Objective:To study the effect of totally endoscopic surgery and Miccoli surgery for papillary thyroid microcarcinoma. Methods Totally 64 patients with papillary thyroid microcarcinoma from April 2013 to April 2014 in our hospital were divided into the ob-servation group and the control group according to a random number table.And the intraoperative and postoperative situation of the two groups were compared.Results The number of lymph node dissection,postoperative hospital stay,hospital costs of the two groups had no sig-nificant difference (P >0.05).The blood loss,operative time,drainage time,amount of drainage,incision length,time of postoperative recov-ery of the observation group were significantly less than those of the control group with statistical significance (P <0.05).But the cosmetic score of observation group after operation was lower than that of the control group,and there was a significant difference (P <0.05).Postop-erative pain grade of the observation group was better than the control group with statistical significance (P <0.05).The complication rate of control group was significantly higher than the observation group (P <0.05).Conclusion Miccoli surgery for papillary thyroid microcarci-noma has more advantages compared with totally endoscopic surgery in terms of blood loss,operative time,drainage time,amount of drainage, incision length,time of postoperative recovery,and degree of pain.Moreover,it has a lower complication rate and high security,which should be the first choice in clinic surgery.

According to the theory of nucleic acid metabolism, the different select models were designed By means of physical and chemical derived to the production of inosine Bacillus Subtilis JSIM 1019, we have got the mutative strains of auxotroph of different component, the mutative strains lacking of relating enzyme, the mutative strains resisting some metabolic analog in turn Restrain of the production to metabolite has been relieved Two mutative strains of auxotroph xanthine, X 13 and so on were obtained And it also has resistance to 8 azaguanine After the mutative strains had been separated into the single srain respectively, we got X 13 4 the maximum accumulation of adenosine reachs 12 43g/L in substratum cultivated for 72 hours at 36℃

Objective To evaluate the effect of sitaxsentan on renal microcirculation in beagle dogs undergoing cardiopulmonary bypass(CPB)when ultrasound microbubble angiography was used to monitor renal microcirculation.Methods Eighteen male Beagle dogs,weighing 10-15kg,aged 2-4 yr,were allocated into 3 groups(n=6 each)using a random number table:sham operation group(Sham group),CPB group and sitaxsentan group(S group).Sitaxsentan 0.7 mg/kg was infused over 30min starting from 1 h before CPB in group S.Before CPB(T1),at 1 h of CPB(T2),at the end of CPB(T3)and at 2h after the end of CPB(T4),the time-intensity curve of renal parenchyma perfusion was obtained using ultrasound microbubble angiography,and quantitative parameters including the slope rate of ascending curve(A),area under curve(AUC),derived peak intensity(DPI)and time to peak(TTP)were fitted.Results Compared with Sham group,the value of A was significantly decreased at T2-4,AUC and TTP were increased at T3,4,DPI was decreased at T4 in renal cortex and medulla in CPB group,and the value of A was significantly decreased and TTP was increased at T2-4,AUC was increased at T3,4(P<0.05),and no significant change was found in DPI in renal cortex and medulla in S group(P>0.05).Compared with CPB group,the value of A was significantly increased and AUC and TTP were decreased at T3,4 in renal cortex and medulla(P<0.05),and no significant change was found in DPI in renal cortex and medulla in group S(P>0.05).Conclusion Sitaxsentan can improve renal microcirculation in beagle dogs undergoing CPB.

Objective: To study the role of inducible nitric oxide synthase (iNOS) in activated macrophages and nitric oxide (NO) in the defence against tumors. Methods: Macrophages were obtained by alveolar lavages of mice and activated through incubation with recombinant murine INF? in vitro. P815 cells were added to the culture. Culture supernates were collected to measure the activity of iNOS and NO. Tumoricidal activity of macrophages was determined in presence and absence of the specific inhibitor of NO synthase: L NMMA. Results: NO production and activity of iNOS induced by activated macrophages were positively related with concentration of INF? in macrophage P815 coculture. The addition of L NMMA to the culture suppressed NO production, the inhibitory rate of activated macrophages against P815 cells was reduced distinctly ( P

This article was aimed to study the immunomodulatory effect of ethanol sediments of the seeds of Descurainia sophia(L.) Webb. ex Prantl. both in vitro and in vivo. The lymphocyte proliferation test in vitro was carried out to explore the effect of the ethanol sediments on the proliferation of T cell and B cell in the spleen of normal mice. And, the carbon clearance test, serum hemolysin test, and delayed-type hypersensitivity test were used to investigate the influence of fraction on non-specific immunity, humoral immunity and cellular immunity in the immunosuppressive mice induced by cyclophosphamide. Besides, the immunosuppressive model was used to evaluate the effect of fraction on immune organs and content of cellular factors in blood serum. The results showed that the ethanol sediments promoted Concanavalin A (Con A) induced T cell and Lipopolysaccharides (LPS) induced B cell (P < 0.01). It increased the carbon clearance index K, phagocytic index α, half value hemolysis (HC50), and swelling degree of auricula (P < 0.05 or P < 0.01). It reduced the body weight and atrophy of thymus and spleen index (P < 0.05 or P < 0.01). It increased the contents of IL-2, IFN-γ and IL-4 in serum in immunosuppressive mice (P < 0.05 or P < 0.01). It was concluded that ethanol sediments of the seeds of D. sophia(L.) Webb. ex Prantl. can boost the lymphocyte proliferation, protect the immune organs, and enhance the non-specific and specific immunity in immunosuppressive mice, which indicated that it had immune-promotion effect.

This article was aimed to study immunomodulatory effect of chemical split fractions ofMori Cortex, in order to initially explain effective parts that played a role in immunomodulatory effect ofMori Cortex. The carbon clearance test, serum hemolysin test, E-rosette test, and lymphocyte transformation test were carried out to explore influence of these chemical split fractions ofMori Cortex on immune organs, nonspecific immunity, humoral immunity and cellular immunity. The results showed that in the carbon clearance test, 50% ethanol fraction markedly reduced the thymus index (P<0.01) and the correction indexα (P<0.05). In hemolysin test, the half value hemolysis (HC50) was improved by 30% ethanol fraction and fatty oil fraction (P<0.05). Besides, in the E-rosette test, the E-rosette ration was increased in the 30% ethanol fraction group (P<0.05). In the lymphocyte transformation test, the 30% ethanol fraction can promote the thymus and spleen lymphocytes proliferation (P<0.05 orP<0.01), while the 50% ethanol fraction inhibited the proliferation (P<0.05 orP<0.01). It was concluded that the 30% ethanol fraction can boost both the humoral immunity and cellular immunity; the 50% ethanol fraction can induce the growth of thymus with a suppressive effect on nonspecific immunity and cellular immunity; the fatty oil fraction can improve humoral immunity.

Objective To observe the influence of endothelin A receptor antagonist pretreatment on renal function after cardiopulmonary bypass (CPB) in beagles.Methods A total of 18 male beagles were selected and allocated to 3 groups (n =6) by adopting the random number table method:sham operation group (Sham group),CPB group and endothelin A receptor antagonist (ETA) group.Sitaxsentan 0.7 mg/kg in the ETA group was infused by continuous pumping for 30 min at 1 h prior to CPB.The body temperature,mean arterial pressure (MAP) and arterial gas were collected.The concentrations of serum creatinine (Scr) and blood urea nitrogen (BUN) were detected.The renal tubular necrosis score was evaluated,and the expression levels of phosphorylated Akt (p-Akt),phosphorylated eNOS (p-eNOS) were also detected.Results Serum SCr and BUN levels at 2 h after CPB in the CPB and ETA group were significantly higher than those before operation (P＜0.05),and the ETA group was obviously lower than the CPB group (P＜0.05);the renal tubular necrosis score in the ETA group was obviously lower than that in the CPB group (P＜0.05).Expressions of p-Akt,p-eNOS in the ETA group were significantly higher than those in the CPB group(P＜0.05).Conclusion CPB might contribute to acute kidney injury,the endothelin A receptor antagonist pretreatment might alleviate acute kidney injury after CPB.

Objective To explore the influencing factors of the vaginal birth after cesarean section (VBAC), and establish a model for predicting the risk of trial of the trial of labor after cesarean section (TOLAC). Methods From January 2016 to December 2018, total 694 pregnant women who underwent TOLAC in Northwest Women's and Children's Hospital were retrospectively analyzed. Those cases were divided into two groups according to the mode of delivery: the VBAC group and the failed TOLAC group. At the same time, 700 cases in the elective repeat cesarean section (ERCS) group were randomly selected as control group. The influencing factors of VBAC were analyzed by univariate and multivariate logistic regression, and the pregnancy outcomes between the three groups were compared. Results (1) The VBAC rate was 76.1% (528/694) and 166 women underwent the failed TOLAC (23.9%, 166/694). (2) Univariate analysis found that, the pre-pregnancy body mass index (BMI) [(22.0±3.0),(23.3±2.7) kg/m2], the previous vaginal delivery history [10.4%(55/528),3.6%(6/166)], the cervical score (5.2±1.9,4.3±1.6) and the neonatal birth weight [(3 315 ± 468), (3 484 ± 274) g] of the VBAC group were significantly different from the failed TOLAC group (P<0.05). (3) The comparison of pregnancy outcomes: the neonatal birth weight was (3 315± 468) g, and the intrapartum hemorrhage volume was (255 ± 121) ml in the VBAC group, which were significantly lower than those in the failed TOLAC group [intrapartum hemorrhage (325 ± 173) ml] and the ERCS group [(3 572±344) g, (281±125) ml], there were statistically significant differences in the comparison among the three groups (all P<0.05). Two cases of bladder injury occurred during cesarean section in the TOLAC failure group (1.2%,2/166). The rates of the blood transfusion, puerperal infection, 5-minute Apgar score and neonatal ICU admission among the three groups were no statistically significantly different (all P>0.05). There was no maternal or perinatal death. (4) Multivariate logistic regression analysis showed that the delivery age of pregnant women ( OR=0.92, 95% CI : 0.87-0.98), pre-pregnancy BMI ( OR=0.92, 95% CI :0.86-0.98), vaginal delivery history ( OR=3.31, 95% CI : 1.35-8.01), cervical score ( OR=1.29, 95% CI :1.13-1.42) and the birth weight of the neonates <3 300 g ( OR=3.15, 95% CI : 2.02-4.90) were independent influencing factors for VBAC. The area under curve of the receiver operating characteristic curve was 0.74. Conclusions The influencing factors of VBAC are delivery age, pre-pregnancy BMI, vaginal delivery history, cervical score and neonatal birth weight <3 300 g. The adequate individualized management and assessment of the TOLAC may be helpful to improve the VBAC rate.

OBJECTIVE: To explore the genetic basis for an infant with congenital generalized lipodystrophy. METHODS: Peripheral blood samples of the child and her parents were collected for the extraction of genomic DNA. All exons and flanking sequences of the AGPAT2 gene were subjected to Sanger sequencing. RESULTS: The child was found to harbor compound heterozygous c.792_805delGGAGAACGGGGCCA (p.Gln264Hisfs*208) and c.335C>T (p.P112L) variants in exons 6 and 3 of the AGPAT2 gene, which were respectively inherited from her mother and father. c.792_805delGGAGAACGGGGCCA (p.Gln264Hisfs*208) was previously unreported, while c.335C>T (p.P112L) was known to be pathogenic. CONCLUSION The compound heterozygous variants of the AGPAT2 gene probably underlie the disease in this child.

Objective:To compare the antiosteoporosis effect of conventional treatment and conventional treatment combined with Denosumab after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 211 patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from September 2020 to September 2022. All the patients were female, aged 56-90 years [(71.4±8.1)years]. The bone mineral density T-score of the lumbar spine was (-2.6±1.0)SD before operation. Fracture segments included T 1-T 9 in 45 patients, T 10-L 2 in 146, and L 3-L 5 in 69. Of all, 174 patients were treated with single-segment surgery, 25 with two-segment surgery and 12 with surgery involving three or more segments. According to the wishes of the patients, 107 patients were treated with daily oral administration of calcium and active Vitamin D after PKP (conventional treatment group) and 104 patients with Denosumab combined with the conventional treatment after PKP (Denosumab therapy group). The bone mineral density T-scores of the lumbar spine of the two groups were compared before surgery and at the last follow-up. The visual analogue scale (VAS) and Oswestry disability index (ODI) before surgery, at 3 days, 6 months after surgery, and at the last follow-up were evaluated and the refracture rate after surgery was detected. Possible adverse effects after medication during anti-osteoporosis treatment were observed in two the groups. Results:All the patients were followed up for 12-24 months [(13.5±2.0)months]. Before surgery, the bone mineral density T-score of the lumbar spine was (-2.7±1.1)SD in the Denosumab therapy group and (-2.5±0.8)SD in the conventional treatment group ( P>0.05). At the last follow-up, the bone mineral density T-score of the lumbar spine was (-2.1±1.1)SD in the Denosumab therapy group, significantly higher than (-2.5±0.9)SD in the conventional treatment group ( P<0.05). In the Denosumab therapy group, the bone mineral density T-score of the lumbar spine at the last follow-up was significantly increased compared to that before surgery ( P<0.01), while there was no significant difference in the conventional treatment group ( P<0.05). Before surgery and at 3 days after surgery, the VAS scores and ODI values were (8.5±0.9)points, (2.8±0.8)points, 48.7±4.8 and 25.6±4.0 in the Denosumab therapy group, which was not statistically different from those in the conventional treatment group [(8.5±1.3)points and (2.8±0.9)points, 47.9±7.0 and 25.9±3.7] ( P>0.05). At 6 months after surgery and at the last follow-up, the VAS scores and ODI values were (2.2±0.8)points, (1.7±0.8)points, 24.2±3.6 and 23.2±4.1 in the Denosumab therapy group, significantly lower than those of the conventional treatment group [(2.8±0.9)points, (2.8±1.1)points, 26.4±3.2 and 27.3±4.0] ( P<0.01). The VAS scores at each time point after surgery in both groups decreased significantly compared with those before surgery ( P<0.05). The VAS scores continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while no significant difference was found among those at different time points in the conventional treatment group ( P>0.05). The ODI values at each time point after surgery in both groups significantly decreased compared to those before surgery ( P<0.05). The ODI values continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while in the conventional treatment group, no significant difference was found between those at 6 months after surgery and those at 3 days after surgery ( P>0.05) and they were improved at the last follow-up compared with those at 3 days after surgery ( P<0.05). The refracture rate after surgery was 6.7% (7/104) in the Denosumab therapy group, significantly lower than 16.8% (18/107) in the conventional treatment group ( P<0.05). No serious complications were observed during the antiosteoporosis period in either group. Conclusion:Compared with daily oral administration of Calcium and active Vitamin D after PKP, the conventional treatment combined with Denosumab after PKP can effectively increase the bone density, relieve pain continuously, improve functional restoration, and reduce the risk of refracture in OVCF patients.