Objective To reduce the rate of dysphagia and inhalation pneumonia by changing the food dense and evaluate the swallow function by videofluoroscopy(VF) and fiberoptic endoscopic examination of swallowing(FEES). Methods The videofluoroscopy and fiberoptic endoscopic examination of swallowing were used in 50 healthy volunteer and 35 dysphagia person. Results Aspiration was find in 14% volunteer and penetration was find in 36% volunteer. The positive rate of videofluoroscopy was higher than of fiberoptic endoscopic examination of swallowing in the two indicators. The delay of the thin barium passed the pharynx was the danger factor of aspiration. Videofluoroscopy was more sensitive in diagnosis of penetration. The time that watery barium and pudding barium flowed from pharynx to epiqlottis is longer in patients than that in volunteer. Conclusion The videofluoroscopy and fiberoptic endoscopic examination could be predicted to some extend by some clinical swallowing abnormalities, which could increase the accuracy of clinical evaluation . The viscosity changing can decrease the rate of dysphagia and inhalation pneumonia.

Background and purpose:Pathological lymph node metastasis (LNM) is not rare in clinical lymph node negative (cN0) papillary thyroid carcinoma (PTC). The aim of this study was to investigate the risk factors of LNM, especially of high volume LNM (more than 5 metastatic lymph nodes) and contralateral central compartment LNM, in cN0 PTC.Methods:Medical records of 350 PTC patients (265 female, 85 male, 212 patients with solitary lesion in unilateral lobe) were reviewed. All operations of these patients were performed by one surgical team. The clinical pathological data were collected, and univariate and multivariate analysis was performed.Results:LNM was conifrmed in 138 patients (39.4%) and 20 patients had high volume LNM. In 169 patients with solitary lesion in unilateral lobe with total thyroidectomy and bilateral central neck dissection, 24 patients had contralateral metastasis (14.2%). In univariate analysis, tumor size (58.5% in >1 cmvs 33.6% in≤1 cm) and tumor with calcification in preoperational ultrasonography (43.7% withvs 31.7% without) showed signiifcant difference in prevelance of LNM. In multivariate analysis, tumor size >1 cm (OR=2.792) was the independent risk factor of LNM. Gender (3.8% in male vs 11.8% in female), age (10.7% <40 yearsvs 3.4%≥40 years ), tumor size(13.4% in >1 cmvs 3.4% in≤1 cm) and tumor with low echo in preoperational ultrasonography (13.9% withvs 4.8% without) showed signiifcant difference in univariate analysis of high volume LNM. Male (OR=5.152), tumor size >1 cm (OR=5.712) and age <40 years (OR=3.959) were conifrmed as independent risk factors of high volume LNM. Male (OR=3.105) and tumor size >1 cm (OR=3.863) were also demonstrated as independent risk factors of contralateral LNM in patients with solitary lesion in unilateral lobe, the prevalence of LNM were 26.5% in male and 26.1% in tumor size >1 cm, respectively.Conclusion:LNM was not “rare” in cN0 PTC patients. Prophylactic central neck dissection should be performed in cN0 patients with tumor size >1 cm. For cN0 microcarcinoma, more active surgical treatment may be considered in male and young patients.

Objective To investigate the clinical efficacy of the urethra URSL combined with micro-puncture and drainage treatment for pediatric calculus of lower urinary tract. Methods From January 2003 to January 2013, 66 cases with pediatric urinary tract calculi in our hospital were randomly equally divided into experimental group and control group. The experimental group was treated with transurethral bladder micro URSL combined puncture and drainage treatment, and the control group was given a simple transurethral URSL method of treatment. The operative time, postoperative urine turned clear time,pulling stone clearance after catheter time,postoperative hospital stay and the incidence of postoperative urethral stricture were observed and recorded. In addition, these data were compared between the two groups. Results The operations of two groups have successfully completed. The mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of control group was 30.2±2.45 minutes,2.5±0.5 days,2.1±0.8 days and 4.0±0. 5 days, respectively. Patients were followed up 1 year after operation, and 1 case of urethral stricture occurred. However, the mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of the test group was 20.36±2.35 minutes,1.5±0.7 days,1.1±0.25 days and 3.1±0.3 days,respectively,with no urethral stricture case occurred. There were significant differences between the two groups ( <0.05) . Conclusion Transurethral bladder URSL micro puncture and drainage combined with transurethral ureteroscopy lithotripsy treatment for children with lower urinary tract calculi has better efficacy and safety. It could shorter operative time, postoperative urine turned clear time, the gravel discharge time and average hospitalization time, reduce the incidence of postoperative secondary urethral stricture.

Objective To investigate the feasibility and safety of endoscopic treatment of ureteral calculi acute obstruction with urinary extravasation. Methods 56 patients with ureteral calculi acute obstruction and urinary extravasation were randomly divided into two groups:the treatment group and the control group,28 cases in each group. Patients in the treatment group were given URSL or percutaneous nephrostomy drainage, and the secondary fistula was given URSL stone clearance treatment. Patients in control group were given traditional ureterolithotomy treatment. The stone clearance rate, the average recovery time after surgery, postoperative wound infection rate and the abnormal rate of postoperative albumin were observed in two groups. Results In the treatment group,28 patients had no residual stones with mean postoperative recovery time of (5.2 1.3) days,postoperative fever was found in 3 cases,obvious abnormal postoperative albumin in 3 cases. In the control group,residual stones were found in 3 cases,the average recovery time after surgery was (7.9 2.6) days,postoperative fever was found in 10 cases, and obvious abnormal postoperative albumin in 11 cases. There were statistically significant differences in stone clearance rate, the average recovery time after surgery, postoperative wound infection rate and the abnormal rate of postoperative albumin between two groups (P<0.05) . Conclusion Endoscopic treatment of ureteral calculi acute obstruction and urinary extravasation has advantages including better efficacy, less trauma, less complications and quicker recovery.

Molecular nuclear medicine is a new subject that uses nuclear medicine technology to study the changes of molecular level in organisms in order to understand their functional changes. 2021 Radiological Society of North America annual meeting has more than 40 academic reports on molecular nuclear medicine. The main content includes new tracers and new imaging methods in tumors (prostate cancer, breast cancer, rectal cancer, etc.) and other diseases (Coronavirus Disease 2019 (COVID-19), Alzheimer′s disease, Parkinson′s disease, etc.). This article reviews the relevant research progress.

Objective:To investigate the efficacy of enhanced recovery after surgery(ERAS)combined with laparoscopy for the treatment of colorectal cancer in the elderly and its effects on proinflammatory factors and immune responses.Methods:A total of 158 elderly patients with colorectal cancer treated with surgery were retrospectively analyzed.According to different treatment methods, they were divided into the control group(76 cases)and the study group(82 cases). The control group received traditional open surgery and routine perioperative care.The study group received laparoscopic radical resection of colorectal cancer plus perioperative ERAS.Surgery parameters, complications, postoperative immune function and proinflammatory factor levels were compared between the two groups.Results:The operation duration of the study group was significantly longer than that of the control group[(128.5±33.7)min vs.(117.4±28.7)min, t=2.220, P=0.028], whereas the intraoperative blood loss[(100.8±20.5)ml vs.(250.7±62.3)ml, t=20.621, P<0.01]and the incision length[(4.5±1.2)cm vs.(17.5±3.0)cm, t=36.243, P<0.01]were significantly less than those in the control group.The time to first flatus[(2.0±0.9)d vs.(3.8±1.8)d, t=8.037, P<0.01], time to first defecation[(2.8±0.8)d vs.(4.5±1.1)d, t=11.167, P<0.01], time to first ambulation[(1.2±0.2)d vs.(3.8±1.3)d, t=17.888, P<0.01]and hospitalization length[(7.1±0.2)d vs.(11.4±2.2)d, t=17.625, P<0.01]were also significantly shorter than those in the control group.The incidences of surgical site infections(2.4% vs.10.5%, χ2=4.351, P=0.037), abdominal distension(7.3% vs.19.7%, χ2=5.279, P=0.023)and intestinal obstruction(9.8% vs.22.4%, χ2=4.711, P=0.030)in the study group were significantly lower than those in the control group.The levels of C-reactive protein, interleukin-6 and tumor necrosis factor-α in the study group were significantly lower than those in the control group at 1 d, 3 d and 7 d after surgery( t= 9.612, 7.300, 5.446, 8.762, 12.138, 15.370, 10.186, 10.432, 13.512, respectively, all P<0.05). The levels of CD3 + , CD4 + and CD4 + /CD8 + in the study group were significantly higher than those in the control group at 1 d, 3 d and 7 d after surgery( t= 2.128, 2.957, 2.313, 2.914, 2.937, 2.809, 5.089, 5.623, 5.409, respectively, P<0.05 for all), and the levels of CD8 + were significantly lower than those of the control group( t= 2.008, 2.580, 4.902, all P<0.05). Conclusions:Laparoscopy combined with ERAS for the treatment of colorectal cancer in the elderly can reduce surgical injury and complications and mitigate inflammatory responses with little impact on immune responses.

Objective: To analyze implant survival rate and incidence rate of complications after All-on-4 implantation, and to discuss the technical points and consideration of All-on-4. Methods : According to the criteria of inclusion and exclusion, 23 cases treated with All-on-4 immediate restoration were referred, from January 2007 to December 2015, including 5 cases of edentulous maxillary, 14 cases of edentulous mandibular and 4 cases of both maxillary and mandibular were edentulous. All the patients received immediate function with provisional prostheses at the surgery day. Definitive prostheses were delivered to patients after 3-6 months post operation and follow-up visits were performed up to 9 years (average 3 years) after placement of definitive prostheses. Results : In this study, the rate of implant retention of 108 implants and 27 final restorations was 100% until the last review. Among the 23 patients, 3 patients had complications and the incidence of complications was 13.0%. Conclusion All-on-4 is an effective and reliable method in the treatment of dentures denture. The incidence of complications is low. All-on-4 is a practical method.

Objective To study the compliance of forbidden depasturing livestock on the marshland with Oncomelania snails in schistosomiasis endemic areas. Methods According to 3 levels of human infection rates as > 10% ,5%-10% and <5% , 2 204 residents selected randomly from the schistosomiasis endemic villages were sampled with the stratified cluster sampling method in Hunan, Hubei, Jiangxi, Anhui, Jiangsu, Sichuan and Yunnan provinces, and investigated by questionnaire. The contents of the questionnaire included the recognition and implementation of forbidden depasturing livestock on marshland with Oncomelania snails and breeding livestock in bam. Results A total of 78.4% residents agreed forbidden depasturing livestock on marshland with snails, but 3. 7% residents disagreed it. A total of 83. 9% residents considered the relationship between breeding livestock in bam and schistosomiasis control, but 3. 1% residents thought that it was no relationship. The main reasons of depasturing livestock on marshland with Oncomelania snails were the high cost of breeding livestock in bam (36. 2% ) , unaccustomed (26.4% ) and no room for breeding livestock in bam (25.4% ). Conclusion Forbidden depasturing livestock on the marshland with Oncomelania snails should be strengthened according to the local economic, nature environment, agriculture, residents'culture degree and agriculture habit.

Objective To analyze and identify the volatile constituents in different parts(flowers,stems and leaves)of Huai chrysanthemumin,and to lay a theoretical foundation for the comprehensive utilization for it.Methods The volatile oil in different parts of Huai chrysanthemumin were extracted by hydrodistillation,respectively.Their constituents were analyzed by gas chromatography-mass spectrometry(GC-MS).The compounds were identified by library search and literature screening.The relative percentage of each compound was obtained by the area normalization method.The differences in their chemical compositions were analyzed by Venn diagram,principal component analysis(PCA)and cluster heat map analysis.Results A total of 62 volatile chemical components were identified from different parts of Huai chrysanthemumin,including monoterpenes,sesquiterpenes,and their derivatives,as well as a small amount of aliphatic compounds.32,42 and 40 volatile components were detected from the flowers,stems and flowers,respectively.Furthermore 17 volatile components were shared by three parts,whereas 5,6 and 16 volatile components were unique to the flowers,stems and leaves,respectively.The results of stoichiometric analysis showed that both PCA and cluster heat map analysis could separate the flowers,stems and leaves,and their volatile components were different.Conclusion The types and contents of the volatile oil in the stems,leaves and flowers of Huai chrysanthemumin have certain variability,which provide a scientific basis for the further medicinal or industrial exploitation of different parts of Huai chrysanthemumin.

In this study, we presented the isolation and characterization of eight novel seco-guaianolide sesquiterpenoids (1-8) and two known guaianolide derivatives (9 and 10), from the aerial part of Achillea alpina L.. Compounds 1-3 were identified as guaianolides bearing an oxygen insertion at the 2, 3 position, while compounds 4-8 belonged to a group of special 3-nor guaianolide sesquiterpenoids. The structural elucidation of 1-8, including their absolute configurations, were accomplished by a combination of spectroscopic data analysis and quantum electronic circular dichroism (ECD) calculations. To evaluate the potential antidiabetic activity of compounds 1-10, we investigated their effects on glucose consumption in palmitic acid (PA)-mediated HepG2-insulin resistance (IR) cells. Among the tested compounds, compound 7 demonstrated the most pronounced ability to reverse IR. Moreover, a mechanistic investigation revealed that compound 7 exerted its antidiabetic effect by reducing the production of the pro-inflammatory cytokine IL-1β, which was achieved through the suppression of the NLRP3 pathway.
Humans ; Hypoglycemic Agents/pharmacology* ; Circular Dichroism ; Cytokines ; Glucose ; Hep G2 Cells ; Insulin Resistance