Objective:To investigate the discomfort of chest wall approach area in patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach (GUA), and to analyze its influencing factors. To provide a basis for the development of targeted improvement measures.Methods:A total of 153 patients with GUA from May. 2023 to Aug. 2023 in the Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. The general information questionnaire was collected one day before operation, the pain scales were assessed one day and three days after operation, and the pain and numbness scales were assessed one month after operation. The t test or χ2 test was used for comparison of baseline data between groups according to different types of variables. The patients were divided into two groups: less than moderate pain group (two postoperative average VAS scores<4) and more than moderate pain group (two postoperative average VAS scores ≥4). Mild numbness group (postoperative VAS score<4) ; Moderate and severe numbness group (postoperative VAS score ≥4). Multivariate binary Logistic regression was performed with pain discomfort and numbness discomfort as dependent variables to find possible influencing factors. Results:A total of 153 valid questionnaires were collected. There were 125 patients in the moderate pain group; There were 28 patients in the moderate and above pain group. There were 94 patients in the mild numbness group. There were 59 patients in the moderate to severe numbness group. Multivariate binary Logistic regression results showed that, exercise habits ( OR=0.07 95% CI=0.006, 0.409), operation duration ( OR=1.026 95% CI=1.001, 1.054), total drainage volume ( OR=1.122 95% CI=1.07, P<0.05), 1.198), and drainage tube indwelling time ( OR=0.012 95% CI=0.0, 0.187) had an impact on the discomfort of the chest wall approach area, and the difference was statistically significant ( P<0.05). Gender, BMI, marital status, education, occupation, handed-side surgery, handed-side axillary surgery, smokess and alcohol history, intraoperative blood loss, and length of hospital stay had no effect on the discomfort of chest wall approach area, and the difference was not statistically significant ( P>0.05) . Conclusion:Exercise habits, operation duration, total drainage volume, and drainage duration are independent predictors of discomfort in GUA patients.

Objective: To investigate the differences in enolase and laminin levels in vaginal epithelial tissues between mice successfully infected withGardnerellaand mice not infected with Gardnerella, providing information for further exploration of the correlation between enolase and laminin levels and the incidence of bacterial vaginosis. Methods: Gardnerella strains isolated, purified, and identified from vaginal secretions of patients with bacterial vaginosis were used to infect the vagina of mice and establish a mouse model of bacterial vaginosis. Successful and failed mice was defined as successful and failed groups, respectively. Differential expression of enolase and laminin in the vaginal epithelial tissue of two groups of mice was detected by Western blot. Modeling success rate was statistically analyzed, and the expression differences of enolase and laminin was compared between two groups. Results: One strain of Gardnerella vaginalis infected 10 SPF grade KM mice, 7 mice met the diagnostic criteria for bacterial vaginosis, and 3 mice failed to model, with a success rate of 70%. Western blot was used to detect protein expression levels, and the levels of laminin and enolase in the successfully modeled mouse vaginal epithelial tissue were significantly higher than those in the failed modeling group, with statistical differences between the two groups(P<0.05). Conclusion Enolase and laminin may be involved in the occurrence of bacterial vaginosis, however, further research is needed to determine the mechanisms through which they trigger the occurrence and development of the disease.

Objective To explore the molecular mechanism of lipopolysaccharide(LPS)on the contraction of pregnant uterine smooth muscle at tissue and cellular levels.Methods C57BL/6J mice at 16 days of gestation were randomly divided into control group and LPS group.The mice in LPS group were intraperitoneally injected with 20 μg in LPS solution to establish the model of preterm birth,and the mice in control group were intraperitone-ally injected with the same amount of normal saline.Isolated uterine muscle strips were used to detect changes in the contractile function of the tissue,as well as changes in the expression and function of the contraction key signa-ling molecule TWIK-related K+channel 1(TREK-1).Primary cultured pregnant mouse uterine smooth muscle cells were used to detect the expression of TREK-1 under the regulation of LPS.Results The contractility of mouse u-terine tissues was significantly enhanced by LPS,and the protein expression of TREK-1,a key signal for contrac-tion,was significantly reduced,and activation of TREK-1 resulted in a significant down-regulation of the enhanced contractility of mouse uterine tissues in the LPS group.However,there was no significant difference in the expres-sion of TREK-1 protein,which was highly expressed in the smooth muscle of pregnant mice,when LPS acted on the primary uterine smooth muscle cells of pregnant mice.Conclusion Uterine contractility is enhanced in pregnant mice uterine tissues by inhibiting TREK-1 expression and function in response to LPS,and it may be one of the mechanisms by which LPS induces preterm labor.However,the effect of LPS on TREK-1 on mouse pregnant uter-ine smooth muscle cells may be realized through intercellular signaling and not directly on uterine smooth muscle cells.This further suggests that the animal and histological experiments cannot be completely replaced by isolated cell experiments in the study of inflammatory preterm labor.

Cancer therapy-related cardiovascular toxicity(CTR-CVT)is gradually becoming a critical factor affecting the prognosis of cancer survivors.Vascular endothelial growth factor(VEGF)and its receptor inhibitors(VEGFIs),developed as novel anti-cancer drugs targeting VEGF,are now widely used in clinical practice.They can extend the survival period of the cancer patients and improve the prognosis of the patients.However,the hypertension induced by VEGFIs,as the most common CTR-CVT,may limit and impact their use and leads to severe cardiovascular diseases(CVD).It is essential to closely monitor blood pressure in the cancer patients treated with VEGFIs,conduct early assessments,and optimize the management to achieve the best anti-cancer efficacy and minimize the risk of CTR-CVT.This review discusses the clinical manifestations,pathogenesis,diagnosis,and treatment strategies of VEGFIs-related hypertension,in order to provide better guidances for managing and addressing VEGFIs-related hypertension for the clinicians.

Lipoprotein(a)[Lp(a)]is a highly polymorphic lipoprotein molecule composed of apolipoprotein A(apo A),apo B100,and cholesterol ester core;calcific aortic valve stenosis(CAVS)is a multifactorial valvular heart disease influenced by both environmental and genetic factors.Lp(a)is an independent risk factor for CAVS and can increase the onset risk of CAVS.Lp(a)plays an important role in the treatment of CAVS.Although surgery is currently the main clinical treatment for CAVS,with further exploration into its pathological mechanism,drug therapy targeting Lp(a)has emerged as a new method.This paper reviews studies about the structure and characteristics of Lp(a),its role in the occurrence and development of CAVS,treatment options related to hyperlipoprotein Aemia,and the studies preventing and treating CAVS by combating inflammation,and enhances the clinicians'understanding and awareness of hyperlipoprotein Aemia and provides new insights for the prevention and targeted drug therapy of CAVS.

Objective:To observe the characteristics and outcomes of hospital-acquired venous thromboembolism (HA-VTE), and to guide the clinic to take preventive measures for high-risk patients to reduce the incidence of HA-VTE.Methods:The clinical data of 1 570 hospitalized patients with HA-VTE from December 2013 to December 2019 in Xuanwu Hospital, Capital Medical University were retrospectively analyzed, including the basic information, department, risk factor evaluation of venous thromboembolism (VTE), prevention and outcomes, etc.Results:During the period, the total incidence of HA-VTE was 0.50% (1 570/317 047). The annual incidence of HA-VTE increased year by year, from 0.19% (85/44 737) in 2014 to 0.82% (564/68 780) in 2019. The incidence of HA-VTE in elderly patients (age ≥65 years old) was significantly higher than that in young and middle-aged patients (age form 18 to 64 years old): 0.96% (970/100 768) vs. 0.28% (600/216 279), and there was statistical difference ( χ2 = 654.96, P<0.01). There was no statistical difference in the incidence of HA-VTE between male and female: 0.51% (780/151 617) vs. 0.48% (790/165 430), χ2 = 2.19, P>0.05. HA-VTE patients were mainly distributed in the neurology department, emergency department, neurosurgery department, orthopedics department, vascular surgery department, general surgery department, etc, with the highest proportion of 27.83% (437/1 570) in neurology department. The departments with high incidence of HA-VTE were intensive care unit, emergency department, stroke center, orthopedics department, rehabilitation department and neurology department, with the highest incidence of 7.69% (7/91) in intensive care unit. The hospital stay in patients with HA-VTE was significantly longer than that in patients without HA-VTE: 14 (9, 20) d vs. 7 (3, 11) d, and there was statistical difference ( Z = - 39.75, P<0.01). During hospitalization, 94 patients died, and 7 cases (0.45%, 7/1 570) were directly caused by HA-VTE. Only 0.13% (2/1 570) of the patients underwent the risk factor evaluation of VTE. Conclusions:The annual incidence of HA-VTE has a clear upward trend, and the incidence of critical illness and elderly patients is the highest. HA-VTE significantly prolonged the average hospital stay of patients and increased the risk of death. Screening and evaluation should be strengthened, high-risk groups should be identified, and active preventive measures should be taken to reduce the risk of HA-VTE.

Objective : To select and obtain vaginal Lactobacillus strains with inhibitory effect on Gardnerella vagi⁃ nalis , and to explore the possible mechanism of inhibition of Gardnerella vaginalis by Lactobacillus vaginalis strains , so as to provide a prerequisite for the development of dominant strains for human disease treatment. Methods : Gardnerella vaginalis and vaginal Lactobacillus strains were isolated from vaginal secretions of patients with bacterial vaginosis (BV) and healthy women , respectively. The Lactobacillus strains with the ability to inhibit the proliferation of Gardnerella vaginalis were screened by spot on lawn. Double agar diffusion method was used to compare the inhibitory effects of Lactobacillus solutions , cell⁃free culture supernatants (CFCs) and bacteria on Gardnerella vaginalis. Results : Sixty⁃two strains of vaginal Lactobacillus strains were isolated and purified from vaginal vaginal secretions of 10 patients with bacterial vaginosis. Among the 62 strains of vaginal Lactobacillus , 18 strains could inhibit the proliferation of Gardnerella vaginalis. The vaginal Lactobacillus solutions , the CFCs , and bacteria all had inhibitory effect on Gardnerella vaginalis. The inhibitory effects of vaginal Lactobacillus solutions were higher than those of the CFCs. After the CFCs were treated with proteinase K , the inhibitory effect of eight samples disappeared , and that of 10 samples weakened obviously. Conclusion In this paper, 62 vaginal Lactobacillus strains are purified and identified , of which 18 strains can inhibit the proliferation of Gardnerella vaginalis. The production of antimicrobial protein may be involved in the mechanism that vaginal Lactobacillus inhibits the proliferation of Gardnerella vaginalis.

With the extensive application of highly sensitive genetic techniques in the field of prenatal diagnosis, prenatal chromosomal mosaicisms including true fetal mosaicisms and confined placental mosaicisms are frequently identified in clinical settings, and the diagnostic criteria and principle of genetic counseling and clinical management for such cases may vary significantly among healthcare centers across the country. This not only has brought challenges to laboratory technician, genetic counselor and fetal medicine doctor, but can also cause confusion and anxiety of the pregnant woman and their family members. In this regard, we have formulated a consensus over the prenatal diagnosis and genetic counseling for chromosomal mosaicisms with the aim to promote more accurate and rational evaluation for fetal chromosomal mosaicisms in prenatal clinics.
Consensus ; Female ; Genetic Counseling ; Humans ; Mosaicism ; Placenta ; Pregnancy ; Prenatal Diagnosis/methods*

Post-stroke depression (PSD) can seriously affect the outcome and quality of life of patients with stroke. However, due to the lower diagnostic rate, a large number of patients with PSD have not been treated in time and have a poor outcome. Therefore, only early detection, early diagnosis and early treatment of PSD can improve the prognosis and quality of life of patients with stroke. In recent years, a large number of studies on serum biomarkers have tried to find objective indicators related to PSD. Among them, interleukin-18 is associated with the pathogenesis of stroke and PSD, which may be attributed to its polymorphism and constitutive expression in the brain, especially the role of serum level changes in the risk stratification and outcome of acute ischemic stroke. This article reviews the role of interleukin-18 in the pathogenesis of PSD.

Objective The objective of this study was to investigate the relationship between the methylation of phosphodies-terase 4C(PDE4C)gene in peripheral blood leukocytes,and its interaction with environmental factors and the pathogenesis of breast cancer. Methods A case-control study was conducted to select 402 cases of breast cancer and 470 cancer-free controls from Octo-ber 2010 to December 2014. The specific DNA methylation-modified quantitative PCR method was used to detect the methylation of PDE4C gene. The use of crossover analysis and multivariate logistic regression was used to analyze the relationship between the level of gene methylation and its interaction with environmental factors and the pathogenesis of breast cancer. Results PDE4C methylation was not found to be significantly associated with the onset of breast cancer. High-frequency/high-intake of whole grains,vegetables, onion-based plants,poultry,milk,and regular exercise could reduce the risk of breast cancer;high-frequency/high-intake of pork, irregular menstrual cycle,and a high psychological stress index could increase the risk of breast cancer. PDE4C hypermethylation had a significant combining effect with edible onion-producing plants greater than 3 times/week,with an OR of 0. 373(95% CI:0. 208~0. 668,P=0. 001). Conclusion Hypermethylation of PDE4C is not an independent risk factor for breast cancer,and its combination with environmental factors affects the risk of breast cancer.