[Retrospective analysis of 350 cases with dissection of lymph nodes posterior to right recurrent laryngeal nerve in endoscopic thyroidectomy through gasless axillary posterior approach]

Objective: To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (ⅥB compartment) in endoscopic thyroidectomy through gasless axillary posterior approach. Methods: A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data. Results: All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and ⅥB compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. ⅥB compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%). Conclusion: The dissection of ⅥB compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients.

Intra-individual variability in neurocognitive function in schizophrenia: relationships with the corpus callosum

Patients with schizophrenia not only have impairments in neurological function, but also have instability and variability in neurocognitive function. However, previous researchers have not fully studied the relationships between dispersion across multiple neurocognitive domains and white matter (WM) structures of the brain. This study focuses on intra-individual variability (IIV) in patients with schizophrenia and its relationship with WM integrity of the corpus callosum (CC). Thirty-eight patients with schizophrenia were enrolled in the study. All subjects underwent assessments of neurocognitive function using the Korean-Wechsler Adult Intelligence Scale-Revised (K-WAIS-R) and the severity of clinical symptoms using the Positive and Negative Syndrome Scale (PANSS). IIV across subtests of the K-WAIS-R was calculated using the Holtzer's equation. Tract-based spatial statistics were used to analyze diffusion tensor images. In subjects with schizophrenia, a negative correlation was found between IIV in performance intelligence quotient (PIQ) and fractional anisotropy (FA) values in the genu of the CC. In addition, FA values of the same region were negatively correlated with the total and subscale scores of positive symptoms and general psychopathology from the PANSS. Our findings suggest that the genu of the CC may play an important role in IIV in PIQ and symptomatology in patients with schizophrenia.

[Robot-assisted transaxillary thyroidectomy: our early experience]

Objective:To evaluate the feasibility, effectiveness and safety of robot-assisted transaxillary thyroidectomy (RATT).Method: The clinical data of 66 patients undergoing RATT from November 2016 to May 2018 were prospectively collected and analyzed. The average age was (38.61±11.72) years, 57 cases were female and 9 cases were male. Preoperative fine needle aspiration biopsy revealed papillary thyroid carcinoma in 58 cases and follicular thyroid tumor in 8 cases.Result:All the patients successfully completed RATT, and there was no open operation, in which 54 cases of ipsilateral lobetomy and isthmus resection and ipsilateral central lymph node dissection, 8 cases with ipsilateral lobectomy and contralateral near-total lobectomy, and total thyroidectomy with ipsilateral central lymph node dissection and selective neck dissection combined with retroauricular approach in 4 cases. The mean operative time was (124.30±23.41) min, and the average bleeding volume was (17.73±8.28) ml. The mean diameter of thyroid papillary carcinoma was (0.71±6.22) cm, and the postoperative drainage volume was (67.57±25.11) ml. The average postoperative hospitalization time was (3.24±0.81) days. 3 cases (4.5%) had temporary laryngeal nerve palsy after operation, and 1 case (1.5%) had temporary hypocalcemia after operation, all recovered after one month. No postoperative bleeding, subcutaneous emphysema, drinking water cough and permanent hypocalcemia were observed. The average numbers of lymph node dissection in PTC patients were (6.26±4.76), of which 21 cases (36.2%) had lymph node metastasis, postoperative stage T1 54 cases, T2 4 cases, N1a 17 cases, N1b 4 cases. The follow-up time were 1-18 months. The postoperative cosmetic VAS score in January was (9.66±0.54). Ultrasound showed no residual glands in the affected thyroid gland, and there was no recurrence in the local and regional regions.Conclusion:RATT is safe and feasible with good aesthetic effect and can be used as an option for the treatment of thyroid diseases..

Development of a Rapid Fluorescent Immunochromatographic Test to Detect Respiratory Syncytial Virus

Human respiratory syncytial virus (RSV) is one of the most common viruses infecting the respiratory tracts of infants. The rapid and sensitive detection of RSV is important to minimize the incidence of infection. In this study, novel monoclonal antibodies (mAbs; B11A5 and E8A11) against RSV nucleoprotein (NP) were developed and applied to develop a rapid fluorescent immunochromatographic strip test (FICT), employing europium nanoparticles as the fluorescent material. For the FICT, the limits of detection of the antigen and virus were 1.25 µg/mL and 4.23 × 10⁶ TCID₅₀/mL, respectively, corresponding to 4.75 × 10⁶ ± 5.8 ×10⁵ (mean ± SD) RNA copy numbers per reaction mixture for RSV NP. A clinical study revealed a sensitivity of 90% (18/20) and specificity of 98.18% (108/110) for RSV detection when comparing the performance to that of reverse transcription polymerase chain reaction (RT-PCR), representing a 15% improvement in sensitivity over the SD Bioline rapid kit. This newly developed FICT could be a useful tool for the rapid diagnosis of RSV infection.

[Gasless endoscopic selective lateral neck dissection via an anterior chest approach for papillary thyroid carcinomas]

Objective: To assess the safety and curative effect of gasless endoscopic selective lateral neck dissection (GESLND) via an anterior chest approach for papillary thyroid carcinoma (PTC). Methods: Eighteen patients with PTC(T1-2N1bM0, size<3.0 cm), having GESLND via an anterior chest approach, were included from November 2008 to December 2016. Results: GESLND via an anterior chest approach was successfully performed in all 18 PTC patients (seven male and eleven female) with 83.3% of T1 and 16.7% of T2. The mean operative time of selective lateral neck dissection was 73 min (range 51-92 min). The mean of intraoperative bleeding was 61.1 ml (range 30-120 ml). No major complications occurred except one transient hypoparathyroidism. No residual thyroid glands were detected on ultrasonography and thyroglobulin was(0.73±0.16)ng/ml three months postoperatively. The median of follow-up was 54.5 months (range 6-104 months). No recurrence disease was observed in any patient on ultrasonography, computer tomography, thyroglobulin or selective iodine-131 scan during the follow-up period. The cosmetic result and functional preservation was excellent, when the assessments were performed three months postoperatively. Conclusion: GESLND via an anterior chest approach is feasible and safe for selected PTCs, with superior appearance.

Fornix microalterations associated with early trauma in panic disorder

BACKGROUND

It is well accepted that panic disorder (PD) is associated with early trauma, and that the limbic systems are one of the main structures involved in PD pathophysiology. However, previous studies have not addressed the relationship between early trauma and major limbic white-matter (WM) structures in PD.

METHODS

Participants enrolled in the study consisted of 53 right-handed patients with PD and 21 healthy controls (HC). The Early Trauma Inventory Self Report-Short Form (ETISR-SF), Anxiety Sensitivity Inventory-Revised (ASI-R), and the Albany Panic and Phobia Questionnaire (APPQ) were applied in the study. Tract-based spatial statistics were used for diffusion tensor magnetic resonance imaging analysis.

RESULTS

Among the patients with PD, the fractional anisotropy (FA) values of the fornix body in major limbic WM regions showed significant negative correlation with the ETISR-SF total score, while the scores of mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) in the same region of fornix had significant positive correlation with those scores (p<0.05; FWE corrected). Further significant correlation was observed between these four scores and the measures of symptom severity in PD, such as that in ASI-R and APPQ in the same region.

LIMITATIONS

Recall bias is possible in evaluating early trauma in the participants.

CONCLUSIONS

The current study suggests a significant association of early trauma with the fornix body possibly through axons and myelin disruptions within major limbic structures in PD. A multi-centered large sample will be needed to confirm these findings.

Rapid Detection of Avian Influenza Virus by Fluorescent Diagnostic Assay using an Epitope-Derived Peptide

Currently, the point of care testing (POCT) is not fully developed for subtype-specific avian influenza virus detection. In this study, an H5N1 hemaglutinin 1 (HA1) epitope (P0: KPNDAINF) and three modified peptides (P1: KPNTAINF, P2: KPNGAINF, P3: KPNDAINDAINF) were evaluated as POCT elements for rapid detection of avian influenza virus. Based on modeling predictions by Autodock Vina, binding affinity varied depending on alteration of one amino acid in these peptides. The binding energy of P2 indicated its potential for a strong interaction with HA. Fluorescence-linked immunosorbent assay experimentally demonstrated the interaction between these peptides and virus. The four peptides interacted with HA1 of H5N3 with different binding affinities with P2 showing the strongest binding affinity. When P0 and P2 peptides were used in rapid fluorescent immunochromatographic test (FICT) as detection elements, the inter-assay coefficients of variation (CV) indicated that P2-linked FICT was more acceptable than the P0-linked FICT in the presence of human specimens. Antibody pair-linked FICT was influenced by clinical samples more than the P2-linked FICT assay, which showed a 4-fold improvement in the detection limit of H5N3 and maintained H5 subtype-specificity. Compared to the rapid diagnostic test (RDT) which is not specific for influenza subtypes, P2-linked FICT could increase virus detection. In conclusion, results of this study suggest that HA epitope-derived peptides can be used as alternatives to antibodies for a rapid fluorescent diagnostic assay to detect avian influenza virus.

6-trifluoromethyl-2-thiouracil possesses anti-Toxoplasma gondii effect in vitro and in vivo with low hepatotoxicity

Since pyrimethamine, the general therapeutic drug for toxoplasmosis, presents several adverse side effects, the need to develop and evaluate new drugs for the condition is critical. In this study, anti-Toxoplasma gondii activities of 3-[{2-((E)-furan-2-ylmethylene)hydrazinyl}methylene]-1,3-dihydroindol-2-one (ATT-5126) and 6-trifluoromethyl-2-thiouracil (KH-0562) were evaluated in vitro using a 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay and in vivo by measuring amount of the tachyzoites in mice ascites. Biochemical parameters such as lipid peroxidation (LPO), glutathione (GSH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were also evaluated in livers of mice at 4 days post-infection. As a result, the ATT-5126 and KH-0562 showed anti-T. gondii activity in vitro. Treatment of ATT-5126 or KH-0562 decreased the amount of tachyzoites in T. gondii infected ICR mice. The relative weight of liver and spleen increased by T. gondii infection were decreased by treatment of ATT-5126 or KH-0562. The levels of LPO, ALT and AST, which are biochemical parameters involved in liver injury, were also significantly recovered by treatment of ATT-5126 or KH-0562 (p<0.05). In particular, the recovered levels by KH-0562 were similar to those of pyrimethamine-treated group (p<0.05). However, the level of GSH, which is an antioxidant indicator, showed insignificant statistics. The results suggest that KH-0562 show anti-T. gondii activities in vitro and in vivo with low hepatotoxicity. Therefore, KH-0562 may be a useful candidate for treating T. gondii infection.

A batch study on the bio-fixation of carbon dioxide in the absorbed solution from a chemical wet scrubber by hot spring and marine algae

Carbon dioxide mass transfer is a key factor in cultivating micro-algae except for the light limitation of photosynthesis. It is a novel idea to enhance mass transfer with the cyclic procedure of absorbing CO(2) with a high performance alkaline abosorber such as a packed tower and regenerating the alkaline solution with algal photosynthesis. Hence, the algae with high affinity for alkaline condition must be purified. In this study, a hot spring alga (HSA) was purified from an alkaline hot spring (pH 9.3, 62 degrees C) in Taiwan and grows well over pH 11.5 and 50 degrees C. For performance of HSA, CO(2) removal efficiencies in the packed tower increase about 5-fold in a suitable growth condition compared to that without adding any potassium hydroxide. But ammonia solution was not a good choice for this system with regard to carbon dioxide removal efficiency because of its toxicity on HSA. In addition, HSA also exhibits a high growth rate under the controlled pHs from 7 to 11. Besides, a well mass balance of carbon and nitrogen made sure that less other byproducts formed in the procedure of carboxylation. For analysis of some metals in HSA, such as Mg, Mn, Fe, Zn, related to the photosynthesis increased by a rising cultivated pH and revealed that those metals might be accumulated under alkaline conditions but the growth rate was still limited by the ratio of bicarbonate (useful carbon source) and carbonate. Meanwhile, Nannochlopsis oculta (NAO) was also tested under different additional carbon sources. The results revealed that solutions of sodium/potassium carbonate are better carbon sources than ammonia carbonate/bicarbonate for the growth of NAO. However, pH 9.6 of growth limitation based on sodium was lower than one of HSA. The integrated system is, therefore, more feasible to treat CO(2) in the flue gases using the algae with higher alkaline affinity such as HSA in small volume bioreactors.

[The changes of density of platelet glycoprotein (GP) II b/III a receptor in the perioperative period of gastrectomy in aged rats]

AIM

To investigate changes of density of platelet glycoprotein (GP) II b/III a receptor in the perioperative period of gastrectomy in aged rats.

METHODS

The subtotal gastrectomy operation was performed in 16 adult rats and 16 aged rats respectively. Platelet surface density of GP II b/III receptors were determined by flow cytometric analysis before and 6, 12, 24, 48, 72 hours after operation.

RESULTS

6, 12, 24, 48 and 72 hours after operation, the density of GP II b/III a in aged group increased continuously compared with preoperative period (6h, 12, 72: P < 0.05; 24, 48: P < 0.01).

CONCLUSION

Gastrectomy can lead to an increase of density of platelet GP II b/III a receptor in aged rats.

Synthesis of a 10,000 member 1,5-benzodiazepine-2-one library by the directed sorting method

The solid-phase synthesis of a 10,000 member combinatorial library of 1,5-benzodiazepine-2-one derivatives is reported. The 3-amino-1,5-benzodiazepine-2-one scaffold was prepared in solution, and the benzamide nitrogen was used as a point of attachment to the resin. The 5-aniline and 3-amine were then used as points of diversity. A 10,000 member library was synthesized using the Irori directed sorting system, and after analysis of a representative sample from the library, the Irori system was used to remove the compounds of lower purity.

Prevalence of human papillomaviruses 16 and 18 in transitional cell carcinoma of bladder

It has been speculated that human papillomaviruses (HPV) might be a causative agent of transitional cell carcinoma of the bladder. With the polymerase chain reaction technic, fresh specimens of 53 transitional cell carcinomas of the bladder were examined, and bladder epithelium from 12 patients with hyperplasia of prostate and peripheral blood lymphocytes of 8 normal individuals served as controls. The primers set for HPV-16 and 18 were selected from E6/E7 regions of open reading frames. HPV-16 was positive in 52.8% of the specimens examined, whereas HPV-18 positive in only 3.7%. No controls showed either HPV-16 or 18. Reports on the role of HPVs in carcinogenesis of bladder are scanty and yet there exist conspicuous discrepancies among them. There is a diversity of opinions on the contamination and variation of technical procedures. More work should be done before the relationship between HPV-16 and development of bladder carcinoma can be clarified.

[The bioavailability of transdermal therapeutic system of timolol]

A matrix-type transdermal therapeutic system of timolol (TTS-timolol) was well prepared. The patch consisted of backing membrane layer, timolol reservoir layer, pressure sensitive adhesive layer and protective layer. A sensitive and reliable HPLC-UV method for the determination of plasma level of timolol in healthy volunteers was developed. Effective therapeutic plasma level of timolol (4 ng/ml) was attained 4 h after application of the timolol patches and was maintained within 32 h while the patch was removed at 24 h. The pharmacokinetic behavior of this transdermal therapeutic system (TTS)-timolol in human showed zero order absorption and well fitted to a one compartment model. The pharmacokinetic parameters are: Tmax = 18.8 h; Cmax = 11.2 ng/ml; AUC = 265.7 ng/ml.h; Vss = 120.0 L; K = 0.084 h-1. In comparison with the results of oral administration of timolol tablets, TTS-timolol possesses some advantages: stable plasma level, long effective time and convenient administration.

Effect of endothelin-1 on the vascular smooth muscle cell cycle

Rabbit vascular smooth muscle cells were cultured in various concentrations of endothelin-1 (ET-1) at 37 degrees C for 24 h. The vascular smooth muscle cell cycle distribution was determined by flow cytometry according to DNA content. In the control group, the mitotically active phase (S + G2 + M phase) of vascular smooth muscle cells was 11.94%. In ET-1-cultured smooth muscle cells, the mitotically active phase was 11.69% at a concentration of 1 pM ET-1, whereas the mitotically active phases were 18.98 and 26.91% at concentrations of 0.1 and 10 nM ET-1, respectively. The findings show that ET-1 significantly increased mitotic activity of cultured vascular smooth muscle cells.