[Retrospective analysis of 350 cases with dissection of lymph nodes posterior to right recurrent laryngeal nerve in endoscopic thyroidectomy through gasless axillary posterior approach].

Objective: To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (ⅥB compartment) in endoscopic thyroidectomy through gasless axillary posterior approach. Methods: A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data. Results: All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and ⅥB compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. ⅥB compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%). Conclusion: The dissection of ⅥB compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients.

Deep Underground Laboratory Measurement of

The ^{13}C(α,n)^{16}O reaction is the main neutron source for the slow-neutron-capture process in asymptotic giant branch stars and for the intermediate process. Direct measurements at astrophysical energies in above-ground laboratories are hindered by the extremely small cross sections and vast cosmic-ray-induced background. We performed the first consistent direct measurement in the range of E_{c.m.}=0.24 to 1.9 MeV using the accelerators at the China Jinping Underground Laboratory and Sichuan University. Our measurement covers almost the entire intermediate process Gamow window in which the large uncertainty of the previous experiments has been reduced from 60% down to 15%, eliminates the large systematic uncertainty in the extrapolation arising from the inconsistency of existing datasets, and provides a more reliable reaction rate for the studies of the slow-neutron-capture and intermediate processes along with the first direct determination of the alpha strength for the near-threshold state.

[Epidemic status of imported malaria before and after malaria elimination in Jiaozuo City of Henan Province].

OBJECTIVE: To analyze and compare the epidemiological characteristics of imported malaria in Jiaozuo City before and after malaria elimination, so as to provide insights into the malaria surveillance during the post-elimination stage and prevention of re-establishment of imported malaria. METHODS: Data pertaining to the epidemic situation and individual investigation of malaria in Jiaozuo City before (from 2010 to 2016) and after malaria elimination (from 2017 to November, 2020) were captured from the National Notifiable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention of Chinese Center for Disease Control and Prevention and were analyzed statistically. RESULTS: A total of 74 imported malaria cases were reported in Jiaozuo City from 2010 to 2021. Imported cases were predominantly Plasmodium falciparum malaria cases in Jiaozuo City before and after malaria elimination, and there was no significant difference in the proportion of malaria parasite species (χ2 = 0.234, P > 0.05). The imported malaria cases was predominantly reported in Wuzhi County, and was identified in overseas male farmers and businessmen at ages of 20 to 59 years, while the greatest number of imported malaria cases was reported in June and December before and after malaria elimination. The imported malaria cases predominantly acquired malaria parasite infections in sub-Saharan African countries; however, the proportion of imported malaria cases returning from Southeast Asian counties increased after malaria elimination than before malaria elimination (χ2 = 5.989, P < 0.05). The longest duration from onset to definitive diagnosis of malaria reduced from 27 days before malaria elimination to 18 days after malaria elimination, and the median duration reduced from 3 days to 2 days, while the proportion of definitive diagnosis of malaria increased from 60.47% before malaria elimination to 83.87% after malaria elimination (χ2 = 4.724, P < 0.05). In addition, the proportion of malaria cases definitively diagnosed and reported by medical institutions increased after malaria elimination than before malaria elimination (χ2 = 5.406, P < 0.05). CONCLUSIONS: The imported malaria patients were predominantly P. falciparum malaria cases in Jiaozuo City during 2010 to 2021, and the patient's medical care-seeking awareness and medical staff's diagnosis and treatment ability have improved after malaria elimination. It is necessary to strengthen and improve malaria surveillance and response system and prevent the re-establishment of overseas imported malaria.

[Testosterone levels in patients with varicocele and azoospermia].

OBJECTIVE: Androgen deficiency is common in aging males and may have unfavourable health consequences. Large-scale studies suggested low testosterone level might increse mortality and morbidity in ageing males. However, young men with low testosterone level might be neglected. Recent studies reported young men with infertility may have reduced testosterone level. To investigate the incidence of androgen deficiency in males with infertility and possible factors affecting the low testosterone level. METHODS: Between January 2011 and December 2012, 407 men with infertility caused by varicocele (VC), obstructive azoospermia (OA) and nonobstructive azoospermia (NOA) in our center were included. The number of men in each group of OA, NOA and VC was 141, 97 and 169, respectively. All the eligible patients underwent a serum testosterone assessment by a single morning blood draw (between 8:00 to noon) to test for concentration of the total testosterone. All serum samples were determined by radioimmunoassay in our andrology laboratory. Androgen deficiency was defined as having a total testosterone level less than 300 ng/dL. RESULTS: The mean age was (30.4±5.8) years. The mean testosterone level was (4.18±1.64) ng/dL (range 0.30 to 11.32 ng/dL). The overall incidence of androgen deficiency was 26.5% (108/407). The incidences of androgen deficiency in NOA, OA and VC groups were 40.2% (39/97), 19.1% (27/141) and 24.9% (42/169), respectively, which were significantly higher in the NOA than in the VC and OA groups (P < 0.001). The incidences had no difference between the VC and OA groups (P=0.229). Univariate analysis revealed the cause of infertility, FSH and the mean testis volume as possible affecting factors for androgen deficiency. However, on multivariate analysis the only cause of infertility was an independent predictor. The incidence of androgen deficiency was the highest in the NOA group [OR 0.492 (95% confidence interval 0.288-0.840)]. CONCLUSION: NOA and varicocele might be risk factors of androgen deficiency. Young men with NOA may have a higher possibility of low testosterone level. Testosterone level should be followed up after NOA and varicocele treatment. Androgen deficiency should be assessed in males with infertility in clinical practice.

Effects of tai chi and qigong on rehabilitation after COVID-19: a protocol for systematic review and meta-analysis.

INTRODUCTION: COVID-19 is a public health emergency of international concern, which is characterised by rapid and widespread transmission, high mortality and complications. Several studies have shown the benefits of tai chi and qigong for recovery after COVID-19; however, no meta-analysis has been reported. Therefore, the purpose of this study is to evaluate the efficacy and safety of tai chi and/or qigong on rehabilitation after COVID-19 through a systematic review and meta-analysis to provide a reference and basis for clinical application. METHODS AND ANALYSIS: This study will use the Cochrane Library, PubMed, Web of Science, Embase, China Knowledge Network, China Biomedical Literature Database, Chinese Scientific Journal Database and Wanfang Database. The time period is from the inception of the database to November 2021, with no language restrictions. Searches will be conducted using the subject terms "Taichi","Qigong" and "COVID-19" plus free-text words. Articles will be screened and collected by two reviewers independently. Included studies will be assessed for quality using the Cochrane Risk of Bias Assessment Tool. Statistical analyses will be performed using the Revman V.5.3 software. The primary outcomes include 1-second forced expiratory volume and 1-second forced vital capacity, oxygen saturation, total white cell count and quality of life score. Secondary outcomes include time to remission of major symptoms, incidence of adverse events, clinical cure rate and mortality. Subgroup and sensitivity analyses will also be used to explore and interpret the heterogeneity. This protocol is written based on the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocol. ETHICS AND DISSEMINATION: Ethical approval and consent are unnecessary because no primary data will be collected. The results will be disseminated through peer-reviewed publications. PROSPERO REGISTRATION NUMBER: CRD42021288962.

[Investigation and analysis of a mass ammonia gas poisoning accident].

Objective: To investigation and analysis of ammonia gas leakage in a meat factory. Methods: In April 2013, Enterprise managers and workers were investigated, and clinical data of 24 patients were analyzed. Results: The company caused a leak in the ammonia pipeline maintenance operation, Among the patients, 20 had stimulus response and 4 had mild poisoning. Conclusion: To prevent group occupational ammonia poisoning, it is necessary to strengthen the awareness of occupational disease prevention of enterprise owners and the awareness of self-protection of workers.

Direct Measurement of the Astrophysical

Fluorine is one of the most interesting elements in nuclear astrophysics, where the ^{19}F(p,α)^{16}O reaction is of crucial importance for Galactic ^{19}F abundances and CNO cycle loss in first generation Population III stars. As a day-one campaign at the Jinping Underground Nuclear Astrophysics experimental facility, we report direct measurements of the essential ^{19}F(p,αγ)^{16}O reaction channel. The γ-ray yields were measured over E_{c.m.}=72.4-344 keV, covering the Gamow window; our energy of 72.4 keV is unprecedentedly low, reported here for the first time. The experiment was performed under the extremely low cosmic-ray-induced background environment of the China JinPing Underground Laboratory, one of the deepest underground laboratories in the world. The present low-energy S factors deviate significantly from previous theoretical predictions, and the uncertainties are significantly reduced. The thermonuclear ^{19}F(p,αγ)^{16}O reaction rate has been determined directly at the relevant astrophysical energies.

[Application of immunohistochemical staining of bcl-2, Ber-EP4, CD10, CK20, and Ki-67 in differential diagnosis between trichoblastoma and basal cell carcinoma].

Objective: To study the utility of immunohistochemistry (IHC) in differential diagnosis between trichoblastoma (TB) and basal cell carcinoma (BCC). Methods: Fifty-eight cases of TB and 40 cases of BCC were collected at Fudan University Shanghai Cancer Center from January 2009 to December 2019 and retrospectively analyzed by IHC for bcl-2, Ber-EP4, CD10, CK20 and Ki-67. Fisher exact test was performed for statistical analysis. Results: Twenty-five (43.1%) TBs and 5 (12.5%) BCCs showed bcl-2 staining in the outermost layer of the epithelial nests, the difference was statistically significant (P<0.01). The proportion of cases with bcl-2 staining>75% of epithelial cells in BCC group was much higher than that in TB group (40% vs. 12.1%; P<0.01). BCC group showed larger proportions with Ber-EP4 staining>75%, 51%-75% of epithelial cells than TB group (12.5% vs. 1.7%, 37.5% vs. 8.6%;P<0.05). Fifty-five (94.8%) TBs demonstrated CD10 expression in the follicular stroma, while only 16 (40.0%) BCCs showed focal or scattered CD10 expression in reactive fibrous stroma (P<0.01). CK20 expression was present in 37 (63.8%) TBs with scattered pattern, but BCCs exhibited no CK20 staining except for only one case (2.5%) showing focal staining (P<0.01). Compared with TB group, the BCC group included more cases with Ki-67 labeling index ≥15% on average and ≥25% in hotspot areas (P<0.05). Conclusion: IHC is helpful in differential diagnosis between TB and BCC. Scattered CK20 staining pattern and stromal CD10 expression support the diagnosis of TB. Bcl-2 staining limited to the outermost layer of the proliferation is more likely to be found in TB. In contrast, Ber-EP4 positivity and higher Ki-67 labeling index tend to be present in BCC.

Development of a tunable multi-channel Doppler reflectometer on J-TEXT tokamak.

Doppler reflectometer is a powerful diagnostic tool to study the turbulence for tokamak plasmas. It can provide information on the density fluctuation, the poloidal rotation, the radial electric field, its shear, etc. A tunable multi-channel V-band (50-75 GHz) Doppler reflectometer system has been developed on the J-TEXT tokamak for the measurement under various toroidal magnetic fields. A universal serial bus controlled synthesizer is used as a source that can adjust the probing frequency remotely. This Doppler reflectometer can measure the plasma in 0.3 < ρ < 1 . Its radial resolution is <2 cm, and k⊥ is ∼ 4-12 cm-1. Based on the Doppler reflectometer, the perpendicular turbulence propagation velocity, the profile of the radial electric field, the geodesic acoustic mode, and some other phenomena have been observed on J-TEXT.

[Association between child care environment and childhood early development].

Objective: To investigate the factors related to child care environment and the association between child care environment and children's early development. Methods: Using stratified cluster random sampling, a total of 22 509 children newly enrolled to kindergarten from 187 kindergartens of 16 districts in Shanghai in 2017 were enrolled. A survey was conducted by parent-reported questionnaire. The index of child care environment (ICCE) and the early human capacity index were used to evaluate family child care environment and children's early development respectively. The sample was divided into four groups based on the ICCE score: the lowest family childcare environment (ICCE≤10 scores), lower middle (ICCE=11 scores), upper middle (ICCE=12 scores), and the highest (ICCE=13 scores). The linear regression model and Logistic regression model were used to analyze the factors related to child care environment and the association between child care environment and children's early development respectively. Results: A total of 22 067 children aged (44±7) months, including 11 425 boys (51.8%) and 10 642 girls (48.2%), participated in this study. The multnomial linear regression revealed girls, higher maternal education, higher household annual income, single-child, non-divorced parents, and early breastfeeding experience were protective factors of child care environment for children newly enrolled to kindergarten (ß=0.064, 0.238, 0.119, 0.096, 0.113, and 0.032; 95% confidence interval (CI): 0.020-0.108, 0.175-0.302, 0.058-0.180, 0.046-0.146, -0.012-0.242, and -0.051-0.116; all P<0.01). The multinomial Logistic regression revealed compared with the highest child care environment group, the odds ratio of children's early development risks in upper midclle, lower middle, and the lowest child care environment groups were 1.543 (95%CI: 1.373-1.735, P<0.01), 2.537 (95%CI: 2.254-2.856, P<0.01), and 4.198 (95%CI: 3.757-4.690, P<0.01), respectively. Conclusions: The child care environment is not only significantly related to family structure and socioeconomic status, but also to early breastfeeding experience. The child care environment plays an important role in promoting childhood early development.

[Treatment outcome of 100 patients with hepatoblastoma based on a new risk stratification].

Objective: To provide the risk stratification method of hepatoblastoma (HB) suitable for implementation in China and explore the new treatment method for high-risk HB patients. Methods: A total of 100 cases of children and adolescents under 18 years old with newly diagnosed HB in Sun Yat-sen University Cancer Center and Sun Yat-sen University First Affiliated Hospital from September 2014 to September 2018 were included. According to the clinical stage, AFP level, pathological subtype and other factors, patients were stratified into four groups: extremely low-, low-, intermediate- and high-risk. The patients at very low risk were treated with surgery only and followed-up. The patients at very low risk were treated with C5V(Cisplatin+ 5-Fluroracil+ Vincristine) regimen for 4 courses. The patients at intermediate risk were treated with C5VD(Cisplatin+ 5-Fluroracil+ Vincristine+ Doxorubicin)regimen before and after surgery for 6-8 courses. The patients at high risk were treated with C5VD and IIV (ifoshamide+ irinotecan+ vincristine) alternately before and after surgery for 8 courses. Results: One hundred patients were stratified into extremely low-risk, low-risk, medium-risk and high-risk groups for 2, 10, 51 and 37 cases, respectively. Eighty three cases had evaluable lesions before chemotherapy. Among them, 65 patients achieved partial remission, stable disease and progressive disease were observed in 10, and 8 cases, respectively, with a response rate of 78.3%. During a median follow-up of 20 months, 30 patients experienced tumor relapse or progression, and 27 of them died. The 2-years progression-free survival (PFS) and overall survival (OS) rates were 69.2% and 72.0%, respectively. The 2-years PFS rates of patients with extremely low risk, low risk, medium risk and high risk were 100%, 88.9%, 75.3% and 43.2%, respectively. The 2-years OS rates were 100%, 100%, 81.0% and 44.8%, respectively. Conclusions: The novel HB risk classification is simple and feasible. With active comprehensive treatment, patients at extremely low-, low- and medium-risk have excellent outcomes. The survival rate of high-risk HB patients remains to be improved, and new treatment strategies need to be explored.

The phytotoxin COR induces transcriptional reprogramming of photosynthetic, hormonal and defence networks in tomato.

Coronatine (COR) is a non-host specific phytotoxin secreted by Pseudomonas syringae pv. tomato that can induce leaf chlorosis and increase the virulence of pathogens during plant-pathogen interactions. Studies have shown that COR can regulate multiple physiological processes in plants, but its involvement in bacterial pathogenesis and plant growth regulation is not well understood. In this study, transcriptome sequencing was carried out on 4-week-old tomato leaves that were either mock-treated or treated with COR. Transcriptome sequencing led to the identification of 6144 differentially expressed genes (DEGs), of which 4361 genes were downregulated and 1783 genes were upregulated upon COR treatment. To obtain functional information on the DEGs, we annotated these genes using GO and KEGG databases. Functional classification analysis showed that the DEGs were primarily involved in photosynthesis, chlorophyll and carotenoid biosynthesis, jasmonic acid (JA) synthesis and phenylpropane metabolism. A total of 23 genes related to chlorophyll biosynthesis had significant changes, of which 22 genes were downregulated and one gene was upregulated, indicating that chlorophyll biosynthesis was inhibited upon COR treatment. A total of 17 photosystem I related genes and 22 photosystem II related genes involving 20 protein subunits were also downregulated. In the JA synthesis pathway, 25 genes were up regulated, and six genes were downregulated in COR treated samples. COR was also involved in the regulation of multiple secondary metabolites. The identified DEGs will help us better understand the virulence effects and physiological functions of COR and provide a theoretical basis for breeding resistance into economically important crops.