Objective To analyze retrospectively the factors related with lymph node metastasis in thyroid microcarcinoma.Methods One hundred and eieghty-seven cases of thyroid microcarcinoma were collected from the First Affiliated Hospital of Dalian Medical University from January 2007 to December 2011,who were operated at the first time and confirmed by pathology.According to the occurrence of lymph node metastasis,they were divided into metastasis group and non-metastasis group.The factors related were analyzed retrospectively.Results The total metastasis rate was 26.7％ (50/187),the metastasis rate of central lymph node was 22.9％ (43/187),and the metastasis rate of lateral lymph node was 11.8％ (22/187).Tumor's diameter more than 5 mm,multiple foci and extrathyroidal extension were related to neck lymph node metastasis of thyroid microcarcinoma (P ＜ 0.05).Conclusions Neck lymph node metastasis was seen most common in central lymph nodes.Tumor size,multiple foci and extrathyroidal extension were related to neck lymph node metastasis of thyroid microcarcinoma,operation therapy should be routinely performed.

Objective: To investigate the effect of Yupingfeng on hyaluronic acid (HA) and Foxp3⁺ Treg in patients with nasopharyngeal carcinoma. Methods: A total of 58 cases of nasopharyngeal carcinoma were divided into two groups, 30 cases in the treatment group, 28 cases in the control group. Patients in two groups were treated with synchronous radiotherapy and chemotherapy treatment, the treatment group was treated with the Yupingfeng granules through oral administration, 10 g/time, tid for 2 courses. The serum Foxp3⁺ Treg markers of each group were detected by flow cytometry assay before treatment and after treatment, and the level of HA in serum was detected by radio immunoassay. Results: After radiotherapy and chemotherapy, the contents of Foxp3⁺ Treg and HA were significantly decreased in two groups (P < 0.05), and the decrease of treatment group was more significantly (P < 0.01). Correlation analysis showed positive correlation between Foxp3⁺ Treg and HA (P < 0.05). After treatment, the incidence of side effects in two groups was significantly decreased. And there was significant difference between two groups (P < 0.05). Conclusions: Combined chemotherapy and radiotherapy with Yupingfeng treatment can decrease the levels of Foxp3⁺ Treg and HA in nasopharyngeal carcinoma patients. Yupingfeng can also effectively reduce the side effect due to radiation and chemotherapy.

BACKGROUNDPost-traumatic stress disorder (PTSD) is a mental disorder with delayed or chronic onset caused by unusual, threatening, or disastrous psychological trauma, and it is an important manifestation of post-disaster mental and behavioral disorders. Studies have shown that IL-6 is a cytokine associated with PTSD occurrence. This study aimed to explore the role of cytokine and ethnicity in the pathogenesis of PTSD by examining levels of serum cytokines IL-2, IL-6, IL-8, TNF-α, and cortisol in PTSD patients of Li and Han ethnic groups.

METHODSLevels of serum cytokines IL-2, IL-6, IL-8, TNF-α, and cortisol were examined by enzyme-linked immunoabsorbent assay (ELISA) method and assessed by PCL-C scale among 30 PTSD patients of Han ethnicity and 30 of Li ethnicity, and compared with 30 normal controls of Han and Li ethnicity, respectively.

RESULTSPTSD patients of Li ethnicity scored higher than PTSD patients of Han ethnicity, and normal controls of Li and Han ethnic groups in each of the re-experiencing, avoidance/numbing, and hyperarousal symptoms. The differences reached statistical significance (P < 0.05). In PTSD patients of Li ethnicity compared to patients of Han ethnicity and normal controls of either Li or Han ethnicity, the levels of IL-2, IL-6, IL-8, and TNF-α were higher, and the level of cortisol was lower.

CONCLUSIONSThere are ethnic differences in re-experiencing, avoidance/numbing, and hyperarousal symptoms among PTSD patients. The levels of serum cortisol and cytokines are strongly associated with the race.

Adult ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hydrocortisone ; blood ; Interleukin-2 ; blood ; Interleukin-8 ; blood ; Male ; Stress Disorders, Post-Traumatic ; blood ; Tumor Necrosis Factor-alpha ; blood

【Objective:】 To construct a palliative care training course for medical student volunteers, so as to provide reference for palliative care institutions to carry out palliative care training for medical student volunteers. 【Methods:】 Based on literature review, semi-structured interviews and the expert group meeting method, the first draft of the palliative care training course for medical student volunteers was drawn up. Then two rounds of expert consultation with 16 experts in relevant fields by Delphi method was conducted. 【Results:】 The positive coefficients of the two rounds of expert consultation were 89% and 100%, respectively. The expert authority coefficients of the two rounds were both 0.89. The Kendall coefficient of the second round was 0.196 to 0.328 (P<0.05). The final form of palliative care training course for medical student volunteers was consisted of 5 primary indicators (training objective, training content, training hour, training method, and assessment method), 23 secondary indicators, and 41 tertiary indicators. 【Conclusion:】 The palliative care training course for medical student volunteers is comprehensive and practical in content, scientific and reliable in construction, which can be used for hospice care institutions to provide palliative care volunteer service training for medical student volunteers, in order to improve the quality of volunteer service.

Periodontitis is the inflammation of periodontal tissue caused by dental plaque, which absorbs the alveolar bone and cementum. The immune response triggered by CD4+T cells is the key factor for the aggravation of periodontitis. The activation of dendritic cells and the receptor activator of the NF-κB ligand (RANKL) pathway is an important link in the alveolar bone resorption of periodontal tissue. Pro-inflammatory factors such as interferon-γ (IFN-γ), tumor necrosis factor (TNF-α) and interleukin-1β (IL-1β) also play important roles in the development of periodontitis. Interleukin-37(IL-37), which is a newly discovered cytokine in the IL-1 family, has five shear variants from a to e, among which the clover β-structure encoded by exon 4 plays an important role in the binding of cytokines and the corresponding receptors. IL-37 has strong anti-inflammatory and inhibition of autoimmunity, can enter the nucleus with the help of caspase-1 and bind with Smad proteins to regulate the transcription of pro-inflammatory genes. Extracellular IL-37 can bind to IL-18 binding protein and inhibit the production of pro-inflammatory factors. IL-37 can inhibit the progression of periodontitis by inhibiting the RANKL signaling pathway, inhibiting the proliferation and differentiation of dendritic cells and CD4+T cells, binding to Smad proteins, and releasing pro-inflammatory factors such as IFN-γ and TNF-α. The IL-37 concentration in periodontal tissue can indicate the progression of periodontitis. Few studies have described the interaction between the anti-inflammatory factor IL-37 and periodontitis. Thus, in this paper, the structure and function of IL-37 and the related factors between IL-37 and periodontitis will be reviewed.

Objective To investigate residents' psychological stress factors and research the correlation between post-traumatic stress disorder (PTSD) and platelet 5-HT concentrations so as to provide scientific bases for diagnosis and treatment of PTSD and psychological intervention for people in the disaster area. Methods A questionnaire survey of 5 500 residents who have accepted psychological help was conducted by the emphatic investigation method. While high performance liquid chromatography was used to detect the platelet serotonin concentration of 100 PTSD patients and 100 healthy people. Results (1) Of the 5 114 cases, 3 167 (61.93%) showed positive results in screening for psychological stress symptoms, and 399 (7.8%) were tested having apparent PTSD symptoms. Male and female prevalence showed no significant difference (χ

Ruxolitinib， a small molecule inhibitor， selectively targets Janus kinase （JAK） by competitively binding to adenosine triphosphate on the catalytic site of the JAK1 and JAK2 domain， thereby inhibiting JAK activation and signal transducer and activator of transcription （STAT） phosphorylation and prevents the expressions of the JAK-STAT signaling pathway. Oral ruxolitinib has demonstrated promising efficacy for myelofibrosis and polycythemia vera. The topical Ruxolitinib cream， approved by the US FDA as the first non-segmental vitiligo home treatment drug， is set to be launched in domestic medical pioneer areas in August 2023 and is expected to bring about a breakthrough in the treatment of vitiligo. Clinical cases have also shown that Ruxolitinib cream has significant curative effects on atopic dermatitis， alopecia areata， and other conditions， indicating great application prospects.

To analyze the frequency and spectrum of thalassemia mutations in amniotic fluid samples collected from Han and Li people in Hainan province of China. Methods: We carried out a retrospective analysis on prenatal diagnosis of amniotic fluid samples collected from pregnant women who may have next generation with high risks of medium or severe thalassemia between 2005 and 2016. Diverse fetal thalassemia genotypes and mutated alleles in Han and Li people were analyzed and cmpared. Results: We examined 536 amniotic fluid samples from Han people and 588 from Li people, among which 406 Han and 500 Li samples were found to carry at least one thalassemia gene mutation, with a detection rate of 75.75% and 85.03%, respectively. Among all - and β-thalassemia mutant alleles detected, the most frequently found mutations in Han and Li samples were SEA-type of -thalassemia and 41/42 (-CTTT) of β-thalassemia, respectively. A total of 75 severe thalassemia cases were identified in Han samples and 53 in Li samples. In most of these severe cases, parents chose to terminate pregnancy after being informed of thalassemia-related risks. Conclusions: The thalassemia mutations shows ethnic and area specificity, and that prenatal diagnosis for high-risk thalassemia carrier pregnant women is an efficient approach to prevent and control the occurrence of severe thalassemia in the high-prevalence areas.

Objective To explore the feasibility of diffusion-weighted imaging (DWI) in assessing the efficacy of chemoradiotherapy for cervical cancer.Methods Data of magnetic resonance imaging (MRI) and DWI were analyzed in 32 patients with uterine cervical cancer received conventional prior to chemoradiotherapy and after 1 and 3 months of therapy.13 cases of normal controls also had been examed by MRI and DWL DWI with b values of (0,300) s/mm2 and b values of (0,600) s/mm2 were performed in all patients.Pretreatment post-treatmentADC values were compared between the health group and patients group.Results When the b =300 s/mm2,normal cervical average ADC value was (1.72±0.31)×10-3 mm2/s,cervical cancer was (1.10±0.24)×10-3 mm2/s before treatment and was (1.61±0.23)×10-3 mm2/s after treatment.When the b =600 s/mm2,normal cervical average ADC value was (1.46±0.25)×10-3 mm2/s cervical cancer was (0.89±0.21)×10-3 mm2/s before treatment and was (1.54±0.18)×10-3 mm2/s after treatment.When b =300 s/mm2,ADC value was higher than when b =600 s/mm2.ADC values of cervical cancer was significantly lower than that of the normal cervix group,ADC values of cervical lesions after chemoradiotherapy was significantly higher than that before chemoradiotherapy (P ＜ 0.05).In the same group with different b values,ADC value was not significant (P ＞ 0.05).Conclusion Joint observation of DWI and ADC values could be more objective and accurate in the analysis of the disease and would help to evaluate the efficacy of chemoradiotherapy.