A modified, single-incision, gasless, endoscopic thyroidectomy and bilateral central neck dissection via axillary approach technique for bilateral papillary thyroid microcarcinoma: A preliminary report.

Background: Our objective was to assess the viability and oncological security of a gasless, transaxillary single-incision endoscopic procedure for performing total thyroidectomy and bilateral central neck dissection (TT + BCND). This study focused on patients diagnosed with bilateral papillary thyroid microcarcinoma (PTMC). Method: Between April 2020 and November 2021, 22 patients with bilateral PTMC underwent single-incision, gasless, transaxillary endoscopic TT + BCND. The patients' clinicopathologic characteristics, surgical completeness and complications were analyzed. Result: Single-incision, gasless, transaxillary endoscopic TT + BCND was successful performed in all patients. The median (IQR) total surgical time was 143 (85-160) min. Only two patients experienced transient unilateral RLN palsy or transient hypocalcemia. All these complications resolved within 1 month after surgery. The median duration of hospital stay after surgery was 4 (3-4.5) days. The median hospitalization expense for these patients was 3848 (3781-4145) USD. The median number of lymph node yielded was 10.5 (8-15). The cosmetic outcomes were well-received by all individuals. Conclusion: In certain cases, gasless, transaxillary endoscopic TT + BCND procedure performed through a single incision proved to be a secure alternative for managing bilateral PTMC.

A propensity score matching analysis of gasless endoscopic transaxillary thyroidectomy with five-settlement technique versus conventional open thyroidectomy in patients with papillary thyroid microcarcinoma.

BACKGROUND: In a previous study, we proposed a novel anatomy-based five-settlement method for transaxillary endoscopic thyroidectomy (fs-TAT) for patients with papillary thyroid carcinoma. The safety of this new method has been reported in a retrospective study of a single cohort. The safety and short-term oncological outcome of this method was confirmed by comparing it with conventional open surgery (COT) in patients with papillary thyroid microcarcinoma. METHODS: The medical records of patients who underwent fs-TAT or COT by a single surgeon from February 2019 to December 2021 were reviewed retrospectively. All patients were diagnosed with papillary thyroid microcarcinoma and underwent lobectomy and ipsilateral central compartment neck dissection. Propensity score matching was used to compare the technical safety and short-term oncologic outcomes of fs-TAT and COT for the purpose of reducing potential selection bias. Reporting was consistent with the STROCSS 2021 guidelines. RESULT: After propensity score matching, 460 (fs-TAT: 230; COT: 230) patients remained in the study population. There were no significant differences in sex, age, tumor size, Hashimoto's thyroiditis, or tumor multifocality between the groups. The operative time was longer [104.5 (90.3, 120.0) vs. 62.0 (52.0, 76.0), P < 0.001] and the total postoperative drainage volume [135(90, 210) vs. 75 (55, 115), P < 0.001] was greater in the fs-TAT group than in the COT group. However, intraoperative bleeding [3.0 (2.0, 5.0) vs. 5.0 (5.0, 7.5), P < 0.001] was greater, and the median number of lymph nodes yielded [5.0 (2.3, 8.0) vs. 7.0 (5.0, 11.0), P < 0.001] was greater in the COT group than in the fs-TAT group. The groups exhibited no significant difference in the rate of complications (fs-TAT: 2.2% vs. COT: 2.6%, P = 0.856), rate of positive lymph nodes (fs-TAT: 32.2% vs. COT: 36.5%, P = 0.377), length of postoperative hospital stay (3 days vs. 3 days, P = 0.305) or total medical costs (26,936 vs. 26,549, P = 0.144). CONCLUSION: Compared to conventional open surgery, fs-TAT offered excellent safety and acceptable short-term oncological outcomes in a selected cohort of patients with papillary thyroid microcarcinoma.

Potential functions of engineered nanomaterials in cadmium remediation in soil-plant system: A review.

Soil cadmium (Cd) contamination is a global environmental issue facing agriculture. Under certain conditions, the stable Cd that bound to soil particles tend to be remobilized and absorbed into plants, which is seriously toxic to plant growth and threat food safety. Engineering nanomaterials (ENMs) has attracted increasing attentions in the remediation of Cd pollution in soil-plant system due to their excellent properties with nano-scale size. Herein, this article firstly systematically summarized Cd transformation in soil, transport in soil-plant system, and the toxic effects in plants, following which the functions of ENMs in these processes to remediate Cd pollution are comprehensively reviewed, including immobilization of Cd in soil, inhibition in Cd uptake, transport, and accumulation, as well as physiological detoxication to Cd stress. Finally, some issues to be further studied were raised to promote nano-remediation technology in the environment. This review provides a significant reference for the practical application of ENMs in remediation of Cd pollution in soil, and contributes to sustainable development of agriculture.

A novel anatomy-based five-settlement method for endoscopic thyroid lobectomy and ipsilateral central compartment neck dissection via gasless unilateral axillary approach: a preliminary report.

Background: Endoscopic thyroidectomy (ET) via gasless unilateral axillary (GUA) approach has been widely implemented worldwide. Based on our concept of mesothyroid excision in open surgery, we proposed a novel anatomy-based five-settlement method in ET via the GUA approach. This preliminary report aimed to explore the efficacy and safety of this method in patients with papillary thyroid carcinoma (PTC). Methods: PTC patients who underwent endoscopic ET and unilateral central compartment neck dissection (CCND) via GUA approach with the five-settlement method at the Department of General Surgery, Nanfang Hospital, Southern Medical University from March 2020 to December 2021 were retrospectively collected. The data included general clinicopathological characteristics, surgical information (including duration, complication, and clinicopathological features), and hospital stay information, and other medical records were documented. Results: In total, 521 patients underwent lobectomy and CCND under the GUA approach with the five-settlement method. The mean number of lymph nodes yielded (LNY) and positive lymph nodes (PLN) was 5.7 ± 4.3 (range, 1-30) and 1.0 ± 1.8 (range, 0-12), respectively. The incidence of transient recurrent laryngeal nerve injury was 1.1%. Chyle leakage and Horner's syndrome respectively occurred in one patient (0.2%). Five (0.9%) patients developed a hematoma. No severe complications or conversion to open surgery have occurred. Conclusion: The five-settlement method could be implemented safely and efficiently in ET+CCND via the GUA approach in selected PTC patients.

The lymph node yield in the initial lateral neck dissection predicts recurrence in the lateral neck of papillary thyroid carcinoma: a revision surgery cohort study.

BACKGROUND: This study aimed to evaluate the relationship between lateral lymph node yield (LLNY) and the ratio of lateral positive lymph nodes to lymph node yield (LPLR) from initial lateral neck dissection (LND) in patients with papillary thyroid carcinoma (PTC), as well as the risk of recurrence in patients undergoing LND reoperations. METHODS: This retrospective cohort study enrolled patients with PTC who underwent revision LND between 1 January 2012, and 31 December 2021. The initial and revised clinical data were retrieved. Patient demographics, clinicopathological features, clinical records, and follow-up information were also reviewed. LLNY and LPLR were determined during the initial LND. RESULTS: In total, 156 patients with PTC were included in this study, with a median follow-up of 36.5 months; 107 had recurrent lateral neck disease. The optimal LLNY and LPLR cutoff values for recurrent/persistent disease were 24.5 and 32.74%, respectively. The high-risk group (LLNY<25) had the lowest recurrence-free survival rate compared with to moderate-risk group (LLNY≥25, LPLR≥32.74%) and low-risk group (LLNY≥25, LPLR<32.74%) ( P <0.001). The moderate-risk group had lower recurrence-free survival than the low-risk group. Multivariate analysis revealed that an LLNY less than 25 in the initial LND was an independent risk factor for recurrence/persistence of lateral neck ( P <0.001). CONCLUSIONS: This study identified that LLNY and LPLR were associated with recurrence/persistence in PTC patients at the time of revision surgery was performed.

Investigation on the perception of medical school learning environment among freshmen / 中华医学教育探索杂志

Objective:To assess freshmen's perception of medical university learning environment, and to provide evidence and suggestions for the university to improve its learning environment in a targeted way.Methods:From March to April 2020, JHLES (Johns Hopkins University Learning Environment Scale) questionnaires were distributed to 260 freshmen from a military medical university. The influence factors of students' scores were analyzed by one-way analysis of variance (ANOVA) and general linear model. SAS 9.4 software was used for statistical analysis.Results:A total of 244 valid questionnaires were collected, with a response rate of 93.85%(244/260). The average score of inclusion and safety dimension was the lowest (2.21±1.08), while the average score of community of peers' dimension was the highest (4.41±0.54). There were significant differences among gender, whether one-child, parents' education level, overall learning environment evaluation and learning interest (all P<0.05). Gender ( P<0.05), learning interest ( P<0.05) and maternal education ( P<0.05) were main influencing factors of students' learning environment perception. Conclusion:Medical universities should further encourage good relationship among students, and enhance students' interest in learning through various measures, especially for female students and students who has relative poorer maternal education.

Epidemiological investigation and risk factor analysis of infant dyschezia in Xi′an / 中华实用儿科临床杂志

Objective:To investigate the epidemiological characteristics of infant dyschezia in Xi′an city based on the Rome Ⅳ Criteria for Functional Gastrointestinal Disorders in Infants/Toddlers, and to analyze the related risk factors so as to provide epidemiological basis for clinical diagnosis and treatment.Methods:It was a cross-sectional survey conducted in the child health department of community health service center or hospital in Xi′an from October 2020 to October 2021 using the multi-stage cluster random sampling method.Infants aged 0-12 months were enrolled and their caregivers were interviewed by face-to-face electronic questionnaire.The prevalence and influencing factors of defecation difficulty in infants aged 0-9 months were analyzed according to the Rome Ⅳ Criteria for Functional Gastrointestinal Disorders in Infants/Toddlers.The prevalence of dyschezia in infants aged over 9 months was explored as well.The counting data were compared by Chi- square test.Univariable and multivariate Logistic regression analysis were performed to identify risk factors for dyschezia. Results:A total of 1 446 infants were collected, including 735 boys (50.8%) and 711 girls (49.2%), with an average age of (5.94±3.27) months.The prevalence of dyschezia aged 0-9 months in Xi′an was 3.46% (42/1 215), which gradually decreased with the increased age.Infants with dyschezia could defecate 2-3 times a day, or once a few days.Family history of defecation disorders ( OR=3.785, 95% CI: 1.912-7.494) was the risk factor for infant dyschezia, while complementary food ( OR=0.193, 95% CI: 0.075-0.495) was the protective factor for infant dyschezia ( P<0.05). Breastfeeding ( OR=8.126, 95% CI: 2.258-29.236) was the risk factor for dyschezia in infants who defecated less frequently ( P<0.05). Only 2 cases of 10-month-old infants had defecation-like symptoms, manifested as crying for a long time before defecation. Conclusions:The prevalence of dyschezia in infants aged 0-9 months in Xi′an is 3.46%.Dyschezia infants may also have a lower frequency of defecation.Timely addition of complementary food is beneficial to alleviate infant dyschezia, while infant who defecated less frequently are more likely to have dyschezia while breastfeeding.

Dietary patterns of preschool children based on factor analysis combined with cluster / 公共卫生与预防医学

Objective To investigate the dietary intake of preschool children in Northwest China, and provide scientific basis for studying the dietary patterns and characteristics of preschool children and formulating targeted dietary interventions. Methods Using the self-designed “Semi-quantitative Food Frequency Questionnaire for Preschool Children in Northwest China“, a convenient sampling method was used to investigate the dietary intake of children aged 3 to 7 years in Northwest China. The factor analysis combined with the cluster method was used to extract the dietary pattern. Results Through factor analysis of the average daily food intake of preschool children, the results show that the KMO test value was 0.82, Bartlett’s test value was 4 528.97, and the associated probability was <0.001, so factor analysis can be performed. In order to obtain more typical factor components so that the results were easier to explain, under the guidance of nutrition experts, the first 4 common factors were finally retained for analysis, and the cumulative variance contribution rate was 62.17%. On this basis, the number of clusters was 4, and the K-means cluster analysis method was used to cluster the factor scores of various foods for preschool children. According to the proportions of various foods and the characteristics of the foods, The dietary patterns of preschool children can be divided into staple food-based dietary patterns, high-protein dietary patterns, healthy dietary patterns, and high-sugar dietary patterns. Conclusion Using factor analysis method, the scores of each food factor of preschool children were continuous variables, and the results were highly repeatable, and subsequent analysis can be carried out. The factor analysis combined with cluster analysis method extracting the dietary pattern of preschool children that had certain degree of science. According to the characteristics of the four dietary patterns extracted in this study, children's dietary interventions can be targeted to promote children's physical and mental health.

Contrast-enhanced ultrasound features of carotid plaque and its relationship with peripheral blood leukocytes in patients with type 2 diabetes mellitus / 中华超声影像学杂志

Objective:To explore the features of atherosclerotic plaque in patients with type 2 diabetes mellitus by contrast-enhanced ultrasound (CEUS), and to analyze the correlation between the features and leukocyte count in peripheral blood.Methods:A total of 30 type 2 diabetic patients with carotid atherosclerotic plaque treated in Tangdu Hospital of Air Force Military Medical University who underwent CEUS from March 2018 to September 2021 were included as the diabetes group. Thirty-two non-diabetic patients with carotid atherosclerotic plaque who were matched for age and sex during the same period served as the control group. The optimized plaques were performed by CEUS to obtain parameters including peak (P), time to peak (TP), sharpness (S) and area under the curve (AUC) of time-intensity gamma fitting curve (FC curve). The differential count of leukocytes in peripheral blood was detected by the automatic hematology analyzer. Spearman rank correlation and multiple linear regression were used to analyze the correlation between CEUS parameters of plaque and the differential leukocyte count in peripheral blood.Results:①The peripheral blood leukocyte count, monocyte count and monocyte proportion in the diabetes group were higher than those in the control group (all P<0.05). ②P and AUC in the diabetes group were higher than those in the control group (all P<0.05). ③There was linear relationship( B=75.440, P<0.001) and positive correlation ( rs=0.929) between P and peripheral blood monocyte count in the diabetes group. Conclusions:The neovascularization density and perfusion in carotid plaques in patients with type 2 diabetes mellitus are increased, which may be related to the increase of leukocytes in circulation, especially monocytes.

Development, reliability and validity of infectious disease specialist Nurse's Core competence scale.

AIM: This study aims to develop an instrument to measure infectious disease specialist nurses' core competence and examining the scale's validity and reliability. BACKGROUND: With the increase of infectious diseases, more and more attention has been paid to infectious disease nursing care. The core competence of the infectious disease specialist nurses is directly related to the quality of nursing work. In previous researches, infectious disease specialist nurses' core competence was measured by the tools developed for general nurses instead of specialized tools, which made it difficult to clarify the core competence of nurses in infectious diseases department. METHODS: Preliminary items were developed through literature review, theoretical research, qualitative interview and Delphi method. The confirmed 47 items were applied in the two rounds of data collection. Evaluation data on 516 infectious disease specialist nurses' core competence in the first round were utilized to preliminarily evaluate and explore the scale's constrution, while evaluation data on 497 infectious disease specialist nurses' core competence in the second round were utilized to do reliability analysis and validity analysis. In this study, factor analysis, Cronbach's α, Pearson correlation coefficients were all adopted. RESULTS: The final scale is composed of 34 items and 5 factors, and adopted the 5-point scoring method. The factors are Professional Development Abilities, Infection Prevention and Control Abilities, Nursing Abilities for Infectious Diseases, Professionalism and Humanistic Accomplishment, and Responsiveness to Emergency Infectious Diseases. The explanatory variance of the five factors was 75.569%. The reliability and validity of the scale is well validated. The internal consistency, split-half reliability and test-retest reliability were 0.806, 0.966 and 0.831 respectively. The scale has good structural validity and content validity. The content validity was 0.869. Discrimination analysis showed that there were significant differences in the scores of core competence and its five dimensions among infectious disease specialist nurses of different ages, working years in infectious diseases, titles, educational background, marital status and wages (all P < 0.05). CONCLUSIONS: The proposed scale takes on high reliability and validity, and is suitable for assessing the infectious disease specialist nurses' core competence. RELEVANCE TO CLINICAL PRACTICE: This scale provides a reference for clinical assessment of infectious disease nursing.

Lymph node yield in the initial central neck dissection (CND) associated with the risk of recurrence in papillary thyroid cancer: A reoperative CND cohort study.

BACKGROUND: To evaluate the relationship between lymph node yield (LNY) from the initial central neck dissection (CND) and the risk of recurrence in patients undergoing reoperative CND for papillary thyroid cancer (PTC). METHOD: We reviewed clinical data from all patients with pathologically proven PTC who underwent central neck and/or lateral neck dissection reoperations at Nanfang Hospital between 2012 and 2020. Patient demographics, tumor characteristics, clinical data and follow-up information were obtained. In the initial CND, the total number of lymph nodes removed (LNY), total positive nodes removed, and the percentage of positive lymph nodes to the number of lymph nodes removed (PLN%) were determined. RESULTS: A total of 162 patients were included in the study, with a median follow-up of 44 months. 62 had central neck disease recurrence. The optimal LNY and PLN% cut-off values for recurrence were 11 and 65%, respectively. Group 2 (LNY ≥ 11, PLN% < 65%) showed a significantly higher RFS rate than group 1 (LNY < 11 and PLN% < 65%; P < 0.001), group 3 (LNY < 11, PLN% ≥ 65%; P < 0.001), and group 4 (LNY ≥ 11, PLN% ≥ 65%; P = 0.038). Furthermore, group 4 had a higher RFS rate than group 1 (P = 0.008) and group 3 (P = 0.001). Multivariate analysis revealed that LNY < 11 in the central neck was an independent risk factor for recurrence/persistence in the initial surgery (P < 0.001). CONCLUSION: Higher LNY in central and neck dissections is associated with lower papillary thyroid cancer recurrence rates, which was confirmed by a reoperative CND procedure. To minimize the risk of recurrence and the need for secondary therapy, surgeons should perform compartment-oriented CNDs when indicated.

Military-related posttraumatic stress disorder and mindfulness meditation: A systematic review and meta-analysis / 中华创伤杂志(英文版)

PURPOSE@#Posttraumatic stress disorder (PTSD) is a significant global mental health concern, especially in the military. This study aims to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD, by synthesizing evidences from randomized controlled trials.@*METHODS@#Five electronic databases (Pubmed, EBSCO Medline, Embase, PsychINFO and Cochrane Library) were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD. The selection of eligible studies was based on identical inclusion and exclusion criteria. Information about study characteristics, participant characteristics, intervention details, PTSD outcomes, as well as potential adverse effects was extracted from the included studies. Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool. R Statistical software was performed for data analysis.@*RESULTS@#A total of 1902 records were initially identified and screened. After duplicates removal and title & abstract review, finally, 19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria. The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions, such as treatment as usual, present-centered group therapy and PTSD health education (standardized mean difference (SMD) = -0.33; 95% CI [-0.45, -0.21]; p < 0.0001). Mindfulness interventions with different control conditions (active or non-active control, SMD = -0.33, 95% CI [-0.46, -0.19]; SMD = -0.49, 95% CI [-0.88, -0.10], respectively), formats of delivery (group-based or individual-based, SMD = -0.30, 95% CI [-0.42, -0.17], SMD = -0.49, 95% CI [-0.90, -0.08], respectively) and intervention durations (short-term or standard duration, SMD = -0.27, 95% CI [-0.46, -0.08], SMD = -0.40, 95% CI [-0.58, -0.21], respectively) were equally effective in improving military-related PTSD symptoms.@*CONCLUSION@#Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD. Further evidence with higher quality and more rigorous design is needed in the future.

PTSD: Past, present and future implications for China / 中华创伤杂志(英文版)

There has been a long history since human beings began to realize the existence of post-traumatic symptoms. Posttraumatic stress disorder (PTSD), a diagnostic category adopted in 1980 in the Diagnostic and Statistical Manual of Mental Disorders-Ⅲ, described typical clusters of psychiatric symptoms occurring after traumatic events. Abundant researches have helped deepen the understanding of PTSD in terms of epidemiological features, biological mechanisms, and treatment options. The prevalence of PTSD in general population ranged from 6.4% to 7.8% and was significantly higher among groups who underwent major public traumatic events. There has been a long way in the studies of animal models and genetic characteristics of PTSD. However, the high comorbidity with other stress-related psychiatric disorders and complexity in the pathogenesis of PTSD hindered the effort to find specific biological targets for PTSD. Neuroimage was widely used to elucidate the underlying neurophysiological mechanisms of PTSD. Functional MRI studies have showed that PTSD was linked to medial prefrontal cortex, anterior cingulate cortex and sub-cortical structures like amygdala and hippocampus, and to explore the functional connectivity among these brain areas which might reveal the possible neurobiological mechanism related to PTSD symptoms. For now, cognitive behavior therapy-based psychotherapy, including combination with adjunctive medication, showed evident treatment effects on PTSD. The emergence of more effective PTSD pharmacotherapies awaits novel biomarkers from further fundamental research. Several natural disasters and emergencies have inevitably increased the possibility of suffering from PTSD in the last two decades, making it critical to strengthen PTSD research in China. To boost PTSD study in China, the following suggestions might be helpful: (1) establishing a national psychological trauma recover project, and (2) exploring the mechanisms of PTSD with joint effort and strengthening the indigenized treatment of PTSD.

CRLF1-MYH9 Interaction Regulates Proliferation and Metastasis of Papillary Thyroid Carcinoma Through the ERK/ETV4 Axis.

In our previous study, we have shown that CRLF1 can promote proliferation and metastasis of papillary thyroid carcinoma (PTC); however, the mechanism is unclear. Herein, we investigated whether the interaction of CRLF1 and MYH9 regulates proliferation and metastasis of PTC cells via the ERK/ETV4 axis. Immunohistochemistry (IHC), qPCR, and Western blotting assays were performed on PTC cells and normal thyroid cells to profile specific target genes. In vitro assays and in vivo assays were also conducted to examine the molecular mechanism. Results showed that CRLF1 directly bound MYH9 to enhance the stability of CRLF1 protein. Inhibition of MYH9 in PTC cells overexpressing CRLF1 significantly reversed malignant phenotypes, and CRLF1 overexpression activated ERK pathway, in vitro, and in vivo. RNA-sequencing revealed that ETV4 is a downstream target gene of CRLF1, which was up-regulated following ERK activation. Moreover, it was revealed that ETV4 is highly expressed in PTC tissues and is associated with poor prognosis. Finally, the ChIP assays showed that ETV4 induces the expression of matrix metalloproteinase 1 (MMP1) by binding to its promoter on PTC cells. Altogether, our study demonstrates that CRLF1 interacts with MYH9, promoting cell proliferation and metastasis via the ERK/ETV4 axis in PTC.

Primary squamous cell carcinoma (PSCC) of the thyroid: a case report and review of the literature.

Primary squamous cell carcinoma (PSCC) is a rare neoplasm of the thyroid with a very poor prognosis. We report a case of a 42-year-old woman with occasionally found mass in the right anterior area of the neck. After a total thyroidectomy, histopathology and immunohistochemistry tests confirmed primary squamous cell carcinoma of the thyroid with the exclusion of all other possible primary tumor locations. 5 months later, PET scan discovered abnormality in right cervical lymph nodes with a fine needle aspiration confirming to be tumor recurrence. After a modified radical neck dissection was performed with pathological results of the neoplasms being PSCC of the thyroid origin, a full course consecutive radiotherapy was then followed. Due to a prompt diagnosis and the complete dissection of primary tumor and metastatic lymph nodes, no recurrence was observed at the follow-up visits. Comparing to the published cases of PSCC of the thyroid, our paper stated a whole process of diagnosis and standardized treatment, together with classical matched figures of pre-op examinations and dissected specimen. Furthermore, a review of the present literatures summarized the diagnosis, treatment and prognosis of thyroid PSCC. The management of PSCC requires a multi-disciplinary approach.

Mechanism of renal injury and apoptosis in rats with nephrotic syndrome induced by mercury / 中华劳动卫生职业病杂志

Objective@#To investigate the relationship between renal injury and apoptosis in rats with nephrotic syndrome induced by mercury, in order to find out the pathogenesis.@*Methods@#Forty-eight healthy male SPF-grade BN (Brown-Norway) rats were divided into the control group and the exposure group by random number table. The nephrotic syndrome was caused by subcutaneous injection of HgCl2 (1 mg/ml) in the abdominal weight per kg of body weight. The control group was injected with the same volume of NaCl as the exposure group. Some rats were sacrificed on the 14th, 21st, 28th, and 35th days, and the serum kidney injury indicators creatinine (CRE) and urea nitrogen (BUN) were detected, and the renal tissue mercury content was detected; the in situ terminal transferase labeling technology (TUNEL) was detected Apoptosis, immunofluorescence detection of Cyt C content, Western blot detection of mitochondrial pathway apoptosis-related proteins [B-cell lymphoma 2 (Bcl-2) , Bcl-2 related X protein (BAX) , cysteine proteinase 3 (Caspase 3) ], mitogen-activated protein kinase (MAPK) signaling pathway-related proteins[p38 mitogen-activated protein kinase (P38MAPK) , extracellular regulatory protein kinase (ERK) ] expression.@*Results@#Compared with the control group, the BUN content in the serum of rats in the exposure group was significantly increased on days 7, 21, and 28, the CRE content was significantly increased on 21 days, the CRE content was significantly decreased on 28 and 35 days, and the organ coefficient and renal mercury content were 14 to 35 days. Significantly increased, and the differences were statistically significant (P<0.05) . Compared with the control group, rats in the exposed group showed increased glomerular stroma, tubule dilatation and other renal cell apoptosis at 14 to 35 days, and Cyt C expression was obvious in the exposed groups at 14, 21 days. Compared with the control group, the BAX content of the rats in the exposed group was significantly increased on the 21st day, the content of Caspase 3 in the rats on the 14th and 21st days was significantly increased, and the content of the P38MAPK in the 35th day was significantly increased (P<0.05) .@*Conclusion@#HgCl2 may cause renal cell damage through the mitochondrial pathway of apoptosis and cause nephrotic syndrome, and the MAPK signaling pathway may regulate this process and exert an inhibitory effect on apoptosis.

Risk factors affecting coagulation function in premature infants at birth / 中国新生儿科杂志

Objective To study the coagulation function of premature infants at birth and the associated risk factors.Method From January 2014 to January 2018,a prospective study was conducted on preterm infants born in obstetrics department of our hospital.According to the gestational age,these infants are assigned into early preterm group,moderate preterm group and late preterm group.The prothrombin time (PT),activated partial thromboplastin time (APTF),fibrinogen (FIB) and thrombin time (TT) were measured using automatic coagulation analyzer.The possible risk factors affecting the coagulation function in each group were analyzed.Result A total of 795 preterm infants were studied including 93 in the early preterm group,151 in the moderate preterm group and 551 in the late preterm group.In the early preterm group,infants with premature rupture of membranes (PROM) had increased FIB,shortened TT,and infants with severe asphyxia had prolonged PT,and the differences were statistically significant (P ＜ 0.05).In the moderate preterm group,infants with PROM had significantly prolonged APTT (P ＜ 0.05).In the late preterm group,PT and TT were prolonged and FIB was decreased in male infants.Infants with PROM have increased FIB;PT was prolonged among infants with severe asphyxia (P ＜ 0.05).Multivariate linear regression analysis showed that neonatal asphyxia,weight and gender were the main factors affecting PT (P ＜ 0.05),gestational age was the main risk factor affecting APTT (P ＜ 0.05),PROM,gestational age,weight and gender were the main factors affecting FIB (P ＜ 0.05),and neonatal asphyxia was the main factor affecting TT (P ＜ 0.05).Conclusion The coagulation function of premature infants is affected by many factors including gender,gestational age,weight,asphyxia,PROM,and maternal complications.Coagulation function should be monitored in preterm infants with severe asphyxia.

Lymph node metastasis in suprasternal space in pathological node-positive papillary thyroid carcinoma.

BACKGROUND: The objective of the current study was to investigate the clinical significance of the suprasternal space lymph node (SSLN) in pathological node-positive (pN+) papillary thyroid carcinoma (PTC) patients. METHOD: One hundred and forty patients with pN + PTC who underwent neck dissection were enrolled into this study. SSLN was resected and used as a specimen to investigate the relationship of SSLN with several clinicopathological parameters. RESULTS: The metastasis rate of SSLN was 20.7%. On univariate analysis, we found that SSLN metastasis was significantly associated with primary cancer site (inferior portion), strap muscle invasion, level III metastasis, Level IV metastasis and lymph node metastasis between sternocleidomastoid and sternohyoid muscles. On multivariate analysis, primary cancer site (inferior portion), strap muscle invasion, Level IV metastasis and lymph node metastasis between sternocleidomastoid and sternohyoid muscles were independent risk factors for SSLN metastasis of PTC. CONCLUSION: For pN + PTC patients, special attention should be paid to the issue of SSLN metastasis.

Is Epstein-Barr Virus Infection Associated With Thyroid Tumorigenesis?-A Southern China Cohort Study.

Background: Epstein-Barr virus (EBV) is associated with many epithelial malignancies. A few reports on the association between EBV and thyroid tumorigenesis have been investigated. However, the conclusion is highly contradictory. We aimed to explore the role of EBV in thyroid nodule development and its clinical significance in a cohort from southern China. Method: We conducted a retrospective data abstraction study of patients who underwent thyroidectomy between December 2017 and June 2018. We retrospectively analyzed the clinicopathological parameters and EBV infection status (serological antibodies and in situ hybridization). Result: The cohort comprised 384 patients with newly diagnosed thyroid diseases, including 261 papillary thyroid carcinomas, 87 nodular goiters, 21 follicular adenomas, 12 follicular thyroid carcinomas, and 3 medullary thyroid carcinomas. Forty-two (10.9%) patients were identified as being serological antibody positive. However, there was no association between the clinicopathological parameters and serological antibody positivity. Additionally, none of the patients showed EBER expression in thyroid normal/cancer cell nuclei in in situ hybridization. Conclusion: In this study, no correlation between EBV and thyroid diseases was found in a cohort from southern China.