Bilateral axillo-breast approach robotic thyroglossal duct cyst resection in an adolescent: a case report and literature review.

Background: Thyroglossal duct cyst (TGDC) is a common congenital neck mass that is the most frequent cause of neck swelling in children. The traditional open Sistrunk procedure for TGDC often leaves a visible scar on the neck. Therefore, it is essential to consider the impact of neck scarring on the quality of life for children and adolescents. Our study aimed to assess the safety and efficacy of robotic TGDC resection using the bilateral axillo-breast approach (BABA) in adolescents. Case Description: A 16-year-old female patient presented with a neck mass (no pain or redness) that had been present for 3 years. The palpable neck mass moved with swallowing and there was no history of other significant medical conditions. An ultrasound scan of the neck indicated a weak hypoechoic area in the thyrohyoid region measuring 29 mm × 20 mm. Additionally, the ultrasonography of the thyroid gland showed no obvious abnormalities. A computer tomography (CT) scan confirmed a low-density lesion on the right hyoid bone, measuring 27 mm × 18 mm × 26 mm, consistent with a TGDC. We successfully performed a BABA robotic TGDC resection on the 16-year-old female adolescent who had a strong desire for scar-free surgery. Conclusions: BABA robotic TGDC resection could achieve the same surgical effect as conventional open surgery while providing better cosmetic outcomes, which are essential for the physical and mental well-being of teenagers. Therefore, BABA robotic TGDC resection may be a safe and feasible treatment option with excellent cosmetic results in adolescents.

The prevalence and related factors associated with psychosocial distress among 420 hospitalised lung cancer patients in China: A case study.

Previous studies have reported high prevalence of psychosocial distress among lung cancer patients in Western countries, but the prevalence of distress in Chinese patients is not established. The study objectives were to report the prevalence of and factors associated with psychosocial distress in a sample of hospitalised patients in China and to implement distress screening in one thoracic specialty department. In this cross-sectional study, adult patients completed a self-reported demographic and clinical questionnaire and the distress thermometer with the problem list. Distress was dichotomised (high vs. low) and compared. Regression analyses were used to determine which variables were associated with psychosocial distress. One hundred eighty-six of 420 patients (38.6%) reported distress ≥4/10. They were unemployed, had New Rural Cooperative Medical System (NRCMS) insurance and Stage IV cancer. NRCMS insurance contributed to the likelihood of high distress and worry. Patients reported significant psychosocial distress during hospitalisation related to practical, emotional and physical problems. In this case study, staff reported they screened consecutive patients but there were no available referrals after discharge. We concluded it may be premature to screen patients for distress prior to instituting resources to establish services. To do otherwise is premature in ensuring patients' relief.

Involvement of MAPK/NF-κB signaling in the activation of the cholinergic anti-inflammatory pathway in experimental colitis by chronic vagus nerve stimulation.

BACKGROUND: Autonomic nervous system dysfunction is implicated in the etiopathogenesis of inflammatory bowel diseases (IBD). Therapies that increase cardiovagal activity, such as Mind-Body interventions, are currently confirmed to be effective in clinical trials in IBD. However, a poor understanding of pathophysiological mechanisms limits the popularization of therapies in clinical practice. The aim of the present study was to explore the mechanisms of these therapies against 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis in rats using a chronic vagus nerve stimulation model in vivo, as well as the lipopolysaccharide (LPS)-induced inflammatory response in human epithelial colorectal adenocarcinoma cells (Caco-2) by acetylcholine in vitro. METHODS AND RESULTS: Colitis was induced in rats with rectal instillation of TNBS, and the effect of chronic VNS (0.25 mA, 20 Hz, 500 ms) on colonic inflammation was evaluated. Inflammatory responses were assessed by disease activity index (DAI), histological scores, myeloperoxidase (MPO) activity, inducible nitric oxide synthase (iNOS), TNF-α and IL-6 production. The expression of Mitogen-activated protein kinases (MAPK) family members, IκB-α, and nuclear NF-κB p65 were studied by immunoblotting. Heart rate variability (HRV) analysis was also applied to assess the sympathetic-vagal balance. DAI, histological scores, MPO activity, iNOS, TNF-α and IL-6 levels were significantly decreased by chronic VNS. Moreover, both VNS and acetylcholine reduced the phosphorylation of MAPKs and prevented the nuclear translocation of NF-κB p65. Methyllycaconitine (MLA) only reversed the inhibitory effect on p-ERK and intranuclear NF-κB p65 expression by ACh in vitro, no significant change was observed in the expression of p-p38 MAPK or p-JNK by MLA. CONCLUSION: Vagal activity modification contributes to the beneficial effects of the cholinergic anti-inflammatory pathway in IBD-related inflamed colonic mucosa based on the activation of MAPKs and nuclear translocation of NF-κB. Our work may provide key pathophysiological mechanistic evidence for novel therapeutic strategies that increase the cardiovagal activity in IBD patients.

Caveolin-3 is involved in the protection of resveratrol against high-fat-diet-induced insulin resistance by promoting GLUT4 translocation to the plasma membrane in skeletal muscle of ovariectomized rats.

Insulin resistance is recognized as a common metabolic factor which predicts the future development of both type 2 diabetes and atherosclerotic disease. Resveratrol (RSV), an agonist of estrogen receptor (ER), is known to affect insulin sensitivity, but the mechanism is unclear. Evidence suggests that caveolin-3 (CAV-3), a member of the caveolin family, is involved in insulin-stimulated glucose uptake. Our recent work indicated that estrogen via ER improves glucose uptake by up-regulation of CAV-3 expression. Here, we investigated the role of CAV-3 in the effect of RSV on insulin resistance in skeletal muscle both in vivo and in vitro. The results demonstrated that RSV ameliorated high-fat-diet (HFD)-induced glucose intolerance and insulin resistance in ovariectomized rats. RSV elevated insulin-stimulated glucose uptake in isolated soleus muscle in vivo and in C2C12 myotubes in vitro by enhancing GLUT4 translocation to the plasma membrane rather than increasing GLUT4 protein expression. Through ERα-mediated transcription, RSV increased CAV-3 protein expression, which contributed to GLUT4 translocation. Moreover, after knockdown of CAV-3 gene, the effects of RSV on glucose uptake and the translocation of GLUT4 to the plasma membrane, as well as the association of CAV-3 and GLUT4 in the membrane, were significantly attenuated. Our findings demonstrated that RSV via ERα elevated CAV-3 expression and then enhanced GLUT4 translocation to the plasma membrane to promote glucose uptake in skeletal muscle, exerting its protective effects against HFD-induced insulin resistance. It suggests that this pathway could represent an effective therapeutic target to fight against insulin resistance syndrome induced by HFD.