LL-37 is a widely-distributed human antimicrobial peptide with antimicrobial activity.In recent years,it has been found that LL-37 not only has antibacterial effect,but also can exert comprehensive immune regulatory function on different immune cells in different microenvironments,and then play a pro-inflammatory or anti-inflammatory role in a series of autoimmune diseases.This article focuses on immunomodulatory effect of LL-37 and its possible role in autoimmune diseases.

LL-37 is a widely-distributed human antimicrobial peptide with antimicrobial activity.In recent years,it has been found that LL-37 not only has antibacterial effect,but also can exert comprehensive immune regulatory function on different immune cells in different microenvironments,and then play a pro-inflammatory or anti-inflammatory role in a series of autoimmune diseases.This article focuses on immunomodulatory effect of LL-37 and its possible role in autoimmune diseases.

Objective:To investigate the efficacy and prognosis of different surgical approaches in sporadic medullary thyroid carcinoma.Methods:A retrospective analysis was conducted on 101 patients with sporadic medullary thyroid carcinoma (MTC) who underwent surgical treatment at the Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University, from Feb. 2009 to Nov. 2023. The patients included 36 males and 75 females, with a male-to-female ratio of 1:2.1. The median age of the patients was 47 years old, with an age range of 21 to 72 years old. The study divided participants into two groups based on their surgical methods: an observation group (78 cases) and a control group (23 cases). The observation group received surgical methods in accordance with expert consensus, while the control group did not. The study compared the efficacy and prognosis of the two groups.Results:Statistical differences were found between the two groups in terms of stage II and III in TNM staging, intraoperative frozen pathological findings, number of lymph node resections in the central group, number of lymph node metastases in the central group, number of lymph node resections in the lateral cervical region, postoperative follow-up time, and five-year postoperative serum procalcitonin (Ctn) levels ( P<0.05) .Both groups of patients obtained a significant decrease in Ctn after surgical treatment. In the observation group, Ctn was at the remission level in 57 cases (73.1%), at the stable level in 13 cases (16.7%), and at the progression level in 8 cases (10.2%), while in the control group, Ctn was at the remission level in 20 cases (86.9%), at the progression level in 3 cases (13.1%), and there were no patients at the stable level after the operation.One patient (1.3 per cent) in the observation group had a recurrence after surgery; Two patients (8.7 per cent) in the control group had a recurrence. Conclusions:Standardised and thorough surgery can maximise the clearance of metastatic lymph nodes, effectively reduce the recurrence rate, achieve better efficacy, and improve the long-term prognosis of patients without increasing the risk of surgery and postoperative complications.

Differentiated thyroid carcinoma (DTC) is the most common endocrine tumor,characterized by high incidence,low recurrence rate,and low mortality. Locally advanced thyroid cancer (LATC) is rare in clinical practice,with poor prognosis,and is one of the leading causes of death among thyroid cancer patients. In August 2024,the Thyroid Surgery Department of China-Japan Union Hospital of Jilin University admitted a 61-year-old male patient with a history of "neck mass surgery 16 years ago and progressive enlargement with ulceration of the mass over the past 3 months." Physical examination revealed an irregularly shaped mass measuring approximately 12 cm × 12 cm in the left supraclavicular fossa,with a dark red surface,ulceration,bleeding,and necrotic exudate in some areas. After admission,a multidisciplinary team (MDT) consultation was initiated,and the patient underwent his fifth surgery,which included resection of the left cervical mass,left cervical lymphadenectomy,resection of a submental mass,and free flap transplantation. The patient was discharged on postoperative day 10 in good condition. One month after surgery,a follow-up ultrasound at our hospital showed no significant abnormalities in the neck,with good healing of the local skin and survival of the transplanted flap. This article reviews the MDT treatment process of this LATC case and summarizes the characteristics of LATC based on domestic and international literature,providing experience and references for the comprehensive treatment of this disease.

Differentiated thyroid carcinoma (DTC) is the most common endocrine tumor,characterized by high incidence,low recurrence rate,and low mortality. Locally advanced thyroid cancer (LATC) is rare in clinical practice,with poor prognosis,and is one of the leading causes of death among thyroid cancer patients. In August 2024,the Thyroid Surgery Department of China-Japan Union Hospital of Jilin University admitted a 61-year-old male patient with a history of "neck mass surgery 16 years ago and progressive enlargement with ulceration of the mass over the past 3 months." Physical examination revealed an irregularly shaped mass measuring approximately 12 cm × 12 cm in the left supraclavicular fossa,with a dark red surface,ulceration,bleeding,and necrotic exudate in some areas. After admission,a multidisciplinary team (MDT) consultation was initiated,and the patient underwent his fifth surgery,which included resection of the left cervical mass,left cervical lymphadenectomy,resection of a submental mass,and free flap transplantation. The patient was discharged on postoperative day 10 in good condition. One month after surgery,a follow-up ultrasound at our hospital showed no significant abnormalities in the neck,with good healing of the local skin and survival of the transplanted flap. This article reviews the MDT treatment process of this LATC case and summarizes the characteristics of LATC based on domestic and international literature,providing experience and references for the comprehensive treatment of this disease.

In recent years, clinical applications of robotic thyroid surgery have been gradually promoted with the continuous improvement of the da Vinci robotic surgical system. Unlike traditional open surgery, robotic thyroid surgery mainly adopts remote access, which has many advantages, such as magnified high-definition 3D view and hand vibration stabilization. The rates and causes of postoperative complications differ due to different approaches, view angles, and operation sequences. This paper presents the literature on both transoral and bilateral areolar axillary approaches in robotic thyroid surgery, focusing on five common complications under both approaches, including laryngeal recurrent nerve injury and hypoparathyroidism, to provide theoretical support for the standardization of robotic thyroid surgery.

Thyroid cancer is the most common malignant tumor of the endocrine system, and its incidence is increasing year by year showing younger trend. The pathological types of thyroid cancer are papillary carcinoma, follicular carcinoma, medullary carcinoma and undifferentiated carcinoma. Medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) are the two common types of thyroid cancer. Since MTC and PTC have different biological origins, invasiveness and prognosis. Therefore, the occurrence of both medullary carcinoma and papillary carcinoma is very rare and rarely reported in China and abroad and the treatment is challenging. In this paper, we review the pathogenesis, ancillary tests, diagnosis and treatment of this disease, with the aim of providing reference for clinical treatment of patients with medullary thyroid carcinoma complicated by papillary carcinoma.

Objective:To investigate the clinical effectiveness of da Vinci robotics in thyroid surgery.Methods:304 cases of robotic thyroid surgery performed by the same experienced surgeon at the Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University during the period from Apr. 3, 2020 to Nov. 5, 2021 were prospectively included, and the operation time, operation type, postoperative drainage, postoperative hospital stay, total number of lymph node dissection and number of positive lymph nodes, operation complications, and postoperative pain level of all patients were counted. The learning curve was plotted by applying the moving average method, divided into the initial stage and the mature stage, and the differences in surgical outcomes and surgical complications between the two stages were compared. SPSS 23.0 was applied for statistical analysis, and t-test and Mann-Whitney U test were used for comparison of measurement data, and χ2 test was used for comparison of count data. Result:All surgeries were completed successfully without conversion to open cases, including 29 males and 275 females, with a mean age of (33.8±8.9) years and a range of 27-41 years. The mean body mass index (BMI) was (22.9±3.6) kg/m 2 and a range of 20.5-25.4 kg/m 2. The median operative time was 140 min, the median postoperative drainage was 52.5 ml, and the median postoperative hospital stay was 3 days. The mean number of lymph nodes cleared was 4.4±3.5, and the mean number of positive lymph nodes was 0.9±1.7. The incidence of postoperative transient laryngeal nerve (RLN) injury was 3.3%, and the incidence of transient hypoparathyroidism was 0.7%. A significant decrease in operative time occurred after the 26th case and subsequently stabilized. Compared with the initial stage of the learning curve, the mature stage had a shorter operative time (146.0±36.5 vs 198.7±56.7 min, P<0.001) , a lower incidence of temporary RLN injury (2.5% vs 11.5%, P<0.05) , and a lower percentage of benign tumor surgery (12.2% vs 26.9%, P<0.05) . Conclusion:The application of robotic technology in thyroid surgery is safe and reliable, and its successful implementation should follow a corresponding learning curve, from easy to difficult, with different surgical approaches selected according to the patient’s condition, wishes, and the operator’s technical level.

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