Purpose To evaluate the safety and efficacy of microwave ablation(MWA)treatment for papillary thyroid cancer(PTC)in patients with Hashimoto thyroiditis(HT).Materials and Methods A retrospective analysis was conducted on clinical data from April 2020 to May 2022,involving 181 patients who underwent MWA at the China-Japan Friendship Hospital.All patients were divided into experimental group(n=89 cases)and control group(n=92 cases).The technical success rate,tumor volume reduction rate(VRR),disease progression and incidence of complications were compared between the two groups,respectively.Results Both groups achieved a technical success rate of 100%,with a median follow-up time of(16.90±11.43)months.At 3,6,12,and 18 months post-ablation,the VRR in the experimental group was significantly lower than that in the control group(3 months:-405.10(-778.57,-119.64)%vs.-190.00(-525.62,0)%;6 months:-50.00(-318.00,45.52)%vs.52.75(-93.33,97.13)%;12 months:83.33(17.70,100.00)%vs.100.00(64.88,100.00)%;18 months:100.00(96.05,100.00)%vs.100.00(100.00,100.00)%,Z=-2.77,-3.70,-2.41,-2.18,all P<0.05).At the end of follow-up,there was no significant difference in the disease progression rates and the incidence of hoarseness between the two groups(5.61%vs.4.34%,2.24%vs.4.34%,both P>0.05).Conclusion Patients with HT who received MWA treatment demonstrate safety and effectiveness,with no significant differences in postoperative disease progression rates compared to the controls.

AIM:To investigate whether direct stimulation of the Du Meridian improves autism-like behaviors in mice by modulating synaptic pruning.METHODS:Pregnant mice received intraperitoneal injections of valproic acid(VPA)or saline on gestational day 12.5.Offspring from saline-treated mice were assigned to the saline group.Offspring from VPA-treated mice were randomly divided into the model(VPA)group and the VPA-model-DuMaiTuiFa(VPA-DMTF)group.Each group included five mice.The VPA-DMTF group received direct stimulation along the Du Mai at 80 times per minute,10 minutes per session,twice daily for 21 days.After treatment,behavioral tests were conducted,in-cluding the three-chamber test for social interaction and the open field test for anxiety-like behavior.Hippocampal tissue was collected for analysis.Golgi staining was used to assess dendritic spine density.Immunofluorescence staining for post-synaptic denisty protein(PSD95)and synapsin 1(SYN1)was performed to evaluate synaptic protein expression.Staining for ionized calcium-binding adapter molecule 1(IBA1)and CD68 was used to assess microglial phagocytosis.Western blot analysis was conducted to evaluate hippocampal expression levels of PSD95,SYN1,IBA1,complement component 1,q subcomponent(C1q),complement component 3(C3),and complement receptor 3(CR3).RESULTS:Compared with the saline group,VPA mice showed reduced social behavior and increased anxiety(P<0.05).The expression levels of IBA1,PSD95,and SYN1 were significantly increased(P<0.05),whereas C1q,C3,and CR3 were significantly de-creased(P<0.05).Microglial phagocytosis declined.Immunofluorescence analysis showed increased levels of synaptic proteins(PSD95 and SYN1)in the VPA group(P<0.05).Golgi staining revealed a higher dendritic spine density and an increased proportion of immature dendritic spines(P<0.05).Compared with the VPA group,VPA-DMTF mice showed improved behavior,reduced IBA1,PSD95,and SYN1 levels(P<0.05),and increased expression of C1q,C3,and CR3(P<0.05).Microglial phagocytosis was enhanced,and dendritic spine number was reduced.CONCLUSION:Direct stimulation of the Du Mai alleviates autism-like behaviors in mice.This effect may be mediated by upregulation of comple-ment proteins C1q and C3,which enhance microglia-mediated synaptic pruning and reduce synaptic overabundance.

AIM:To investigate whether direct stimulation of the Du Meridian improves autism-like behaviors in mice by modulating synaptic pruning.METHODS:Pregnant mice received intraperitoneal injections of valproic acid(VPA)or saline on gestational day 12.5.Offspring from saline-treated mice were assigned to the saline group.Offspring from VPA-treated mice were randomly divided into the model(VPA)group and the VPA-model-DuMaiTuiFa(VPA-DMTF)group.Each group included five mice.The VPA-DMTF group received direct stimulation along the Du Mai at 80 times per minute,10 minutes per session,twice daily for 21 days.After treatment,behavioral tests were conducted,in-cluding the three-chamber test for social interaction and the open field test for anxiety-like behavior.Hippocampal tissue was collected for analysis.Golgi staining was used to assess dendritic spine density.Immunofluorescence staining for post-synaptic denisty protein(PSD95)and synapsin 1(SYN1)was performed to evaluate synaptic protein expression.Staining for ionized calcium-binding adapter molecule 1(IBA1)and CD68 was used to assess microglial phagocytosis.Western blot analysis was conducted to evaluate hippocampal expression levels of PSD95,SYN1,IBA1,complement component 1,q subcomponent(C1q),complement component 3(C3),and complement receptor 3(CR3).RESULTS:Compared with the saline group,VPA mice showed reduced social behavior and increased anxiety(P<0.05).The expression levels of IBA1,PSD95,and SYN1 were significantly increased(P<0.05),whereas C1q,C3,and CR3 were significantly de-creased(P<0.05).Microglial phagocytosis declined.Immunofluorescence analysis showed increased levels of synaptic proteins(PSD95 and SYN1)in the VPA group(P<0.05).Golgi staining revealed a higher dendritic spine density and an increased proportion of immature dendritic spines(P<0.05).Compared with the VPA group,VPA-DMTF mice showed improved behavior,reduced IBA1,PSD95,and SYN1 levels(P<0.05),and increased expression of C1q,C3,and CR3(P<0.05).Microglial phagocytosis was enhanced,and dendritic spine number was reduced.CONCLUSION:Direct stimulation of the Du Mai alleviates autism-like behaviors in mice.This effect may be mediated by upregulation of comple-ment proteins C1q and C3,which enhance microglia-mediated synaptic pruning and reduce synaptic overabundance.

Purpose To evaluate the safety and efficacy of microwave ablation(MWA)treatment for papillary thyroid cancer(PTC)in patients with Hashimoto thyroiditis(HT).Materials and Methods A retrospective analysis was conducted on clinical data from April 2020 to May 2022,involving 181 patients who underwent MWA at the China-Japan Friendship Hospital.All patients were divided into experimental group(n=89 cases)and control group(n=92 cases).The technical success rate,tumor volume reduction rate(VRR),disease progression and incidence of complications were compared between the two groups,respectively.Results Both groups achieved a technical success rate of 100%,with a median follow-up time of(16.90±11.43)months.At 3,6,12,and 18 months post-ablation,the VRR in the experimental group was significantly lower than that in the control group(3 months:-405.10(-778.57,-119.64)%vs.-190.00(-525.62,0)%;6 months:-50.00(-318.00,45.52)%vs.52.75(-93.33,97.13)%;12 months:83.33(17.70,100.00)%vs.100.00(64.88,100.00)%;18 months:100.00(96.05,100.00)%vs.100.00(100.00,100.00)%,Z=-2.77,-3.70,-2.41,-2.18,all P<0.05).At the end of follow-up,there was no significant difference in the disease progression rates and the incidence of hoarseness between the two groups(5.61%vs.4.34%,2.24%vs.4.34%,both P>0.05).Conclusion Patients with HT who received MWA treatment demonstrate safety and effectiveness,with no significant differences in postoperative disease progression rates compared to the controls.

Objective To study the treatment outcomes using transcatheter arterial chemoemboliza tion (TACE) followed by hepatic resection (HR) in patients with BCLC stage B hepatocellular carcinoma (HCC).Methods The clinical data of 46 patients with intermediate stage HCC in the Third Affiliated Hospital of Sun Yat-sen University from Jan.2004 to Jul.2013 were analyzed retrospectively.The baseline characteristics of these 46 patients were recorded.The levels of serum aspartate transaminase (AST),ala nine aminotransferase (ALT),total bilirubin (TBil),and albumin (Alb),and the prothrombin time (PT) at 1 week and 1 month after HR were compared with those at the baseline.The overall survival (OS) and progression-free survival (PFS) were analyzed by the Kaplan-Meier method.The effect on PFS by the changes in the alpha-fetal protein level and the modified Response Evaluation Criteria In Solid Tumors (mRECIST) after TACE were analyzed using the log-rank test.Results The number of cycles of TACE given before HR was 1.7 ± 1.1.The mean time interval between TACE and HR was 3.0 ± 3.2 months.The levels of serum AST,ALT,TBil,Alb and PT at 1 week after HR were significantly different from the baseline levels (P ＜ 0.05),while those levels at 1 months after HR showed no significant difference from the baseline levels (P＞0.05).The mean OS was 72.1 ±6.0 (95％ CI 60.36 ～83.86) months.The median PFS was 46.0 (95％ CI:42.60～49.40) months.Using the log-rank test,the decrease in AFP (P ＜ 0.001) and the improvement in mRECIST (CR + PR) (P ＜ 0.001) after TACE were significantly associated with better PFS.Conclusions HR after TACE was safe for patients with BCLC stage B HCC and might prolong the PFS and OS.Decreases in AFP level and improvement in mRECIST (CR + PR) after TACE were factors they could be used to predict the survival outcomes of HR.

Objective To investigate the technique,efficacy,and safety of percutaneous interventional treatments for biliary complications (BC) after liver transplantation (LT).Methods The clinical and imaging data of 127 patients with BC after LT,who received percutaneous interventional treatments in the Third Affiliated Hospital of Sun Yat-sen University from January 2006 to December 2015,were analyzed retrospectively.On the basis of the cholangiographic appearance,patients were classified into 5 groups:biliary leakage group (n =11),anastomotic biliary strictures group (n=28),hilar biliary strictures group (n =30),multifocal biliary strictures group (n =51),and bilomas group (n =7).The modality of interventional treatments was percutanous transhepatic biliary drainage (PTBD),PTBD combined with balloon dilation,PTBD combined with balloon dilation and stent implantation.The methods of biliary drainage included external drainage and external-internal drainage.All the patients were followed up after treatment.The curative effect and operation-correlated complications were observed.Results The first successful rate of PTBD was 97.6％ (124/ 127).The total curative rate,improvement rate and inefficacy rate of interventional treatments were 37.8％ (48/127),44.9％ (57/127) and 17.3％ (22/127) respectively.In biliary leakage group,all the patients were cured by percutaneous interventional treatments with the curative rate being 100％.In anastomotic biliary strictures group,the cure and improvement rates were 64.3％ (18/28) and 35.7％ (10/28) respectively.The efficacy rate was 100％ (28/28).In hilar biliary strictures group,the cure,improvement and inefficacy rates were 40％ (12/30),53.3％ (16/30) and 6.7％ (2/30) respectively.The efficacy rate was 93.3％ (28/30).In multifocal biliary strictures group,the cure,improvement and inefficacy rates were 13.7％ (7/51),54.9％ (28/51) and 31.4％ (16/51) respectively.The efficacy rate was 68.6％ (35/51).In bilomas group,3 cases (3/7) obtained improvement and treatment of 4 cases was inefficative.The efficacy was the best for the patients with bilary leakage,and it was the worst for the patient with bilomas (P＜0.001).The main operation-correlated complication was bile tract infection during drainage.The rates of bile tract infection were 32.4％ (34/105) and 81.8％ (18/22) in patients with external drainage and external-internal drainage,respectively.There was statistically significant difference between these two items (P＜ 0.001).Conclusion PTBD combined with balloon dilation and biliary stent implantation is a safe and effective therapeutic modality for BC after LT,which can improve patients' clinical symptoms,improve patients' quality of life.The patients with bilomas should be treated by retransplantation as soon as possible.The biliary external drainage can decrease the rate of biliary tract infection significantly.

Objective To study the feasibility and efficacy of percutaneous transhepatic intrahepatic portosystemic shunt (PTIPS) in patients with portal hypertension due to chronic portal vein occlusion after splenectomy.Methods 27 patients who had portal hypertension due to chronic portal vein occlusion after splenectomy underwent PTIPS between December 2010 and March 2015.These patients were enrolled in this retrospective study.The success rates,efficacy,and complications were evaluated.Significance in the differences in the portosystemic pressure gradient (PPG) as measured before and after PTIPS procedure was assessed.Results PTIPS was successfully carried out in 25 patients but failed in 2.No fatal procedural complications were observed.The mean PPG dropped from (22.3 ± 5.7) mmHg to (12.4 ± 3.1) mmHg after successful PTIPS (1 mmHg =0.133 kPa,P ＜0.05).The median follow-up in the 25 patients with successful PTIPS were 22 months and there were 3 (12.0％) deaths from liver failure due to severe cirrhosis,and 1 death (4.0％) from stroke during the follow-up period.Shunt dysfunction happened in 4 (16.0％) patients.The original symptoms reoccurred in 2 patients (8.0％) and the remaining patients were diagnosed by routine CT or US examination.Three patients recovered after shunt revision with stent implantation or balloon angioplasty,while one patient refused any further therapy except oral medication.This patient suffered from the first episode of rebleeding 36 months after PTIPS.Hepatic encephalopathy developed in 2 (8.0％) patients,1 patient recovered after medical treatment,while the other who developed Grade 3 hepatic encephalopathy recovered after implanting a smaller cover stent.The remaining patients were asymptomatic with patent shunts.Conclusion PTIPS was a feasible,safe,and efficacious treatment for portal hypertension due to chronic portal vein occlusion after splenectomy.

Objective To evaluate combination multiple interventional therapies for acute lower extremity deep venous thrombosis (DVT).Methods From January 2008 to October 2014,96 patients with acute unilateral proximal or mixed DVT received interventional treatments including 74 DVT cases of the left lower extremity,and 22 patients in the right.Procedures undertaken included catheter-directed thrombolysis (CDT) only (n =7),CDT combined with thrombolysis (n =89),balloon angioplasty (n =32),and stent implantation (n =6).Results The mean circumference difference between the normal and affected thighs dicreased from (6.7 ± 1.8) cm to (0.8 ± 0.3) cm,t =13.48,P ＜ 0.001.That between the normal and affected calves decreased from (5.9 ± 1.6)cm to (0.7 ±0.4)cm,t =12.84,P ＜0.001.After intervention the Porter's score reduced from (9.7 ± 2.4) points to (1.1 ± 0.6) points,t =15.46,P ＜0.001,and the venous patency rate was (90 ± 8)％.Conclusion CDT combined with thrombolysis through dorsal vein,PTA,and stent implantation is a safe and effective therapeutic modality for acute lower extremity DVT.

Objective To investigate the therapeutic efficacy of somatostatin on chylothorax after congenital heart disease surgery in children.Methods Retrospective analysis was performed in 13 postoperative chylothorax cases from Jan.2003 to Dec.2012,who were divided into control group (n =6) and treatment group (n =7),and there was no significant difference in age,weight,and time of occurrence between the 2 groups.The diagnosis standard for chylothorax was the same.The changes of chylous volume during the treatment were analyzed between 2 groups,and healing time and other data were analyzed too.Results Control group:clinical cure in 3 cases,conservative treatment failed in 3 cases(2 cases recovered after operation and 1 case died).The chyle volume of control group reduced obviously compared with post treatment from beginning [(256.6 ± 124.2) mL/d] to 1 week [(155.5 ± 85.7) mL/d] and 2 weeks [(142.3 ± 110.3) mL/d] later(t =4.623,2.099 ; P =0.002,0.044).But it did not reduce obviously in 3 weeks later[(139.4 ± 113.4) mL/d] (t =1.745,P =0.07).Treatment group:6 cases in treatment group were successful in recovery after conservative treatment and 1 case underwent operation.The chyle volume of treatment group reduced obviously compared with post treatment from beginning to 1 week [(51.2 ± 18.7) mL/d] and 2 weeks [(19.3 ± 7.05) mL/d] later (t =5.549,6.638 ;P =0.001,0.001).Compared with the control group,the difference between 2 groups in post treatment (1 week later,2 weeks hater) was of statistical significance (t =2.900,2.412 ; P =0.014,0.034).The healing time of conservative treatment in 2 groups (only for recovery) had obvious difference [(32.8 ± 1.8) d,(25.2 ± 1.7) d] (t =2.512,P =0.028).Conclusions The use of somatostatin can significantly promote the recovery of chylothorax in children,and it should be actively used in early conservative treatment.

Objective To investigate pathogen bacteria distribution and clinical analysis of ventilator-associated pneumonia in infants and young children with congenital heart disease after surgery for guiding the rational clinical use of antimicrobial drugs.Methods The clinical data of ventilator-associated pneumonia in infants and young children with congenital heart disease after surgery were retrospectively analyzed for microbiologically documented infection.Bacterial identification was performed in an automatic VITEK2Jr expression system and antimicrobial susceptibility testing by Kirby2Bauer method.The results of antimicrobial susceptibility testing were performed in WHONET 5.0 system software.Results There were 16 strains of pathogenic bacteria in 2010,Gram-negative bacteria 9 stains (Klebsiella pneumoniae 18.75％,Acinetobacter baummannii 12.5％),gram positive coccus 6strains (Streptococcus 18.75％),Fungi 1 strain.There were 32 strains of pathogenic bacteria in 2011,Gram-negative bacteria 24 stains (Acinetobacter baummannii 31.25％,Klebsiella pneumoniae 25％,Pseudomonas aeruginosa 6.25％),gram positive coccus 8 strains (Enterococcus 12.5％,Streptococcus 6.25％).There were 42 strains of pathogenic bacteria in 2012,Gram-negative bacteria 38 stains (Acinetobacter baummannii 26.19％,Klebsiella pneumoniae33.33％,Pseudomonas aeruginosa 21.42％),gram positive coccus 4 strains (Enterococcus 4.76％).Acinetobacter baummannii remained highly sensitive to Amikacin and Levofloxacin,highly resistant to Meropenem,Imipenem,Klebsiella pneumonia remained highly sensitive to Amikacin and Levofloxacin,highly resistant to Cefoperazone/Sulbactam,Meropenem,Imipenem,trimethoprim-sulfamethoxazole,Ciprofloxacin.Pseudomonas aeruginosa only remained sensitive to Levofloxacin and Piperacillin/Tazobactam.Gram-positive cooci proportion in pathogenic bacteria decreased year by year,Streptococcus and Enterococcus had major proportion in Gram-positive cooci,Staphylococci decreased,There was no Staphylococcus,Enterococcus and Staphylococci resistant to vancomycin.Conclusions Gram-negative bacteria was the major pathogenic bacteria in ventilator-associated pneumonia with congenital heart disease postoperative infants and young children,Acinetobacter baummannii Klebsiella pneumoniaeand Pseudomonas aeruginosa had major proportion in gram-negative bacteria and drug resistance increased.Rational use of antibacterials was very important to reduce drug resistant strains.