Objective To compare real -time tissue elastography (RTE)and ultrasound in the diagnosis of papillary thyroid carcinoma (PTC)with cervical lymph node (LN)metastasis.Methods A retrospective analysis was carried out on the clinical data of 72 patients with PTC.Eighty -four LNs of them were performed with ultrasound-guided fine -needle aspiration biopsy.Patients were divided into two groups:with cervical lymph node metastasis group and without cervical lymph node metastasis group.All patients were reviewed their B -mode ultrasonography (BUS)on cervical lymph node and RTE on thyroid.RTE elasticity indices (EI)of mean (Emean),minimum (Emin),maximum (Emax)and the ratio of Emean in LNs and surrounding muscle (Emean -m)were measured at the thyroids.The performances of RTE and BUS in predicting of PTC with LN metastasis were compared and ana-lyzed.Results The sensitivity and specificity of BUS on diagnosis of the cervical lymph nodes metastasis were 84.0% and 90.0%.The RTE Emea,Emax,Emin and SI in meta -static LNs were significantly higher than those in benign LNs(P =0.001,0.002,0.001,0.007).The RTE results of PTC patients with lymph node metastasis was ana-lyzed by ROC curve.The largest area was Emin.AUC was 0.918,the critical value was 0.240.AUC of SI was 0.896, AUC of Emean was 0.718,AUC of Emax was 0.670.The sensitivity and specificity were 94.0% and 99.4%,respec-tively.Conclusion Co -operation of RTE and BUS was more accurate than simple BUS in diagnosis of PTC with lymph node metastasis.SI and Emin has a high diagnostic value.

Objective To study the therapeutic effects and mechanism of Sodium Fendate(SF) on rats with severe acute pancreatitis(SAP) induced by L-arginine. Method A total of 60 adult SD rats were randomly and e-qually divided into control group, SAP group and SF group, with 20 rats in each group. The rat model of SAP wes established by injecting 2.5 g/kg L-arginine at a dose of intraperitoneally twice at an interval of 1 hour, and rats in SAP group and SF groups were administrated intraperitoneally with 20% L-arginine solution(2.5 g/kg×2) twice at an interval of 1 hour; rats in control group were injected intraperitoneally with the same volume of physiological saline twice alone.At 5 minutes after L-arginine administration,rats in SF group were injected with SF solution (100 mg/kg, qd×3 d) via the tail vein, and rats in the other two groups received a sham injection of the same volume of physiological saline alone. The characteristics of ascites, the pathological changes of pancreatic tissue and the serum levels of amylase(AMY), endothelin-l(ET-1), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and the contents of malonaldehyde (MDA), suede dismutase (SOD), reduced glutathioue (GSH) of pan-creatic tissue of rats and prognosis were compared at 72 hours after L-arginine administration. Measurement data were evaluated by oue-way ANOVA, and numeration data were assessed by Fisher' s exact test. P<0.05 was considered statistically significant. Results Compared with control group,at 72 hours after L-arginine administra-tion,rats in SAP group presented characteristically histopathological changes of SAP with significantly higher serum levels of AMY, ET-1, TNF-α, IL-6 and MDA of pancreatic tissue[(9715.5±301.3) IU/L vs. (729.2±134.2) IU/L;(25.32±3.67) ng/L vs. (14.32±2.69) ng/L;(102.95±11.24) ng/L vs. (38.62±3.87) ng/L; (538.63±9.53) ng/L vs. (186.35±1.19) ng/L;(34.8±3.9) mol/kg vs. (8.1±2.1) mol/kg, all P< 0.01], and lower GSH and SOD in the pancreatic tissue[(7.1±0.6) mg/kg vs. (16.9±1.9) mg/kg; (6423± 1978) kU/kg vs. (29905+2945) kU/kg,both P<0.01].Compared with SAPmodel group,at 72 hours after ad-ministration of L-arginiue, the pathological lesions of SAP in rats of SF group were significantly alleviated with lower pathological scores (P<0.05), lower serum levels of AMY, ET-1 ,TNF-α,IL-6 and MDA in the pancreatic tissue [(8104.6±149.9) IU/L vs. (9715.5±301.3) IU/L; (20.26±5.86) ng/L vs. (25.32±3.67) ng/L; (84.19±15.14) ng/L vs. (102.95±11.24) ng/L;(458±5.37) mol/kg vs. (538.63±9.53) rig/L;(28.3±2.5) moL/kg vs. (34.8±3.9) mol/kg,all P<0.05], and higher SOD and GSH in the pancreatic tissue[(8.5 ±1.4) mg/kg vs. (7.1±0.6) mg/kg;(10 316±2810) kU/kg vs. (6423±1978) kU/kg, both P<0.05].At 72 hours the death rate in SF group was lower than that in SAP group,but the difference had no significance (P= 0.2.5). Conclusions SF can scavenge oxygen-derived free radicals, upgrade the contents of SOD and GSH of pancreatic tissue,decrease the levels of serum proinflammatory cytokines and ET-1, ameliorate the pathological le-sions of pancreatic tissue in rats,and has the capability of decreasing death rate, so it possesses a distinct advantage for the treatment of SAP.

Objective:To explore the role CD4+CD45RO+memory T cells in the pathogenesis of Hashimoto's thyroiditis (HT) by detecting the percentages of CD4+CD45RO+ memory T cells in peripheral blood mononuclear cells in peripheral blood of newly diagnosed HT patients. Methods:53HT patients and 43 matched healthy controls (HC) were included in this study. According to the thyroid functions,HT patients were divided into euthyroid subset(HT-A,n =15) ,subclinical hypothyroidism(HT-B,n=14) and overt hypothyroidism subset (HT-C,n=24). The percentages of CD4+CD45RO+memory T cells in PBMCs,as well as the level of serum IFN-γ and IL-17,and thyroid functions,and the titers of thyroid-specific autoantibodies (TPOAb,TgAb) were respectively detected by flow cytometry,ELISA,and ECLIA. Results:The percentages of CD4+CD45RO+ memory T cells in PBMCs,as well as the level of serum IFN-γ and IL-17,the titers of TPOAb,TgAb were all significantly higher than that in HC(P<0. 01). Bivariate correlation revealed that the percentages of CD4+CD45RO+ memory T cells positively correlated with the level of serum IFN-γ,TPOAb and TgAb(P<0. 01,P=0. 015,P<0. 01) in HT patients. Conclusion:The significant increase of CD4+CD45RO+memory T cells in peripheral blood of patients with HT suggested a role of CD4+CD45RO+ memory T cells in the pathogenesis of this disease.

Lysine-germanium ( Ge401 ) was a newly synthesized organoger-manium compound in China. The LD50 of Ge401 for mice was 9.26 and 5.62 g/kg po and ip administrations. The inhibition rates of subcutaneously transplanted S-180 sarcoma in mice were 25%, 32% and 55% respectively when ip, po and iv administrations of Ge401 were used. The antitumor activity of cyclophosphamide (30 mg/kg? 2d-1, ip ) in S-180 bearing mice was significantly potentiated by Ge401 (30 mg/kg?d-1, iv ) .

Objective To summarize the clinical technique and experience of one stage combination of renopancreatic transplantation(SKPT) with portal venous drinage of pancreatic endocrine and enteric drainage of exocrine(PE).Methods Five patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with PE drainage.The clinical data,operative techbuque,and the prevention of non-technical complications were summarized.Results This procedure was successfully applied in the 5 patients.Three patients recovered excellently;but 2 died perioperatively,one died of sepsis due to pancreatic leakage,and one of FK506 toxicity.On postoperative day 3,in the 3 survivors,blood creatinine and urea nitrogen levels returned to normal;insulin administration was discontinued on 7d postoperatively,and the endogenous and exogenous secretory functions of the graft were normal.Conclusions SKPT with PE is a resonable procedure,because of its potential physiologic,metabolic,and immunologic advantages.PE drainage may become the prefer technique of pancreas transplantation.Intensive perioperative managements are effective methods to prevent complications and to improve the therapeutic effects.

Objective To investigate the effect of thyroid stimulating hormone (TSH) on the expression of endothelial nitric oxide synthase (eNOS) and its mechanism in human microvascular endothelial cells (HMEC-1) in vitro culture.Methods Different concentrations of TSH (0,10,50 mIU/ml) were used to intervene HMEC-1.The expression of eNOS mRNA was detected with quantitative polymerase chain reaction (qPCR) method.The protein expressions of eNOS,phosphorylated protein kinase B (p-AKT),protein kinase B (AKT),phosphorylated extracellular signal-regulated kinase (P-ERK),and extracellular signal-regulated kinase (ERK) were determined with Western Blot.Results (1) The expression level of eNOS was significantly decreased by TSH in dose-dependent manner (P ＜ 0.05).(2) TSH could promote the phosphorylation of AKT and ERK (P ＜ 0.05).Conclusions Thyroid-stimulating hormone may inhibit the expression of nitric oxide synthase in human microvascular endothelial cells by activating AKT and ERK signaling pathways.

Objective To explore the influencing factors of medication experience in patients with schizophrenia based on benefit-risk perception.Methods Patients with stable schizophrenia who were hospitalized in 2 tertiary psychiatric hospitals in Heilongjiang Province from September to December 2023 were selected by convenience sampling method.A convergent mixed method was adopted.In quantitative study,data of 400 patients were collected by general situation questionnaire,Subjective Well-being Under Neuroleptic Treatment Scale,the Living with Medicines Questionnaire,Beliefs about Medication Questionnaire,Positive and Negative Syndrome Scale.Binary logistic regression analysis was used to explore the influencing factors of medication experience in patients with schizophrenia.15 patients with adverse medication experience in quantitative study were selected for qualitative study,and the interview data were sorted and analyzed according to the topic frame analysis method.Results Quantitative results:medication burden,medication beliefs,and psychiatric symptoms of patients with schizophrenia were influential factors of medication experience(P<0.05).Qualitative results:the medication experience of schizophrenia patients includes 4 themes,namely perceived necessity of medication,perceived benefit of medication,perceived risk of medication,and the need for multi-party cooperation to improve the medication experience.The results of quantitative and qualitative research are complementary in terms of perceived benefit,consistent in terms of perceived risk,and expansive in terms of perceived value.Conclusion Psychiatric nurses can reduce patients'perceived risk of medication,enhance the perceived benefit of medication,and then improve patients'adverse medication experience and promote mental rehabilitation.

Objective To analyze the efficacy and safety of CyberKnife combined with temozolomide (TMZ) in treatment of brain metastasis of non-small cell lung cancer (NSCLC). Methods From March 2013 to March 2016, 62 NSCLC patients with brain metastases in department of oncology of the 187th Hospital of PLA were divided into two groups according to the random number table method, the CyberKnife combined with TMZ group (CyberKnife + TMZ group, 31 cases) and simple CyberKnife group (CyberKnife group, 31 cases). Hypofractionated radiation of CyberKnife was given 18-36 Gy in 1-5 fractions of 5-25 Gy. CyberKnife+ TMZ group was given temozolomide 150 mg·m-2·d-1 for 5 days in first cycle, then every 28 days they received temozolomide therapy from the second to the sixth cycles: 200 mg·m-2·d-1 for 5 days. The clinical symptom remission rate after the treatment of CyberKnife in one week, the effective rate after CyberKnife in 3 months, the median intracranial progression-free survival time, overall survival, and the incidences of adverse reaction were comparatively analyzed. Results The clinical symptom remission rates of CyberKnife+TMZ group and CyberKnife group after the treatment of CyberKnife in one week were 93.6 ％ (29/31) and 96.8 ％ (30/31). There was no significant difference in the clinical symptom remission rates (χ2= 1.207, P=0.547). The effective rates of the two groups after CyberKnife in 3 months were 93.6 ％ (29/31) and 90.3 ％(28/31). There was no significant difference in the effective rates (χ2 = 0.695, P= 0.706). The median intracranial progression-free survival time in CyberKnife + TMZ group (14.0 months) was significantly higher than that in the CyberKnife group (9 months) (χ2=8.977, P=0.003), and the median overall survival time in CyberKnife + TMZ group (15.0 months) was also significantly higher than that in the CyberKnife group (12.0 months) (χ2 = 5.190, P= 0.023). There was no significant difference in the adverse reaction of the central nervous system between the two groups (χ2=0.746, P=0.689), but the adverse reactions of the digestive system (χ2 = 6.062, P= 0.014) and the hematologic system (χ2 = 6.613, P= 0.010) in CyberKnife + TMZ group were significantly higher than those in the CyberKnife group. Systemic adverse reactions of the two groups were tolerated by most patients. Conclusions CyberKnife combined with TMZ is a feasible therapeutic option for NSCLC patients with brain metastases. This therapy can improve the median survival time to cerebral progression of the disease and the median overall survival time.

Objective:To compare the clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy (RARP) versus extraperitoneal single port RARP.Methods:A retrospective analysis was perfoumed on 142 cases of RARP from July 2019 to June 2020 in Robotic Minimally Invasive Center of Sichuan Provincial People's Hospital, including 82 cases(Group A) , aged 70.0(65.6-78.0), undergoing transperitoneal RARP and 60 cases(Group B), aged 68.2 years old(60.1-79.2), undergoing extraperitoneal single port RARP. For group A, PSA was 12.9(5.6-64.0) ng/ml, with 26 cases of less than 10 ng/ml(31.7%), 40 cases of 10-20 ng/ml(48.8%), and 16 cases of more than 20 ng/ml(19.5%), the Gleason score was 7.2(6.0-10.0), with 14 cases(17.1%) of ≤6, 56 cases(68.3%) of 7, and 12 cases(14.6%) of ≥8, and the prostate volume was 61.3(29.0-112.0) ml. There were 49 cases with BMI≤25 kg/m 2, accounting for 59.8%, and 33 cases with BMI>25 kg/m 2, accounting for 40.2%. There were 17 cases(20.7%) of T 1, 44 cases(53.7%) of T 2 and 21 cases(25.6%) of T 3. The proportion of lymph node dissection was 17.1%, and 4 cases(4.9%)had a history of operation. For group B, the PSA was 12.2(1.0-42.6)ng/ml, with 20 cases (33.3%) of <10 ng/ml, 31 cases(51.7%)of 10-20 ng/ml, and 9 cases (15%) of >20 ng/ml. Gleason score was 7.1(6.0-9.0), with 12 cases (20.0%) of ≤6, 42 cases (70.0%) of 7, and 6 cases (10.0%)of ≥8. Prostate volume was 42.4(31.2-72.8)ml on average. There were 37 cases (61.7%) with BMI≤25 kg/m 2, and 23 cases (38.3%)with BMI >25 kg/m 2 . There were 17 cases(28.3%)of T 1, 32 cases(53.3%)of T 2 and 11 cases(18.3%)of T 3.The proportion of lymph node dissection was 11.7% and 4 cases (6.7%) had a history of operation.There was no statistically significant difference in term of age, PSA level, Gleason score, BMI, clinical stage, proportion of lymph node dissection or history of operation between the two groups( P>0.05), but there was statistically significant difference for prostate volume( P<0.05). All operations were performed by the same operator. Four different ways of bladder neck and urethral dissociation was selected according to the intraoperative conditions in Group A, include VIP style, T-shape incision style, VIP plus T-shape incision style or the style along the lateral side of the bladder neck. Small and single anterograde incision stripping of bladder neck was routinely performed in the Group B. Postoperative follow-up was performed to compare the operation time, intraoperative blood loss, bladder neck and urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, postoperative complications, positive rate of surgical margin, indwelling time of urinary catheter, urinary continence satisfaction rate of immediately after operation, 3 months and 6 months after operation, wound healing and aesthetics. Results:All of the operations were successfully completed under robot-assisted laparoscopy, and there was no conversion to open surgery. The operation time was 56.0(45.0-112.0) min in the Group A and 65.4(55.5-96.8) min in the Group B, and there was no statistically significant difference( P>0.05). The intraoperative blood loss was 76.2(30.0-120.5) ml and 55.6(45.5-114.6) ml, respectively, and the difference was not statistically significant( P>0.05). The time of bladder neck urethral anastomosis was 18.9(12.6-25.6) min and 16.2(10.7-19.3) min, respectively, and the difference was not statistically significant( P>0.05). The postoperative hospital stay days were 9.3(8.0-16.0) d and 8.4(7.0-13.0) d, respectively, and the difference was not statistically significant( P>0.05). The postoperative exhaust time was 1.3(0.7-3.0) d and 3.4(2.0-7.0) d, respectively, and the difference was statistically significant( P<0.05). There was 1 case of anastomotic fistula with ureteral injury in Group A, and no serious complication in Group B, and the difference was not statistically significant( P>0.05). The number of positive surgical margin in the two groups was 13(15.9%)and 9(15.0%)respectively, and the difference was not statistically significant( P>0.05). The indwelling time of urinary catheter after operation was 9(7-21) d and 6(4-8) d, respectively, and the difference was statistically significant( P<0.05). The number of patients with satisfactory urinary continence immediately after surgery, 3 months and 6 months after surgery in the two groups were 8(9.8%), 51(62.2%), 62(75.6%) and 17(28.3%), 43(71.7%) and 54(90.0%), respectively. The differences were statistically significant( P<0.05). The total incision lengths in the two groups were 12.1(10.4-13.4) cm and 5.6(5.0-6.0) cm, respectively, and the difference was statistically significant( P<0.05). Conclusions:The extraperitoneal single port RARP is safe and feasible, and the postoperative effect is similar to that of transperitoneal RARP. It has the advantages of shorter recovery time, higher urinary continence satisfaction rate, neater and more beautiful incision. The long-term therapeutic effect needs further confirming by prospective study.

Objective:To explore the clinical effects of concentrated growth factor (CGF) combined with plasma albumin gel (PAG) in treating facial depressed scar.Methods:From January 2018 to June 2019, 14 patients in the First Affiliated Hospital of Zhengzhou University and 10 patients in Henan NO.3 Provincial People′s Hospital with facial depressed scar who met the inclusion criteria were admitted, and their clinical data were retrospectively analyzed by the method of case-control study. Based on the method of treatment, 8 patients (4 males and 4 females) aged 28.50 (25.50, 31.50) years were enrolled in CGF alone group, 8 patients (3 males and 5 females) aged 32.00 (28.50, 35.00) years were enrolled in PAG alone group, and 8 patients (5 males and 3 females) aged 33.50 (29.00, 35.75) years were enrolled in CGF+ PAG group. Suitable amount of CGF, PAG, and CGF+ PAG (mixed at a ratio of 1.0∶1.0-1.0∶1.5) prepared from autologous blood were injected subcutaneously via a single or multiple entrance (s) into the depressed scar of patients in CGF alone, PAG alone, and CGF+ PAG groups respectively to fill up the concavity, once every 4 weeks for a total of 3 times. Before the first treatment (hereinafter referred to as before treatment) and 3 months after the last treatment (hereinafter referred to as after treatment), the Goodman & Baron Acne Scar Grading System was used for scar grading, and the difference was calculated; the Anxiety Self-Rating Scale was used to score anxiety, and the difference was calculated. The Visual Analogue Score was used to score pain immediately after the first treatment. By one, two, and three months after treatment, the patients′ satisfaction to scar treatment was scored, and the Global Aesthetic Improvement Scale was used to score the scar improvement. Adverse reaction of patients after treatment was monitored. Data were statistically analyzed with Fisher′s exact probability test, Kruskal-Wallis H test, Mann-Whitney U test, Bonferroni correction, and Wilcoxon signed rank sum test. Results:(1) The scars of patients in the three groups were all graded 4.00 (4.00, 4.00) before treatment ( χ2<0.001, P>0.05). By three months after treatment, compared with 2.00 (1.25, 2.00) of CGF alone group, the scar grades of patients in PAG alone group and CGF+ PAG group (3.00 (2.00, 3.00) and 1.00 (1.00, 1.00), respectively) had no significant change ( Z=2.199, 2.003, P>0.05). The scar grade of patients in CGF+ PAG group was significantly lower than that in PAG alone group ( Z=3.229, P<0.01). Compared with those before treatment, the scar grades of patients in CGF alone group, PAG alone group, and CGF+ PAG group were significantly reduced three months after treatment ( Z=2.588, 2.598, 2.640, P<0.05 or P<0.01). The difference in scar grade before and after the treatment was significantly higher in CGF+ PAG group than in PAG alone group ( Z=3.229, P<0.01). (2) The anxiety scores of patients in the three groups were similar before treatment and 3 months after ( χ2=2.551, 2.768, P>0.05). Compared with those before treatment, the anxiety scores of patients in CGF alone group, PAG alone group, and CGF+ PAG group were significantly reduced three months after treatment ( Z=2.395, 2.527, 2.533, P<0.05). The differences in anxiety score before and after the treatment were similar among the three groups ( χ2=1.796, P>0.05). (3) The pain scores of patients in the three groups were similar immediately after the first treatment ( χ2=0.400, P>0.05). (4) By one and two month (s) after treatment, the patients′ satisfaction scores to scar treatment in the three groups were similar ( χ2=2.688, 5.989, P>0.05). By three months after treatment, the patients′ satisfaction score to scar treatment in CGF+ PAG group was significantly higher than that in PAG alone group ( Z=2.922, P<0.01). Compared with those one month after treatment within the same group, the patients′ satisfaction scores to scar treatment in CGF alone group, PAG alone group, and CGF+ PAG group were significantly increased two and three months after treatment ( Z=1.121, 2.392, 2.000, 2.828, 2.449, 2.598, P<0.05 or P<0.01). Compared with those two months after treatment within the same group, the patients′ satisfaction scores to scar treatment in CGF alone group, PAG alone group, and CGF+ PAG group were significantly increased three months after treatment ( Z=2.271, 2.000, 2.646, P<0.05 or P<0.01). (5) One month after treatment, the scar improvement scores of patients in the three groups were similar ( χ2=4.438, P>0.05). Two months after treatment, the scar improvement scores of patients in CGF alone group and CGF+ PAG group were 2.00 (2.00, 2.75) and 2.00 (2.00, 2.00) points, respectively, which were significantly higher than 1.00 (1.00, 1.00) point of PAG alone group ( Z=3.303, 3.771, P<0.01). Three months after treatment, the scar improvement score of patients in CGF+ PAG group was 3.00 (3.00, 3.00) points, which was significantly higher than 2.00 (2.00, 2.75) points of CGF alone group and 1.00 (1.00, 2.00) points of PAG alone group ( Z=2.450, 3.427, P<0.05 or P<0.01). Compared with those one month after treatment within the same group, the scar improvement scores of patients were significantly higher in CGF alone group and CGF+ PAG group two and three months after treatment and in PAG alone group three months after treatment ( Z=2.828, 2.828, 2.530, 2.640, 2.121, P<0.05 or P<0.01). Compared with that two months after treatment within the same group, the scar improvement score of patients in CGF+ PAG group was significantly higher three months after treatment ( Z=2.449, P<0.05). (6) After injection, all patients in the three groups had slight redness and swelling at the needle prick point and no other adverse reactions. Conclusions:CGF combined with PAG can reduce the scar grading, anxiety of patients, and enhance patients′ satisfaction and scar improvement in the treatment of patients with facial depressed scar. The combined CGF+ PAG injection, without significant adverse reactions, is better than single component injection and is worthy of clinical application.