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Objective:To investigate the clinical significance of color Doppler ultrasonography combined with detection of thyroid autoantibodies in the early diagnosis of thyroid cancer.Methods:A total of 108 patients with thyroid cancer who treated in Shaoxing Central Hospital Medical Community General Hospital from September 2019 to September 2021 were selected as the research group, and 108 patients with benign thyroid lesions during the same period were selected as the control group. The ultrasound examination results and the levels of serum thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and thyroid receptor antibody (TRAb) were compared between the two groups. The relationship between the thyroid autoantibodies index and the early diagnosis of thyroid cancer were analyzed by Spearman correlation analysis; the value of early diagnosis by color Doppler ultrasonography combined with detection of thyroid autoantibodies were evaluated by the receiver operating characteristic (ROC) curve.Results:The main features of ultrasonic images in the research group were unclear edge, low echo, irregular shape, chaotic blood flow distribution, internal micro calcification, no envelope and blood flow resistance index ≥0.7. The sensitivity of ultrasonography for the diagnosis of thyroid cancer was 86.11% (93/108), the specificity was 87.18% (102/117) and the accuracy was 90.28% (195/216). The levels of serum TgAb, TPOAb and TRAb in the research group were higher than those in control group: (32.28 ± 2.85) kU/L vs. (21.96 ± 2.54) kU/L, (81.28 ± 7.32) kU/L vs. (51.53 ± 5.86) kU/L, (4.48 ± 1.25) U/L vs. (2.35 ± 0.63 ) U/L, there were statistical differences ( P<0.05). The levels of serum TgAb, TPOAb and TRAb in patients with lymph node metastasis were higher than those in the patients without lymph node metastasis: (36.28 ± 3.12) kU/L vs. (30.60 ± 2.54) kU/L, (93.51 ± 8.57) kU/L vs. (76.13 ± 6.62) kU/L, (5.73 ± 1.54) U/L vs. (3.95 ± 1.12) U/L, there were statistical differences ( P<0.05). The levels of serum TgAb, TPOAb and TRAb in patients with stage Ⅲ-Ⅳ were higher than those in the patients with stage Ⅰ-Ⅱ: (35.84 ± 3.28) kU/L vs. (29.74 ± 2.29) kU/L, (89.35 ± 8.16) kU/L vs. (75.52 ± 6.23) kU/L, (5.28 ± 1.49) U/L vs. (3.91 ± 1.25) U/L, there were statistical differences ( P<0.05). The results of Spearman correlation analysis showed that the levels of serum TgAb, TPOAb and TRAb were positively correlated with lymph node metastasis ( r = 0.758, 0.824, 0.695, P<0.05) and clinical stage of thyroid cancer ( r = 0.735, 0.796, 0.673, P<0.05). The results of ROC curve analysis showed that the area under the curve(AUC) of ultrasound examination combined with TgAb, TPOAb and TRAb for early diagnosis of thyroid cancer was 0.930, the sensitivity was 85.19%, and the specificity was 91.67%. The combined diagnostic value was better than single diagnosis. Conclusions:Ultrasound examination combined with serum TgAb, TPOAb and TRAb has high diagnostic value for early stage thyroid cancer, which is helpful to clinically clarify the condition, and provides a reliable basis for preoperative diagnosis and targeted individualized treatment plan.
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Objective:To examine the effects of apelin-13 on ferroptosis of the C2C12 skeletal muscle cell line induced by a high-iron environment and explore potential underlying mechanisms.Methods:C2C12 cells were cultured in Dulbecco's Modified Eagle Medium(DMEM)and divided into a control group, a ferric citrate(FAC)group, an apelin-13 group, an FAC+ apelin-13 group, a ferroptosis inducer RSL3 group and an FAC+ apelin-13+ RSL3 group.Cell viability was detected by the 3-(4, 5-dimethyl thiazole-2)-2, 5-diphenyl thiazolyl blue(MTT)assay.The intracellular concentrations of total iron and divalent iron were measured by colorimetry; the levels of glutathione(GSH), malondialdehyde(MDA)and intracellular reactive oxygen species(ROS)in cells were detected by an enzyme-linked immunosorbent assay, visible spectrophotometry and a chemifluorescence method, respectively.The ultrastructure of C2C12 cells was examined by transmission electron microscopy.The protein expression of glutathione peroxidase 4(GPX-4), ferritin heavy chain 1(FTH-1), heme oxygenase 1(HO-1)and nuclear factor E2-related factor 2(Nrf-2), were detected by Western blotting.Results:Compared with the FAC group, the FAC+ Apelin-13 group had significantly elevated cell viability(optical density: 0.52±0.06 vs.0.28±0.04, t=7.837, P=0.007)and higher concentrations of GSH(2.41±0.35 vs.0.91±0.12 μmol/g Pro, t=9.778, P=0.003), but significantly decreased levels of ROS(22.06±5.79 vs.52.71±7.28 a. u./mg Pro, t=8.064, P=0.006), MDA(4.63±0.51 vs.9.11±0.84 mmol/mg Pro, t=8.642, P=0.006), total iron(1.53±0.24 vs.3.17±0.55 μmol/g Pro, t=6.135, P=0.013)and divalent iron(0.75±0.08 vs.1.94±0.36 μmol/g Pro, t=5.068, P=0.027), as well as reduced intracellular iron deposition.In the control group and the apelin-13 group, the morphology of the mitochondria was clear and normal.In contrast, the mitochondria in the FAC group had increased membrane density, membrane shrinkage and rupture, vacuolar degeneration, and obvious mitochondrial damage, which were consistent with the morphological characteristics of ferroptosis.Compared with the FAC group, the FAC+ apelin-13 group showed significant improvement in mitochondrial damage.Moreover, compared with the FAC+ apelin-13 group, the cell viability of the FAC+ apelin-13+ RSL3 group was significantly decreased(optical density: 0.23±0.04 vs.0.48±0.06, t=7.642, P=0.007). Compared with the FAC group, the FAC+ apelin-13 group had significantly up-regulated cellular expression of GPX-4(relative expression: 0.96±0.14 vs.0.31±0.07, t=7.712, P=0.008), FTH-1(0.57±0.08 vs.0.27±0.05, t=6.944, P=0.011), and HO-1(0.49±0.07 vs.0.28±0.05, t=6.472, P=0.012), as well as increased nuclear expression of Nrf-2(relative expression: 0.42±0.04 vs.0.19±0.05, t=7.114, P=0.008)with a higher ratio of nuclear expression over total cellular expression[(58.36±5.24)% vs.(36.58±5.32)%, t=5.858, P=0.015]and a higher level of HO-1 protein expression(relative expression: 0.49±0.07 vs.0.28±0.05, t=6.472, P=0.012). Conclusions:Apelin-13 inhibits ferroptosis induced by a high iron environment in C2C12 cells, and the underlying molecular mechanisms may be related to the Nrf-2/HO-1 signaling pathway.
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Objective To evaluate the risk-benefit of aspirin discontinuation during the perioperative period in elderly patients undergoing laparoscopic surgery.Methods Eighty-eight patients of both sexes,aged ≥65 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective laparoscopic cholecystectomy,taking aspirin to prevent cardiovascular diseases,were divided into 2 groups (n =44 each) using a random number table method:non-discontinuation group (N group) and discontinuation group (D group).No aspirin was discontinued during the perioperative period in group N.Aspirin was discontinued at 7 days before surgery and resumed at 3 days after surgery.Venous blood samples were collected at 24 h before surgery (To) and 30 min and 24 h after surgery (T1.2) for measurement of blood coagulation by thromboelastography,and clot reaction time,coagulation time,angle oα,maximal amplitude,and coagulation index were recorded.The occurrence of TEG parameters below/above normal values of clinical significance was recorded.The intraoperative blood loss,postoperative drainage,reoperation due to hemorrhage within 48 h,perioperative blood transfusion and fluid infused,and adverse cardiovascular events (myocardial ischemia,venous thrombosis of lower extremity,pulmonary embolism,etc.)within 30 days after surgery were also recorded.Results Compared with group N,no significant change was found in the intraoperative blood loss,intraoperative fluid infused,postoperative drainage rate and drainage volume,reoperation due to hemorrhage within 48 h,or length of hospitalization (P＞0.05),angle α,maximal amplitude and coagulation index were increased,clot reaction time was shortened,the incidence of clot reaction time below normal values of clinical significance was increased in group D (P＜0.05).There was no significant difference in the incidence of adverse cardiovascular events between group D (7％) and group N (0) (P＞0.05).Conclusion Perioperative discontinuation of aspirin does not reduce the perioperative blood loss with no clinical benefit,induces blood hypercoagulation and increases the risk of adverse cardiovascular events,and thus it is recommended not to discontinue aspirin in the perioperative period in elderly patients undergoing laparoscopic surgery.
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Objective To observe the effect of intraoperative 5 cm H2O positive end expiratory pressure on vascular endothelial function in patients with uvulopalatopharynplasty (UPPP ). Methods Forty patients with obstructive sleep apnea-hypopnea syndrome (OSAHS)scheduled for UPPP were selected,including 25 males and 15 females,fully met the following conditions as age<60 years,BMI<30 kg/m2and ASA physical status Ⅰ or Ⅱ.Patients were divided into two groups, 20 in each group using random number table method.The observation group was given the intermit-tent positive pressure ventilation (IPPV)with 5 cm H2O PEEP,while the controls group were given IPPV.3 ml of arterial blood was drawn at the time of 5 min of pure oxygen Inhalation (T0),intuba-tion (T1),extubation (T2),and 20 min after extubation (T3).Vascular endothelium expansion fac-tors such as nitric oxide (NO),endothelin (ET),and soluble cell adhesion molecule (CAMs)were detected by ELISA.Results There was no significant difference in plasma ET concentrations between the two groups at different time points.Plasma NO concentration in the observation group was signif-icantly higher than that in the control group at T2and T3(P<0.05).Compared with T0,the concen-trations of CAMs in the control groups from T1to T3,and in the observation group at T2and T3in-creased significantly (P<0.05).In the perioperative period,the plasma CAMs of the control group increased along with the prolongation of the operation time,but the plasma CAMs concentrations in the observation group decreased in the same observation time (P<0.05).Conclusion Low level of PEEP 5 cm H2O may improve endothelial function in general anesthesia patients with OSAHS.
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Enterovirus 71 (EV71) is a neurotropic pathogen that can induce hand, foot and mouth disease in children. There is an appreciable mortality rate after EV71 infections. The mechanism of action of EV71 replication is not known. Recent work has identified some of cell factors of the host that participate in the synthesis of the RNA and proteins of EV71 (e.g., hnRNP K, reticulon 3 (RTN 3)). In that work, researchers used a competitive assay to show that hnRNP K can interact with EV71 5' UTR, which is required for efficient synthesis of viral RNA. Using a yeast two-hybrid system, other researchers demonstrated that RTN 3 interacts with the N-terminal domain of EV71 2C, which is crucial for replication of viral RNA. Here, we discuss recent work focusing on the molecular mechanisms of hnRNP K and RTN 3 in the synthesis of the RNA and proteins of EV71.