Objective To evaluate the clinical benefits and safety of endoscopic thyroidectomy via bilat -eral-nipple approach and breast approach by comparison with conventional open thyroidectomy .Methods 59 pa-tients undergoing open thyroidectomy , 76 patients undergoing endoscopic thyroidectomy via breast approach , and 122 patients undergoing endoscopic thyroidectomy via bilateral-nipple approach were retrospectively analyzed . Patients'age, operation duration, intraoperative blood loss, the first day drainage volume after operation , postop-erative hospital stay , the incidence of complications , pain visual analogue score ( VAS) , postoperative satisfaction rate as well as the evaluation of cosmetic results were compared among different groups .Results No significant difference was observed in the intraoperative blood loss and the postoperative hospital stay among different groups . The operation duration and the first day drainage volume after operation in the endoscopic thyroidectomy groups ((103.5 ±26.2)min vs (108.1 ±23.9)min,(106.5 ±31.0)ml vs (117.4 ±38.8)ml)were significantly high-er than those in the open thyroidectomy group((65.3 ±22.4)min and (50.5 ±23.8)ml)(P<0.05, respective-ly).No significant difference was observed in the complication incidence among different groups .On the first day after operation, VAS of the endoscopic thyroidectomy groups (2.8 ±0.4 vs 2.9 ±0.4)was significantly lower than that of the open thyroidectomy group(3.8 ±0.6)(P<0.05, respectively), even though on the second and the third day no significant difference was observed among different groups .Besides, postoperative satisfaction rate and the evaluation of cosmetic results in endoscopic thyroidectomy groups were significantly higher than those in the open group(P<0.05, respectively).Furthermore, 90 days after operation, the satisfaction rate and the eval-uation of cosmetic results in the endoscopic thyroidectomy group through bilateral -nipple approach (96.7%,8.8 ± 0.9)were significantly higher than those in the endoscopic thyroidectomy group through breast approach (92.1%, 7.3 ±0.7)(P<0.05, respectively).Conclusions Endoscopic thyroidectomy is a feasible and safe procedure . Endoscopic thyroidectomy through bilateral-nipple approach has a higher long-term satisfaction rate as well as bet-ter cosmetic results , which is an ideal choice of thyroidectomy .

OBJECTIVETo explore gene expression of NANOG in T-cell acute lymphoblastic leukemia (T-ALL) cell lines and the effects of NANOG gene down-regulation on apoptosis of leukemia cells.

METHODSReal-time PCR (RT-PCR) and Western blot were used to detect the expression level of NANOG gene and protein in MOLT-4, CCRF-HSB2 and Jurkat cells. To test the efficiency of RNA interference, MOLT-4 cells were firstly infected by lentiviral vectors, which were successfully constructed with NANOG specific shRNA. NANOG expression levels were subsequently re-evaluated by RT-PCR and Western blot. The percentages of early apoptotic cells (Annexin V⁺/7-AAD⁻) and late apoptotic cells (Annexin V⁺/7-AAD⁺) were analyzed by flow cytometry. The expression of apoptosis-related genes was also detected.

RESULTSBoth NANOG gene and protein expression was positive in MOLT-4 and CCRF-HSB2 cells. The lentiviral vectors pLB-shNANOG-1, pLB-shNANOG-2, and pLB-sh control were successfully constructed, as evidenced by the viral titers (1.83-3.12)× 10⁸ IU/ml. The experimental data on infection of MOLT-4 cells with such lentiviral vectors revealed that both shRNA interfering sequences (shNANOG-1 and shNANOG-2) could stably down-regulate NANOG gene and protein expressions. The percentages of early apoptotic cells in groups of shNANOG-1[(8.06 ± 1.61)%]and shNANOG-2[(5.67 ± 1.59)%]were significantly increased as compared to that of MOLT-4 group[(1.13 ± 0.40)%]or sh-control [(1.15±0.49)%](P<0.05). However, no statistical difference among them was observed for late apoptotic cells (P>0.05). The gene expression of TP53, PMAIP1, and CASP9 of either shNANOG-1 or shNANOG-2 group was augmented as compared to that of MOLT-4 group or sh-control (P<0.05). Reversely, a significant down-regulation of Bcl-2 gene expression was observed (P<0.05).

CONCLUSIONNANOG can be expressed in various human T-ALL cell lines. Down-regulation of NANOG can trigger leukemia cellular apoptosis through mitochondria-dependent apoptosis pathway.

Apoptosis ; genetics ; Cell Line, Tumor ; Down-Regulation ; Gene Expression ; Genetic Vectors ; Homeodomain Proteins ; genetics ; Humans ; Nanog Homeobox Protein ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics

Objective To explore a new outpatient mode for pregnancy nutrition to adapt to digital hospital.Methods The outpatient management mode and methods were analyzed for pregnancy nutrition.A new outpatient mode combining the technologies of mobile internet and remote monitoring was developed with consideration on standardization,and the effect of the new mode was discussed on pregnancy nutrition outpatient.Results Mobile internet technology and remote monitoring technology contributed to enhancing the efficiency of pregnancy nutrition outpatient,and facilitated the nutrition service of common pregnant women as well as the precision and individualized nutrition management of high-risk ones such as those with gestational diabetes mellitus.Conclusion The new outpatient mode enhances the doctor's efficiency and pregnancy care,and thus is worthy promoting practically.

Objective To study the clinical, endoscopic and pathological features of gastrointestinal and mesenteric reactive nodular fibrous pseudotumor (RNFPT). Methods A retrospective analysis was conducted on data of 24 RNFPT patients in Nanjing Drum Tower Hospital admitted from October 2008 to June 2016. The clinical, endoscopic, pathological and immunohistochemical characteristics were analyzed. Results Among the 24 patients, 16 complained about discomfort in the upper abdomen and 10 had a history of surgery or trauma. Twenty-one had isolated masses and 3 had multiple masses, with diameter of 0. 5-4. 0 cm. Endoscopically, the tumors were mainly hard submucosal masses with broad base, and smooth surface with no mucosal bridge. Seventeen patients underwent endoscopic ultrasonography, which showed low echoes in lesions and nonuniform echoes partly. Among them, 13 lesions derived from muscularis, 4 others from submucosa. Microscopically, the tumors had clear boundary with no envelope, and most areas showed disorderly arranged spindle cells and extensively collagenous degenerated mesenchyma. The spindle cells had shuttle fibroblast-like morphology and elongated nucleus with no visible necrosis or mitosis. Inflammatory cells scattered between the tumor cells, and lymphoid follicles and calcium deposition could be seen in local areas. Immunohistochemically, SMA was focally positive in 7 cases and only 4 cases expressed CD117 scattered. Desmin, Dog-1, CD34, ALK-1 and S-100 were all negative, and Ki-67 proliferation index was lower than 1％. Conclusion RNFPT has diverse clinical manifestations, with a good prognosis and unlikely recurrences, and should be distinguished from spindle cell tumors.

Trichinosis is a global food-borne zoonotic parasitic disease caused by Trichinella spiralis(T.spiralis),which causes serious harm to animal production,and the public health safety of humans and animals.T.spiralis has a complex devel-opment history,and its entire life cycle is completed in the same host.To coexist with the host,it has evolved various immune escape mechanisms for avoiding immune clearance by the host,thus establishing long-term chronic infection.In this study,to aid in understanding the pathogenic mechanism of T.spiralis,the immune escape mechanism of Trichinella is discussed from three aspects:the molecular role of antigens in various stages,the immune regulatory effect on the host,and the formation of cysts to generate immune isolation.

ABSTRACT:OBJECTIVE To observe the differences of curative effect among superficial needle therapy,Xiakucao oral solu-tion and Vitamin E soft capsules on the breast tenderness caused by mammary glands hyperplasia and to explore the optimum therapeutic method.METHODS 105 patients with mammary glands hyperplasia were randomly divided into the superficial needling group,the Xiakucao group and the Vitamin E group,with 35 cases in every group.Patients in the superficial needling group were treated with the superficial needling retaining for 5 hours.Patients in the Xiakucao group and the Vitamin E group took medicine with oral administration.Treatment in the three groups all began from 7 ± 3 days before menstruation and stopped during menstruation.The superficial needling group was treated once every other day with total 3 times.Patients in the Xiakucao group took medicine twice a day in the morning and evening.The Vitamin E group was treated once a day.Com-pare the scores of short form McGill pain Questionnaire(SF-MPQ) before and after the treatment and after one month follow-up.Record the time needed for pain relieving in the first treatment of the superficial needling group and the adverse effects in the three groups.RESULTS After the treatment,the breast tenderness was improved obviously in the three groups (P <0.01)and the superficial needling group was superior to the other groups(P <0.01).During the one-month follow up,the su-perficial needling group showed good effects(P <0.01).It also showed fast effect on relieving the pain in the first treatment. The Xiakucao group was superior to the Vitamin E group in the improvement of the breast tenderness(P <0.05).CONCLU-SION The superficial needling therapy shows fast and lasting effects on relieving the pain of mammary glands hyperplasia, which is superior to Xiakucao oral solution and Vitamin E soft capsules.

Objective Tissue uptake and distribution of nano-/microplastics was studied at a single high dose by gavage in vivo.Methods Fluorescent microspheres (100 nm, 3 μm, and 10 μm) were given once at a dose of 200 mg/(kg·body weight). The fluorescence intensity (FI) in observed organs was measured using the IVIS Spectrum at 0.5, 1, 2, and 4 h after administration. Histopathology was performed to corroborate these findings.Results In the 100 nm group, the FI of the stomach and small intestine were highest at 0.5 h, and the FI of the large intestine, excrement, lung, kidney, liver, and skeletal muscles were highest at 4 h compared with the control group (P < 0.05). In the 3 μm group, the FI only increased in the lung at 2 h (P < 0.05). In the 10 μm group, the FI increased in the large intestine and excrement at 2 h, and in the kidney at 4 h (P < 0.05). The presence of nano-/microplastics in tissues was further verified by histopathology. The peak time of nanoplastic absorption in blood was confirmed.Conclusion Nanoplastics translocated rapidly to observed organs/tissues through blood circulation;however, only small amounts of MPs could penetrate the organs.

·AIM: To evaluate the effect of bupivacaine in non-catheter infiltration anesthesia during vitretomy operation.·METHODS:Fifty-eight patients (58 eyes) with vitreous retinal surgery were selected. Patients were randomly divided into observation group ( 28 eyes ) and control group ( 30 eyes ) . The observation group were received non-catheter infiltration anesthesia. The control group were received traditional Sub- Tenon's block ( STB ) . Degree of pain, basic vital signs, the duration of anesthesia and analgesia grade were recorded and compared between two groups.·RESULTS: No significant difference was found in the 11-point numeric rating scale ( NRS - 11 scoring ) of anesthesia process, sclera incision, intraocular operation and the end of operation between two groups (P>0. 05). The difference were not significant in heart rate and blood pressure between two groups(P>0. 05). There was statistically significant difference in the duration of anesthesia between two groups (P<0. 05).·CONCLUSION: Both groups can provide the same anesthetic effect. Compared to STB, non - catheter infiltration anesthesia takes short time, and it is a safe and effective anesthesia methods. In addition, compare to the mixture of bupivacaine and lidocaine injection, bupivacaine injection can provide the same anesthetic effect.

Objective To examine the associations between season of birth and factors as age at menarche,age at menopause and reproductive span.Methods A total of 285 186 female from the China Kadoorie Biobank,with complete data on critical variables and had menarche at 9-18 years old,were included.A total of 132 373 female with natural menopause were included for the analysis on age at menopause and reproductive span.Multiple linear regression models were used to assess the associations of birth season and the age at menarche,menopause,and reproductive span.Subgroup analyses were performed on birth cohorts and urban/rural residence.Results Compared with the Spring-born (March,April,and May),participants who were born in Summer (June,July,and August),Autumn (September,October,and November),and Winter (December,January,and February)appeared late on both age at menarche and menopause.Multivariable-adjusted coefficients (95％ CI)appeared as 0.14 (95％CI:0.13-0.16),0.26(95％CI:0.24-0.27),0.10 (95％CI:0.08-0.12) for age at menarche respectively and 0.14 (95％CI:0.08-0.20),0.18 (95％CI:0.12-0.24),0.09 (95％CI:0.03-0.16) for age at menopause respectively.No statistically significant association was found between the season of birth and reproductive span.The association was consistent between urban and rural residents and across the birth cohorts.Conclusions female born in spring showed both earlier age on both menarche and menopause,compared to the ones born in other seasons.Our findings suggested that exposures in early life with some degree of seasonal variation might influence the development of female reproductive system.

Adolescent ; Busulfan ; therapeutic use ; Child ; Child, Preschool ; Cyclophosphamide ; therapeutic use ; Cyclosporine ; therapeutic use ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Infant ; Leukemia ; drug therapy ; mortality ; therapy ; Leukemia, Myeloid, Acute ; drug therapy ; mortality ; therapy ; Male ; Mycophenolic Acid ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; mortality ; therapy ; Retrospective Studies ; Treatment Outcome