Objective:To investigate the safety, feasibility and efficacy of trans-oral robotic surgery in the treatment of lingual thyroglossal duct cyst. Methods:The clinical data of 21 patients with lingual thyroglossal duct cyst underwent trans-oral robotic surgery from May 2017 to March 2025 were analyzed retrospectively. Results:The cysts in all 21 patients were successfully excised by trans-oral robotic surgery. The mean robotic set-up and exposure time, operation time, estimated intraoperative blood loss and recovery time for oral intake were （14.3±7.2） min （[range 5.0-32.0]min）, （17.0±8.4） min （range[6.0-36.0]min）, （8.4±5.9） mL （range[2.0-25.0]mL） and （2.1±2.2） days （range[0-7]days）, respectively. No patients required tracheostomy, and no severe postoperative complications occurred. The patients were followed up for 2 to 96 months, with median follow-up time of 47 months, and 1 recurrence was observed. Conclusion:Excision of lingual thyroglossal duct cyst by trans-oral robotic surgery is safe and feasible, with rapid recovery and low recurrence rate, which is worth popularizing in clinical practice.
Humans ; Thyroglossal Cyst/surgery* ; Robotic Surgical Procedures/methods* ; Retrospective Studies ; Female ; Male ; Adult ; Treatment Outcome ; Middle Aged ; Adolescent

AIM:To explore the mechanisms behind the inhibition of lymphangiogenesis in pregnant rats with obstructive nephropathy and assess the protective effects on kidney function.METHODS:Forty nulliparous female Wi-star rats were randomly assigned to four groups:sham operation,sham operation+pregnancy,model,and Esaxerenone groups,with 10 rats in each group.Renal injury was induced in the model and Esaxerenone groups via unilateral ureteral obstruction(UUO).The other two groups underwent ureteral dissociation without ligation.Nine weeks post-UUO,female rats in the sham operation+pregnancy,model,and Esaxerenone groups were mated with male rats(2:1 ratio)to establish a rat model of obstructive nephropathy during pregnancy.Starting the day after UUO,rats in the Esaxerenone group re-ceived Esaxerenone at 1 mg·kg-1·d-1.On the 18th day of pregnancy,24-hour urine was collected using metabolic cages.The following day,the rats were sacrificed,serum samples collected,and the contralateral kidney removed.Blood urea ni-trogen(BUN)was measured using standard biochemical methods,and endogenous creatinine clearance rate(Ccr)was calculated.Kidney tissue pathology was assessed using HE,Masson,and Sirius red staining.Serum aldosterone levels were determined via ELISA.Immunohistochemistry,real-time PCR,and Western blot were employed to assess mineralo-corticoid receptor(MR)activation,lymphangiogenesis,signaling pathways,and fibrosis-related markers.RESULTS:Renal function tests revealed increased BUN levels and decreased Ccr in the model group(P<0.01).Pathological exami-nation showed dilated renal tubules,significant collagen deposition,and inflammatory cell infiltration in the model group.ELISA results indicated a significant increase in serum aldosterone levels in the model group(P<0.01).Immunohisto-chemistry showed enhanced nuclear translocation of MR in the kidneys of the model group post-activation.Western blot and real-time PCR demonstrated a marked increase in neutrophil gelatinase-associated lipocalin(NGAL)expression in the model group(P<0.01).Additionally,the expression of vascular endothelial growth factor C(VEGF-C)and its receptor VEGFR3 was significantly elevated in the renal tubulointerstitium of the model group,as shown by both immunohistochem-istry and real-time PCR(P<0.01).The PI3K/Akt signaling pathway was activated in the model group,with significantly increased phosphorylation levels observed primarily in renal tubular epithelial and interstitial cells(P<0.01).Collagen type III(Col III)expression,primarily in the renal tubulointerstitium,was also significantly upregulated in the model group,consistent with real-time PCR results(P<0.01).Esaxerenone treatment improved renal function,reduced patho-logical damage,inhibited aldosterone secretion,and downregulated the expression of MR,NGAL,VEGF-C,VEGFR3,phosphorylated PI3K,phosphorylated Akt,and Col III(P<0.01).CONCLUSION:Esaxerenone mitigates aldosterone-induced MR activation,modulates the PI3K/Akt signaling pathway,reduces lymphangiogenesis in the contralateral kidney of pregnant rats with obstructive nephropathy,decreases collagen deposition,and delays the progression of renal intersti-tial fibrosis.

OBJECTIVE: We aimed to understand the willingness and barriers to the acceptance of tuberculosis (TB) preventive treatment (TPT) among people with latent TB infection (LTBI) in China. METHODS: A multicenter cross-sectional study was conducted from May 18, 2023 to December 31, 2023 across 10 counties in China. According to a national technical guide, we included healthcare workers, students, teachers, and others occupations aged 15-65 years as our research participants. RESULTS: Overall, 17.0% (183/1,077) of participants accepted TPT. There were statistically significant differences in the acceptance rate of TPT among different sexes, ages, educational levels, and occupations ( P < 0.05). The main barriers to TPT acceptance were misconceptions that it had uncertain effects on prevention (57.8%, 517/894), and concerns about side effects (32.7%, 292/894). CONCLUSION An enhanced and comprehensive understanding of LTBI and TPT among people with LTBI is vital to further expand TPT in China. Moreover, targeted policies need to be developed to address barriers faced by different groups of people.
Humans ; China/epidemiology* ; Adult ; Male ; Female ; Cross-Sectional Studies ; Middle Aged ; Young Adult ; Adolescent ; Aged ; Latent Tuberculosis/prevention & control* ; Patient Acceptance of Health Care ; Tuberculosis/prevention & control* ; Antitubercular Agents/therapeutic use* ; Health Knowledge, Attitudes, Practice

Objective:To understand the views of respiratory nurses on the status quo of nursing quality evaluation in acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to preliminarily screen the key indexes, so as to provide reference for scientifically constructing the evaluation index system of nursing quality during AECOPD.Methods:Eighteen clinical nurses and nursing managers with rich experience and working in respiratory department from three general tertiary hospitals in Shanghai were selected by means of purpose sampling to conduct focus group interviews, and analyze the collected materials by means of Colaizzi content analysis.Results:Three themes were extracted, namely, lack of specificity and sensitivity of disease care in current nursing quality index, opinions and suggestions on the setting of AECOPD nursing quality index and the setting of key index of AECOPD nursing quality. Besides, twenty-five key indexes were obtained, inclusive of four structural indexes, sixteen process indexes and five result indexes.Conclusions:It is necessary and important to establish AECOPD nursing quality evaluation index system in a scientific manner and it is advised that the qualities of structure, process and result should all be taken into consideration in the course of establishment. The twenty-five key indexes picked out at this stage can serve as reference for further establishment of a scientific AECOPD nursing quality evaluation index system.

Creutzfeldt-Jakob disease is a type of fatal central nervous system degeneration caused by infectious pathogenic prion protein. The early clinical manifestations of the disease are diverse and lack of specificity, so it is difficult to distinguish it from other neurological diseases. Researchers have made long-term exploration and clinical applications in imaging, electroencephalography, and detection of special proteins in cerebrospinal fluid of patients with Creutzfeldt-Jakob disease. In recent years, the development of new methods for the detection of pathogenic prion protein has provided great help for the early diagnosis of the disease, and it has great clinical application prospects. This article reviews the current research on the epidemiology, etiology and pathological mechanism and early diagnosis biomarkers of Creutzfeldt-Jakob disease, in order to help clinical colleagues to further enhance the understanding of Creutzfeldt-Jakob disease.

Objective:To investigate the effect of miR-148b-3p on invasion and migration of glioma cells and the possible molecular mechanism.Methods:Human glioma U251 cells were cultures in vitro. MiR-148b-3p mimic or negative control was transfected into U251 cells by Lipofectamine 2000 transfection reagent, which were recorded as miR-148b-3p group and NC group, respectively. A blank control (Ctr group) was set. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the transfection effect. Transwell assay was used to detect the invasive ability of U251 cells in each group. The scratch test was used to detect the migration ability of U251 cells in each group. The concentrations of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in the supernatant of the cells were determined by enzyme-linked immunosorbent assay (ELISA). Western blot was used to detect the expressions of Wnt signaling pathway-related proteins in cells.Results:The qRT-PCR experiment showed that the expression level of miR-148b-3p in U251 cells of miR-148b-3p group (2.45±0.25) was significantly higher than that of NC group (0.97±0.10) and Ctr group (1.00±0.11) ( P<0.05). Transwell and scratch experiments showed that the number of invasive cells (50.62±5.36) in miR-148b-3p group was significantly lower than those in NC group (108.84±10.14) and Ctr group (113.40±10.06) ( P<0.05). The results of the scratch experiment showed that the cell migration rate of miR-148b-3p group (23.19±2.50)% was significantly lower than those of NC group (51.81±5.25)% and Ctr group (52.06±5.33)% ( P<0.05). Overexpression of miR-148b-3p inhibited the expressions of MMP-2 and MMP-9, downregulated the expressions of Wnt1 and GSK-3β protein. Conclusion:miR-148b-3p can inhibit the invasion and migration of human glioma U251 cells by inhibiting the activation of Wnt signaling pathway.

Objective: To evaluate the indication, safety and effectiveness of transoral robotic surgery (TORS) for oropharyngeal cancer based on our preliminary experience. Methods: Twelve patients, including six with tonsil cancer, five with tongue base cancer and one with posterior pharyngeal wall cancer, who underwent TORS with Da Vinci Si surgical system from March 2017 to October 2018 at Tongji Hospital of Huazhong University of Science Technology were respectively analyzed. And the surgical time, intraoperative blood loss, postoperative local bleeding, dyspnea, nerve function injury, oral intake time, whether or not to receive chemoradiotherapy were analyzed. Results: All tumors in the 12 patients were en bloc removed by TORS. Surgical time ranged from 25 to 80 min with an average of 34.2 min. The blood loss ranged from 10 ml to 50 ml with an average of 20.8 ml. The recovery time for oral intake ranged from 1 day to 30 days with an average of 8.4 days. No patient underwent tracheostomy after TORS. Also, no patient manifested with airway obstruction, bleeding or nerve injury symptoms after operation. All 12 patients reached pathologically negative surgical margins. The patients were followed up for 4 to 22 months, with a median of 12 months. All patients who combined with more advanced than T3 stage, or more advanced than N2 stage were recommended to oncologist, then, followed with radiotherapy or chemoradiotherapy if no relevant contradictions occurred. No local recurrence or distant metastasis case was found. Conclusion With proper indications, the application of TORS in oropharyngeal cancer is a relatively safe, effective and minimal invasive therapy, which merits more clinical applications.

Objective:To investigate the effect of miR-148b-3p on invasion and migration of glioma cells and the possible molecular mechanism.Methods:Human glioma U251 cells were cultures in vitro. MiR-148b-3p mimic or negative control was transfected into U251 cells by Lipofectamine 2000 transfection reagent, which were recorded as miR-148b-3p group and NC group, respectively. A blank control (Ctr group) was set. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the transfection effect. Transwell assay was used to detect the invasive ability of U251 cells in each group. The scratch test was used to detect the migration ability of U251 cells in each group. The concentrations of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in the supernatant of the cells were determined by enzyme-linked immunosorbent assay (ELISA). Western blot was used to detect the expressions of Wnt signaling pathway-related proteins in cells.Results:The qRT-PCR experiment showed that the expression level of miR-148b-3p in U251 cells of miR-148b-3p group (2.45±0.25) was significantly higher than that of NC group (0.97±0.10) and Ctr group (1.00±0.11) ( P<0.05). Transwell and scratch experiments showed that the number of invasive cells (50.62±5.36) in miR-148b-3p group was significantly lower than those in NC group (108.84±10.14) and Ctr group (113.40±10.06) ( P<0.05). The results of the scratch experiment showed that the cell migration rate of miR-148b-3p group (23.19±2.50)% was significantly lower than those of NC group (51.81±5.25)% and Ctr group (52.06±5.33)% ( P<0.05). Overexpression of miR-148b-3p inhibited the expressions of MMP-2 and MMP-9, downregulated the expressions of Wnt1 and GSK-3β protein. Conclusion:miR-148b-3p can inhibit the invasion and migration of human glioma U251 cells by inhibiting the activation of Wnt signaling pathway.

Objective To explore the accuracy of endoscopic ultrasonography (EUS) for evaluating T3 esophageal squamous cell carcinoma (ESCC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 733 patients diagnosed with T3 ESCC by preoperative EUS who were admitted to the Sun Yat-sen University Cancer Center from January 2003 to December 2015 were collected.All the patients underwent radical resection of ESCC.The postoperative pathological stage as a gold standard,the accuracy,overstaged and understaged rates of clinical staging by preoperative EUS were assessed.Observation indicators:(1) comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' diseases and postoperative survival up to December 30,2016.Overall survival time was from operation time to death or last effective follow-up.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Count data were represented as cases and percentage.The survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results (1) Comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging:all the 733 patients were confirmed as T3 ESCC by preoperative EUS.Postoperative pathological diagnosis showed that 9 patients were detected in pT1b,87 in pT2,630 in pT3 and 7 in pT4a.The accuracy,overstaged and understaged rates of preoperative EUS in evaluating T3 ESCC were 85.95％(630/733),13.10％(96/733) and 0.95％(7/733),respectively.N0,N1,N2 and N3 of postoperative pathological N stage were respectively detected in 329,247,110 and 47 patients.Twenty-seven,323 and 383 patients were in stage Ⅰ,Ⅱ and Ⅲ of TNM stage,respectively.The high-,moderate-and lowdifferentiated tumors were respectively detected in 125,403 and 205 patients.(2) Follow-up and survival situations:among 733 patients,639 were followed up for 1.0-153.0 months,with a median time of 29.0 months.The median survival time,1-,3-,5-year overall survival rates were 53.0 months (range,37.7-68.3 months),85.3％,58.1％ and 48.2％ in 733 patients,respectively.The 5-year overall survival rate was 75.2％ in 9 patients with pT1b,63.0％ in 87 patients with pT2,46.3％ in 630 patients with pT3 and 0 in 7 patients with pT4a,respectively,with a statistically significant difference (x2=24.089,P＜0.05).Conclusion There is a higher accuracy of EUS for evaluating T3 ESCC,however,the stage migration should be noted.

Objective To investigate the correlation between TYMS gene mRNA expression level and EGFR mutation in stage Ⅲ A-N2 non-small-cell lung cancer tissue (NSCLC).Methods The branched DNA-liquidchip technology (bDNA-LCT) and mutant-enriched liquidchip (MEL) technology were used to detect the TYMS mRNA expression and EGFR mutations at exon 19 and 21 in NSCLC tissues from 30 patients with stages Ⅲ A-N2 NSCLC,and the results were analyzed.Results Among 30 cases,low TYMS mRNA expression was in 14 cases (46.7 ％),middle to low TYMS mRNA expression in 7 cases (23.3 ％),middle mRNA expression in 7 cases (23.3 ％),middle to high TYMS mRNA expression in 0 case and high TYMS mRNA expression in 2 cases (6.7％);12 cases of EGFR mutation were detected out with the mutation rate of 40.0％,including 6 cases of exon 19 deletion and 6 cases of exon 21 missense mutation.The TYMS mRNA expression level was correlated with the EGFR mutation.The EGFR mutation commonly occurred in the tumor tissue of the patients with TYMS mRNA low expression (Z=-2.604,P=0.009).Conclusion The TYMS mRNA expression in NSCLC tissue is correlated with the EGFR gene mutation,which can provide references for the drug selection aiming at the patients with different conditions.