Objective:To construct a shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach and to explore its effectiveness.Methods:The first draft of the shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach was constructed through literature review, and two rounds of expert consultation were conducted with 20 experts to determine the final draft of the program with the results of the pretest. A total of 98 patients who underwent endoscopic thyroidectomy by a gasless unilateral axillary approach in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from September 2023 to January 2024 were selected for the study using the convenience sampling method. Patients from September to December 2023 were set up as control group and patients from October 2023 to January 2024 were set up as experimental group, with 49 patients in each group. Control group implemented routine nursing, and experimental group received the shoulder and neck functional exercise program developed in this study on the basis of control group. Constant-Murley Score score, occurrence of numbness in the chest wall access area, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores in cancer patients were compared between the two groups at one week, one month, and three months post-intervention.Results:In the two rounds of expert consultation, the effective questionnaire recovery rates were 85.00% (17/20) and 94.12% (16/17), and the coefficient of the expert familiarity was 0.938, the coefficient of basis of judgment was 0.891, and the coefficient of authority was 0.915. The coefficients of variation for the importance ratings of the entries in the second round of consultation were 0.096 to 0.190 and Kendall's harmony coefficient was 0.155 ( P<0.01). The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach included three first-level items, five second-level items, and 13 third-level items. At one week post-intervention, the difference in occurrence of numbness in the chest wall access area was statistically significant in both groups ( P<0.05). At one month post-intervention, the differences in shoulder function scores, occurrence of numbness in the chest wall access area, and quality of life scores between the two groups were statistically significant (all P<0.05). At three months post-intervention, the differences in shoulder function scores and quality of life scores between the two groups were statistically significant (all P<0.05) . Conclusions:The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach has certain scientific validity and feasibility, which can improve the shoulder and neck function of patients undergoing endoscopic thyroidectomy by axillary approach, reduce the numbness in the chest wall access area, and improve the quality of life of the patients in the postoperative period.

Objective:To construct a shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach and to explore its effectiveness.Methods:The first draft of the shoulder and neck functional exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach was constructed through literature review, and two rounds of expert consultation were conducted with 20 experts to determine the final draft of the program with the results of the pretest. A total of 98 patients who underwent endoscopic thyroidectomy by a gasless unilateral axillary approach in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from September 2023 to January 2024 were selected for the study using the convenience sampling method. Patients from September to December 2023 were set up as control group and patients from October 2023 to January 2024 were set up as experimental group, with 49 patients in each group. Control group implemented routine nursing, and experimental group received the shoulder and neck functional exercise program developed in this study on the basis of control group. Constant-Murley Score score, occurrence of numbness in the chest wall access area, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores in cancer patients were compared between the two groups at one week, one month, and three months post-intervention.Results:In the two rounds of expert consultation, the effective questionnaire recovery rates were 85.00% (17/20) and 94.12% (16/17), and the coefficient of the expert familiarity was 0.938, the coefficient of basis of judgment was 0.891, and the coefficient of authority was 0.915. The coefficients of variation for the importance ratings of the entries in the second round of consultation were 0.096 to 0.190 and Kendall's harmony coefficient was 0.155 ( P<0.01). The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach included three first-level items, five second-level items, and 13 third-level items. At one week post-intervention, the difference in occurrence of numbness in the chest wall access area was statistically significant in both groups ( P<0.05). At one month post-intervention, the differences in shoulder function scores, occurrence of numbness in the chest wall access area, and quality of life scores between the two groups were statistically significant (all P<0.05). At three months post-intervention, the differences in shoulder function scores and quality of life scores between the two groups were statistically significant (all P<0.05) . Conclusions:The shoulder and neck function exercise program for patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach has certain scientific validity and feasibility, which can improve the shoulder and neck function of patients undergoing endoscopic thyroidectomy by axillary approach, reduce the numbness in the chest wall access area, and improve the quality of life of the patients in the postoperative period.

Objective:To investigate the application effect of research-assisted teaching mode in histology teaching by taking the construction of rat spinal cord injury model as an example.Methods:A convenient sampling method was used to select 52 freshmen majoring in clinical medicine of grade 2020 in our school as the research subjects.They were randomly divided into the conventional teaching group and the research-assisted teaching group,with 26 students in each group.The conventional teaching group received traditional classroom teaching combined with experimental teaching.On this basis,research elements were added to the experimental teaching in the research-assisted teaching group to provide more in-depth research methods and experimental design,so as to cultivate students'research abilities.The theoretical assessment and practical skills assessment of histology course were compared between the two groups.A subjective evaluation questionnaire on experimental animal models teaching was used to evaluate the advantages of teaching programs in three dimensions:psychological quality training,technical skill enhancement,and theoretical knowledge expansion.The research abilities of the two groups were compared.Pearson correlation analysis was used to analyze the correlation between research ability scores and comprehensive scores.Results:The usual score and comprehensive score in the research-assisted teaching group were significantly higher than those in the conventional teaching group(P＜0.05).The scores of adaptability to challenging tasks,determination and perseverance in problem-solving,communication skills in teamwork,literature reading,integration of practical experience with theoretical knowledge,practical application value of the course,and innovation of teaching resources in the research-assisted teaching group were higher than those in the conventional teaching group(P＜0.05).The scores in experimental design ability,background knowledge in literature review,communication and reporting skills,awareness of evidence-based medicine,and overall research ability in the research-assisted teaching group were higher than those in the conventional teaching group(P＜0.05).The total score of students'research abilities was positively correlated with comprehensive scores(r=0.716,P＜0.01).Conclusions:The application of research-assisted teaching significantly improved students'research abilities in histology teaching.The enhancement of research abilities can promote the mastery of theoretical knowledge and the improvement of experimental skills.

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 establish a ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry method for rapid simultaneous determination of quinclorac, acetochlor, butachlor and metolachlor in urine. Methods: Urine samples were diluted 10 times, prepared into the mixed standard solution, and subjected to gradient elution on the ACQUITY UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm) with 0.1% formic acid and acetonitrile as the mobile phase. The quinclorac, acetochlor, metolachlor and butachlor levels were determined using electrospray ionization-positive ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry with the multiple reaction monitoring mode. Results: Four herbicides were effectively separated on the ACQUITY UPLC BEH C18 column (100 mm× 2.1 mm, 1.7 μm), and good linear relationships were observed for quinclorac, acetochlor and butachlor at 1 to 25 μg/L and for metolachlor at 0.2 to 25 μg/L, with all linear correlation coefficients of >0.999. The detection limts of quinclorac, acetochlor, butachlor and metolachlor were 0.10, 0.10, 0.20 and 0.01 μg/L, respectively. The recovery rates of quinclorac, acetochlor and butachlor were 107.42%, 93.94% and 90.27% from urine samples at a spiked level of 5 µg/L, with relative standard deviations of 4.82%, 3.84% and 6.76%, and the recovery rate of metolachlor was 89.51% at a spiked level of 0.5 µg/L, with a relative standard deviation of 8.98%. Conclusion The chromatography and mass spectrometry conditions are optimized in this ultra-high performance liquid chromatography-tandem mass spectrometry, which is effective for rapid simultaneous determination of quinclorac, acetochlor, metolachlor and butachlor in urine samples.

Objective: To explore the pathogenic genes in a Chinese family affected by nonsyndromic tooth agenesis so as to study the pathogenesis of oligodontia. Methods : Hospital ethical approval and informed consent of the patients and family members were obtained. Clinical data of the proband and close family members were collected, peripheral venous blood was collected, and DNA was extracted. Gene sequencing was performed through whole-exome sequencing, and then the screened pathogenic genes were verified by Sanger sequencing. The three-dimensional structure of the mutant proteins was analyzed and compared with the wild-type using bioinformatics tools. Results: The two patients with congenital majority tooth loss in this family were cousins, and there were no other patients with congenital majority tooth loss in the family. Besides congenital multiple tooth loss, the two patients had no obvious hair abnormalities, finger/toe abnormalities, sweating abnormalities or other abnormal manifestations of ectodermal tissue. We found a mutant gene that in this family by carrying out gene sequencing of the patients and their close family members. A novel EDA (ectodysplasin A) missense mutation c.983C>T (p. Pro328Leu) was identified, which changed the encoded amino acid from proline (Pro) to leucine (Leu). Analysis of the mutation site showed that the site was highly conserved, and three-dimensional structure modeling also found that it changed the structure of EDA. Conclusion A novel EDA missense variant (c.983C>T, p.Pro328Leu) was first identified in a Chinese family with nonsyndromic tooth agenesis, extending the mutation spectrum of the EDA gene.

ObjectiveThe effect of inoculation with different organophosphate-resolving bacteria or compound bacteria on the quality of Paris polyphylla var. yunnanensis medicinal materials and rhizosphere soil fertility were studied to provide a reference for the development and application of biological bacterial fertilizer in artificial cultivation of P. polyphylla var. yunnanensis. MethodThe three dominant species of organophosphate-solubilizing bacteria were inoculated separately and in combination in sterilized soil by single-factor indoor pot planting， and no inoculation was used as the control group. The effect of inoculation of organophosphate-solubilizing bacteria on total saponins content in rhizomes of P. polyphylla var. yunnanensis， as well as microbial numbers， enzyme activities and nutrient contents in rhizosphere soil were analyzed. ResultIn the seven treatments inoculated with organophosphate-solubilizing bacteria， the total saponin content in the rhizomes of Paris polyphylla var. yunnanensis was increased by 16.42%， 3.83%， 16.86%， 33.69%， 2.11%， 13.44%， and 28.83%， respectively， compared with the control. Inoculation with organophosphate-solubilizing bacteria increased the number of soil microorganisms to varying degrees， and the effects of S6 and S7 treatments were the most significant. Inoculation with organophosphate-solubilizing bacteria improved the enzyme activity， and the effect of S7 treatment was the most significant. The activities of acid phosphatase， neutral phosphatase， alkaline phosphatase， protease， invertase and catalase were 49.96% and 104.67% ， 110.17%， 99.61%， 26.26%， 11.29% higher than those of the control， respectively. Inoculation with organophosphate-solubilizing bacteria reduced the pH of the rhizosphere soil and increased the content of soil available nutrients. Under the S7 treatment， the contents of alkaline hydrolyzable nitrogen， available phosphorus and available potassium in the rhizosphere soil of P. polyphylla var. yunnanensis were 181.46%， 51.64% and 42.62% higher than those of the control， respectively. Correlation analysis showed that there was a significant positive correlation between total saponins and phosphatase activities， a significant positive correlation between soil microorganisms and soil enzyme activities， and a very significant positive correlation between soil nutrients. ConclusionInoculation of different organophosphate-resolving bacteria or compound bacteria can improve the quality and rhizosphere soil fertility of P. polyphylla var. yunnanensis. Among them， the mixed inoculation of three kinds of bacteria and the mixed inoculation of B. mycoides and B. wiedmannii have the best effect.

Amyotrophic lateral sclerosis is a neurodegenerative disease caused by the loss of motor neurons in the brain and spinal cord. There is currently no effective cure. The emergence of gene therapy brings hope to treatment, which can be achieved by delivering transgenes to replace or correct defective genes, as well as the expression of neurotrophic factors. The vectors of gene therapy can be viral vectors and non-viral vectors. Lentiviral vectors can be used to deliver therapeutic sequences to motor neurons in the central nervous system. Adeno-associated viruses can effectively mediate gene expression and delivery of neurotrophic factors. Gene editing and antisense oligonucleotides therapy are also perspective treatment options. This article summarizes gene therapy for amyotrophic lateral sclerosis from basic experiments and clinical trials.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease which is associated with genetic and environmental factors, though the pathogenesis is still unclear and there is also a lack of effective treatment. With the rapid advance of genetic testing techniques, over 30 genes have been associated with the disease. Some ALS patients harboring genetic variants may present unique clinical characteristics and particular mode of inheritance, but the correlation between genotype and phenotype is still not very clear. Studies have shown that research on the pathogenic genes of ALS is important for the diagnosis and selection of potential drug targets. Here the pathogenic genes of ALS, in particular the newly discovered genes, and their underlying mechanisms are reviewed. The necessity of genetic testing for ALS patients is also stressed.
Amyotrophic Lateral Sclerosis/genetics* ; Genetic Testing ; Genotype ; Humans ; Neurodegenerative Diseases/genetics* ; Phenotype