Objective:To analyze the clinical characteristics of elderly patients with papillary thyroid cancer(PTC)by age grouping.Methods:The patients were divided into three groups according to age at diagnosis: old(≥60 years, 90 cases), middle(40-59 years, 359 cases)and young patients(<40 years, 203 cases). The clinical data of 652 patients with PTC who were admitted to the Department of Thyroid Surgery of Beijing Hospital from December 2019 to December 2021 were retrospectively analyzed.The patients were divided into elderly group(≥60 years old, 90 cases), middle-aged group(40-59 years old, 359 cases)and young group(<40 years old, 203 cases). The clinical characteristics, ultrasound characteristics and invasion-related factors of patients in different groups were analyzed by statistical methods.Results:Compared with the young and middle-aged group, the elderly patients with PTC had a higher proportion of microcarcinoma(75.6%, 75.2%, 61.4%, χ2=13.054, P=0.001), less cervical lymph node metastasis(24.4%, 34.3%, 58.1%, χ2=41.650, P<0.001), and lower proportion of metastatic lymph nodes(0.08, 0.14, 0.24, χ2=40.618, P<0.001). There was no significant difference in tumor location and extra glandular invasion among the three age groups(35.56%, 36.2%, 38.4%, χ2=0.959, P=0.545). Conclusions:Compared with the young and middle-aged groups, PTC showed low invasiveness in the elderly population.In addition to surgical treatment, for elderly patients with low-risk clinical characteristics, it is worth performing a further study on whether careful observation or palliative treatment can be selected after comprehensive evaluation.

Objective:To evaluate clinical outcomes and complications of minimal invasive surgery for the treatment of elderly patients with fragility fracture of pelvis.Methods:Elderly patients with fragile pelvic fractures undergoing minimally invasive surgery and being followed up were retrospectively analyzed from January 2015 to December 2019.Based on the classification of pelvic fragile fractures(FFP), open reduction and internal fixation with pelvic anterior ring instability internal fixator(INFIX)plus posterior ring sacroiliac screw, or open reduction and internal fixation with iliac fossa approach, were performed for elderly patients with fragile pelvic fractures.The general data of all patients(age, sex, mechanism of injury)were recorded.Time from injury to operation, VAS(visual analogue scale)before and after operation, blood loss during operation, complications during hospitalization, time to ambulation, mortality, and Koval walking index at 2 year follow-up were recorded to evaluate clinical outcomes and complications of minimal invasive surgery for the treatment of fragility fracture of pelvis.Results:Thirty-two patients were followed up, including 11 males and 21 females, aged 65-88 years(76.9±5.5)years.The mechanism of injury was fall on the ground as a percentage of 59.4%(19/32), fall in the sitting position as a percentage of 25.0%(8/32), and 15.63%(5/32)had unknown history of trauma.The time from injury to operation was 3-36 days(9.6±3.3)days.There were 50.0%(16/32)type Ⅱ, 31.3%(10/32)type Ⅲ and 18.8%(6/32)type Ⅳ cases according to FFP classification.The mean blood loss during operation was(65.9±35.2)ml(range, 20-200 ml). The preoperative VAS score was 5-9 scores, with an average of(6.41±1.07)scores.The postoperative VAS score was 1-4(1.71±0.63). Average time from injury to operation was(9.6±3.3)days(range, 3~36). The incidence of complications during operation was 9.4%(3/32), including 1 case of gastrointestinal bleeding, 1 case of lower extremity deep vein thrombosis, and 1 case of superficial wound infection.Ambulation was at 4 weeks post-operation in 56.3%(18/32)cases, at 6 weeks post-operation in 31.3%(10/32)cases and at 8 weeks post-operation in 12.5%(4/32)cases.6.25%(2/32)patients died within 2 year follow-up.Koval walking index of the rest 30 patients included grade 1 in 46.9%(15/32)cases, grade 2 in 18.8%(6/32)cases, grade 3 in 6.3%(2/32)cases, grade 4 in 18.8%(6/32)cases and grade 6 in 3.1%(1/32)case(1 year after surgery, hemiplegia after cerebral infarction).Conclusions:Minimal invasive surgery achieves significant pain relief and early mobilization in patients with fragility fracture of pelvis.

Objective:To investigate the changes of mean venous sinus pressure (MVP) and trans-stenosis pressure gradient in patients with idiopathic intracranial hypertension (IIH) under awake setting and general anesthesia.Methods:Thirty-eight patients with IIH accepted venous sinus stent implantation in our hospital from January 2010 to January 2020 were chosen in our study; their clinical data were analyzed retrospectively. The manometry results of these 38 patients were recorded under awake setting and general anesthesia before stenting; MVP and trans-stenosis pressure gradient were obtained and compared.Results:MVP in the superior sagittal sinus, torcular, transverse sinus and sigmoid sinus showed no significant difference between patients under awake setting and general anesthesia ( P>0.05). Mean trans-stenosis pressure gradient in patients under awake setting ([22.784±7.606] mmHg) was significantly higher as compared with that in patients under general anesthesia ([18.388±8.992] mmHg, P<0.05). Conclusion:Mean trans-stenosis pressure gradient in patients under awake setting is higher as compared with that in patients under general anesthesia, and selection for venous sinus stent implantation should be decided by trans-stenosis pressure gradient in patients under awake setting.

Objective To discuss the establishment of cerebral venous sinus thrombosis (CVST) model in rabbits by local application of ferric chloride at sinuses sagittalis superior (SSS) combined with thrombin injection, and to evaluate its feasibility and application value. Methods A total of 39 New Zealand white rabbits were randomly and equally divided into three groups with 13 rabbits in each group, local application of cotton piece saturated with saline at SSS for 10 minutes was performed for the rabbits of group A, SSS local application of cotton piece saturated with 40％ ferric chloride for 10 minutes was adopted for the rabbits of group B, while SSS local application of cotton piece saturated with 40％ ferric chloride for 5 minutes together with injection of thrombin was carried out for the rabbits of group C. Whole cerebral DSA was performed immediately after modeling to judge if there was formation of thrombosis. Two days after the modeling, every 3 rabbits from each group were sacrificed to make 2, 3, 5-chloride triphenyl tetrazole (TTC) staining. Seven days after the modeling, the remaining 10 rabbits of each group were examined with DSA, the vascular recanalization rates were calculated, and the histopathological examination was made. Results In group B and group C, SSS thrombosis with surrounding cerebral infarction, edema, inflammatory cell aggregation and other pathological changes were observed. The 7-day vascular recanalization rate in group C was strikingly lower than that in group B (10％ vs 70％, P＜0.05). Surrounding cortical vein thrombus and subcortex petechial hemorrhages were obviously seen in group C. Conclusion For the establishment of CVST model in rabbits, local application of ferric chloride at SSS together with thrombin injection is effective and feasible. The thrombus thus induced is quite stable, and its pathogenesis and pathophysiology are quite similar to clinical manifestations. Therefore, this method can be used for basic research and clinical trials of CVST.

Objective To evaluate the clinical safety and efficacy of LVIS stent (a low profile knitting designed self-expandable stent) in assisting endovascular embolization for intracranial saccular aneurysms.Methods A total of 127 patients with intracranial saccular aneurysm,who were admitted to authors' hospital during the period from April 2014 to June 2016 to receive LVIS stent-assisted endovascular embolization,were retrospectively analyzed.The safety of the operation,the immediate postoperative outcomes,the recurrence rate,and the clinical and radiographic follow-up results were analyzed.Results A total of 130 LVIS stents were successfully implanted in the 127 patients with intracranial saccular aneurysm,implantation failure was seen in one patient,the technical success rate was 99.2％.During or after the endovascular embolization process in-stent thrombosis was observed in 7 patients (7/127,5.5％).Neither perioperative bleeding nor death occurred.Immediately after the operation,complete occlusion of the aneurysm was obtained in 112 aneurysms (88.1％) and neck remnant was observed in 15 aneurysms (11.9％).The patients were followed up for a mean period of 8 months.Follow-up angiography was performed in 37 patients,which showed that complete occlusion of the aneurysm was obtained in 33 patients (89.1％),and visualization of the aneurysm was seen in 4 patients (10.9％),including 3 patients who had aneurysm visualization immediately after embolization and one patient who had aneurysm recurrence.No death occurred.Conclusion The use of LVIS stent to assist endovascular embolization for intracranial saccular aneurysms is safe and effective,although its long-term effect needs further observation.

Endometrial Neoplasms ; pathology ; Female ; Humans ; Pregnancy ; Trophoblastic Neoplasms ; pathology ; Trophoblasts ; pathology

Objective To investigate the influence of donepezil on neurogenesis in the subventricular zone (SVZ) under the cerebral ischemic conditions. Methods Sixty mice were randomly assigned to a sham +vehicle group, a middle cerebral artery occlusion(MCAO) + vehicle group and a MCAO + donepezil group, 20 in each group. A model of MCAO was established. Neural stem cells/progenitor cells were labeled by Mash1, and neuroblasts were labeled by doublecortin (DCX). The expressions of DCX in the SVZ cells of each group were detected by immunofluorescence. The expressions of Mash1 and DCX in the SVZ cells of each group were quantified by Western blot. Results 10 days after MCAO was undergone, DCX-positive cells were seen in the SVZ of each group, and the expressions of DCX and Mash1 in MCAO + vehicle group were markedly increased as compared with the sham + vehicle group (P < 0.05), and that in MCAO + donepezil group were significantly increased as compared with the other two groups (P < 0.05). Conclusion As a kind of acetylcholinesterase inhibitors, donepezil can promote neurogenesis in SVZ under the cerebral ischemic conditions.

Objective To investigate the role of lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) in the pathogenesis of nasal polyps.Methods Using immunohistochemistry and immunofluorescence double staining method,the expressions of albumin,D2-40 and CD34-α-SMA in 11 specimens of normal nasal mucosa,26 specimens of nasal polyp and 26 specimens of inferior turbinate tissue from patients with nasal polyps were investigated.The counts of microvessel density (MVD),lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) were compared.SPSS 17.0 software was used to analyze the data.Results The nasal polyp group(0.269 ±0.096) had more albumin than inferior turbinate tissue group (0.159 ± 0.078) and normal nasal mucosa group (0.138 ± 0.045),the differences were significant (q value was 4.873,4.446,both P ＜ 0.05).The counts of MVD in nasal polyp group (30.52 ± 4.42) were not significantly higher than those in inferior turbinate tissue group (30.33 ± 6.03) and normal nasal mucosa group(28.21 ±6.84),the differences were not significant (q value was 0.130,1.147,both P ＞0.05).The MPI in nasal polyp group (0.291 ±0.096) was significantly lower than those in inferior turbinate tissue group(0.432 ± 0.101) and normal nasal mucosa group(0.416 ± 0.071),the difference was significant (q value was 5.399,3.680,both P ＜ 0.05).The counts of LVD in the nasal polyp group (0.245 ± 0.073) were significantly lower than those in inferior turbinate tissue group (0.431 ± 0.054) and normal nasal mucosa group (0.470 ± 0.078),the difference was significant (q value was 10.004,9.328,both P ＜ 0.05).MPI expression in the nasal polyp group was negetively correlated to albumin expression(r =-0.889,P ＜ 0.05).The LVD expression in the nasal polyp group was negetively correlated to albumin expression(r =-0.901,P ＜ 0.05).Conclusion Different LVD and MIP in nasal polyp tissues and normal nasal mucosa tissues imply that microcirculatory dysfunction plays a crucial role in the pathogenesis of nasal polyps.

OBJECTIVE: To construct a kind of recombinant plasmid PGCsi-AQP1 delivery with DOPC and explore the inhibit effect of laryngeal carcinoma by RNAi targeting AQP1 in vivo. METHOD: Male BALB/c mice, 6 weeks of age transplanted with laryngeal carcinoma cell line Hep-2, four groups were divided randomly: Tail vein injection group (TVIG), Carcinoma around injection group (CAIG), negative control group (NCG) and blank control group (BCG). The recombinant plasmid PGCsi-AQP1 delivery with DOPC were inject into tail vein or surrounding tumor. HE pathological slides and tumor size were observed and inhibitory rate was figured up. The level of AQP1 protein expression and high microvessel density were detected by Immunohistochemical staining (IHC). RESULT: We constructed BALB/c mice models of laryngeal carcinoma successfully (1) HE staining: cell putrescence, nuclear pyknosis and apoptotic bodies were more in the tumor tissues of experimental groups than two control groups. (2) The total volumes of tumor in experimental group were both smaller than in two control groups (P < 0.01). The inhibition rate of TVIG and CAIG were 52.4% and 53.5% respectively and there was no significant difference (P > 0.05). (3) IHC: the AQP1 positive cells and microvessel density in TVIG and CAIG were both less than in two control groups (P < 0.01). CONCLUSION Neutral lipsomes DOPC could help carriaging the recombinant plasmid PGCsi-AQP1 to tumor and then play an inhibit role in laryngeal carcinoma tissue by RNAi targeting AQP1 in vivo.
Animals ; Aquaporin 1 ; therapeutic use ; Cell Line, Tumor ; Laryngeal Neoplasms ; therapy ; Liposomes ; Male ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; Plasmids ; RNA Interference ; RNA, Small Interfering ; Random Allocation ; Transfection

Objectives To investigate the immune effect of hepatitis B vaccine under the influence of congenital human cytomegalovirus (HCMV) infection. Methods The newborn rat model of congenital HCMV infection was developed by intra-peritoneally inoculating pregnant rat with HCMV suspension,while the offsprings of healthy rats were used as the control group. Offspring rats in all groups were inoculated with hepatitis B vaccine in the postnatal 1st, 3rd and 5th week and were taken blood from hearts separately in 3rd, 5th, 7th and 11th week. Antibody to Hepatitis B surface antigen (HBsAb) titer in all groups was de-tected by ELISA method. Results The serum HBsAb titer in both groups all showed a trend of increasing gradually with added vaccinating times and decreased differently with time extending after completed vaccinations. Differences among changes of HBsAb titer along with prolonged time in each group were all statistically significant (P<0.001). At all time points (3rd, 5th, 7th, 11th week), the titer of serum HBsAb in congenital HCMV infection group was lower than that in the control group respectively, and there were statistically significant differences (P<0.01). Conclusions Congenital HCMV infection could weaken the im-mune effect of hepatitis B vaccine.