OBJECTIVE To evaluate the value of BRAF V600E mutation detection combined with liquid-based thin-preparation cytologic test(LCT)in the preoperative diagnosis of papillary thyroid carcinoma(PTC)and the related pathological characteristics of BRAF V600E mutation.METHODS Clinical data of 428 patients with thyroid nodules who underwent surgery at the First Affiliated Hospital of Xiamen University from January 2023 to December 2023 were retrospectively analyzed.All patients underwent ultrasound-guided fine needle aspiration and liquid-based cytology diagnosis and BRAF V600E gene mutation detection simultaneously before surgery.RESULTS The results of BRAF V600E mutation were significantly correlated with the results of liquid-based cytology diagnosis in patients(P<0.01).The area under the curve(AUC value)of LCT was 0.88,and the AUC value of BRAF V600E was 0.84.The sensitivity and specificity of LCT for preoperative diagnosis of PTC were 0.80 and 0.96,respectively.The sensitivity and specificity of BRAF V600E for preoperative diagnosis of PTC were 0.72 and 0.96,respectively.The AUC value of LCT combined with BRAF V600E for the diagnosis of PTC was 0.93 while the sensitivity and specificity were 0.88 and 0.92,respectively.The combined diagnosis significantly improved the sensitivity and specificity of thyroid nodule disease diagnosis,with a statistically significant difference(Z=-5.50,-4.60,P<0.001).In addition,BRAF V600E mutation was associated with the age of patients,the maximum diameter of nodules,and whether the capsule was invaded,with significant statistical differences between groups(P<0.05),but was not associated with gender,whether the nodules were multifocal,whether lymph node metastasis occurred,or whether Hashimoto's thyroiditis was present.CONCLUSION The combination of FNA liquid-based thin-preparation cytologic test and BRAF V600E detection can significantly improve the preoperative diagnostic accuracy of PTC.

Discipline construction is the power source to realize the high quality development of public hospitals,and high quality scientific research management is the inevitable path to realize the connotative development of public hospitals.The quality improvement of scientific research project process management is step-by-step,and mid-term inspection is a representative work.This paper applies PDCA cycle theory to the mid-term inspection of scientific research projects,analyzes the problems encountered in the mid-term inspection of scientific research projects from the four stages of plan,implementation,check and act,and develops effective intervention measures.The mid-term inspection mode,which combines publicity activities of scientific research norms with self-examination by researchers and on-the-spot inspection by the scientific research department,should be carried out to standardize the process of mid-term inspection of scientific research projects and promote the high-quality development of scientific research in hospitals.

Objective:To investigate the efficacy of Da Vinci robot-assisted surgery for mediastinal tumor, and summarize the value of Da Vinci system in mediastinal surgery.Methods:The clinical data of 339 cases of robot-assisted mediastinal mass in Shanghai Chest Hospital from April 2015 to September 2020 were retrospectively analyzed, to compare perioperative outcomes of robotic surgery and conventional video-assisted thoracoscopic surgery 2 949 cases.Results:All the operations were successfully completed as planned. No residual lesions, conversion or second operation was observed in the consecutive cohort. The operating time[(81.8±36.8)min vs.(95.6±58.3)min, P=0.015]and post-operation stay[(3.1±1.9)days vs.(3.8±2.3)days, P=0.002] were statistically shorter in robotic group than those inconventional thoracoscopic group. Intraoperative blood loss in two groups was similar[(43.2±22.6)ml vs.(44.0±33.4)ml, P>0.05]. Conclusion:The Da Vinci robot system in mediastinal surgery is safe and feasible with great perspective in the new age of minimally invasive thoracic surgery. Compared with thoracoscopic surgery, it can shorten the operation time and reduce the postoperative hospital stay. It has certain advantages in operator experience and patient recovery.

Xiyanping injection, a traditional Chinese medicine injection made of andrographolide sulfonate, consisting of well-defined ingredients with antiviral, antibacterial, anti-inflammatory and antipyretic efficacy, has been widely used for treating infectious diseases of respiratory and digestive systems. However, its wide applications may easily lead to unreasonable clinical medication. In order to guide the precise clinical application and rational use of Xiyanping injection, experts in related fields conducted systematically literature review, evaluated and deliberated the application of Xiyanping injection in treating acute infectious diseases using evidence-based medicine method, and jointly drafted the consensus to summarize types of acute infectious diseases in children and adults that can be treated with Xiyanping injection, and recommend the intervention time, usage and dosage, course of treatment and combined medication of the injection. Besides, the consensus elucidates the safety, precautions and contraindications of the injection, so as to provide guidance for clinical use.

Objective To explore the application value of JCI standard and HIMSS 7 grade clinical closed loop system in pathological specimen handover. Methods The First Affiliated Hospital of Xiamen University adopted the traditional way to transfer pathological specimen in 2014, and improved the process under guidance of JCI standard in 2015. Then HIMSS 7 level clinical closed-loop system was applied to pathological handover on the basis of JCI standard guidance in 2017. Comparative analysis was made on the failure rate of the pathological specimen,the average handover time of pathological specimen and the timely rate of pathological frozen reports in the above 3 years. Results A comparison of the failure rate of pathological specimens found the following: That of 2015 was significantly lower than that of 2014 (P <0.05);and that of 2017(Jan. -Sept.) was significantly lower than that of 2015(P<0.01). A comparison of the handover timeliness of frozen digestive endoscopy specimens and a single frozen specimen handover duration found the following:That of 2015 was significantly shorter than that of 2014 (P< 0.01),and that of 2017 (Jan. - Sept.) was significantly shorter than that of 2015 (P < 0.01). A comparison of the timeliness of frozen specimen pathological reports found the following: that of 2015 was significantly better than that of 2014 (P< 0.05),and that of 2017 (Jan. -Sept.) was significantly better than that of 2015 (P< 0.05). Conclusions The guidance of JCI concept has reduced the failure rate of pathological specimen, shortened the average handover during, and improved the timeliness of pathological frozen specimen reports. Under the JCI standard guidance, the HIMSS 7 level clinical closed-loop system was applied to the pathological specimen handover process. This practice could significantly reduce the failure rate of pathological specimen and improve the pathological specimen handover efficiency. Furthermore,it is conducive to full-course tracking and dynamic management of such specimen.

As a standard of care, lymph node dissection is an indispensible step in lung cancer surgery. The quality of dissection determines completeness of surgery and the accuracy of N staging. Hereby, we suggest labeling all surgically resected nodes according to the new lymph node map in the 8th TNM classification for lung cancer. As systematic lymph node dissection remains the gold standard of lymphadenectomy, at least three mediastinal stations and ten nodes should be removed in an en-bloc fashion, if possible. For patients with stage Ⅰ lung cancer, lymph node dissection via video-assisted thoracoscopic surgery (VATS) or open thoracotomy may has similar oncological outcome. Besides, limited lymph node sampling in selected patients with early staged lung cancer to minimize unnecessary surgical damage still need further investigation.

Objective Iodine loading would be carried out on orthopedic titanium Kirschner-wire by electrophoretic deposition.And by this,a kind of orthopedic iodine-coated implant with antibacterial properties was supposed to be developed,that would provide a theoretical basis for the development of clinical orthopedic implants with antibacterial properties.Methods Iodine loading on the surface of titanium Kirschner-wire was carried out by electrophoretic deposition.PVP-I solution as 1 000 ppm,2 000 ppm and 4 000 ppm was prepared respectively (1 ppm=1 mg/kg=1 mg/L).Three kinds of iodine-coated orthopedic titanium Kirschner-wires with different iodine content were prepared by electrophoretic deposition at 200 V voltage for 30 min and then stoved after being washed with distilled water.The surface signs and composition structure of iodine coated titanium Kirschnerwire were studied through scanning electron microscopy (SEM) and energy dispersive spectrometer (EDS).Antibacterial experiments of Iodine coating titanium Kirschner needle were performed in vitro.Antimicrobial test:10 pieces of uncoated titanium Kirschner-wires;10 pieces of iodine-coated titanium Kirschner-wires with 1 000 ppm;10 pieces of iodine-coated titanium Kirschner-wires with 2 000 ppm;10 pieces of iodine-coated titanium wires with 4 000 ppm.Because iodine is easy to sublimate and does not withstand high temperature,all the titanium Kirschner needles are fumigated and disinfected by ethylene oxide (supported by the supply room of our hospital).Titanium wires were immersed respectively in 106 CFUJ/ml (ATCC25923) bacterial suspension of standard Staphylococcus aureus so that bacteria would be fully inoculated on the surface of the titanium wire.The sterilized titanium Kirschner needle was placed in a sterile culture cup and 30 ml suspension was added into the culture cup.The sterilized titanium Kirschner needle was completely immersed in the bacterial solutionand was kept at 37°C for 6 h before taking out.Take out the titanium Kirschner needle slowly,rinse the titanium Kirschner needle with 5 ml sterile PBS buffer,after rinsing the surface of titanium Kirschner needle,transfer the titanium Kirschner needle to the new sterile culture cup and add 5 ml sterile saline until the titanium Kirschner needle is completely immersed.Then put the titanium Kirschner needle into the ultrasonic oscillator to wash the surface of the bacteria fully.After 10 000 times dilution,100 μl was smeared on agar medium for culture (37°C) and the number of colonies was observed and counted 24 h later.Results The surface of three kinds of iodine coating titanium Kirschner-wires was covered with uniform iodized compound coating and had a brown look.The film structure was stable and there was no falling off after ultrasonic cleaning.SEM exhibited that the surface of Titanium Kirschner-wire is covered with a compact coating;the appearance structure is relatively flat and a slight collapse can be seen scattered in the surface of the wire.The results of EDS showed that the iodine content in the surface coating of 3 groups was 4.38 wt％,9.05 wt％ and 14.48 wt％.The bacteria growing on the surface of titanium needle were shaken down by ultrasonic vibration.The CFU counting was carried out after the bacterial solution being diluted,coated and cultured for 24 h.It can be seen that the antibacterial property increases continuously with the increase of iodine coating content.The antibacterial properties of iodine-coated implant which content 14.48 wt％ iodine was more than 1 orders of magnitude than the control group.The results showed that the plants coated with iodine had obvious antibacterial effect.Conclusion The iodine coated titanium wire was prepared by electrophoretic deposition,after being characterized by SEM,EDS and quantitative measurement,the successful loading of iodine was proved,the antibacterial experiment proved that the iodinecoated orthopedic titanium Kirschner-wire has a stronger antibacterial properties than the ordinary titanium Kirschner-wire under laboratory conditions.

OBJECTIVETo investigate the clinical significance of cell blocks obtained by ultrasound-guided fine needle aspiration in diagnosing parotid gland masses.

METHODSCell blocks were made in 285 parotid gland masses by ultrasound-guided fine needle aspiration. Diagnosis was conducted using the cell blocks. Non-tumor masses were subjected to conservative treatment, and cysts and tumors were treated with surgery. The cell block sections from masses with the diagnosis of adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA) were applied to the detection of immunocytochemical staining for the stem cell factor receptor CD117.

RESULTSThe satisfaction rate of the specimen was 95.1% (271/285). The accuracy rate of the diagnosis was 94.5% (256/271), the sensitivity was 87.0% (67/77), and the specificity was 98.1% (157/160). The positive rate of CD117 in ACC was 95.2% (20/21), whereas that in PA was 20.3% (25/123). The positive rate of CD117 in ACC was higher than that in PA (P<0.01).

CONCLUSIONSThe use of cell blocks obtained from ultrasound-guided fine needle aspiration, together with molecular marker detection, has great significance in diagnosing parotid gland masses.
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Adenoma, Pleomorphic ; Biopsy, Fine-Needle ; Carcinoma, Adenoid Cystic ; Cysts ; Female ; Humans ; Male ; Parotid Gland ; Parotid Neoplasms ; Personal Satisfaction ; Staining and Labeling ; Ultrasonics

Eosine Yellowish-(YS) ; Frozen Sections ; Hematoxylin ; Humans ; Staining and Labeling

Objective To study the clinical efficacy of cell block yielded by ultrasound-guided fine needle aspiration in the early diagnosis of thyroid cancer and differential diagnosis of thyroid follicular tumor.Methods Cytological smears were performed in 864 thyroid nodules by ultrasound-guided fine needle aspiration.Then the residual specimens were made as cell blocks.Diagnosis was made by observation of the organization structure of the cell block.Cell block sections from 78 nodules with diagnosis of follicular tumors were applied to the detection of immunocytochemical staining for minichromosome maintenance protein (MCM2), growth arrest and DNA damage-induced nuclear protein 153 (GADD153), and Ki-67.Results Satisfaction rate of cytological smear combined with cell block specimen was 94.3 ％ (815/864) and accuracy rate of the diagnosis was 94.0％ (766/815), which were higher than in cytological smear group (P＜0.01).The false negative rate of cytological smear combined with cell block specimen was 16.6％ (41/247)in diagnosis of thyroid cancer.Positive rate of M CM2 and GADD153 in thyroid follicular neoplasia were lower than that of follicular carcinoma (P ＜ 0.01).There was no significant difference between thyroid follicular neoplasia and follicular carcinoma in regard to positive rate of Ki-67 (P ＞ 0.05).Conclusions The combination of ultrasound-guided fine needle aspiration-yielded cell block and molecular markers has great significance in early diagnosis of thyroid cancer and differentially diagnosis of thyroid follicular tumor.