dosage of dietary iron induced oxidative stress in broilers. Dilated endoplasmic reticulum (ER), autophagosome formation of jejunal enterocytes and decreased villi were caused by this oxidative stress. Compared to the control, concentration of the malondialdehyde (MDA) in jejunal mucosa in the 908 and 1,651 mg/kg Fe groups increased by 180% (p < .01) and 155% respectively (p < .01); activity of copper-zinc superoxide dismutase (Cu/ZnSOD) increased in jejunum (p < .01); and the concentration of plasma reduced glutathione (GSH) decreased by 34.9% (p < .01) in birds fed 1,651 mg/kg Fe. Gene expression of nuclear factor, erythroid-derived 2-like 2 (Nrf2) and zonula occludens-1 (ZO-1), in the higher dietary Fe groups was enhanced (p < .05). Species of microbial flora in caecum increased caused by oxidative stress. The PCR-DGGE (denaturing gradient gel electrophoresis) dendrograms revealed different microbiota (65% similarity coefficient) between the control and iron-supplemented groups (p < .05). These data suggest high dosage of iron supplement in feed diet can induce oxidative stress in Chinese Yellow broilers, and composition of microbiota in the caecum changed. It implied there should be no addition of excess iron when formulating diets in Chinese Yellow broilers.

Effects of corn distillers dried grains with solubles on performance, oxidative status, intestinal immunity and meat quality of Chinese Yellow broilers.

The study assessed the effects of different dietary levels of corn distillers dried grains with solubles (DDGS) on performance, oxidation status, intestinal immunity and meat quality in Chinese Yellow broilers aged from 1 to 63 days. Lingnan male hatchings (1440) were randomly assigned to six treatments, each consisting of six replicates of 40 birds. The basal diet (I) was a typical corn-soya bean ration while the experimental diets (II to VI) partially substituted corn DDGS for soya bean meal. The level of substitution in starter, grower and finisher diets was as follows: II, 2%, 4% then 6%; III, 4%, 8% then 12%; IV, 6%, 12% then 18%; V, 8%, 16% then 24%; VI, 10%, 20% then 30%. Average daily feed intake and feed-to-gain ratio increased as linear responses to corn DDGS substitution from 1 to 21 days (p < 0.001). The plasma content of triglycerides and liver content of malondialdehyde increased as linear responses to corn DDGS substitution (p < 0.05). There was a linear decrease (p < 0.001) in jejunal abundance of IL-6 transcripts, with a substantial reduction to approximately 25% those of broilers fed the control diet, and a quadratic effect existed for secretory immunoglobulin A (sIgA) (p < 0.001). In addition, increased dietary corn DDGS caused favourable changes in selected functional properties of the meat: drip loss at 24 and 96 h increased as linear response to corn DDGS substitution (p < 0.001). Further, meat colour L* values decreased and a* values increased linearly in response to increasing corn DDGS (p < 0.05). In conclusion, diet IV (6%, 12% then 18% corn DDGS) in Chinese Yellow broiler diets had no negative effects on performance, antioxidant capacity and meat quality. This level of inclusion also appeared to promote sIgA secretion and enhance anti-inflammatory status.

Facilitating the measurement of circulatory hydrogen sulfide with fluorescence probe-coated microplates.

OBJECTIVE: The hydrogen sulfide (H2S) role in pathogenesis of various diseases were wildly addressed in recent decade. The circulatory (plasma or serum) and biological fluid H2S measurement is still an enormous issues due to the technical limitation. This paper aimed to develop a novel measurement method based on fluorescence probe. METHODS: Firstly, 20 µL ethanol was used to dissolve 100 pmol fluorescence probe, then added in a 96-well plate. An equal volume of ethanol was also added to the blank well of the plate. The plate was placed in a dark room for about 1 h until the fluorescence probe was evenly coated in the 96-well microplate and dried. The plate was frozen at -20 °C for later use. Secondly, the plasma or serum sample was added with saturated ammonium sulfate buffer (pH 7.8) and then centrifuged to remove the proteins. The equal volume supernatant liquid was added to the probe-coated well and the probe-uncoated well. The plate was incubated in a dark environment at 37 °C for 2 h. Finally, after incubation, the fluorescence density was acquired at ΛEx/ΛEm 340/445 nm in a microplate reader. The differences of the fluorescence density values between the probe-coated well and probe-uncoated well were counted and H2S concentration of plasma/serum was calculated by standard curve with NaHS. RESULTS: The method had high sensitivity (from 0.3 to 100 µmol/L) and specificity for measuring H2S as compared with other biologically relevant reactive sulfur species and sulfur-containing amino acid. Serum H2S concentrations were assayed in 188 health volunteers using this method [(12.1±3.5) µmol/L, 95%CI: 4.6-19.8 µmol/L], and the frequency distribution showed a normal tendency(one-sample Kolmogorov-Smirnov test, P>0.1). The serum H2S concentrations in 30 hypertension patients were decreased compared with 22 age- and gender-matched health individuals (paired-samples t test, t=9.937, P<0.001). There were no differences of H2S concentration in serum [(19.66±2.32) µmol/L] or plasma [(18.67±2.07) µmol/L], between the samples acquired from artery [(19.34±0.51) µmol/L] or vein [(18.99±0.50) µmol/L] of male Wistar rats (repeated measurement of ANOVA, P=0.38). One week frozen samples did not affect the detection. The values of the repeated measurement did not differ (two-way ANOVA, P>0.05). CONCLUSION: The present method is easily performed with high sensitivity, specificity and repeatability for circulatory H2S. It is also quick and may apply for large samples.

[Effect of interleukin-6 promoter DNA methylation on the pathogenesis of systemic lupus erythematosus].

Objective: To analyze peripheral blood interleukin-6 (IL-6) promoter DNA methylation status and its clinical significance in patients with systemic lupus erythematosus (SLE). Methods: Blood samples of 41 adult patients with SLE and 20 healthy controls were collected.The methylation status of IL-6 promoter was determined by methylation specific polymerase chain reaction (MSP). The IL-6 expression was detected by real-time PCR.Correlations between IL-6 promoter methylation status and clinical features or laboratory findings in patients with SLE were analyzed. Results: The levels of IL-6 mRNA were significantly higher in peripheral blood of SLE.DNA methylation levels of IL-6 promoter were reduced in SLE patients as compared with healthy controls.The methylation status and expression of IL-6 in peripheral blood reflected the levels in peripheral blood mononuclear cells (PBMCs). Significantly positive correlation was found between IL-6 hypomethylation and renal disorder, as well as hypocomplementemia in patients with SLE. Conclusion: Hypomethylation of interleukin-6 promoter in peripheral blood might be involved in the etiology of SLE.

Effects of high peanut meal with different crude protein level supplemented with amino acids on performance, carcass traits and nitrogen retention of Chinese Yellow broilers.

This study assessed the effects of feeding high peanut meal diets of reduced crude protein (CP) content supplemented with essential amino acids (EAA) on growth performance, carcass traits, biochemical indices in plasma, and nitrogen (N) retention of male and female Lingnan Yellow broilers from day 22 to day 42 of age. Each of four dietary treatments (19%, 18%, 17% or 16% CP, dietary CP level reduced by the reduced dietary peanut meal) contained six replicate pens with 35 birds of each sex (males and females with equal number), separately (1680 in total). The three diets with reduced CP were supplemented with 5 EAA to meet the requirements and provide the same levels as in the 19% CP diet. Average daily gain decreased and feed:gain ratio was worse in both sexes with reduced CP% (linear, p < 0.05). Dressing percentage increased as CP% decreased in males (linear, p < 0.05) and thigh muscle percentage reduced slightly in females (linear, p < 0.05). Abdominal fat percentage of males fed the 17% CP was the lowest (quadratic, p < 0.05). The plasma metabolic indices, concentrations of triglycerides and malondialdehyde, showed linear responses to reduced CP% (p < 0.05) with triglycerides increasing while malondialdehyde decreased. Plasma uric acid increased in females (linear, p < 0.05), but not in males, as CP% decreased. Efficiency of N retention increased and N excretion strikingly decreased with lower CP diets (p < 0.001), and both variables showed significant (p < 0.05) linear and quadratic effects. It is concluded that there was a limit to which dietary CP of broilers could be reduced without adverse effects. Dietary CP could be reduced to 17% for males and 18% for females (or 18% when fed together) between day 22 and day 42, if diets are supplemented with synthetic EAA.

[Mitigating metal artifacts from cobalt-chromium alloy crowns in cone-beam CT images through deep learning techniques].

Objective: To develop and evaluate metal artifact removal systems (MARS) based on deep learning to assess their effectiveness in removing artifacts caused by different thicknesses of metals in cone-beam CT (CBCT) images. Methods: A full-mouth standard model (60 mm×75 mm×110 mm) was three-dimensional (3D) printed using photosensitive resin. The model included a removable and replaceable target tooth position where cobalt-chromium alloy crowns with varying thicknesses were inserted to generate matched CBCT images. The artifacts resulting from cobalt-chromium alloys with different thicknesses were evaluated using the structural similarity index measure (SSIM) and peak signal-to-noise ratio (PSNR). CNN-MARS and U-net-MARS were developed using a convolutional neural network and U-net architecture, respectively. The effectiveness of both MARSs were assessed through visualization and by measuring SSIM and PSNR values. The SSIM and PSNR values were statistically analyzed using one-way analysis of variance (α=0.05). Results: Significant differences were observed in the range of artifacts produced by different thicknesses of cobalt-chromium alloys (all P<0.05), with 1 mm resulting in the least artifacts. The SSIM values for specimens with thicknesses of 1.0, 1.5, and 2.0 mm were 0.916±0.019, 0.873±0.010, and 0.833±0.010, respectively (F=447.89, P<0.001). The corresponding PSNR values were 20.834±1.176, 17.002±0.427, and 14.673±0.429, respectively (F=796.51, P<0.001). After applying CNN-MARS and U-net-MARS to artifact removal, the SSIM and PSNR values significantly increased for images with the same thickness of metal (both P<0.05). When using the CNN-MARS for artifact removal, the SSIM values for 1.0, 1.5 and 2.0 mm were 0.938±0.023, 0.930±0.029, and 0.928±0.020 (F=2.22, P=0.112), while the PSNR values were 30.938±1.495, 30.578±2.154 and 30.553±2.355 (F=0.54, P=0.585). When using the U-net-MARS for artifact removal, the SSIM values for 1.0, 1.5 and 2.0 mm were 0.930±0.024, 0.932±0.017 and 0.930±0.012 (F=0.24, P=0.788), and the PSNR values were 30.291±0.934, 30.351±1.002 and 30.271±1.143 (F=0.07, P=0.929). No significant differences were found in SSIM and PSNR values after artifact removal using CNN-MARS and U-net-MARS for different thicknesses of cobalt-chromium alloys (all P>0.05). Visualization demonstrated a high degree of similarity between the images before and after artifact removal using both MARS. However, CNN-MARS displayed clearer metal edges and preserved more tissue details when compared with U-net-MARS. Conclusions: Both the CNN-MARS and U-net-MARS models developed in this study effectively remove the metal artifacts and enhance the image quality. CNN-MARS exhibited an advantage in restoring tissue structure information around the artifacts compared to U-net-MARS.

[Preliminary outcomes of neoadjuvant chemoimmunotherapy combined with transoral robotic surgery for locally advanced oropharyngeal squamous cell carcinoma].

Objective: To evaluate the efficacy of neoadjuvant chemoimmunotherapy (NACI) combined with transoral robotic surgery (TORS) in the treatment of locally advanced oropharyngeal squamous cell carcinoma (OPSCC). Methods: This was a retrospective study of 15 patients with locally advanced OPSCC who underwent TORS after neoadjuvant therapy (NAT) at the Department of Otolaryngology-Head and Neck Surgery of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from April 2019 to February 2023. There were 12 males and 3 females, aged 31 to 74 years. Twelve cases were tonsil cancer, and 3 cases were tongue base cancer. There were 11 cases in stage Ⅲ and 4 cases in stage Ⅳ. Two patients received neoadjuvant chemotherapy and 13 patients received NACI, with 2 to 3 cycles, and all patients underwent TORS after multidisciplinary team consultation. The clinicopathological characteristics, surgical outcomes, and oncological results were summarized. Results: All surgeries were successfully completed with negative surgical margins, and no case was required conversion surgery. All patients were fed via nasogastric tubes postoperatively, with a median gastric tube stay of 7 days (range: 2-60 days). No tracheotomy was applied. There were no major complications such as postoperative bleeding. Pathological complete response (pCR) was found in 10 cases (76.9%) among the 13 patients with NACI. The follow-up time was 21 months (range: 10-47 months), and there was no death or distant metastasis. One patient with rT0N3M0 tonsil cancer had local recurrence 5 months after surgery. The 2-year overall survival and 2-year disease-free survival were respectively 100.0% and 93.3% in the 15 patients. Conclusion: NACI combined with TORS provides a safe, effective and minimally invasive treatment for patients with locally advanced oropharyngeal squamous cell carcinoma.

[Mitigating metal artifacts in cone-beam CT images through deep learning techniques].

Objective: To develop and evaluate metal artifact removal systems (MARSs) based on deep learning to assess their effectiveness in removing artifacts caused by different thicknesses of metals in cone-beam CT (CBCT) images. Methods: A full-mouth standard model (60 mm×75 mm×110 mm) was three-dimensional (3D) printed using photosensitive resin. The model included a removable and replaceable target tooth position where cobalt-chromium alloy crowns with varying thicknesses were inserted to generate matched CBCT images. The artifacts resulting from cobalt-chromium alloys with different thicknesses were evaluated using the structural similarity index measure (SSIM) and peak signal-to-noise ratio (PSNR). CNN-MARS and U-net-MARS were developed using a convolutional neural network and U-net architecture, respectively. The effectiveness of both MARSs were assessed through visualization and by measuring SSIM and PSNR values. The SSIM and PSNR values were statistically analyzed using one-way analysis of variance (α=0.05). Results: Significant differences were observed in the range of artifacts produced by different thicknesses of cobalt-chromium alloys (all P<0.05), with 1 mm resulting in the least artifacts. The SSIM values for specimens with thicknesses of 1.0 mm, 1.5 mm, and 2.0 mm were 0.916±0.019, 0.873±0.010, and 0.833±0.010, respectively (F=447.89, P<0.001). The corresponding PSNR values were 20.834±1.176, 17.002±0.427, and 14.673±0.429, respectively (F=796.51, P<0.001). After applying CNN-MARS and U-net-MARS to artifact removal, the SSIM and PSNR values significantly increased for images with the same thickness of metal (both P<0.05). When using the CNN-MARS for artifact removal, the SSIM values for 1.0, 1.5 and 2.0 mm were 0.938±0.023, 0.930±0.029, and 0.928±0.020 (F=2.22, P=0.112), while the PSNR values were 30.938±1.495, 30.578±2.154 and 30.553±2.355 (F=0.54, P=0.585). When using the U-net-MARS for artifact removal, the SSIM values for 1.0, 1.5 and 2.0 mm were 0.930±0.024, 0.932±0.017 and 0.930±0.012 (F=0.24, P=0.788), and the PSNR values were 30.291±0.934, 30.351±1.002 and 30.271±1.143 (F=0.07, P=0.929). No significant differences were found in SSIM and PSNR values after artifact removal using CNN-MARS and U-net-MARS for different thicknesses of cobalt-chromium alloys (all P>0.05). Visualization demonstrated a high degree of similarity between the images before and after artifact removal using both MARSs. However, CNN-MARS displayed clearer metal edges and preserved more tissue details when compared with U-net-MARS. Conclusions: Both the CNN-MARS and U-net-MARS models developed in this study effectively remove the metal artifacts and enhance the image quality. CNN-MARS exhibited an advantage in restoring tissue structure information around the artifacts compared to U-net-MARS.

[Preliminary experience of gasless transoral vestibular robotic thyroidectomy].

Objective: To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. Methods: The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. Results: The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [M (P25, P75), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Conclusion: Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.