Background and Aims:With the widespread use of electrosurgical devices in open thyroid surgery,the surgical smoke generated during procedures has become a significant concern,as it compromises surgical visibility,reduces operational efficiency,and poses health risks to medical staff.Currently,local smoke evacuation is commonly performed by an assistant using a handheld suction device,which is limited in range,interferes with surgical procedures,and increases labor costs.This study aimed to evaluate the effectiveness,safety,feasibility,and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods:A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group(41 patients each).During surgery,the observation group used a self-made annular smoke evacuation device for continuous smoke removal,while the control group used conventional manual suction via an assistant.Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field,operative time,intraoperative blood loss,and medical staff satisfaction with smoke removal.Results:During thyroid tissue dissection,the PM2.5 concentration in the observation group was(63.26±11.71)μg/m3,corresponding to a"good"air quality level,while in the control group it was(126.35±40.12)μg/m3,ranging from"mild to severe pollution"—a statistically significant difference(P<0.05).In the observation group,operative times for unilateral and bilateral procedures were(31.25±11.36)min and(71.13±17.12)min,respectively,with intraoperative blood loss of(10.5±5.3)mL and(18.6±5.5)mL.In the control group,times were(39.27±15.42)min and(78.35±22.35)min,with blood loss of(12.5±5.8)mL and(20.5±6.5)mL,respectively—all differences not statistically significant(all P>0.05).Staff satisfaction was significantly higher in the observation group compared to the control group(97.6%vs.31.7%,P<0.05).Conclusion:The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery,effectively reducing surgical smoke concentration,improving visibility,and minimizing health risks to medical staff without compromising surgical efficiency or safety.The device is cost-effective,easy to assemble,and can be repurposed postoperatively as a drainage tube,requiring no additional consumables.Its reusability and ease of integration offer strong practical value and clinical applicability.

Background and Aims:With the widespread use of electrosurgical devices in open thyroid surgery,the surgical smoke generated during procedures has become a significant concern,as it compromises surgical visibility,reduces operational efficiency,and poses health risks to medical staff.Currently,local smoke evacuation is commonly performed by an assistant using a handheld suction device,which is limited in range,interferes with surgical procedures,and increases labor costs.This study aimed to evaluate the effectiveness,safety,feasibility,and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods:A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group(41 patients each).During surgery,the observation group used a self-made annular smoke evacuation device for continuous smoke removal,while the control group used conventional manual suction via an assistant.Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field,operative time,intraoperative blood loss,and medical staff satisfaction with smoke removal.Results:During thyroid tissue dissection,the PM2.5 concentration in the observation group was(63.26±11.71)μg/m3,corresponding to a"good"air quality level,while in the control group it was(126.35±40.12)μg/m3,ranging from"mild to severe pollution"—a statistically significant difference(P<0.05).In the observation group,operative times for unilateral and bilateral procedures were(31.25±11.36)min and(71.13±17.12)min,respectively,with intraoperative blood loss of(10.5±5.3)mL and(18.6±5.5)mL.In the control group,times were(39.27±15.42)min and(78.35±22.35)min,with blood loss of(12.5±5.8)mL and(20.5±6.5)mL,respectively—all differences not statistically significant(all P>0.05).Staff satisfaction was significantly higher in the observation group compared to the control group(97.6%vs.31.7%,P<0.05).Conclusion:The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery,effectively reducing surgical smoke concentration,improving visibility,and minimizing health risks to medical staff without compromising surgical efficiency or safety.The device is cost-effective,easy to assemble,and can be repurposed postoperatively as a drainage tube,requiring no additional consumables.Its reusability and ease of integration offer strong practical value and clinical applicability.

In order to explore the treatment of Her-2 positive breast cancer patients who failed in multi-line treatments, we retrospectively analyzed the clinical data of a patient with refractory Her-2 positive breast cancer.The patient was initially diagnosed as Her-2 positive advanced breast cancer.After six line treatment in the outer hospital, the patient′s condition was basically in a progressive state.The breast tumor was broken and purulent, the lung metastasis increased, and the patient′s quality of life was poor.The patient was admitted to Department of Breast Surgery of Affiliated Suqian Hospital of Xuzhou Medical University, after MDT discussion, we gave pyrrolotinib combined with capecitabine treatment, the chest wound healed gradually, the lung metastasis gradually reduced, and the quality of life was better.A retrospective analysis of this case showed that pyrrolidine combined with capecitabine may bring hope to Her-2 positive breast cancer patients who failed to receive multi-line therapies, especially those who failed to target therapy.

Objective:This article summarized the characteristics of inpatients with the COVID-19 by psychiatric contact consultation in Wuhan.Method:This was a retrospective study. A total of 105 patients consulted by the Guangdong psychological medical team from March 1, 2020 to March 7, 2020 were selected. Data were collected by 20 psychiatrists responsible for the contact consultation, including age, gender, the main reasons for the contact consultation and the psychiatric treatment plan. The consultant doctor decided whether to enter the isolation ward according to the patient′s condition introduced by the attending physician, and whom were followed up within a week. Descriptive statistical analysis was used to analyze the data.Results:There were 105 patients from 5 designated hospitals, aged （58.3±18.9） years, 62.9% (66/105) were females, and 102 (97.1%) were consulted face-to-face in the isolated ward. Main reasons for consultation were anxiety (65, 61.9%), depression (27, 25.7%), insomnia (6, 5.7%), agitation (6, 5.7%), and illusion (1, 1%). Seventy-seven of those patients (73.3%) received individualized psychotherapy, 1(1.0%) was prescribed with psychiatric medication, and 27 (25.7%) were treated with both measures. Follow-up showed that psychological symptoms relieved in 102 cases (97.1%).Conclusion:Psychosocial symptoms such as anxiety and depression are common in infected patients, and thereby psychiatric contact and consultation is in great demand in the treatment of COVID-19. Early intervention of mental health professionals in the diagnosis and treatment of patients plays a positive role in the recovery of them.

Objective:This article summarized the characteristics of inpatients with the COVID-19 by psychiatric contact consultation in Wuhan.Method:This was a retrospective study. A total of 105 patients consulted by the Guangdong psychological medical team from March 1, 2020 to March 7, 2020 were selected. Data were collected by 20 psychiatrists responsible for the contact consultation, including age, gender, the main reasons for the contact consultation and the psychiatric treatment plan. The consultant doctor decided whether to enter the isolation ward according to the patient′s condition introduced by the attending physician, and whom were followed up within a week. Descriptive statistical analysis was used to analyze the data.Results:There were 105 patients from 5 designated hospitals, aged （58.3±18.9） years, 62.9% (66/105) were females, and 102 (97.1%) were consulted face-to-face in the isolated ward. Main reasons for consultation were anxiety (65, 61.9%), depression (27, 25.7%), insomnia (6, 5.7%), agitation (6, 5.7%), and illusion (1, 1%). Seventy-seven of those patients (73.3%) received individualized psychotherapy, 1(1.0%) was prescribed with psychiatric medication, and 27 (25.7%) were treated with both measures. Follow-up showed that psychological symptoms relieved in 102 cases (97.1%).Conclusion:Psychosocial symptoms such as anxiety and depression are common in infected patients, and thereby psychiatric contact and consultation is in great demand in the treatment of COVID-19. Early intervention of mental health professionals in the diagnosis and treatment of patients plays a positive role in the recovery of them.

Objective: To investigate the effect of nucleophosmin 1 (NPM1) mutant A on TGF-β1-induced K562 cell proliferation and AKT phosphorylation. Methods: K562 cells were infected with Ad5-NPM1 to create an NPM1 over-expression cell model. NPM1 levels were determined by ELISA and Western blot analysis. The levels of AKT and P-AKT were determined by Western blot. MTT was used to measure the proliferation of K562 cells. Results: NPM1 protein levels in K562 cells increased in an Ad5-NPM1-MOI-dependent manner. Cell proliferation and NPM1 levels in the supernatant were significantly increased in K562 cells infected with Ad5-NPM1-30 and Ad5-NPM1-100 compared to those infected with Ad5-vector-100 (P<0.01). Treatment with (10 ng/mL) TGF-β1 increased P-AKT levels, but not total AKT levels in K562 cells. TGF-β1-induced phosphorylation of AKT was significantly increased by infection of K562 cells with Ad5-NPM1-100. No significant differences were found in total AKT levels among all groups. TGF-β1 (10 ng/mL) treatment also in-creased the proliferation of K562 cells. TGF-β1-induced K562 cell proliferation was significantly increased by infection with Ad5-NPM1-100 (P<0.01). Conclusions: NPM1 improves TGF-β1-induced cell proliferation by up-regulating AKT phosphorylation levels.

Objective To explore the application of paclitaxel or docetaxel combined with cisplatin (TP) with cyclophosphamide,pirirubicin and fluorouracil (FAC) in the primary tumor molecular typing Luminal A,axillary lymph node metastasis three negative breast cancer. Methods From January 2012 to January 2014, the clinical data of forty-nine patients with were selected. All patients were divided into two groups by balance randomization method, TP group and FAC group. Twenty-five patients were treated with TP regimen and 24 patients were treated with FAC regimen. The clinical efficacy was evaluated after six cycles of chemotherapy. Chemotherapy effects,adverse reactions and survival rates of two groups were compared. Results All patients were given intravenous chemotherapy according to the plan and were evaluated for clinical efficacy. The response rate (RR) was 64. 0％ in TP group,including 4 cases of complete remission (CR),12 cases of partial remission (PR),7 cases of stable disease(SD) and 2 cases of progressive disease(PD). The adverse reactions were gastrointestinal reactions and granulocytopenia. The median progression-free survival ( PFS) and overall survival ( OS) were respectively 12. 4 months and 34. 1 months. In FAC group,the response rate ( RR) was 33. 3％,including 2 cases of CR,6 cases of PR,11 cases of SD and 5 cases of PD. The adverse reactions were gastrointestinal reactions,granulocytopenia and premature atrial contraction. The median PFS and OS were 7. 2 months and 20. 7 months respectively. The effective rate of TP group was higher than that of FAC group (χ2=4. 608,P=0. 032),and the progression-free survival time and total survival time were longer than those of FAC group (χ2 =8. 317, 8. 563, P=0. 004, 0. 003 ) . Conclusion Compared to FAC regimen, TP regimen could improve the survival rate of patients better with breast cancer of Primary tumor Luminal A and Axillary Lymph Node Metastasis Triple negative type, and adverse reactions were tolerated, it may be an optimized chemotherapy.

Objective To explore the expression of HR and Her?2 in breast cancer primary tumor and axillary lymph node metastasis. Methods Four hundred and twenty?eight female patients with unilateral breast cancer combined with axillary lymph node metastasis treated in the Affiliated Suqian Hospital of Xuzhou Medical University from January 2011 to January 2016 were selected in this study. Immunohistochemistry was used to detect the expression of ER,PR,Her?2 and Ki67 in primary tumor and axillary lymph node metastasis. Results The positive rates of ER expression were 75. 9% ( 325/428 ) and 70. 3% ( 301/428 ) respectively in primary tumor and axillary lymph node metastasis. The positive rates of PR expression were 61. 4% ( 263/428) and 56. 1% ( 240/428 ) respectively in primary tumor and axillary lymph node metastasis. The rates of Her?2 overexpression were 20. 1% ( 86/428) in primary tumor and the positive rate of Her?2 in axillary lymph node metastasis was 22. 7%( 97/428 ) . The positive rates of Ki67 expression were 45. 6%( 195/428 ) and 39. 7%(170/428) respectively in primary tumor and axillary lymph node metastasis. The expression of ER,PR,Her?2 and Ki67 in primary and axillary lymph node metastasis showed no statistical significance ( P>0. 05 ) . The molecular typing of primary tumor and axillary lymph node metastasis were not consistent in 31 patients ( 31/428,7. 24%) ,including 14 cases of primary tumor Luminal A,9 cases of Her?2 overexpression in axillary lymph node metastasis and 5 cases of triple negative breast cancer. Primary tumor Luminal B was detected in 10 cases, while 6 cases of Her?2 overexpression in axillary lymph node metastasis and 4 cases of triple negative breast cancer. Primary tumor Her?2 was overexpressed in 4 cases,while 1 case of Luminal A,3 cases of Luminal B in axillary lymph node metastasis. There were 3 cases of primary tumor triple negative breast cancer,while 2 cases of Luminal B in axillary lymph node metastasis and 1 case of Her?2 overexpression. Conclusion The expressions of ER, PR, Her?2 and Ki67 in primary tumor and axillary lymph node metastasis of some breast cancer were different. Immunohistochemistry for primary tumor and axillary lymph node metastasis of stage II?III breast cancer patients should be routinely carried out. Based on molecular typing of primary tumor and axillary lymph node metastasis,individualized treatment plan can be developed,so that patients will benefit from it.

Objective To evaluate the efficacy and safety of gefitinib plus capecitabine in treatment of recurrent and metastatic triple negative breast cancer.Methods From Jan.2011 to Jun.,41 patients who have recurrent and metastatic triple negative breast cancer after treated by adjuvant chemotherapy were enrolled in this study They were divided into two groups according to their wishes.The 24 cases in the experimental group were treated with gefitinib plus capecitabine.The 17 cases in the control group were treated with capecitabine.The two groups were followed up for 12 months.They were treated until the disease progression or the toxicity could not be tolerated.Results The objective response rate (ORR) in the experimental group and the control group was 70.83％(17/24) vs 35.29％(6/17).The disease control rate (DCR) in the two groups was 91.67％ (22/24) vs 64.71％ (11/17).The difference between the two groups was statistically significant (P＜0.05).The incidence rate of adverse drug reactions in the two groups was similar (P＞0.05),and the reactions were tolerable.Conclusion Gefitinib plus capecitabine is an effective and safe treatment for recurrent and metastatic triple negative breast cancer with tolerable adverse reactions,and some patients were able to survive for more than 12 months.

Objective To study the method and clinical value of preservation of intercostobrachial nerve( ICBN) by fat dissolving meth-od during breast cancer operation. Methods The clinical data of 50 cases withⅠ~Ⅲa stage breast cancer from January 2013 to June 2013 were analyzed. Fifty patients were randomly divided into two groups,there were 26 patients in preservation group,whose ICBN were preserved by fat dissolving method during axillary lymph nodes dissection,and 24 patients in resection group,whose ICBN were not preserved by routine method during axillary lymph nodes dissection. Comparison of operation times,bleeding volume,the number of axillary lymph nodes dissection and upper arm sensory function of patients after operation between both groups was done. Results The mean time of operation was (102. 3 ± 15. 6) min in preservation group and(95. 6 ± 12. 4) min in resection group,while the number of axillary lymph nodes dissection was (19. 5 ± 8. 8 ) in preservation group and ( 19. 2 ± 9. 5 ) in resection group, with no significant difference between both groups (P>0. 05). Bleeding volume was (51. 2 ± 11. 5)mL in preservation group and (98. 5 ± 13. 4)mL in resection group,with significant differ-ences(P<0. 05). After postoperative one month,we observed upper arm sensory function of patients. It showed that 3 cases of sensory numb-ness or pain occurred in preservation group (11. 5%),20 cases of sensory abnormality occurred in resection group (83. 3%),mainly as sen-sory loss,numbness,pain or burning sensation,there was significant difference between both groups (P<0. 05). All patients were followed up half a year,patients with sensory abnormality in preservation group recovered,and recovery in resection group was not obvious,it still showed sensory abnormality in varying degrees. During the follow-up,no local recurrence or distant metastasis was found in both groups. Conclusion Preserving intercostobrachial nerve by fat dissolving method in breast cancer operation is based on conventional operation and made a few of improvements. It is simple and feasible. During the operation,we find that the axillary neurovascular is clearer,preservation of ICBN is easier. It does not affect the axillary lymph node dissection and operation time,while it can reduce incidence of postoperative sensory abnormality and improve the quality of life of patients,therefore it is worthy of clinical application.