ObjectiveTo investigate early nutrition and growth of preterm monochorionic diamniotic（MCDA） twins combined with selective intrauterine growth restriction（sIUGR） and explore the potential role of DNA methylation in regulating extrauterine growth. MethodsTwenty-four pairs of preterm MCDA twins combined with sIUGR hospitalized in the Department of Neonatology of The First Affiliated Hospital of Sun Yat-sen University from March 2019 to February 2022 were enrolled， divided into larger twins group（n=24） and smaller twins group （n=24） according to birth weight. The comparison of daily nutritional intakes， the incidence of neonatal complications and physical growth from birth to 24 months of corrected age between two groups was performed using t-test， analysis of ANOVA， Chi-square test or Fisher's exact test. Differential DNA methylation analysis was performed using the methylation microarrays and differentially methylated site was validated using pyrosequencing method. ResultsThere were no significant differences in the daily intake of carbohydrate， protein， fat and energy between two groups （all P＞0.05）. There were no significant differences in the incidence of asphyxia， neonatal respiratory distress syndrome， bronchopulmonary dysplasia， retinopathy of prematurity and necrotizing enterocolitis between two groups （all P＞0.05）. Z-scores for weight， length and head circumference were significantly lower in the smaller twins group compared with the larger twins group from birth to 24 months of corrected age（all P =0.000）. Difference in Z-scores for weight and length at term， 6 months， 12 months of corrected age did not differ significantly from that at birth（all P＞0.05） while difference in Z-scores for weight and length between the twins at 18 months and 24 months of corrected age were significantly lower than that at birth （P = 0.009， P = 0.032， P = 0.026， P = 0.004）. Difference in Z-scores for head circumference at 6 months， 12 months， 18 months， 24 months of corrected age were significantly lower than at birth （P = 0.001， others P = 0.000） except at term（P＞0.05）. The differences in weight， length and head circumference between the twins at term， 6 months， 12 months， 18 months and 24 months of corrected age significantly reduced （P = 0.001， P = 0.007， P = 0.001， others P = 0.000）. Eighteen differentially methylated sites were identified and the methylation level of NFATC1 gene in the smaller twins group was significantly higher than that in the larger twins group（P = 0.043）. ConclusionMCDA twins combined with sIUGR shares similar early nutrition and neonatal complications， while smaller twins at 24 months of corrected age grow faster than larger twins， which might be related to a higher methylation level of NFATC1 gene in smaller twins.

Objective:To compare the clinical effects of endoscopic thyroidectomy using the modified gasless transaxillary approach (TA group) and transsubclavian approach (TS group) in the treatment of cN0 papillary thyroid carcinoma (PTC) .Methods:A total of 190 PTC patients (mean age 39.88±9.35 years,38 males, 152 females), who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from Oct. 2020 to Oct. 2022 were retrospectively analyzed, including 65 cases in TA group, 43 cases in TS group and 82 cases through traditional neck approach (TN group). The endoscopic group (TA+TS) consists of the TA group and the TS group. Comparative analyses were performed on operation time, full exposure rate of central compartment, postoperative hospitalization time, postoperative drainage, hospitalization costs, the number of dissected lymph nodes and postoperative complications. The t-test or Wilcoxon rank sum test, the χ2 test or the exact probability method were used for statistical analysis. Results:All endoscopic operations were successfully completed without conversion to traditional neck approach. ① Compared with the TN group, the endoscopic group (TA+TS) had longer operation time[TN group =74.5 (65-87) min, (TA+TS) group =102 (89-121) min, P<0.001], lower full exposure rate of central compartment (TN group=100%, (TA+TS) group=89.8%, P=0.008), more postoperative drainage[TN group=60 (45-76) ml, (TA+TS) group =100 (80-130) ml, P<0.001], higher hospitalization costs[TN group=￥23638 (22158-25901), (TA+TS) group =￥26967 (25572-28284), P<0.001], and higher parathyroid autotransplantation rate (TN group=4.9%, (TA+TS) group =50.9%, P<0.001). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative parathyroid hormone (PTH) ( P>0.05). ② Compared with the TS group, the TA group had longer operation time[TA group=110 (97-127) min, TS group=89 (80-111) min, P<0.001], lower full exposure rate of central compartment (TA group=83.1%, TS group=100%, P=0.012), longer postoperative hospitalization time[TA group=3 (3-4) d, TS group=3 (3-3) d, P=0.002], more postoperative drainage[TA group=110 (82-140) ml,TS group=95 (65~120) ml, P=0.046] and higher hospitalization costs (TA group=￥27510±2578,TS group=￥26609±1878, P=0.038). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative PTH, and parathyroid autotransplantation between the two groups ( P>0.05) . Conclusions:Endoscopic thyroidectomy through axillary/subclavian approach is safe and feasible for the treatment of cN0 PTC. There was no significant difference in the number of dissected central lymph nodes compared with conventional surgery, and the incision was well concealed. In comparison, transsubclavian endoscopic surgery has better clinical application value, with shorter operation time, higher full exposure rate of central compartment and faster postoperative recovery.

Objective:To evaluate the effectiveness of the course of Laboratory Medicine and Clinical Sciences in the Laboratory Medicine Faculty of Sun Yat-sen University. Methods:Twenty-four undergraduate students in Batch 2016 of Medical Laboratory Faculty were divided into small groups (4-6 students per group). They learned each case in groups before class. In the first session of each class, the case-based study (CBS) tutor would randomly assign case-related questions to the students. Students were required to present their answers in class. The CBS tutor would guide the students to discuss the case further. In the second session, a lecture associated with the case would be given by a special subject lecturer. After the course, students, tutors and lecturers were given questionnaires and were randomly interviewed to comprehensively understand the course's effectiveness. SPSS 19.0 was used for statistics.Results:Most case discussion tutors agreed that they could guide students to discuss clinical cases well in class and give comments according to students' presentations (93.75%, 15/16). Most of the lecturers agreed that they could well guide students to think about the relationship between laboratory and clinical diagnosis and treatment in class (91.67%, 11/12). Both teachers and students had very positive evaluations of the learning mode, learning content, inspiration to students, and teachers' ability of this course. All the teachers and students agreed that the learning mode of combining CBS with special subject lecture was more helpful for the students to systematically learn medical knowledge compared with a CBS session alone or a lecture alone.Conclusion:The course, Laboratory Medicine and Clinical Sciences, which combines the CBS with the traditional lecture mode, integrates the advantages of the two learning modes. It not only stimulates students' enthusiasm for active learning, deepens clinical knowledge memory, and builds a clinical thinking model, but also enriches the teaching modes of medical laboratory education.

Objective:The composition of thrombi obtained during mechanical thrombectomy in patients with acute ischemic stroke is analyzed to investigate its relation with stroke etiology and its influence in surgical parameters and clinical prognoses.Methods:The thrombi and clinical data of 41 patients with acute ischemic stroke directly treated by mechanical thrombectomy in our hospital from January 2019 to December 2019 were collected. Hematoxylin-eosin (HE) staining was used to quantitatively analyze the composition of thrombi, and the components of thrombi in patients with different causes of stroke (large artery atherosclerosis [LAA], cardiogenic embolism [CE], and unexplained type) were compared. These patients were divided into erythrocyte-rich group (erythrocyte content>fibrin content) and fibrin-rich group (erythrocyte content0.05). Conclusion:Thrombus composition has influence in surgical parameters, but no influence in clinical prognoses.

According to the cause of hyperparathyriodism (HPT) , it can be divided into three types: primary hyperparathyroidism (PHPT) , secondary hyperparathyroidism (SHPT) and tertiary hyperparathyroidism (THPT) . THPT is a state of excessive autonomous excretion of parathyroid hormone (PTH) after longstanding SHPT. In the past, reports of THPT is relatively rare in domestic, which may be related to the understanding and experience of clinicians. With the increase of kidney transplant cases all over the word, the incidence rate has also gradually increased. Therefore, it is especially important to deepen the knowledge of THPT, standardize the medical treatment, and strictly control the indications for surgery.

Objective To study the detection of cytomegalovirus (CMV)-DNA in different kinds of blood and urine sample .Methods The CMV-DNA loads in 3 different kinds of blood sample from 52 patients and 3 different kinds of urine sample from 85 patients were detected by real-time fluorescence quantitative polymer-ase chain reaction(FQ-PCR) .The differences in CMV-DNA detection rate and virus loads were compared a-mong different kinds of blood and urine samples .Results The CMV-DNA detection rates in serum ,whole blood ,plasma and peripheral blood mononuclear cell (PBMC) from 52 patients were 48 .08％ ,71 .15％ ,57 .69％ and 69 .23％ respectively .The CMV-DNA detection rates of whole blood and PBMC were higher ,the difference was statistically significant (P<0 .05) .The quantitative results of PBMC was higher .The CMV-DNA detec-tion rates of mixed urine ,urine supernatant and urine sediment from 85 patients were 72 .94％ ,62 .35％ and 84 .71％ respectively ,the CMV-DNA detection rate of urine sediment was higher ,while the quantitative re-sults of mixed urine was higher .Conclusion The CMV-DNA detection results of blood and urine have large difference ,therefore using the same kind of sample for conducting detection has an important clinical signifi-cance in the clinical diagnosis ,treatment and monitoring of CM V infection .

Objective To develop a data glove evaluation system to assist rehabilitation physicians and therapists in assessing the degree of rehabilitation of hand-wounded patients. Methods A data glove containing 136-axis inertial sensors was designed and produced. It was tested on 10 healthy subjects and 3 hand trauma pa-tients admitted to the Department of Rehabilitation Medicine at Run Run Shaw Hospital. The glove transmitted ac-celeration and angular velocity components in the X, Y and Z directions to a computer terminal, allowing the ben-ding angles of the subject′s finger joints to be calculated. Traditional protractor measurements were used to verify to what extent the data glove accurately reflected the hand and joint activity. Results Compared with the traditional protractor measurement method, the data glove quickly gave accurate maximum bending angles both in healthy and hand-wounded subjects . Such data can facilitate the rehabilitation of hand injuries. Conclusions The data glove produced in this study can effectively assist rehabilitation doctors and therapists in assessing the recovery of hand-injured patients.