[Summary] In this case report , a 44-year-old female patient complained of three years of tightness and chest pain , and was hospitalized in January 2016.The thymus and tumor were completely resected under video-assisted thoracoscopic surgery (VATS). Postoperative pathological examination presented a thymic mucoepidermoid carcinoma .The patient received 30 times of chemotherapy after operation and were followed up for 2 months.Postoperative recovery was smooth without symptoms .The CT scanning showed negative result .We consider that VATS was feasible and safe for the treatment of thymic carcinoma .

BACKGROUND:Proanthocyanidin,a kind of grape seed extract(GSE),has the effect of anti-oxidation and elimination of free radicals.Research finds that increase of free radicals in skeletal muscle and active oxygen in other forms induced by exercise is one of the important causes of the injury and fatigue of skeletal muscle. Supplement of antioxidant can inhibit this kind of change and improve motor ability. OBJECTIVE:To study the anti-fatigue effects of proanthocyanidin. DESIGN:A completely randomized controlled experimental study taking experimental animals as the subjects. SETTING:A toxicological department of a provincial center for disease control and prevention. PARTICIPANTS:The experiment was completed in the Department of Toxicology,Jiangsu Center for Disease Control and Prevention from September to December 2001.Male mice of Kunming strain and common grade[certification number:SCXK(Su) 2002-0011;certification number of environmental equipment for experimental animal:SYXK(Su) 2001-0004]were purchased from the Experiment Animal Center of Chinese Pharmacological University.The 120 mice were randomly divided according to body mass into control group and 3 experiment groups, namely,low-,medium-and high-dose GSE groups,with 10 mice in each group.The mice in the 3 experiment groups received oral administration of GSE every day. INTERVENTIONS:The mice in the 3 experiment groups received oral administration of GSE of 1.7, 16.7 and 50.0 mg/kg body mass,respectively,while those in control group were only given twice distilled water for 30 consecutive days. After GSE treatment for 30 days,the loaded swimming time, contents of hepatic glycogen,blood lactic acid(LA) and hemoglobin were measured. MAIN OUTCOME MEASURES:Loaded swimming time, hepatic glycogen,LA and hemoglobin contents. RESULTS:The loaded swimming time of mice in experiment groups was significantly prolonged as compared with that in control group (P< 0.01),with(17.84± 8.48) and(25.80± 7.45) minutes in medium-and high-dose GSE groups,respectively.LA content after exercise in experiment groups was all lower than that in control group,with greatly significant difference between high-dose GSE group[(6.78± 2.45) mmol/L] and control group[(9.98± 1.22) mmol/L](P< 0.01).The content of hepatic glycogen after exercise in experiment groups was higher than that in control group; medium-dose GSE group[(1 244.65(177.58) mg/100 g liver mass]and high-dose GSE group[(1 383.96± 141.20) mg/100 g liver mass]differed greatly significantly from control group[(817.67(114.72) mg/100 g liver mass](P< 0.05,P< 0.01). CONCLUSION:Grape seed extract proanthocyanidin has an anti-fatigue effect.

BACKGROUND:Open fracture of tibia and fibula is a common fracture of long bones. Simple external fixation is often difficult to achieve thorough and effective reduction and fixation. Shortcomings of open reduction and internal fixation highlighted in the high incidence of postoperative complications, and seriously affected the recovery of joint function. Therefore, external fixation combined with internal fixation for repair of open fractures of tibia and fibula has been extensively used in the clinic.
OBJECTIVE:To explore the repair efficacy of bilateral external fixation combined with limited internal fixation on open fractures of middle and distal tibia and fibula.
METHODS: Clinical data of 56 patients, who were identified by X-ray or CT examination and were diagnosed as having open fractures of middle and distal tibia and fibula in the Jining No.1 People’s Hospital, as the treatment group, were retrospectively analyzed from January 2009 to January 2013. Patients were subjected to thorough debridement, reduction of the fracture fragments, limited internal fixation and fixed bilateral external fixation within 8 hours. They received stage I suture. When the local conditions of the wound permitted, they received stage II grafting, and were repaired with adjacent muscle flap or free flap. The efficacy and postoperative complication were observed. Above data were compared with those of 44 patients with open fractures of middle and distal tibia and fibula who received reduction and internal fixation (control group).
RESULTS AND CONCLUSION:Among the 56 patients in the treatment group, the outcomes were excelent in 35 cases, good in 16 cases, average in 4 cases and poor in 1 case. The excelent and good rate was 91%. Among the 44 patients in the control group, the outcomes were excelent in 23 cases, good in 10 cases, average in 7 cases and poor in 4 cases. The excelent and good rate was 75%. The excelent and good rate was significantly higher in the treatment group than that of the control group (P < 0.05). Significant differences in incision length, operation time, fracture healing time and bone nonunion rate were detected between the two groups, and above indexes were better in the treatment group than in the control group (P < 0.05). These findings verify that bilateral external fixation combined with limited internal fixation for open fractures of middle and distal tibia and fibula is reliable, can significantly reduce postoperative complications after internal fixation, promote the healing of fracture, and is conducive to the early recovery training of the affected limb.

BACKGROUND:Studies have shown that a single injection of smal-dose simvastatin can significantly improve bone microstructure and promote trabecular bone remodeling of the femoral condyle after osteoporosis. OBJECTIVE:To investigate the effect of local single injection of simvastatin on the prognosis of mild-to-moderate unstable humeral fractures. METHODS:A total of 93 patients with mild-to-moderate unstable humeral fracture were selected and randomized into injection group (49 cases) and normal group (44 cases). The normal group received normal physical therapy, and the injection group underwent local single injection of simvastatin based on the physical therapy. Bone mineral density and healing time were compared between two groups. RESULTS AND CONCLUSION:There was no difference in the bone mineral density between the two groups within 2 weeks after treatment (P>0.05), but the bone mineral density was significantly higher in the injection group than the normal group at 1-2 months after treatment (P<0.05). In addition, the injection group was superior to the normal group in the fol owing aspects:incidence of complications, excel ent-good rate of joint function recovery, and hospital stay. These findings indicate that the local injection of simvastatin based on conventional physical therapy can shorten the time of fracture healing, increase bone mineral density and improve the prognosis of patients with mild-to-moderate unstable proximal humeral fractures.

Biochemical indexes and blood composition in early lactation health,ketosis and hypocalcemia dairy cows were analyzed to make sure the milk composition characteristics with related diseases,the correlation analysis between early lactating dairy milk composition and blood biochemical were also make in order to provide support for the cattle health assessment.According to theblood index,72 Holstein cows 7-21 d postpartum,were divided into group subclinical hypocalcemia,ketosis test group and control group,24 heads each group.The blood and milk of cows were collected and used to analyze the correlation between blood biochemical indexes and milk composition.The results showed that ketosis and hypocalcemia induced the level of milk protein and non fat milk solids decreased,while the content of citric acid in milk increased.The correlation equation between citric acid in milk and serum NEFA,BHBA and GLU was y=3.192x-0.802,(R2 =0.363),y=4.594x-0.793,(R2 =0.320),y=1.228x+0.775,(R2 =0.261),in which x was the content of citric acid in milk.The results showed that the content of citric acid in milk had positively related to blood NEFA,which could be used as an early marker for the diagnosis of negative energy balance.The levels of BUN and ALB in blood can be used to evaluate the levels of milk protein and urea.

The objective of this study was to determine the concentrations of calcium,phosphorus and magnesium in blood and compare the differences in seven areas of Heilongjiang province,and then estimate calcuim-phosphorus metabolism of beef cattle in seven beef cattle farms to provi detheoretical foundation for the prevention of calcium phosphorus metabolism diseases of beef cattle.Seven beef cattle farms of Daqing,Shuangyashan,Jiusan and Mudanjiang in Heilongjiang province were selected as the survey sites,which were recorded as group A (both grazing and stall-feeding in Shuangyashan),group B (stall-feeding mode in Shuangyashan),group C (stall-feeding mode in Daqing),group D (grazing mode in Jiusan),group E (both grazing and stall-feeding in Daqing),group F (both grazing and stall-feeding in Daqing) and group G (stall-feeding mode in Mudanjiang).Then the concentrations of Ca,Mg,P,free fatty acid (NEFA),glucose (Glc) and β-hydroxybutyric acid (BHBA) in the blood were compared to estimate the calcuim-phosphorus metabolic states.Results showed that the concentrations of calcium,magnesium and phosphorus in the plasma of 65 beef cattle in seven survey sites were within the normal range,and there was no significant difference in calcium concentration among seven sites.The P contents in group C and G were significantly higher those that in group A and B(P＜0.01),which in group C was significantly higher than those in group D,E and F (P＜0.01),which in group G was significantly higher than those in group D,E and F(P＜0.01).NEFA content in group B was significantly higher than that in group D (P＜0.05),and there was no difference among other groups.The concentration of Glc in group A was significantly higher than that in group E (P＜0.05),which in group B was significantly higher than those in group A and D,and was very significantly higher than those in group E,F and G (P＜0.01),which in group C was very significantly higher than those in group A,D,E,F and G (P＜0.01),which in group C was significantly higher than those in group A,D,E,F and G (P＜0.01),which in group D was significantly higher than that in group E (P＜0.05),and which in group F was significantly higher than that in group E (P＜0.05).The concentration of BHBA in group C,D and E were significantly higher than that in group A (P＜0.01),which in group C was significantly higher than that in group B (P＜0.05),which in group D and E was significantly higher than that in group B (P＜0.01),which in group C was significantly higher than that in group G (P＜0.01),which in group D was significantly higher than those in group F and G (P＜0.01),and in group E was highly significantly higher than that in group F and G (P＜0.01).Overall,there were not calcuim-phosphorus metabolic disorders within the seven beef cattle farms which were selected,but it is also necessary to strengthen feeding management and health care to prevent the occurrence of nutrition and metabolic diseases.

AIM:To perform a multidimensional analysis of the clinical study characteristics of endo-metriosis based on the ClinicalTrials.gov,providing comprehensive and objective information for re-searchers,clinicians,and clinical pharmacists.METHODS:A thorough investigation was conduct-ed on clinical trials related to endometriosis,regis-tered on the ClinicalTrials.gov from its inception to October 20,2023.Relevant trial data were extract-ed and statistically analyzed using bibliometrics and comparative research methods.RESULTS:A to-tal of 667 endometriosis clinical studies were regis-tered globally,showing an annual increase.The United States(127 trials),France(70 trials),and Ita-ly(57 trials)had the highest number of registered trials.Interventional studies were predominant(416 trials,62.4%),followed by observational stud-ies(251 trials,37.6%).Within interventional stud-ies,drug therapy was the primary intervention(223 trials,53.6%).Despite endometriosis being a female condition,male subjects were also consid-ered,with 6 trials specifically requiring male partici-pants and 37 trials not restricting gender.Compa-nies/corporations were the main funding sources,while public and governmental organizations pro-vided relatively less funding.CONCLUSION:Clinical trial research on endometriosis is in a phase of growth,with drug therapy being the main treat-ment approach.However,there is a relative lack of investment and attention from public funds and governmental organizations.

AIM:To evaluate the clinical effective-ness and safety of generic and branded dienogest in the treatment of endometriosis.so as to provide the basis for clinical use of dienogest.MEHTODS:The data of patients admitted to Third Affiliated Hospital of Zhengzhou University from August 2022 to August 2023 who received dienogest(2 mg/d,orally,for 6 months)for treatment of endometrio-sis were collected.The clinical efficacy and adverse reactions of generic drugs and original drugs in the treatment of endometriosis-related pain were com-pared through follow-up surveys of the two groups of patients at 3 months and 6 months respectively.RESULTS:There was highly significant reduction in pelvic pain in both groups with mean of similar in generic group(34.0±3.0)mm and branded group(34.5±3.9)mm.The most frequent drug-related ad-verse effects in generic dienogest was vaginal bleeding(93%)which was no statistical difference with branded dienogest(90%).CONCLUSION:The generic and branded dienogest have the same clini-cal effectiveness and similar safety.

Objective To investigate the therapeutic effect of axillary single-site laparoscopic mastectomy in the treatment of gynecomastia.Methods From August to October of 2023,axillary single-site laparoscopic bilateral mastectomy was conducted in 31 patients with gynaecomastia.A 2-2.5 cm incision in the axilla was made,followed by lipolysis and liposuction in the anterior and posterior glandular spaces.After scalpel dissection of the subcutaneous Cooper's ligament,laparoscopic mastectomy was completed,with placement of a drainage tube in the area of the operation.Results The axillary single-site laparoscopic bilateral mastectomy was successfully completed in all the 31 cases.The median operating time was 70(60,90)min,the intraoperative hemorrhage was(12.6±2.3)ml,the time to remove bilateral drainages was(1.5±0.2)d,and the duration of hospitalization was(3.0±0.5)d.The weight of resected mammary gland was(66.1±25.9)g on the right side and 67.7(42.0,87.0)g on the left side.The differences in postoperative chest circumference,nipple to nipple distance,bilateral sternal notch to nipple distance,nipple to midline distance,and nipple height were statistically significant when compared with the preoperative period(P<0.05).Postoperative reduction in chest circumference was(6.52±3.12)cm,the distance between nipples reduced by(2.46±1.53)cm,the right nipple height shifted upwards by 0.82(0.17,1.47)cm,and the left nipple height shifted upwards by 0.87(0.00,1.40)cm.The bilateral nipple position was symmetry postoperatively.There was no statistically significant difference in the bilateral nipple to midline distance and height difference values(P>0.05).Numbness and discomfort in the area of the right nipple and areola occurred after surgery in 1 case,and the symptoms were largely resolved 2 months after surgery.Subcutaneous hemorrhage on the left chest wall occurred postoperatively in 1 case and was resolved by placing a tube through a small incision in the areola to irrigate and drain.No postoperative complications such as hemorrhages,effusions,infections,or nipple-areola necrosis occurred in the remaining 29 cases.Patients'subjective self-assessment of cosmetic results 2 months after surgery was very satisfactory(all were 15 points).Conclusion Axillary single-site laparoscopic mastectomy is a safe and effective treatment for gynecomastia,which is of high value for promotion.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.