Modified gasless trans-subclavian approach endoscopic lateral neck dissection for treatment of papillary thyroid carcinoma: a series of 31 cases / 中华外科杂志

Objective: To examine the feasibility of the modified gasless trans-subclavian approach endoscopic thyroidectomy for lateral neck dissection (LND) in papillary thyroid carcinoma (PTC). Methods: The clinical data of 31 patients with PTC who underwent modified gasless trans-subclavian approach endoscopic LND in the Department of Head and Neck Surgery, Run Run Shaw Hospital, from January to October 2022 were retrospectively analyzed. There were 2 males and 29 females, aged (32.6±8.3) years (range: 17 to 55 years). The maximum diameter of the primary thyroid lesion (M(IQR)) was 1.06 (1.16) cm (range: 0.53 to 2.44 cm), and the maximum diameter of the metastatic lymph node was (1.04±0.37) cm (range: 0.44 to 1.88 cm). Operation time, postoperative hospital stay, number of lymph nodes dissected, and postoperative complications were recorded. Outpatient follow-up was conducted until November 30, 2022. Results: All operations were successfully completed with the endoscopy approach without conversion to open surgery. The operation time was 160 (20) minutes (range: 100 to 215 minutes), and the postoperative hospital stay was 4 (2) days (range: 2 to 14 days). The number of lymph nodes obtained by dissection in the central and lateral compartment of the neck was 11 (12) (range: 0 to 37) and 34.7±14.8 (range: 15 to 69), respectively. Temporary hypoparathyroidism occurred in 4 cases and all recovered within 1 month after the operation. One case suffered from recurrent laryngeal nerve injury (continuing followed up to assess whether it is a temporary injury). The complication of LND included 1 case of chylous leakage that was recovered with conservative treatment, 1 case of Horner syndrome returned to normal 3 months after surgery. During follow-up, there was no residual tumor or recurrence. Conclusion: The modified gasless trans-subclavian approach endoscopic LND for PTC is feasible, with a thorough dissection and concealed incision.

Gasless submental-transoral combined appoach endoscopic thyroidectomy for papillary thyroid carcinoma: a series of 41 cases / 中华外科杂志

Objective: To examine the safety and feasibility of gasless submental-transoral combined appoach endoscopic thyroidectomy for papillary thyroid carcinoma (PTC). Methods: A retrospective analysis of the clinical data of 41 patients with PTC who underwent the gasless submental-transoral combined appoach endoscopic thyroidectomy at the Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from November 2020 to April 2021. There were 5 males and 36 females with the age of (35.0±8.7) years (range: 19 to 58 years). A horizontal incision with a length of 2.0 cm is made under the chin as an observation hole, a 10 mm Trocar and a self-developed retractor are inserted, and two 5 mm longitudinal incisions are made on the labial side in the vestibule of the oral cavity as an operation hole, each inserting a 5 mm Trocar, the operation direction is from the cranial side to the caudal side. The sensation of the lower lip and chin was measured on the first day and one month postoperative. The operation time, hospital stay, the number of lymph nodes dissected and postoperative complications were recorded. Results: Surgical procedures in all cases were successfully completed under endoscopic approach without transfering to open surgery. The operation time was (99±34) minutes (range: 50 to 180 minutes) and the postoperative hospital stay was (3.4±2.2) days (range: 2 to 16 days). The maximum diameter of PTC was (7.6±5.8) mm (range: 2 to 30 mm), and the number of lymph nodes of the central compartment dissection was 6(5) (M(IQR)) (range: 1 to 25). The duration of follow-up is 1 month after operation, and the follow-up method is adopted in outpatient clinic. Postoperation complications included 2 cases of transient hypoparathyroidism, One case of recurrent laryngeal nerve injury (continue to follow up to assess whether it is a temporary injury). Postoperative minor chyle leak, seroma, and local redness and swelling in 1 case each were cured after conservative treatment. 1 case of transient minor numbness of the lower lip was observed. No permanent hypoparathyroidism, postoperative bleeding and numbness of the chin was observed. Conclusion: The gasless submental-transoral combined appoach endoscopic thyroidectomy is a feasible approach in selected PTC patients and has clinical application value.

Protective effects and mechanism of ghrelin on human retinal vascular endothelial cells under high glucose / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the protective effect and mechanism of ghrelin on human retinal vascular endothelial cells under high glucose.<p>METHODS: A hyperglycemic injury model as a research object was established on human retinal vascular endothelial cells. CCK-8 kit was used to detect the effects of ghrelin with different concentrations on cell proliferation under high glucose, so as to screen the optimal concentration of ghrelin. The cells were then divided into normal control group(NC), ghrelin group(ghrelin), high glucose group(HG)and ghrelin+ high glucose group(ghrelin+HG). Cell proliferation was detected by CCK-8 kit, apoptosis was detected by Annexin-APC/7-AAD kit, and the expressions of NLRP3, Caspase-1, IL-1β and IL-18 proteins were detected by western blotting.<p>RESULTS: Compared with NC group(100.00%±0.00%), the cell proliferation rate of HG group(69.87%±0.68%, <i>P</i><0.05)was significantly decreased. Compared with HG group, the cell proliferation rate of ghrelin + HG group was significantly increased(92.31%±3.62%, <i>P</i><0.05). Compared with NC group(4.94%±0.15%), the cellular apoptosis rate of HG group(28.33%±1.37%, <i>P</i><0.05)was significantly increased. Compared with HG group, the cellular apoptosis rate of ghrelin+HG group(14.24%±0.32%, <i>P</i><0.05)was significantly decreased. Compared with NC group, the expressions of NLRP3, Caspase-1, IL-1β and IL-18 proteins were all significantly increased(all <i>P</i><0.05). Compared with HG group, the expressions of NLRP3, Caspase-1, IL-1β and IL-18 proteins in ghrelin + HG group were all significantly decreased(all <i>P</i><0.05).<p>CONCLUSION: Ghrelin can protect retinal vascular endothelial cells damaged by high glucose, it may function by inhibiting NLRP3 inflammasome signaling pathway.

Impact of mild hypothermia therapy on hemodynamics during the induction stage in neonates with moderate to severe hypoxic-ischemic encephalopathy / 中国当代儿科杂志

OBJECTIVE@#To study the changes in hemodynamics during the induction stage of systemic mild hypothermia therapy in neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE).@*METHODS@#A total of 21 neonates with HIE who underwent systemic mild hypothermia therapy in the Department of Neonatology, Dongguan Children's Hospital Affiliated to Guangdong Medical University, from July 2017 to April 2020 were enrolled. The rectal temperature of the neonates was lowered to 34℃ after 1-2 hours of induction and maintained at this level for 72 hours using a hypothermia blanket. The impedance method was used for noninvasive hemodynamic monitoring, and the changes in heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), cardiac output (CO), cardiac index (CI), and total peripheral resistance (TPR) from the start of hypothermia induction to the achievement of target rectal temperature (34℃). Blood lactic acid (LAC) and resistance index (RI) of the middle cerebral artery were recorded simultaneously.@*RESULTS@#The 21 neonates with HIE had a mean gestational age of (39.6±1.1) weeks, a mean birth weight of (3 439±517) g, and a mean 5-minute Apgar score of 6.8±2.0. From the start of hypothermia induction to the achievement of target rectal temperature (34℃), there were significant reductions in HR, CO, and CI (@*CONCLUSIONS@#The systemic mild hypothermia therapy may have a significant impact on hemodynamics in neonates with moderate to severe HIE, and continuous hemodynamic monitoring is required during the treatment.

Analysis of Causes of Death and Related Factors of 102 Perinatal Infants in Chongqing / 法医学杂志

OBJECTIVES@#To analyze the causes of perinatal death and related factors from the perspective of forensic medicine, and to provide references for reducing perinatal mortality and guidance for forensic identification.@*METHODS@#A retrospective analysis was performed on 102 cases of perinatal autopsy with clinical data from the Department of Forensic Medicine of Chongqing Medical University in 2004-2016.@*RESULTS@#Of the 102 cases of perinatal deaths, 66 （64.71%） were neonatal deaths, 24 （23.53%） were stillborn foetuses, and 12 （11.76%） were stillbirths. Among the 66 neonatal death cases, 39 （59.09%） died within 1 d, 19 （28.79%） died within 1-3 d, and 8 （12.12%） died within >3-7 d of birth. The top 3 causes of neonatal death were pulmonary diseases, congenital malformation, umbilical cord and placental abnormalities. The causes of stillborn foetus and stillbirth were mainly umbilical cord and placental abnormalities, and intrauterine asphyxia.@*CONCLUSIONS@#Pulmonary diseases, umbilical cord and placental abnormalities, and congenital malformations are the main causes of perinatal death. In order to reduce the perinatal mortality, pre-pregnancy examination and prenatal care should be strengthened, and the knowledge of pregnancy care should be popularized.

The optimization of culture conditions of MRC -5 human diploid cell / 预防医学

Objective To optimize the culture conditions of MRC -5 human diploid cell.Methods To compare the growth status of MRC -5 cells,three kinds of culture medium with T25 bottles and Spinner cultivation system Cytodex1 micro carrier were used.Morphology,cell counting,growth curve,glucose -lactic acid value were observed and detected daily for screening a kind of suitable medium.Cell proliferation was compared with different levels of the bovine serum.Results There were no significant differences among the three kinds of culture medium.There were significant differences among MEM((43.25 ±0.60)×104 cells/mL,(12.98 ±1.27)×105 cells /mL),M199 ((35.40 ±1.41 )×104 cells/mL, (10.76 ±1.31)×105 cells /mL)and DMEM/F12 ((36.75 ±1.59)×104 cells/mL,(11.22 ±1.42)×105 cells /mL)(P<0.01).The cell proliferation of MEM cultures was 5.17 and 6.49 times better than those of M199 and DMEM/F12 cultures.Imported fetal bovine serum cell proliferation ((4.55 ±0.51)×105 cells /mL)was better than the other three bovine serum ((4.12 ±1.03,3.59 ±0.48,3.53 ±0.52)×105 cells /mL).Conclusion Tree kinds of culture medium can be used to culture MRC -5 human diploid cell.The MEMculture is better.Imported fetal bovine serum is better than other kinds of serum.

Blunt Dissection: A Solution to Prevent Bile Duct Injury in Laparoscopic Cholecystectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Laparoscopic cholecystectomy (LC) has been a standard operation and replaced the open cholecystectomy (OC) rapidly because the technique resulted in less pain, smaller incision, and faster recovery. This study was to evaluate the value of blunt dissection in preventing bile duct injury (BDI) in laparoscopic cholecystectomy (LC).</p><p><b>METHODS</b>From 2003 to 2015, LC was performed on 21,497 patients, 7470 males and 14,027 females, age 50.3 years (14-84 years). The Calot's triangle was bluntly dissected and each duct in Calot's triangle was identified before transecting the cystic duct.</p><p><b>RESULTS</b>Two hundred and thirty-nine patients (1.1%) were converted to open procedures. The postoperative hospital stay was 2.1 (0-158) days, and cases (46%) had hospitalization days of 1 day or less, and 92.8% had hospitalization days of 3 days or less; BDI was occurred in 20 cases (0.09%) including 6 cases of common BDI, 2 cases of common hepatic duct injury, 1 case of right hepatic duct injury, 1 case of accessory right hepatic duct, 1 case of aberrant BDI 1 case of biliary stricture, 1 case of biliary duct perforation, 3 cases of hemobilia, and 4 cases of bile leakage.</p><p><b>CONCLUSION</b>Exposing Calot's triangle by blunt dissection in laparoscopic cholecystectomy could prevent intraoperative BDI.</p>

Correlation of DNA methylation status of imprinted gene H19 ICR with oligozoospermia and asthenozoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the correlation of the DNA methylation status of the imprinted gene H19 imprinting control region (ICR) with oligozoospermia and asthenozoospermia.</p><p><b>METHODS</b>We eliminated chromosomal abnormality as the cause of male infertility in the subjects by karyotype analysis and detection of Y-chromosome microdeletions, and identified 18 cases of single factor-induced oligozoospermia (sperm concentration < 15 x 10(6)/ml) and 20 cases of single factor-induced asthenozoospermia (progressively motile sperm <32%) by computer-aided sperm analysis (CASA). Then we extracted genome-wide sperm DNA, treated it with bisul- fite, subjected the target gene fragments to PCR amplification and sequencing. Lastly, we analyzed the DNA methylation status of the target genes with BIQ Analyzer and processed the data using SPSS17.0.</p><p><b>RESULTS</b>The DNA methylation level of the H19 ICR was increased significantly in the oligozoospermia patients ([9.19 +/- 2.45]%, P < 0.05), especially in the severe oligozoospermia males with sperm concentration < 3 x 10(6)/ml (P < 0.01), as compared with that of the 20 fertile control men ([0.30 +/- 0.06]%). However, no significant differences were found in the level ([0.30 +/- 0.07]%) and pattern of the DNA methylation of the H19 ICR (P = 0.62). Further analysis of the DNA methylation status of the CTCF-6 binding sites indicated that the DNA methylation degree was significant higher in the oligozoospermia men ([2.67 +/- 0.75]%) than in the fertile control ([0.05 +/- 0.03]%) or the asthenozoospermia group ([0.03 +/- 0.02]%), with no significant differences between the latter two (P = 0.35).</p><p><b>CONCLUSION</b>The reduced DNA methylation of the H19 ICR is negatively correlated with sperm concentration but not associated with sperm motility.</p>

ICSI causes abnormal H3K9 methylation in the male pronuclei and growth retardation of mouse embryos / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the safety of intracytoplasmic sperm injection (ICSI) in the mouse model.</p><p><b>METHODS</b>We simulated clinical ICSI technology and comprehensively evaluated it by parthenogenetic activation, immunofluorescence, embryo transplantation, examination of early implantation, and measurement of the crown-rump length (CRL).</p><p><b>RESULTS</b>ICSI significantly reduced the ability of preimplantation embryo development of the mouse, especially after the 8-cell stage (P < 0.01). The fluorescence of H3K9 dimethylation was abnormal at the male pronuclei of the embryos derived from ICSI. Further examination of the development of the transferred ICSI embryos indicated no significant difference in the rate of early implantation at E5. 5 days as compared with normal fertilization (P = 0.6), but the percentage of "normal embryos" was decreased significantly at E9.5 days (P < 0.01). Obvious growth retardation phenotype was observed even in the normal ICSI embryos at E9.5 days.</p><p><b>CONCLUSION</b>ICSI might result in growth retardation of embryos by affecting H3K9 dimethylation in the male pronuclei.</p>

Case-control study on the treatment of patellar fracture with "8" tension band wire fixation either by percutaneous or open reduction / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical efficacy of the treatment of patellar fracture percutaneous or open reduction with "8" tension band wire fixation.</p><p><b>METHODS</b>From July 2007 to April 2010,96 patients with patellar fracture were treated by percutaneous or open reduction with "8"tension band wire fixation. In percutaneous group,there were 28 males and 20 females with an average age of (53.8 +/- 4.7) years old (ranged, 21 to 84); there were 27 transverse fractures and 21 comminuted fractures. In open reduction group, there were 26 males and 22 females with an average age of (49.1 +/- 4.2) years old (ranged, 19 to 86); there were 25 transverse fractures and 23 comminuted fractures. The operation time, hospital stay, and pain score on the first day and one week after operation were compared, and Böstman score was compared too.</p><p><b>RESULTS</b>All patients were followed up with an average of 13 months ranging from 6 to 19 months. The mean operation time of percutaneous group was (53.0 +/- 4.3)min and the open reduction group was (49.0 +/- 3.1) min, and there was no statistic differences between two groups (P > 0.05). The hospital stay, healing time in percutaneous group was shorter than that of open reduction group; VAS score on first day and the first week after operation in percutaneous group was lower than that of open reduction group. The mean Böstman score in percutaneous group (28.8 +/- 4.7) was lower than open reduction group (24.6 +/- 4.3).</p><p><b>CONCLUSION</b>Percutaneous internal fixation for the treatment of patellar fracture has advantages of minimally invasive, quick recovery. The clinical effectiveness of this method is superior to the open reduction.</p>

Comparison of mtDNA extracting methods for common sarcosaphagous insects / 法医学杂志

OBJECTIVE@#To compare effects of three different methods for mtDNA extraction from common sarcosaphagous insects including cetyl trimethyl ammonium bromide (CTAB) method, sodium dodecyl sulfate-potassium acetate (SDS-KAc) method and sodium dodecyl sulfate-proteinase K (SDS-PK) method.@*METHODS@#Seventy-two insects from four species [Chrysomya megacephala (Fabricius, 1784), Eusilpha bicolor (Fairmaire, 1896), Paraeutrichopus pecoudi (Mateu, 1954), Vespa velutina (Lepeletier, 1836)] were collected from the corpses of the rabbits in Changsha district. The total DNA of above samples was extracted by CTAB, SDS-Kac and SDS-PK methods. The purity and concentration of DNA were examined by protein-nucleic acid spectrophotometry, and mtDNA were amplified by specific primers and PCR products were detected by agarose gel electrophoresis. Then PCR products were sequenced and subsequently up-loaded to GenBank.@*RESULTS@#mtDNA was successfully extracted with three methods from most of the samples. The SDS-PK method was better in DNA purity compared to other methods and the CTAB method was superior in extracting DNA from old samples, while SDS-KAc method showed no significant difference for extraction effects of different samples.@*CONCLUSION@#The most appropriate method should be chosen depending on different situations. SDS-PK method is expected to obtain high-quality DNA, while CTAB method is preferred in extracting obsolete samples. SDS-KAc method is low cost and can be used in various kinds of preliminary experiments.

Succession of sarcosaphagous insects at summer and autumn in Shijiazhuang area / 法医学杂志

OBJECTIVE@#To study the succession of sarcosaphagous insects and their regular activity on carcass in Shijiazhuang area.@*METHODS@#Nine rabbits were sacrificed and placed at the same site during June to September in 2007-2009. The common species of sarcosaphagous insects were observed.@*RESULTS@#Nine main species could be identified belonging to 3 families and 4 genera from Diptera, including Musca domestica (Linnaeus), Muscina stabulans (Fall én), Hydrotaea (Ophyra) capensis (Wiedemann), Hydrotaea (Ophyra) spinigera (Stein), Lucilia sericata (Meigen), Chrysomya megacephala (Fabricius), Boerttcherisca Peregrina (Robineau-Desvoidy), Parasarcophaga crassipalpi (Macquart) and Helicophagella melanura (Meigen). Eleven main species belonging to 4 families from Coleoptera include Nicrophorus concolor (Kraatz), Silpha carinata(Herbst), Nicrophorus fossor (Eneshas), Ptomascopus morio (Kraatz), Eusilpha bicolor (Fairmaire), Scarabaeus rugosus (Hausmann), Harpalus rufipes (DeGeer), Dolichus halensis (Schaller), Goncephalum pusillum (Fabricius), Cafius seminitens (Horn) and Aleochara pacifica (Casey). Two main species from 2 families were Tetramorium caespitum (Linnaeus) and Vespa velutina(Lepeletier).@*CONCLUSION@#It is evident that the succession of sarcosaphagous flies in Shijiazhuang with its unique geographical features. It may be used for estimating postmortem interval in Shijiazhuang area.

Extract human DNA from maggot crop contents by phenol-chloroform method coupled with paramagnetic particle method / 法医学杂志

OBJECTIVE@#To establish an effective phenol-chloroform method coupled with paramagnetic particle method for human DNA extraction from maggot crop contents in STR genotyping.@*METHODS@#Human DNA was extracted from the maggot crop contents using phenol-chloroform method and purified by paramagnetic particle method. DNA was quantified by PCR with Quantifiler Human DNA Quantification Kit using 7500 real-time fluorescence quantitative PCR instrument. PCR products were genotyped by AmpFlSTR Identifiler PCR Amplification Kit using 3130XL-Avant genetic analyzer.@*RESULTS@#The template DNA yield by the method described were increased at least 2 times than the phenol-chloroform extraction method alone. All of the full 16 STR profiles could be obtained with the samples extracted by this method when the DNA yield reached (0.218 +/- 0.041) ng/microL.@*CONCLUSION@#Phenol-chloroform method coupled with paramagnetic particle method can effectively increase the sensitivity of STR analysis of human DNA recovered from maggot crop contents and is a valuable tool for forensic entomology.

Advances of forensic entomology in China / 法医学杂志

Forensic entomology is a branch of forensic medicine, which applies studies of insects and arthropods to getting evidence for court and has an analogous advantage in the estimation of the postmortem interval (PMI) and other questions of forensic relevance. The paper expounds its definition and contents and reviews some progress of the studies in some aspects in China such as the constitution and succession of insect community on the different cadavers, the applications of morphological features of insects and the technology of analysis of deoxyribonucleic acid (DNA) in forensic entomology, and forensic entomological toxicology etc.

Effect of Diabetic Status on the Preventive Efficiency of Methylcobal on Peripheral Neuropathy in Rats / 中国康复理论与实践

@#ObjectiveTo investigate the effect of varied hyperglycemia and durations on preventing peripheral neuropathy (PN) with methylcobal in diabetic rats.Methods80 Sprague Dawley rats were selected and randomly chosen 16 as normal control (NC) group, others 64 animals as diabetic model induced by alloxan. The model rats were evenly divided into relatively good control (GC) group and relatively poor control (PC) group based on levels of hyperglycemia regulated with exogenous insulin. 16 rats of each GC/PC group were intramuscularly injected with methylcobal (500 μg/kg). The sensory nerve conduction velocity (SNCV), motor nerve conduction velocity (MNCV) and evoked potential amplitute (EPA) of sciatic nerve of rats were detected by evoked electromyogram respectively at 2nd, 8th and 12th week after onset of diabetes. Fructosamine in serum was also detected.ResultsThe rats injected with methylcobal had a significantly delayed reduction of SNCV, MNCV and EP in GC group (fructosamine,1.0 mmol/L) than that in PC group (fructosamine, 1.2 mmol/L) ( P<0.05～0.01). Up to 8th week after onset of diabetes, there was no obvious difference in physioelectroparameters between the GC group and NC group. At 12th week after onset of diabetes, physioelectroparameters in the PC group fell to the level of non-methylcobal injected group. No effect of methylcobal on blood glucose revealed in any groups ( P>0.05).ConclusionMethylcobal has a beneficial effect on delaying the onset of diabetic PN, and is of high efficacy with a good control of diabetic state, especially at early stage.

SCREENING OF STRAINS PRODUCING EXTRACELLULAR MELANIN / 微生物学通报

The growth and pigment production of 47 strains on casein medium were studied comparatively.T4 and Neurospora crassa AS 3.1602 were selected for their capacity of producing melanin on five different culture media. Melanin produced by T4 was investigated, and T4 was identified as Proteus mirabilis primarily.