CircRNA ITCH Inhibits Epithelial-Mesenchymal Transformation and Promotes Apoptosis in Papillary Thyroid Carcinoma via miR-106a-5p/JAZF1 Axis.

Circular RNA ITCH (circ-ITCH) is implicated in papillary thyroid carcinoma (PTC) development. Nevertheless, the more detailed molecular mechanism remains uncovered. The transcriptional level of circ-ITCH was tested via quantitative real-time PCR. Transwell assay was introduced to assess the migrative and invasive abilities of cells. RNA interference technology was employed to reduce the level of circ-ITCH as well as JAZF1 in PTC cells. Western blot assay was utilized to reveal the content of JAZF1 and proteins related to epithelial-mesenchymal transformation (EMT) progression. Circ-ITCH was downregulated in PTC tissues as well as cells. Overexpression of circ-ITCH suppressed EMT, migration, invasion, facilitated apoptosis in PTC cells, while silencing circ-ITCH exhibited reversed effects. Additionally, miR-106a-5p was the target of circ-ITCH and negatively regulated through circ-ITCH. MiR-106a-5p mimic partly eliminated the influences of overexpressed circ-ITCH in PTC cells. Moreover, JAZF1 could interact with miR-106a-5p, then it was regulated via circ-ITCH. Silencing JAZF1 partially counteracted the role of circ-ITCH in PTC cells progress. This study uncovered that circ-ITCH suppressed the development of PTC cells at least partly by mediating miR-106a-5p/JAZF1 network.

Metabolic dysfunction-associated fatty liver disease in the elderly with diabetic foot ulcers: A longitudinal cohort study.

This study aimed to explore the association between metabolic-associated fatty liver disease (MAFLD) and ulcer recurrence risk in patients with diabetic foot ulcers (DFUs) through an ambispective longitudinal cohort. From December 2013 to December 2022, a total of 482 inpatients with DFUs (PEDIS grade 3 and above with a severe infection) were eligible for inclusion in this study. This was an ambispective longitudinal cohort study. All participants were followed up every 6 months for 9 years with a median of 36 months. According to whether having MAFLD or not, all subjects were placed into two groups: non-MAFLD (n = 351) and MAFLD (n = 131). The association between MAFLD and ulcer recurrence in patients with DFUs was then evaluated through multivariate Cox regression analysis, stratified analyses and Kaplan-Meier survival analysis. Throughout the follow-up period, out of 482 subjects with DFUs, 68 had ulcer recurrence (14.1%). Three Cox regression models were established for data analyses. In the model I (unadjusted), MAFLD was significantly associated with the ulcer recurrence rate in patients with DFUs (HR = 1.79; 95% CI = 1.097-2.92; p = 0.02). Model II (adjusted model I with gender and age) (HR = 1.781; 95% CI = 1.09-2.912; p = 0.021) and model III (adjusted model II with CVD, duration of diabetes and Cr.) (HR = 1.743; 95% CI = 1.065-2.855; p = 0.027) also showed that MAFLD was significantly related to the ulcer recurrence risk in patients with DFUs, respectively. Stratified analysis indicated that subjects aged ≥60 had a greater risk of ulcer recurrence in MAFLD than in non-MAFLD (HR = 2.31; 95% CI = 1.268-4.206; p = 0.006). Kaplan-Meier survival curve analysis showed that ulcer recurrence rate had a significant association with MAFLD (log-rank, p = 0.018). This study indicated a close association between ulcer recurrence risk and MAFLD in patients with DFUs, especially in the elderly (aged ≥60). Therefore, special attention should be paid to the elderly with both DFUs and MAFLD because they have a higher ulcer recurrence rate than other general populations in routine clinical practice.

The advantages of carbon nanoparticles in level VII lymph node dissection in patients with papillary thyroid cancer.

BACKGROUND: The characteristics of level VII lymph nodes were explored and the advantages of using carbon nanoparticles (CNs) in papillary thyroid cancer (PTC) surgeries were examined. This was a retrospective study investigating the clinical data of patients with PTC who underwent surgical treatment. METHODS: From September 2019 to December 2020, a total of 191 consecutive patients with PTC were retrospectively analyzed. The patients were randomly divided into the CNs group and the control group. CNs were used in the CNs group during the operation. There were 103 cases in the CNs group, including 25 males and 78 females, and 88 cases in the control group, including 21 males and 67 females. Parameters, including the characteristics of dissected lymph nodes in level VII, metastatic rate, postoperative complications, and other inpatient-related indicators, were compared between the two groups. RESULTS: The number of lymph nodes dissected in level VII in the CNs group was significantly greater than that in the control group, and the metastatic rate of black-stained lymph nodes was significantly higher than that of non-black-stained lymph nodes (P<0.05). The postoperative hypoparathyroidism rate in the CNs group was significantly lower than that in the control group (P<0.05). There were no differences in the operation duration, intraoperative blood loss, postoperative drainage duration, or hospitalization days between the two groups (P>0.05). CONCLUSIONS: The application of CNs for patients with PTC significantly increased the number of lymph nodes dissected in level VII and helped to protect the parathyroid glands (PGs). Moreover, the use of CNs did not increase the rate of postoperative complications. Thus, CNs may be a simple and safe approach when performing surgery in PTC patients.

Evaluation of ITGA3 as a Biomarker of Progression and Recurrence in Papillary Thyroid Carcinoma.

OBJECTIVE: To investigate the expression of ITGA3 and its association with clinical outcomes in papillary thyroid carcinoma (PTC). METHODS: The expression level, association with clinicopathologic characteristics, co-expressed genes, signaling pathways of ITGA3 in thyroid cancer were comprehensively analyzed using bioinformatics analysis through multiple public gene databases. PTC specimens and cell lines were used to verify the results of bioinformatics analysis. RESULTS: Data mining based on the Oncomine database revealed that ITGA3 expression in classical PTC and tall cell variant PTC was much higher than that in normal thyroid tissue except the follicular variant PTC. Analysis based on The Cancer Genome Atlas (TCGA) database showed that the expression of ITGA3 varies greatly in pathological stages, pathological types, tumor invasion stages, and lymph node metastasis stages of thyroid carcinoma. High expression level of ITGA3 was correlated with tumor regional invasion and lymph node metastasis. Multivariate analysis using logistic regression model showed that high expression of ITGA3 was a risk factor that associated with PTC recurrence and lymph node metastasis. Survival analysis showed that patients with high expression of ITGA3 in PTC had a poorer relapse-free survival (RFS) than patients with low expression of ITGA3 (P < 0.05). Immunohistochemistry experiments showed that the expression of ITGA3 in recurrent thyroid cancer tissues was stronger than that in no-recurrent thyroid cancer tissues (P < 0.05). Knockdown of ITGA3 by sh-RNA in PTC cell lines suppresses cell viability and invasive and migrating capacity. CONCLUSION: ITGA3 is overexpressed in PTC, especially in those with higher tumor invasion grades and lymph node metastasis, and was associated with recurrence and poor RFS of PTC. High expression of ITGA3 may have the potential role of predicting PTC recurrence and lymph node metastasis.

Endoscopic thyroidectomy versus traditional open thyroidectomy for identification of the external branch of the superior laryngeal nerve.

AIM: To explore the anatomical features of the external branch of the superior laryngeal nerve (EBSLN) and determine an effective approach for its preservation during endoscopic thyroidectomy (ET). METHODS: From January 2017 to December 2018, a total of 405 consecutive patients with thyroid disease were retrospectively analyzed. These patients were divided into the ET group and the open thyroidectomy (OT) group according to the surgical approaches. There were 195 cases in the ET group including 43 males and 152 females, and 210 cases in the OT group including 65 males and 145 females. The dissection process of EBSLN, detection rate, distribution of identification methods of the EBSLN and rate of voice change were recorded. RESULTS: There were 205 EBSLNs detected under direct vision in ET group for a detection rate of 88.0%, while 158 EBSLNs were detected under direct vision in OT group for a detection rate of 58.1%. But with the assistant of intraoperative neuromonitoring (IONM), the number of EBSLNs detected visually reached up to 220 in ET group and 226 in OT group, respectively, for a visual detection rate of 94.4% and 83.1%, respectively. There were significant difference in the rate of direct visual identification, total visual identification with IONM. Stratified risk estimation indicated that the tumor size and location were risk factors for the direct visual dissection of EBSLN. Stratified analysis by tumor size indicated that when tumor diameter was ≤ 4 cm, the incidence of vocal cord fatigue and total vocal changes in ET group was significantly lower than that in OT group. CONCLUSIONS: Recognition and exposure of the EBSLN can be facilitated by the magnification and focusing function of high-definition endoscopy and the advantage of a 30° variable angle. Full exposure of the sternothyroid-laryngeal triangle and fine dissection along the superior thyroid vessels is beneficial for recognizing the EBSLN.

Pros and Cons of Transoral Endoscopic Thyroidectomy Via Vestibular Approach: A Comparative Study.

OBJECTIVE: The objective of this study was to explore the feasibility and safety of transoral endoscopic thyroidectomy via vestibular approach (TOETVA) compared with endoscopic thyroidectomy via bilateral areola approach (ETBAA) in the treatment of patients with benign thyroid nodules. MATERIALS AND METHODS: From January 2017 to December 2018, 60 patients who received TOETVA were enrolled as the research group; 65 patients who underwent ETBAA were included as the control group. A retrospective study was performed using the clinical data for these cases. All patients were diagnosed with benign nodules by preoperative examinations. Parameters including surgical trauma, complications, cosmetic satisfaction, and postoperative discomfort were compared between the 2 groups. RESULTS: All operations were completed without incident. There were significant differences in operation time (137.8±18.7 vs. 95.7±17.2 min), intraoperative blood loss (16.8±9.1 vs. 24.6±16.6 mL), drainage volume (123.1±20.9 vs. 153.6±40.2 mL), C-reactive protein level (7.2±5.2 vs. 9.0±4.7 mg/L), drainage time (3.2±0.6 vs. 3.9±1.3 d), postoperative hospital stay (3.3±0.8 vs. 4.1±1.5 d), and sense of skin tension on the neck (0% vs. 10.8%) between the TOETVA and ETBAA groups (P<0.05). There were no significant differences in pain score, incidence of recurrent laryngeal nerve injury, transient hypoparathyroidism, infection, inadvertent parathyroidectomy, or swallow discomfort between the 2 groups. The cosmetic satisfaction score in the TOETVA group was significantly higher than that in the ETBAA group at 1 month after surgery (9.8±0.5 vs. 9.4±0.9, P<0.05), but at 3 months after the operation, the difference was not statistically significant. CONCLUSIONS: TOETVA was accompanied by less surgical trauma and skin tension on the neck than ETBAA, and the cosmetic effect of this approach was better than that of ETBAA in the early postoperative period. TOETVA for benign thyroid nodules is safe and feasible. However, there are disadvantages with TOETVA, such as a long surgical period. More cases and further research are needed to delve further into this approach.