ObjectiveAssess the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of schizophrenia and its social function .Methods 156 patients with schizophrenia were randomly assigned to a real rTMS treatment group (n=78) or a sham rTMS treatment group(n=78) ,each patient in the real rTMS group received 20 rTMS sessions over 4 weeks .Efficacy was evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at 4 weeks .Social function was evaluated u-sing the Personal and Social Performance Scale(PSP) at baseline and at 4 weeks .Results The study group is better than the control group in PANSS total and negative symptoms and PSP total after treatment (P<0 .05) .There is not serious adverse reactions in the treatment .Conclusion rTMS can reduce the negative symptoms and improve social function in schizophrenia with high safety .

Objective To investigate the diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy(FNA-Tg).Methods This study included 63 patients with thyroid cancer or with enlarged lymph nodes during the follow-up from Aug.2010 to Jun.2012.Ultrasound-guided fine-needle aspiration was done in the 63 patients with 79 suspicious enlarged lymph nodes.Then thyroglobulin(Tg) in FNA washout fluid and serum Tg were assayed with electrochemiluminescenceimmunoassay(ECLIA).Diagnostic sensitivity,specificity and area under the ROC curve were evaluated according to 5 predetermined threshold levels:FNA-Tg/serum-Tg ＞ 1,mean + 2SD of node-negative patients,10 ng/ml,optimal operating point of ROC curve and 1000 ng/ml.Results The sensitivity value was 90.70％,90.70％,95.35％,90.70％ and 65.12％ respectively on the 5 threshold level,significantly lower than those on the threshold level of 1000 ng/ml(P ＜0.05).The specificity value was 97.22％,91.67％,72.22％,97.22％ and 100％ (P ＞0.05) on those threshold levels,significantly lower than those on the threshold level of 10 ng/ml (P ＜0.05).The area under the ROC curve was 0.940,0.912,0.838,0.940 and 0.826 respectively.There was no statistical difference(P ＞0.05).Conclusion Selecting FNA-Tg/serum-Tg ＞ 1 as a positive threshold value can be a secondary diagnosis of lymph nodes metastasis in patients with papillary thyroid cancer.

BACKGROUND:Due to the importance of pedicle adjacent structures, once the screw replacement appears a deviation, adjacent structures may be damaged, leading to extremely serious consequences. Although the security of screw placement in thoracic vertebral pedicle-rib complex is significantly greater than that of pedicle screws, the mechanics of the pedicle-rib complex at different cross-sectional areas of the screw are rarely reported.
OBJECTIVE:To observe mechanical property of different cross-sectional area screws in the middle and upper thoracic vertebral pedicle-rib complex.
METHODS:Five specimens of adult cadaveric thoracic spine (T 1-T 10 ) and adjacent rib segment (50-60 mm long) were used. The bone density of specimens was measured using difunctional bone density testing machine, and osteoporotic vertebral body was excluded. The position of the screws was detected with CT images. The maximal withdrawal force of the pedicle screw was measured with biomechanical force test machine.
RESULTS AND CONCLUSION:Thirty-eight specimens at normal bone density were implanted with 25 screws (5.5 mm), 25 screws (6.0 mm) and 26 screws (6.5 mm). Because the pedicle screws destroyed the pedicle-rib complex and perforated the vertebral body, we final y obtained the withdrawal force of 68 screws. The axial withdrawal force of pedicle screws at different diameters was (812.36±147.22) N, (868.64±160.48) N and (946.48±157.58) N, respectively. There were significant differences between the 5.5 mm screws and the 6.5 mm screws (P<0.05). Experimental findings indicate that, the pedicle screws (diameter>5.5 mm) are suitable in the middle and upper thoracic vertebral pedicle-rib complex due to strong internal fixation and clinical requirement.

Objective To find new way to reduce non-recurrent laryngeal nerve (NRLN) injuries by applying intraoperative neuromonitoring(IONM) to identify NRLN in thyroidectomy. Methods Records of 279 patients who underwent complex thyroidectomy by applying IONM to identify and monitor RLN from Mar. 2009 to Jan. 2010 were veviewed. We proposed the skills to identify and monitor NRLN and predict RLN varition through exploring vagus nerve and RLN before RLN dissection. Results 6 cases NRLN located on the right side were all accurately identified by IONM, thus no injury of NRLN occurred during thyroid operations. Conclusions NRLN is difficult to be predicted preoperatively and identified by naked eyes. The application of IONM to predict, identify and monitor NRLN could remarkably reduce the possibility of NRLN injury.

ObjectiveTo investigate the mechanism and prevention of invisible injury of recurrent laryngeal nerve (RLN) system in thyroid surgery, with the application of intraoperative neuromonitoring ( IONM ) system. MethodsThe type of invisible RLN injury and its protection with the application of IONM system were analyzed. ResultsThe causes of invisible RLN injury mainly included stretching of Berry ligament or the tumor,contusion, thermal injury, cutting of silk and suction injury. RLN invisible injury was recoverable through neurotrophic and symptomatic treatment. No permanent vocal cord paralysis occurred. ConclusionsWith the application of IONM system, some invisible type of RLN injuries can be found. The risk of RLN injury can be reduced if the surgical techniques are improved with the development of study on mechanism of IONM system.

Objective To analyze prevention and management of lymphatic fistula after cervical lymph node dissection in thyroid carcinoma.Methods Clinical data of 9 cases of lymphatic fistula following neck dissection were analyzed retrospectively from Jan.2004 to Apr.2009.Results Of the 9 cases,4 cases had chylous fistula(3 were on the leftside and 1 was on the rightside),1 case had chylotborax,1 case had pleural effusion lymph,and 3 cases showed light yellow lymph.AII patients were cured finally by conservative methods.Conclusions Most lymphatic fistula can be cured by non-surgical treatment.Surgeons need to be familiar with the anatomic structure of neck lymphatic vessels.

BACKGROUND:Thoracic lumbar segment is prone to spinal tuberculosis, caseous necrosis tissue, dead bone compression of spinal cord and nerve root may cause neurological symptoms, and the majority of them is accompanied with mild and moderate spinal kyphosis deformity. Surgical treatment of spinal tuberculosis has been frequently reported in recent years, the commonly used treatment includes lesion clearance, bone graft fusion and internal fixation. OBJECTIVE:To investigate the principle of choosing different internal fixation treatment for thoracolumbar spinal tuberculosis. METHODS:42 patients with thoracolumbar spinal tuberculosis were involved in this study from January 2001 to December 2011. Al patients suffered from waist and back pains, with the disease course range of 1 month to 7 years. Four cases showed neurological deficit before surgery. According to the Frankel classification, 1 case was graded as Frankel C and 3 cases as Frankel D. The preoperative average Cobb angle of kyphosis was 27° (range 12°-45°). The internal fixation approaches were chosen according to the tuberculose focus and vertebral fracture extent. Thoraco-abdominal approach for thoracolumbar spine via diaphragm with the removal of 11 rib and(or) 12 rib was performed for al patients. Among these protocols, 25 cases underwent anterior focal debridement and bone grafting. 17 cases had anterior focal debridement and posterior pedicle screw internal fixation (one-stage surgery in 7 cases and second-stage surgery in 10 cases). Al patients received anti-tuberculosis chemotherapy before and after operation. 36 cases used rib and 6 cases used iliac bone as bone graft. Al patients were fol owed up from 17 months to 9 years. The correction of spinal deformity, spinal stability and spinal functional recovery were observed. RESULTS AND CONCLUSION:30 patients were fol owed up after operations and the back pains disappeared. X-ray examination showed that, al patients were fixed wel without no loosening and rupture, and achieved bony fusion (the mean time were 5.4 months). No tuberculosis recurred. Four cases complicated with spinal cord injury were E grade according to the Frankel classification. The Cobb angle was 0-26° (mean 14°) at 12 months after operation. On the premise of standard anti-tuberculosis chemotherapy, various internal fixation methods can be determined according to general conditions of patients and tuberculose focus site.

Objective:To explore the clinical efficacy of posterior short-segment internal fixation for the treatment of brucella spondylitis (BS).Methods:The medical records of 34 patients with BS admitted from January 2014 to June 2019 were retrospectively analyzed. There were 22 males and 12 females; the age was 52.3±10.6 years (range 35-72 years). On the basis of standardized use of antibacterial drugs, the lumbar spine posterior short-segment internal fixation was used. Twenty-nine cases underwent simple internal fixation, and posterolateral bone graft fusion, while 5 cases underwent primary debridement, autologous bone grafting and interbody fusion. Monitor erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and test tube agglutination test (SAT) were used to assess inflammation control. Imaging examinations of patients before operation, 1 month after operation, 3 months after operation, 6 months after operation, 1 year after operation to the last follow-up were analyzed to evaluate the condition of intervertebral fusion. The clinical efficacy evaluation was based on the pain visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, modified MacNab grading, and American Spinal Injury Association (ASIA) grading, as well as surgery-related complications.Results:The operation time of 34 patients was 104.64±16.72 min (range 65-145 min), the average hospital stay was 16.49±7.41 days (range 7-38 d), and the average postoperative follow-up time was 20.2 months (range 12-34 months). At the last follow-up, the ESR and CRP fell to the normal range, and the SAT was negative. At 3 months postoperatively, 11 cases (32.35%) reached Bridwell fusion criteria of grade II, 23 cases (67.65%) of grade III; 3 cases (8.82%) of grade I fusion at 6 months after surgery, 31 cases reached grade II fusion (91.18%); all reached grade I fusion at the last follow-up. After the operation, the symptoms of the waist or lower extremities were significantly relieved. The VAS score was 6.3±1.4 before the operation, 4.1±1.2 at 1 month after the operation, 2.7±1.4 at 3 months after the operation, 1.6±1.0 at 6 months after the operation, and 1.2±0.8 at the last follow-up. The JOA score before surgery was 13.8±2.4, 1 month after surgery 17.6±2.6, 3 months after surgery 21.7±3.1, 6 months after operation 4.9±2.7, and at the last follow-up 25.7±1.8. Compared with the preoperative time nodes of the above indicators, the differences were statistically significant. At the last follow-up, of the 12 patients (2 cases of grade C, 10 cases of grade D) with preoperative neurological dysfunction, 2 cases recovered from grade C to grade D, and 10 cases recovered from grade D to E; the excellent and good rate of modified MacNab grading reached 97.06% (33/34). No extradural hematoma, nerve damage, cerebrospinal fluid leakage and other surgical complications occurred. Only 1 case had wound infection complication, and the prognosis was good after active treatment. There were no recurrences during the follow-up period.Conclusion:On the basis of standardized antimicrobial treatment, posterior lumbar short-segment internal fixation is a safe and effective method for the treatment of BS, and good clinical effects can be obtained.

Fruit cracking is a common physiological disease. Many fruits such as tomato, sweet cherry, apple, jujube, pomegranate, and litchi are liable to crack, causing considerable economic loss and agricultural resources waste. The mechanisms of fruit cracking are comprehensive. Some correlations have been observed between susceptibility of fruit cracking and some fruit traits (genetic, fruit size, fruit shape, fruit growth rate, water content, fruit skin characteristics, related gene expression, etc). Also, environmental condition (temperature, light, rainfall, etc) and orchard management (irrigation, sun-shade, mineral, growth regulator, etc) can influence fruit cracking. Here, progress in studies on fruit cracking is reviewed to provide a reference for prevention and control of fruit cracking.
Fruit ; Litchi ; Lycopersicon esculentum

The environmental gas concentration affects the storage period and quality of fruits and vegetables. High concentration CO₂ treating for a long time will cause damage to fruits, However, the specific molecular mechanism is unclear. To analyze the mechanism of CO₂ injury in apple, high-throughput sequencing technology of Illumina Hiseq 4000 and non-targeted metabolism technology were used to analyze the transcriptome sequencing and metabolomics analysis of browning flesh tissue of damage fruit and normal pulp tissue of the control group. A total of 6 332 differentially expressed genes were obtained, including 4 187 up-regulated genes and 2 145 down regulated genes. Functional analysis of the differentially expressed genes confirmed that the occurrence of CO₂ injury in apple was related to redox process, lipid metabolism, hormone signal transduction process and energy metabolism process. Twenty candidate browning genes were successfully screened, among which grxcr1 (md14g1137800) and gpx (md06g1081300) participated in the reactive oxygen species scavenging process, and pld1_ 2 (md15g1125000) and plcd (md07g1221900) participated in phospholipid acid synthesis and affected membrane metabolism. mdh1 (md05g1238800) participated in TCA cycle and affected energy metabolism. A total of 77 differential metabolites were obtained by metabolomic analysis, mainly organic acids, lipids, sugars and polyketones, including 35 metabolites related to browning. The metabolism of flavonoids was involved in the browning process of apple. Compared with the control tissue, the content of flavonoids such as catechin and quercetin decreased significantly in the damaged apple tissue, the antioxidant capacity of cells decreased, the redox state was unbalanced, and the cell structure was destroyed, resulting in browning. The results of this study further enrich the theoretical basis of CO₂ damage, and provide reference for the practical application of high concentration CO₂ preservation technology.
Carbon Dioxide ; Fruit ; Gene Expression Regulation, Plant ; Malus/genetics* ; Metabolome ; Transcriptome