Objective:To analyze the factors related to metastasis of contralateral central lymph node (CLN) in cN0 papillary thyroid car-cinoma (PTC) and discuss the indications for CLN dissection. Methods:We enrolled 149 unilateral PTC patients who underwent total thyroidectomy and prophylactic bilateral (CLN) dissection. This work analyzed the relationship of gender, age, extrathyroidal extension, multifocality, thyroiditis, ipsilateral central lymph nodes, and prelaryngeal lymph node with CLNs. Results:The rates of metastasis to ip-silateral and contralateral central compartments were 73.2%and 23.5%, respectively. In univariate analysis, gender, age, tumor size, multifocality, and thyroiditis were not important in predicting contralateral central compartment lymph node metastasis (P=0.792, 0.097, 0.531, 0.269, and 1.000, respectively);by contrast, extrathyroidal extension (P=0.017), prelaryngeal lymph nodes (P=0.006), and ipsilateral CLNs (P<0.001) are related to CLN metastasis. However, multivariate analysis showed that ipsilateral central metastasis was an independent risk factor for lymph node metastasis in the contralateral central region when the number of ipsilateral central metas-tases is≥3 (P=0.010). Conclusion:Extracapsular invasion, prelaryngeal lymph nodes, and ipsilateral CLN influence the metastases of CLN. Bilateral CLN dissection should be performed when the number of ipsilateral central metastases is≥3 and there is merger of ex-tra-laryngeal lymph nodes or capsule invasion.

Objective To investigate the effects of proanthocyanidins on depressant-like behaviors and the structure of adrenal gland in chronic unpredictable mild stress (CUMS) rats. Methods Rats were randomly divided into 6 groups:control group, stressed group (CUMS + vehicle), three treatment groups (CUMS + proanthocyanidins 25,50,100 mg·kg-1,respectively) ,and imipramine group (CUMS + imipramine 10 mg·kg-1). Used the CUMS model in rats to investigate the effects of chronic oral administration (21 days) of proanthocyanidins and imipramine (ip) on the open-field;and forced swimming and sucrose consumption tests and the ratio of adrenal gland/body weight,and its thickness were examined by HE stain. Results Compared with control group, rats subjected to CUMS exhibited increased ratio of adrenal gland /body weight ( P < 0. 01), less sucrose consumption( P<0.01) and inhibited in the open-field test( P<0.01) as well as more despair time in the forced swimming test( P<0.01). While compared with stressed group,treatments with proanthocyanidins (25,50,100 mg·kg-1, po ,21 days) could significantly improve the activities in open-field test ((39.6±3.4) vs (49±4.5), (52.6±3.7),(54.1±1.8) ;all P<0.01) and sucrose consumption( (5.8±2.5)ml vs (8.1±3.3)ml,(8.5±4.1) ml, (9.2±2.6) ml; P < 0.05, P < 0.05, P < 0.01 respectively); Meanwhile, it could reduce the duration time in forced swimming test significantly( (103.5±10.2)s vs (83.7±8.8)s,(75.8±5.9)s,(67.2±6.5)s; all P<0.01) as well as thickness of the adrenal gland(P<0.05, P<0.01).Conclusions This study suggests that the proanthocyanidins (25,50,100 mg·kg-1) has an antidepressant-like effects in CUMS rats. The antidepressant actions of proanthocyanidins, in some degrees, may be related with the regulation of the adrenal gland's structure.

Objective To improve the canines myocardial infarction curative effect by using ultrasound targeted microbubble destruction (UTMD) combining with nuclear localization signal(NLS) peptide to increase hAng-1 gene transfection efficiency.Methods Forty-six canines were randomly divided into 4 groups (n=10 in each group) after the models of myocardial infarction were prepared.Group A were untreated control;Group B were transfected with hAng-1;Group C were transfected with UTMD+hAng-1;Group D were transfected with UTMD+NLS nuclear localization signal+hAng-1.The therapeutic agents were intravenously injected at one week after myocardial infarction in each group,and the ultrasound were irradiated at the precardium in group C and D.①Echocardiography was used before and at one week after myocardial infarction and 28 days after gene transfection.Two-dimensional echocardiography was used to detect cardiac function,the left ventricular ejection fraction,the left ventricular wall motion and the myocardial contrast echocardiography were used to detect myocardial perfusion of all canines in the four groups.②On twenty-eight days after gene transfection,mRNA and Western Blot were used to detect the expression of hAng-1.Immunohistochemistry was used to detect capillary density of peri-infarct area and microvessel density (MVD).Masson′s trichromatic staining and gross specimen were used to evaluate the degree and the area of myocardial fibrosis.The gene transfection efficiency and the curative effect of all the four groups were evaluated and compared.Results ①Before myocardial infarction,in four groups canine ventricular wall motion and cardiac function were normal,and myocardial filling defect was not showed by myocardial contrast echocardiography.At one week after myocardial infarction,the left ventricular anterior and interval walls motion and the left ventricular ejection fraction in the four groups were significantly decreased.Myocardial contrast echocardiography showed anterior and interval walls myocardial filling defect.There was no significant difference among the four groups(P>0.05);On 28 days after gene transfection the left ventricular ejection fraction in the four group were increased in an order of group A,B,C,D,there was significant difference when comparing group C and D with other groups separately(P<0.05).Myocardial contrast echocardiography showed much contrast filling in the infarction and surrounding area in group D,a little contrast filling in group C and filling defect in group A and group B,there was significant difference when comparing group C and D with other groups separately(P<0.05).②RT-PCR and Western Blot showed the hAng-1 mRNA and protein expression in group D were higher than those in the other group.There was significant difference when comparing group C and group D with other groups separately(P<0.05).③Immunofluorescence showed the capillary densities were(4.7±1.6)/mm2,(11.2±2.8)/mm2,(70.0±6.4)/mm2 and (85.3±7.0)/mm2 in group A,group B,group C and group D.The differences were statistically significant compared group C and group D with other groups (P<0.05).④Masson′s trichromatic staining and cardiac gross specimen showed that the degree and area of myocardial fibrosis were gradually reduced in an order of group A,B,C,D.Conclusions UTMD and NLS peptide could effectively transfect hAng-1 gene and it provided a novel strategy of gene treatment for ischemic heart disease.

Objective:To implement PRECEDE-PROCEED based intervention in community patients with type 2 diabetes mellitus (T2DM) and explore its effects on patients' diabetes knowledge and self-efficacy.Methods:Totally 86 T2DM patients treated in a community health service center in Hangzhou between May and October 2014 were selected using convenient sampling and divided into intervention group ( n=43) and control group ( n=43) . Patients in the intervention group received 6-month intervention based on PRECEDE-PROCEED, while patients in the control group received a regular community health education course once during the same period. The diabetes knowledge and self-efficacy scores were evaluated between the two groups before and 3 and 6 months after intervention. At last, a total of 40 patients in the intervention group and 42 patients in the control group completed the study. Results:Repeated measures analysis of variance showed that there were time-dependent, between-group and combined effects in diabetes knowledge and self-efficacy scores in the two groups ( P<0.05) . Pairwise comparison between the two groups revealed that there was no statistically significant difference in diabetes knowledge and self-efficacy scores between the two groups before intervention ( P>0.05) , but there were statistically significant differences in diabetes knowledge and self-efficacy scores between the two groups 3 and 6 months after intervention ( P<0.05) . Conclusions:The PRECEDE-PROCEED based intervention can effectively improve the diabetes knowledge and self-efficacy of T2DM patients, which is worth promoting in clinical practice.

Objective To construct a knowledge system of cultural competence education among undergraduate nursing students, so as to enhance the cultural capacity of undergraduate nursing students. Methods From September 2015 to January 2016, a two-round expert consultation was conducted among 11 nursing experts who engaged in multicultural related work in Shanghai, Hangzhou and other places by Delphi method. Results The active coefficient of the two rounds of the expert consultation were both 100%. The expert authority (Cr) was 0.89, and the coordination coefficients of the first and second round of consultation were 0.227 and 0.236 respectively (P<0.01). Finally, the knowledge system of cultural competence education in undergraduate nursing students was constructed, including 5 first-level indicators, 10 second-level indicators and 39 third-level indicators. Conclusions The primarily constructed knowledge system of cultural competence education among undergraduate nursing students is a scientific and reasonable frame work system, which provides content references and evaluation basis for the cultural competence education among undergraduate nursing students in our country.

Objective Coronary heart disease(CHD)is one of the major lethal diseases in the world at present.The detection of biomarkers is an important non-invasive method to evaluate the progression of CHD,which is of great significance for the diagnosis and secondary prevention of CHD.This study aims to screen diagnostic biomarkers in the pathogenesis of myocardial infarction,analyze cuprotosis-related genes in the development of this disease,and further predict the traditional Chinese medicine of regulating cuprotosis-related genes.Methods The GEO database was searched to obtain chip data of myocardial infarction,differentially expressed genes(DEGs)were analyzed.Then,DEGs enrichment analysis was performed,and key genes were screened based on least absolute shrinkage and selection operator(LASSO)and random forest(RF)methods.Diagnostic model was constructed and verified.After immune cell infiltration analysis was performed on differential genes,the results were further combined with weighted gene co-expression network analysis to obtain differentially expressed immune-related genes,which were intersected with cuproptosis genes to obtain cuproptosis immune-related Hub genes.The correlation between cuproptosis-related genes and diagnostic genes were analyzed.Gene set enrichment analysis(GSEA)was performed on cuproptosis-related genes to further predict the traditional Chinese medicines of regulating the genes related to cuproptosis.Results A total of 115 DEGs,which were mainly enriched in the biological processes and pathways related to lymphocyte-mediated immunity,mitochondrial respiratory chain complex Ⅳ,C-type lectin receptor signaling pathway,and chemokine signaling pathway,were obtained by differential analysis.Five diagnostic genes,SNORA20,SNORA19,H4C3,SNORD81,and COX7B,were screened out by machine learning methods.Immune infiltration analysis found dendritic cells,macrophages M2,monocytes,neutrophils,natural killer cells,CD4+T cells,CD8+T cells,and γδ T cells.It was indicated the above eight immune cells play a certain role in the pathogenesis of myocardial infarction in coronary heart disease.Weighted correlation network analysis(WGCNA)and immune infiltration analysis were used to obtain 358 key module genes,which were intersected with cuproptosis genes to obtain three cuproptosis and immune signature genes.The correlation analysis results of five diagnostic genes and Hub genes showed that there was a correlation between the expressions of SLC31A1 and SNORA20,LIAS and SNORA19,SNORD81,MTF1 and H4C3,SNORA20,SNORA19,SNORD81.GSEA analysis results indicated that LIAS and MTF1 had a significant effect on the NF-κB signaling pathway,NOD-like receptor signaling pathway and Toll-like receptor signaling pathway.The potential regulatory Chinese medicines are mainly blood-activating and stasis-eliminating,qi-promoting and analgesic drugs.Conclusion SNORA20,SNORA19,H4C3,SNORD81,COX7B have a certain diagnostic value for myocardial infarction in coronary heart disease.The prediction of genes related to cuproptosis and immune infiltration in the pathogenesis of myocardial infarction provides a certain reference for the study of the mechanism of traditional Chinese medicine intervention in myocardial infarction.

Objective To investigate the relationship between subgroups of central lymph node metastasis (sCLNM) and lateral lymph node metastasis (LNM) of unilatal papillary thyroid carcinoma (uPTC) with cervical lymph node negative(cN0).Methods The clinical and pathological data of 161 patients with cN0-uPTC who underwent total thyroidectomy+central lymph node dissection+lateral lymph node dissection from Jan.2016 to Dec.2016 were retrospectively analyzed.The relationship between the lymph node metastasis of each subarea in the central area of the affected side and the lymph node metastasis of the affected side was investigated.Results Binary logistic regression analysis of cN0-uPTC subregions in the affected central region showed:pre-laryngeal lymph node metastasis,pre-tracheal lymph node metastasis and paratracheal lymph node metastasis were independent risk factors for lymph node metastasis in the affected lateral region(P=0.008,0.016,0.035,respectively).Prelaryngeal lymph node metastasis was an independent risk factor for lymph node metastasis in the affected area Ⅱ (P=0.015).Pre-tracheal lymph node metastasis was an independent risk factor for lymph node metastasis in affected area Ⅲ (P=0.004).Pre-tracheal and para-tracheal lymph node metastasis were independent risk factors for lymph node metastasis in the affected Ⅳ area (P=0.035,0.011,respectively).Conclusions The lymph node metastasis pathway of thyroid cancer had certain regularity.The pre-laryngeal lymph node metastasis has the prediction value for the lymph node metastasis of the affected area Ⅱ.The pre-tracheal lymph node metastasis has the prediction value for the lymph node metastasis of the affected area Ⅲ.The pre-tracheal and paratracheal lymph node metastasis have the prediction value for lymph node metastasis of the affected area Ⅳ.Lymph node dissection in affected areas Ⅲ and Ⅳ needs to be considered in patients with pre-tracheal or paratracheal lymph node metastases.On this basis,lymph node dissection on the affected areas Ⅱ,Ⅲ,and Ⅳ might be considered if there is pre-laryngeal lymph node metastasis at the same time.

OBJECTIVETo investigate the anti-human CEM lymphoma cell activities induced by TCR idiotypic DNA vaccine containing different antigen determinants in BALB/c mice.

METHODSThe specific rearranged gene fragment encoding TCRVbeta region of CEM cell line was obtained by RT-PCR technique. The PCR product was cloned into eukaryocytic expression vector pcDNA3, which was used as DNA vaccine and template for PCR amplifying different antigen determinant. Gene fragments encoding different antigen determinant were amplified and cloned into pcDNA3, separately. The experimental mice were immunized by intramuscular injection of the DNA vaccines. The specific anti-idiotype antibodies were detected by indirect immunofluorescence assay.

RESULTSTCRbetaV of CEM cell line contains five antigen determinants. Specific anti-idiotype antibody was detected in all of the six mice immunized with DNA vaccine containing all the five determinants (the highest titer was 1:480). Although the antibody could also be detected in four of the six mice immunized with DNA vaccine containing four of the five antigen determinants, the antibody titer was lower (the highest titer was 1:80). DNA vaccine containing two of the five determinants could not induce the specific antibody.

CONCLUSIONThe idiotypic DNA vaccine containing the whole TCRbetaV five antigen determinants could induce the specific anti-lymphoma idiotypic antibody in BALB/c mice.

Amino Acid Sequence ; Animals ; Antibodies, Anti-Idiotypic ; blood ; immunology ; Base Sequence ; Complementarity Determining Regions ; genetics ; immunology ; Epitopes ; genetics ; immunology ; HL-60 Cells ; Humans ; Lymphoma ; immunology ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Receptors, Antigen, T-Cell, alpha-beta ; genetics ; immunology ; Sequence Analysis, DNA ; Tumor Cells, Cultured ; Vaccines, DNA ; genetics ; immunology

This study was undertaken to investigate the anti-lymphocytic malignacy immunologic effects induced by TCR idiotypic DNA vaccine on BALB/c mice. CEM lymphoma cell line and BALB/c mice were used as models. The rearrangement gene fragment coding TCR Vbeta region of CEM cell line was obtained by RT-PCR technique. The PCR product was cloned into the eukaryocytic expression vector pcDNA3 to be used as DNA vaccine. The experimental animals were immunized by intramuscular injection with DNA vaccine. The specific anti-idiotypic antibody was detected by indirect immunofluorescence assay. The specific anti-idiotypic cellular immunity was detected by CTL activity assay using MTT method. The results showed that specific anti-idiotypic antibody in the immunized mice sera could be found since four weeks after immunization and came to the peak of titer on the sixth week. Using IL-6 as immunological adjuvant could significantly increase the antibody titers. It was concluded that the TCR idiotypic DNA vaccine could induce effectively the specific anti-lymphoma idiotypic antibody in BALB/c mice. Using IL-6 as immunological adjuvant could significantly increase the antibody titers induced by idiotipic DNA vaccine.

Near-infrared spectroscopy (NIRS) can be employed to monitor regional oxygen saturation (rSO 2), to reflect the oxygen metabolism and local effective blood perfusion of the measured site in a real-time and noninvasive manner.NIRS has been extensively used in monitoring blood perfusion of brain, kidney, gastrointestinal tract and organ function evaluation in different conditions.During the perioperative period of congenital heart disease, hemodynamic fluctuation may easily cause organ hypoperfusion, which would lead to the development of ischemia, hypoxia and internal environment disorder, thus resulting in harmful changes in tissue oxygenation status.However, there is no change in the arterial oxygen saturation (SaO 2) and mixed venous saturation (SvO 2). NIRS can be employed to sensitively monitor the changes of tissue rSO 2, so as to prevent further injury caused by tissue ischemia and hypoxia.This paper briefly describes the basic principle, limitations and new progress of NIRS in the perioperative application of CHD, in order to provide new ideas and directions for its clinical application in the perioperative period of CHD, early evaluate the patient′s condition and guide clinical work.