Objective To evaluate the methods of carrying out radiotherapy quality control (QC) and quality assurance (QA) in the whole province. Methods From 1995, radiotherapy quality control center of Zhejiang province (the guiding team consists of specialists in radiation oncology of the province) has carried out a QC and QA program including evaluation of administration, departmental infrastructure, equipment, staff and treatment for 28 centers in the whole province. The regulation and scoring system were designed and first informed to every center, with the 28 centers checked and examined by the guiding team from 1999 to 2000. Results Great variations in equipment and staff were observed among participating centers. Equipment condition was not very satisfactory. Most of the treatment protocols were reasonable except that the indication for radiotherapy was not strict enough in some centers. Conclusions It is feasible for the radiotherapy quality control center to check and examine the department of radiation oncology in the whole province. Good QC and QA is invaluable to standardize the treatment protocol and ensure the radiotherapy quality and also helpful to carry out multi center study in the future.

Background: The intake of red meat and processed meat will increase the risk of colorectal cancer. Heterocyclic amines (HCAs), the intermediate mutagen in the processing of meat food, may be a potential risk factor for meat food to cause cancer. Aims: To investigate the association between HCAs intake and colorectal cancer, thereby providing a basis for prevention of colorectal cancer. Methods: Case-control and cohort studies concerning the association between HCAs intake and colorectal cancer were retrieved from PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang and CQVIP databases. The literature was screened according to the inclusion and exclusion criteria. Meta-analysis was conducted by Stata 12.1 software. Results: A total of 17 studies involving 18 295 colorectal cancer patients were included, of which 14 were case-control studies and 3 were cohort studies. MeIQx intake could increase the risk of colorectal cancer (OR=1.16, 95% CI: 1.01-1.32, P=0.032), DiMeIQx intake (OR=1.20, 95% CI: 1.01-1.43, P=0.045), MeIQx intake (OR=1.24, 95% CI: 1.03-1.50, P=0.023) could increase the risk of colon cancer. No association between PhIP, HCAs and colorectal cancer, colon cancer, or rectal cancer was found. No dose-response relationship between DiMeIQx, MeIQx, PhIP, HCAs and colorectal cancer was found. Conclusions: MeIQx intake may increase the risk of colorectal cancer, DiMeIQx, MeIQx intake may increase the risk of colon cancer, and no dose-response relationship between HCAs intake and colorectal cancer was found.

Objective: To review the research progress of the surgical treatment for lateral malleolus defect. Methods: The related literature about surgical treatment and effectiveness of lateral malleolus defect at home and abroad was reviewed, summarized, and analysed. Results: Lateral malleolus defects are often caused by severe trauma or wide resection of fibular neoplasms. Although the incidence is not high, the defects are difficult to handle. These bony defects should be reconstructed to prevent an abnormal gait induced by ankle instability and avoid the occurrence of traumatic arthritis. Various repair methods have been developed, including bone transplantation, fibula lengthening, and ankle arthrodesis. Conclusion: There are various surgical methods to repair the defect of lateral malleolus, but each has its own advantages and disadvantages. In order to achieve the best results, the surgeon should choose the appropriate operation according to his own level, the patient's specific injury, and age.

Objective: To analyze the mutation of autoimmune regulator ( AIRE ) gene in a pedigree with autoimmune polyendocrine syndrome type Ⅰ (APS-Ⅰ). Methods: The peripheral blood samples from family members were collected for DNA extraction, and then the mutation sites on AIRE gene were screened by PCR and Sanger sequencing. The mutation sites were further verified in 100 healthy persons by the created restriction site PCR (CRS-PCR) and PCR restriction fragment length polymorphism (PCR-RFLP). The effects of mutation on the structure and function of AIRE protein were analyzed with SIFT, PolyPhen-2, Mutation Taster and Antheprot Editor softwares. The effects of mutation on the splicing sites of AIRE mRNA were predicted with Alternative Splice Site Predictor, FruitFly Splice Predictor and SplicePort softwares, and further verified by Sanger sequencing. Results: Two novel heterozygous mutations c.47 C＞G T16R and c.1631-2 A＞T were found in the proband. The c.47 site is highly conserved and homologous in different species. The missense mutation of c.47C＞G changed the secondary structure and hydrophobicity of AIRE protein, and affected its function. The c.1631 -2 A＞T mutation changed the splicing site of AIRE mRNA, and led to the deletion of exon 13. Conclusion Two novel pathogenic mutations c.47 C＞G T16R and c.1631-2 A＞T are identified in a pedigree with autoimmune polyendocrine syndrome type Ⅰ.

Objective: To investigate the expression and clinical significance of circDLGAP4 from peripheral blood in coronary heart disease (CAD). Methods: The relative expression level of circDLGAP4 in peripheral blood leukocytes (PBLs) from 142 CAD patients and 169 healthy controls were detected by real-time PCR. Logistic regression, Spearman correlation and multivariate regression analysis were used to investigate the correlation of circDLGAP4 with CAD. THP-1 macrophages were treated with oxidized low density lipoprotein (ox-LDL) to construct an atherosclerotic foam cell model. The levels of circDLGAP4 mRNA were detected at different time points. Results: The mRNA expression of circDLGAP4 in PBLs of CAD patients was significantly decreased compared with controls (P=0.019). With increased unit (2 -ΔCt ) of circDLGAP4 expression, the risk of CAD occurrence reduced by 41.6% (adjusted OR=0.584, 95% CI: 0.394-0.866, P=0.007). The expression of circDLGAP4 was negatively correlated with T2DM history (β=-0.182，P=0.030). The level of circDLGAP4 in ox-LDL-treated THP-1 macrophages was decreased in a time-dependent manner. Conclusion The expression of circDLGAP4 was significantly decreased in PBLs of CAD patients and THP-1 macrophages-derived foam cells, and might be a protective factor in the pathophysiology of CAD.

Objective  To study the effects of fine particulate matter(PM_2.5) on the autophagy in human melanocytes. Methods PM_2.5 was collected in Huanggang city. Then the water-soluble extracts and non-water-soluble extracts were isolated and the melanocytes were exposed to a W-PM_2.5 or NW-PM_2.5 with various concentrations. Autophagy of melanocytes was observed by MDC staining, and the expression of LC3-II /I were detected by immunohistochemistry and western blot. Results With the increase of concentration of W-PM_2.5 and NW-PM_2.5, the expression of melanocyte autophagosome and LC3-II /I increased, and the autophagy response was significantly enhanced（P<0.01）.In addition, the results of western blot showed that, at the same concentration, NW-PM_2.5 components had a stronger effect on promoting LC3II/I expression than W-PM_2.5 components（P<0.01）.Conclusion PM_2.5 can induce oxidative stress injury and excessive autophagy of melanocytes.

Objective: To explore the values of intraoperative fine-needle aspiration (IFNA) and parathyroid hormone (PTH) detection in the eluate of aspirated tissue during parathyroidectomy. Methods: Fifty-four patients with secondary hyperparathyroidism (SHPT) including 24 males and 30 females, aged 20-83 years, admitted to Zhongnan Hospital of Wuhan University from January 2019 to October 2019, were included. All patients received subtotal parathyroidectomy with autologous transplantation, during surgery, IFNA and PTH detection in the eluate of aspirated tissue were performed, and also routine postoperative pathological examination was performed. The results of PTH detection in the eluate of aspirated tissue and postoperative pathological examinations were compared and analyzed by SPSS and R software for evaluating of the sensitivity, specificity, positive predictive value, negative predictive value, misdiagnosis rate, missed diagnosis and accuracy. Results: Surgery was completed successfully in all patients. After surgery, the symptoms were improved in the patients except two who were asymptomatic. None had any serious postoperative complications such as hypocalcaemia or hoarseness. A total of 231 aspirated tissue samples were tested, of which 216 were identified as parathyroid and 15 non-parathyroid based on intraoperative PTH detection in tissue eluate; while 217 were confirmed as parathyroid tissues and 14 non-parathyroid tissues with postoperative pathological examinations. The specificity and sensitivity of intraoperative IFNA and PTH detection in tissue eluate for identifying parathyroid tissues were 99.5% and 100.0%, respectively. Conclusion: The IFNA and PTH detection in tissue eluate is a rapid, simple, and accurate procedure, which helps the surgeon to identify parathyroid tissue and to ensure the endocrine activity of preserved or autografted parathyroid tissue during parathyroidectomy.
Female ; Humans ; Hyperparathyroidism, Secondary/surgery* ; Male ; Parathyroid Glands/surgery* ; Parathyroid Hormone ; Parathyroidectomy ; Predictive Value of Tests

Objective: To investigate the application efficacy of the "classification of external branch of superior laryngeal nerve (EBSLN)" combined with intraoperative neuromonitoring (IONM) in the dissection of EBSLN for protecting the nerve from injuery, compared with ligation of branches of the superior thyroid vessels without attempts to visually identify the nerve. Methods: A prospective randomized controled study was performed in our center. Patients subjected to thyroidectomy from January 2017 to June 2019 were randomly divided into 2 groups, patients in experimental group underwent thyroidectomy and "classification of EBSLN" with IONM to dissect EBSLN, and patients in control group received synchronous surgery without attempts to visually identify the nerve. The anatomical subtypes of EBSLN in experimental group were recorded. The voice handicap index 10 (VHI-10) score was evaluated and the movement of bilateral vocal cords was examined by laryngoscope before surgery, 1 month, 3 months, and 6 months after surgery, respectively. SPSS 26.0 statistical software was used for statistical analysis. Results: Among the 1 377 EBSLN from 827 patients (317 males and 510 females, aged 24-58 years old), 691 EBSLNs in experimental group and 686 EBSLNs in control group. Totally 98.3% of EBSLNs in experimental group were identified by IONM including 16.4% (113/691) for type Ⅰ, 21.3% (147/691) for type Ⅱa, 31.4% (217/691) for type Ⅱb, 10.4% (72/691) for type Ⅲa, 3.9% (27/691) for type Ⅲb, 16.6% (115/691) for type Ⅲc. There was no statistical significance difference in baseline data between 2 groups (all P>0.05). All patients were followed up for more than 6 months. The postoperative nerve injury rate of experimental group was significantly lower than that of control group (1.2% vs. 7.5%, χ²=12.659, P<0.001), and the VHI-10 scores and laryngoscope results of experimental group were better than those of control group in three follow-up visits (P<0.001). With postoperative laryngoscope examination, 3 patients in the experimental group and 23 patients in the control group showed vocal cord relaxation, bilateral oblique asymmetry and other phenomena, which were considered as the results of permanent injury. Other patients with symptoms were relieved to varying degrees during the follow-up, and their symptoms were considered as the results of temporary injury. Conclusion: IONM combined with "classification of EBSLN" can reduce significantly the risk of EBSLN injury in thyroidectomy, which is better than direct ligation of branches without attempts to visually identify the nerve.
Adult ; Female ; Humans ; Laryngeal Nerve Injuries ; Laryngeal Nerves ; Male ; Middle Aged ; Monitoring, Intraoperative ; Prospective Studies ; Thyroid Gland ; Thyroidectomy ; Young Adult

OBJECTIVETo investigate the restoration of erectile function by reconstructing cavernous nerves with sural nerve grafts.

METHODSForty-eight male Sprague-Dawley rats(3-4 m old and 300-400 g) were randomly divided into three groups: the sham-operated group (n = 16) underwent pelvic exploration without transection of the cavernous nerve; the nerve ablation group (n = 16) had a 5 mm segment of the cavernous nerve excised bilaterally; the graft group (n = 16) had a 5 mm segment of the cavernous nerve excised bilaterally, followed by immediate microsurgical reconstruction with an interposition graft of the sural nerve. The cavernous nerves of each group were electrostimulated to determine their potency after 2 and 4 months. And fluorescent retrograde-transported material Fluoro-Gold(FG) was injected into the penis. FG-labeled neuron cells in whole mounts of major pelvic ganglions were observed five days after injection.

RESULTSElectrical stimulation produced no erection in either the nerve ablation or the graft group, but 100% erection in the sham-operated group after 2 months. The numbers of FG-labeled neurons significantly differed between the nerve ablation group and the graft group. After 4 months erection examination showed statistical significance in the difference between the graft group and the nerve ablation group(P < 0.05). The FG-labeled neurons in the graft group significantly differed from those in the ablation (P < 0.05), and almost reached the level of the sham-operated(P < 0.05).

CONCLUSIONCavernous nerve grafting can successfully restore erectile dysfunction in rats after surgical injury.

Animals ; Electric Stimulation ; Male ; Penile Erection ; Penis ; innervation ; Rats ; Rats, Sprague-Dawley ; Sural Nerve ; transplantation

OBJECTIVETo investigate the relationship between germ cell apoptosis and expressions of Bcl-2 and Bax in contralateral testes of experimental unilateral cryptorchid rats.

METHODSTwenty male Sprague-Dawley rats were randomly divided into 2 groups (namely cryptorchid group and control group), with 10 rats in each group. Cryptorchid animal model was established, and contralateral testes were captured 90 days later. The evidence of germ cell apoptosis was detected by TUNEL assay. The expressions of Bcl-2 and Bax were detected by immunohistochemical method.

RESULTSIn the contralateral testes of experimental unilateral cryptorchidism, apoptosis index of germ cell and Bax expression significantly increased compared with those in the control group, respectively (P < 0.01), while Bcl-2 expression and testis weight obviously decreased (P <0.01). The apoptotic cells were mostly pachytene spermatocytes and round spermatids.

CONCLUSIONThe germ cell apoptosis is highly correlated with expressions of Bcl-2 and Bax in contralateral testes of experimental unilateral cryptorchidism. Bcl-2/Bax plays an important role in germ cell apoptosis.

Animals ; Apoptosis ; Cryptorchidism ; metabolism ; pathology ; Gene Expression ; Germ Cells ; pathology ; Male ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Testis ; metabolism ; pathology ; bcl-2-Associated X Protein ; biosynthesis