Objective To summarize the experience of intraoperative rapid parathyroid hormone (PTH) detection by immunochromatography in thyroid surgery.Methods Patients undergoing thyroid surgery in Shanghai Tenth People's Hospital from Nov.2016 to Jul.2017 were collected and the clinical data including level of blood calcium,serum phosphorus and PTH,and pathological findings were analyzed.Results In this study,im munochromatographic assay was used in 45 cases (experimental group) and nano carbon method was used in 47 cases (control group).In benign cases,levels of blood calcium and PTH in experimental group were higher than those in the control group ((2.07±0.09) vs (2.04±0.06) and (3.41±1.82) vs (3.34±1.84),P＞0.05).In malignant cases,blood calcium level in experimental group was higher than that in the control group ((2.02±0.13) vs (1.99±0.38),P＞0.05) and PTH level was significantly higher than that in the control group ((2.22±1.27) vs (1.44±1.44),P＜0.05).Serum phosphorus level in experimental group group was much lower than that in the control group ((1.02±0.17) vs (1.14±0.23),P＜0.05).Conclusions Using intraoperative rapid PTH detection by immunochromatography can identify parathyroid and avoid accidental injury of parathyroid gland,which can reduce the postoperative incidence of hypocalcemia.

BACKGROUND:Development of neural crest cels, which is regulated by various genes, plays an important role in the formation of central nervous system, heart, craniofacial organs and other tissues. However, the relationship among these genes is unclear. OBJECTIVE:To investigate the molecular regulatory networks involved in the process of neural crest cel development based on a bioinformatic analysis. METHODS:Totaly 500 differentialy expressed genes during the process ofneural crest cel development were obtained from the GEO on-line database. Then the DAVID and STRING on-line databases were used to evaluate the relationship among these genes. RESULTS AND CONCLUSION:Totaly 500 differentialy expressed genes during theprocess of neural crest cel development could be enriched into different subgroups based on the analysis of DAVID database, including “transforming growth factor β signal pathway”, “WNT signal pathway”, “homeobox gene” , “neural crest cel differentiation” and “neural tube development”. Additionaly, 12 genes molecular networks were built based on the analysis of STRING database, such as DLX5, MSX2, SNAIL2, PAX7, SHH, SOX9, NOG, GSC, KAL1, bone morphogenetic protein 5, fibroblast growth factor 8 and WNT3a.These genes exhibited interactions by co-expression, activation and antagonism. Therefore, many genes involved in the process of neural crest cel development were interacted and formed the networks. These findings imply that we should understand these neural crest-related diseases from a holistic view of the signaling pathway and molecular regulatory networks.

Objective To discuss the effectiveness of knowledge-attitude-practice(KAP)-based health management on type 2 diabetes in community residents.Methods From June 2010 to December 2011,930 type 2 diabetes patients living in Mishi Lane Community were enrolled and assigned to the intervention group(n=494) and the control group(n=436).The KAP mode was used for the intervention group,and the routine management mode was applied to the control group.Fasting blood glucose(FBG),PBG2 h,HbAlc,blood pressure(BP),triglyceride(TG) and body mass index(BMI) were tested and recorded.Student's t test or Chi-square test was used for data analysis.Results Age(t=0.124,P＞0.05),gender(x2=2.0,P＞0.05) and other demographics showed no statistically significant difference between the two groups(all P＞0.05).After one-year KAP-based health management,HbA 1 c of the intervention group reduced to(6.1 ± 1.2)％,FBG and PBG2 h reduced by 1.7 and 3.23 mmol/L,respectively(t=4.926,P＜0.05; t=4.306,P＜0.05; t=4.523,P＜ 0.05).Diet,physical exercises,medication,regular inspection,unhealthy habits and questionare test awaveness of the intervention group were improved(86.03％,82.19％,85.63％,70.45％ 76.11％ and 88.46％,respectively.Drinking,dietary structure,overweight and physical exercises of the intervention group were also improved(14.17％,15.79％,70.65％ and 68.83％,respectively; all P＜0.001).Conclusion The KAPbased health management is proved to be effective in the control of community diabetic patients.

Objective To discuss the effectiveness of community-based intensified health management on type Ⅱ diabetes patients.Metbods From June 2010 to December 2011,1 024 type Ⅱ diabetes patients in Mishi Lane community were enrolled and assigned to the intervention group (n=501,obtaining intensive health management) and the control group (n=523,obtaining routine community health management).Fastingbloodglucose (FBG),2-hour postprandial blood glucose (PBG2h),HbA1c,blood pressure (BP),triglyceride (TG) and body mass index (BMI) were tested and recorded before and after the intervention.Student's t test or Chi-square test were used for data analysis.Results Differences of age (t=0.124,P＞0.05) and gender (x2=2.0,P＞0.05) were not statistically significant (both P＞0.05).Following the intensive health management,the control rates of HbA1c,BP,TG and BMI were increased to 75.4％,30.4％,85.6％ and 49.0％,respectively (x2 values were 4.54,4.71,6.54 and 3.67; all P＜0.05).TG,FBG and PBG2h of the intervention group were (1.5 ± 0.9),(6.2 ± 1.3) and (8.3 ± 2.4) mmol/L,respectively,which were significantly lower than those of the control group (all P＜0.05).Conclusion Community-based intensive health management could be effective for diabetes patients.

Objective To elucidate the association of fibroblast growth factor 23 (FGF23)with coronary artery calcification in patients with moderate and advanced stage chronic kidney diseases (CKD). Methods Serum intact FGF23 levels in 150 patients with CKD stage 3 to 5 and 25 age- and sex-matched healthy controls were measured by ELISA.The association between FGF23 and coronary artery calcification was studied. Results Serum FGF23 levels in CKD patients were significantly higher than those in healthy controls [196.46 (83.09,355.02) ng/L vs 27.17 (21.63,51.20) ng/L,P＜0.01].The levels of FGF23 were significantly higher in dialyzed patients than those in non-dialyzed patients (P＜0.01),and hemodialysis patients had higher levels as compared to peritoneal dialysis ones [6048.29 (1129.08,34807.45) ng/L vs 1625.80 (602.83,7521.78) ng/L,P＜0.01].The incidence of coronary artery calcification was relatively high in patients with moderate and advanced stage CKD (74/130,56.9％ ).Serum FGF23 level was positively correlated with coronary artery calcification score (CaS) (r=0.177,P＜0.05).Logistic regression analysis showed that age (β=0.091,OR=1.095,P＜0.01),duration of dialysis (β=2.013,OR=7.483,P＜0.05) and FGF23 level (β=0.838,OR=2.311,P＜0.05) were independent risk factors for coronary artery calcification in patients with moderate and advanced stage CKD.ROC curve of coronary artery calcification revealed that area under curve (AUC) of FGF23 was 0.705 (P＜0.01).With the cut-off value of FGF23 as 786.73 ng/L,the diagnostic sensitivity and specificity in coronary artery calcification were 62.5％ and 75.9％.ROC curve of coronary artery calcification showed that AUC of alkaline phosphatase (AKP) was 0.626 (P=0.017).With the cutoff value of AKP as 79.75 U/L,the diagnostic sensitivity and specificity in coronary artery calcification were 84.5％ and 41.5％.There was no diagnostic value of serum phosphorus in coronary artery calcification. Conclusions Serum FGF23 level is correlated with coronary artery.calcification in patients with moderate and advanced stage CKD.The sensitivity of FGF23 is lower and the specificity is higher than those of AKP for the diagnosis of coronary artery calcification.

Objective To study the effects of PVA-H coating thickness and tip angle on the tissue injury caused by the implantation of neural electrodes. Methods Simulated implantation experiments were conducted based on a tissue injury evaluation system to evaluate the tissue injury caused by electrode implantation. The coating thicknesses were controlled by the number of dip coating times (0, 1, 2, and 3), whereas the tip angles were set as 30°, 40°, and 50°. The maximum tissue strain and insertion force were selected as the measurement of the tissue injury. Results thicker hydrogel coating and larger tip angle would cause more serious tissue injury. Simultaneously, reducing the tip angle of the neural electrode could reduce the degree of the hydrogel coating effect on the tissue injury. When the tip angle was 30°, the maximum strain and the peak insertion force increased by 3.4% and 3.8%, respectively, whereas when the wedge angle was 60°, the maximum strain and maximum insertion force increased by 11.3% and 18.1%, respectively. Conclusions The hydrogel coating of the neural electrode increased the injury of biological tissues caused by the implantation of the neural electrode. However, the method of decreasing the tip angle of the electrode could reduce the degree of the negative effects of the hydrogel coating thickness on the implantation injury.

[Summary] To explore the therapeutic effect of fecal microbiota transplantation (FMT) for severe psoriasis. A patient, male, 36 years old, diagnosed as severe plaque psoriasis for 10 years and irritable bowel syndrome (IBS) for 15 years, was administrated twice FMT via both upper endoscopy and colonoscopy with a 5‐week interval. The following items were used to evaluate responses: body surface area (BSA), psoriasis area and severity index (PASI), dermatology life quality index (DLQI), histological examination, intestinal symptoms, adverse reactions and serum level of tumor necrosis factor (TNF)‐α. After second FMT treatment for 5 weeks, aforementioned items were improved greatly compared with those before treatment. Moreover, IBS was completely relieved and no adverse reactions were observed during the treatment and follow‐up. In conclusion, FMT could be a novel therapy for psoriasis. Further clinical trials are needed to provide solid evidences.

OBJECTIVE To explore mecha-nisms of imperatorin on regulating P-glycoprotein(P-gp)in blood-brain barrier(BBB)based on net-work pharmacology combined with in vitro experi-ment.METHODS Drug targets were predicted using the Pharmapper and Swiss targets data-bases;disease targets were obtained through the Genecards database;intersections between drugs and disease targets were screened by Cytoscape software;the obtained core targets were used to construct protein-protein interaction(PPI)network,gene ontology(GO)functions,and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis.The effects of imperatorin(20,50,100 μ mol·L-1)on P-gp activity were monitored in hCMEC/D3in vitro BBB model,and the effects of imperatorin on the expression of target proteins were verified using Western blot method.RESULTS 55 drug targets and 3102 disease targets were obtained from the network pharmacology screening,and 37 core targets were obtained after the combination.Enrichment analysis showed that core targets were closely related to chemical synaptic trans-mission regulation,neurotransmitter receptor activity,proteinkinaseregulationactivity,G protein-coupled receptor signaling pathway,neural active ligand receptor interaction pathway,PI3K-Akt sig-naling pathway,VEGF signaling pathway,etc..In vitro experimental validation suggested that all tested concentration groups of imperatorin signifi-cantly reduced the activity and expression of P-gp,which were achieved by significantly downregu-lating the phosphorylation levels of PI3K and Akt,and repressing the expression of VEGFR2 pro-tein.CONCLUSION Network pharmacology was used to predict the core targets and signaling pathways of imperatorin on regulating P-gp in BBB and relevant validation was conducted through in vitro experiments,providing a refer-ence basis for further exploration of the mecha-nisms of imperatorin on regulating P-gp in BBB.

Objective To investigate the impact of different treatment options on lumbar function, pain intensity, and anterior vertebral height in elderly patients with thoracolumbar vertebral compression fractures. Methods The clinical data of 102 elderly patients with thoracolumbar vertebral compression fractures who completed 1-year follow-up were retrospectively analyzed. They were divided into conservative group (32 cases), percutaneous kyphoplasty (PKP) group (35 cases), and percutaneous vertebroplasty (PVP) group (35 cases) based on different treatment options. One year after treatment, the clinical efficacy and complications of the three groups were evaluated. The Visual Analogue Scale (VAS) score, Japanese Orthopedic Association (JOA) score, Cobb angle, and anterior vertebral height were compared before and 1 year after treatment among the three groups. Results The excellent and good rates of the PKP group and PVP group were higher than those of the conservative group (P < 0.05). There was no significant difference in the excellent and good rates between the PKP group and PVP group (P>0.05). There was no significant difference in occurrence of complications among the three groups (P>0.05). One year after treatment, the VAS scores of the three groups were lower than before treatment, and the JOA scores were higher than before treatment, and the VAS scores of the PKP group and PVP group were lower than those of the conservative group, and the JOA scores were higher than those of the conservative group (P < 0.05). The VAS score of the PKP group was lower than that of the PVP group, and the JOA score was higher than that of the PVP group (P < 0.05). One year after treatment, the Cobb angles of the three groups were smaller than before treatment, and the anterior vertebral heights were higher than before treatment, and the Cobb angles of the PKP group and PVP group were smaller than those of the conservative group, and the anterior vertebral heights were higher than those of the conservative group (P < 0.05). The Cobb angle of the PKP group was smaller than that of the PVP group, and the anterior vertebral height was higher than that of the PVP group, the difference in anterior vertebral height was greater than that of the PVP group (P < 0.05). Conclusion Compared with conservative treatment, surgery can improve the clinical efficacy of elderly patients with thoracolumbar vertebral compression fractures. PKP is superior to PVP in reducing pain of patients, improving lumbar function and Cobb angle, and anterior vertebral height. Moreover, it has better safety.

Objective:To analyze the electrophysiological characteristics of subacute combined degeneration of spinal cord in 10 patients with nitrous oxide poisoning.Methods:Ten patients with nitrous oxide poisoning (case group) and 20 controls (control group)treated in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from January 2016 to January 2020 were included in this study. MRI and electrophysiological examinations were performed on the head, cervical spine and thoracic spine, including distal motor latency (DML), motor nerve amplitude (CMAP), motor conduction velocity (MNCV), sensory conduction velocity (SNCV), sensory nerve amplitude (SNAP), N20 latency of upper limb cortical somatosensory evoked potential and P40 latency of lower limb cortical somatosensory evoked potential. The above indexes were compared between the two groups.Results:In the case group, DML of motor nerve was prolonged, MNCV was slowed down, CMAP was decreased, SNCV was slowed down and SNAP was decreased compared with the control group, the differences were statistically significant ( P<0.05). The incubation periods of N20 and P40 in the case group were longer than those in the control group: (32.70 ± 3.34) ms vs. (18.85 ± 1.37) ms, (57.00 ± 4.08) ms vs. (38.40 ± 1.54) ms, the differences were statistically significant ( t = 16.20, 18.20, P<0.01). The inverted "V" type T 2 long signal of cervical spinal cord and thoracic spinal cord could be seen on MRI of cervical or cervical and thoracic vertebrae in 5 patients. Conclusions:Nitrous oxide poisoning can cause obvious subacute combined degeneration of spinal cord, involving peripheral nerve and spinal cord damage. Peripheral nerve damage can involve motor fibers and sensory fibers, mainly axonal damage, accompanied by demyelination damage, especially in both lower limbs.