Clinical study of endoscopic surgery through thoraco mammary approach in treatment of thyroid papillary carcinoma / 中华内分泌外科杂志

Objective:To investigate the effect of endoscopic thyroidectomy through breast milk approach in patients with papillary thyroid carcinoma and its influence on Wnt and integrin signaling pathways.Methods:A total of 136 patients diagnosed with papillary thyroid carcinoma in our hospital from Jul. 2018 to Mar. 2020 were selected and were hospitalized for surgical treatment. According to different surgical procedures, they were divided into a study group (68 cases) and a control group (68 cases) . The control group was treated with open thyroidectomy and the study group was treated with thoracoscopic thyroidectomy. The two groups were compared in terms of immune function [CD4+, CD8+ and CD4+/CD8+], and pain index [PGE2, IL-6, Cor and VAS score]. RT-PCR method was used to detect WNT1, β-catenin, GSK3β and integrin Signal pathway before and after surgery.Results:Three days after operation, compared with the control group, the study group had significantly higher CD4+ and CD4+/CD8+ levels [ (27.62±2.52) vs (24.63±2.67) , (0.66±0.18) vs (0.52±0.13) ], while the CD8+ level was significantly lower [ (41.62±3.54) vs (45.62±3.63) ] ( P<0.001) ; PGE2, IL-6, Cor, VAS of the study group were significantly lower than the control group [ (48.54±9.86) vs (57.21±8.12) , (5.13±0.71) vs (6.99±0.95) , (511.23±67.52) vs (633.12±71.47) , (1.26±0.56) vs (3.99±2.06) ] ( P<0.001) ; WNT1, β-catenin, GSK3β, integrin β1, FAK, Ras, and MAPK mRNA expression levels in the study group were significantly lower than those of the control group[ (1.79±0.15) vs (2.85±0.25) , (1.94±0.15) vs (2.64±0.24) , (2.13±0.19) vs (2.97±0.28) , (1.95±0.17) vs (2.58± 0.23) , (2.15±0.16) vs (2.87±0.22) , (1.95±0.18) vs (2.91±0.27) , (1.89±0.12) vs (2.87±0.31) ] ( P<0.001) . Conclusion:Endoscopic thyroidectomy through thoracolumbar approach can effectively reduce postoperative pain in patients with papillary thyroid cancer, have a smaller impact on immune function, and block the expression of Wnt and integrin signaling pathways to reduce tumor metastasis risk.

A Capacitive Venous Transfusion Alertor Based on NB-IoT / 中国医疗器械杂志

This capacitive venous transfusion alertor is based on rise time of RC circuit and input capture function of timer in the microcontroller. The measure element of alertor is integrated with circuit board, it has the advantages of simple structure and low cost. Combined with narrow band intent of things(NB-IoT) technology to upload data, it can reduce the workload of medical personnel and caregivers, avoid unnecessary trouble and danger.

Effects of different conversion time to open surgery on prognosis after laparoscopic radical resection for colorectal cancer / 中华消化外科杂志

Objective To investigate the effects of early and delayed conversion to open surgery on the prognosis after laparoscopic radical resection for colorectal cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 119 patients who were converted to open surgery in laparoscopic radical resection for colorectal cancer in the ZiBo First People's Hospital from January 2008 to December 2014 were collected.There were 66 males and 53 females,aged from 20 to 84 years,with an average age of 55 years.Of the 119 patients,82 who were converted to open surgery within 60 minutes after the start of laparoscopic surgery and 37 who were converted to open surgery after 60 minutes since the start of laparoscopic surgery were allocated into early conversion group and delayed conversion group.Observation indicators:(1) surgical situations and postoperative recovery;(2) perioperative complications;(3) follow-up.Follow-up using telephone interview,mail and outpatient examination was performed to detect patients' survival once 3 months within 2 years and once a year after 2 years postoperatively up to September 2017.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed using the independent sample t test.Count data were represented as absolute number or percentage,and comparison between groups was analyzed using the chi-square test or Fisher exact propability.Comparison of ordinal data was analyzed using the rank sum test.The survival rate was calculated using the Kaplan-Meier method and Log-rank test was used for survival analysis.Results (1) Surgical situations and postoperative recovery:patients in the two group underwent laparoscopic radical resection of colorectal cancer successfully.The operation time,time to first defecation,duration of postoperative hospital stay were (202±44) minutes,(2.6 ± 1.1) days,(9 ± 5) days in the early conversion group and (230±45) minutes,(3.7±2.1) days,(12±6) days in the delayed conversion group,showing statistically significant differences between the two groups (t=-3.106,-3.450,-2.865,P＜0.05).The time to first flatus was (1.8± 0.6) days and (2.0 ± 0.8) days in the early conversion group and delayed conversion group,respectively,with no statistically significant difference between the two groups (t =-1.245,P＞ 0.05).(2) Perioperative complications:8.5％ (7/82) of patients in the early conversion group had perioperative complications,including 2 of early postoperative inflammatory bowel obstruction,2 of postoperative incisional infection,1 of chylous fistula,1 of urinary retention,3 of anastomotic fistula;the same patient can merge multiple complications.Patients with perioperative complications were cured after symptomatic and supportive treatment.Meanwhile,35.1％ (13/37) of patients in the delayed conversion group had perioperative complications,including 8 of early postoperative inflammatory bowel obstruction,3 of postoperative incisional infection,6 of urinary retention,3 of anastomotic fistula;the same patient can merge multiple complications.Patients with perioperative complications were cured after symptomatic and supportive treatment.There was a statistically significant difference in the incidence of perioperative complications between the two groups (x2=12.902,P＜0.05),a statistically significant difference in the early postoperative inflammatory bowel obstruction and urinary retention between the two groups (P＜0.05),and no statistically significant difference in the postoperative incisional infection,chylous fistula,anastomotic fistula between the two groups (P＞0.05).(3) Follow-up:112 out of 119 patients were followed up for 5.2-101.9 months,with a median time of 32.1 months.The 5-year survival rate was 70.5％ and 63.6％ in the 79 patients of early conversion group and 33 of delayed conversion group,showing no statistically significant difference between the two groups (x2 =0.038,P＞0.05).Conclusions Delayed conversion after 60 minutes since the start of laparoscopic surgery will lead to the slower recovery of intestinal function and prolonged hospitalization time,and increase the rates of early postoperative inflammatory intestinal obstruction and postoperative urinary retention.Therefore,a comprehensive analysis of the feasibility of laparoscopic surgery in the initial exploration is recommended and a fast decision on early conversion is necessary.

Expression of the thermostable carboxypeptidase Taq gene in Pichia pastoris GS115 / 生物工程学报

To express recombinant carboxypeptidase from Thermus aquaticus (Cpase Taq) in Pichia pastosis, the open reading frame coding thermostable Cpase Taq was optimized based on the preference of P. pastoris codon usage and synthesized in vitro. The novel gene was cloned into P. pastoris expression vector pHBM905A and the sequence coding 6xHis tag was fused with the ORF of Cpase Taq gene. The recombinant plasmid was named pHBM905A-Cpase Taq and transformed into P. pastoris GS 115. Transformants were induced with 1% methanol for 72 h until the enzyme yield reached 0.1 mg/ml. The enzyme was purified and its enzymatic properties were analyzed. The results showed that the specific enzyme activity reached maximum at 75 °C and pH 7.5, which was about 80 U/mg. It was the first report about the secretory expression of Cpase Taq in P. pastoris GS115. Because of its large-scale preparation, this enzyme may be applied in industrial hydrolysis of peptides into amino acids in the future.

Construction of directional T vector for gene cloning and expression / 生物工程学报

Traditional T vector cloning method requires onerous procedures for identifying recombinant, and directional cloning was impossible. In order to overcome these problems, we have devised a directional T vector pETG based on pET-23a(+). For gene cloning, 7 bp partial LacO sequence was introduced into DNA fragment to reconstitute a full length LacO with Bfu I digested T vector. After transformation, blue colonies were selected on LB plate supplemented with X-gal. Restriction enzyme digestion and PCR identification showed that all blue colonies contained the directionally inserted recombinants and the recombinant efficiency was nearly 100%. We have successfully cloned 103 genes from human liver cDNA; in the study complicated procedures for screening of recombinant were not required. Eight pETG clones were picked for protein expression, and all the clones successfully produced corresponding proteins. We demonstrated that the directional T vector was successfully constructed, and it was very suitable for gene cloning and expression.

The study of the biodegradable biliary duct stent in vivo / 生物医学工程学杂志

The present paper is aimed to evaluate safety and efficiency of a biodegradable biliary stent used in the Roux-en-Y cholangiojejunostomy of dogs in vivo. We separated 18 hybrid dogs into control group and experimental group randomly, with each group 9 dogs. The Roux-en-Y cholangiojejunostomy was carried out in the two groups. We placed the biodegradable stents into the anastomotic stoma of the dogs in the experimental group during the operation. After 3 months' close observation, we evaluated the degradable property and biocompatibility of the stents. We found that the morbidity rate of bile leakage in the dogs in the control group was much higher than that in the experimental group (P > 0.05). The X-ray photograph showed that the figures of the stents were complete and the stents were fixed at right place throughout the experimental period. The diameter of the dogs' common bile ducts of control group narrowed down obviously compared to those in the experimental group (P < 0.05). There were no impure materials adhered to the inside walls of the stents. The pathological test showed that there were no inflammation signs in mucous membrane and abnormal epithelium hyperplasia of the bile tract and jejunum. It can be concluded that the biliary duct stent, which was made with a mixture of poly-L-lactic acid (PLLA) and poly lactide-co-glycolide (PLGA), possesses qualities of relatively long degradable period (> 3 months) and good biocompatibility. Moreover, using the stent can effectively prevent bile leakage and anastomotic stom stenosis in the cholangio-intestinal anastomosis from happening.

Clinical analysis of bacterial infection in liver transplant recipients / 西安交通大学学报(医学版)

Objective To explore the incidence and risk factors of bacterial infection after othtotopic liver transplantation (OLT). Methods Altogether 56 OLT recipients from January 2005 to October 2007 were included in the study. The incidents and the related variables of the infection were analyzed retrospectively. The related variables were evaluated using multivariate logistic regression model to identify the significant risk factors. Results Bacterial infection was confirmed in 29 recipients (51.8%). Among them, the lung infection was the most common site (53.7%). The Gram-positive cocci were 46.3%, while the Gram-negative bacilli were 53.7%. The risk factors for bacterial infection included duration of the operation and detained respirator using. Conclusion Bacterial infection is a major complication following OLT. Surveillance for the risk factors, enhancement the skill of operation, and improving the recovery of respiratory function is the key to decreasing the incidence of bacterial infection after transplantation.