[Microwave ablation versus radiofrequency ablation for solid or predominantly solid benign thyroid nodules: a randomized controlled clinical trial].

Objective: To compare the short-term efficacy and the safety of microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of benign thyroid nodules (BTNs). Methods: This prospective randomized controlled trial, performed from December 2019 to September 2021, included 36 patients with solid or predominantly solid BTNs who met the eligibility criteria and provided written informed consent at the Nanjing sub-center (Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine). Patients were assigned to either the MWA group or the RFA group (18 patients in each group) at a ratio of 1∶1 using a block randomization design and allocation concealment using sealed envelope randomization. The independent-sample t-test and χ2 test were used to compare the volume reduction rates (VRRs), effective rates (VRRs≥50%), cosmetic scores, and complication rates at 1, 3, and 6 months after treatment between the two groups. Results: The clinical characteristics of the two groups of patients were comparable. After ablation, the nodule volume was significantly reduced in both groups. At 1, 3, and 6 months, there was no significant difference in the volume between the two groups (all P>0.05). At 3 months, the RFA group had a larger VRRs than that in the MWA group (62.08%±12.46% vs. 46.90%±23.16%, t=-2.45, P=0.021). However, at 1 and 6 months, no statistical significance was observed (both P>0.05). No significant difference was observed in the effective rates at the last follow-up (14/18 vs. 18/18, P=0.104). However, the RFA group had a lower cosmetic score than that in the MWA group (1.78±0.43 vs. 2.17±0.51, t=-2.47, P=0.019). There was no statistically significant difference in the complication rates between the two groups (all P>0.05). Conclusions: Both MWA and RFA were effective and safe treatments for BTNs, with no significant differences in short-term efficacy and safety. In addition, the RFA group showed slightly more favorable outcomes than the MWA group in terms of cosmetic improvement.

[Current advances in research of burning mouth syndrome: biological nerve and social psychology patterns].

Burning mouth syndrome (BMS) is a complex chronic disorder characterized symptomatically by burning sensation mainly localized in the tongue with no specific lesions. Its etiology is not fully understood. Due to the persistent pain and unsatisfactory outcome of treatment, patients with high expectation when seeking medical advice easily feel discontent after treatment, which might cause medical dispute. This review introduces the epidemiology, manifestations, etiology, diagnosis, classification and treatment of BMS. The authors hope the current advances about BMS, mainly focus on the etiology of biological nerve and social psychology, may help the clinicians in treatment of BMS.

[Effects of intrathecal transient receptor potential vanilloid 1 blocker on cervical distension induced visceral pain response].

Objective: With the aid of an acute visceral pain model of uterine cervical distension (UCD), the present study aimed to observe the effects of intrathecal administration of transient receptor potential vanilloid 1 (TRPV1) antagonist SB-366791 on UCD induced-visceral nociception as well as its involved molecular mechanisms. Methods: A total of 30 Sprague-Dawley-derived adult virgin female rats were used. UCD model was established under isoflurane inhalation anesthesia. Briefly, a lower abdominal incision at midline was made to expose the uteral cervix, two metal rods were inserted through both sides of the cervix separately, one rod was fixed and the other one was connected to a pulley system with application of manual weighted traction (0, 25, 50, 75 or 100 g) for simulating 1 h of cervical distension. In addition, 12 Sprague-Dawley-derived adult virgin female rats were subjected to intrathecal catheter implantation, and UCD was established 7 days later. The rats were divided randomly into two groups; one group was administrated with intrathecal SB-366791 while the other was administrated with the same volume of saline as control. The 75 g distension force was then applied for an hour and the electromyographic (EMG) of musculus rectus abdominis, heart rate as well as respiratory frequency were measured continuously during the surgery. The spinal cord (T(12)-L(2)) was collected 30 minutes after UCD for the detection of changes of c-FOS and TRPV1 expression. Results: UCD increased EMG activity (P<0.05) and c-FOS expression (P<0.05) in the deep dorsal horn region and central canal of the spinal cord (T(12)-L(2)) in a stimuli-dependent manner, the expression of TRPV1 in the T(12)-L(2) spinal cord also increased in response to UCD stimulation (P<0.05). Compared with the saline group, intrathecal SB-366791 significantly decreased EMG activity (P<0.05) as well as spinal c-FOS (P<0.05) expression induced by UCD. Conclusions: UCD in rats increases EMG activity of musculus rectus abdominis as well as spinal c-FOS and TRPV1 expression. Intrathecal administration of TRPV1 antagonist SB-366791 significantly decreases the visceral nociception induced by UCD.

Sperm mediated human coagulation factor VIII gene transfer and expression in transgenic mice.

PRINCIPLES: B-domain deleted human coagulation factor VIII cDNA (BDD-hFVIIIcDNA) transgenic mice were produced by using sperm mediated gene transfer (SMGT). The transcription and expression of human FVIII in transgenic mice were also investigated. METHODS: Sperm were isolated from caudae epididymides of male C57BL/6 mice and transfected with linearized RC/RSV-BDDhFVIIIcDNA plasmid, and subsequently used to fertilize female mice via artificial insemination in vivo. After birth, F0 progeny were identified by PCR and Southern blotting for BDD-hFVIIIcDNA transgenic mice. F1 progeny were subsequently derived from a male transgenic F0 mouse and a normal C57BL/6 female mouse. The F1 progeny were then identified as BDD-hFVIIIcDNA transgenic mice by Southern blotting. The transcription and expression of BDDhFVIIIcDNA in transgenic mice were determined by northern blotting, western blotting and immunohistochemical staining. Blood was also collected from both F0 and F1 progeny to detect hFVIII:Ag and anti-hFVIII inhibitors. RESULTS: A total of 9 F0 and 8 F1 progeny were delivered, in which 3 F0 and 2 F1 progeny were identified to have BDD-hFVIIIcDNA. The transcription and expression of BDD-hFVIIIcDNA were found to exist in the liver and kidneys of all transgenic mice. HFVIII:Ag in plasma of the transgenic F0 progeny was 31.95 ng/ml, 23.52 ng/ml and 26.36 ng/ml respectively, whilst the F1 transgenic mice showed results of 18.82 ng/ml and 12.16 ng/ml. Anti-hFVIII inhibitors were negative in both F0 and F1 progeny. CONCLUSIONS: Human FVIII gene transgenic mice can be produced by the SMGT technique and express human FVIII protein in their bodies.

Migration of a swallowed toothpick into the liver: the value of multiplanar CT.

Foreign body ingestion is not an uncommon problem encountered in clinical practice. However, the associated complication of bowel perforation and migration of the foreign body to the liver is rare. We report two cases of hepatic foreign bodies identified intra-operatively as toothpicks, with the alimentary tract being the presumed origin.