Objective:To prepare liquid-gas phase modified nanoparticles (TMZ/PFP/PLGA NPs) of perfluoropentane (PFP) and temozolomide (TMZ) encapsulated by polylactic-glycolic acid copolymer (PLGA), combined with low intensity focused ultrasound (LIFU) irradiation, and to investigate its ultrasound imaging ability and intervention effect on human glioma cells in vitro.Methods:TMZ/PFP/PLGA NPs were prepared by compound emulsion method. The basic physical and chemical properties and drug loading ability of TMZ/PFP/PLGA NPs were detected. CCK-8 assay was used to detect the cytotoxicity of nanoparticles in vitro and the effect of synergistic intervention with LIFU on the survival rate of glioma cells. The expression levels of apoptosis related proteins Bcl-2, Bax and caspase-3 were detected by Western blot.Results:Under transmission electron microscope, TMZ/PFP/PLGA NPs showed a circular core-shell structure with regular morphology, particle size was (137.9±63.31)nm, encapsulation efficiency of TMZ was (83.01±5.57)%, drug loading was (3.19±0.22)%. The survival rate of U251 cells was still above 70% after 24 hours of co-incubation with nanoparticles. Under the synergistic effect of LIFU irradiation, the apoptosis of U251 cells was accelerated and the survival rate of U251 cells was significantly decreased. The results of Western blot showed that the synergic intervention could significantly down-regulate the expression of apoptosis related protein Bcl-2, and significantly up-regulate the expression of Bax protein and caspase-3 protein (all P<0.05). Conclusions:TMZ/PFP/PLGA NPs have good basic physical and chemical properties. TMZ/PFP/PLGA NPs have low cytotoxicity in vitro while efficiently loading chemotherapeutic drug timozolomide. Synergistic intervention under LIFU irradiation can significantly accelerate the apoptosis of U251 glioma cells, which has a good application prospect.

Differentiated thyroid cancer is one of the most common endocrine malignant tumors, and thyroidectomy is its basic treatment measures. Insufficient attention is paid to its postoperative bone hungry syndrome and parathyroid hyperfunction or hyperparathyroidism, which will seriously affect the patient’s life quality and prognosis. This paper will explore the etiology, dangers, diagnosis, prevention, and treatment for hungry bone syndrome, parathyroid hyperfunction and hyperparathyroidism of thyroid cancer patients after thyroidectomy.

Objective:To evaluate the clinical feasibility, safety, and advantages of small lateral cervical incision for parathyroid exploration and resection.Methods:A total of 31 consecutive patients who underwent parathyroidectomy with a small lateral cervical incision, in the Department of Endocrinology and Breast Surgery of the First Affiliated Hospital of Chongqing Medical University from Apr. to Nov. 2021, including 11 males and 20 females, aged (49.32±13.79) years, ranging from 28 to 86 years, were selected to make retrospective statistical analysis of the surgical time, hospital stay, intraoperative blood loss, postoperative drainage and postoperative complications of the patients. All patients were injected with carbon nanoparticles suspension injection guided by color ultrasound to locate the enlarged parathyroid gland before surgery. EXCEL 2019 software was used for statistical analysis.Results:Thirty-one patients underwent parathyroidectomy through a small lateral cervical incision. Primary hyperparathyroidism was performed in 19 cases (including 2 cases with bilateral small lateral cervical incision, 2 cases with unilateral excision of thyroid mass combined with parathyroidectomy, 1 case with resection of huge parathyroid adenoma, and 1 case with local anesthesia) . Twelve patients with secondary hyperparathyroidism underwent total parathyroidectomy through bilateral small lateral cervical incision and forearm autogenous parathyroid transplantation (including bilateral thyroid mass resection combined with bilateral total parathyroidectomy and forearm autogenous parathyroid transplantation in 2 cases, local anesthesia and cervical plexus nerve block in 2 cases, and ectopic parathyroid gland in thyroid in 1 case) . Among them, the average operative time of patients with primary hyperparathyroidism was (54.74±27.71 & 74.14±31.73) min, the average intraoperative blood loss was (8.11±5.05 & 14.43±10.94) ml, the average postoperative drainage was (14.37±24.64 & 26.36±32.87) ml, the average postoperative parathyroid hormone was (11.59±16.46 & 26.65±56.38) pg/ml, the average hospital stay was (10.00±5.09 & 10.96±4.55) d, and the postoperative complication rate was (3.2% & 0%) .Conclusions:Parathyroid gland exploration and resection through small lateral cervical incision is a safe and effective surgical method and can also complete thyroid exploration and parathyroidectomy at the same time. Appropriate anesthesia should be selected after a full assessment of the patient’s basic condition.

Metabolic-dysfunction associated fatty liver disease (MAFLD) is a common concomitant disease of breast cancer. It is one of the main causes of liver damage during chemotherapy and also an important cause of liver damage during endocrine therapy or follow-up, which seriously affects the quality of life and prognosis of breast cancer patients. Nonalcoholic fatty liver disease was renamed as MAFLD, which changed the original "exclusive diagnosis" to "inclusive diagnosis" and the non-negligible role of metabolic factors in the occurrence and development of fatty liver disease was recognized, but the clinical attention is not enough at present. More attention should be paid to the diagnosis and treatment of MAFLD in breast cancer patients because the proportion and risk of metabolic disorders are higher than that in general people. In this article, we will focus on the clinical significance, prevention and treatment of the new definition of MAFLD in the comprehensive management of concomitant diseases of breast cancer, so as to further improve the quality of life and prognosis of breast cancer patients.

With the development of various laboratory testing techniques such as serum calcium and parathyroid hormone (PTH) , a large number of asymptomatic or normocalcemic primary hyperparathyroidism (PHPT) can be diagnosed early. PHPT has become the third most common endocrine disease affecting human health. Currently, most PHPT, especially normocalcemic primary hyperparathyroidism, are not primary diseases and may be related to vitamin D deficiency/insufficiency and/or insufficient calcium supplementation. That is, the relative hypocalcemia caused by long-term vitamin D deficiency/insufficiency and/or insufficient calcium supplementation leads to parathyroid hyperfunction, stimulates parathyroid hyperplasia, and secretes excessive parathyroid hormone to compensate for the regulation of calcium and phosphorus balance. When it is in the initial reversible stage, it can be cured by internal medicine; if it progresses freely, long-term hypocalcemia stimulation will lead to excessive parathyroid hyperplasia and even tumor occurrence with the formation of so-called PHPT and parathyroidectomy has to be performed. Therefore, routine screening of bone mineral density, calcium, magnesium, phosphours, 25-hydroxyvitamin D, parathyroid hormone and other bone metabolism indicators in the physical examination of general population is beneficial to the prevention and treatment of bone metabolism diseases, urinary stones and hyperparathyroidism. At the same time, attention should be paid to identifying the stage of prehyperparathyroidism in which vitamin D deficiency/insufficiency and insufficient calcium supplementation will stimulate parathyroid hyperfunction. Active intervention on prehyperparathyroidism is an effective way to avoid the development of primary hyperparathyroidism.

Hyperparathyroidism is a common endocrine disease that seriously affects human health, depending on its etiology, which can be divided into three types: primary, secondary and tertiary. In clinical practice, we found that some primary hyperparathyroidism may be secondary or tertiary hyperparathyroidism caused by insufficient calcium intake and/or vitamin D deficiency/insufficiency, and become a common type of hyperparathyroidism. The daily calcium intake of Chinese people is generally insufficient. Vitamin D can promote the absorption of calcium, but vitamin D deficiency/insufficiency is also a worldwide public health problem. Long-term hypocalcemia will stimulate parathyroid hyperplasia and secrete excessive parathyroid hormone, resulting in parathyroid hyperfunction (pre-hyperparathyroidism) and then secondary hyperparathyroidism, both of which may damage bone and release calcium into blood, leading to diseases of multiple organs and tissues. The detection of bone metabolism indexes such as calcium, magnesium, phosphorus, parathyroid hormone and vitamin D may be helpful for the early diagnosis of pre-hyperparathyroidism and hyperparathyroidism. Supplementation of calcium and vitamin D in early stage can control the development of the disease and change "unpreventable and uncontrollable" into "preventable and controllable" . The health screening of bone metabolism indexes and parathyroid ultrasonography should be advocated, and the prevention and treatment of calcium and/or vitamin D insufficiency associated parathyroid hyperfunction and hyperparathyroidism should be strengthened, so as to greatly improve the bone health, urinary calculus, metastatic vascular calcification and systemic abnormal calcium migration and precipitation in the population.

Vitamin D deficiency can be a trigger factor for recurrent oral ulcers. This article combining two cases of recurrent oral ulcers in patients with vitamin D deficiency who were cured by active vitamin D supplementation emphasizes that 25-hydroxyvitamin D and other indicators should be screened in patients with recurrent oral ulcers, so as to improve the understanding of the disease and the ability of clinical diagnosis and treatment for it.

In Oct. 2016, the Central Committee of the Communist Party of China and the State Council issued the "Outline for Healthy China 2030" , which planned to achieve chronic disease management for the entire population and the overall 5-year survival rate of cancer increasing by 15% by 2030. In Jan. 2019, the "2618 Glycolipid Project" was launched, which promoted the comprehensive management of blood glucose, blood pressure and blood lipids in the grassroots. Breast cancer is the most common malignant tumor in women. With the improvement of its diagnosis and treatment, most of the patients survive for a long time in a state of chronic disease. Diabetes, dyslipidemia, and hypertension have a higher prevalence in breast cancer patients, and are most common concomitant diseases of breast cancer. Breast cancer patients also have a higher proportion of carotid plaques and carotid intima thickening. However, there is no obvious symptoms, and there is a lack of clinical understanding of its harm, which will inevitably affect the treatment and prognosis of breast cancer patients. This article will explore the significance and implementation of "2618 Glycolipid Project" in the management of patients with breast cancer, in order to further improve the life quality and the prognosis of breast cancer patients.

Vitamin D deficiency/insufficiency has become a worldwide public health problem, especially in breast cancer patients. Vitamin D is a fat-soluble vitamin necessary for human body, which has important physiological functions such as regulating calcium and phosphorus metabolism and affecting cell proliferation and differentiation. Vitamin D deficiency/insufficiency is closely related to the occurrence of bone diseases and various extra-bone diseases, and is also a risk factor for the occurrence, development and poor prognosis of breast cancer. Vitamin D deficiency/insufficiency and low blood calcium are the main cause of enhanced parathyroid function or secondary hyperparathyroidism, but are often overlooked due to the absence of early clinical manifestations. Bone problems of breast cancer patients are more obvious than those of general population because of the systemic treatment such as chemotherapy and endocrine therapy and changes in menstrual state, and vitamin D deficiency and secondary hyperparathyroidism will further aggravate their bone health problems. Therefore, it is necessary to strengthen the monitoring of blood calcium, parathyroid hormone and bone metabolism indicators in breast cancer patients, so as to make targeted supplementation of vitamin D and calcium. We should pay attention to the prevention and treatment of vitamin D deficiency/insufficiency associated hyperparathyroidism and bone health problems to improve the quality of life and prognosis of patients.

Objective:To explore the short-term effect of arthroscopic posterior suture of the glenoid labial capsule in the treatment of recurrent posterior subluxation (RPS) of shoulder joint.Methods:A retrospective study was conducted on 16 RPS patients who had undergone arthroscopic posterior glenoid capsule folding suture from January 2016 to December 2018, including 12 males and 4 females, with an average age of 22 years (range, 18-37 years). 11 had full-thickness posterior glenoid tear (2 with SLAP injury, 7 with posterior capsular laxity), and 5 had partial posterior glenoid tear (5 with posterior capsular laxity). All 16 patients had active shoulder pain and had undergone arthroscopic posterior glenoid capsule folding suture with suture anchors. After surgery, shoulder abduction was fixed with a sling for 6 weeks to prevent internal rotation of the shoulder; full range of active and passive activities were performed 2-3 months after surgery, and normal movement was resumed 6 months after surgery. Shoulder function was assessed using the American Society of Shoulder and Elbow Surgery (ASES) score and the University of California at Los Angeles (UCLA) end-result score, and shoulder stability was assessed using the instability score in the ASES score.Results:All 16 patients were followed up for 19 months (range, 12-36 months). The shoulder instability score was reduced from 7.6±1.6 preoperatively to 2.0±1.2 postoperatively ( t=5.562, P< 0.001); the ASES score was improved from 45.9±9.8 preoperatively to 85.8±6.1 ( t=39.937, P< 0.001); the pain score was increased from 18.9±5.4 preoperatively to 40.9±4.2 ( t=22.063, P< 0.001); the daily life score was improved from 27.0±7.8 preoperatively to 44.9±3.4 ( t=17.875, P< 0.001), and the UCLA score was improved from 16.1±4.5 preoperatively to 31.9±2.6 ( t=15.813, P< 0.001). One patient had pain during boxing 12 months after surgery, and all patients had significant improvement in shoulder weakness and instability. No patient had instability recurrence. Magnetic resonance showed sutured posterior labrum tearhealed. Conclusion:Arthroscopic posterior glenoid capsule folding suture can repair the labrum injury and restore the tension of the posterior capsule. The glenoid capsule complex healed can increase the posterior obstruction of the scapula. This method can effectively treat RPS with good short-term efficacy.