Objective:To investigate the efficacy of preoperative ultrasound-guided injection of carbon nanoparticle suspension in cervical lymph node dissection for thyroid cancer reoperation.Methods:Ninety-four patients undergoing reoperation for thyroid cancer admitted by the same physician team of the Department of Thyroid and Breast Surgery of the Ninety-sixty Hospital of the People’s Liberation Army (PLA) from Jan. 2019 to Sep. 2024 were retrospectively analyzed. According to the different scope of the initial surgery, they were divided into the re-specification clearance group, the regional lymph node clearance group, and the metastatic lymph node dissection group, and the groups were subdivided into the carbon nanoparticle group and the control group according to whether they were injected with carbon nanoparticle before the surgery or not. The t-test, χ2-test, and non-parametric test were used to compare the age, gender, surgical method, duration of surgery, total number of lymph nodes detected, and positive lymph node detection rate between the nano-charcoal group and the control group in the three groups. Results:There was no statistically significant difference between the three groups in terms of age, gender, surgical methods, or the total number of lymph nodes detected (all P>0.05) , and the difference between the surgical time of the carbon nanoparticle group in the re-regulation clearance group and the control group was not statistically significant ( P>0.05) ; the surgical time of the carbon nanoparticle group was shorter than that of the control group in both the regional lymph node clearance and the metastatic lymph node dissection groups, and the difference was statistically significant (all P<0.05) ; the positive detection rate of lymph nodes in the carbon nanoparticle group was higher than that in the control group among the three groups, and the difference was statistically significant (all P<0.05) . Conclusion:In the operation of cervical lymph node dissection for papillary thyroid cancer, preoperative ultrasound-guided injection of carbon nanoparticle can accurately localize the lymph nodes, increase the positive detection rate of lymph nodes, reduce the difficulty of surgical operation, and shorten the operation time.

Objective:To investigate the application of transoral robotic thyroidectomy (TORT) in overweight patients.Methods:Clinical data of 109 thyroid tumor patients who underwent TORT at 960th Hospital of People’s Liberation Army from May. 2020 to Aug. 2023 were retrospectively collected and analyzed. After excluding 10 patients who underwent prophylactic lateral neck dissection, a total of 99 patients were included in this study. According to the World Health Organization (WHO) guidelines, which define people with BMI:25-29.9 kg/m 2 as overweight, we divided the 99 patients into normal weight group (n=69) and overweight group (n=30) . To make the baseline data consistent between the two groups and ensure comparability, 20 matched pairs were generated using a 1∶1 propensity score matching (PSM) method, considering four clinicopathologic factors: age, gender, diameter of tumor and operation scope. In the normal-weight group, there were 18 females and 2 males, aged (32.82±9.51) years (range: 17-53 years) , and there exhibited 18 females and 2 males in the overweight group, aged (35.14±10.63) years (range: 18-55 years) . Results:All patients successfully underwent the operation without conversions to open surgery. After matching, both groups had 2 cases of thyroid adenoma and 18 cases of papillary thyroid carcinoma ( P=1) , with no statistically significant difference in the surgical scope between the two groups ( P=0.376) . There was no statistically significant difference in the mean tumor diameter between the normal-weight group and the overweight group (5.38±1.79 mm vs. 5.61±3.32 mm, P=0.575) . All malignant tumor cases in both groups were classified as T1 stage, and there was no statistically significant difference in N stage ( P=0.186) . All patients with malignant tumors underwent central lymph node dissection, there was no significant difference in the number of central lymph nodes dissected ( P=0.623) and metastatic lymph nodes ( P=0.109) between the two groups. There were no statistically significant differences in operative duration (217.53±62.83 min vs. 220.67±73.73 min, P=0.808) , median postoperative hospital stay [6 (6,7.75) days vs. 6 (6,7) days, P=0.682], or 24-hour drainage volume (78.52±30.49 mL vs. 68.23±29.11 mL, P=0.180) between the normal-weight group and the overweight group. There was no permanent hypoparathyroidism, postoperative hemorrhage, lymphatic fistula, mental nerve injury, postoperative infection in both groups. In both groups, there occurred one case of transient hypoparathyroidism. As for other complications, 1 case of temporary recurrent laryngeal nerve injury and oral tearing occurred in the overweight group, while the normal-weight group had 1 case of skin scald. Conclusions:Among patients who underwent TORT, the overweight group exhibited comparable surgical outcomes and postoperative complications to those in the normal-weight group. TORT is a safe and feasible surgical option for overweight patients, which provides more surgical options for this patient population.

Exerkines play important roles in the regulation of metabolic diseases, cardiovascular diseases, and neurological disorders, including obesity, diabetes, sarcopenia, osteoporosis, myocardial infarction, and Alzheimer′s disease. This review summarizes recent research on several key exerkines and their physiological effects.

Exerkines play important roles in the regulation of metabolic diseases, cardiovascular diseases, and neurological disorders, including obesity, diabetes, sarcopenia, osteoporosis, myocardial infarction, and Alzheimer′s disease. This review summarizes recent research on several key exerkines and their physiological effects.

Objective:To investigate the efficacy of preoperative ultrasound-guided injection of carbon nanoparticle suspension in cervical lymph node dissection for thyroid cancer reoperation.Methods:Ninety-four patients undergoing reoperation for thyroid cancer admitted by the same physician team of the Department of Thyroid and Breast Surgery of the Ninety-sixty Hospital of the People’s Liberation Army (PLA) from Jan. 2019 to Sep. 2024 were retrospectively analyzed. According to the different scope of the initial surgery, they were divided into the re-specification clearance group, the regional lymph node clearance group, and the metastatic lymph node dissection group, and the groups were subdivided into the carbon nanoparticle group and the control group according to whether they were injected with carbon nanoparticle before the surgery or not. The t-test, χ2-test, and non-parametric test were used to compare the age, gender, surgical method, duration of surgery, total number of lymph nodes detected, and positive lymph node detection rate between the nano-charcoal group and the control group in the three groups. Results:There was no statistically significant difference between the three groups in terms of age, gender, surgical methods, or the total number of lymph nodes detected (all P>0.05) , and the difference between the surgical time of the carbon nanoparticle group in the re-regulation clearance group and the control group was not statistically significant ( P>0.05) ; the surgical time of the carbon nanoparticle group was shorter than that of the control group in both the regional lymph node clearance and the metastatic lymph node dissection groups, and the difference was statistically significant (all P<0.05) ; the positive detection rate of lymph nodes in the carbon nanoparticle group was higher than that in the control group among the three groups, and the difference was statistically significant (all P<0.05) . Conclusion:In the operation of cervical lymph node dissection for papillary thyroid cancer, preoperative ultrasound-guided injection of carbon nanoparticle can accurately localize the lymph nodes, increase the positive detection rate of lymph nodes, reduce the difficulty of surgical operation, and shorten the operation time.

Objective:To investigate the application of transoral robotic thyroidectomy (TORT) in overweight patients.Methods:Clinical data of 109 thyroid tumor patients who underwent TORT at 960th Hospital of People’s Liberation Army from May. 2020 to Aug. 2023 were retrospectively collected and analyzed. After excluding 10 patients who underwent prophylactic lateral neck dissection, a total of 99 patients were included in this study. According to the World Health Organization (WHO) guidelines, which define people with BMI:25-29.9 kg/m 2 as overweight, we divided the 99 patients into normal weight group (n=69) and overweight group (n=30) . To make the baseline data consistent between the two groups and ensure comparability, 20 matched pairs were generated using a 1∶1 propensity score matching (PSM) method, considering four clinicopathologic factors: age, gender, diameter of tumor and operation scope. In the normal-weight group, there were 18 females and 2 males, aged (32.82±9.51) years (range: 17-53 years) , and there exhibited 18 females and 2 males in the overweight group, aged (35.14±10.63) years (range: 18-55 years) . Results:All patients successfully underwent the operation without conversions to open surgery. After matching, both groups had 2 cases of thyroid adenoma and 18 cases of papillary thyroid carcinoma ( P=1) , with no statistically significant difference in the surgical scope between the two groups ( P=0.376) . There was no statistically significant difference in the mean tumor diameter between the normal-weight group and the overweight group (5.38±1.79 mm vs. 5.61±3.32 mm, P=0.575) . All malignant tumor cases in both groups were classified as T1 stage, and there was no statistically significant difference in N stage ( P=0.186) . All patients with malignant tumors underwent central lymph node dissection, there was no significant difference in the number of central lymph nodes dissected ( P=0.623) and metastatic lymph nodes ( P=0.109) between the two groups. There were no statistically significant differences in operative duration (217.53±62.83 min vs. 220.67±73.73 min, P=0.808) , median postoperative hospital stay [6 (6,7.75) days vs. 6 (6,7) days, P=0.682], or 24-hour drainage volume (78.52±30.49 mL vs. 68.23±29.11 mL, P=0.180) between the normal-weight group and the overweight group. There was no permanent hypoparathyroidism, postoperative hemorrhage, lymphatic fistula, mental nerve injury, postoperative infection in both groups. In both groups, there occurred one case of transient hypoparathyroidism. As for other complications, 1 case of temporary recurrent laryngeal nerve injury and oral tearing occurred in the overweight group, while the normal-weight group had 1 case of skin scald. Conclusions:Among patients who underwent TORT, the overweight group exhibited comparable surgical outcomes and postoperative complications to those in the normal-weight group. TORT is a safe and feasible surgical option for overweight patients, which provides more surgical options for this patient population.

Objective To establish mouse models exposed to different doses of neodymium oxide via tracheal instillation,and to investigate the mechanisms underlying brain tissue damage induced by neodymium oxide exposure in mice.Methods Forty-eight male C57/BL6 mice were randomly assigned to four groups:the control group,the low-dose group,the medium-dose group,and the high-dose group.The low-dose,medium-dose,and high-dose groups received 62.5 mg/mL,125 mg/mL,and 250 mg/mL neodymium oxide,respectively,via non-exposed tracheal instillation.The control group received an equivalent volume of saline using the same administration method.After 35 days,the mice were euthanized,and brain tissues were collected.RT-PCR was used to assess the mRNA expression changes of Claudin-5 and Occludin.Western blot analysis was performed to evaluate the expression changes of Claudin-5 and Occludin tight junction proteins,as well as the expression changes of MMP-2 and MMP-9 in the brain tissues.Additionally,the expression of the RhoA/ROCK2 signaling pathway and downstream cofilin protein was examined.Changes in oxidative stress markers,including MDA,T-AOC,and NO,were measured using a kit method.Results The mRNA expression of Claudin-5 was significantly reduced in the middle-dose and high-dose groups compared to the control group(P<0.05).Similarly,the mRNA expression of Occludin was significantly lower in the low-dose,medium-dose,and high-dose groups compared to the control group(P<0.05).Additionally,the protein expression of Claudin-5,MMP-2,and Occludin was significantly decreased in the low-dose,medium-dose,and high-dose groups compared to the control group(P<0.05).The protein expression of MMP-9 and RhoA was also signifi-cantly lower in the medium-dose and high-dose groups compared to the control group(P<0.05).Furthermore,the protein expression of ROCK2 and p-cofilin in the high-dose group was significantly lower than that in the control group(P<0.05).The content of MDA and T-AOC was significantly lower in the medium-dose and high-dose groups compared to the control group(P<0.05),and the content of NO in the high-dose group was significantly lower than that in the control group(P<0.05).Conclusion Exposure to neodymium oxide results in increased permeability of the blood-brain barrier in mice,leading to oxidative stress,inflammatory responses,and activation of the RhoA/ROCK2 signaling pathway.

Immunoglobulin A (IgA) nephropathy is a globally prevalent type of primary glomerulonephritis, characterized by complex symptoms and diverse clinical manifestations. The internationally recognized " multiple hit hypothesis" explains the systemic immune disease features of IgA nephropathy. However, current treatment strategies primarily focus on local pathological changes, inadequately addressing its complex systemic mechanisms. The " qi cycle in round" theory, an integral concept of the academic thought of HUANG Yuanyu, a prominent medical expert from the Qing Dynasty, offers a concise and insightful framework for understanding complex pathologies. For example, this theory provides valuable insights for elucidating the pathogenesis of IgA nephropathy and guiding its clinical management by simplifying intricate systemic processes. This study applies the " qi cycle in round" theory to postulate that patients with IgA nephropathy experience disrupted qi flow owing to spleen-stomach qi deficiency and dampness-heat accumulation. These imbalances manifest as internal symptoms, such as diarrhea; external vulnerability to illness; upper body symptoms, like sore throat; and lower body symptoms, such as hematuria and proteinuria. Pathologically, the condition is characterized by immune complex deposition. This article also emphasizes strategies that prioritize tonifying spleen-stomach qi to enhance the pivotal functions of transportation and transformation. Regulating qi and relieving stagnation are emphasized to harmonize ascending and descending dynamics. Additionally, eliminating turbidity and unblocking collaterals are highlighted to promote qi transformation. These approaches aim to restore the harmonious operation of organ qi dynamics and harmonious qi transformation functions. This study aims to provide a reference for syndrome differentiation and IgA nephropathy treatment using traditional Chinese medicine based on the " qi cycle in round" theory.

Objective To establish mouse models exposed to different doses of neodymium oxide via tracheal instillation,and to investigate the mechanisms underlying brain tissue damage induced by neodymium oxide exposure in mice.Methods Forty-eight male C57/BL6 mice were randomly assigned to four groups:the control group,the low-dose group,the medium-dose group,and the high-dose group.The low-dose,medium-dose,and high-dose groups received 62.5 mg/mL,125 mg/mL,and 250 mg/mL neodymium oxide,respectively,via non-exposed tracheal instillation.The control group received an equivalent volume of saline using the same administration method.After 35 days,the mice were euthanized,and brain tissues were collected.RT-PCR was used to assess the mRNA expression changes of Claudin-5 and Occludin.Western blot analysis was performed to evaluate the expression changes of Claudin-5 and Occludin tight junction proteins,as well as the expression changes of MMP-2 and MMP-9 in the brain tissues.Additionally,the expression of the RhoA/ROCK2 signaling pathway and downstream cofilin protein was examined.Changes in oxidative stress markers,including MDA,T-AOC,and NO,were measured using a kit method.Results The mRNA expression of Claudin-5 was significantly reduced in the middle-dose and high-dose groups compared to the control group(P<0.05).Similarly,the mRNA expression of Occludin was significantly lower in the low-dose,medium-dose,and high-dose groups compared to the control group(P<0.05).Additionally,the protein expression of Claudin-5,MMP-2,and Occludin was significantly decreased in the low-dose,medium-dose,and high-dose groups compared to the control group(P<0.05).The protein expression of MMP-9 and RhoA was also signifi-cantly lower in the medium-dose and high-dose groups compared to the control group(P<0.05).Furthermore,the protein expression of ROCK2 and p-cofilin in the high-dose group was significantly lower than that in the control group(P<0.05).The content of MDA and T-AOC was significantly lower in the medium-dose and high-dose groups compared to the control group(P<0.05),and the content of NO in the high-dose group was significantly lower than that in the control group(P<0.05).Conclusion Exposure to neodymium oxide results in increased permeability of the blood-brain barrier in mice,leading to oxidative stress,inflammatory responses,and activation of the RhoA/ROCK2 signaling pathway.

Objective:To establish a prognostic model and explore its clinical application based on disease progression within 24 months(POD24)in patients with multiple myeloma(MM).Methods:A total of 289 patients newly diagnosed with MM at Wuxi People's Hospital from January 2007 to June 2022 were selected as the training group for retrospective analysis.A prognostic model based on POD24 was constructed using Cox univariate and multivariate analyses of overall survival(OS).A total of 184 patients from The First Affiliated Hospital of Soochow University from August 2015 to December 2019 were included in the validation group to verify the predictive efficacy of the model.Results:Age,β2-microglobulin,Calcium,and POD24 were independent prognostic factors for MM.Patients in the high-risk group(≥2 points)had shorter OS(25.0 months vs.60.0 months)and progression-free survival(PFS)(14.0 months vs.56.0 months)than those in the low-risk group(<2 points).In addition,OS and PFS differed between the high-and low-risk groups in the entire validation group,as well as in each patient subgroup(P<0.05).Conclusions:The prognostic model based on POD24,age,β2 microglobulin,and Calcium holds prognostic value for patients newly diagnosed with MM in clinical practice.