Effects of different surgical approaches on health-related quality of life in pediatric and adolescent patients with papillary thyroid carcinoma.

OBJECTIVE: We aimed to compare the health-related quality of life (HRQOL) in pediatric and adolescent patients with papillary thyroid carcinoma who underwent bilateral or unilateral thyroidectomy. METHODS: This prospective observational study recruited children and adolescents diagnosed with papillary thyroid carcinoma at low risk of recurrence. Participants were categorized into bilateral or unilateral thyroidectomy groups. They were asked to complete one questionnaire regarding basic information and three others regarding quality of life. HRQOL data from patients who underwent different procedures at various time points were compared. RESULTS: Thirty patients underwent unilateral thyroidectomy and 54 bilateral thyroidectomy (median age = 14.27 years). HRQOL of the unilateral thyroidectomy group was higher than the bilateral group. CONCLUSION: For children and adolescents with papillary thyroid carcinoma at low risk of recurrence, bilateral thyroidectomy is associated with a lower HRQOL than unilateral thyroidectomy. Surgeons should consider tumor impact and HRQOL when selecting the most appropriate surgical method.

Thermal-Radiation-Driven Ultrafast Crystallization of Perovskite Films Under Heavy Humidity for Efficient Inverted Solar Cells.

Fabricating perovskite solar cells (PSCs) in air is conducive to low-cost commercial production; nevertheless, it is rather difficult to achieve comparable device performance as that in an inert atmosphere because of the poor moisture toleration of perovskite materials. Here, the perovskite crystallization process is systematically studied using two-step sequential solution deposition in an inert atmosphere (glovebox) and air. It is found that moisture can stabilize solvation intermediates and prevent their conversion into perovskite crystals. To address this issue, thermal radiation is used to accelerate perovskite crystallization for integrated perovskite films within 10 s in air. The as-formed perovskite films are compact, highly oriented with giant grain size, superior photoelectric properties, and low trap density. When the films are applied to PSC devices, a champion power conversion efficiency (PCE) of 20.8% is obtained, one of the best results for air-processed inverted PSCs under high relative humidity (60 ± 10%). This work substantially assists understanding and modulation to perovskite crystallization kinetics under heavy humidity. Also, the ultrafast conversion strategy by thermal radiation provides unprecedented opportunities to manufacture high-quality perovskite films for low-temperature, eco-friendly, and air-processed efficient inverted PSCs.

Surgical Treatment of Primary Tracheal Adenoid Cystic Carcinoma.

Primary tracheal adenoid cystic carcinoma (TACC) occurring in the cervical trachea and invading the thyroid is very rare. Surgical resection and airway reconstruction are the main treatment methods, and other treatments include radiotherapy and endoscopic intervention. Herein, we present the case of a 74-year-old female patient with TACC. The patient underwent surgery and postoperative pathology showed that the tumor invaded the adventitia of the trachea and bilateral thyroid, where nerve involvement was observed. The patient recovered well after the operation without adjuvant therapy. Eight months after the operation, Computed tomography showed that the trachea was unobstructed and there was no recurrence.

Quantification and Pattern of Central Compartment Lymph Nodes in pN1a Papillary Thyroid Cancer Patients.

Background: The background is to investigate the results of central compartment lymphadenectomy for pN1a papillary thyroid carcinoma (PTC) with regard to quantification and pattern of resected lymph nodes thereby providing basis for future compartment VI surgical intervention. Methods: The study comprised 443 pN1a PTC patients whose clinicopathological characteristics and central compartment lymphadenectomy results were compared and correlated with the primary thyroid cancer and lymph node metastasis (LNM) features. Ultimately, multivariate analysis was conducted to identify statistically significant impact factors for a high metastatic ratio (MR). Results: Dissected lymph nodes (DLNs) were more frequently identified in right level VI than left (P < .05) although there was no difference in in the number of resected metastatic lymph nodes (MLNs). Male sex, multifocality, extrathyroidal extension (ETE), and fewer DLNs were related to a high MR. There was a positive correlation between DLN and MLN, and a negative correlation between DLN and MR. Disease multifocality and ETE were identified more frequently in the left than the right thyroid lobe. Conclusion: The outcome of central compartment lymphadenectomy in pN1a PTC patients is associated with several factors, and a thorough dissection of lymph nodes improves the rate of metastatic lymph node resection.

Analysis of risk factors for posterior laryngeal recurrent nerve metastasis in micropapillary thyroid carcinoma.

Posterior recurrent laryngeal nerve (RLN) lymph node dissection remains controversial in the operation of thyroid cancer, especially in cases of papillary thyroid microcarcinoma (PTMC). The present study aimed to evaluate the risk factors for posterior RLN lymph node metastasis in patients with PTMC. Two hundred and thirty-nine patients pathologically diagnosed with PTMC after surgery between June 2016 and June 2017 were included. Risk factors including age, sex, tumor diameter, multiple tumor focus, membrane invasion and lateral cervical lymph node metastasis condition, were analyzed, and their corresponding OR values were calculated. The results indicated that posterior RLN lymph node metastasis was pathologically identified in 27/239 patients. Membrane invasion (p = 0.024), VIa lymph node metastasis (p < 0.01), and lateral cervical lymph node metastasis (p < 0.01) were considered to be risk factors for posterior RLN lymph node metastasis. It is concluded that membrane invasion, VIa lymph node metastasis, and lateral cervical lymph node metastasis significantly increased the incidence of posterior RLN lymph node metastasis. Complete dissection of the posterior RLN lymph node was essential for patients with these risk factors.

Is There a Regular Pattern in the Recovery of Parathyroid Function After Thyroid Cancer Surgery?

PURPOSE: To investigate whether there is a pattern of recovery of parathyroid function after thyroid cancer surgery. PATIENTS AND METHODS: The study included 183 patients with papillary thyroid cancer (PTC) who underwent "total thyroidectomy (TT)" plus "unilateral central lymph node dissection (UCLND)" or "bilateral central lymph node dissection (BCLND)". The intact parathyroid hormone (iPTH) and serum calcium (sCa) were analyzed several times within 1 month after surgery to explore the recovery pattern of parathyroid gland function. Then, these 183 cases were divided into group A (97 cases) with UCLND and group B (86 cases) with BCLND to analyze whether the impairment and recovery of parathyroid function were different between the two subgroups. RESULTS: Postoperative hypoparathyroidism was seen in 115 out of 183 cases. iPTH values decreased significantly on postoperative day (POD) 1 compared with preoperative values, dropped to the lowest point on POD 3, showed an increasing trend on POD 5 and 14, and increased to 85.0% of preoperative values at POD30, whereas changes in sCa differ from changes in iPTH, which showed the lowest sCa value on POD1, and rebounded on the POD3 with the intervention of calcium supplementation, and continued to rise on the POD5 and POD14, and the sCa value reached 96.6% of the preoperative level at POD30. Subgroup analysis showed that temporary hypoparathyroidism was more pronounced in group B than in group A. SCa and iPTH levels in both subgroups showed the same trend of first decrease and then increase. CONCLUSION: The recovery of hypocalcemia and hypo-iPTHemia in the first month after thyroid cancer surgery shows a trend of decreasing and then increasing, and knowing the recovery of parathyroid function at different time points is of great value to surgeons and patients alike.

Preoperative risk factors and recommendations for surgical intervention in cN0 papillary thyroid microcarcinoma.

The evaluation and management of papillary thyroid microcarcinoma (PTMC) have always been challenging and controversial. Our retrospective study aimed to investigate the metastatic trend and risk factors of cN0 papillary thyroid microcarcinoma patients and provide advice for surgical strategies. The clinicopathological features of 556 cN0 PTMC patients undergoing thyroidectomy combined with central compartment dissection (CCD) were compared by the χ2 test and risk factors were identified by binary logistic regression analysis. Numbers of dissected lymph nodes (DLN) and metastatic lymph nodes (MLN) were analyzed using the Mann-Whitney U test to compare metastatic trends between different lobes. Male gender, tumor maximum diameter (TMD) larger than 5 mm, multifocality, and capsular/extracapsular invasion were metastatic risk factors of central compartment metastasis (CCM) (p<0.05). The number of DLN in the right level VI was larger than in the left (p<0.05), while the number of MLN was similar (p>0.05). The chance of CCM was higher when the number of DLN was larger than 5 (p<0.05). After identified metastatic trends and risk factors, we recommend surgery for patients deciding on aggressive treatment, especially for cases where a combination of risk factors is present. And to ensure no residual metastatic lymph nodes and reduce secondary surgery rates, adequate lymphadenectomy on the diseased side would be a better choice considering the standard of care.

A Dual-Functional Conjugated Polymer as an Efficient Hole-Transporting Layer for High-Performance Inverted Perovskite Solar Cells.

Conductive polyelectrolytes such as P3CT-Na have been widely used as efficient hole-transporting layers (HTLs) in inverted perovskite solar cells (PSCs) due to their high hole mobility. However, the acid-base neutralization reaction is indispensable for preparing such polyelectrolytes and the varied content of cations usually leads to poor reproducibility of the device performance in PSCs. In this work, a commercially available polymer poly[3-(4-carboxybutyl)thiophene-2,5-diyl] (P3CT) was directly applied as an HTL in PSCs for the first time. Encouragingly, it was found that due to the dual functionality of carboxyl groups on side chains, a thin layer of P3CT can not only strongly anchor on ITO electrode and optimize its work function but also show an effective passivation effect toward perovskite active layer. Benefiting from such dual functionality, a uniform perovskite film with better quality was obtained on P3CT. As a result, the P3CT-based PSCs show much lower nonradiative recombination and achieve a champion power conversion efficiency (PCE) of 21.33% with a high fill factor (FF) of 83.6%. Impressively, as the device area is increased to 0.80 cm2, a PCE of 19.65% can still be obtained for the PSCs based on P3CT HTL. Our work provides important strategy for developing HTLs for high-performance PSCs.

Development of active and smart packaging films based on starch, polyvinyl alcohol and betacyanins from different plant sources.

In this study, active and smart packaging films were prepared by individually adding betacyanins-rich plant extracts (red pitaya flesh extract (RPFE), prickly pear fruit extract (PPFE), red beetroot extract (RBRE), globe amaranth flower extract (GAFE) and red amaranth leaf extract (RALE)) into starch/polyvinyl alcohol. The structural, physical and functional properties of the films containing betacyanins from different plant sources were compared for the first time. Results showed betacyanins from RPFE, PPFE and RBRE were betanin-type betacyanins. Betacyanins from GAFE and RALE were gomphrenin-type and amaranthin-type betacyanins, respectively. The films containing RPFE and PPFE presented more uniform cross-sections and had the highest water vapor barrier (9.37 and 9.26 × 10-11 g m-1 s-1 Pa-1) and mechanical strength (8.26 and 7.87 MPa). However, the film containing GAFE presented the lowest light transmittance but the highest 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity (EC50 = 0.47 mg/mL). All the films containing betacyanins are sensitive to pH 8-12 buffer solutions and volatile ammonia. Notably, the film containing RPFE exhibited distinct color changes (from purple-red to pink) when shrimp spoiled. Our results suggest the structural, physical and functional properties of betacyanins-rich films are closely related to the source and type of betacyanins.

Highly efficient synthesis and characterization of starch aldehyde-catechin conjugate with potent antioxidant activity.

In this study, cassava starch aldehyde was functionalized with catechin through acid catalyzed condensation reaction. The structural characterization, stability and antioxidant activity of starch aldehyde-catechin conjugates were investigated. Thin layer chromatography revealed the conjugates did not contain free catechin. UV-vis spectra of the conjugates exhibited an absorption band at 280 nm, attributing to the B-ring of catechin moiety. Fourier-transform infrared and proton nuclear magnetic resonance spectroscopy demonstrated the conjugation occurred between the H-6/H-8 of catechin A-ring and the aldehyde groups of starch aldehyde. X-ray diffraction pattern indicated that the conjugates had an amorphous structure. Scanning electron microscopy showed the conjugates were fragmentary slices with rough surfaces. Notably, the conjugates were more stable than catechin in phosphate buffered saline (pH 7.4). In addition, the conjugates could not be digested in simulated saliva, gastric and small intestinal juices. The reducing power and free radical scavenging activity of starch aldehyde were remarkably elevated by conjugating with catechin. Meanwhile, the conjugates were non-cytotoxic to RAW264.7 mouse macrophage cells and possessed higher resistant starch contents than starch. Our results suggest starch aldehyde-catechin conjugates can be used as antioxidants in food industry.

Teaching an Old Anchoring Group New Tricks: Enabling Low-Cost, Eco-Friendly Hole-Transporting Materials for Efficient and Stable Perovskite Solar Cells.

As a key component in perovskite solar cells (PVSCs), hole-transporting materials (HTMs) have been extensively explored and studied. Aiming to meet the requirements for future commercialization of PVSCs, HTMs which can enable excellent device performance with low cost and eco-friendly processability are urgently needed but rarely reported. In this work, a traditional anchoring group (2-cyanoacrylic acid) widely used in molecules for dye-sensitized solar cells is incorporated into donor-acceptor-type HTMs to afford MPA-BT-CA, which enables effective regulation of the frontier molecular orbital energy levels, interfacial modification of an ITO electrode, efficient defect passivation toward the perovskite layer, and more importantly alcohol solubility. Consequently, inverted PVSCs with this low-cost HTM exhibit excellent device performance with a remarkable power conversion efficiency (PCE) of 21.24% and good long-term stability in ambient conditions. More encouragingly, when processing MPA-BT-CA films with the green solvent ethanol, the corresponding PVSCs also deliver a substantial PCE as high as 20.52% with negligible hysteresis. Such molecular design of anchoring group-based materials represents great progress for developing efficient HTMs which combine the advantages of low cost, eco-friendly processability, and high performance. We believe that such design strategy will pave a new path for the exploration of highly efficient HTMs applicable to commercialization of PVSCs.

Comparison of the physical and functional properties of starch/polyvinyl alcohol films containing anthocyanins and/or betacyanins.

Anthocyanins and betacyanins are two different types of natural pigments. In this study, active and intelligent packaging were prepared by adding anthocyanins or betacyanins or anthocyanins/betacyanins mixture (in the weight ratios of 3:1, 1:1 and 1:3) into starch/polyvinyl alcohol (PVA) films. The physical and functional properties of developed films were compared. Results showed anthocyanins were more pH-sensitive than betacyanins. However, betacyanins were more beneficial to improve the compactness of the films and had stronger hydrogen bonding interactions with film matrix as compared with anthocyanins. The addition of anthocyanins and/or betacyanins slightly decreased the crystallinity of the films but significantly increased the ultraviolet-visible light barrier, water vapor barrier, antioxidant, antimicrobial, and ammonia-sensitive properties of the films. Moreover, the barrier, antioxidant and antimicrobial properties of the films increased with the increase of betacyanins proportion. Amongst different films, the film containing anthocyanins/betacyanins mixture in the weight ratio of 1:3 presented obvious color changes when the film was utilized to monitor the freshness of pork. Our results suggested betacyanins was more beneficial to enhance the barrier, antioxidant and antimicrobial properties of starch/PVA films. Starch/PVA films simultaneously added with anthocyanins and betacyanins were more suitable to monitor the freshness of pork.

Development of multifunctional food packaging by incorporating betalains from vegetable amaranth (Amaranthus tricolor L.) into quaternary ammonium chitosan/fish gelatin blend films.

Multifunctional food packaging was prepared by incorporating betalains-rich vegetable amaranth (Amaranthus tricolor L.) extract into quaternary ammonium chitosan (QC)/fish gelatin (FG) blend films. The structures, physical and functional properties of the films with and without amaranth extract (AE) were determined. Results showed betalains-rich AE was pH-sensitive and could change its colors under alkaline conditions. Structural characterization revealed the interactions between AE and film matrix were based on hydrogen bonds, which influenced the compactness of the films. Notably, AE significantly enhanced the thickness (from 0.076 to 0.089 mm), UV-vis light barrier ability, elongation at break (from 66.7% to 88.8%), 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity (from 6.8% to 95.8% at 5 mg/mL), antimicrobial activity against four foodborne pathogens (Escherichia coli, Staphylococcus aureus, Salmonella typhimurium and Listeria monocytogenes) and ammonia sensitivity of the films. However, AE remarkably reduced the water vapor permeability (from 34.9 × 10-11 to 26.4 × 10-11 g m-1 s-1 Pa-1) of the films. Notably, the films containing 5 wt% and 10 wt% of AE were suitable to monitor the freshness of shrimp. Our results suggested QC/FG films with betalains-rich AE could be used as antioxidant, antimicrobial and intelligent packaging in food industry.

Raman study of impurity influence on active center in artemisinin.

The unusual endoperoxide bridge is believed to be the active center for artemisinin activations. Our Raman study indicated that the active center endoperoxide bridge is more significantly influenced by impurity than other parts in artemisinin molecule. This phenomenon provides a Raman spectroscopy method for quantitative measurement of impurity content basing on the relative intensity ratio analysis of characteristic vibrational modes. The proposed Raman method can be a good alternative to high performance liquid chromatography, which is a commonly applied technique for measuring impurity content. Also, the Raman method can provide additional information of impurity homogeneity. In addition, Raman imaging is presented for easy visualization of impurity content and homogeneity in artemisinin simultaneously.

Recent advances in phenolic-protein conjugates: synthesis, characterization, biological activities and potential applications.

Proteins and phenolic compounds are two types of food ingredients with distinct functionalities. In the past decade, many attempts have been made to conjugate phenolic compounds with proteins through covalent linkages. Four types of conjugation reactions including alkaline, free radical mediated grafting, enzyme catalyzed grafting and chemical coupling methods are frequently used to synthesize phenolic-protein conjugates. The synthesized phenolic-protein conjugates can be well characterized by several different instrumental methods, such as UV spectroscopy, Fourier transform infrared spectroscopy, fluorescence spectroscopy, circular dichroism, mass spectroscopy, sodium dodecyl sulfate polyacrylamide gel electrophoresis and differential scanning calorimetry. Importantly, phenolic-protein conjugates exhibit improved biological properties (e.g. antioxidant, anticancer and antimicrobial activities) as compared with native proteins. Moreover, the applications of native proteins can be greatly widened by conjugation with phenolic compounds. Phenolic-protein conjugates have been developed as antioxidant emulsions for nutraceutical delivery, edible films for food packaging, stabilizers for metal nanoparticles, and hydrogels and nanoparticles for controlled drug release. In this review, recent advances in the synthesis, characterization, biological properties and potential applications of phenolic-protein conjugates were summarized.

Complete endoscopic radical resection of thyroid cancer via an oral vestibule approach.

The aim of the present study was to explore the feasibility, safety and effectiveness of complete endoscopic radical resection of thyroid cancer via an oral vestibule approach. A total of 60 patients with unilateral thyroid papillary carcinoma were divided into two groups. Half of them underwent complete endoscopic surgeries via an oral vestibule approach at the Department of Head and Neck Surgery of Fujian Cancer Hospital between November 2014 and December 2016. The other 30 patients underwent traditional open surgeries. All the patients underwent unilateral lobectomy and central neck dissection. Tumor diameter, surgery duration, intraoperative inflation pressure and end-tidal CO2 flow rate, intraoperative peak value of the partial pressure of end-tidal CO2, postoperative extubation time, the number of lymph nodes in the specimens of central neck dissection and postoperative complications were noted. From this data, tumor diameter (T stage of tumor), surgery duration, postoperative extubation time, the number of lymph nodes in the specimens of central neck dissection and postoperative complications were compared between the two groups. In the endoscopic group, 1 patient had a tracheal injury, and 1 patient had a submental skin perforation. Furthermore, 17 patients experienced transient numbness of the lower lip, 5 patients experienced an abnormal increase in the partial pressure of end-tidal CO2, and 2 patients experienced postoperative headache. No recurrent laryngeal nerve injury, postoperative bleeding, or infection was determined. There were no significant differences in all items of the indexes, compared with those patients who underwent open radical surgery. The lymph nodes from region VI may be well exposed and completely removed through this novel procedure with no visible scars, which not only ensured the surgery criterion was met, but also met the cosmetic requirements of the patients. The present study conducted procedures safely by surgeons highly skilled in performing laparoscopic surgery.