A new pyrazine from Hypecoum erectum L / 药学学报

Four pyrazines were isolated from the n-butanol fraction of Hypecoum erectum L. by using various chromatographic methods, including MCI gel, ODS, silica gel and semi-preparative HPLC. The structures of the isolated compounds were identified as hyperectpyrazin A (1), 1′S-(6-methylpyrazin-2-yl)-ethane-1′,2′-diol (2), 2-hydroxymethyl-6-methylpyrazin (3) and pyrazine-2-carboxylic acid (4) by spectroscopy methods (1D NMR, 2D NMR, UV, IR, MS, etc.). The absolute configuration of compound 2 was determined by using the Mo2(OAc)4 induced CD analysis for the first time. Compound 1 was a new compound, compounds 2-4 were isolated from H. erectum for the first time. Compounds 1-4 were evaluated for their inhibition against acetylcholinesterase and nitric oxide generation induced by lipopolysaccharide-RAW264.7 macrophage cells. At a concentration of 50 μmol·L-1, compounds 2 and 4 displayed inhibitory effects on acetylcholinesterase with the inhibition rates of 44.40% and 43.99%, respectively.

Correlation analysis between tumor burden and biochemical indicators of parathyroid adenoma / 中华内分泌外科杂志

Objective:To determine the correlation of tumor volume and weight with biochemical parameters in patients with parathyroid adenoma (PA) .Methods:A prospective electronic database collected clinical data on 208 patients with PA treated for the first time by surgery at department of general surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.The relationship between biochemical parameters and tumor volume and weight was analyzed with Spearman’s correlation.Results:Tumor volume and weight were positively correlated with parathyroid hormone (PTH) ( r=0.33, P<0.001; r=0.39, P<0.001), calcium ( r=0.16, P=0.018; r=0.18, P=0.007) and alkaline phosphatase levels ( r=0.24, P<0.001; r=0.27, P<0.001), respectively. Clinical correlates affecting serum PTH were age, serum calcium and tumor weight ( F=30.325, P<0.001) . Conclusions:Tumor burden in patients with PA correlates with some laboratory biochemical parameters. Age and cystic lesions of the tumor may influence the actual serum PTH levels.

Alkaloids from fruit of Lycium chinense var. potaninii / 中国中药杂志

Ten alkaloids(1-10) were isolated from the ethyl acetate extract of the fruit of Lycium chinense var. potaninii by silica gel, ODS, and preparative high performance liquid chromatography(HPLC), and identified by NMR and MS as methyl(2S)-[2-formyl-5-(hydroxymethyl)-1H-pyrrol-1-yl]-3-(phenyl)propanoate(1), methyl(2R)-[2-formyl-5-(methoxymethyl)-1H-pyrrol-1-yl]-3-(phenyl)propanoate(2), 3-hydroxy-4-ethyl ketone pyridine(3), indolyl-3-carbaldehyde(4),(R)-4-isobutyl-3-oxo-3,4-dihydro-1H-pyrrolo[2,1-c][1,4]oxazine-6-carbaldehyde(5),(R)-4-isopropyl-3-oxo-3,4-dihydro-1H-pyrrolo[2,1-c][1,4]oxazine-6-car-baldehyde(6), methyl(2R)-[2-formyl-5-(methoxymethyl)-1H-pyrrol-1-yl]-3-(4-hydroxyphenyl)propanoate(7), dimethyl(2R)-[2-formyl-5-(methoxymethyl)-1H-pyrrol-1-yl]butanedioate(8), 4-[formyl-5-(methoxymethyl)-1H-pyrrol-1-yl]butanoate(9), 4-[2-formyl-5-(methoxymethyl)-1H-pyrrol-1-yl]butanoic acid(10). All the compounds were isolated from the plant for the first time. Among them, compounds 1-3 were new compounds. Compounds 1-9 were evaluated for hypoglycemic activity in vitro with the palmitic acid-induced insulin resistance in HepG2 cells. At 10 μmol·L~(-1), compounds 4, 6, 7, and 9 can promote the glucose consumption of HepG2 cells with insulin resistance.

The remedial surgery for parathyroid carcinoma / 中华内分泌外科杂志

The incidence of parathyroid carcinoma (PC) is low while the long-term outcome is poor in most cases. Most patients with PC suffered from relapse or metastasis, and the main reason of mortality is hypercalcemia and related complications. Surgery is the main therapy for PC. Local resection is suitable for benign lesion while radical resection including parathyroid lesion, ipsilateral thyroid lobe and surrounding soft tissue is suggested for parathyroid carcinoma. It is still difficult to identify the malignancy among parathyroid neoplasm before operation without distant metastasis. Parathyroid carcinoma was diagnosed after first surgery of local resection in most patients with histopathological evaluation. The significance of remedial surgery for this situation was still indeterminate. In this review, the different opinions about the management of PC were introduced and several suggestions were presented based on the literatures.

Application of Endoscopic Parathyroidectomy in the Treatment of Primary Hyperparathyroidism / 中华内分泌外科杂志

Objective:To summarize the experience and the clinical data of patients with primary hyperparathyroidism undergoing endoscopic parathyroidectomy.Methods:A total of 24 patients who underwent endoscopic parathyroidectomy for primary hyperparathyroidism in Peking Union Medical College Hospital during Feb. 2021 to May. 2022 were concluded in this study (20 cases of parathyroidectomy via axillary approach and 4 cases of parathyroidectomy via thoracic and breast approach) . The operation time, postoperative drainage, length of stay, level of parathyroid hormone and serum calcium of those patients were collected. Postoperative complications and recurrence of hyperparathyroidism were also observed.Results:The postoperative levels of serum parathyroid hormone and serum calcium were significantly reduced (over 50%) compared with preoperative level ( P<0.05) . The average operation time was (96±22) min (64-157 min) . The mean postoperative drainage volume was (47±16) ml on day 1, (46±11) ml on day 2, and (30±9) ml on day 3, respectively. The average length of postoperative hospital stay was (2.8±1.1) days (2-6 days) . In one case of parathyroidectomy via axillary approach, the operation was converted to open surgery because of the low position of lesion. Other cases completed endoscopic surgery and obtained satisfactory cosmetic results. There were no postoperative complications such as bleeding, permanent hoarseness, coughing while drinking water, or surgical site infection. The mean follow-up time was (7.4±4.2) months (1-16 months) . There was no obvious discomfort and no recurrence during follow-up. Conclusion:Endoscopic parathyroidectomy is safe and effective in the treatment of primary hyperparathyroidism, which can be used as a surgical option for patients with cosmetic requirements.

Implementation of a SBAR sign-out template in the standardized residency training in a neonatal ward / 中华医学教育探索杂志

Objective:To analyze the effect of SBAR (situation, background, assessment, and recommendation) sign-out template in the standardized residency training in a neonatal ward.Methods:Based on SBAR communication mode, we designed and optimized neonatal ward sign-out checklist, and a total of 67 residents were trained for 2 weeks from April 2019 to June 2019, with control group (before training) and observation group (after training). The assessment indicators of sign-out information included sign-out duration, the incidence of sign-out errors, quality assessment scores and shift satisfaction (including sign-out satisfaction and self-evaluation) as well as competencies. A total of 1 553 children's morning shift data were collected, and SPSS 22. 0 was used for t test and chi-square test. Results:In the control group, the sign-out duration was (23.4±4.7) min, the incidence of sign-out errors was (43.6±6.6)%, quality assessment scores were (6.3±0.7) points, the satisfaction degree was (76.5±4.6)%, and the self-evaluation scores were (5.2±2.1) points. While, in the observation group, the sign-out duration was (15.9±3.2) min, the incidence of sign-out errors was (21.1±2.3)%, quality assessment scores were (8.9±0.9) points, the satisfaction degree was (94.1±2.9)%, and the self-evaluation scores were (8.9±0.8) points, with statistically significant difference ( P<0.05). There were statistically significant differences between the two groups in clinical skills and medical service ability [(2.2±0.1) vs. (3.8±0.3)], interpersonal communication ability [(2.6±0.5) vs. (4.2±0.1) points], teamwork ability [(3.1±0.2) vs. (4.6±0.3)], information and management ability [(2.5±0.5) vs. (4.2±0.2)] ( P<0.05). Conclusion:The SBAR template can improve sign-out process and the clinical skills of standardized training residents.

Pancreatic serous microcystic neoplasm with atypical clinical and image features / 中华肝胆外科杂志

Objective:To summarize the atypical manifestations and treatment strategies of serous microcystic neoplasm of the pancreas.Methods:Review the case data of 11 cases of pancreatic serous microcystic adenoma with atypical preoperative clinical imaging findings admitted to Peking Union Medical College Hospital from July 2008 to October 2019, and summarize their clinical manifestations, CT/MRI features, and preoperative clinical diagnosis, surgical methods, postoperative conditions.Results:The median age of the 11 patients was 50 (46-66) years old, 7 females, and 4 males. There were 8 cases with back pain and 6 cases with weight loss. The preoperative imaging examination found that the lesion was located in the head and neck in 8 cases, with pancreaticobiliary duct dilatation in 7 cases, suspected vascular invasion in 3 cases, and pancreatic parenchymal atrophy in 2 cases, 3 cases showed rich blood supply and solid space, and 2 cases were connected to the pancreatic duct. Preoperative diagnosis of pancreatic malignant tumors accounted for 4 cases, neuroendocrine tumors in 3 cases, solid pseudopapillary tumors in 3 cases, and intraductal papillary mucinous tumors in 1 case. All patients underwent surgical treatment, 3 cases of distal pancreatectomy (2 cases of using Kimura method to protect the spleen), 3 cases of pancreaticoduodenectomy, 1 case of total pancreatectomy, 2 cases of pancreatic head resection with duodenum preservation, 2 cases of local resection. All patients had no early postoperative deaths. There were 2 cases of grade B pancreatic fistula, 2 cases of biochemical leakage, 1 case of postoperative abdominal hemorrhage, and 2 cases of delayed gastric emptying, all of which were cured after active treatment. The median postoperative hospital stay was 18 (7-63) days.Conclusions:Pancreatic serous microcystic neoplasm could be accompanied by atypical features such as pancreatic/bile duct dilation, parenchyma atrophy, or even present vessel invasion. Understanding the atypical clinic and image features would help improving differential diagnosis and treatment. For those with invasive features, surgical exploration should be recommended.

The research of molecular mechanism for parathyroid carcinoma and prospects of clinical application / 中华内分泌代谢杂志

Parathyroid carcinoma is an endocrine malignancy with poor outcomes. Its incidence is low and the molecular mechanisms related with carcinogenesis and development remains largely unknown. It is difficult to diagnose and manage parathyroid carcinoma. In this review, the recent advances in the molecular mechanism of parathyroid carcinoma are summarized, with emphasis on the prospects for future clinical applications.

Diagnostic value of 4-dimensional computed tomography in preoperative localization in patients with primary hyperparathyroidism / 中华内科杂志

Objective:To provide more options for preoperative localization diagnosis in patients with primary hyperparathyroidism (PHPT), the diagnostic efficacy of parathyroid 4-dimensional computed tomography (4D-CT) in patients with PHPT was evaluated.Methods:This was a single-center retrospective study including 57 patients with surgical proved PHPT. All of the patients underwent 4D-CT, 99Tc m -sestamibi parathyroid imaging (MIBI), and ultrasonography (US) preoperatively. The reference standard for correct localization was based on operation reports and pathology confirmation. The patients were grouped according to the preoperative serum calcium levels, tumor diameter, or ectopic lesions (yes/no), respectively. The sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) of 4D-CT, MIBI and US, alone or in combination, were analyzed in total and each subgroup patients. Results:Fifty-seven patients (39 women, 18 men; mean age of 56.5 years) were evaluated, including four cases with multi-gland disease and thirteen cases with ectopic parathyroid lesions. In all the patients, similar diagnostic efficacy was found in 4D-CT (AUC: 0.943) and MIBI (AUC: 0.927), both of which were higher than that of US (AUC: 0.847) ( P = 0.01 for 4D-CT vs. US; P = 0.04 for MIBI vs. US). In a subset analysis for ectopic quadrants, the diagnostic efficacy of 4D-CT was significantly higher than that of MIBI ( P = 0.04) or US ( P = 0.01), with the sensitivity of 100%, 69.2%, and 61.5%, and AUC of 0.989, 0.846, and 0.808 for 4D-CT, MIBI and US, respectively. Conclusions:4D-CT has similar diagnostic efficacy for preoperative localization to MIBI in patients with PHPT, and it is superior to MIBI and US in identifying the ectopic parathyroid gland. 4D-CT can be recommended as an alternative preoperative localization method, especially when parathyroid lesions could not be precisely located by US and MIBI.

Effect of Hematopoietic Pre-B-cell Leukemia Transcription Factor Interacting Protein Knockdown on Proliferation,Cell Cycle and Apoptosis in Pancreatic Cancer Cells / 中国医学科学院学报

To unravel the role of hematopoietic pre-B-cell leukemia transcription factor interacting protein(HPIP)in the proliferation,cell cycle,and apoptosis of pancreatic ductal adenocarcinoma(PDAC)cells. The HPIP expression in PDAC tissue was determined by immunohistochemical staining.Knockdown of HPIP was accomplished in MIA PaCa-2 and BxPC-3 cell lines by transient transfection of HPIP siRNA and validated by Western blotting.Cell proliferation was assessed using the cell counting kit-8 assay and colony formation assay.Cell cycle and apoptosis were detected by flow cytometry.Western blotting was performed to detect the expression levels of cyclin D1,caspase 7,and cleaved caspase 7. HPIP was overexpressed in PDAC tissue compared with matched adjacent pancreatic tissue(=-2.060,=0.039).Knockdown of HPIP inhibited the proliferation of MIA PaCa-2 and BxPC-3 cells(all <0.05).Knockdown of HPIP significantly reduced the positive colonies formed by MIA PaCa-2 and BxPC-3 cells(=4.706,=0.009;=9.514,=0.000).Knockdown of HPIP decreased the proportion of S phase cells(=7.642,=0.001;=2.714,=0.051)and increased the proportion of G/G phase cells(=3.244,=0.031;=6.095,=0.003)in MIA PaCa-2 and BxPC-3 cells.Meanwhile,knockdown of HPIP increased the proportions of late-phase MIA PaCa-2 and BxPC-3 cells(=24.58,=0.000;=36.45,=0.000)and the overall apoptosis rate(=29.43,=0.000;=43.52,=0.000).In MIA PaCa-2 and BxPC-3 cells,knockdown of HPIP decreased the expression level of cyclin D1(=6.705,=0.002;=6.238,=0.003)and increased the expression level of cleaved caspase 7(=3.991,=0.016;=6.536,=0.002). HPIP is overexpressed in PDAC tissue.Knockdown of HPIP inhibits the proliferation and G/G to S transition of PDAC cells.Meanwhile,knockdown of HPIP promotes the apoptosis of PDAC cells.Thus,HPIP may act as an oncogene in PDAC.

Study on transport mechanism of brucine and strychnine in MDCK-MDR1 cell monolayer model / 中草药

Objective: To study the bi-direction transport behavior of brucine and strychnine in the MDCK-MDR1 cell monolayer model. Methods: MTT method was employed to confirm the safe concentration of brucine and strychnine towards MDCK-MDR1 cells. The effects of transport time, drug concentration, and P-glycoprotein inhibitor verapamil on cumulative absorption concentration (Ccum) and apparent permeability coefficient (Papp) of brucine and strychnine in MDCK-MDR1 monolayer cells were studied. Results: The Papp value of brucine and strychnine was larger than 1 × 10-5 cm/s and the ratio of Papp(BL→AP) vs Papp(AP→BL) was less than 2. Brucine/ strychnine combined with verapamil decreased the ratio of Papp(BL→AP) vs Papp(AP→BL). Conclusion: The absorption of brucine and strychnine in MDCK-MDR1 cell monolayer model was well and the passive transference was its main intestinal absorption mechanism. The P-gp inhibitor verapamil has a significant inhibitory effect on brucine and strychnine absorption. Brucine and strychnine may be a substrate of P-glycoprotein.

Effect of three different gargling liquid on bacterial colonies in air during oral ultrasound scaling / 中国感染控制杂志

Objective To evaluate the effect of different gargling liquid on colony number in air during oral ultrasound scaling for patients with periodontitis.Methods Patients with mild (n=54), moderate (n=54), and severe chronic periodontitis (n=54) were selected, then patients with same degree of periodontitis were randomly divided into three groups, with 18 in each group. Before scaling, patients in each group of mild, moderate, and severe periodontitis were given honeysuckle liquid (gargle A), 3％ hydrogen peroxide (gargle B), and normal saline (gargle C) respectively. Bacterial culture and identification of air specimens were conducted at 0 and 30 minutes after the beginning of ultrasonic scaling as well as 10, 20 minutes after the end of ultrasonic scaling.Results Variance analysis of three-factor factorial design data showed that degree of periodontitis, types of gargling liquid, and sampling time had interaction (F=2.666, P=0.002). Comparisons of air colonies: At the beginning of scaling, there was no significant difference in colony number of air around patients using different gargling liquid in mild, moderate and severe groups (all P＞0.05). Among patients using the same gargling liquid at 30 minutes after the beginning of scaling, colony number of air was the lowest around patients with mild periodontitis and the highest around patients with severe periodontitis, colony numbers of air around patients with gargle A and B were lower than that of patients with gargle C. Comparison of each sampling points showed that colony number of air around the right side of patients' head was highest, differences were all statistically significant (all P＜0.05). 20 minutes after the end of scaling, there was no significant difference in colony number among groups compared before scaling (all P＞0.05). The main isolated strains in the air were Streptococcus viridans (32.53％), coagulase negative staphylococcus (24.56％), and filamentous fungi (18.48％).Conclusion There are variety of opportunistic pathogens in the air during oral ultrasound scaling, and the number of colonies is positively correlated with the degree of periodontitis. honeysuckle liquid has a good effect on reducing the number of air colonies during and after scaling.

Three-dimensional finite element analysis of cuspal-coverage thickness influence on the stress distribution of all-ceramic onlay-restored premolars / 华西口腔医学杂志

OBJECTIVE@#To investigate the influence of cuspal-coverage thickness on the stress distribution of all-ceramic onlay-restored premolars by using 3D finite element (FE) analysis and to provide references for the design of all-ceramic onlays for clinical application.@*METHODS@#3D FE models of all-ceramic onlays with three cuspal-coverage thicknesses (2, 3, and 4 mm) of endodontically treated maxillary premolar were constructed based on micro-CT images. Stress distributions in the onlay, adhesive resin cement layer, and dentin of models were analyzed under vertical load (600 N) and oblique load (200 N).@*RESULTS@#When the cuspal-coverage thickness increased, the peak maximum principal stress value decreased inside the onlay but increased in the margin of the adhesive resin cement layer. In addition, stress concentration areas increased in the coronal residual dentin on the palatal side under oblique load.@*CONCLUSIONS@#An increase in the cuspal-coverage thickness of all-ceramic onlays may reduce the risk of rupture of the restoration but may deteriorate the restoration and cause palatal dentin fracture.

Determination of Hydroxyl Radical in Atmosphere by Molecularly Imprinted Electrochemical Sensor / 分析化学

p-Hydroxybenzoic acid can be oxidized by hydroxyl radicals ( · OH) to produce electroactive 3,4-dihydroxybenzoic acid (3,4-DHBA). Therefore, it can be used as a probe to detect ·OH. In this work, 3,4-DHBA/ PPy / TiO2 molecularly imprinted polymer film was prepared for indirect determination of ·OH based on its recognition ability for 3,4-DHBA. The sensor was constructed by using pyrrole as the functional monomer and 3, 4-DHBA as the template molecule. The sensor was characterized by scanning electron microscope and different electrochemical methods. The preparation and determination conditions, such as the electropolymerization cycle number, pH value in the electropolymerization process, and elution time, were optimized. Under the optimal conditions, a linear range of 1. 0×10-8-1. 0×10-6 mol/ L was obtained for 3,4-DHBA and the detection limit was down to 4. 2×10-9 mol/ L (S / N = 3). This new approach was of low cost and convenience, and was successfully applied to measure the concentration of ·OH in the atmosphere.

Preoperative diagnosis and surgical strategies of primary hyperparathyroidism / 中华内分泌外科杂志

Objective To investigate the preoperative localizaion diagnosis and surgical strategies of primary hyperparathyroidism (pHPT).Methods The clinical data of pHPT patients who underwent initial parathyroid surgery at the Peking Union Medical College Hospital from Jan.2009 to Apr.2017 were retrospectively analyzed to explore preoperative localization and surgical options.Results There were a total of 902 surgical cases included in the study with 674 women and 228 men.All had preoperative parathyroid ultrasonography (US) (sensitivity 97.18％,positive predictive value (PPV) 98.40％) and 99Tcm-sestamibi (MIBI) scan (sensitivity 94.24％,PPV 98.00％).The combination of US and MIBI scan had a sensitivity of 92.39％ and PPV of 97.37％.MIBI scan showed negative results in 51 cases.We found that male patients with cystic lesions were more likely related to negative MIBI scan (P＜0.05).Among 89 patients with negative MIBI and/or US,39 received neck CT,17 received positron emission tomography (PET)/CT,and 9 received ultrasound-guided biopsy for further localization.800 patients (88.69％) underwent minimally invasive parathyroid surgery (MIP) with anesthesia of cervical plexus block.656 patients (72.72％) had normal parathyroid hormone (PTH) level on the first post-operative day,140 patients (15.52％) had postoperative hypocalcaemia and 234 patients (25.94％) presented hypocalcaemic symptoms within 3 days after operation,which could be relieved by intravenous calcium or continuous medicine taken by mouth.During the follow-up of the 800 MIP patients,4 had recurrence and one patient was not cured.Conclusions Parathyroid US and MIBI scan are of good value in localizaion diagnosis.Neck CT or PET/CT should be used as supplementary approaches in patients with negative US and/or MIBI scan.MIP with anesthesia of cervical plexus block is simple and feasiable for pHPT cases with accurate localization.

miR-498 inhibits A549 cell migration and invasion by down-regulating FOXM1 / 西安交通大学学报(医学版)

Objective To verify whether miR-498 can inhibit A549 cell migration and invasion by down-regulating FOXM1.Methods miR-498 mimic and miR-NC were transfected into A549 cells.Wound healing and Transwell method were employed to test the migratory ability and invasion ability of A549 cells;Western blot was used to detect the expressions of COL1A1,COL1A5 and FOXM1 in A549 cells.Luciferase assay was used to confirm whether FOXM1 is the target gene of miR-498.Results Compared with those in the control group,the expressions of COL1A1,COL1A5 and FOXM1 were decreased,and the migration and invasion abilities of A549 cells were decreased in the miR-498 group (both P<0 .01 ).The luciferase activity of the FOXM1-3′-UTR plasmid was significantly suppressed by miR-498 (P<0 .05 );over-expression of FOXM1 could reverse the effect of miR-498 on A549 cells.Conclusion miR-498 inhibits A549 cell migration and invasion by down-regulating FOXM1.

Comprehensive Evaluation on Effect of IMPX977 on Expression of Methyl-CpG-binding Protein 2 in Rats / 中草药·英文版

Objective To investigate the effect of IMPX977 on methyl-CpG-binding protein 2 (MeCP2) expression in rats. Methods Forty-eight SD rats were randomly divided into four groups: normal control group, olive oil (negative control, 5 mL/kg oil) group, and 10 mg/kg and 30 mg/kg IMPX977 administration groups. All rats were given corresponding dose of drugs each other day and administered orally for two weeks. Tissues including cortex and cerebellum were collected from rats to assay the expression of MeCP2 by quantitative RT-PCR and Western blotting. Results The IMPX977 supplement showed no significant effect on the body weight of rats. In normal rats, MeCP2 was highly expressed in cerebellum, cortex and hippocampus, and less expressed in heart, spleen and lung. In addition to male rats, compared with the control group, the expression of MeCP2 mRNA was significantly increased in cerebellum after 30 mg/kg IMPX977 treatment and contrarily, absolutely decreased in cortex of all treatment groups. Furthermore, in female rats MeCP2 mRNA was reduced in cortex of both olive oil and 30 mg/kg IMPX977 treatment groups compared with control group. Meanwhile, MeCP2 protein level was significantly elevated in cerebellum of treated male rats compared to the control group. In contrast to the control group, the expression of MeCP2 protein in both cerebellum and cortex of female rats in other three groups was increased. Conclusion IMPX977 treatment (10 mg/kg) may elevate the expression of MeCP2, which establishes experimental foundation for the further research on rat models of Rett syndrome.

The clinical analysis of preventable reoperation for primary hyperparathyroidism / 中华外科杂志

Objective@#To discuss the diagnosis, preoperative imaging and surgical technique of patients who underwent reoperation for persistent hyperparathyroidism.@*Methods@#A prospective database about primary hyperparathyroidism in Department of General Surgery, Peking Union Medical College Hospital was searched for the patients who underwent reoperation for persistent hyperparathyroidism from January 2009 to December 2016. The information about the initial operation, preoperative imaging study and result of reoperations were collected and reviewed. A total of 58 patients underwent reoperation for hyperparathyroidism. Eleven of these patients were referred to this institute for reoperation after missing single parathyroid lesion in the initial parathyroidectomy. Nine patients were female, and the mean patient age at reoperation was 54.9 years.@*Results@#For this group, the accuracy of ultrasound neck scan and sestamibi scintigraphy was 10/11 in identifying diseased parathyroid gland before reoperation. Combined with enhanced CT and SPECT, all parathyroid lesions were localized before reoperations. With general anesthesia or cervical plexus block, all diseased parathyroid glands were removed in the reoperations. No signs of hyperparathyroidism appeared during follow-up.@*Conclusions@#The initial surgery for primary hyperparathyroidism should be performed in experienced center to avoid reoperations. Combining preoperative localization and cervical exploration will help to increase the success rate of reoperation.

Ultrasound-guided Selective Cervical Nerve Root Block Plus Superficial Cervical Plexus Block for Minimally Invasive Parathyroidectomy / 中国医学科学院学报

Objective To explore the efficacy and safety of ultrasound-guided cervical root block (CRB) in patients undergoing minimally invasive parathyroidectomy (MIP).Methods We enrolled 35 patients with hyperparathyroidism undergoing MIP in Peking Union Medical College Hospital.C4-7 nerve roots were identified in ultrasound imaging by the shape of the transverse process.A 50 mm insulated needle was gently introduced by an in-plane approach toward the posterior edge of the nerve root located at the inside of the posterior tubercle.After careful aspiration,a total of 3-4 ml of a mixture of 0.5% ropivacaine and 1% lidocaine was slowly injected.The superficial block was administered at the midpoint of the posterior border of the sternocleidomastoid by injecting 5-6 ml of the same mixture.The patients were administrated with dexmedetomidine during the surgery.All patients were assessed for sensory following the procedure and for pain after the surgery.Results Totally 35 patients successfully received MIP under ultrasound-guided CRB plus superficial block.There was no conversion to general anesthesia,no toxic reaction of local anesthetics,and no intravertebral injection.Hoarseness occurred in 6 patients (17.1%) and Horner syndrome occurred in 3 patients (8.6%).The median cold sensory visual analogue scale score was 1.2 [0,5] points at 10 minutes after the procedure.Patient's satisfaction score was 9.5 points.Conclusion Ultrasound-guided CRB plus superficial block can achieve accurate and safe anesthesia,and it provides lasting analgesic effect during and after MIP.

Effects of SRSF9/SRp30c on proliferation and migration abilities of glio-ma cells by regulating GRβ / 中国病理生理杂志

AIM:To investigate the expression of serine-arginine-rich splicing factor 9/serine-arginine-rich protein 30c (SRSF9/SRp30c) and glucocorticoid receptor β(GRβ) in the glioma cells and the relationship of them. METHODS:Small interfering RNA ( siRNA) was used to knock down the expression of SRSF9 in the U87 cells.Short hairpin RNA ( shRNA) derived from lentivirus was used to establish U 87 stable knockdown cell line .Fluorescence micros-copy was used to observe and detect transfection efficiency .The expression of Grβand SRSF9/SRp30c at mRNA and pro-tein levels was determined by RT-qPCR and Western blot .The cell viability , colony formation ability and migration ability were measured by CCK-8 assay, colony formation assay and wound healing experiment .RESULTS:The mRNA and pro-tein levels of SRSF9/SRp30c and Grβin the U87 cells were both down-regulated after knockdown of SRSF9 (P<0.05). Fluorescence microscopic observation showed that a stable cell line was constructed successfully , and the transfection effi-ciency exceeded 80%.After knockdown of SRSF9 expression in the U87 cells, the cell viability and colony formation abili-ty were reduced (P<0.05).The migration ability was weakened significantly after SRSF9 was knocked down (P<0.05). CONCLUSION:SRSF9/SRp30c may promote the proliferation and migration of the glioma cells by regulating GRβ.