A retrospective comparative study between robotic thyroidectomy through transoral vestibular approach and bilateral breast-axillary approach / 中华外科杂志

Objective: To compare the surgical outcome of robotic thyroidectomy through transoral approach and the bilateral breast-axillary approach. Methods: Retrospective analysis was made on the clinical data of patients who performed transoral robotic thyroidectomy (TORT group) or bilateral breast-axillary approach (BABA group) in the Department of Thyroid and Breast Surgery, the 960th Hospital of People's Liberation Army from July 2020 to May 2022. Both groups received lobectomy with lymph node dissection of the central region. A total of 100 cases were included in the study, including 48 cases in the TORT group and 52 cases in the BABA group. The propensity score matching method was used for 1∶1 matching of patients between the 2 groups, with a match tolerance of 0.03. There were 31 patients in each group successfully matched. In the TORT group, there were 5 males and 26 females, aged (33.2±7.9) years (range: 21 to 53 years). While there were 4 males and 27 females in the BABA group, aged (34.6±9.2) years (range: 19 to 58 years). The t test, Mann-Whitney U test, χ2 test or Fisher exact test were used to compare the clinical efficacy between the two groups. Results: All the patients successfully completed robotic thyroid surgery without conversion to open surgery. Compared with BABA group, the TORT group had longer operation time ((211.3±57.2) minutes vs. (126.2±37.8) minutes, t=6.915, P<0.01), shorter drainage tube retention time ((5.4±1.0) days vs. (6.4±1.2) days, t=-3.544, P=0.001), shorter total hospital stay ((6.6±1.2) days vs. (7.4±1.3) days, t=-2.353, P=0.022), and higher cosmetic score (9.46±0.25 vs. 9.27±0.26, t=2.925, P=0.005). There was no significant difference between the two groups in the number of lymph nodes dissection, metastasis in the central compartment, and the incidence of postoperative complications (all P>0.05). Conclusions: Compared with the bilateral breast-axillary approach, the transoral vestibular approach of robotic thyroidectomy is also safe and effective. It shows similar surgical results to the bilateral breast-axillary approach in strictly selected patients, but the postoperative recovery speed is much faster, and the hospital stay is shorter. Transoral robotic thyroidectomy is a more recommended surgical method for patients with high aesthetic demand.

Comparison of different timing of empirical antifungal strategy in febrile neutropenic children with acute leukemia / 中国小儿急救医学

Objective:To compare the clinical value of early and deferred empirical antifungal strategies in febrile neutropenic children with acute leukemia.Methods:A total of 101 cases of febrile neutropenic children with acute leukemia hospitalized in Qilu Hospital of Shandong University from January 2019 to June 2021 were divided into two groups according to different empirical antifungal strategies.There were 41 cases in early group in which antifungal therapy was given within 4 days of fever, and 60 cases in deferred group in which antifungal therapy was not given within 4 days of fever.Outcomes such as time to stable defervescence, positive diagnosis rate of invasive fungal disease, incidence of severe pneumonia, rate of transference to PICU, exposure time and costs of antifungal agents, and infection-related hospitalization days were compared between two groups.Results:There were no significant differences in time to stable defervescence[5 (4, 7) days vs.5 (3, 7) days, P=0.986], positive diagnosis rate of invasive fungal disease[9.8%(4/41) vs.8.3%(5/60), P=1.000], incidence of severe pneumonia[19.5%(8/41) vs.10.0%(6/60), P=0.174], and rate of transference to PICU[2.4%(1/41)vs.0(0/60), P=0.406] between two groups.Exposure time of antifungal agents was longer in early group than that in deferred group[10 (6, 12)days vs.0 (0, 6)days, P<0.001]. Costs of antifungal agents were higher in early group than those in deferred group[0.78(0.51, 0.95)ten thousand yuan vs.0(0, 0.44)ten thousand yuan, P<0.001]. Infection-related hospitalization days were longer in early group than those in deferred group[16 (10, 21) days vs.9(6, 13)days, P<0.001]. Conclusion:For febrile neutropenic children with acute leukemia, clinical effect of early empirical antifungal strategy is not superior to that of deferred empirical antifungal strategy.Pediatricians should make reasonable antifungal decisions according to overall situation of patients.

Circular RNA_CNST Promotes the Tumorigenesis of Osteosarcoma Cells by Sponging miR-421.

Circular RNAs (circRNAs) act crucial roles in the progression of multiple malignancies including osteosarcoma (OS). But, the underlying mechanisms by which hsa_circ_0017311 (circCNST) contributes to the tumorigenesis of OS remain poorly understood. Our present study aimed to explore the role and mechanisms of circCNST in OS tumorigenesis. The differentially expressed circRNAs were identified by the Gene Expression Omnibus database. The association of circCNST with clinicopathological features and prognosis in patients with OS was analyzed by RNA fluorescence in situ hybridization (FISH) and quantitative real-time polymerase chain reaction (PCR) analysis. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), colony formation assays, and a xenograft tumor model were conducted to assess the role of circCNST in OS cells in vitro and in vivo. CircCNST-specific binding with miR-421 was confirmed by FISH, luciferase gene report, and RNA immunoprecipitation assays. As a result, we found that the expression levels of circCNST were dramatically increased in OS tissues and cell lines as compared with the adjacent normal tissues, and it was associated with tumor size and poor survival in OS patients. Knockdown of circCNST repressed cell viability, colony formation, and xenograft tumor growth, while restored expression of circCNST reversed these effects. Furthermore, circCNST was colocalized with miR-421 in the cytoplasm and acted as a sponge of miR-421, which attenuated circCNST-induced proliferation-promoting effects in OS cells by targeting SLC25A3. In conclusion, our findings demonstrate that circCNST promotes the tumorigenesis of OS cells by sponging miR-421, and provides a potential biomarker for patients with OS.

Diagnostic value of optic disc retinal nerve fiber layer thickness for diabetic peripheral neuropathy / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#To investigate the value of optic disc retinal nerve fiber layer (RNFL) thickness in the diagnosis of diabetic peripheral neuropathy (DPN).@*METHODS@#Ninety patients with type 2 diabetes, including 60 patients without DPN (NDPN group) and 30 patients with DPN (DPN group), and 30 healthy participants (normal group) were enrolled. Optical coherence tomography (OCT) was used to measure the four quadrants and the overall average RNFL thickness of the optic disc. The receiver operator characteristic curve was drawn and the area under the curve (AUC) was calculated to evaluate the diagnostic value of RNFL thickness in the optic disc area for DPN.@*RESULTS@#The RNFL thickness of the DPN group was thinner than those of the normal and NDPN groups in the overall average ((101.07± 12.40) µm vs. (111.07±6.99) µm and (109.25±6.90) µm), superior quadrant ((123.00±19.04) µm vs. (138.93±14.16) µm and (134.47±14.34) µm), and inferior quadrant ((129.37±17.50) µm vs. (143.60±12.22) µm and (144.48±14.10) µm), and the differences were statistically significant. The diagnostic efficiencies of the overall average, superior quadrant, and inferior quadrant RNFL thicknesses, and a combined index of superior and inferior quadrant RNFL thicknesses were similar, and the AUCs were 0.739 (95% confidence interval (CI) 0.635-0.826), 0.683 (95% CI 0.576-0.778), 0.755 (95% CI 0.652-0.840), and 0.773 (95% CI 0.672-0.854), respectively. The diagnostic sensitivity of RNFL thickness in the superior quadrant reached 93.33%.@*CONCLUSIONS@#The thickness of the RNFL in the optic disc can be used as a diagnostic method for DPN.

Ultrasound-guided angioplasty in treatment of lower extremity arteriosclerosis obliterans in patients with relative contraindications for DSA / 中国介入影像与治疗学

Objective: To explore the clinical value of ultrasound-guided treatment of lower extremity arteriosclerosis obliterans (ASO) in patients with relative contraindications of DSA. Methods: Eighteen not suitable for DSA patients with lower extremity ASO (evolving 20 arteries) were enrolled and treated with ultrasound-guided endovascular interventional therapy. Peak systolic velocity (PSV) was detected before and 24 hours, 3 months, 6 months, 12 months and 24 months after treatment. Statistical analysis was performed to evaluate the total recurrence rate of stenosis and occlusion of the arteries. Results: Among 20 evolved lower extremity arteries, complete occlusion and severe stenosis (the stenosis rate ranged from 70% to 99%) were found in 15 and 5 arteries, respectively. The success rate of ultrasound-guided balloon angioplasty was 40.00% (8/20), while of stent placement was 100% (12/12). There was significant difference of PSV among preoperative and all postoperative time points (F=4.26, P=0.046). Significant differences of PSV were observed between before operation and each time point after operation, 12 months and 24 months after operation compared with 24 hours after operation (all P<0.05). The total recurrence rate at 24 hours, 3 months, 6 months, 12 months and 24 months after operation was 0, 5.00% (1/20), 10.00% (2/20), 20.00% (4/20) and 50.00% (10/20), respectively. Conclusion: Ultrasound-guided endovascular interventional therapy plays an important role for treatment of lower extremity ASO in patients with relative contraindications of DSA.

Construction of type Ⅰ collagen nerve conduit and its mechanism of action in reconstruction of median nerve injury of the forearm / 中国组织工程研究

BACKGROUND: Type I collagen is a polymer material that has good biocompatibility and good cell affinity, and can degrade under certain conditions. It can also develop good mechanical properties after cross-linking, but it is less reported in the reconstruction of the injured median nerve of the forearm. OBJECTIVE: To explore the preparation method of type I collagen nerve conduit and its mechanism in the reconstruction following median nerve injury in the forearm. METHODS: A total of 40 Sprague-Dawley rats were selected from the Medical Animal Experimental Center, the Affiliated Hospital of Guizhou Medical University, 10 of which were randomly selected as sham surgery group. The remaining 30 rats were used to establish a rat model of median nerve injury in the forearm by laser-induced photochemical reaction. After successful modeling, the model rats were randomly divided into positive control group (n=10), type I collagen group (n=10) and autologous nerve group (n=10). The sham surgery group was routinely fed and did not participate in the modeling; the positive control group did not take special treatment after the successful modeling; the type I collagen group was subjected to bridging with type I collagen nerve conduit; and the autologous nerve group was subjected to bridging with autologous nerve. The repair effects were compared among groups. RESULTS AND CONCLUSION: (1) Under the inverted microscope, the type I collagen was loosely arranged before cross-linking, and it had honeycomb-shaped irregular pores with the pore size of 10-100 μm and the porosity of 20-200 μm, and the pore interstitial was relatively thin. After cross-linking, the type I collagen was densely arranged, the collagen fibers could form relatively regular pores with the pore size of 50-100 μm and the porosity of 20-200 μm, the interstitial mass was thickened, and the spatial structure changed significantly. (2) After 4, 8 and 12 weeks of repair, the scores on the Minnesota Manual Dexterity Test in the type I collagen and autologous nerve groups were significantly lower than those in the positive control group (P < 0.05) and higher than those in the sham surgery group (P < 0.05). (3) At 12 weeks after repair, there was no significant difference in amplitude and latency between the type I collagen group and the autologous nerve group (P> 0.05), but the amplitude and latency in both groups were significantly higher than those in the positive control group (P < 0.05). (4) At 12 weeks after repair, the nerve injury site surrounded by necrotic tissues was visible in the positive control group; no injury was found in the autologous nerve group, and the surrounding necrotic area decreased, indicating good recovery; no injury was shown by toluidine blue staining in the type II collagen group, indicating good recovery. Overall, the type I collagen nerve conduit can be successfully prepared by the self-made mold, and it can be used for the reconstruction following median nerve injury in the rat forearm, helping nerve repair.

Ultrasonic appearances and misdiagnosis analysis of intrascrotal adenomatoid tumors / 中国医学影像技术

Objective To investigate the sonographic features and to analyze misdiagnosis causes of intrascrotal adenomatoid tumors.Methods Preoperative sonographic data of 15 patients confirmed as intrascrotal adenomatoid tumor by surgery and pathology were retrospectively analyzed.Compared with pathological results,the sonographic features and the misdiagnosis causes were analyzed.Results Among 15 patients,the tumors located at the tail of epididymis in 8 patients,at the head of epididymis in 5 patients and within the testis in 2 patients.The lesions were misdiagnosed as inflammatory diseases in 3 patients,as cysts in 3 and as malignant tumors in 2 patients,while in the others were indeterminate.Solid tumors were detected with ultrasound in 12 patients,while cystica in 3 patients.Among 12 patients with solid tumors,lesions in 7 patients had clear boundary and regular shape,while the boundary in the rest 5 patients were less clear.The internal echo was homogeneous in 6 patients and inhomogeneous in the rest 6 patients with echoless and punctate hyperecho.Cystic mass was characterized by polycystic with isolation belt.Among 15 patients of intrascrotal adenomatoid tumor,detectable blood flow signals were found in 8 patients,while no obvious blood flow signals were found in the rest 7 patients.Conclusion Ultrasonic features of intrascrotal adenomatoid tumor were less characteristic.Combination of clinical information and other imaging findings might help to decrease misdiagnosis.

Ultrasonographic quantitative evaluation of thyroid nodule capsular reaction / 中国医学影像技术

Objective To quantitatively observe the value of relationship between nodule and corresponding capsular with ultrasonography in assessment of malignant and benign thyroid nodules.Methods A total of 79 cases with subcapsular tumors of thyroid gland confirmed pathologically were analyzed retrospectively,and the relationship between tumors and capsule was analyzed.Longitudinal diameter of nodules (from the junction of nodule and capsule to the deepest of nodule,V) and distance from nodule protruding thyroid capsule to the highest point of nodule (L) were measured,and L/V was evaluated.Diagnostic efficiency of L/V in diagnosis of malignant thyroid nodule was evaluated.Results The average L/V of benign and malignant nodules was 0.241± 0.041 and 0.162± 0.054,respectively (t=-7.367,P＜0.01).The area under ROC curve of L/V in diagnosis of benign and malignant thyroid nodules was 0.87 (P＜0.01).When L/V=0.225,the sensitivity was 82.17％,and the specificity was 87.53％;when L/V=0.245,the sensitivity was 67.10 ％,and the specificity was 95.12％.Conclusion Ultrasonography can clearly show the relationship between thyroid nodules and capsule,and L/V can be used for differential diagnosis of benign and malignant thyroid nodules.

Effects of Coptis chinensis decoction on the metabolic index and renal protection in rats with metabolism syndrome / 解放军医学杂志

Objective To investigate the protective effects of Coptis chinensis decoction on the metabolic index and renal function of rats with fructose-induced metabolism syndrome (MS).Methods From 56 male Wistar rats,6 were randomly selected as normal control group,the other rats were daily fed with 10％ fructose water for 8 weeks to reproduce the MS model.Twenty-four rats were established successfully as MS model and randomly divided into 4 groups (6 each):model group,Coptis decoction group,tauroursodeoxycholic acid (TUDCA) group and berberine hydrochloride (BH) group.The body weight,visceral fat weight,fasting blood glucose (FBG),fasting insulin (FINS),insulin resistance index (HOMA-IR),cholesterol (TC),triglyceride (TG),systolic blood pressure (SBP),diastolic blood pressure (DBP),urinary N-acetyl-β-D-glucosidase (NAG),urine microalbumin (m-ALB),blood urea nitrogen (BUN) and serum creatinine (Scr) levels were compared between the groups,and the renal pathological changes were observed by light microscopy and electron microscopy.Results The levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP,DBP and urinary NAG were obviously higher in the four MS model groups than in normal control group (P＜0.05),while the levels of m-ALB,BUN and Scr showed no significant difference (P＞0.05).After the intervention,the levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP and DBP decreased significantly in Coptis decoction group than in model group (P＜0.05).Compared with BH group and TUDCA group,the levels of FINS and HOMA-IR decreased obviously in Coptis decoction group (P＜0.05),while the levels of body weight,TC,TG,SBP,DBP,urinary NAG,BUN and Scr showed no significant difference (P＞0.05).It was observed in model group by light microscopy and electron microscopy that the glomerular swelled obviously,the capillary basement membrane of glomerular and renal tubules thickened,mesangial region and interstitial substances hyperplasia,podocytes swelled markedly and most of fusion,the epithelial cells of renal tubules serious vacuolar degeneration,and a lot of secondary lysosomes formed,autophagy of organelles occurred,and most of endoplasmic reticulum and mitochondria disappeared.The kidney pathological damage reduced obviously after treatment of Coptis decoction,but no significant difference when compared with that in BH group and TUDCA group.Conclusions Coptis decoction may decrease the body weight,reduce the levels of blood lipid and blood pressure,and better improve the insulin resistance when compared with BH and TUDCA.In addition,Coptis decoction can also reduce the renal pathological damage,and has the protective function for kidney.

Preparation of silk fibroin/nano-hydroxypatite composite scaffold and its treatment outcomes in spinal fusion / 中国组织工程研究

BACKGROUND:Silk fibroin, as an inorganic mineralization template, can induce hydroxyapatite crystal growth, and combined with nano-hydroxyapatite can simulate the inorganic and organic components of natural bone, which is expected to become the most ideal bone graft material. OBJECTIVE:To prepare the silk fibroin/nano-hydroxyapatite composite material and investigate its treatment outcomes in spinal fusion. METHODS:Silk fibroin/nano-hydroxyapatite composite was synthesized by the co precipitation method with silk fibroin and calcium phosphate as raw materials, to simulate the structure and composition of the bone tissue. The crystal phase composition and microstructure of the composite scaffold were analyzed by X-ray diffraction and transmission electron microscope. Osteoblasts were seeded onto the composite, and the cel adhesion and proliferation were observed under inverted microscope. The lumbar posterolateral spinal fusion models were established in the New Zealand rabbits, fol owed by treated with autologous bone graft (control group) and composite (composite group), respectively. The gross, radiological and histological observations of bone fusion were compared between groups. RESULTS AND CONCLUSION:Silk fibroin/nano-hydroxyapatite composite appeared to be fascicular under electron microscope, the length was 200-500 nm and width was 20-30 nm. And the hydroxyapatite was about 200 nm in length and 50 nm in width. X-ray diffraction showed that the bottom of diffraction peak was wide, and the peak was not sharp. Transmission electron microscope found that cel s adhered wel onto the composite scaffold at 2 days. Scanning electron microscope showed that the polygonal, oval or conical cel s covered most of the composite scaffold holes, presented obvious mitotic phase at 5 days. The third generation of MC3T3-E cel s tended to rise at first 3 days, and then decreased. The fusion site of L5-6 transverse process was strong, and non-bony fusion occurred. At the same time, numerous new bones were visible in the composite group. Hematoxylin-eosin staining showed a large number of cel aggregation, abundant osteoblasts surrounding cartilage, and the bone tissues were in a regular arrangement in the composite group. Moreover, irregular trabecular bone with medul ary cavity was found in the composite material. These results suggest that the silk fibroin/nano-hydroxyapatite composite with the similar structure and composition of natural bone can achieve satisfactory fusion effect in the rabbit lumbar posterolateral fusion.

A rapid and cost-effective method for genotyping apolipoprotein E gene polymorphism.

BACKGROUND: Apolipoprotein E (ApoE) is a major cholesterol carrier and plays an important role in maintaining lipid homeostasis both in the periphery and brain. Human APOE gene is polymorphic at two single nucleotides (rs429358 and rs7412) resulting in three different alleles (ε2, ε3 and ε4). ApoE isoforms modulate the risk for a variety of vascular and neurodegenerative diseases; thus, APOE genotyping is crucial for predicting disease risk and designing individualized therapy based on APOE genotype. RESULTS: We have developed an APOE genotyping method that is based on allele-specific PCR methodology adapted to Real Time PCR monitored by TaqMan probe. Rather than using TaqMan probes specific for the two polymorphic sites, only one TaqMan probe is used as the polymorphic alleles are recognized by site-specific PCR primers. Each genotyping assay can be completed within 90 minutes and is applicable to high-throughput analysis. Using this protocol, we genotyped a total of 1158 human DNA samples and obtained a 100% concordance with the APOE genotype determined by sequencing analysis. CONCLUSION: The APOE genotyping assay we have developed is accurate and cost-effective. In addition, our assay can readily be applied to genotyping large sample numbers. Therefore, our APOE genotyping method can be used for assessing the risk for a variety of vascular and neurodegenerative diseases that have been reported to be associated with APOE polymorphism.

Biomechanics and stability of the spine after implantation with pedicle screw and cervical vertebral screw fixation / 中国组织工程研究

BACKGROUND:From the point of view of human anatomy, the load of the spine is more. When the body moves, the range of activities, and activity are relatively large. After screws were implanted in the spine, if biomechanical properties and stability are not up to the standard, it easily leads to lack of grip force of screw and screw loosening so as to increase the incidence of complications after treatment. OBJECTIVE:To compare biomechanical properties and stability of the spine after insertion of pedicle screw and cervical vertebral screw into the spine. METHODS:100 vertebrae under human cervical spine specimens were analyzed and randomly divided into cervical vertebral screw fixation group and pedicle screw fixation group. Cervical vertebral screws and pedicle screws were implanted in lower cervical spine specimens. Electro Force 3510 material testing machine was used to test axial pul-out force, axial pul-out strength after the fatigue loading, and fixed stability. The biomechanical properties and stability were compared after two kinds of screws were implanted in the spine. RESULTS AND CONCLUSION:(1) Instantaneous pul out force and immediate pul out stiffness were significantly higher in the pedicle screw fixation group than in the cervical vertebral screw fixation group (P<0.05). (2) Fatigue pul-out strength and fatigue pul-out stiffness did not have significant differences in both groups, but statistical analysis showed significant differences (P<0.05). Fatigue pul-out strength and fatigue pul-out stiffness were significantly higher in the pedicle screw fixation group than in the cervical vertebral screw fixation group. (3) These results suggested that pedicle screw fixation after implantation in the spine provides sufficient fixation stability, has better fatigue resistance, elevates instantaneous pul-out force and fatigue pul-out strength, and presents strong stability.

Biomechanical properties of lower anterior vertebral pedicle screw system and its effects on osteoporotic vertebral stability / 中国组织工程研究

BACKGROUND:Although the traditional surgical treatment can improve the symptoms of patients with senile osteoporotic vertebral fracture, the treatment easily produces bone graft fusion failure and pseudoarticulation formation and affects clinical effects. OBJECTIVE:To investigate biomechanical properties of anterior cervical pedicle screw and the effects on osteoporotic vertebral stability. METHODS:A total of 16 fresh cadaver cervical specimens contained 64 motion segments (C3-4, C4-5, C5-6 and C6-7). The 64 segments by the way of implantation were randomly divided into ordinary anterior locking screw fixation group and lower anterior vertebral pedicle screw system group (32 segments per group). The mechanical properties were determined on the biomechanical testing machine for each group. RESULTS AND CONCLUSION:(1) Biomechanics:Compared with the ordinary anterior locking screw fixation group, the maximum pul-out strength, screw path length, postoperative vertebral column height, the maximum surface strain, strain maximum and the range of maximum values were increased in the lower anterior vertebral pedicle screw system group (P<0.05). (2) Results suggest that compared with the ordinary anterior locking screw fixation group, lower cervical anterior pedicle screw required larger extraction force and was more stable for osteoporotic vertebrae.

Implant fixation with titanium alloy repairs spinal tuberculosis:its biocompatibility and mechanical properties / 中国组织工程研究

BACKGROUND:Currently, surgical implant fixation is mainly applied for spinal tuberculosis. How to choose implant materials, however, is stil under discussion.OBJECTIVE:To compare the biocompatibility and mechanical properties of titanium al oy and stainless steel for rabbit spinal tuberculosis. METHODS:Thirty rabbits were chosen to prepare spinal tuberculosis models. Then, the rabbits were equivalently randomized into two groups, which underwent implant fixation with stainless steel or titanium al oy, respectively. At 30 days after implantation, biocompatibility and biomechanical properties of the two materials in the repaired region of spine were observed and detected, respectively. RESULTS AND CONCLUSION:In view of the biocompatibility, infection and immunological rejection could not been found in the titanium al oy group;in contrast, infection appeared in three rabbits of the stainless steel group. Flexion, extension and lateral bending displacements under the spinal loading in the titanium al oy group were significantly less than those in the stainless steel group (P<0.05);axial pul-out strength in the titanium al oy group was significantly higher than that in the stainless steel group (P<0.05);flexion, extension, lateral bending and axial compression in the titanium al oy group were significantly greater than those in the stainless steel group (P<0.05). In conclusion, titanium al oy material has good biocompatibility that can be used to restore and maintain the spinal stability.

Comparative Study between Robotic Total Thyroidectomy with Central Lymph Node Dissection via Bilateral Axillo-breast Approach and Conventional Open Procedure for Papillary Thyroid Microcarcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A large proportion of the patients with papillary thyroid microcarcinoma are young women. Therefore, minimally invasive endoscopic thyroidectomy with central neck dissection (CND) emerged and showed well-accepted results with improved cosmetic outcome, accelerated healing, and comforting the patients. This study aimed to evaluate the safety and effectiveness of robotic total thyroidectomy with CND via bilateral axillo-breast approach (BABA), compared with conventional open procedure in papillary thyroid microcarcinoma.</p><p><b>METHODS</b>One-hundred patients with papillary thyroid microcarcinoma from March 2014 to January 2015 in Jinan Military General Hospital of People's Liberation Army (PLA) were randomly assigned to robotic group or conventional open approach group (n = 50 in each group). The total operative time, estimated intraoperative blood loss, numbers of lymph node removed, visual analog scale (VAS), postoperative hospital stay time, complications, and numerical scoring system (NSS, used to assess cosmetic effect) were analyzed.</p><p><b>RESULTS</b>The robotic total thyroidectomy with CND via BABA was successfully performed in robotic group. There were no conversion from the robotic surgeries to open or endoscopic surgery. The subclinical central lymph node metastasis rate was 35%. The mean operative time of the robotic group was longer than that of the conventional open approach group (118.8 ± 16.5 min vs. 90.7 ± 10.3 min, P < 0.05). The study showed significant differences between the two groups in terms of the VASs (2.1 ± 1.0 vs. 3.8 ± 1.2, P < 0.05) and NSS (8.9 ± 0.8 vs. 4.8 ± 1.7, P < 0.05). The differences between the two groups in the estimated intraoperative blood loss, postoperative hospital stay time, numbers of lymph node removed, postoperative thyroglobulin levels, and complications were not statistically significant (all P > 0.05). Neither iatrogenic implantation nor metastasis occurred in punctured porous channel or chest wall in both groups. Postoperative cosmetic results were very satisfactory in the robotic group.</p><p><b>CONCLUSIONS</b>Robotic total thyroidectomy with CND via BABA is safe and effective for Chinese patients with papillary thyroid microcarcinoma who worry about the neck scars.</p>

Evaluation of inapparent dengue infections during an outbreak in Southern China.

Few studies evaluating inapparent dengue virus (DENV) infections have been conducted in China. In 2013, a large outbreak of DENV occurred in the city of Zhongshan, located in Southern China, which provided an opportunity to assess the clinical spectrum of disease. During the outbreak, an investigation of 887 index case contacts was conducted to evaluate inapparent and symptomatic DENV infections. Post-outbreak, an additional 815 subjects from 4 towns with, and 350 subjects from 2 towns without reported autochthonous DENV transmission, as determined by clinical diagnosis, were evaluated for serological evidence of dengue IgG antibodies. Between July and November 2013, there were 19 imported and 809 autochthonous dengue cases reported in Zhongshan. Of 887 case contacts enrolled during the outbreak, 13 (1.5%) exhibited symptomatic DENV infection, while 28 (3.2%) were inapparent. The overall I:S ratio was 2.2:1 (95% CI: 1.1-4.2:1). Post-outbreak serological data showed that the proportion of DENV IgG antibody detection from the 4 towns with and the 2 towns without reported DENV transmission was 2.7% (95% CI: 1.6%-3.8%) and 0.6% (95% CI: 0-1.4%), respectively. The I:S ratio in the 3 towns where clinical dengue cases were predominately typed as DENV-1 was 11.0:1 (95% CI: 3.7-∞:1). The ratio in the town where DENV-3 was predominately typed was 1.0:1 (95% CI: 0.5-∞:1). In this cross-sectional study, data suggests a high I:S ratio during a documented outbreak in Zhongshan, Southern China. These results have important implications for dengue control, implying that inapparent cases might influence DENV transmission more than previously thought.

3D-printing microfludic device for breast cancer cell culture and pharmacological research / 中国药学杂志

OBJECTIVE: To develop a microfluidic mammalian cell culture device with human breast cancer cells co-cultured with extracellular matrix (ECM), reconstitute the 3-dimension human body microenvironment and preliminarily conduct drug screening on the breast cancer chip. METHODS: 3D Printing technology was utilized to build a two-layer microchip with cell culture reservoirs. The breast cancer cells (MCF7) were cultured in the matrix gel structure which mimiced the 3-dimension human body microenvironment. The cell toxicity of paclitaxel (PTX) on MCF7 cells was preliminarily observed using this microfluidic chip. With the use of AO/EB immunofluorescent staining and laser confocal microscopy, the cell death ratio induced by PTX was determined and compared with that determined by 2-dimension drug screening methods. RESULTS: MCF7 cells cultured on the chip successfully formed a 3D cavity structure in the matrix after 6-day dynamic incubation. The flow rate was 10 μL · h-1. After 24 h dynamic culture, the culture medium was changed to culture solution containing 0.02 μmol · mL-1 PTX, and the incubation was continued for 24 h. Obvious cell death was detected under laser confocal microscopy. CONCLUSION: The microfluidic chip developed in this study can successfully culture breast cancer cells in 3-dimension structure and perform drug screening, which lays a foundation for actualization of "human-on-a-chip".

Changes in renal tissue proteome induced by mesenteric lymph drainage in rats after hemorrhagic shock with resuscitation.

Kidney injury commonly occurs after hemorrhagic shock. Previous studies have shown that post-hemorrhagic shock mesenteric lymph (PHSML) return negatively affects the kidneys and may induce injury. This study investigates the effect of PHSML drainage on the proteome in renal tissue. A controlled hemorrhagic shock model was established in the shock and shock+drainage groups. After 1 h of hypotension, fluid resuscitation was implemented within 30 min. Meanwhile, PHSML was drained in the shock+drainage group. After 3 h of resuscitation, renal tissue was extracted for proteome analysis using two-dimensional fluorescence difference gel electrophoresis. Differential proteins with intensities that either increased or decreased by 1.5-fold or greater were selected for trypsin digestion and analyzed by matrix-assisted laser desorption/ionization time-of-flight (TOF) mass spectrometry and tandem TOF/TOF mass spectrometry. Enzyme-linked immunosorbent assay was used to validate the identified partial proteins. Compared with the sham group, hnRNPC and Starp decreased in the shock group, whereas Hadha, Slc25a13, Atp5b, hnRNPC, Starp, Rps3, and actin were downregulated in the shock+drainage group. Meanwhile, Atp5b and actin decreased in the shock+drainage group relative to the shock group. The identified proteins can be classified into different categories, such as cell proliferation (hnRNPC, Strap, and Rps3), energy metabolism (Hadha, Atp5b, and Slc25a13), cell motility, and cytoskeleton (actin). Moreover, enzyme-linked immunosorbent assay measurement validated the changed levels of Atp5b and Actg2. Our findings provide a starting point for investigating the functions of differentially expressed proteins in acute kidney injury induced by hemorrhagic shock. These findings hold great potential for the development of therapeutic interventions.

[Phosphorus availability in cropland soils of China and related affecting factors].

Soil phosphorus (P) availability directly determines cropland productivity. Based on the long-term fertilization experiments in different climatic zones of China, this paper summarized the P content, its availability, and the factors affecting the P transformation in China cropland soils. The total and available P contents in different types of China cropland soils were 0.31-1.72 g x kg(-1) and 0.1-228.8 mg x kg(-1), respectively. Soil parent material, soil physical and chemical prosperities, and fertilization practices were the main factors affecting the soil P availability. It was suggested that more attentions should be paid on the mixed application of organic manure and chemical fertilizers to improve the P availability of cropland soils and on the potential environmental impacts of this fertilization.

The expression and regulatory mechanism of microRNA-708 in pediatric common B-cell acute lymphoblastic leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the expression of microRNAs and reveal the regulatory mechanism of miRNA-708 in pediatric common acute lymphoblastic leukemia (ALL) (common-ALL).</p><p><b>METHODS</b>The expressions of microRNAs in common-ALL patients were detected by microarrays in 3 pediatric common-ALL samples, and then verified by stem-loop quantitative RT-PCR in 34 common-ALL samples. The target genes of miR-708 were found by bioinformatics software, and verified by dual-luciferases reporter assay, RT-PCR and Western blot.</p><p><b>RESULTS</b>Compared to normal bone marrow samples, of all the 2006 detected miRNAs, the expression of miR-708, miR-181b and miR-210 were 16.886 ± 16.854, 5.710 ± 4.652, and 9.789 ± 1.178, retrospectively, being significantly up-regulated expressed than those in normal control (1.872 ± 0.339, 1.276 ± 0.531 and 1.005 ± 0.080, retrospectively) (P < 0.05), while miR-27b and miR-345 were the two most down-regulated ones (0.524 ± 0.085 and 0.675 ± 0.086, retrospectively) (normal control: 1.123 ± 0.066 and 1.204 ± 0.140, retrospectively) (P < 0.05). And the expression of miR-708 and miR-181b were significantly correlated with the clinical types in common-ALL. In high risk common-ALL, miR-708 and miR-181b were much higher than in standard and middle risk common-ALL (P < 0.05). The further verification research in 293 cell line showed that miR-708 decreased the expression level of its target genes CNTFR, NNAT and GNG12 by combining with 3'-UTR of the 3 genes, moreover, miR-708 combined with CNTFR 3'-UTR in 394 ∼ 400 bp sequence region.</p><p><b>CONCLUSION</b>MicroRNAs plays an important regulatory role during the occurrence and development of the pediatric common-ALL and miR-708 is an important factor for high risk common-ALL.</p>