Objective:To research the efficacy and safety of robotic thyroidectomy and bilateral modified radical neck dissection through bilateral axillo-breast approach (BABA) .Methods:We retrospectively analyzed the clinical data of 37 patients with thyroid cancer who received bilateral modified radical neck dissection through the BABA at the Department of Thyroid and Breast Surgery of the 960th Hospital of the People’s Liberation Army from Jan. 2014 to Jan. 2023. There were 24 females and 13 males, and the average age of the patients was (33,22±10.53) years old. The tumor diameter, number of lymph node dissection and metastasis in the central and lateral regions, average operation time, average hospital stay, complications, and aesthetic score were recorded. SPSS 25.0 software was used for statistical analysis, and the measurement data was calculated using mean ± standard deviation ( ± s), and the counting data was expressed in percentages and numbers. Results:A total of 37 thyroid cancer patients underwent robotic bilateral regional lymph node dissection. The 37 patients received total thyroidectomy, bilateral central compartment and cervical lateral regional lymph node dissection. All the pathological types were papillary carcinoma, with a maximal tumor diameter of (1.47±0.85) cm. The average number of central lymph nodes dissected was 19.46±8.84, and there were (10.24±5.95) metastases; The average number of lymph nodes removed from the bilateral cervical region was 38.92±14.21, and there were (7.92±5.84) metastases. The average operation time was (288.05±77.09) min, the average length of stay in the hospital was (10.76±3.92) days, and the average length of stay in the hospital following surgery was (8.03±2.08) days. These patients had no permanent hypoparathyroidism, permanent recurrent laryngeal nerve palsy, infection, accessory nerve injury and phrenic nerve injury after operation. Transient hypoparathyroidism occurred in 15 patients, transient recurrent laryngeal nerve palsy occurred in 1 patient, and chyle leak occurred in 2 patients. One month after surgery, the aesthetic score was 9.51±0.69.Two patients were found lymph node metastases during the (27.81±15.10) months of follow-up, and received robotic cervical lymph node dissection with BABA.Conclusion:For carefully chosen thyroid cancer patients with bilateral lateral cervical region lymph node metastases, robotic bilateral cervical lymph node regional dissection via BABA is safe and feasible, and good cosmetic results can be obtained.

A convolutional neural network-based algorithm is proposed for calculating lower limb joint angle in X-ray films.After identifying the region of interest of a specific category in X-ray films through Yolov5 object detection model,U-Net model is used to perform heat map regression for identifying the key feature points,and then the lower limb joint angle is calculated.The results show that the proposed algorithm has higher accuracy than the previous algorithms and can obtain accurate and reliable results,providing references for clinical research and practice.

Objective To compare the clinical efficacy and safety of carbon dioxide (CO2) versus high-frequency electroacupuncture based on the assistance of drilling and blunt dissection in the treatment of steatocystoma multiplex.Methods A randomized,self-controlled study was performed in 15 patients.The median line of the body served as the dividing line,and the lesions on the two sides of the median line of the body were randomly divided into 2 groups to be treated with CO2 laser or high-frequency electroacupuncture,which left micropathways into the cyst cavity.After the above treatment,contents in the cysts were squeezed out or drawn out with a mosquito clamp,and the cysts were bluntly dissected.The decrustation time,erythema subsiding time,adverse reactions and recurrence were compared among lesions at different sites or with different sizes.Results For the lesions at the same sites or with similar sizes after treatment,the decrustation time and erythema subsiding time were both significantly shorter in the CO2 laser group than in the high-frequency electroacupuncture group (both P ＜ 0.05).There were significant differences in the decrustation time and erythema subsiding time among lesions at different sites or with different sizes (all P ＜ 0.05).Mild pain occurred in the 2 groups,and no hematoma or secondary infection occurred.There were significant differences in the incidence of scar formation or pigmentation between the 2 groups (both P ＜ 0.05).During the follow-up of 6-18 months,relapse occurred in 1 patient in each group.Conclusion Compared with the high-frequency electroacupuncture,CO2 laser assisted by drilling and blunt dissection shows better efficacy in the treatment of steatocystoma multiplex,and it can remove lesions at various sites at one time.

Objective To evaluate the role of phosphatidylinositol 3-kinase (PI3K)/protein-serinethreonine kinases (Akt) signaling pathway in dexmedetomidine postconditioning-induced reduction of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Seventy-two healthy male Sprague-Dawley rats,aged 4-5 months,weighing 200-240 g,were heparinized and anesthetized with intraperitoneal pentobarbital sodium 40 mg/kg.Their hearts were rapidly excised and perfused in a Langendorff apparatus with oxygenated (95％ O2-5％ CO2) K-H solution at 0-4℃.The isolated hearts were randomly divided into 6 groups (n =12 each):control group (group C),group I/R,dexmedetomidine postconditioning group (gruop D),solvent group (group DMSO),PI3K inhibitor LY294002 group (group L) and LY294002 + dexmedetomidine postconditioning group (group L + D).After a 20 min stabilization period,the hearts were continuously perfused with K-H solution for 120 min in group C and were subjected to 30 min of global no-flow ischemia followed by 90 min of repeffusion in the other groups.Dexmedetomidine 100 nmo/L was added during the initial 30 min of reperfusion in D and L + D groups.LY294002 15 μmol/L was added in L group.0.02％ DMSO containing 15 μmol/L LY294002 was added in L + D group.0.02％ DMSO was added in DMSO group.HR,left ventricular end-diastolic pressure,left ventricular developed pressure and ± dp/dtmax were recorded at the end of 20 min stabilization and 15,30 and 90 min of reperfusion.The expression of phosphorylated Akt (p-Akt) and Akt was measured at 30 min of reperfusion.Myoeardial infarct size was determined using TTC staining at 90 min of reperfusion.Results Compared with group C,HR,left ventricular developed pressure and ± dp/dtmax were significantly decreased,and left ventricular enddiastolic pressure and myocardial infarct size were increased in the other 5 groups,and the expression of p-Akt was significantly up-regulated in group D (P ＜ 0.05).Compared with group I/R,HR was significantly decreased at 15 and 30 min of reperfusion,the expression of p-Akt was up-regulated,and myocardial infarct size was decreased in group D (P ＜ 0.05).Compared with group D,the expression of p-Akt was down-regulated,and myocardial infarct size and HR was increased in L + D group (P ＜ 0.05).Conclusion Dexmedetomidine postconditioning attenuates myocardial I/R injury throuth activating PI3K/Akt signaling pathway in rats.

Objective To analysis the influence factors of standardization in the hierarchical chain management of type 2 diabetes and to enhance the hierarchical chain management of type 2 diabetes.Methods ( 1 ) Six hundred and ninty patients with type 2 diabetes completed 1 years management were divided into well-controlled glycosylated hemoglobin ( HbAlc ) group (＜7.0％ ) and bad-controlled glycosylated hemoglobin (HbAlc) group ( ≥ 7.0％ ).The conditions of diet,physical activity,medication,self-blood sugar monitoring and participation in health seminars were investigated and analyzed.(2) The patients were divided into standardized management group and not standardized management group.Their age,sex,educational background,occupation,monthly income per person,medical security,the course,cognition for glycuresis,two-way transfer,and chronic complications were investigated and statistically analyzed.Results ( 1 ) The proportions of physical activity (70.1％ vs 54.2％,x2=6.163,P=0.018),self-blood sugar monitoring(60.4％ vs 43.8％,x2=6.268,P=0.016) and participation in health seminars (56.0％ vs 41.7％,x2=4.577,P=0.045) in the well-controlled HbAlc group were significantly higher than those in the bad-controlled HbAlc group.(2) Their age [(61.08 ±10.04) years old vs ( 57.75 ± 9.89 ) years old,t=2.539,P=0.012],educational background ( ratio of low educational attainment:8.3 ％ vs 17.2％,x2=6.426,P=0.041 ),medical security (own expense ratios:4.6％ vs 11.5％,x2=3.543,P=0.048 ),awareness of diabetes ( ratio of poor awareness of diabetes:19.4％ vs 41.0％,x2=17.518,P=0.000 ),two-way transfer ( ratio of not transfer treatment:4.6％ vs 14.8％,x2=7.662,P=0.022) and chronic complications ( ratio of chronic complication:41.7 ％ vs 26.2％,x2=6.130,P=0.017) were significantly different between the standardized management group and not standardized management group.(3) Logistic regression analyses indicated that the age ( OR=0.954,P=0.006),monthly income per person ( OR=4.101,P=0.018 ),medical security ( OR=7.617,P=0.003 ),cognition for glycuresis ( OR=0.030,P=0.000),two-way transfer ( OR=9.079,P=0.000) and chronic complications ( OR=0.456,P=0.031 ) were the risk factors of standardized management.Conclusion We should focus on the impact factors affecting the standardized management of patients including age,monthly income per person,medical security,awareness of diabetes,ratio of not transfer treatment,positive strategies for chronic complications,improve the hierarchical chain management of type 2 diabetes,and then make the diabetic patients to early participate in standardization management of diabetes mellitus and delay the appearance of complications.

Objective To explore the hierarchical chain management model in blood glucose control and its influence factors in patients with diabetes mellitus.Methods Health management database of diabetic patients was established in 2007 and managed by hierarchical chain management.The number of the patients reached to 1010 till 2011.The blood glucose control of diabetic patients was analyzed and its influence factors were analyzed by multivariate unconditional Logistic regression method.Results The concentration of glycosylated hemoglobin( HbA1c ) of 1010 patients with type 2 diabetes was (8.21 ±:2.70)％.Four hundred and eighty-seven cases (48.22％) reached the blood glucose standard,303 cases (30.00％)reached the blood pressure standard,245 cases (24.26％) reached the blood lipids standard,and 76 cases (7.52％) reached all three standards.Multivariate analysis showed that occupation (OR =2.521,95％ CI:1.871 - 3.397),education level (OR =1.890,95％ CI:1.642 - 2.174),disease course (OR =1.035,95％CI:1.016 -1.055),systolic pressure (OR =1.016,95％ CI:1.007 -1.025) and triglyceride (OR =1.204,95％CI:1.063 - 1.365) were the risk factors of blood glucose control (P ＜0.01).Conclusions Hierarchical chain management model is helpful for the blood glucose control in patients with type 2 diabetes.The comprehensive control and treatment of type 2 diabetes should be taken combined with related risk factors,such as blood pressure,blood lipids and diabetes disease course.

Objective To explore the hierarchical chain management model of type 2 diabetes and determine its evaluation.Method Based on the hierarchical chain management of the three community health service institutions and Dahua hospital in Shanghai Xuhui district,215 cases of type 2 diabetes had been involved in the study.Results Compared with the baseline before management,lasting blood glucose (FBG),2 h postprandial glucose (2hPBG),glycosylated hemoglobin (HbA1c),low density lipoprotein cholesterol (LDL-C),systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the diabetes after 12 months' management declined [(8.50 ±2.81) mmol/L,(11.09 ±4.01) mmol/L,(8.56 ±2.41)% ,(3.31 ± 1.06) mmol/L,(139.06 ±20.68) mm Hg (1 mm Hg = 0.133 kPa),(78.20 ± 12.11) mm Hg vs.(7.41 ±2.04) mmol/L,(9.03 ±2.46) mmol/L,(7.34 ± 1.59)% ,(3.00 ± 1.06) mmol/L,(135.48 ± 17.82) mm Hg,(77.27 ±11.83) mm Hg],and the differences were statistically significant(P＜0.01 );control rate of FBG,2hPBG,HbA1c,LDLC,SBP,DBP had improved significantly [19.5% (42/215),20.9% (45/215),24.7%(53/215),20.0%(43/215),27.4%(59/215),30.2%(65/215) vs.50.7%(109/215),53.0% (114/215),54.0%(ll6/215),42.3%(91/215),47.0%(101/215),45.6%(98/215)](P＜0.01).Conclusion Primary and secondary-care hospital based hierarchical chain management model is valid and can be implemented for type 2 diabetes.

A series of novel biodegradable and bionic functional polymers, PLLA-PC-PLLA, were synthesized using L-lactide ring-opening polymerization by L-a-Glycerophosphorylcholine (PC) from nature source. The hydrophilicity of the polymers was investigated. The results made known that, as PC group was brought into the backbone of PLLA, PLLA-PC-PLLA gained much better hydrophilicity than did PLLA, and polar phosphatidylcholines probably transferred to the sample surface in aqueous environment. The relative growth ratios of ECV304 cells to the lixivium of all PLLA-PC-PLLA were higher than 84% in 5 d culture. The cells adhesion of ECV304 on the films of PLLA-PC-PLLA lagged as compared to that on PLLA, but they could proliferate and cover the films in total. The difference between PLLA-PC-PLLA and PLLA was due to the existence of PC group. Thus, PLLA-PC-PLLA, the same as PLLA, are not cytotoxic, and ECV304 can attach and proliferate on them. PLLA-PC-PLLA have potential applications in the fields of tissue engineering and drug delivery system.
Cell Adhesion ; physiology ; Drug Carriers ; Endothelial Cells ; cytology ; Humans ; Hydrophobic and Hydrophilic Interactions ; Lactic Acid ; chemistry ; pharmacology ; Phosphorylcholine ; chemistry ; pharmacology ; Polyesters ; Polymers ; chemistry ; pharmacology ; Surface Properties ; Tissue Scaffolds ; Umbilical Veins ; cytology

This study was undertaken to elucidate the degradation regularity of calcium polyphosphate (CPP) scaffolds with different preparation parameters. CPP scaffolds with different main crystalline phases were prepared by controlling the particle size of the calcining stuff and the calcining heat. Specimens were soaked into Tris-buffer solution and simulated body fluid (SBF) for 60 days. Results show: alpha-CPP degrades faster than does beta-CPP, and beta-CPP degrades faster than does gamma-CPP; the lower the sinter temperature, the better the degradation of CPP morever, the degradation rate of CPP is inversely proportional to the original particle size. These data suggest that crystal type, sinter temperature and particle size influence the degradation rate of CPP markedly.
Absorbable Implants ; Biocompatible Materials ; chemistry ; Bone Substitutes ; chemistry ; Calcium ; chemistry ; Calcium Phosphates ; chemistry ; Ceramics ; chemistry ; Polymers ; chemistry ; Polyphosphates ; chemistry ; Tissue Scaffolds ; chemistry

Self-assembly of peptides is ubiquitous in the body of creatures. The molecules of peptides combine with each other to form proteins with different functions through self-assembly. The formation of a specific conformation of one type of protein is owing to the self-assembly of its compositive amino acids. So, researchers can design self-assembly of peptides at the molecular level and can control its formation and configuration. It has the potential for application in the preparation of new medicines and biomaterials. In recent years, self-assembling peptides have been increasingly high-lighted and used to simulate the function of natural biomolecules, to synthesize peptide-medicine, and to serve as the carriers of medicine.
Biocompatible Materials ; chemical synthesis ; Molecular Conformation ; Nanotechnology ; methods ; Peptides ; chemistry ; Protein Engineering ; methods