OBJECTIVE To investigate the related factors of central lymph node metastasis(CLNM)in papillary thyroid carcinoma(PTC)with capsular invasion,and to construct a clinical nomogram prediction model.Its purpose is to provide theoretical basis for clinical diagnosis and treatment.METHODS The clinical data of PTC patients with capsule invasion admitted to the Department of General Surgery,Baoding First Central Hospital from October,2020 to October,2023 were retrospectively analyzed.The data included gender,age,body mass index(BMI),aspect ratio,tumor location,multifocality,microcalcification,Hashimoto thyroiditis(HT)and tumor diameter.According to the presence or absence of CLNM,the patients were divided into the normal group(107 cases)and the metastasis group(108 cases).Univariate and multivariate analysis of the data were performed to construct a visual nomogram prediction model,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of the model.The nomogram model was internally verified using a Bootstrap test with 1000 repeated samples.Consistency index(C-index)and calibration curve were used to describe the prediction performance and prediction accuracy of the model.Finally,the clinical decision curve(DCA)was drawn to determine the clinical application ability of the model.RESULTS A total of 215 PTC patients with capsular invasion were included,of whom 108(50.23%)had CLNM.Univariate analysis showed that the occurrence of CLNM was associated with tumor diameter,aspect ratio>1,tumor located in the lower pole,multifocality,and HT(P<0.05).Multivariate regression analysis showed that tumor diameter,aspect ratio>1,tumor located in the lower pole and multifocus were independent risk factors for CLNM(OR=1.401,1.875,2.291,2.303,P<0.05),and HT was a protective factor for CLNM(OR=0.501,P<0.05).Based on the above risk factors,a nomogram prediction model for CLNM in patients with PTC with capsule invasion was constructed.The ROC curves showed that the area under the curve(AUC)was 0.859(95%CI:0.792-0.925,Yoden Index was 0.734,the sensitivity was 0.878,a specificity was 0.856),and the model had higher predictive value.Internal validation consistency index(C-index)was 0.83(95%CI,0.748 to 0.959).The calibration curve showed that the predictive value was close to the ideal curve,and it had good consistency.The DCA curve showed that the model had good clinical efficacy.CONCLUSION Larger tumor size,aspect ratio>1,tumor located in the lower pole and multifocality suggest higher risk of CLNM in PTC with capsular invasion,while HT is a protective factor for CLNM.The nomogram model based on the above risk factors has high discrimination and calibration,which is helpful for clinicians in preoperative evaluation and intraoperative exploration,so that high-risk patients can be prevented and treated as soon as possible.

Clinical data of 15 patients diagnosed with acute renal infarction (ARI) in Affiliated Zhongshan Hospital of Dalian University from Jan 2011 to Dec 2021 were retrospectively analyzed. Of the included 15 patients, there were 14 cases of cardiac origin and 1 case of antiphospholipid syndrome. We found that there were 12 cases of atrial fibrillation, 2 cases of atrial premature beats, 12 cases of elevated level of D-dimer, 15 cases of elevated level of LDH, 11 cases of positive urine occult blood and positive urine protein. Among the 15 patients, catheter-directed thrombolysis was performed in 4 cases, of which 3 cases were revascularized successfully, intravenous thrombolysis in 2 cases and alone anticoagulation therapy in 9 cases. It is suggested that CECT or CTA can assist the early diagnosis of ARI especially in patients with acute onset and persistent abdominal pain with high risk factors of thromboembolism, high levels of LDH, microscopic hematuria and/or proteinuria. Despite prolonged embolic ischemia, try to reconstruct blood flow to save the kidney as much as possible. Late standardized anticoagulant therapy is of critical importance to prevent recurrent embolic episodes.

CRISPR-based genome editing systems have been successfully and effectively used in many organisms. However, only a few studies have reported the comparison between CRISPR/Cas9 and CRISPR/Cpf1 systems in the whole-genome applications. Although many web-based toolkits are available, there is still a shortage of comprehensive, user-friendly, and plant-specific CRISPR databases and desktop software. In this study, we identified and analyzed the similarities and differences between CRISPR/Cas9 and CRISPR/Cpf1 systems by considering the abundance of proto-spacer adjacent motif (PAM) sites, the effects of GC content, optimal proto-spacer length, potential universality within the plant kingdom, PAM-rich region (PARR) inhibiting ratio, and the effects of G-quadruplex (G-Q) structures. Using this information, we built a comprehensive CRISPR database (including 138 plant genome data sources, www.grapeworld.cn/pc/index.html), which provides search tools for the identification of CRISPR editing sites in both CRISPR/Cas9 and CRISPR/Cpf1 systems. We also developed a desktop software on the basis of the Perl/Tk tool, which facilitates and improves the detection and analysis of CRISPR editing sites at the whole-genome level on Linux and/or Windows platform. Therefore, this study provides helpful data and software for easy selection and application of CRISPR-based genome editing systems in plants.

From December 2011 to August 2017,56 patients with acute abdomen surgery were treated in Affiliated Zhongshan Hospital of Dalian University.The anatomical structure of ileocecal Treves folds was observed during operation,and 15 samples of Treves folds were taken for histological examination.The mean length of the fold was (5.56±0.18)cm for males and (5.22±0.05)cm for female,the width was (1.82± 0.04) cm for males and (1.78 ± 0.06) cm for females;the thickness was (0.18 ± 0.02) cm.HE and verhoeff staining showed that Treves fold was mainly composed of elastic fiber,collagen fiber and smooth muscle with abundant blood supply.Thirty patients were repaired with their own Treves folds,including the fixation with overlay suture to the stump of appendectomy in 26 cases,repairing for perforation of colonic diverticulum in 3 case,and repairing for perforation of colonic diverticulum in 1 case.There were no complications such as fecal fistula,intestinal obstruction and intussusception after operation.The Treves fold has a constant location,which can be used as a clear sign of ileal terminal.It has abundant blood supply,and is suitable for the repair and reconstruction in ileocecal operation.

PURPOSE: To investigate the effects of a sustained-released mixture of vascular endothelial growth factor 165 (VEGF165) and fibrin glue (FG) local administration on postoperative rabbit ileal anastomoses. METHODS: One hundred twenty-eight male and female New Zealand white rabbits underwent intraperitoneal infection subsequent ileal anastomosis surgery were divided randomly into 4 groups, including 32 animals in each, applied with saline solution, FG, rhVEGF165 and a mixture of rhVEGF165 with FG (VEGF + FG) on the anastomoses, respectively. The incidences of anastomotic leakage were observed. Histopathological examination for inflammatory infiltration, fibroblast proliferation, and capillary vascular proliferation were performed. Then, bursting pressure and hydroxyproline concentrations were assessed in anastomoses sits on postoperative days 3, 5, 7, and 14. RESULTS: Rabbits in VEGF + FG group had the lowest incidence of leakage (P < 0.05). Histological evaluations revealed that granulation tissue was formed on days 5 after anastomosis; fibroblast proliferation and capillary vascular proliferation were significantly increased on days 7 and 14 in VEGF + FG group. Furthermore, there was a statistically significant difference in the mean bursting pressures between VEGF + FG group and other groups on days 7 and 14 (P < 0.05), and rabbits in VEGF + FG group exhibited a higher concentration than VEGF group (P < 0.05) and FG group (P < 0.05) on day 14. CONCLUSION: Administration of VEGF165 mixed with FG to ileal anastomosis accelerates wound healing and enhances the anastomosis by increased angiogenesis.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Anastomotic Leak ; Animals ; Capillaries ; Delayed-Action Preparations ; Female ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibroblasts ; Granulation Tissue ; Humans ; Hydroxyproline ; Ileum ; Incidence ; Male ; Rabbits ; Sodium Chloride ; Vascular Endothelial Growth Factor A* ; Wound Healing

Objective To observe the clinical effect of monosialotetrahexosyl ganglioside sodium injection (GM1) on spastic cerebral palsy. Methods 98 children with spastic cerebral palsy were randomly divided into control group (n=50) and treatment group (n=48). Both groups received Bobath approach, and the treatment group received GM1 in addition. They were assessed with Functional Independence Measure for Children (WeeFIM), Gross Motor Function Measure (GMFM) and Gesell Development Schedule (GDS) before and after 90 days of treatment. Results The scores of WeeFIM, all the dimensions of GMFM and the gross motor, fine motor, personal-social and adaption of the GDS improved in both groups after treatment (P<0.05), and improved more in the treatment group than in the control group (P< 0.05). Conclusion GM1 may further improve the recovery of function for children with spastic cerebral palsy.

Objective To investigate the value of ultrasound elastosonography in the diagnosis of liver fibrosis. Methods One hundred and twenty patients with chronic hepatitis B were examined by ultrasound elastosonography and given elasticity scores,the correlation coefficient between the elasticity scores and the histologic fibrosis stage was evaluated and its difference in the diagnosis of liver fibrosis was compared. Results The Spearman's correlation coefficient between the elasticity scores and the histologic fibrosis stage was 0. 875,which was highly significant ( P＜0. 01). There was no significantly difference between elasticity scores and fibrosis staging in the diagnosis of liver fibrosis by Marginal Homogeneity (Z=- 1. 144, P = 0. 149). The sensitivity,specificity and accuracy of ultrasonic elastography for diagnosing liver fibrosis were 92. 5%, 85.0%, 90.0%, respectively. Conclusions Elastosonography is helpful for the diagnosis of liver fibrosis.

Objective To find out the valuable ultrasonographic features for differentiating benign and malignant thyroid solitary nodular, and to apply the binary Logistic regression model in analysis of ultrasonography of thyroid solitary nodular. Methods Two-dimensional ultrasonography was performed in 194 patients with thyroid solitary nodular confirmed with surgical pathology. A Logistic model was obtained on the basis of ultrasonographic features. A receiver operator characteristic (ROC) curve was constructed to assess the performance of the Logistic model. Results Three ultrasonographic features including shape, calcification and heterogeneous texture were finally entered into the Logistic model. The percentage of correct prediction was 91.75%. The area under ROC curve was 0.916±0.035. Conclusion The binary Logistic regression can select the valuable indexes in the differential diagnosis of thyroid solitary nodular. The application of binary Logistic regression model can improve the diagnosis accuracy of thyroid solitary nodular.

Objective To evaluate the value of grey scale ultrasonography (US) combined with elastography in the difference diagnosis of benign and malignant thyroid lesions. Methods Sixty-two patients with 81 lesions were examined by grey scale US and elastography preoperatively. All the lesions were confirmed by pathology. According to their features of grey scale ultrasonograms and elastograms, two receiver operating characteristic (ROC) curves were drawn, one for gray ultrasound and one for the combination methods. The area under curve (AUC) of them were made a comparison. Results The cut-off value of the grey scale group was equal or more than 5, the sensitivity,specificity was 60. 0% ,98. 5%. And the cut-off value of grey scale US combined with elastography group was equal or more than 6, the sensitivity, specificity was 80.0%, 89.4%. The AUC of grey scale US was 0.860 and that of the combination group was 0. 916. The difference between them was statistically significant Z = - 7. 863, P = 0. 000). Conclusions The grey scale US combined with elastography could improve sensitivity and decrease omission diagnose rate. It may be more helpful in the difference diagnosis of malignant from benign thyroid lesions.

The fabrication and experimental test results were presented for a micro-electro-mechanical systems (MEMS)-based gas chromatography column. Compared with conventional column, this micro-gas chromatography column is suitable for on-line analysis and monitoring because of the small size, rapid analysis and other characteristics. These 0.5, 1 and 3 m GC columns were fabricated using a deep reactive-ion etching (DRIE) and were coated the stationary phase via a dynamic coating procedure. These GC columns perfectly separated the mixture of benzene, toluene and o-xylene in less than 200 s, where, the 3.0 m of the GC column achieved) a high resolution of 14.3 between toluene and o-xylene and yielded approximately 6160 plates. Moreover, the effect of separation performance for different column length were examined and compared. These GC columns are suitable for the application of a variety of disciplines, including environmental analysis, methane gas probes and homeland security.