Correlation between deep venous thrombosis of lower extremity and methylenetetrahydrofolate reductase C677T / 国际外科学杂志

Objective:To investigate the mechanism of methyltetrahydrofolate reductase ( MTHFR) C677T polymorphism in the pathogenesis of lower extremity deep vein thrombosis (DVT). Methods:Used retrospective controlled study method, a total of 64 DVT patients (DVT group) and 96 healthy people (control group) were enrolled in the Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University from August 2019 to August 2021. Clinical manifestations and related detection, including D-dimer, fibrinogen, prothrombin time, prothrombin activity and prothrombin time-international normalized ratio of the subjects were recorded, and plasma homocysteine (Hcy) and soluble endothelial cell protein C receptor (sEPCR) were detected by enzyme linked immunosorbent assay (ELISA). The polymorphism of C677T locus of MTHFR gene was detected by polymerase chain reaction-restricted fragment length polymor-phism (PCR-RFLP), and the differences of blood indexes and MTHFR genotypes between the two groups were compared. Measurement data with normal distribution were represented as mean ± standard deviation ( ± s), and comprison between groups was conducted using the t-test; the skewness data were expressed by M( Q1, Q3), and rank-sum test was used for inter-group comparison. comprison between groups of count data was conducted using the chi-square test or Fisher exact probability. Results:Compared with the control group, DVT group showed more symptoms of limb skin redness, limb swelling, skin temperature rise, local tenderness, skin rupture, skin tension, pigmentation, limb movement and sensory disturbance, the difference were statistically significant ( P<0.05); the prothrombin time-international normalized ratio [0.98(0.95, 1.04) vs 1.05(1.00, 1.13)], fibrinogen [2.76(2.31, 3.30) mg/L vs 3.36(2.74, 4.35) mg/L], D-dimer [0.52(0.38, 0.62) mg/L vs 4.73(2.44, 12.05) mg/L], Hcy[(1 639.03±390.29)ng/mL vs (2 423.03±631.95) ng/mL] and sEPCR [(108.62±25.07) ng/mL vs (137.79±26.23) ng/mL] in DVT group were significantly higher than those in control group, the difference were statistically significant ( P<0.05); the prothrombin activity [90.70% (75.80%, 100.00%) vs 103.00%(93.00%, 112.50%)] was significantly lower than that of the control group, the difference was statistically significant ( P<0.05). Compared with the control group, CC, CT, TT genotype frequency and allele frequency of MTHFR C677T site in DVT group showed a trend of change, but the difference were not statistically significant ( P>0.05). Conclusion:TT mutation at MTHFR C677T site in patients with DVT has an increasing trend, which may promote the expression level of Hcy, and high expression of Hcy and sEPCR can induce the occurrence and development of DVT.

Effects of transaxillary approach endoscopic and traditional open radical thyroidectomy on the levels of inflammatory factors in patients with thyroid cancer / 中国医师进修杂志

Objective:To investigate the effects of transaxillary endoscopic and traditional open radical thyroidectomy on the levels of inflammatory factors in patients with thyroid cancer.Methods:The clinical data of 102 thyroid cancer patients underwent radical thyroidectomy from October 2019 to October 2021 in Xinjiang Medical University Hospital of Chinese Medicine were retrospectively analyzed. Among them, 50 cases underwent transaxillary approach endoscopic radical thyroidectomy (study group), and 52 cases underwent open radical thyroidectomy (control group). The operation related indexes were compared between two groups, including operation time, intraoperative blood loss, postoperative drainage, lymph node clearance and hospital stay; the pain scores 1, 3 and 7 d after operation were recorded; the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), galectin-3 (Gal-3) and tumor necrosis factor-α (TNF-α) before operation and 1 d after operation were measured by enzyme-linked immunosorbent assay; the postoperative complications were recorded, including hoarseness, limb numbness, cough after drinking water and hypocalcemia; and the cosmetic satisfaction was followed up 3 months after discharge, and the recurrence was observed by CT 6 months after discharge.Results:The operation time in study group was significantly longer than that in control group: (88.69 ± 15.16) min vs. (61.47 ± 15.48) min, while the intraoperative blood loss, postoperative drainage and hospital stay were significantly lower in control group: (51.21 ± 10.06) ml vs. (85.46 ± 11.37) ml, (98.29 ± 30.61) ml vs. (117.47 ± 30.25) ml and (5.35 ± 0.54) d vs. (7.72 ± 0.61) d, and there were statistical differences ( P<0.01); there was no statistical difference in lymph node clearance between two groups ( P>0.05). The pain score 1 and 3 d after operation in study group was significantly lower than that in control group: (5.13 ± 1.07) scores vs. (7.87 ± 1.46) scores and (4.22 ± 1.35) scores vs. (6.42 ± 1.28) scores, and there were statistical differences ( P<0.05); there was no statistical difference in pain score 7 d after operation between two groups ( P>0.05). There were no statistical differences in IL-6, IL-10, TNF-α and Gal-3 between two groups ( P>0.05); the IL-6, IL-10, TNF-α and Gal-3 1 d after operation in study group were significantly lower than those in control group: (26.27 ± 3.14) ng/L vs. (29.22 ± 4.52) ng/L, (7.54 ± 2.31) ng/L vs. (10.92 ± 2.54) ng/L, (14.98 ± 3.76) μg/L vs. (23.65 ± 2.46) μg/L and (3.54 ± 0.48) μg/L vs. (4.48 ± 0.63) μg/L, and there were statistical differences ( P<0.01). There was no statistical difference in the incidence of total complications between two groups ( χ2 = 1.73, P>0.05). The total satisfaction rate in study group was significantly higher than that in control group: 94.0% (47/50) vs. 78.8% (41/52), and there was statistical difference ( χ2 = 4.94, P<0.05). The patients were followed up for 6 months after discharge, and there was no recurrence. Conclusions:The transaxillary approach endoscopic radical thyroidectomy can reduce intraoperative blood loss, length of stay, postoperative drainage, postoperative pain, and to some extent inhibit inflammatory response. It can improve the postoperative cosmetic satisfaction, reduce the incidence of postoperative complications, and does not increase the recurrence rate

Effect of two short striae incision or traditional "L" shaped incision in neck dissection of differentiated thyroid carcinoma on serum trauma cytokines / 中南大学学报(医学版)

OBJECTIVE@#To compare the trauma of neck dissection on the human body between two-striae incision and traditional "L" shaped incision by serum trauma cytokines.@*METHODS@#Patients with differentiated thyroid carcinoma hospitized from December 2008 to July 2011 were divided into 2 groups according to their own will. The first group 26 patients) had two-striae incision and the second group 32 patients) had traditional "L" shaped incision. The serum level of interleukin(IL)-2, IL-6 and C-reactive protein (CRP) in all patients were examined 1 day before and 1, 3 and 5 days after the surgery.@*RESULTS@#No statistical significance was found between the 2 groups, although level of IL-2 decreased 1 day after the surgery, but recovered to normal 3 days later. The level of IL-6 in both groups increased 1 day after the surgery, began to decrease 3 days after the surgery, and recovered to normal 5 days after the surgery. The level of CRP suggested statistical significance (P0.05). After follow-up for 8-40 months, no local recurrence or lymph node metastasis was found.@*CONCLUSION@#Compared with the traditional "L" shaped incision, two-striae incision in neck dissection does not increase the serum level of trauma cytokines and trauma to human body after the surgery. Two-striae incision is an ideal surgical approach to differentiated thyroid carcinoma.

Expression of type Ⅰ transforming growth factor beta receptor and type Ⅰ collagen in the peripheral and central area of human skin hypertrophic scar / 中国组织工程研究

BACKGROUND: Many studies focus on transforming growth factor β (TGF β) and its receptors, however, the distdbution of type Ⅰ TGF receptor (TGF-βR Ⅰ) in peripheral region of hypertrophic scars remain poorly understood. OBJECTIVE: To determine the expression and distribution of TGF-βR Ⅰ and type Ⅰ collagen in the peripheral and central areas of human skin hypertrophic scar. METHODS: A total of 30 cases with human cutaneous scars admitted at the Department of Plastic Surgery, First Affiliated Hospital and Department of Mammary Gland, Head and Neck Surgery, Tumor Hospital of Xinjiang Medical University from 1999 to 2002, were selected, including 20 cases with hypertrophic scar and 10 cases with normal scars. A total of 180 scars were obtained from central and peripheral areas of scars as well as normal skin tissues. The protein contents of TGF-βR1 and type Ⅰcollagen was detected by immunohistochemistry. In addition, the immunostaining positive in these samples was analyzed by semiquantitative analysis. RESULTS AND CONCLUSION: Compared to non hypertrophic scar and normal skin tissues, the TGF-βR1 expression of hypertrophic scar was obvious greater with strong positive reaction. The TGF-β R Ⅰ content was 100% in peripheral region of hypertrophic scar, which was notably 20% greater than that of central area (P < 0.05). The content of type Ⅰ collagen was both 100% in peripheral and central areas. The differences of positive TGF-β R Ⅰ and type Ⅰ collagen had no significance between peripheral and central areas of non hypertrophic scars (P > 0.05). There were few contents of TGF-βR Ⅰ and type Ⅰ collagen in normal skin tissues. The expression of TGF-β R Ⅰ is higher in peripheral than central areas of hypertrophic scar. Therefore, the peripheral area would be emphasized in the clinic work.