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Objective:To investigate the correlation of central compartment lymph node metastasis(CLNM) in stage T 1a solitary papillary thyroid carcinoma (PTC) with the clinicopathological characteristics, sonographic features and the number of lymph node dissection, and to analyze the risk factors of CLNM. Methods:The data of 218 patients with stage T 1a solitary PTC who underwent thyroid cancer surgery from January 2017 to May 2021 in Tangshan Union Medical College Hospital were retrospectively analyzed. All patients were divided into CLNM positive group and CLNM negative group according to CLNM. The age, gender, preoperative sonographic features, pathological type, the number of lymph node dissection and the number of metastasis were recorded. Logistic regression was used to analyze the risk factors of CLNM. Results:Among 218 patients, there were 71 cases (32.6%) in CLNM positive group and 147 cases (67.4%) in CLNM negative group. There were statistically significant differences in age, tumor diameter, capsular invasion in thyroid or not, tumor blood supply or not, and the number of lymph node dissection between two groups (all P < 0.05). There were no statistically significant differences in gender, clear tumor boundary or not, tumor shape, tumor aspect ratio, calcification, nodular goiter and Hashimoto's thyroiditis or not (all P > 0.05). Multivariate binary logistic regression analysis showed that age < 55 years ( OR = 2.995, 95% CI 1.228-7.307), capsular invasion in thyroid ( OR = 5.297, 95% CI 2.494-11.248) and the number of lymph node dissection ≥6 ( OR = 4.085, 95% CI 2.059-8.104) were independent risk factors of CLNM (all P < 0.05). Conclusions:Patients with stage T 1a solitary PTC, age < 55 years and capsular invasion in thyroid are prone to CLNM; sufficient number of lymph node dissection can get more accurate CLNM rate.
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Objective:To explore the reasons for delayed medical treatment in diabetic foot patients using the health ecology model as a framework.Methods:From November of 2021 to March of 2022, descriptive phenomenological research methods was used in 20 patients with diabetic foot who delayed medical treatment were interviewed face-to-face semi-structured in depth, and the data analysis was carried out using the seven-step method of Colaizzi phenomenology to refine the theme.Results:According to the five levels of the health ecology model, the reasons for delayed medical treatment were summarized into 11 themes, and the reasons for the personal trait layer included foot ulcers are not detected promptly, and the perceptual decline of advanced patients. Behavioral characteristics included lack of knowledge of diabetic foot, negative medical psychology. Reasons for the interpersonal network included insufficient family support and lack of social support; reasons for living and working conditions included high economic pressure, low electronic health literacy, and inconvenient medical treatment; the reasons for the policy environment included uneven medical insurance reimbursement ratios and limited medical conditions.Conclusions:The reason for the delay in seeking medical treatment for diabetic foot patients is multi-layered and systematic, and medical staff need to improve the self-management ability of diabetic patients′ feet from the individual level, and also need to guide patients from the system level on how to obtain the best medical resources.
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Objective To explore the correlation between lipoprotein a (Lpa),fibrinogen (FIB) and D-dimer (D-D) and vascular cognitive impairment in patients with ischemic cerebral small vessel diseases (CSVD).Methods Totally 300 patients with ischemic CSVD who were admitted to the Department of Neurology,Affiliated Hospital of North China University of Science and Technology were selected as the research objects,and 70 healthy outpatients in the same period were selected as the control group.Cognitive function was assessed with Mini Mental State Examination (MMSE).According to the results of MMSE,patients with ischemic CSVD were divided into cognitive normal group (106 cases) and cognitive impairment group (194 cases).The cognitive impairment group was further divided into mild cognitive impairment group (100 cases),moderate cognitive impairment group (60 cases) and severe cognitive impairment group (34 cases).Lpa level was detected by latex immunoturbidimetry,FIB level by coagulation and D-D level by ELISA.The results were compared and analyzed.Results (1) Compared with the control group (Lpa:(101.67±37.37) rmg/L,FIB:(3.02±0.67) g/L,D-D:(231.49±95.00) mg/L),the levels of Lpa,FIB and D-D in normal group (Lpa:(150.58± 89.55) mg/L,FIB:(3.48 ± 0.80) g/L,D-D:(287.79± 125.25)mg/L) and cognitive impairment group (Lpa:(257.98 ± 189.23) mg/L,FIB:(3.86± 0.97) g/L,D-D:(347.23± 120.69) rmg/L)increased significantly (all P＜0.01).Compared with the cognitive normal group,the levels of Lpa,FIB and D-D in cognitive impairment group increased significantly (all P＜0.01).(2)Compared with mild cognitive impairment group (Lpa:169.08±51.63 mg/L,FIB:(3.10±0.69)g/L,D-D:(288.91±92.58) mg/L),the levels of Lpa,FIB and D-D of in moderate cognitive impairment group (Lpa:(236.78± 107.15) mg/L,FIB:(3.52±0.67) g/L,D-D:(345.03± 132.68) mg/L),severe cognitive impairment group (Lpa:(292.65±108.19) mg/L,FIB:(4.04±1.08) g/L,D-D:(401.58±84.87) mg/L)increased significantly (all P＜0.01).Compared with the moderate cognitive impairment group,the levels of Lpa,FIB and D-D in the severe cognitive impairment group increased significantly (all P＜0.01).(3) The ROC curve was fitted with cognitive impairment as state variable.The area under the ROC curve of Lpa was 0.706,P＜0.01,95％ CI was (0.646-0.766),the area under the ROC curve of FIB was 0.613,P=0.001,95％ CI was (0.548-0.679),and the area under the ROC curve of D-D was 0.670,P＜0.01,95％ CI was (0.604-0.736).(4) Lpa,FIB and D-D were positively correlated with the degree of cognitive impairment in patients with ischemic cerebral small vessel diseases (rLpa =0.522,P＜0.01;rFIB =0.410,P＜0.01;rD-D =0.488,P＜0.01).Conclusion Serum Lpa,FIB and D-D are closely related to the degree of vascular cognitive impairment and cognitive impairment in patients with ischemic CSVD,which may be involved in the occurrence and development of cognitive impairment.Detection of serum levels of Lpa,FIB and D-D is of great clinical value in the early diagnosis,assessment and treatment of cognitive impairment in ischemic CSVD.
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A simple assay for detection of phospholipase C (PLC) activity was developed based on a fluorescence liposome probe using the Liss Rhod PE-loaded phospholipid liposomes.The liposome probe was prepared by the coassembly of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) and fluorescent lipid (Liss Rhod PE).The probe showed very low background fluorescence due to fluorescence self-quenching effect of Liss Rhod PE.As the PLC enzyme selectively digested lipid, the Rhod fluorescence was recovered from its quenched state, leading to the sensitive detection of PLC.This assay provided a limit of detection (at a signal-to-noise ratio of 3) of 2 U/L for PLC.In the presence of PLC inhibitor, the fluorescent response of the sensor for PLC decreased, indicating that the assay could also be used for screening PLC inhibitors.
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OBJECTIVE To investigate the effects of lead exposure on the permeability,secretion and transportation function of blood-cerebro-spinal fluid barrier (BCB)of rats in order to provide the theo-rical basis for elucidating the mechanis m of lead induced neurotoxicity.MEHTODS 60 SPF SD rats were rando mly divided into 4 groups,including a control group and three doses lead exposed groups. Rat in the lead exposure groups were given drinking water containning 0.05%,0.1 % and 0.2% lead acetate (at dose of 80,160,320 mg·kg -1 )for 8 weeks.Laser scanning confocal microscopy was uti-lized to determine the lead content in seru m,cerebrospinal fluid (CSF)and choroid plexus sa mples. Morris maze was used to test learning and me mory.Fe moral artery perfusion of Evans blue (EB)and fluorescein sodiu m (NaFI)was performed to measure BCB permeability function.Confocal laser scan-ning was applied to detect junction adhesion molecule (JAM)and occludin protein expression in choroid plexus.ELISA was used to measure the concentration of transthyretin (TTR)and leptin in seru m and CSF.RESULTS The lead content in seru m,choroid plexus and CSF significantly increased,especially the lead level in CSF.Morris water maze data showed that escape latency of rat in lead acetate 160 and 320 mg·kg -1 group were 52 ±12,(89 ±19)s,respectively,longer than that of control group 〔(28 ±7)s, P<0.05〕.The ti mes across platform of rats in lead acetate 160 and 320 mg·kg -1 group were lower than that of control group(P <0.05).The NaFI content in CSF of rats in all lead acetate exposure groups were 0.94 ±0.09,1 .02 ±0.03 and (1 .08 ±0.18)mg·L -1 ,respectively,and were higher than those of control group〔(0.74 ±0.04)mg·L -1 〕;While the EB content in CSF of rat in lead acetate 160 and 320 mg·kg -1 group were higher than the control group(P <0.05),which indicated that lead acetate exposure at low dose can lead to the increase of permeability of BCB.Laser scanning confocal micro-scope i mages showed that the JAM protein expression of choroid plexus in lead acetate 160 and 320 mg·kg -1 group were 44.9% and 42.9% of the control group.Sa me decline was seen in terms of occludin expression.The TTR content of CSF of rats in lead acetate 80 mg·kg -1 group was (32.3 ± 1 1 .7)ng·g -1 protein,lower than that of the control group,and the difference was significant.This decline was also noted in lead acetate 160 and 320 mg·kg -1 group.The data of TTR in CSF suggested that the low dose lead acetate exposure can disrupt the BCB secretion function.The leptin levels in CSF of lead acetate 160 and 320 mg·kg -1 group were lower than that in the control group (P <0.05 ). CONCLUSION Lead exposure did disrupt the permeability,transportation and secretion function of BCB.Our data suggest that BCB dysfunction might be involved in the mechanis m of lead induced neurotoxicity.
