Postoperative thyroid scar not only causes itching, pain, and pulling, but also seriously affects the patient’s aesthetics, so it is important to study the prevention and treatment of postoperative thyroid scar. In the past 20 years, clinicians have made many innovative researches to alleviate postoperative thyroid scar growth, and the following progresses have been made: firstly, thyroid surgery methods and surgical accesses have been improved to a certain extent, resulting in more concealed and less traumatic accesses; secondly, the use of lasers and silicone and other drugs has significantly improved the scar treatment effect; thirdly, the concept of "cosmetic" is gradually gaining popularity, and related technical means are used throughout the treatment of postoperative scarring of the thyroid gland, and multiple treatment modalities are used "early" and "in combination" to "prevent" scar growth after surgery. The use of multiple treatment modalities to prevent scar growth in the early postoperative period has achieved twice the result with half the effort.

Objective:To evaluate the clinical efficacy of intra-biliary drainage versus T-tube drainage following laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis.Methods:The clinical data of 50 patients undergoing LCBDE for choledocholithiasis in Dalian Friendship Hospital of Dalian Medical University from January 2018 to October 2022 were retrospectively analyzed, including 23 males and 27 females, aged (61.3±16.2) years old. Patients were divided into the intra-biliary drainage group and T-tube drainage group. Propensity score matching was used to match the baseline data of the two groups at a 1∶1 ratio. The operation time, intraoperative blood loss, postoperative hospital stay, abdominal drainage tube indwelling time, postoperative bile drainage volume and postoperative complications were compared between the groups.Results:Compared with the T-tube group, the operative time [(155.0±36.5) min vs. (194.4±55.8) min], length of postoperative hospital stay [8.0(7.0, 8.0) d vs. 11.0(8.0, 13.0) d], and abdominal drainage tube indwelling time [5.0(4.0, 6.0) d vs. 6.0(5.0, 8.0) d] were all shorter in the intra-biliary drainage tube group (all P<0.05). The postoperative bile drainage volume was reduced [0 ml vs. 431.4(344.7, 484.3) ml]. No postoperative bile leakage occurred in either group. The intraoperative blood loss, proportion of postoperative residual stone, stone recurrence and biliary stricture were comparable between the two groups (all P>0.05). Conclusion:Intra-biliary tube drainage following LCBDE could be safe and effective for choledocholithiasis. Compared to the classic procedure of T-tube drainage, it may be superior in the operation time, postoperative hospital stay, abdominal drainage tube indwelling time, postoperative bile drainage volume.

Objective To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). Methods The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed. RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine. The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared. The t test was used for comparison of normally distributed continuous data between groups. Results There were eight males (88.9%) and 1 female enrolled. The patients aged 28-77 years old, with an age of (52.9±18.0) years. By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition. All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset). The white blood cell counts ((13.52±8.24)×10 9 /L vs (10.49±4.46) ×10 9 /L), C-reactive protein ((139.71±87.46) mg/L vs (78.60±55.40) mg/L) and procalcitonin ((2.32±4.03) ng/mL vs (0.28±0.58) ng/mL) , lactic acid ((3.70±4.14) mmol/L vs (2.33±0.53) mmol/L) in deteriorated group were all significantly higher than those in improved group ( t =2.908, 5.009, 4.391 and 2.942, respectively, all P <0.01). A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death. Conclusion Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases.

Protein lysine methylation is a prevalent post-translational modification (PTM) and plays critical roles in all domains of life. However, its extent and function in photosynthetic organisms are still largely unknown. Cyanobacteria are a large group of prokaryotes that carry out oxygenic photosynthesis and are applied extensively in studies of photosynthetic mechanisms and environmental adaptation. Here we integrated propionylation of monomethylated proteins, enrichment of the modified peptides, and mass spectrometry (MS) analysis to identify monomethylated proteins in Synechocystis sp. PCC 6803 (Synechocystis). Overall, we identified 376 monomethylation sites in 270 proteins, with numerous monomethylated proteins participating in photosynthesis and carbon metabolism. We subsequently demonstrated that CpcM, a previously identified asparagine methyltransferase in Synechocystis, could catalyze lysine monomethylation of the potential aspartate aminotransferase Sll0480 both in vivo and in vitro and regulate the enzyme activity of Sll0480. The loss of CpcM led to decreases in the maximum quantum yield in primary photosystem II (PSII) and the efficiency of energy transfer during the photosynthetic reaction in Synechocystis. We report the first lysine monomethylome in a photosynthetic organism and present a critical database for functional analyses of monomethylation in cyanobacteria. The large number of monomethylated proteins and the identification of CpcM as the lysine methyltransferase in cyanobacteria suggest that reversible methylation may influence the metabolic process and photosynthesis in both cyanobacteria and plants.
Bacterial Proteins/metabolism* ; Lysine/metabolism* ; Methyltransferases/metabolism* ; Photosynthesis ; Protein Processing, Post-Translational ; Synechocystis/growth & development*

To establish the UPLC fingerprint of Zhongyi Angong Niuhuang Pills, in order to evaluate its quality by chemical pattern recognition. The method was developed on a column of Poroshell 120 EC-C_(18), with methanol-0.1% formic acid solution as the mobile phase for gradient elution at a flow rate of 0.4 mL·min~(-1). The column temperature was 30 ℃,and the detective wavelength was 254 nm. The similarity of 24 batches of Angong Niuhuang Pills was compared by using Traditional Chinese Medicine Chromatographic Fingerprint Similarity Evaluation System(2004 A). Hydrophobic cluster analysis,principal components analysis and partial least squares discriminant analysis were conducted by using SIMCA 13.0 software to investigate different components among these products. The UPLC characteristic fingerprint was established in this study. And 17 common peaks were identified by standard reference and UPLC-MS. The similarity of 24 batches samples were above 0.980,which can be classified into three categories for pattern recognition. Baicalin,berberine,jatrorrhizine,wogonin and wogonoside were identified as the main markers that cause differences of various batches. The method is simple,rapid,accurate and reproducible,and can provide scientific basis for improving the quality standard of Zhongyi Angong Niuhuang Pills.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Tandem Mass Spectrometry

OBJECTIVE: To explore clinical efficacy of bridge-link combined fixation system for adult mid-shaft clavicle fractures. METHODS: From January 2016 to August 2016, 28 patients with mid-shaft clavicle fractures were treated by bridge-link combined fixation system, including 15 males and 13 females, aged from 27 to 82 years old with an average of(48.50±15.34) years old; the courses of disease was for 13 to 15 months with an average of (14.17±0.77) months. Fracture healing time and complication were observed, postoperative and postoperative Constant function score of shoulder joint at 1, 3 and 13 months and were compared. RESULTS: All patients were followed up for 13 to 15 months with an average of (14.17±0.77) months. Twenty-eight patients achieved clinical fracture healing without infection, bone un-union, delayed union, breakage of internal fixation and re-fracture after removing of the internal fixation occurred. Fracture healing time ranged from 2.5 to 4 months with (3.05±0.44) months. Postoperative Constant score at 1, 3 and 13 months were 76.57±4.70, 90.75±3.62, 96.07±2.40 respectively, and had significant difference compared with before operation(58.36±4.98). CONCLUSIONS Bridge-link combined fixation system could be used as a new internal fixation for adult mid-shaft clavicle fractures, which has advantages of rapid recovery, less complications, and could reduce incidence of breakage of internal fixation, osteoporosis, re-fractures after removing the internal fixation.
Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Clavicle ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo investigate the computer-assisted virtual reduction combined with 3D printing technique as preoperative planning and assess their therapeutic effects.

METHODSThirty-five cases of acetabular fracture treated by internal fixation from March 2011 and March 2014 were retrospectively analyzed. All patients underwent operations with internal fixations implanted. The patients were divided into 2 groups according whether they used the computer-assisted virtual reduction combined with 3D printing technology. Fifteen patients in the digital group included 9 males and 6 females with a mean age of (39.4±8.8) years old ranging from 22 to 58 years old;time from injury to the operation was (8.8±2.0) days;for Letournel-Judet classification, 4 cases were both column fracture, 5 cases were posterior wall fracture, 4 cases were T-fracture, 2 cases were posterior wall with transverse fracture. Twenty cases in the control group included 12 males and 8 females with a mean age of (38.7±13.1) years old ranging from 19 to 59 years old;time from injury to the operation was(8.2±2.3) days;for Letournel-Judet classification, 6 cases were both column fracture, 8 cases were posterior wall fracture, 3 cases were T-fracture, 3 cases were posterior wall with transverse fracture. The volume of intraoperative blood loss and blood transfusion, operative time, satisfaction rate of fracture reduction and excellent and good rate of d`Aubigne Postal function evaluation were compared between the two groups and statistical analysis was conducted.

RESULTSAll the incisions healed without infection occurred. All the fractures healed without breakage or loosening of plates and screws. There was 1 case of postoperative nerve stimulation symptoms in each group. One patient in the digital group was found necrosis of the femoral head at 6 months after operation. One patient in the control group was found heterotopic ossification at 8 months after operation. All patients were follow-up for 13 to 28 months with an average of 17.6 months. The volume of intraoperative blood loss and blood transfusion in the digital group were significantly less than those in the control group(<0.05). The operation time in the digital group was shorter than that in the control group(<0.05). The excellent and good rates of fracture reduction were 92.9%(14/15) and 85%(17/20) in the digital group and the control group respectively, and there was no statistical significance (>0.05). The excellent and good rates of Aubigne Postal function evaluation were 86.7%(13/15) and 80%(16/20) respectively, and there was no significant difference(>0.05).

CONCLUSIONSThe computer-assisted virtual reduction combined with 3D printing technique can reduce the operative time, volume of intraoperative blood loss and blood transfusion in acetabular surgeries for patients with acetabular fractures. The technique is an effective method for preoperative planning, which worth promoting.

In order to prevent the canceration of gallbladder polyps or avoid the misdiagnosis of gallbladder cancer,the mainstream practice is cholecystectomy for polyps larger than 1 cm,while gallbladder polyps larger than 0.5 cm as an indication of gallbladder preserving surgery.The reasons for this result is that we put the diameter of more than 1 cm of gallbladder polyps as high risk factors for prediction of gallbladder carcinoma,and we ignored the characteristics of gallbladder polyps that most of them are not gallbladder cancer or are not cancerous even larger than 1 cm.We analysed the high risk factors for gallbladder cancer on the basis of variety of clinical data,and we believe that the most valuable indicator of gallbladder cancer are the growth time of gallbladder polyps,the age of the patients,the combination of gallstones,the single polyps,and the sex.Polyps diameter greater than 1 cm are not a high risk factor for gallbladder cancer.We can use these five high risk factors to manage gallbladder polyps and reduce unnecessary cholecystectomy and gallbladder preserving surgery.

Objective To study the effect of microscopic observation drug susceptibility assay (MODS)for testing Mycobacteri-um tuberculosis in sputum ,and to evaluate its clinical value .Methods A total of 150 sputum samples were collected from patients with pulmonary tuberculosis ,and Mycobacterium tuberculosis were detected by Lowenstein-Jensen (L-J) method and MODS ,and compared the results of the two methods .Results The concordance rates of the test results of sputum sample between MODS and L-J was 77 .8% .The sensitivity and specificity of MODS were 93 .3% and 70 .0% ,positive predictive value (PPV ) was 60 .8% , negative predictive value (NPV) was 95 .4% ,as well as accuracy by MODS was 77 .8% .Conclusion MODS assay could be used as a rapid tuberculosis detection method ,with rapid ,sensitive ,simple ,and other advantages .

OBJECTIVETo investigate clinical and epidemiological characteristics of hospitalized severe acute respiratory illnesses (SARI) patients under 15 years old registered by sentinel hospitals at 10 cities and risk factors analysis of severe illness.

METHODSThe objects of this study were 2 937 SARI patients under 15 years old registered by sentinel surveillance in internal wards, pediatrics wards and intensive care units (ICU) of 10 sentinel hospitals in 10 cities during the period from December 2009 to June 2014. We also collected case report form (CRF) of them and their throat swabs for influenza testing. The inclusion criteria was hospitalized patients who were admitted by surveillance departments, registered by SARI surveillance system, under 15 years old, meeting SARI case definition and with complete CRF. Rank-sum test was used to compare the difference of age, the duration including from onset to admission, hospital stay and from onset to discharging/death between mild illness and severe illness. Chi-square test was used to compare the difference of demographic characteristics, influenza psoitive rate, vaccination rate of influenza, chronic medical conditions and clinical characteristics between mild illness and severe illness. Logistic regression was used to analysis risk factors associated with severe illness by two stratifications from SARI surveillance protocol (< 2 years old and ≥ 2 years old).

RESULTSAmong 2 937 SARI patients under 15 years old, 97.7% (2 872/2 937) was mild illnesses, and 2.3% (65/2 937) was severe illnesses. 78.8% (2 315/2 937) was under 5 years old. The median ages of severe illness and mild illness were 0.4 and 2.0 years old (U = -6.23, P < 0.001). The proportions of severe illness and mild illness with at least one chronic medical condition were 32.3% (21/65) and 8.4% (240/2 872) (χ² = 45.03, P < 0.001). The positive rate of influenza virus was 6.5% (190/2 937), which was 6.5% (186/2 858) for mild illness and 6.2% (4/65) for severe illness (χ² = 0.08, P = 0.961). The proportion of seasonal influenza vaccination was 1.5% (42/2 853), which was 1.5% (42/2 788) for mild illness and higher than that for severe illness (0) (χ² = 6.09, P = 0.048). For under 2 years old patients, age < 11 months and with at least one chronic medical condition were risk factors for severe SARI illness, and the risk for SARI patients who was 12-23 months and without medical condition was 14.71 (5.35-40.44) and 5.61 (2.96-10.63). For ≥ 2 years old patients, age, with at least one chronic medical condition and seasonal influenza vaccination history have no association with severe illness, OR (95% CI) was 0.92 (0.80-1.05), 0.67 (0.09-5.05) and 0.85 (0.31-2.35), respectively.

CONCLUSIONMost of SARI patients registered by 10 urban sentinel hospitals were patients under 5 years old. Age < 11 months and with at least chronic medical conditions were possible risk factors of severe illness of SARI patients.

Adolescent ; Child ; Child, Preschool ; China ; Chronic Disease ; Cities ; Hospitalization ; Hospitals ; Humans ; Infant ; Influenza, Human ; Orthomyxoviridae ; Respiratory Tract Diseases ; Risk Factors ; Sentinel Surveillance ; Vaccination