Objective Based on investigating the results of brachial plexus nerve transfer to repair the femoral nerve in rats, C7 nerve root transfer to femoral nerve autograft to reconstruct the function of quadriceps femoris of paraplegia was designed and evaluated clinically. Methods 16 SD rats were randomized into 2 groups. Group A: the radial nerve of the left side was severed, and the proximal end of the radial nerve was transferred to the femoral nerve of the lower limb on the same side through the vascularized sciatic nerve bridging in one stage; Group B: the radial nerve anastomosed with the bridging nerve at first, then 3 months later the femoral nerve was sectioned, and the distal end of which anastomosed with the bridging nerve. Electrophysiology and histology including amplitude of compound action muscle potential, muscle wet weight, cross section areas were used to evaluate the effects at sixth month after operation. Furthermore, two patients with paraplegia were treated by the C7 nerve root transfer to reconstruct the function of quadriceps femoris. The C7 was sectioned at the distal of nerve root , and proximal end was used for motor nerve, the vascularized tibial nerve sectioned at the middle of the crus and dissected to the rump along the posterior of lower limb was reversed to the ipsilateral cervical incision through the tunnel and used for bridging nerve to anastomose with the proximal end of C7. When the nerve fiber regenerated into the hip through bridging nerve, the femoral nerve was sectioned and distal end anastomosed with bridging nerve. Results There was no significant difference between the two groups in the results of nerve regeneration and amplitude of compound action muscle potential, but group B was superior to the group A in muscle net weight and section area of muscle fiber. One case suffered paraplegia had already been repaired the double side femoral nerve by the method, after 41 months follow up, the muscle power of quadriceps was 4 grade on the right side and 3 grade on the left. The other was followed up for 24 months, the muscle power of quadriceps was 2 grade on both sides. Conclusion C7 nerve transfer to repair the femoral nerve through the vascularized tibial nerve bridging in two stages could reconstruct the movement and sensation function of lower limb of paraplegia.

ObjectiveTo discuss the more aesthetic and minimally invasive surgical approach of endoscopic thyroidectomy.Methods50 cases of endoscopic thyroidectomy via breast areola-axillary approach were retrospectively analyzed.Among these cases,12 received unilateral partial lobectomy,30 received unilateral total lobectomy and 8 received bilateral partial lobectomy.Results Endoscopic thyroidectomy was completed in all the patients.The intraoperative blood loss was ( 12.77 ± 20.12 ) ml.The operation time was (67.00 ± 21.28 )min.The postoperative hospital stay was (3.77 ± 0.50)days.Hoarseness occurred in 2 cases.All the 50 cases were followed up from 1 to 6 months and no other complication occurred.ConclusionEndoscopic thyroidectomy via breast areola-axillary approach is more aesthetic and minimally invasive; however,the operator needs an adaptive process for a better surgical view angle.

Cancer-related fatigue (CRF) is one of the most common symptoms in clinical cancer patients.It is associated with cancer itself or with cancer-related therapies.It is a persistent and subjective tiredness experience.It not only affects the patient;s physical,psychological and physical condition,social function,quality of life,but also may cause interruption of cancer-related treatment and affect the patient's life.However,the etiology and mechanism of CRF are not fully understood.Many foreign scholars believe that the occurrence of CRF may be related to anemia,obesity,tumor type,insomnia,inflammatory cytokines,hypothalamic-pituitary-adrenal axis and so on.As cancer patients demand higher quality of life,CRF are increasingly receiving medical attention.In this paper,the related factors and mechanisms of CRF are stated.

Objective:To summarize experience and effect of the stylized operation step in the neck endoscopic thyroidectomy for papillary thyroid microcarcinoma (PTMC).Methods:The clinical data of 51 patients who underwent transthoracic breast approach scarless neck endoscopic thyroidectomy (SET) from January 2018 to September 2019 in Tungwah Hospital Affiliated to Sun Yat-sen University were retrospectively analyzed. The operative procedure used stylized operation steps: establishment of operating space, three-step method thyroidectomy, central lymph node dissection (CLND), close operating space.Results:Among 51 patients, 25 cases underwent unilateral thyroidectomy plus isthmic resection, 26 cases underwent total/near-total thyroidectomy, and 16 cases underwent preventive CLND. The recurrent laryngeal nerve (RLN) was exposed in all 51 cases, the external branches of the superior laryngeal nerve (EBSLN) was exposed in 35 cases, no procedure was converted into open neck incision thyroidectomy. Forty-two cases were followed up, 2 cases had postoperative hoarseness and unilateral recurrent laryngeal nerve paralysis, which were recovered 55 and 75 d after operation respectively. There was no bucking, voice blunt or permanent low calcium. One patient had abnormal sensation of neck skin after operation, and recovered gradually 3 months after operation.Conclusions:The stylized operation step in the SET can increase safety of surgery.

Objective:To analyze the 6-year operation faults of PHILIPS Brilliance big bore CT, identify the common problems, make corresponding maintenance plans, reduce the incidence of failures, and carry out simulation prediction of the occurrence rate of failures in the next few years.Methods:The failure data of Brilliance big bore CT from June 2012 to June 2018 were collected, and the curve estimation function in SPASS 19.0 software and the pareto diagram were used to analyze the relationship between the number of failures, time and failure types, and the prediction was made.Results:A total of 28 faults occurred during the 6-year opeation of Brilliance big bore CT. During the first half year, five times of faults occurred with the highest fault rate and then tended to stabilize. The linear function model was obtained using the curve estimation: y=-0.033 x+ 2.099( y for the number of fault, unit for times, x for the unit of time for half a year), the model of R2=0.003. In the next three years, approximately twice faults occurred within half year. The pareto chart showed that 16 faults occurred during data collection, including 3 faults in the treatment bed and 3 faults in the power supply system, respectively. The accumulative ratio of the above three faults was 71.4%, which were the main fault sources. Conclusion:The fault statistical analysis of Brilliance big bore CT is helpful for department maintenance personnel to better understand CT, develop effective maintenance programs, reduce the occurrence of faults, and predict the incidence of faults in the future.

BACKGROUND: Mesenchymal stem cell (MSC)-based cell transplantation is an effective means of treating chronic liver injury, fibrosis and end-stage liver disease. However, extensive studies have found that only a small number of transplanted cells migrate to the site of injury or lesion, and repair efficacy is very limited. METHODS: Bone marrow-derived MSCs (BM-MSCs) were generated that overexpressed the erythropoietin (EPO) gene using a lentivirus. Cell Counting Kit-8 was used to detect the viability of BM-MSCs after overexpressing EPO. Cell migration and apoptosis were verified using Boyden chamber and flow cytometry, respectively. Finally, the anti-fibrosis efficacy of EPO-MSCs was evaluated in vivo using immunohistochemical analysis. RESULTS: EPO overexpression promoted cell viability and migration of BM-MSCs without inducing apoptosis, and EPO-MSC treatment significantly alleviated liver fibrosis in a carbon tetrachloride (CCl4 ) induced mouse liver fibrosis model. CONCLUSION EPO-MSCs enhance anti-fibrotic efficacy, with higher cell viability and stronger migration ability compared with treatment with BM-MSCs only. These findings support improving the efficiency of MSCs transplantation as a potential therapeutic strategy for liver fibrosis.

BACKGROUND: Mesenchymal stem cell (MSC)-based cell transplantation is an effective means of treating chronic liver injury, fibrosis and end-stage liver disease. However, extensive studies have found that only a small number of transplanted cells migrate to the site of injury or lesion, and repair efficacy is very limited. METHODS: Bone marrow-derived MSCs (BM-MSCs) were generated that overexpressed the erythropoietin (EPO) gene using a lentivirus. Cell Counting Kit-8 was used to detect the viability of BM-MSCs after overexpressing EPO. Cell migration and apoptosis were verified using Boyden chamber and flow cytometry, respectively. Finally, the anti-fibrosis efficacy of EPO-MSCs was evaluated in vivo using immunohistochemical analysis. RESULTS: EPO overexpression promoted cell viability and migration of BM-MSCs without inducing apoptosis, and EPO-MSC treatment significantly alleviated liver fibrosis in a carbon tetrachloride (CCl4 ) induced mouse liver fibrosis model. CONCLUSION EPO-MSCs enhance anti-fibrotic efficacy, with higher cell viability and stronger migration ability compared with treatment with BM-MSCs only. These findings support improving the efficiency of MSCs transplantation as a potential therapeutic strategy for liver fibrosis.