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1.
Sci Total Environ ; 733: 139383, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32446090

RESUMO

Perfluoroalkyl substances (PFASs) are of particular environmental concern due to their environmental persistence and potential toxicity. Phytoremediation may be used to remove PFASs from wastewater. Here we investigated the uptake mechanism, subcellular distribution, and uptake process of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate acid (PFOS) in the wetland plant Alisma orientale by using a series of hydroponic experiments. Active uptake facilitated by water transporters and anion channels was involved in the uptake of PFASs by plant roots. PFOA and PFOS were mainly distributed in the water-soluble fraction (46.2-70.8%) and in cell walls (45.6-58.4%), respectively. The uptake process was proposed as follows: PFOS and PFOA were first distributed in the soluble fraction; a proportion of PFOS and PFOA were adsorbed gradually by the cell wall, and a proportion of PFOS and PFOA in the cell wall passed through the cell wall and plasmalemma and bind with organelles. PFOS and PFOA were transported from the external solution to the vascular bundle of the plant root through both symplastic and apoplastic routes.

2.
Int J Biol Macromol ; 158: 1047-1054, 2020 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-32353507

RESUMO

Gleditsia sinensis, fenugreek and guar galactomannans (referred to as GSG, FG, and GG) were extracted from their gums and investigated using various techniques. Mannose to galactose ratios were 3.55, 1.11, and 1.65, respectively. The intrinsic viscosity of GSG was very close to that of GG, while that of FG was the lowest one. This was attributed to the influence of high galactose substitution of FG on the mannan backbone, which induced a lower chain dimension due to intermolecular entanglement. High degrees of substitution and high temperatures contributed to improving the solubility of galactomannan. Rheological behavior indicated that GG had the highest apparent viscosity, yet the power-law model could well-fitted the flow curves of GSG and FG, but not GG. Through morphological observations, the extracted galactomannans exhibited rod-like structure in deionized water and showed fibrous filament network structure after dehydration by freeze-drying. The thermal behavior was greatly influenced by the degree of side groups and Mw of galactomannans.

3.
Ultrason Sonochem ; 67: 105117, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32283493

RESUMO

In order to evaluate the effect of ultrasound to chitinase from a molecular level, atomic force microscopy (AFM) was employed to investigate the interaction force of chitinase binding onto chitin surface. In the measurement of force-distance curve, a series of pull-off events were discovered using the immobilized AFM tips with chitinase either treated by ultrasound or not, whereas no interaction peak was observed by the AFM tips without chitinase, indicating that the obtained adhesion forces were coming from the binding functions between chitinase and chitin. Through the analysis of these force curves, at the loading velocity of 0.3 µm/s, the maximum binding force of the chitinase treated by ultrasound for 20 min onto chitin was measured to be 105.33 ± 23.51 pN, while the untreated onto chitin was 71.05 ± 12.73 pN, suggesting the stronger binding force between ultrasonic treated chitinase and chitin substrate. Therefore, AFM has provided a useful method to directly and quantitatively characterize the interactions between chitinase and chitin, and successfully proved that ultrasound could activate chitinase by enhancing the binding ability of chitinase onto chitin.

4.
J Cell Mol Med ; 24(10): 5629-5639, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32285621

RESUMO

There is increasing evidence that vitamin D deficiency is the risk factor for multiple diseases, such as immune disorder, cardiovascular disease and cancer. Calcitriol is the active form of vitamin D with beneficial effects on anti-cancer by binding vitamin D receptor (VDR). The primary aim of this study was to investigate the role of Calcitriol on papillary thyroid carcinoma (PTC) and explore the possible mechanism. We found nuclear VDR expression in PTC samples was negatively correlated with STAT3 hyperphosphorylation that indicated worse PTC clinicopathologic characteristics. Calcitriol treatment up-regulated VDR and protein tyrosine phosphatase N 2 (PTPN2) expression, down-regulated signal transducers and activators of transcription (STAT3) phosphorylation and thereby facilitating chemotherapy drug Doxorubicin-induced apoptosis in PTC cell lines. However, the apoptosis-promoting effect of Calcitriol and Doxorubicin co-treatment was abrogated by STAT3 hyperphosphorylation, indicating suppression of STAT3 phosphorylation was essential for combined treatment of Calcitriol and Doxorubicin in PTC. Together, these results suggested that Calcitriol reinforced the sensitivity of PTC cells to Doxorubicin by regulating VDR/PTPN2/p-STAT3 signalling pathway.

5.
ChemSusChem ; 2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32311230

RESUMO

Developing an efficient and easy-to-handle strategy in designing catalysts for CO2 reduction into CO by harnessing sunlight is a promising project. Here, a facile strategy was developed to design a Re catalyst modified with an ionic secondary coordination sphere for photoreduction of CO2 to CO by visible light. By adding ionic liquids or tuning a different ionic secondary coordination sphere, it was discovered that an outstanding optical property, other than CO2 absorption ability or the ability to dissociation of chloride anion, is the prerequisite for catalyst design. Accordingly, a novel Re catalyst, {Re[BpyMe(tris(2-hydroxyethyl)amine)](CO)3 Cl}Br (Re-THEA), was designed, screened, and resulted in a relative high quantum yield (up to 34 %) for visible-light-induced CO2 reduction with a single-molecule system. DFT calculations, combined with experimental outcomes, suggested the pendant ionic tris(2-hydroxyethyl)amino (THEA) group on Re-THEA can enhance visible-light absorption, stabilize reaction intermediates, and suppress the Re-Re dimer formation.

6.
J Biol Inorg Chem ; 25(4): 597-607, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32232583

RESUMO

Cyclometalated iridium(III) complexes represent a promising approach to developing new anticancer metallodrugs. In this work, three phosphorescent cyclometalated iridium(III) complexes Ir1-Ir3 have been explored as mitochondria-targeted anticancer agents. All three complexes display higher antiproliferative activity than cisplatin against the cancer cells screened, and with the IC50 values ranging from 0.23 to 5.6 µM. Colocalization studies showed that these complexes are mainly localized in the mitochondria. Mechanism studies show that these complexes exert their anticancer efficacy through initiating a series of events related to mitochondrial dysfunction, including depolarization of mitochondrial membrane potential (MMP), elevation of intracellular reactive oxygen species (ROS) levels, and induction of apoptosis. Mitochondria-targted cyclometalated iridium complexes induce apoptosis through depolarized mitochondria, elevation of intracellular ROS and activated caspase.

7.
Dalton Trans ; 49(11): 3562-3569, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32123890

RESUMO

The combination of chemotherapeutic and photodynamic activities in an iridium-based molecular compound is less reported. Herein, two iridium complexes (IrC1 and IrC2) with ß-carboline alkaloid ligands were designed and synthesized. Both complexes exhibited high anticancer activities with IC50 values of around 1 µM in the dark against several cell lines tested. Notably, the cytotoxicity of these two complexes against lung cancer (A549) cells increased significantly under light (425 nm) irradiation, with phototoxicity index (PI) values of 120 and 93, respectively. They were specifically enriched in the mitochondria. Cell-based assays demonstrated that IrC1 induced an increase in intracellular reactive oxygen species (ROS) levels, reduction in ATP production, mitochondrial DNA damage, an increase in lipid peroxidation levels, and proteasomal activity inhibition. Under light conditions (in some cases a two-photon laser was also applied), these effects were greatly enhanced. Overall, we have demonstrated that these iridium complexes have dual activities of chemotherapy and photodynamic therapy, which may help to design new metal-based anticancer agents for combined chemo-photodynamic therapy.

8.
Genetics ; 215(1): 41-58, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32132097

RESUMO

Age-at-onset is one of the critical traits in cohort studies of age-related diseases. Large-scale genome-wide association studies (GWAS) of age-at-onset traits can provide more insights into genetic effects on disease progression and transitions between stages. Moreover, proportional hazards (or Cox) regression models can achieve higher statistical power in a cohort study than a case-control trait using logistic regression. Although mixed-effects models are widely used in GWAS to correct for sample dependence, application of Cox mixed-effects models (CMEMs) to large-scale GWAS is so far hindered by intractable computational cost. In this work, we propose COXMEG, an efficient R package for conducting GWAS of age-at-onset traits using CMEMs. COXMEG introduces fast estimation algorithms for general sparse relatedness matrices including, but not limited to, block-diagonal pedigree-based matrices. COXMEG also introduces a fast and powerful score test for dense relatedness matrices, accounting for both population stratification and family structure. In addition, COXMEG generalizes existing algorithms to support positive semidefinite relatedness matrices, which are common in twin and family studies. Our simulation studies suggest that COXMEG, depending on the structure of the relatedness matrix, is orders of magnitude computationally more efficient than coxme and coxph with frailty for GWAS. We found that using sparse approximation of relatedness matrices yielded highly comparable results in controlling false-positive rate and retaining statistical power for an ethnically homogeneous family-based sample. By applying COXMEG to a study of Alzheimer's disease (AD) with a Late-Onset Alzheimer's Disease Family Study from the National Institute on Aging sample comprising 3456 non-Hispanic whites and 287 African Americans, we identified the APOE ε4 variant with strong statistical power (P = 1e-101), far more significant than that reported in a previous study using a transformed variable and a marginal Cox model. Furthermore, we identified novel SNP rs36051450 (P = 2e-9) near GRAMD1B, the minor allele of which significantly reduced the hazards of AD in both genders. These results demonstrated that COXMEG greatly facilitates the application of CMEMs in GWAS of age-at-onset traits.

9.
Small ; : e2000293, 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32196919

RESUMO

Wearable in-plane Zn-based microbatteries are considered as promising micropower sources for wearable electronics due to their high capacity, low cost, high safety, and easy integration. However, their applications are severely impeded by inadequate energy density arising from unsatisfactory capacity of cathode and poor cycling stability caused by degradation of electrode materials and Zn dendrite. Additionally, the short-circuit induced safety issue caused by Zn dendrite is still a roadblock for Zn-based microbatteries. Herein, a textile-based Co-Zn microbattery with ultrahigh energy density and excellent cycling stability is demonstrated. Benefiting from the fast electron transport of three-dimensional (3D) porous Ni-coated textile and synergistic effect from the hierarchical Co(OH)2 @NiCo layered double hydroxide (LDH) core-shell electrode, the fabricated Co-Zn microbattery with high flexibility delivers superior energy/power densities of 0.17 mWh cm-2 /14.4 mW cm-2 , outperforming most reported micro energy storage devices. Besides, the trench-type configuration as well as the 3D porous Zn@carbon clothes can avoid the short-circuit-induced safety issues, resulting in excellent cycling stability (71% after 800 cycles). The unique core-shell structure and novel configuration provide a brand-new design strategy for high-performance wearable in-plane microdevices.

10.
J Psychoactive Drugs ; : 1-7, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32188355

RESUMO

Betel nut chewing has become prevalent in Hunan Province, China. There are different voices over its health risks. In spite of this, the local government has not taken any effective measures to control its expansion. It is necessary to reveal the concern of interests and public health behind such voices. This study used qualitative and quantitative methods to investigate the dispute over the health risks of betel nut chewing. The different voices over the risks demonstrate the tension of power, interests and public health among the government, institution, business, media and medical elites. Discursive practices of these institutions and individuals are associated with the exercise of power and expression of interests. With the deep concern about its cancerogenicity, majority of the public hold a negative attitude, and agree that the related industry should be controlled. Faced with conflicting perspectives, the government has the responsibility to clarify the issue and express an official stance. Measures should be taken to protect public health.

11.
Sci Adv ; 6(12): eaaz0368, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32219165

RESUMO

Adhesion G protein-coupled receptor G6 (Adgrg6; also named GPR126) single-nucleotide polymorphisms are associated with human height in multiple populations. However, whether and how GPR126 regulates body height is unknown. In this study, we found that mouse body length was specifically decreased in Osx-Cre;Gpr126fl/fl mice. Deletion of Gpr126 in osteoblasts resulted in a remarkable delay in osteoblast differentiation and mineralization during embryonic bone formation. Postnatal bone formation, bone mass, and bone strength were also significantly affected in Gpr126 osteoblast deletion mice because of defects in osteoblast proliferation, differentiation, and ossification. Furthermore, type IV collagen functioned as an activating ligand of Gpr126 to regulate osteoblast differentiation and function by stimulating cAMP signaling. Moreover,the cAMP activator PTH(1-34), could partially restore the inhibition of osteoblast differentiation and the body length phenotype induced by Gpr126 deletion.Together, our results demonstrated that COLIV-Gpr126 regulated body length and bone mass through cAMP-CREB signaling pathway.

12.
Water Res ; 175: 115656, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32145399

RESUMO

Microalgae-mediated biodegradation of antibiotics has recently gained increased attention from international scientific community. However, limited information is available regarding microalgae-mediated biodegradation of SMX in a co-metabolic system. Here we investigated the biodegradation of sulfamethoxazole (SMX) by five algal species (Pseudokirchneriella subcapitata, Scenedesmus quadricauda, Scenedesmus obliquus, Scenedesmus acuminatus and Chlorella pyrenoidosa), and its transformation pathways by C. pyrenoidosa in a sodium acetate (3 mM) co-metabolic system. The results showed that the highest SMX dissipation (14.9%) was detected by C. pyrenoidosa after 11 days of cultivation among the five tested algal species in the absence of other carbon sources. The addition of sodium acetate (0-8 mM) significantly enhanced the dissipation efficiency of SMX (0.4 µM) from 6.05% to 99.3% by C. pyrenoidosa after 5 days of cultivation, and the dissipation of SMX followed the first-order kinetic model with apparent rate constants (k) ranging from 0.0107 to 0.9811 d-1. Based on the results of mass balance analysis, biodegradation by C. pyrenoidosa was the main mechanism for the dissipation of SMX in the culture medium. Fifteen phase I and phase II metabolites were identified, and subsequently the transformation pathway was proposed, including oxidation, hydroxylation, formylation and side chain breakdown, as well as pterin-related conjugation. The majority of metabolites of SMX were only observed in the culture medium and varied with cultivation time. The findings of the present study showed effective co-metabolism of a sulfonamide by microalgae, and it may be applied in the aquatic environment remediation and wastewater treatment in the future.


Assuntos
Chlorella , Microalgas , Scenedesmus , Água Doce , Sulfametoxazol
13.
Injury ; 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32201118

RESUMO

BACKGROUND: There is little information on the cost and outcome of different treatments for femoral neck fractures. This study aimed to evaluate the cost-effectiveness of internal fixation compared with hemiarthroplasty (HA) for elderly patients with displaced femoral neck fractures. MATERIALS AND METHODS: A total of 121 patients ≥ 65 years old were divided into internal fixation (n = 58) or HA group (n = 63). Clinical outcome was evaluated by the EuroQol 5 dimensions (EQ-5D) score at 3, 12, and 24 months. The total costs including medical and non-medical expense were collected through hospitalisation information, cost diaries, and telephone interviews. A cost-utility analysis of the total costs in combination with quality-adjusted life years (QALYs) calculated by EQ-5D and survival time was conducted. Results were expressed in incremental cost-effectiveness ratio (ICER). RESULTS: The mean EQ-5D index score in the HA group were higher at the early follow-up (p<0.05). At 24 months there were no differences in EQ-5D between the 2 treatment groups (p>0.05). Over the 2-year period, patients treated with HA gained 0.09-0.10 more QALYs than those treated with internal fixation, while the mean total costs for internal fixation (CNY 55,676) were significantly lower than for HA (CNY 80,297) (P<0.001). ICER indicated that internal fixation may be more cost-effective than HA. CONCLUSION: HA is associated with better outcome than internal fixation in the treatment of displaced femoral neck fractures in elderly patients. However, internal fixation may be more cost-effective because of less total cost.

14.
Cell Death Dis ; 11(2): 88, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32015325

RESUMO

Ferroptosis is a new type of cell death that was discovered in recent years and is usually accompanied by a large amount of iron accumulation and lipid peroxidation during the cell death process; the occurrence of ferroptosis is iron-dependent. Ferroptosis-inducing factors can directly or indirectly affect glutathione peroxidase through different pathways, resulting in a decrease in antioxidant capacity and accumulation of lipid reactive oxygen species (ROS) in cells, ultimately leading to oxidative cell death. Recent studies have shown that ferroptosis is closely related to the pathophysiological processes of many diseases, such as tumors, nervous system diseases, ischemia-reperfusion injury, kidney injury, and blood diseases. How to intervene in the occurrence and development of related diseases by regulating cell ferroptosis has become a hotspot and focus of etiological research and treatment, but the functional changes and specific molecular mechanisms of ferroptosis still need to be further explored. This paper systematically summarizes the latest progress in ferroptosis research, with a focus on providing references for further understanding of its pathogenesis and for proposing new targets for the treatment of related diseases.

15.
Artigo em Inglês | MEDLINE | ID: mdl-32028764

RESUMO

A rechargeable aqueous zinc-ion battery (ZIB) is one of the attractive candidates for large-scale energy storage. Its further application relies on the exploitation of a high-capacity cathode and the understanding of an intrinsic energy storage mechanism. Herein, we report a novel layered K2V3O8 cathode material for the ZIB, adopting a strategy of charging first to extract part of K-ions from vanadate in initial few cycles, which creates more electrochemically active sites and lowers charge-transfer resistance of the ZIB system. As a result, a considerable specific capacity of 302.8 mA h g-1 at 0.1 A g-1, as well as a remarkable cycling stability (92.3% capacity retention at 4 A g-1 for 2000 cycles) and good rate capability, are achieved. Besides, the energy storage mechanism was studied by in situ X-ray diffraction, in situ Raman spectroscopy, X-ray photoelectron spectroscopy, and inductively coupled plasma mass spectroscopy. An irreversible K-ion deintercalation in the first charge process is proved. It is believed that this novel cathode material for the rechargeable aqueous ZIB and the optimizing strategy will shed light on developing next-generation large-scale energy storage devices.

16.
Artigo em Inglês | MEDLINE | ID: mdl-32100927

RESUMO

The reaction of propargylic amines and CO2 can provide high-value-added chemical products. However, most of catalysts in such reactions employ noble metals to obtain high yield, and it is important to seek eco-friendly noble-metal-free MOFs catalysts. Here, a giant and lantern-like [Zn116 ] nanocage in zinc-tetrazole 3D framework [Zn22 (Trz)8 (OH)12 (H2 O)9 ⋅8 H2 O]n Trz=(C4 N12 O)4- (1) was obtained and structurally characterized. It consists of six [Zn14 O21 ] clusters and eight [Zn4 O4 ] clusters. To our knowledge, this is the highest-nuclearity nanocages constructed by Zn-clusters as building blocks to date. Importantly, catalytic investigations reveal that 1 can efficiently catalyze the cycloaddition of propargylic amines with CO2 , exclusively affording various 2-oxazolidinones under mild conditions. It is the first eco-friendly noble-metal-free MOFs catalyst for the cyclization of propargylic amines with CO2 . DFT calculations uncover that ZnII ions can efficiently activate both C≡C bonds of propargylic amines and CO2 by coordination interaction. NMR and FTIR spectroscopy further prove that Zn-clusters play an important role in activating C≡C bonds of propargylic amines. Furthermore, the electronic properties of related reactants, intermediates and products can help to understand the basic reaction mechanism and crucial role of catalyst 1.

17.
Sci Total Environ ; 715: 136975, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32018106

RESUMO

Dissemination of antibiotic resistance genes (ARGs) in the water environment has become an increasing concern. There have been many reports on ARGs in surface water, but little is known about ARGs in groundwater. In this study, we investigated the profiles and abundance of ARGs in groundwater in comparison with those in surface water of Maozhou River using high-throughput quantitative PCR (HT-qPCR). Totally 127 ARGs and 10 MGEs were detected by HT-qPCR, and among them the sulfonamides, multidrug and aminoglycosides resistance genes were the dominant ARG types. According to the results of HT-qPCR, 18 frequently detected ARGs conferring resistance to 6 classes of antibiotics and 3 MGEs were further quantified by qPCR in the wet season and dry season. The absolute abundance ranged from 1.23 × 105 to 8.89 × 106 copies/mL in wet season and from 8.50 × 102 to 2.65 × 106 copies/mL in the dry season, with sul1 and sul2 being the most abundant ARGs. The absolute abundance of ARGs and MGEs has no significant difference between the wet season and dry season while the diversity of ARGs in the dry season was higher than that in the wet season (p < 0.05). Totally 141 and 150 ARGs were detected in the water and sediments of Maozhou River, respectively. A total of 116 ARGs were shared among the groundwater, river water, and sediment, which accounted for 67.1% of all detected genes. Redundancy analysis further demonstrated that the environmental factors contributed 70.7% of the total ARG variations. The findings of large shared ARGs, abundant Total Coliforms and large wastewater burden in the groundwater provide a clear evidence that anthropogenic activities had a significant impact on groundwater.


Assuntos
Água Subterrânea , Antibacterianos , Resistência Microbiana a Medicamentos , Genes Bacterianos , Água
19.
BMC Surg ; 20(1): 14, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31948420

RESUMO

BACKGROUND: An intro-abdominal hernia through the lesser omentum is a rare but severe condition that can cause intestinal obstruction and other life-threating complications. Until now, only a handful of cases have been reported worldwide. The diagnosis of lesser omental hernia remains challenging for emergency surgeons because of the unspecific symptoms. Therefore, there is a need for a better understanding of the characteristics of this condition. CASE PRESENTATION: In this report, we described the case of a 73-year-old female patient who was diagnosed with a lesser omental hernia caused by previous total colectomy. The patient underwent emergency surgery, and the intraoperative findings revealed a 200-cm segment of the small intestine was herniated through a defected lesser omentum (approximately 3 × 4 cm) from the lesser retrogastric curvature of the stomach. Besides, we summarize the specific abdominal computed tomography (CT) findings of lesser omental hernia by reviewing the literature. CONCLUSION: The lesser omental hernia is extremely rare but can cause serious complications. The cause of lesser omental hernia can be congenital or acquired. Careful examination of the small omentum before the closure of the abdomen is expected to reduce the occurrence of these abdominal surgery-associated complications. The specific features of abdominal CT in cases of lesser omental hernia, which are summarized in this article, can help other clinicians to obtain accurate diagnoses of lesser omentum hernia in the future.

20.
Surg Oncol ; 32: 90-98, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31987575

RESUMO

OBJECTIVE: Prophylactic dissection of the right paraesophageal lymph node (RPELN) in thyroid cancer is controversial. We performed a meta-analysis to provide evidence for RPELN dissection in thyroid cancer. METHODS: We searched the PubMed and Science Citation Index Expanded (SCIE) databases for relevant studies published up to January 31, 2019. The patients involved all had a pathological diagnosis of papillary thyroid cancer (PTC) and had undergone total thyroidectomy or right lobectomy with central compartment lymph node dissection. The RPELNs had been kept aside during the operation. RESULTS: Fourteen cohort studies involving 11,090 patients with PTC were included in the meta-analysis. There was RPELN metastases (RPELNM) in 1038 patients (9.36%). The factors related to RPELNM were: age <45 years, male sex, right lobe tumor, tumor >1 cm, extrathyroidal extension, capsular invasion, right paratracheal lymph node metastasis (RPTLNM), central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM), and tumor multifocality. There was no association between RPELNM and Hashimoto's thyroiditis (HT) and inferior pole tumors or tumor in the middle of the gland. With superior pole tumors, there was even less RPELNM. CONCLUSIONS: The clinical features related to RPELNM are age <45 years, male sex, tumor >1 cm, tumor diameter >2 cm, right lobe tumor, RPTLNM, extrathyroidal extension, capsular invasion, CLNM, CLNM ≥3, LLNM and multifocality, which should be considered when evaluating RPELN dissection.

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