Management of vena cava tumor thrombus dislodgement in robot-assisted laparoscopic surgery / 现代泌尿外科杂志

Renal cancer complicated with inferior vena cava tumor thrombus has been difficult to manage in urological surgery, because it has a complex anatomical relationship and involves vascular blockage of vital organs such as kidney, liver and heart, as well as the blockage and reconstruction of inferior vena cava. In addition, tumor thrombus dislodgement may occur intraoperatively, leading to acute pulmonary embolism, which makes the surgery extremely difficult and risky. In this paper, we report the successful treatment of thrombus dislodgement in a case of right kidney tumor with inferior vena cava thrombus during robot-assisted laparoscopic surgery and explore the treatment methods, aiming to avoid lethal pulmonary embolism caused by tumor thrombus dislodgement.

Simultaneous determination of seven components and their distribution in Anoectochilus roxburghii by UHPLC-MS/MS / 药学学报

Based on ultra high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS), a rapid and simultaneous quantitative method for the measurement of seven components (kinsenoside; rutin; kaempferol-3-O-rutinoside; quercimeritrin; narcissin; isorhamnetin-3-O-glucoside; quercetin) of A. roxburghii was established. The separation was performed over 8.0 minutes on a Waters Acquity UPLC BEH Shield RP18 (2.1 mm × 100 mm; 1.7 μm) with a mobile phase consisting of acetonitrile (A) and 0.1% formic acid water solution (B) with gradient elution at a flow rate of 0.2 mL·min-1; the column temperature was 30 ℃ and the injection volume was 2 μL. Electrospray spray ionization source (ESI source) was used for mass spectrometry, and positive and negative ion modes were detected at the same time. The results showed good linearity (R2 ≥ 0.998 0), with good precision, repeatability and stability, and the average recovery was 97.71%-103.33%. Through cluster heat map and redundancy analysis, we found that kinsenoside was mainly distributed in stems, followed by leaves, and the lowest content in roots. The content of kinsenoside increased significantly in the stems of plants 6 months, but less change was evident in the roots and leaves. Flavonoids and flavonoid glycosides were mainly distributed in leaves. The UHPLC-MS/MS method established in this paper can be used for the quality control of A. roxburghii and provides a reference for establishing a more comprehensive quality detection method for this medicinal.

One case report of recurrent primary hyperparathyroidism caused by iatrogenic implant ectopic parathyroid adenoma / 中华内分泌外科杂志

Parathyroid adenoma (PTA) is an important cause of hyperparathyroidism (HPT) . The author reported a case of HPT caused by proliferation of parathyroid cells caused by implantation during surgery, and the formation of adenoma in sternocleidomastoid muscle was detected. The understanding of primary hyperparathyroidism (PHPT) caused by ectopic PTA was analyzed from clinical symptoms, laboratory examination, the neck Doppler ultrasound, imaging ( 99TC m-MIBI SPECT/CT fusion imaging, CT) and pathological examination results, combined with the parathyroidism of the patient during the first operation.

Computational Study of Fenestration and Parallel Grafts Used in Aortic Arch Lesion / 医用生物力学

Objective To explore hemodynamics of the aortic arch and supraarch vessels after thoracic endovascular aortic repair with fenestration and parallel grafts techniques, and compare the differences of these techniques. Methods Four patients with aortic arch lesions whose supraarch vessels were reconstructed by different surgical techniques (fenestration, chimney and periscope) were studied, and three-dimensional (3D) geometric models were established based on postoperative image data. The physiological flow obtained from two dimensional (2D) phase contrast magnetic resonance imaging were imposed on the ascending aorta inlet and the supraarch vessels outlets. The pressure waveform of 3-element Windkessel model was imposed on the descending aorta outlet. Through computational fluid dynamics ( CFD ) simulations, the hemodynamic parameters were obtained, including the pressure of supraarch vessels, the velocity vector of the stent inlet, and the relative residence time. Results The pressure change of the periscope stent was the largest, followed by the fenestration stent, and the pressure change of the chimney stent was the smallest. The velocity of the fenestration and periscope stent inlet was uneven, which might form vortex. The velocity of the chimney stent inlet was even. The high relative residence time concentrated in distal end of the fenestration stent outer wall, the ‘gutter’ part, and the place where the chimney and periscope stent adhered to the vessel wall. Conclusions The pressure difference between the inner and outer walls of the fenestration and periscope stent was high, so it was recommended to use the balloon-expandable stent. The pressure difference between the inner and outer walls of the chimney stent was low, so it was recommended to use the self-expanding stent. The predicted location of thrombosis was consistent with the clinical follow-up data, so it may be used for surgical planning and risk assessment of interventional treatment of aortic arch lesions.

Locking plate fixation with fibular strut allograft versus locking plate fixation alone for the treatment of proximal humeral fractures in adults:a Meta-analysis / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy of locking plate fixation with a fibular strut allograft (FA group) and locking plate fixation alone (LP group) in the treatment of proximal humeral fractures in adults by Meta-analysis.@*METHODS@#Databases including PubMed, The Cochrane Library, Embase, Chinese BioMedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI), WanFang Data, and China Science and Technology Journal Database (cpvip Database) were searched by computer from establishing to March 2020 to collect studies about locking plate fixation with fibular strut allograft versus locking plate fixation alone for proximal humeral fractures in adults. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. The postoperative humeral head height changes, neck-shaft angle changes, Constant-Murley score, American Shoulder and Elbow Surgeons(ASES)score, visual analogue scale(VAS), varus malunion rate, and screw penetration rate were compared by RevMan 5.3 software for Meta-analysis.@*RESULTS@#Ten cohort studies were enrolled in a total of 749 patients, 300 patients in the FA group and 449 patients in the LP group. The results of Meta-analysis showed that locking plate with fibular strut allograft was superior to locking plate fixation alone in the changes in humeral head height [MD=-2.69, 95%CI(-3.24, -2.13), P<0.000 01], the changes in neck-shaft angle [MD=-5.65, 95%CI(-7.18, -4.12), P<0.000 01], Constant-Murley score [MD=9.00, 95%CI(4.26, 13.73), P=0.000 2], the ASES score [MD=5.56, 95%CI(4.29, 6.84), P=0.000 01], VAS score [MD=-0.23, 95%CI(-0.37, -0.09), P=0.001], the varus malunion rate [RR=0.22, 95%CI(0.09, 0.53), P=0.000 7] and the screw penetration rate [RR=0.26, 95%CI(0.13, 0.55), P=0.000 3], respectively.While there was no significant difference in the rate of osteonecrosis of the humeral head [RR=1.18, 95%CI(0.57, 2.45), P=0.65].@*CONCLUSION@#For proximal humeral fractures in adults, current evidence shows that locking plate fixation with fibular strut allograft is superior to single locking plate fixation in improving postoperative radiological outcomes and shoulder function, relieving postoperative pain, reducing varus malunion rate and screw penetration rate. However, the efficacy in decreasing the osteonecrosis rate is not clear. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.

Clinical observation of microwave ablation combined with anhydrous ethanol in the treatment of cystic thyroid nodules inical / 中华内分泌外科杂志

Objective:To observe the therapeutic effect of microwave ablation combined with anhydrous ethanol for cystic thyroid nodules.Methods:From Jan. 2019 to Dec. 2019, 56 patients with thyroid cystic nodules (≥2cm) underwent ultrasound guided thyroid cystic nodule ablation in Department of Thyroid and Breast Surgery, Nanjing Hospital of Traditional Chinese Medicine. According to different ablation methods, the patients were divided into microwave ablation combined with anhydrous ethanol group and microwave ablation group. There were 36 cases in microwave ablation combined with anhydrous ethanol group and 20 cases in microwave ablation group. The volume reduction rate of thyroid nodules, the incidence of postoperative complications and the changes of thyroid function were compared between the two groups after treatment. Statistical analysis were performed using SPSS, version 21.0, the mean±SD deviation ( ± s) was used to describe the statistics, t-test was performed, and the adoption rate of counting data (%) was expressed by χ 2 test. The difference was statistically significant with P<0.05. Results:The nodule volume reduction rates of the microwave ablation combined with anhydrous ethanol group and microwave ablation group were (49.86±6.78) % vs (22.84±1.88) %, (67.57±5.84) % vs (47.25±7.09) % and (75.70±4.51) % vs (71.14±4.65) % at 3 months, 6 months and 12 months after operation, respectively. There was significant difference between the two groups ( P<0.001) . The incidence of postoperative complications in the two groups was 38.89% and 45.00% respectively, and there was no significant difference between the two groups ( P>0.05) , and all complications were cured within 2 months. There was no significant difference in thyroid function (T3, T4, FT3, FT4, TSH) between the two groups before and 12 months after operation ( P>0.05) . Conclusions:Microwave ablation combined with anhydrous ethanol is more effective in treatment of cystic thyroid nodules (≥2cm) than microwave ablation alone. It can significantly improve patients’symptoms and nodule volume reduction, and does not affect thyroid function. It can be used as a recommended option for treatment of cysticthyroid nodules.

Resource characteristics and propagation techniques of Anoectochilus roxburghii in China / 药学学报

italic>Anoectochilus roxburghii (Wall.) Lindl. is a medicinal species belonging to the Orchidaceae, whose whole plant can be used as a medicinal herb, known as "JinXianLian". It has antidiabetic, liver-protecting, anti-inflammatory, etc. A. roxburghii has long been used as food and medicine in Guangdong and Fujian provinces. With the wide recognition of the concept of "medicine and food homology" and the surge of market demand, wild A. roxburghii has been far from meeting the supply. It is important to establish an artificial propagation system. Resource characteristics are the key basis for optimizing germplasm and propagation systems. Therefore, this paper summarizes the germplasm resource characteristics and propagation technologies of A. roxburghii in China to provide a reference for sustainable development and subsequent mechanistic research.

Oral administration of TRPV4 inhibitor improves atrial calcium handling abnormalities in sterile pericarditis rats / 生理学报

Atrial Ca2+ handling abnormalities, mainly involving the dysfunction of ryanodine receptor (RyR) and sarcoplasmic reticulum Ca2+-ATPase (SERCA), play a role in the pathogenesis of atrial fibrillation (AF). Previously, we found that the expression and function of transient receptor potential vanilloid subtype 4 (TRPV4) are upregulated in a sterile pericarditis (SP) rat model of AF, and oral administration of TRPV4 inhibitor GSK2193874 alleviates AF in this animal model. The aim of this study was to investigate whether oral administration of GSK2193874 could alleviate atrial Ca2+ handling abnormalities in SP rats. A SP rat model of AF was established by daubing sterile talcum powder on both atria of Sprague-Dawley (SD) rats after a pericardiotomy, to simulate the pathogenesis of postoperative atrial fibrillation (POAF). On the 3rd postoperative day, Ca2+ signals of atria were collected in isolated perfused hearts by optical mapping. Ca2+ transient duration (CaD), alternan, and the recovery properties of Ca2+ transient (CaT) were quantified and analyzed. GSK2193874 treatment reversed the abnormal prolongation of time to peak (determined mainly by RyR activity) and CaD (determined mainly by SERCA activity), as well as the regional heterogeneity of CaD in SP rats. Furthermore, GSK2193874 treatment relieved alternan in SP rats, and reduced its incidence of discordant alternan (DIS-ALT). More importantly, GSK2193874 treatment prevented the reduction of the S2/S1 CaT ratio (determined mainly by RyR refractoriness) in SP rats, and decreased its regional heterogeneity. Taken together, oral administration of TRPV4 inhibitor alleviates Ca2+ handling abnormalities in SP rats primarily by blocking the TRPV4-Ca2+-RyR pathway, and thus exerts therapeutic effect on POAF.

Effect of miR-5787 on breast cancer cell invasion and proliferation by targeting HSPG2 gene / 中国医师杂志

Objective:To observe the expression of microRNA (miRNA, miR)-5787 in breast cancer tissues and various cell lines, analyze the effect of overexpression of miR-5787 on breast cancer cell invasion and proliferation, and explore its possible molecular mechanism.Methods:Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) method was used to detect the expression of miR-5787 in 47 breast cancer tissues and adjacent tissues, 4 breast cancer cell lines and normal breast epithelial cells. Breast cancer cell lines with the lowest miR-5787 expression were selected and transfected with miR-5787 mimics (experimental group) and control NC mimics (control group), respectively. qRT-PCR was used to detect the expression of miR-5787 in cells of the two groups. Transwell invasion experiment and cell counting kit-8 (CCK-8) were used to detect the effect of miR-5787 overexpression on breast cancer cell invasion and proliferation. Bioinformatics software and dual luciferase reporter gene experiments were used to predict and verify the target genes that miR-5787 could complementally bind. qRT-PCR and Western blot were used to detect the expression of target gene mRNA and protein.Results:Compared with adjacent tissues (5.05±0.82), the expression of miR-5787 in breast cancer tissues (1.32±0.33) was significantly reduced ( P<0.01). Compared with normal breast epithelial cells, the expression of miR-5787 in the four breast cancer cell lines was reduced ( P<0.05), and the expression in HCC1937 cells was the lowest ( P<0.01). After transfection of miR-5787 mimics, the expression of miR-5787 in HCC1937 cells in the experimental group was significantly higher than that in the control group ( P<0.01). Overexpression of miR-5787 could inhibit the invasion ( P<0.05) and proliferation ( P<0.05) of breast cancer HCC1937 cells. Bioinformatics software showed that the target gene of miR-5787 might be heparan sulfate proteoglycan 2 (HSPG2), and miR-5787 could complement HSPG2 mRNA ( P<0.01). qRT-PCR and Western blot indicated that overexpression of miR-5787 could significantly inhibit the expression of HSPG2 gene ( P<0.01), with the decreased expression of Vimentin, N-cadherin, Ki67 and PCNA. Conclusions:miR-5787 expression was low in breast cancer tissues and cell lines. Overexpression of miR-5787 could inhibit the invasion and proliferation of breast cancer HCC1937 cells by interfering with the expression of HSPG2 gene.

Chronic Toxicity of Tanreqing Injection in Beagle Dogs / 中国实验方剂学杂志

Objective:To observe the possible toxicity of long-term intravenous injection of Tanreqing injection in Beagle dogs， so as to provide experimental data for its clinical safe medication. Method:A total of 32 Beagle dogs （16 males and 16 females） were randomly divided into the low- （2.5 mL·kg^-1）， medium- （5.0 mL·kg^-1）， and high-dose （10.0 mL·kg^-1） Tanreqing injection groups and control group according to their body mass indices， with eight dogs in each group. In the waking state， the dogs were treated with intravenous injection of corresponding drugs into the medial cephalic vein of forelimb for 13 weeks， followed by four-week drug withdrawal. After the observation of general condition， body mass， and food consumption， the Beagle dogs were subjected to electrocardiography， ophthalmoscopy， hematological examination， serum biochemistry， and blood coagulation test in the middle of medication （week 6）， at the end of medication （week 13）， and during recovery （week 17）. Then the gross anatomy was conducted for calculating the major organ coefficients and observing the histopathological changes. Result:No obvious toxic reaction was found in each group， but the decreased fibrinogen and increased Kupffer's cells phagocytizing yellow-brown pigment in hepatic sinusoids were observed in the high-dose Tanreqing injection group following three months of medication. Reduction of fibrinogen was not observed in recovery period， but Kupffer's cells that phagocytized yellow-brown pigment still existed. Conclusion:The intravenous injection of Tanreqing injection at 2.50 mL·kg^-1（low dose）， 5.00 mL·kg^-1 （medium dose） or 10.00 mL·kg^-1（high dose） for three months in Beagle dogs resulted in no obvious toxic reaction. However， it is still suggested to test the liver function and blood coagulation after long-term administration of high-dose Tanreqing injection.

The transcription factor NF-kB1 regulates miR-195 expression in prostate cancer / 中华男科学杂志

Objective@#To investigate the regulatory effect of the transcription factor NF-kB1 on the expression of miR-195 in prostate cancer (PCa).@*METHODS@#We analyzed the possibility of NF-kB1 binding to the miR-195 promoter and the expression of NF-kB1 in PCa using the JASPAR and Oncomine databases, respectively, and determined the expressions of NF-kB1 and miR-195 in PCa cells by real-time quantitative PCR after inhibiting the former by interfering RNA targeting NF-kB1. We detected the activity of the luciferase reporter gene after constructing its gene plasmid in the miR-195 promoter region and having it co-transfected with the NF-kB1 plasmid. Then we analyzed the correlation between the expressions of miR-195 and NF-kB1 in the prostate tissue.@*RESULTS@#NF-kB1 was overexpressed in PCa. After inhibition of the expression of NF-kB1, that of miR-195 was increased in PC-3 and DU-145 cell lines, with a negative correlation between the NF-kB1 and miR-195 expressions in the PCa tissue. The results of luciferase reporter gene assay showed direct binding of NF-kB1 to the miR-195 promoter zone.@*CONCLUSIONS@#NF-kB1 regulates the expression of miR-195 in prostate cancer.

The clinical effect of modified arrow flap for nipple reconstruction / 中华内分泌外科杂志

Objective:To investigate the clinical effect of modified arrow flap for nipple reconstruction.Methods:From Jan. 2018 to Oct. 2019, 10 patients in Nanjing Hospital of Traditional Chinese Medicine who received the modified arrow flap for nipple reconstruction were collected. The rate of nipple retraction, patient satisfaction and the incidence of local flap complications were evaluated.Results:The operation time of 10 patients was 13-18 minutes, and the average operation time was (15.10±1.52) minutes. All patients were followed up for 3-24 months, with an average follow-up time of (14.60±1.07) months. The retraction rate of nipple height was 23.5%-33.2%, the average retraction rate of nipple height was (28.53±3.02) %, the diameter retraction rate of nipple was 7.1%-10.5%, and the average diameter retraction rate of nipple was (8.92±1.05) %. The patients’ satisfaction was 96%-100%, with an average of (97.9±1.60) %. None of the 10 patients had complications such as bad wound healing, incision dehiscence or flap necrosis.Conclusion:The design of the improved arrow flap is simple, the operation is simple, the curative effect is satisfactory, and the incidence of postoperative complications is low.

Effect and mechanism of microRNA-155 on cell biological behavior of thyroid papillary carcinoma cells / 中华内分泌外科杂志

Objective:To study the role of miR-155 in the differentiation of papillary thyroid carcinoma (PTC) cells, and to explore the possible mechanism.Methods:Human miR-155 analogues were constructed and transfected into PTC BCPAP cells in vitro. CCK8 test and Transwell test were used to observe the changes of cell proliferation and invasiveness. The miR-155 was transfected into BCPAP cells in vitro and the protein background and phosphorylation expression of MAPK pathway were detected by Western blot. ERK pathway inhibitor U0126 was given to observe whether it could reverse the abnormal proliferation and invasion of thyroid cancer cells caused by over-expression of miR-155.Results:The proliferation of BCPAP cells was detected by CCK8 test 48 hours after overexpression of miR-155, and the invasiveness of thyroid cancer cells was significantly enhanced by Transwell test 48 hours after overexpression of miR-155 ( P<0.05) ; Western blot method found that the expression of JNK, ERK and p38 in MAPK signal pathway was significantly up-regulated ( P<0.05) . At the same time, the expression of p-ERK protein in the cells was increased significantly ( P<0.05) . The expression of p-ERK in the cells treated with ERK pathway inhibitor U0126 and miR-155 was significantly lower than that in the miR-155 group ( P<0.05) . By detecting the proliferation and invasion of cells in each group, we found that the U0126 could reverse the proliferation and invasion promoting effect caused by miR-155. Conclusion:miR-155 can promote the proliferation and invasion of PTC BCPAP cells by activating the ERK pathway of MAPK pathway, which provides a potential target for the treatment of thyroid cancer.

Sub-chronic Toxicity of Defoamer Used in Seawater Desalination / 生物医学与环境科学（英文）

OBJECTIVE@#To explore the possible long-term health effects of the defoamer used in seawater desalination by sub-chronic toxicity testing.@*METHODS@#Blood analysis, internal organ assessment, and histopathological examination were carried out in rats exposed to low, medium, and high (0.5, 1.0, and 2.0 g/kg BW, respectively) doses of defoamer for 90 days through oral administration.@*RESULTS@#The high dose group showed decreased blood alanine aminotransferase and aspartate aminotransferase (P < 0.05). All doses resulted in a significant increase in albumin and decrease in globulin (P < 0.05). The direct bilirubin and indirect bilirubin were decreased in the medium and high dose groups (P < 0.05). All dose groups showed significant induction of alkaline phosphatase (P < 0.05). Pathological examination revealed a case of liver mononuclear cell infiltration in the medium dose group and three cases of liver congestion, steatosis of hepatic cells around the central vein, and punctate necrosis with multiple focal mononuclear cell infiltration in male rats administered the high dose. The No Observed Adverse Effect Level was 0.5 g/kg BW in rats, with albumin and total bilirubin as health effect indices.@*CONCLUSION@#Long-term defoamer exposure may cause liver injury but has no significant impact on renal function in rats. The effect on blood cells in female rats was more prominent than that in male rats.

Comparison of curative effect between osteochondral mosaic transplantation and micro-fracture in the treatment of knee joint articular cartilage injury / 中国骨伤

OBJECTIVE@#To compare the clinical outcomes of microfracture and autogenous osteochondral mosaic transplantation in the treatment of knee joint cartilage injury.@*METHODS@#A retrospective analysis of 71 patients with articular cartilage defects on the femoral condyles who were by autogenous osteochondral mosaic transplantation or microfracture from February 2011 to February 2016, and these patients were followed up for at least 2 years. According to the sugical procedures, the patients were divided into two groups. In the microfracture group, there were 33 patients, 20 males and 13 females, with a mean age of(28.1±4.2) years old; in the mosaicplasty group, there were 38 patients, 26 males and 12 females, with a mean age of(27.8±3.5) years old. The Lysholm knee score, Hospital for Special Surgery (HSS) knee score and the Ahlbäck classification grade were recorded to evaluate the clinical efficacy. Complications were also recorded.@*RESULTS@#The mean Lysholm scores of the microfracture group and the mosaicplasty group improved from 62.9±6.8 and 60.3±7.5 preoperatively to 77.0±5.4 and 85.8±5.6 post-operatively, respectively(<0.05). Mean HSS scores of the microfracture group and the mosaicplasty group improved from 81.5±7.6 and 79.6±8.6 preoperatively to 88.0±4.7 and 91.9±4.7 post-operatively, respectively(<0.05). The mean Lysholm score and HSS score were significantly higher in the mosaicplasty group than those in the microfracture group at the latest follow-up. One patient in the mosaicplasty group suffered superficial wound infection. During the follow-up, no knee osteoarthritis was observed in two groups.@*CONCLUSIONS@#Autogenous osteochondral mosaicplasty and microfracture are proved to be safe and effective procedures for knee articular cartilage defects. However, the mosaicplasty has better clinical outcome than the microfracture.

The valuee and short-term efficacy of Miccoli for cervical lymph node dissection / 中华内分泌外科杂志

Objective To evaluate the value and short-term efficacy of Miccoli for cervical lymph node dissection in patients with thyroid papillary carcinoma.Methods From Mar.2017 to Jan.2018,15 patients with thyroid papillary carcinoma received cervical lymph node dissection in Department of Thyroid and Breast Surgery of Nanjing Chinese Traditional Medicine Hospital,and they were divided into open surgery group (8 cases) and Miccoli surgery group (7 cases).The operation time,incision length,intraoperative blood loss,total number of dissection lymph nodes,incidence of postoperative complications and length of hospital stay between the two groups were analyzed.These groups were followed up for 6 months after surgery,in terms of neck comfort,incidence of enlarged lymph nodes in the cervical region and blood thyroglobulin level.Results There was no obvious difference between the two groups in intraoperative blood loss(P=0.651),total number of dissection lymph nodes(P=0.887),the incidence of postoperative complications(P=0.52),incidence of intumescent lymph node(P=1.000) and blood thyroglobulin level(P=0.826) after 6 months.The operation time of Miccoli group was longer than that of the open group(P=0.001),but the incision length(P=0.001),length of hospital stay(P=0.001)and postoperative neck comfort(P=0.001)were superior to those of the open surgery group.Conclusion Miccoli operation can be used to perform cervical lymph node dissection for PTC patients,which can achieve the curative effect of open surgery,without increasing the risk of postoperative complications,and the postoperative neck comfort was better.

Role of adenosine A1 receptor within nucleus tractus solitarii in dexmedetomidine-induced increase in baroreflex sensitivity in rats / 中华麻醉学杂志

Objective To evaluate the role of A1 adenosine receptor ( A1 AR) within the nucleus tractus solitarii ( NTS ) in dexmedetomidine-induced increase in baroreflex sensitivity ( BRS ) in rats. Methods Thirty-two clean-grade healthy male Sprague-Dawley rats, weighing 240-280 g, were divided in-to 4 groups ( n=8 each) using a random number table method: control group ( group C) , solvent control group ( group S) , dexmedetomidine group ( group D) , and dexmedetomidine plus 8-cyclopentyl-1,3-diprop-ylxanthine (DPCPX, a highly selective A1AR blocker) group (group DD). After the rats were anesthe-tized, 1 μl drug liquid was injected into the right NTS with a brain stereotaxic apparatus. Oneμl normal sa-line was injected into the right NTS in C and D groups, 1 μl dimethyl sulfoxide in group S, and 1 μl DPCPX in group DD. After catheters were implanted into the femoral vein, dexmedetomidine was intrave-nously infused as a bolus of 100μg/kg over 15 min followed by an infusion of 50μg·kg-1 ·h-1 for 105 min in D and DD groups. The equal volume of normal saline was given instead of dexmedetomidine in C and S groups. BRS was measured using phenylephrine immediately before intravenous infusion (T0) and at 60 and 120 min after beginning of infusion ( T1,2 ) . Results Compared with C and S groups, the BRS was signifi-cantly increased at T1,2 in D and DD groups ( P＜0. 05) . Compared with group D, the BRS was significantly decreased at T1,2 in group DD ( P＜0. 05) . Conclusion A1 AR within the NTS is involved in dexmedetomi-dine-induced increase in BRS in rats.

Changes in expression of Cx45 and Cx40 in sinoatrial node during dexmedetomidine-induced sinus bradycardia in rats / 中华麻醉学杂志

Objective To evaluate the changes in the expression of Cx45 and Cx40 in the sinoatrial node during dexmedetomidine-induced sinus bradycardia in rats. Methods Forty healthy Sprague-Dawley rats, weighing 250-300 g, were divided into 5 groups ( n=8 each) using a random number table method:control group ( group C) , low-dose dexmedetomidine group ( group D1 ) , high-dose dexmedetomidine group ( group D2 ) , low-dose dexmedetomidine plus atropin group ( group D1 A) , and high-dose dexmedetomidine plus atropin group (group D2A). Normal saline was intravenously infused in group C. Dexmedetomidine was intravenously infused for 10 min as a loading dose of 20 and 120 μg∕kg, followed by an infusion of 10 and 60 μg·kg-1 ·h-1 for 110 min in D1 and D2 groups, respectively. In D1 A and D2 A groups, dexme-detomidine was correspondingly given according to the method previously described in D1 and D2 groups, and in addition atropin 0. 5 mg was intravenously injected at the end of infusing the loading dose of dexme-detomidine. Heart rate ( HR ) , mean arterial pressure ( MAP ) and SpO2 were recorded before giving dexmedetomidine and at 10, 60 and 120 min after giving dexmedetomidine, and the development of brady-cardia was recorded. The sinoatrial node tissues were obtained at the end of administration for determination of the expression of Cx45 and Cx40 protein and mRNA by Western blot and real-time polymerase chain reac-tion, respectively. Results The incidence of bradycardia was 100％ in D1 and D2 groups and 0 after using atropin in D1 A and D2 A groups. Compared with group C, HR and MAP were significantly decreased in the other four groups, the expression of Cx45 protein and mRNA was up-regulated, and the expression of Cx40 protein and mRNA was down-regulated in D1 and D2 groups (P<0. 05), and no significant change was found in the expression of Cx45 and Cx40 protein and mRNA in D1A and D2A groups (P>0. 05). Com-pared with group D1 , HR and MAP were significantly increased, the expression of Cx45 protein and mRNA was down-regulated, and the expression of Cx40 protein and mRNA was up-regulated in group D1 A ( P<0. 05) . Compared with group D2 , HR and MAP were significantly increased, the expression of Cx45 pro-tein and mRNA was down-regulated, and the expression of Cx40 protein and mRNA was up-regulated in group D2 A ( P<0. 05) . Conclusion The mechanism by which dexmedetomidine induces sinus bradycardia may be related to up-regulated expression of Cx45 and down-regulated expression of Cx40, and the auto-nomic nervous activity is involved in dexmedetomidine-induced regulation of Cx45 and Cx40 expression in rats.

Efficacy and safety of microwave ablation for benign thyroid nodules: a Meta-analysis / 中华内分泌外科杂志

Objective To evaluate the efficacy and safety of microwave ablation in treatment of benign thyroid nodules by a meta-analysis.Methods A database searching was performed on the Pubmed (Medline),CochraneLibrary,Embase,China National Knowledge Infrastructure(CNKI),wanfang database,biomedical literature database (Sinomed) and VIP database.Randomized controlled studies of microwave ablation for benign thyroid nodules were selected and analyzed.Documents were screened in accordance with the inclusion and exclusion criteria.Data analysis was performed by using Revman5.3 software.Results Twelve studies matched the selection criteria,which involved 1221 patients.The results showed that microwave ablation was superior to traditional surgery in the following aspects:the time of operation [MD=-50.78,95％ CI=(-58.20,-43.36),P＜0.01,I2=97％],the amount of blood loss[MD=-23.21,95％ CI=(-27.18,-19.23),P＜0.01,I2=99％],the time of hospitalization [MD=-3.39,95％ CI=(-4.08,-2.71),P＜0.01,I2=98％],the changes of CRP,IL-6,TNF-alpha in 12 h,24 h or 48 h after operation,the changes in the level of FT3 and FT4 in 1 month and 3 months after operation,and the incidence of surgical complications [MD=0.20,95％ CI=(0.13,0.32),P＜0.01,I2=0％],P＜0.01 respectively.Conclusions Microwave ablation has many advantages,such as small trauma,beautiful appearance,quick recovery,little influence on thyroid function and fewer operative complications.It is safe and reliable in clinical application.

New progress of minimally invasive and cosmetic surgery of thyroid / 中华内分泌外科杂志

The most prominent advances in thyroid surgery in recent ten years are minimally invasive surgery and cosmetology.With the development of surgical technology and the application of energy devices,the concealment of surgical incision selection and minimization of wounds are increasingly reflected and improved.This study reviews various minimally invasive and cosmetic thyroid surgery at home and abroad,and analyzes the principles,advantages and complications of various surgical methods.