A comparative study for the efficacies of transaxillary non-inflatable endoscopic surgery versus traditional surgery for papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the efficacies between open surgery and axillary non-inflatable endoscopic surgery in papillary thyroid carcinoma (PTC). Methods: A retrospective analysis was performed on 343 patients with unilateral PTC treated by traditional open surgery (201 cases) and transaxillary non-inflating endoscopic surgery (142 cases) from May 2019 to December 2021 in the Head and Neck Surgery of Sichuan Cancer Hospital. Among them, 97 were males and 246 were females, aged 20-69 years. 1∶1 propensity score matching (PSM) was performed on the enrolled patients, and the basic characteristics, perioperative clinical outcomes, postoperative complications, postoperative quality of life (Thyroid Cancer-Specific Quality of Life), aesthetic satisfaction and other aspects of the two groups were compared after successful matching. SPSS 26.0 software was used for statistical analysis. Results: A total of 190 patients were enrolled after PSM, with 95 cases in open group and 95 cases in endoscopic group. Intraoperative blood losses for endoscopic and open groups were [20 (20) ml vs. 20 (10) ml, M (IQR), Z=-2.22], postoperative drainage volumes [170 (70)ml vs. 101 (55)ml, Z=-7.91], operative time [135 (35)min vs. 95 (35)min, Z=-7.34], hospitalization cost [(28 188.7±2 765.1)yuan vs. (25 643.5±2 610.7)yuan, x¯±s, t=0.73], postoperative hospitalization time [(3.1±0.9)days vs. (2.6±0.9)days, t=-3.24], and drainage tube placement time [(2.5±0.8) days vs. (2.0±1.0)days, t=-4.16], with statistically significant differrences (all P<0.05). There was no significant difference in surgical complications (P>0.05). There were significant diffferences between two groups in the postoperative quality of life scores in neuromuscular, psychological, scar and cold sensation (all P<0.05), while there were no statistically significant differences in other quality of life scores (all P>0.05). In terms of aesthetic satisfaction 6 months after surgery, the endoscopic group was better than the open group, with statistically significant difference (χ2=41.47, P<0.05). Conclusion: Endoscopic thyroidectomy by a gasless unilateral axillary approach is a safe and reliable surgical method, which has remarkable cosmetic effect and can improve the postoperative quality of life of patients compared with the traditional thyroidectomy.

Comparison of three kinds of free flaps used in patients with oral and oropharyngeal tumors / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the recovery and quality of life of patients with oral and oropharyngeal tumors treated with three kinds of free soft tissue flaps. Methods: The clinical data of 103 patients, including 66 males and 37 females, aged 26-74 years, who underwent primary repair of defects after resection of oral and oropharyngeal tumors in Sichuan Tumor Hospital from July 2014 to August 2020 were analyzed. Anterolateral thigh flap (ALTF) was used in 43 patients, radial forearm free flap (RFFF) in 45 patients, and lateral arm free flap (LAFF) in 15 patients. Postoperative qualities of life of patients were evaluated by the university of Washington quality of life questionnaire and oral health impact scale (HIP-14 Chinese edition). SPSS 23.0 software was used for statistical analysis. Results: The T staging of RFFF or LAFF group was significantly lower than that of ALTF group (P<0.05). There was no significant difference in mean flap areas between ALTF group ((55.87±27.38) cm2) and LAFF group ((49.93±19.44) cm2), while RFFF group had smaller mean flap area ((33.18±6.05) cm2) than ALTF group (t=5.311, P<0.001) and LAFF group (t=3.284, P=0.005). In terms of oral functions including swallowing, mastication, taste and spitmouth, there were no significant differences between LAFF group and RFFF group (P>0.05), but both groups had better oral functions than ALTF group (P<0.05). There was no significant difference in appearance scores between LAFF group (75(75, 75)) and ALTF group (75(75,75) vs.75(75,75),Z=-1.532, P=0.126), and both groups had higher scores than RFFF group (50(50, 75),Z values were -3.447 and -3.005 respectively, P<0.05). RFFF group had higher speech score (100(67, 100)) than LAFF group (67(50, 76),Z=-2.480, P<0.05) and ALTF group (67(33, 67),Z=-5.414, P<0.05). ALTF group had lower mean score of quality of life than RFFF group [72(56,77) vs.79(69, 89),Z=-3.070, P<0.05), but there was no statistical difference in the mean scores of qualities of life between ALTF group and LAFF group (Z=1.754, P=0.079). According to the evaluation of oral health impact scale (HIP-14 Chinese version) 1 year after surgery, individual item scores and the average score of all items in ALTF group were lower than those in RFFF and LAFF groups (P<0.05), with no significant difference between RFFF group and LAFF group (P>0.05). Conclusions: RFFF has unique advantages for small tissue defects, while ALTF is suitable for large tissue defects, such as buccal penetrating defect, whole tongue and near whole tongue defect, and LAFF is a compromise choice between ALTF and RFFF. ALTF is inferior to RFFF and LAFF in oral functional reconstruction, including swallowing, chewing, taste and spittle. ALTF and LAFF are superior to RFFF in postoperative appearance.

Posaconazole as primary prevention of fungal infection in intensive immunosuppressive therapy for severe aplastic anemia / 中华血液学杂志

Objective: To Evaluate the efficacy and safety of posaconazole as primary prevention of invasive fungal disease (IFD) in patients with severe aplastic anemia (SAA) treated with anti-thymus/lymphocyte immunoglobulin (ATG/ALG) combined with cyclosporine intensive immunosuppressive therapy (IST). Methods: A retrospective analysis of clinical data of 58 SAA patients who received IST of anti-thymocyte immunoglobulin combining cyclosporine and antifungal prophylaxis during April 2013 to May 2017 in Peking Union Medical College Hospital was performed. The patients were divided into posaconazole prophylaxis group and the control group (itraconazole or fluconazole). The disease characteristics, IFD prevention effect and adverse drug reaction, curative effect and prognosis of the two groups were compared. Results: Posaconazole was used to prevent fungal infection in 20 patients. The other 38 patients were used as the control group. Retrospective analysis showed comparable characteristics (gender, age, disease severity, etiology, interval between the onset of disease to treatment, ATG/ALG type) of both groups. The incidence of IFD were 0 and 15.8% in posaconazole prophylaxis group and the control group, respectively (P=0.084). In the control group, there were 6 cases diagnosed as IFD. Of them, 2 were confirmed, 2 suspected and 2 not identified. Five of the 6 cases were pulmonary infection, 1 bloodstream infections. Of the 6 IFD cases, 5 were very severe aplastic anemia (VSAA). There was no obvious adverse reaction in posaconazole prophylaxis group. Conclusion: Posaconazole is safe and effective for primary prevention of fungal infection of SAA patients receiving IST, especially for the VSAA.

CD200/CD200R Expression Levels and Its Significance after Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

<p><b>BACKGROUND</b>CD200 and its receptor CD200R are both type-1 membrane glycoproteins, which are members of the immunoglobulin superfamily (IgSF). Besides the inhibitory effect on macrophages, CD200/CD200R also play an important role in regulating the regulatory T cells, allergicreaction, autoimmune diseases, allograft, neurological diseases and other autoimmune-related diseases, etc.</p><p><b>OBJECTIVE</b>To investigate the role of CD200 and its receptor in the graft versus host disease (GVHD).</p><p><b>METHODS</b>Experimental samples were divided into aGVHD group, non-aGVHD group, cGVHD group and non-cGVHD group, the healthy persons were used as normal controls. Firstly, the expression levels of CD200 and CD200R on CD19+ cell, CD3+ cell and dendritic cell (CD19- CD14- CD1c+) surfaces in each group were detected by using flow cytometry, so as to determine whether there were expression differences among each groups. Then, the mRNA levels of each groups were tested by using real-time quantitative polymerase chain reaction for finding the differences of mRNA expression level among each group. Finally, the peripheral blood mononuclear cells of the patients and healthy controls were co-cultured with anti-CD200R1 antibody for 48 hours, and the interleukin-10 level in the co-culture system was tested by using enzyme linked immunosorbent assay for verifying the function of CD200/CD200R.</p><p><b>RESULTS</b>The CD200 expression level on CD19+ cell surface in the aGVHD group and non-aGVHD group was both lower than that in healthy control group; that in the non-aGVHD group was higher than that in the aGVHD group. The CD200 expression level on CD19+ CD200+ cells in the non-cGVHD group were higher than that in the cGVHD group and healthy control group. There were no significant differences of CD200 and CD200R expression levels on CD3 cells and dendritic cells among all groups. The CD200 mRNA expression levels in the aGVHD group and cGVHD group were both lower than the healthy control group. The CD200 mRNA expression level was lower in the aGVHD group than in the non-aGVHD group, and was lower in the cGVHD group than in the non-cGVHD group. There was no significant difference of the CD200R mRNA expression level among all groups. After the peripheral blood mononuclear cells of the patients and healthy controls were co-cultured with anti-CD200R1 antibody for 48 hours, the interleukin-10 concentration decreased with the increasing of anti-CD200R1 antibody concentrations in the co-culture system.</p><p><b>CONCLUSION</b>The CD200/CD200R may play a role in the pathogenesis of GVHD after allo-HSCT.</p>

Determination of Solubility and Apparent Oil/Water Partition Coefficient of Sitafloxacin / 医药导报

Objective To determine the solubility and apparent oil/ water partition coefficient of sitafloxacin in different solvents. Methods High performance liquid chromatography (HPLC) was used. The column was Dikma Diamonsil C18 (2) (4. 6 mmí250 mm,5 μm). The mobile phase was 0. 05 mol·L-1 KH2 PO4 solution (pH was adjusted with H3 PO4 to 2. 4)-acetonitrile (7030). The column temperature was set at room temperature. The flow rate was 1. 0 mL·min-1 . The detection wavelength was 295 nm and the injection volume was 10 μL. The solubility of sitafloxacin and the apparent oil/ water partition coefficient at pH 2. 0,4. 3,5. 8,6. 6,7. 4,8. 0,10. 0 and 11. 2 were determined. Results The equilibrium solubility of sitafloxacin in water was 0. 44 mg·mL-1 and the apparent oil/ water partition coefficient was 0. 23 (lgP= -0. 64) at (37±2) ℃ . Sitafloxacin has the lowest equilibrium solubility (0. 13 mg·mL-1 ) and the highest apparent oil/ water partition coefficient in pH7. 4 buffer solution system. At pH>10 and pH<5. 8,the solubility of sitafloxacin increased obviously and apparent oil/ water partition coefficient decreased. Conclusion Sitafloxacin is insoluble in water and also poorly soluble in oil,but its solubility could be improved significantly in acidic or alkaline solution.

Study of flavonoids from leaves of Santalum album / 中国中药杂志

<p><b>OBJECTIVE</b>To study the flavonoids from the leaves of Santalum album.</p><p><b>METHOD</b>The sample was extracted with 70% ethanol by continuous thermal reflux. The extraction was separated and purified by column chromatography over macroporous adsorption resin, polyamide and sephadexlh-20. Their structures were identified by detailed spectroscopic analysis.</p><p><b>RESULT</b>Eight flavonoids were isolated and identified as vicenin-2 (1), vitexin (2), isovitexin (3), orientin (4), isoorientin (5). chrysin-8-C-beta-D-glucopyranoside (6), chrysin-6-C-beta-D-glucopyranoside (7), and isorhamnetin (8).</p><p><b>CONCLUSION</b>All compounds were isolated from this plant for the first time.</p>

Correlation between image quality and radiation dose on screening mammography / 中华放射医学与防护杂志

Objective To obtain the matched parameters between image quality and radiation dose by exploring the influence of the exposure parameters of screening mammography on both the image quality and radiation dose.Methods The correlation between the exposure parameters and average glandular doses to 507 patients undergoing screening mammography were retrospectively analyzed.The influence of breast compression thickness on radiation dose by exposing different thickness of PMMA was obtained.The correlation with image quality was analyzed by combined testing of contrast detail test mode ( CDMAM3.4 )and different thickness of PMMAs.Results The groups aged 30 to 49 years were the main groups in 507examined patients,up to 67.06％ of the total.The mean value of average gland doses ( AGD ) in contrastprior mode was the highest in three kinds of exposure modes,accounting for 137.5％ of standard mode.In standard mode,target material/filtration board combination was Mo/Mo,Mo/Rh and Rh/Rh,accounting for 1/3 respectively.Mo/Rh and Rh/Rh were selected in dose-prior mode,accounting for 50％ respectively.Mo/Mo was mainly selected in contrast-prior,accounting for 52％.Breast compression thickness was positively correlated with average gland doses.Image quality figure inverse (IQFinv) under three kinds of modes (STD,DOSE,CNT) was 98.32,95.41 and 107.02,respectively,and IQFinv of contrast-prior mode was the highest among them.IQFinv was in general agreement in the three kinds of exposure modes when the thickness of PMMA plates plates was greater than or equal to 5 cm.Conclusions In clinical practice,when the breast is of density type and pressed thickness is less than 4 em,the dose-prior mode should be selected.When the pressed thickness is between 4 and 6 cm,the standard exposure mode should be selected.When the pressed thickness is larger than 6 cm,the manual mode should be selected.

Clinical features of invasive pulmonary fungal infection secondary to malignant blood diseases / 中国医学科学院学报

<p><b>OBJECTIVE</b>To summarize the clinical features of invasive pulmonary fungal infection (IPFI) secondary to malignant blood diseases (MBD).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 52 patients with IPFI secondary to MBD admitted to Peking Union Medical College Hospital from January 1995 to December 2008.</p><p><b>RESULTS</b>The incidences of IPFI secondary to acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), non-Hodgkin's lymphoma (NHL), and aplastic anemia (AA) were 4.6%, 3.2%, 2.8%, and 2.5%, respectively. In patients with IPFI secondary to AML, 88.5% (23/26) of the patients suffered from the infections during the non-remission (NR) period (including relapse), and 11.5% (3/26) in the complete-remission (CR) period. In all the patients with IPFI secondary to malignant blood diseases, 86.5% (45/52) of MBD were neutropenic or agranulocytic, and 67.3% (35/52) had been treated with broad-spectrum antibiotics for more than 96 hours before anti-fungal therapy. The total mortality after anti-fungal therapy was 13.7% (7/51). More than half of patients with fluconazole or itraconazole as the first-line therapy had to switch to other medicines because of poor infection control.</p><p><b>CONCLUSIONS</b>IPFI secondary to MBD is most common in AML patients. Patients with NR of AML, neutropenia or agranulocytosis, and long-term broad-spectrum antibiotics usage are susceptible to IPFI. Fluconazole and itraconazole have low efficacy, and other more potent anti-fungal medicines should be considered.</p>

The study on the prevention of diluted hyponatremia by intravenous dripping of 3% sodium chloride solution during transurethral vaporization of the prostate / 中华老年医学杂志

Objective To analyze the effect of intravenous dripping of 3% sodium chloride solution on prevention of diluted hyponatremia during transurethral vaporization of the prostate (TUVP). Methods Eighty-five cases with benign prostatic hyperplasia (BPH) accompanied with typical lower urinary tract symptoms (LUTS) were divided into two groups during undergoing TUVP operation: the control group(n=38) given Ringer's solution dripping (3ml/min) and the concentrated sodium chloride injection group(n= 47) given 3% sodium chloride solution dripping (2～4ml/min). All of the operations were taken via Wolf electric resection system, and the operation time was≥60 min. The complete blood count and serum electrolyte were determined before operation and 60 minutes after operation beginning, and the data were compared between the two groups. Results The decrease amplitude of serum sodium was obviously smaller in concentrated sodium chloride injection group[(1.45±5.14)mmol/L] than that in the control group[(7.79±6.64) mmol/L] 60 minutes after operation beginning (P<0.05). Conclusions Giving 3% sodium chloride solution by intravenous drip during TUVP may reduce the severity of diluted hyponatremia and postpone the occurrence of hyponatremia, and thereby decrease the risk of transurethral resection syndrome.

A clinical analysis of 47 cases of female cystitis glandularis / 中国医师进修杂志

Objective To evaluate the procedure of diagnosis and treatment for cystitis glandularis in female. Methods Forty-seven patients were classified into 3 groups randomly after being operated by tuansurethral resection:15 cases without any other therapy(A group), 16 cases with bladder instillation of pirarubicin afterward (B group), 16 cases with bladder instillation of mitomycin afterward (C group). Symptomatic reliof and recurrence were investigated in 1-year follow-up visit. Results Forty-four cases had fulfilled the entire follow-up visit. The effective rates of the three groups were 38.5%,87.5% and 86.7% respectively (X2=13.80,P＜0.01 ), the recurrence rate was 30.8% ,0,13.3% respectively (X2=4.86,P＞0.05).Conclusions The clinical situation of cystitis glandularis has no specificity. Cystisis glandularis has diversification of the clinical symptoms, urodynamics. Transurethral resection with bladder instillation is more effective than transttrethral resection simply, the recurrence rate is lower.

Effects of two fluid resuscitations on the bacterial translocation and inflammatory response of small intestine in rats with hemorrhagic shock / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of two fluid resuscitations on the bacterial translocation and the inflammatory factors of small intestine in rats with hemorrhagic shock.</p><p><b>METHODS</b>Fifty SD healthy male rats were randomly divided into 5 groups (n equal to 10 per group): Group A (Sham group), Group B (Ringer's solution for 1 h), Group C (Ringer's solution for 24 h), Group D (hydroxyethyl starch for 1 h) and Group E ((hydroxyethyl starch for 24 h). A model of rats with hemorrhagic shock was established. The bacterial translocation in liver, content of tumor necrosis factor-alpha (TNF-alpha) and changes of myeloperoxidase enzyme (MPO) activities in small intestine were pathologically investigated after these two fluid resuscitations, respectively.</p><p><b>RESULTS</b>The bacterial translocation and the expression of TNF-alpha in the small intestine were detected at 1 h and 24 h after fluid resuscitation. There were significant increase in the number of translocated bacteria, TNF-alpha and MPO activities in Group C compared with Group B, significant decrease in Group E compared with Group D and in Group B compared with Group D. The number of translocated bacteria and TNF-alpha expression significantly decreased in Group E as compared with Group C.</p><p><b>CONCLUSIONS</b>The bacterial translocation and the expression of TNF-alpha in the small intestine exist 24 h after fluid resuscitation. 6% hydroxyethyl starch can improve the intestinal mucosa barrier function better than the Ringer's solution.</p>

Research and practice on new teaching model for bringing up high quality medical talent / 基础医学与临床

In order to meet the modern needs in medical talent education and bring up highly qualitfied medical talent,Medical College of Shantou University has aggressively and effectively conducted exploration and practice on high medical education,and developed a new teaching model for bringing up medical talent under with high quality the strategies of "Reform of Course System" and "Innovation of Teaching Model".The new teaching model is designed to bring up excellent clinicians with innovative spirit and proficient basic skills.It keeps up with the global ideal of high medical education,and it is an originated teaching model in China with Chinese characteristics and a unique style of Medical College of Shantou University,which will make a positive and significant impact on Chinese high medical education.

Study on quality standard of extracts from Rhizoma Zingiberis by supercritical fluid extraction / 中国中药杂志

<p><b>OBJECTIVE</b>To establish the quality standard of extracts from Rhizoma Zingiberis by supercritical CO2 fluid extraction.</p><p><b>METHOD</b>The extracts were identified by TLC. The total phenols and the 6-gingerol were determined by dual-wavelength UV spectrophotometry and HPLC separately.</p><p><b>RESULT</b>The recovery of total phenols was 97.7% (RSD 2.0%). The linear range of 6-gingerol is 0.20-2.0 microg, the average recovery was 97.7% (RSD 2.0%).</p><p><b>CONCLUSION</b>The method is convenient for a good resolution and can be used for the quality control of extracts from Rhizoma Zingiberis.</p>