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.

Houttuynia cordata polysaccharide alleviated intestinal injury and modulated intestinal microbiota in H1N1 virus infected mice / 中国天然药物

Houttuynia cordata polysaccharide (HCP) is extracted from Houttuynia cordata, a key traditional Chinese medicine. The study was to investigate the effects of HCP on intestinal barrier and microbiota in H1N1 virus infected mice. Mice were infected with H1N1 virus and orally administrated HCP at a dosage of 40 mg(kg(d. H1N1 infection caused pulmonary and intestinal injury and gut microbiota imbalance. HCP significantly suppressed the expression of hypoxia inducible factor-1α and decreased mucosubstances in goblet cells, but restored the level of zonula occludens-1 in intestine. HCP also reversed the composition change of intestinal microbiota caused by H1N1 infection, with significantly reduced relative abundances of Vibrio and Bacillus, the pathogenic bacterial genera. Furthermore, HCP rebalanced the gut microbiota and restored the intestinal homeostasis to some degree. The inhibition of inflammation was associated with the reduced level of Toll-like receptors and interleukin-1β in intestine, as well as the increased production of interleukin-10. Oral administration of HCP alleviated lung injury and intestinal dysfunction caused by H1N1 infection. HCP may gain systemic treatment by local acting on intestine and microbiota. This study proved the high-value application of HCP.

Security and validity of posterior sclera reinforcement for high myopic retinopathy / 眼科新进展

Objective To investigate the efficacy of security and validity of posterior sclera reinforcement (PSR) for high myopic retinopathy (MR).Methods This study included 76 eyes in 41 patients with MR who underwent PSR and were followed up for two years.Preoperative and postoperative axial length,best-corrected visual acuity,the reattachment of retinoschisis and the complications were evaluated.Results The axial length was shortened 3 days,1 month,3 months and 6 months after operation compared with preoperation[(27.71 ± 1.60) mm,(28.11 ± 1.62) mm,(28.58 ± 1.80)mm and (29.01 ± 1.92) mm vs.(30.29 ± 2.01) mm],and the difference was statistically significant (all P =0.000).The axial length gradually increased to preoperative level at 1 year after surgery,and there was no significant difference in the postoperative 2-year and preoperative axial length (P =0.300).The best corrected visual acuity was improved 1 month after surgery,but the improvement had no significantly difference compared with the preoperative one (P =0.080).The best corrected visual acuity was improved at 3 months,6 months,1 year and 2 years postoperatively continuously,and the improvement had significantly difference compared with the preoperative ones (all P ＜0.05).In addition,there were 34 eyes with retinoschisis before surgery,and the retina was completely attached postoperatively in 27 eyes (79.41％),almost attachment was observed in 4 eyes (11.76％),and improvement was in 3 eyes (8.82％).No complications occurred during surgery.Conjunctival irritation,high intraocuiar pressure,orbital inflammation,diplopia and visual deformation and macular bleeding recurrence occurred postoperatively and all recovered in 3 months.Conclusion During 2-year follow-up,it is safe and effective for PSR to treat MR,which can control myopic progression effectively in patients with pathological myopia.

Polymyxin B as an inhibitor of lipopolysaccharides contamination of herb crude polysaccharides in mononuclear cells / 中国天然药物

Lipopolysaccharides (LPS) contamination in herbal crude polysaccharides is inevitable. The present study was performed to explore the effect of polymyxin B on abolishing the influence of LPS contamination in mononuclear cells. LPS was pretreated with polymyxin B sulfate (PB) at different concentrations for 1, 5 or 24 h, and then used to stimulate RAW264.7 and mouse peritoneal macrophages (MPMs). The nitric oxide (NO) and tumor necrosis factor-α (TNF-α) in cell culture supernatant, as the indications of cell response, were assayed. Bupleurum chinensis polysaccharides (BCPs) with trace amount contamination of LPS was treated with PB. 30 μg·mL of PB, treating LPS (10 and 1 000 ng·mL in stimulating RAW264.7 and MPMs respectively) at 37 °C for 24 h, successfully abolished the stimulating effect of LPS on the cells. When the cells were stimulated with LPS, BCPs further promoted NO production. However, pretreated with PB, BCPs showed a suppression of NO production in MPMs and no change in RAW264.7. In the in vitro experiments, LPS contamination in polysaccharide might bring a great interference in assessing the activity of drug. Pretreatment with PB (30 μg·mL) at 37 °C for 24 h was sufficient to abolish the effects of LPS contamination (10 and 1 000 ng·mL).

The protective effect of Jinlida granules on kidney of type 1 diabetic rats / 第二军医大学学报

Objective To explore the protective effect of Jinlida granuleson kidney tissues of type 1 diabetic rats, and to elucidate the related mechanism. Methods SD rats were intraperitoneally injected with streptozotocin (STZ, 60 mg/kg) to establish type 1 diabetic models. Then the model rats were randomly divided into diabetic model group, low-, medium- and high-dose Jinlida groups (0. 75, 1. 5 and 3. 0 g/kg Jinlida granules, respectively), Jinlida + Tongxinluo (TXL) group (1. 5 g/kg Jinlida granules+ 0. 4 g/kg TXL), metformin group (50 mg/kg metformin), and saxagliptin group (1 mg/kg saxagliptin), with each group containing 5 rats. Five healthy rats served as normal controls. Eight weeks after administration of drugs or placebo, the levels of growth hormone (GH), growth hormone receptor (GHR), insulin-like growth factor 1 (IGF-1), insulin-like growth factor 1 receptor (IGF-1R), and insulin-like growth factor lbinding protein 1 (IGFBP-1) mRNA were detected by real-time quantitative PCR, the expressions of MAPK pathway related proteins and fibronectin (FN) were determined by Western blotting; and H-E staining, Masson staining and PAS staining were used to observe the morphological changes of kidney tissues. Results Compared with the normal control group, the levels of GH, GHR, IGF-1, IGF-1R mRNA and the protein expressions of p-ERK, p-JNK, and FN of kidney tissues were significantly increased (P<0. 01), with cellular proliferation and fibrous deposition seen in the kidney tissues in the diabetic model group. After intervention with midde and high-dose Jinhda granules, the levels of GH, GHR, IGF-1, and IGF-1R mRNA and ratios of p-ERK/ERK, p-JNK/JNK, and FN protein expression were significantly decreased (P<0. 05, P<0. 01), with alleviated kidney tissues fibrosis. Conclusion Jinlida granules can protett kidney tissues of type 1 diabetic rats, which is probably through up-regulating the levels of GH and IGF-l mRNA and inhibiting the activation of the MAPK pathway.

The correlation among hMLH1, NIS and TSHR genes with promoter methylation in papillary thyroid carcinoma and its clinical significance / 肿瘤

Objective: To investigate the aberrant methylation status of hMLH1 (human mutL homologue 1) gene in PTC (papillary thyroid carcinoma) tissues, and its correlations with the aberrant methylation of NIS (sodium iodide symporter) and TSHR (thyroid-stimulating hormone receptor) genes. Methods: qMSP (quantitative methylation-specific PCR) was carried out to detect the promoter methylation status of hMLH1, NIS and TSHR genes in PTC tissues and adjacent normal thyroid tissues from 152 patinets with PTC. The correlation between the clinicopathologic characteristics and the promoter methylation status of hMLH1 gene was analyzed. The relationships among the methylation status of hMLH1, NIS and TSHR genes and their independent or synergistic effects on the progression of PTC were investigated. Results: The promoter methylation rate of hMLH1 gene in PTC tissues (37.5%) was significantly higher than that in the adjacent normal thyroid tissues (5.3%) (P 0.05). There was a weak correlation among aberran promoter methylation of hMLH1, NIS and TSHR genes (r 0.05). Conclusion: The aberrant methylation of hMLH1 gene promoter in PTC tissues might be associated with the progression of the tumor. There exists no correlation among the aberrant methylation of hMLH1, NIS and TSHR genes, and their independent or synergistic effect also may not be associated with the progression of PTC. Copyright © 2013 by TUMOR.

Aberrant methylation of hMLH1 gene promoter in papillary thyroid cancer and its clinical significance / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the aberrant promoter methylation of hMLH1 gene promoter and its clinical significance in papillary thyroid cancer (PTC).</p><p><b>METHODS</b>methylation of hMLH1 gene promoter in the cancer tissue and matched tumor-adjacent normal tissue of 152 PTC patients were detected by real-time methylation specific PCR (qMSP). The relationship between the methylation of hMLH1 gene promoter and clinicopathological features was analyzed.</p><p><b>RESULTS</b>The methylation rate of hMLH1 gene promoter in cancer tissues was 37.5% (57/152), of which 33 cases were totally methylated and 24 cases were partially methylated. The methylation rate of adjacent normal tissues was 5.3% (8/152)(all were partially methylated). The methylation rate of PTC tissues was significantly higher than that in the tumor-adjacent normal tissue (P < 0.01). The promoter methylation of hMLH1 gene in PTC was significantly correlated with age, size and number of the primary lesion, local invasion, T stage and lymph node metastasis (P < 0.05) , but not correlated with gender and clinical stage (P > 0.05).</p><p><b>CONCLUSION</b>Promoter methylation of hMLH1 gene is a common molecular event in PTC tissue, and it is significantly correlated with the progression of PTC.</p>