Clinical application study of parathyroid autofluorescence in identification of parathyroid gland in thyroid carcinoma surgery / 中华内分泌外科杂志

Objective:To observe the application of near-infrared autofluorescence imaging (NIRAF) technology combined with carbon nanoparticle (CNP) negative imaging in identification of parathyroid gland (PG) during thyroid carcinoma surgery.Methods:80 patients with thyroid cancer who underwent total thyroidectomy + central lymph node dissection performed by the same experienced physician team at the 960th Hospital of the PLA from Jan. to Mar. 2022 were prospectively included. Before operation, they were divided into two groups using random number table method before surgery: control group (40 cases) using CNP negative imaging, and experimental group (40 cases) using CNP negative imaging combined with NIRAF technique for intraoperative identification of PG. The gold standard for the identification of parathyroid glands was to compare the amount of intraoperative discovery retention misresection and transplantation of PG and the number of postoperative parathyroid hormone (PTH) and the number of complications in the two groups by immune colloidal gold technique. SPSS 25.0 software was used for statistical analysis.Results:All patients in the two groups were successfully operated and followed up. 137 149 PG were found and confirmed in the control group and the observation group, 108 132 PG were retained in situ and 29 17 PG were transplanted, the differences were statistically significant (all P <0.05) ; The number of A1 PG was 103 and 109, respectively. Among them, 84 102 were retained in situ and 19 7 were transplanted, the difference was statistically significant ( P <0.05) . There was no significant difference in the amount of A2 type PG and B type PG between the two groups ( P >0.05) . No A3 type PG was found in the two groups, and a total of 3 A3 types of PG were confirmed in postoperative pathological reports. There were no significant differences in misresection in the control group and the observation group, 5 and 2 PG were mistakenly cut, respectively (all P >0.05) . The PTH 1 day after surgery was 17.7 (5.6,30.4) pg/mL in the control group and 21.7 (12.8,38.3) pg/mL in the observation group, the difference was statistically significant ( P<0.05) . There were no significant differences in the levels of serum calcium and serum phosphorus 1 day after operation and PTH 1 month after surgery between the two groups (all P > 0.05) . Conclusion:Compared with CNP alone, combined with NIRAF technique can quickly and effectively identify PG, and PG can be better protected in situ and postoperative hypoparathyroidism can be reduced.

Progress in researches on cardiovascular health behaviors and factors in perinatal women / 中华预防医学杂志

The cardiovascular health index (CVH) is a composite index consisting of 7 CVH metrics (CVHM) to evaluate the cardiovascular health status in the population. CVH has been proven to be closely related to a variety of health outcomes and widely used in the prevention of many diseases and the evaluation of intervention effectiveness. This review summarizes the recent distribution of CVH and CVHM in pregnant women and the relationship between CVH and CVHM with adverse health outcomes, which aims to explore the application of CVH and CVHM in preventing pregnancy-related diseases and improving the long-term health level of perinatal women and their offspring.

Association between coagulation function indicators and placental abruption among preeclampsia-eclampsia pregnant women / 中华预防医学杂志

Objective: To explore the association between coagulation function indicators and placental abruption (PA) in different trimesters of pregnancy among preeclampsia-eclampsia pregnant women. Methods: From February 2018 to December 2020, pregnant women who participated in the China birth cohort study and were diagnosed with preeclampsia, eclampsia and chronic hypertension with superimposed preeclampsia in Beijing Obstetrics and Gynecology Hospital were enrolled in this study. The baseline and follow-up information were collected by questionnaire survey, and the coagulation function indicators in the first and third trimesters were obtained through medical records. The Cox proportional hazards model was used to analyze the association between the coagulation function indicators and PA. A restrictive cubic spline curve was used to draw the dose-response curve between the relevant coagulation function indicators and PA. Results: A total of 1 340 participants were included in this study. The age was (32.50±4.24) and the incidence of PA was 4.4% (59/1 340). After adjusting for relevant factors, Cox proportional hazards model showed that compared with the high-level classification of fibrinogen (FIB), participants within the middle-(HR=3.28, 95%CI: 1.27-8.48) and low-level (HR=3.84, 95%CI: 1.40-10.53) classification during the first trimester and within the low-level classification (HR=4.18, 95%CI: 1.68-10.39) during the third trimester were more likely to experience PA. Compared with the middle-level classification of pro-thrombin time (PT), the risk of PA in the participants within the low-level classification (HR=2.67, 95%CI: 1.48-4.82) was significantly higher in the third trimester. The restrictive cubic spline analysis showed a linear negative association between FIB and PA in the first and third trimesters, while PT and PA showed an approximately L-shaped association . Conclusion: Among pregnant women diagnosed with preeclampsia-eclampsia, the middle-and low-level classification of FIB in the first and third trimesters and the low-level classification of PT in the third trimester could increase the risk of PA.

Analysis of incidence and associated factors of preterm birth based on pre-pregnancy body mass index stratification / 中华预防医学杂志

Objective: To analyze the incidence of preterm birth based on pre-pregnancy body mass index (BMI) stratification and explore the associated factors of preterm birth among pregnant women at different BMI stratifications. Methods: From February 2018 to December 2020, pregnant women who participated in China Birth Cohort Study (CBCS) and gave birth at Beijing Obstetrics and Gynecology Hospital were enrolled as the study subjects. Electronic Data Capture System and standard structured questionnaires were used to collect data related to pre-pregnancy, pregnancy, and delivery for pregnant women. Pregnant women were divided into the low-weight group, normal-weight group and overweight group based on their pre-pregnancy BMI. A Cox proportional hazards model was used to analyze the associated factors of preterm birth among pregnant women with different BMI before pregnancy. Results: A total of 27 195 singleton pregnant women were included, with a preterm birth rate of 5.08% (1 381/27 195). The preterm birth rates in the low-weight group, normal-weight group and overweight group were 4.29% (138/3 219), 4.63% (852/18 390) and 7.00% (391/5 586) respectively (P<0.001). After adjusting for relevant factors, the Cox proportional hazards model showed that the risk of preterm birth in the overweight group was 1.457 times higher than that in the normal-weight group (95%CI: 1.292-1.643). Preeclampsia-eclampsia (HR=2.701, 95%CI: 1.318-5.537) was the associated factor for preterm birth in the low-weight group. Advanced maternal age (HR=1.232, 95%CI: 1.054-1.441), history of preterm birth (HR=4.647, 95%CI: 3.314-6.515), vaginal bleeding in early pregnancy (HR=1.613, 95%CI: 1.380-1.884), and preeclampsia-eclampsia (HR=3.553, 95%CI: 2.866-4.404) were associated factors for preterm birth in the normal-weight group. Advanced maternal age (HR=1.473, 95%CI: 1.193-1.818), history of preterm birth (HR=3.209, 95%CI: 1.960-5.253), vaginal bleeding in early pregnancy (HR=1.636, 95%CI: 1.301-2.058), preeclampsia-eclampsia (HR=2.873, 95%CI:2.265-3.643), and pre-gestational diabetes mellitus (HR=1.867, 95%CI: 1.283-2.717) were associated factors for preterm birth in the overweight group. Conclusion: Pre-pregnancy overweight is an associated factor for preterm birth, and there are significant differences in the associated factors of preterm birth among pregnant women with different BMI before pregnancy.

A retrospective comparative study between robotic thyroidectomy through transoral vestibular approach and bilateral breast-axillary approach / 中华外科杂志

Objective: To compare the surgical outcome of robotic thyroidectomy through transoral approach and the bilateral breast-axillary approach. Methods: Retrospective analysis was made on the clinical data of patients who performed transoral robotic thyroidectomy (TORT group) or bilateral breast-axillary approach (BABA group) in the Department of Thyroid and Breast Surgery, the 960th Hospital of People's Liberation Army from July 2020 to May 2022. Both groups received lobectomy with lymph node dissection of the central region. A total of 100 cases were included in the study, including 48 cases in the TORT group and 52 cases in the BABA group. The propensity score matching method was used for 1∶1 matching of patients between the 2 groups, with a match tolerance of 0.03. There were 31 patients in each group successfully matched. In the TORT group, there were 5 males and 26 females, aged (33.2±7.9) years (range: 21 to 53 years). While there were 4 males and 27 females in the BABA group, aged (34.6±9.2) years (range: 19 to 58 years). The t test, Mann-Whitney U test, χ2 test or Fisher exact test were used to compare the clinical efficacy between the two groups. Results: All the patients successfully completed robotic thyroid surgery without conversion to open surgery. Compared with BABA group, the TORT group had longer operation time ((211.3±57.2) minutes vs. (126.2±37.8) minutes, t=6.915, P<0.01), shorter drainage tube retention time ((5.4±1.0) days vs. (6.4±1.2) days, t=-3.544, P=0.001), shorter total hospital stay ((6.6±1.2) days vs. (7.4±1.3) days, t=-2.353, P=0.022), and higher cosmetic score (9.46±0.25 vs. 9.27±0.26, t=2.925, P=0.005). There was no significant difference between the two groups in the number of lymph nodes dissection, metastasis in the central compartment, and the incidence of postoperative complications (all P>0.05). Conclusions: Compared with the bilateral breast-axillary approach, the transoral vestibular approach of robotic thyroidectomy is also safe and effective. It shows similar surgical results to the bilateral breast-axillary approach in strictly selected patients, but the postoperative recovery speed is much faster, and the hospital stay is shorter. Transoral robotic thyroidectomy is a more recommended surgical method for patients with high aesthetic demand.

Complications of Da Vinci robot thyroid surgery by bilateral axillo-breast approach / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the complications of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach. Methods: A retrospective analysis of complications was conducted on 1, 198 cases of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach of the 960 th Hospital of the People's Liberation Army from February 2014 to March 2020. There were 263 men and 935 women, age ranged from 9 to 68 years old, and included 288 benign lesions and 910 malignancies according to preoperative imaging examination, FNAC, and intraoperative frozen pathology. Results: Surgical complications occurred in 187 (15.61%) patients, including 10 cases of temporary larynx nerve injury (0.83%), 1 case of permanent larynx nerve injury (0.08%), and 152 cases of temporary hypoparathyroidism (12.69%), no permanent hypoparathyroidism, 1 case of hypoglossal injury (0.08%), 2 cases of facial nerve jaw branch damage (0.17%), 2 cases of trachea injury (0.17%), no esophagus damage, 5 cases of celiac leakage (0.42%), 3 cases of neck skin adhesion (0.25%), 2 cases of subdermal bleeding (0.17%), 2 cases of skin burns (0.17%), 5 cases of hematoma (0.42%), 1 case of cephalic artery rupture (0.08%), 1 case of jugular vein rupture (0.08%), no tumor cultivation, no arm plex nerve, accessory nerve or phrenic nerve damage. Conclusion: Da Vinci robot thyroid surgery by bilateral axillo-breast approach is safe, with less severe complications.

A comparative study of Da Vinci robot and open surgery in primary hyperparathyroidism / 中华内分泌外科杂志

Objective:To investigate the safety and efficacy of da Vinci surgical system in surgical treatment of primary hyperparathyroidism.Methods:The clinical data of 19 patients with primary hyperparathyroidism who received the Da Vinci robot surgical system (the da Vinci surgery group) from Feb. 2016 to May. 2020 and 23 patients undergoing open parathyroid surgery (the open surgery group) were retrospectively analyzed and compared. The operation time, intraoperative blood loss, postoperative drainage volume, hospital stay, postoperative serum calcium and phosphorus, parathyroid hormone, postoperative pain visual analog score, and surgical complications rate and beauty effect of the two groups were statistically compared. The postoperative clinical symptoms and recurrence were followed up in a duration 3 to 84 months.Results:All patients completed the operation successfully, there was no conversion to open operation in the da Vinci surgery group. The operation time (65.5±9.9 vs 54.3±8.3) min ( t=6.231, P=0.015) and postoperative drainage volume (109.7±50.6 vs 97.2±45.2) ml ( t=3.132, P=0.016) in the da Vinci surgery group were more than those in the open surgery group, while the cosmetic effect (9.1±0.6 vs 8.3±0.7) ( t=3.628, P=0.031) was better in the da Vinci surgery group than in the open surgery group. There was no significant difference in intraoperative blood loss (44.3±19.4 vs 39.1±15.4) ml, hospital stay (7.4±1.4 vs 7.9±2.8) days, incidence of complications (15.8% vs 8.7%) , visual analogue scale of postoperative pain (6.9±0.6 vs 6.4±0.8) , clinical symptom relief during the follow-up (100.0% vs 100.0%) , postoperative serum calcium (2.48±0.30 vs 2.43±0.26) mmol/L, serum phosphorus (0.75±0.07 vs 1.37±0.31) mmol/L or parathyroid hormone (36.5±4.7 vs 40.4±5.3) ng/L between the da Vinci surgery group and the open surgery group ( P>0.05) . Conclusion:Leonardo da Vinci robot-assisted surgical treatment for primary hyperparathyroidism with strict surgical indications is similar to traditional open surgery in safety and efficacy, while its cosmetic effect is better.

Clinical application of Da Vinci robot in male thyroid surgery / 中华内分泌外科杂志

Objective:To investigate the safety and surgical treatment effect of da Vinci robot in male thyroid surgery.Methods:Clinical data of 276 male patients undergoing robotic thyroid surgery with bilateral axillo-breast approach (BABA) admitted to our hospital from Feb. 2014 to Jan. 2020 were retrospectively analyzed. They were compared with 372 male patients (open group) who had open surgery by the same team during the same time. Surgical time, the amount of fluid selitransteise after surgery, the length of hospitalization after surgery, the number of metastatic lymph node (for malignant tumor) , cosmetic effect satisfaction, injury of recurrent laryngeal nerve and decrease of parathyroid function and other related surgical complications were analyzed. SPSS 20.0 software was employed to carry out statistical analysis, the measurement data were compared with t-test, and the counting data were analyzed by χ2 test. Results:All operations were successfully completed and on one in the robot group was converted into open surgery. Compared with the open group, surgical time of the robot group (benign: 96.78±9.67min, malignant: 143.93±15.73min) was significantly longer than that of the open group (benign: 70.40±12.49min, malignant: 112.26±15.72min) ( P<0.05) , but the postoperative beauty effect of the robot group (benign: 9.62±0.33 points, malignant: 9.59±0.31 min) was better than that of the open group (benign: 5.33±0.37 points, malignant: 5.87±1.65 points) ( P<0.05) . In patients with pathological malignancy, the average age of the robot group (40.89±11.45 years) was lower than that of the open group (44.84±11.88 years) (P<0.05) . There was no significant difference in the amount of fluid induced after surgery, the length of hospital stay after surgery or the number of cases with lymph node metastasis in the two groups ( P>0.05) . There were 2 cases in the robot group and 5 cases in the open surgery group had recurrent metastasis in the side of the neck after surgery. None of the patients had permanent larynx reflux nerve damage or permanent parathyroid dysfunction. The average follow-up time was (25.36±16.13) months, ranging from 1 to 72 months. Conclusion:Compared with traditional open surgery, da Vinci robot surgery system is safe and feasible in male thyroid surgery, with better beauty effect, and provides new options for male thyroid surgery patients with neck beauty needs.

Clinical observation of Wutou Decoction and Methotrexate for early active rheumatoid arthritis patients / 国际中医中药杂志

Objective:The current study aimed to compare the efficacy of Wutou Decoction (WTD) & Methotrexate (MTX) in treating early active rheumatoid arthritis (RA) patients. Methods:A total of 224 early active RA patients who underwent WTD & MTX or MTX alone treatment for 12 weeks in ShangHai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, from Jul 2015 to Jun 2017, were retrospectively enrolled. Then the patients were divided into united group ( n=131) and MTX group ( n=93) according to their treatments. At time of Week 0, Week 4, Week 8, Week 12, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), disease activity score in 28 joints (DAS28), Health Assessment Questionnaire (HAQ) were collected and assessed. And the clinical remission rate, low disease activity (LDA) rate and total effective rate were calculated. Results:At Week 8 and Week 12, compared with MTX group, the CRP ( t values were 2.100 and 2.488, respectively), ESR ( t values were 2.130 and 2.777, respectively), DAS28 ( t values were 2.886 and 3.718, respectively), and HAQ ( t values were 2.144 and 2.362, respectively) in the united group were significantly decreased ( P<0.05 or P<0.01). At Week 12, clinical remission rate [12.2% (16/131) vs. 4.3% (4/93); χ2=4.188, P=0.041], LDA rate [38.9% (51/131) vs. 25.8% (24/93); χ2=4.207, P=0.040] in the united group were significantly higher than those in the MTX group. At Week 8, total effective rate [37.4% (49/131) vs. 21.5% (20/93); χ2=6.450, P=0.011] in the united group was significantly higher than that of MTX group; and at Week 12, total effective rate [72.5% (95/131) vs. 52.7% (49/93); χ2=9.316, P=0.002] in the united group was also higher than that of the MTX group. Conclusions:WTD in combination with MTX presents better efficacy in decreasing inflammation level and disease activity, and in improving quality of life as well as total effective rate of RA patients compared with MTX.

Comparsion of the clinical application between Da Vinci robot and open operation in thyroid benign tumor with diameter greater than 5 cm / 国际外科学杂志

Objective:To evaluate the feasibility and safety of robotic thyroidectomy for treatment of thyroid benign tumor with diameter larger than 5cm.Methods:The clinical data of 36 patients (in the robot group) who received Da Vinci robot thyroid benign tumor surgery in the thyroid breast Surgery Department of the 960th Hospital of the PLA (Former Jinan Military General Hospital of PLA) from Jan. 2014 to Jun. 2019 were retrospectively analyzed, and compared with 48 patients (in the open group) who received open surgery in the same period.The operative time, intraoperative blood loss, length of hospital stay, postoperative drainage volume, postoperative parathyroid hormone, cosmetic effect, incidence of surgical complications and postoperative recurrence rate of the two groups were observed. Statistical software SPSS16.0 was used for statistical analysis of the data.Results:Both groups successfully completed the operation. Compared with the open group, the operation time ( t=11.232, P<0.001) and postoperative drainage volume ( t=2.892, P=0.003) of the robot group were more than those of the open group, and the aesthetic effect was better ( t=3.291, P=0.024). Intraoperative blood loss ( t=1.575 , P=0.118), hospital stay ( t=-1.784, P=0.091), postoperative PTH ( t=1.892, P=0.086), incidence of surgical complications ( χ2=3.291, P=0.610), visual analogue score of postoperative pain ( t=-2.431, P=0.081) and postoperative recurrence rate were not significantly different ( P>0.05). No recurrence occurred during follow-up. Conclusion:For patients with a selective benign thyroid tumor with a diameter of 5-8 cm, the bilateral axillo-breast and transaxillary approach for thyroid surgery by Da Vinci robot are safe, effective and have better cosmetic results.

Surgical management for persistent and recurrent renal hyperparathyroidism / 中华普通外科杂志

Objective@#To investigate the surgical treatment strategies for persistent and recurrent parathyroidectomy after total parathyroidectomy plus autotransplantation(tPTX+ AT) in cases of renal hyperparathyroidism.@*Methods@#From Oct 2009 to Oct 2018, 480 patients with renal hyperparathyroidism received tPTX+ AT in our hospital. 32 patients suffered from post-op persistent (31) and recurrent (1) hyperparathyroidism .The high frequency ultrasonography combined with fine needle puncture eluent PTH determination and SPECT/CT co-computed tomography fusion imaging were used as qualitative and localizing diagnostic methods before reoperation.@*Results@#Of the 32 patients, 28 cases underwent reoperation for once, and 4 underwent reoperations fort wice. 36 parathyroid glands and 2 grafts were resected.In 31 patients the bone pain, skin pruritus relieved significantly or disappeared, and muscle strength gradually increased compared with that before operation. Level of iPTH in 31 patients fluctuated between 15 and 90 ng/L. Postoperative parathyroid hormone decreased compared with that before the operation (P<0.05). One patient was still with persistent hyperparathyroidism despite reoperation, whose iPTH fluctuated between 550 and 1 000 ng/L during 6 months to 2 years follow-up.@*Conclusion@#Ultrasonography, FNA-iPTH and SPECT/CT co-computed tomography can be used as methods for qualitative and localizing diagnosis of PTPT or PHPT.With accurate preoperative localization, resection of all parathyroid glands is an effective treatment for posto perative persistent and recurrent renal hyper parathyroidism.

Surgical management for persistent and recurrent renal hyperparathyroidism / 中华普通外科杂志

Objective To investigate the surgical treatment strategies for persistent and recurrent parathyroidectomy after total parathyroidectomy plus autotransplantation (tPTX + AT) in cases of renal hyperparathyroidism.Methods From Oct 2009 to Oct 2018,480 patients with renal hyperparathyroidism received tPTX + AT in our hospital.32 patients suffered from post-op persistent (31) and recurrent (1) hyperparathyroidism.The high frequency ultrasonography combined with fine needle puncture eluent PTH determination and SPECT/CT co-computed tomography fusion imaging were used as qualitative and localizing diagnostic methods before reoperation.Results Of the 32 patients,28 cases underwent reoperation for once,and 4 underwent reoperations fort wice.36 parathyroid glands and 2 grafts were resected.In 31 patients the bone pain,skin pruritus relieved significantly or disappeared,and muscle strength gradually increased compared with that before operation.Level of iPTH in 31 patients fluctuated between 15 and 90 ng/L.Postoperative parathyroid hormone decreased compared with that before the operation (P ＜ 0.05).One patient was still with persistent hyperparathyroidism despite reoperation,whose iPTH fluctuated between 550 and 1 000 ng/L during 6 months to 2 years follow-up.Conclusion Ultrasonography,FNA-iPTH and SPECT/CT co-computed tomography can be used as methods for qualitative and localizing diagnosis of PTPT or PHPT.With accurate preoperative localization,resection of all parathyroid glands is an effective treatment for postoperative persistent and recurrent renal hyper parathyroidism.

Structural features of intestinal flora in preterm rats with cognitive impairment: an analysis based on high-thorough sequencing / 中国当代儿科杂志

OBJECTIVE@#To study the structural features of intestinal flora in preterm rats with cognitive impairment and the association of the change in intestinal flora with cognitive impairment in preterm rats.@*METHODS@#Sprague-Dawley rats at 16-17 days of gestation were intraperitoneally injected with lipopolysaccharide for two consecutive days to establish a model of cognitive impairment, and the rats treated with intraperitoneally injected phosphate-buffered saline were established as the control group. Cesarean section was performed on day 21 of gestation, and preterm rats were randomly assigned to healthy maternal rats for feeding. The place navigation test in the Morris water maze was used to evaluate cognition on day 30 after birth. According to the result, the preterm rats were divided into cognitive impairment group with 21 rats and normal control group with 10 rats. Hematoxylin and eosin staining was used to observe pathological changes of the hippocampus, and fecal samples were collected for 16S rRNA sequencing and analysis. A principal component analysis (PCA) was performed for intestinal flora.@*RESULTS@#Compared with the normal control group, the cognitive impairment group showed degeneration and necrosis of a large number of neurons in the hippocampus. Compared with the normal control group, the cognitive impairment group had significant reductions in the abundance and diversity of intestinal flora (P<0.05), with a significant increase in the abundance of Proteobacteria at the phylum level (P<0.05), as well as significant reductions in the abundance of Prevotella and Lactobacillus and significant increases in the abundance of Staphylococcaceae and Oligella at the order, family, and genus levels (P<0.05). PCA showed a significant difference in the composition of intestinal flora between the two groups.@*CONCLUSIONS@#There is a significant change in the structure of intestinal flora in preterm rats with cognitive impairment, which provides a basis for the treatment and intervention of microecological changes due to cognitive impairment after preterm birth.

Genetic Polymorphisms of 27 Y-STR Loci in Dongxiang Population of Gansu Province / 法医学杂志

OBJECTIVES@#To investigate the genetic polymorphisms of 27 Y-STR in Dongxiang population of Gansu province, and to explore the population genetic relationship and the value of forensic application.@*METHODS@#The genotyping of 27 Y-STR loci in 526 unrelated male individuals in Dongxiang population of Gansu province were detected by STRtyper-27Y kit. The allele frequencies and haplotype diversity were also calculated. Combining with other genetics data of 14 loci in same populations, which have been published at home and abroad, the genetic distance and clustering relationship in Dongxiang population of Gansu province were calculated.@*RESULTS@#Totally 55 haplotypes were found in the DYS385a/b biallelic loci, 39 haplotypes in DYF387S1 loci, and 4-16 alleles in the rest 23 single copy STR loci. The GD value was from 0.453 9 （DYS391） to 0.957 5 （DYS385a/b）. Totally 471 haplotypes were observed in 27 Y-STR loci in 526 individuals, and the value of haplotypes diversity was 0.999 5. The genetic distance between Dongxiang and Tibetan populations of Gansu province was the closest （0.068 2）, while it was the longest between Dongxiang population in Gansu province and Han population in Henan province （0.084 7）. The result of dimensional analysis established upon the genetic distance was basically matched with that of the cluster analysis.@*CONCLUSIONS@#The 27 Y-STR loci show a high genetic polymorphism in Dongxiang population of Gansu province, which has significance for the Y-STR database establishment, population genetics study and forensic practice.

Use of da Vinci Si surgical system in total parathyroidectomy with autotransplantation for secondary renal hyperparathyroidism / 中华普通外科杂志

Objective To evaluate the clinical safety and effectiveness of da Vinci Si surgical system in total parathyroidectomy with autotransplantation of secondary hyperparathyroidism.Methods A retrospective analysis was conducted with da Vinci Si surgical system on 16 patients with secondary hyperparathyroidism who were given total parathyroidectomy with autotransplantation from Mar 2014 to June 2016.The changes of clinical symptoms,parathyroid hormone,calcium and phosphate blood levels were followed up from 6 months to 2 years.Results Surgery was successful in all 16 cases and 62 parathyroid glands were resected.There were no operation-related complications and no conversions to open or endoscopic surgery.Mean operation time was (136 ± 24) minutes.In all postoperative cases the musculoskeletal pain,skin itching were relieved or disappeared.PTH,calcium and phosphate blood levels decreased and no recurrence during follow-up period,The postoperative cosmetic result was satisfatory.Conclusions Da Vinci Si surgical system used in the parathyroid surgery is safe and effective,especially suitable for patients with cosmetic requirements.

Annoyance-rate-and-casualty-reality-based method of comfort evaluation of military ambulance / 医疗卫生装备

Objective To explore an method for comfort evaluation of the military ambulance to enhance ride comfort during casualty transport. Methods The method executed quantitative evaluation of vibrational comfort by the existing vibration comfortableness evaluation ways for non-ambulatory casualty, different reactions of casualty to vibrational excitement and annoyance rate analysis based on psychophysics, which took considerations on the ratio of injured sites at war or natural disaster conditions as well as susceptibility analysis. Trials of the the method were carried out on the vibrational comfort analysis of some military ambulance during the road test.Results The method had feasibility for vibration comfortableness evaluation of non-ambulatory casualty,and improved the traditional ways in quantitative analysis.Conclusion The method gains advantages over the international ways, and contributes to the related researches on vibration reduction.

Application of total parathyroidectomy with autotransplantation in secondary hyperparathyroidism / 中华内分泌外科杂志

Objective To evaluate the clinical safety and effectiveness of total parathyroidectomy with autotransplantation on the chronic renal failure (CRF) patients who are suffering from severe secondary hyperparathyroidism (SHPT).Methods A retrospective analysis was performed on 149 patients with secondary hyperparathyroidism who were given total parathyroidectomy with autotransplantation from Apr.2010 to Oct.2015.The changes of clinical symptoms,parathyroid hormone,calcium and phosphate blood levels were followed up during 6 months to 6 years.Results 598 parathyroid glands were obtained form 149 patients who underwent surgical resection.Musculoskeletal pain and skin itching relieved or disappeared in 145 cases the 2nd day after operation,while these symptoms gradually relieved one week after operation for 4 cases.Serum intact parathyroid hormone (iPTH)was 89.67±180.61,serum phosphate 1.74±0.52,and serum calcium 2.07±0.32 the 1st day after operation,and they all decreased compared with those before operation(P＜0.001).Serum calcium,phosphorus and iPTH levels were similar at 6,36 and 60 months after operation (P＞0.05).Two patients had pathological fracture after operation.No persistent bone pain or skin itching was found during the follow-up period.Two patients had secondary hyperparathyroidism.Six patients had recurrence,among whom five underwent surgery again,and one patient had clinical follow-up.One patient died of pulmonary infection at 13 months after operation.Conclusion Total parathyroidectomy with autotransplantation were applied to ineffective medical treatment for advanced secondary hyperparathyroidism in patients with chronic renal failure.

Genetic polymorphisms of 19 X-STR loci for forensic application in China’s three ethnicities / 基础医学与临床

Objective To investigate the genetic data of the 19 X-STR loci in three ethnicities of China ( Han, Gelao,Miao) and to evaluate the application in forensic science.Methods The DNA samples of unrelated individ-ual in Han (n=308), Gelao (n=398), Miao (n=323) ethnicities were amplified using MicroreaderTM19X ID System kit, and the PCR products were analyzed by electrophoresis through 3500XL genetic analyzer. The fragment sizes of alleles were taken subsequently by GeneMapper? ID-X. Allele frequencies and national genetics parameters of the 19 X-STR were analyzed by statistics. The allele frequencies were compared among the three nationalities and were compared with available data of other Han ethnicities from different regions. Results After the Bonferroni correction at a 95% significance level, no significant departures from the Hardy-Weinberg equilibrium was observed. Linkage disequilibrium test showed no significant allelic association between all 19 X-STR loci after Bonferroni’s correction. The cumulative discrimination power in females and in males were greater than 0.999 999 999 99 and 0.999 999 999 94,respectively. The combined power of exclusion in trios and in duos were greater than 0.999 999 999 36 and 0.999 999 52,respectively. The p values,calculated throuth Arle-quin v3.5 software,there were significantly different as detected at loci of X-STR among the different nationalities. Conclusions This panel of X-STR is highly polymorphic in China’s three ethnicities and can be served as a supple-mentary to the current STR system for individual identification.

Surgical and medical treatment with cinacalcet in tertiary hyperparathyroidism / 国际外科学杂志

Tertiary hyperparathyroidism is commonly observed in patients with long-standing chronic kidney disease (CKD) after renal transplantation and is characterized by the autonomous hypersecretion of PTH leading to hypercalcemia.The primary treatment is surgery.After the introduction of cinacalcet,both surgical and medical methods have been commonly performed to treat tertiary hyperparathyroidism.However,which treatment is more appropriate has not been fully demonstrated.In this paper,the author will systematically review the related research of surgical treatment and cinacalcet in the treatment of 3HPT,and summarize their respective therapeutic effects.

Clinical efficacy of Chenshi Qingfei Decoction on rheumatoid arthritis and interstitial lung disease / 中成药

AIM To explore the efficacy of Chenshi Qingfei Decoction (Pseudostellariae Radix,Ophiopogonis Radix,Adenophorae Radix,etc.) against rheumatoid arthritis and interstitial lung disease (RA-ILD).METHODS Based on Prednisolone,RA-ILD patients were randomly divided into control group and observation group by random number table and randomized block design.The observation group took Chenshi Qingfei Decoction.The treatment course was three months for both groups.Before the treatment,the activity of the disease (DAS28) was assessed and ESR,CRP,RF,CCP were measured.Before and after the treatment,high resolution-CT (HRCT) was conducted and graded,and symptoms and signs were graded.RESULTS After the treatment,the effective rate of cough,expectoration and breath hard in the syndromes of Chinese traditional medicine was 71％ in the observation group and 23％ in the control group (P ＜0.01).The effective rate of improved lung imaging by HRCT was 68％ in the observation group but 13％ in the control group (P ＜0.01).CONCLUSION Based on the immunosuppressive agents therapy in RA,Chenshi Qingfei Decoction can relieve clinical symptoms of cough,expectoration and breath hard,and reduce area and degree of interstitial lung disease by HRCT.