Objective:To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (ⅥB compartment) in endoscopic thyroidectomy through gasless axillary posterior approach.Methods:A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data.Results:All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and ⅥB compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. ⅥB compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%).Conclusion:The dissection of ⅥB compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients

In order to understand the characteristics of avian leukosis virus(ALV)infection and the polymorphisms of receptor genes Tva,Tvb and NHE1 sequences in different Qingyuan Ma chick-en breeding farms,the isolation and identification of exogenous ALV virus,receptor gene amplifi-cation and sequencing analysis were carried out in five Qingyuan Ma chicken breeding farms.The results of virus isolation and subtype identification showed that the positive rate of exogenous ALV virus isolation in farms A,B and C was less than 5％,among which there was ALV-J infection alone in farm A,mixed infection with ALV-J and ALV-K in farm B,ALV-K infection a-lone in farm C,and no exogenous ALV infection was detected in farm D and E.Polymorphism anal-ysis of recipient genes showed that there were different frequencies of Tvar3,Tvar4 and Tvbr3 re-sistance alleles in A-E farms,and the distribution frequency of Tvar3 was 0.2-0.6,the distribution frequency of Tvar4 was 0.3-0.7,and the distribution frequency of Tvbr3 was 0.1-0.7.In addition,there were Tvar5 resistance alleles in both B and D farms,with a distribution frequency of 0.2.A to-tal of 18 SNP mutations occurred in the NHE1 receptor gene sequence,and further analysis showed that positions 1 279,1 361,1 369,1 406,1 442,and 1 912 were non-synonymous mutations,which could cause changes in amino acids.The study suggested that there were differences in the exogenous ALV and its subtypes among the five Qingyuan Ma chicken breeders,and each farm should have a more targeted and unique purification strategy.The distribution of Tva and Tvb re-sistance alleles at different frequencies,along with the occurrence of 6 non-synonymous mutations in the NHE1 gene,indicate that Qingyuan Ma chicken have the potential of genetic resistance breeding.

Objective:To explore the regulatory effects of Qinghua Liangxue Huluo Decoction on oxidative stress and inflammation in acute radiation enteritis in rats, as well as its impact on the PI3K/Akt pathway. Methods:A total of 36 SD rats were randomly divided into four groups using block randomization, namely the control, model, low-dose group (6.17 g/kg), and high-dose (24.68 g/kg) groups, with nine rats in each group. These rats were exposed to X-ray irradiation at a dose of 17.5 Gy to induce acute radiation enteritis, followed by continuous intragastric administration for seven days pre- and post-irradiation. Seven days post-irradiation, the perianal and fecal conditions of rats in each group were observed, and rectal tissues were collected and ground. Enzyme-linked immunosorbent assay (ELISA) was employed to assess the activity of superoxide dismutase (SOD), catalase (CAT) expression, and malondialdehyde (MDA) levels indicative of lipid peroxidation. Quantitative real-time polymerase chain reaction (qRT-PCR) was utilized to analyze the mRNA expression of tumor necrosis factor-ɑ (TNF-ɑ), interleukin-6 (IL-6), and interleukin-1β (IL-1β) in the rectal tissues of each group. Additionally, Western blot was conducted to examine the expression of proteins associated with the PI3K/Akt signaling pathway in rectal tissues. The IEC-6 cells were categorized into the control, radiation, blank, and drug administration groups, with all these groups except for the control group subjected to 10 Gy single irradiation. ELISA was then employed to determine the concentrations of SOD, CAT, MDA, TNF-ɑ, IL-6, and IL-1β in cell supernatants, while Western blot was utilized to assess the expression of PI3K/Akt signaling pathway-related proteins in each group.Results:Compared to the model group, rats in the low-dose and high-dose groups exhibited a trend toward normal perianal and fecal conditions, increased SOD activity ( t = 4.86, 8.50, P < 0.05), elevated CAT expression ( t = 8.72, 14.28, P<0.05), and decreased MDA level ( t = 6.94, 10.66, P < 0.05). Furthermore, the mRNA expression of TNF-ɑ, IL-6, and IL-1β in rectal tissues was significantly inhibited in both low-dose and high-dose groups ( t = 5.60, 2.95, 4.31, 9.16, 4.66, 13.35, P < 0.05), along with lower p-PI3K/PI3K and p-Akt/Akt ratios in rectal tissues compared to the model group ( t = 22.35, 13.56, 18.23, 13.85, P < 0.05). Compared to the radiation group, the drug administration groups (10% drug-containing serum) exhibited increased SOD and CAT expressions ( t = 6.85, 10.44, P < 0.05), as well as decreased MDA expression ( t = 10.44, P < 0.05), in the supernatant. Furthermore, compared to the radiation group, this group displayed significantly inhibited TNF-ɑ, IL-6, and IL-1β concentrations in the cell supernatant ( t = 12.07, 6.87, 14.80, P < 0.05), while lowering p-PI3K/PI3K and p-Akt/Akt ratios in cells ( t = 10.95, 5.59, P < 0.05). Conclusions:Qinghua Liangxue Huluo Decoction demonstrates the potential for mitigating oxidative stress-induced injury and suppressing the expressions of inflammatory factors in rats with acute radiation enteritis. The mechanism behind the potential is likely associated with the negative regulation of the PI3K/Akt signaling pathway.

Objective:To observe any effect of repeated transcranial magnetic stimulation (rTMS) in the treatment of diabetic peripheral neuropathic pain (DPNP).Methods:Eighty-six persons with type 2 diabetes mellitus and DPNP were randomly divided into an observation group and a control group, each of 43. Both groups were given basic treatment to control plasma glucose and blood pressure, while the observation group was additionally provided with daily 10Hz rTMS of the primary motor cortex (M1 area) of the non-dominant hand 5 days a week for 4 weeks. Before and after the treatment, pain in both groups was evaluated using a visual analog scale (VAS) and the Patient′s Global Impression Change scale (PGIC). The motor conduction velocity (MCV) and sensory conduction velocity of the median and the common peroneal nerves were also tested.Results:After treatment, the average VAS pain rating and PGIC score of the observation group were significantly lower than the control group′s averages and those before treatment. The observation group′s treatment effectiveness rate (79.07%) was then much better than that of the control group (23.26%). After the treatment, the average MCV of the median and common peroneal nerves of the observation group (47.65±1.94 m/s and 46.98±3.26 m/s, respectively) were significantly faster than before treatment, and those of the control group.Conclusions:rTMS based on routine intervention can significantly relieve DPNP and promote the recovery of injured nerves, bettering diabetics′ physical condition and life quality.

OBJECTIVES: Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment. METHODS: Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline. RESULTS: A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41). CONCLUSIONS Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans ; Citric Acid/adverse effects* ; Prospective Studies ; Sodium Citrate ; Hemorrhage/chemically induced* ; Citrates/adverse effects* ; Anticoagulants/adverse effects* ; Renal Dialysis/adverse effects*

Objective To investigate the effect of BIS-guided closed-loop target-controlled infusion on perioperative Th1/Th2 balance in elderly patients undergoing laparoscopic radical gastrectomy under different anesthesia and sedation depths. Methods We applied random number table method to divide 73 elderly patients undergoing elective laparoscopic radical gastrectomy into BIS closed-loop target-controlled infusion group with BIS value of 55(group H, n=36) and BIS value of 45(group L, n=37).Intravenous blood samples were collected immediately before surgery (T1), 2h after surgery (T2), 24h after surgery (T3) and 72h after surgery (T4).IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ were determined by flow cytometry microsphere array.We compared operation duration, postoperative PACU stay time and postoperative hospitalization time between two groups. Results Compared with T1, IL-6 and IL-10 concentration in group H at T2, T3 and T4 significantly increased (P < 0.05), IL-4 and TNF-α in group H at T4 were significantly increased (P < 0.05), IL-2 and IFN-γ in group H at T2 and T4 were significantly increased (P < 0.05), the concentration of IL-6 and IL-10 in group L at T2, T3 and T4 were increased (P < 0.05), IL-2 in group L at T4 was decreased (P < 0.05), and IFN-γ/IL-6 in two groups were decreased at T2, T3 and T4(P < 0.05).Compared with group L, IL-6 and IL-10 in group H were significantly increased at T2(P < 0.05), IFN-γ/IL-6 in group H was significantly decreased (P < 0.05), IL-2 and IL-10 in group H were significantly increased at T4(P < 0.05).Operation duration, postoperative PACU stay time and postoperative hospitalization time had no statistical significance between two groups (P > 0.05). Conclusion The anesthesia and sedation depth of BIS-guided closed-loop target-controlled infusion set at 45 is better than 55 in maintaining Th1/Th2 balance in elderly patients undergoing laparoscopic radical gastrectomy, but it has no obvious effect on long-term prognosis.

Objective To prepare vardenafil hydrochloride orally disintegrating tablets and evaluate their quality. Methods The tablets were prepared by direct power compression method, using crosslinking povidone ( PVPP ) as disintegrants. The preparation method was optimized by response surface test using amount of PVPP, menthol and taste-masking agents as factors with disintegrating time and distance of bitterness as index. The results of taste of orally disintegrating tablets were determined by electronic tongue, comparing to the results of taste tests. At the same time, the properties of the tablets were evaluated using appearance, content uniformity, disintegrating time, et al. as index. Results The optimal formula was as follows:PVPP 13. 26%, menthol 0. 43%, taste-masking agent SGxj 1. 26%. The results on evaluation of electronic tongue were consistent with the results of taste tests. The quality of the prepared tablets was in line with standard. The disintegrating time was (22. 34 ± 0. 34 ) s. Conclusion The preparation technology of orally disintegrating tablets is simple, and controllable in quality.

Background and objective Non-small cell lung cancer (NSCLC) is the main type of lung cancer, and the related locus mutation detection research has become a hot direction of molecular targeted therapy, studying on gene mu-tation status of echinodem microtubule associated protein like 4-Anaplastic lymphoma kinase (EML4-ALK) and epidermal growth factor receptor (EGFR), detecting the sensitivity of EML4-ALK gene fusion and gene mutation of EGFR. Methods EML4-ALK gene fusion in 85 cases of paraffn embedded tumor tissue and adjacent lung tissue was detected with the applica-tion of immunohistochemistry (IHC), Scorpions ampliifcation refractory mutation system (Scorpions ARMS) lfuorescence quantitative PCR and lfuorescence in situ hybridization (FISH) technology, and EGFR gene in 18, 19, 20 and 21 exon mutation status was detected with the application of ARMS method. Results In 115 cases of NSCLC, IHC showed 32 cases with ALK (D5F3) expression, the expression rate was 27.8%;ARMS showed 27 cases with EML4-ALK fusion gene mutation, the muta-tion detection rate was 23.5%;53 cases were detected with EGFR mutation, the mutation rate was 46%. While FISH showed 23 cases with EML4-ALK fusion gene mutation, the detection rate was 20%, slightly lower than the ARMS detection results, suggesting that ARMS more sensitive. Conclusion hTe application of IHC, ARMS lfuorescence quantitative PCR and FISH technology can make a rapid and accurate evaluation of EML4-ALK gene fusion.

Objective To analyze and evaluate the effects of the tissue engineering bladder reconstruction on the upper urinary tract structure and function.Methods The 8 male beagles were randomly divided into the two groups:sham-operation group (group A,n=4)and the collagen scaffold repair group (group B,n=4).The bladder defect animal model was established in the group B by using the collagen scaffold materials to repair the bladder.The renal function related biochemical indicators were detec-ted and the renal Doppler ultrasonic examination was performed in each group before repair and in 23 weeks after repair.The speci-mens from the two groups were performed the gross morphology observation and the histology examination on postoperative 24 weeks.Results The renal Doppler ultrasound examination showed the normal kidney morphology and normal blood flow signal.In the general observation,no calculi and neoplasm were found in the kidney and ureter of the experimental dogs.The renal function related biochemical indicators had no statistically significant differences between the two groups(P>0.05).The histological exami-nation indicated that the organization structure was integrity,the nephrons in each group had no obvious pathological changes.Con-clusion Using the collagen scaffold materials to reconstruct the canine bladder has no adverse influence on the upper urinary tract structure and function,this tissue engineering approach has good feasibility.

Objective To determine the relationship between the level of plasma homocysteine and coronary calcification in patients with different blood glucose levels. Methods By measuring plasma homocysteine and coronary calcification in 30 cases of diagnosed diabetes (T2D) ,29 cases of diagnosed impaired glucose tolerance (IGT) in patients and 27 cases with normal, we compared the level of plasma homocysteine and coronary calcification in patients with different blood glucose levels. Results We found significant diffieronces among three groups of the level of plasms homocysteine and coronary calcification (P ＜ 0.01). The plasma homocysteine levels were(19.31 ±3.17) μmol/L, (13.85 ± 1.62) μmol/L, (9.80 ± 1.78) μmol/L in the T2D,IGT and normal groups,respectively. The coronary calcification scores were 207.80 ± 154.10,63.24 ± 10.46,14.47 ± 5.16 in the T2D, IGT and normal groups, respectively. The plasma homocysteine level and coronary calcification score increased with the glycosylated hemoglobin rise in the normal,IGT and T2D groups((4.51 ±0.48)%, (6.13 ±0.31)% and (7.69 ±0.81)%, respectively). Conclusions The plasma homocysteine level is a strong independent predictor of type 2 diabetes and also an important factor of coronary artery event occurrence and develepment.