Studies on surgical methods for sporadic micromedullary thyroid carcinoma

Background:To observe the changes in serum calcitonin levels after application of different surgical methods for primary medullary thyroid microcarcinoma(MTMC)and explore a more reasonable surgical method.Methods:A retrospective analysis of 36 patients with MTMC,16 in group A and 20 in group B,was performed.In group A,tumors were single and confined to the thyroid lobe,and thyroid lobectomy with isthmusectomy was performed.In group B,tumors were in the isthmus or invaded the thyroid gland,or there were multiple foci in bilateral lobes,and patients with primary foci underwent total thyroidectomy.The median follow-up time was 3.6 years.Clinical and pathological characteristics and changes in serum calcitonin(CTn)and carcinoembryonic antigen levels after the surgery were compared between the 2 groups.Results:The difference in the biochemical cure rate after surgery was statistically significant between patients with preoperative serum calcitonin levels<150 pg/mL and≥150 pg/mL(P<0.01).No significant differences in the biochemical cure rates and serum calcitonin levels were noted at different time points after surgery between group A and group B(P>0.05).One recurrence and metastasis were observed in each group after surgery.Conclusions:After performing different surgical methods for the primary foci of MTMC,the changes in serum calcitonin and carcinoembryonic antigen levels are similar.Especially for patients with single foci confined to the thyroid lobe without lateral cervical lymph node metastasis and with serum calcitonin levels<150 pg/mL,the unilateral thyroid lobectomy with isthmectomy can achieve the same therapeutic effect and biochemical cure rate as total thyroidectomy.

Long-Term Bending Behaviour of Prestressed Glulam Bamboo-Wood Beam Based on Creep Effect

Creep is an important characteristic of bamboo and wood materials under long-term loading.This paper aims to study the long-term bending beha-viour of prestressed glulam bamboo-wood beam(GBWB).For this,14 pre-stressed GBWBs were selected and subjected to a long-term loading test for 60 days.Then,a comparative analysis was performed for the effects of pre-tension values,the number of pre-stressed wires,and long-term load on the stress variation of the steel wire and the long-term deflection of the beam midspan.The test results showed that with the number of prestressed wires increasing,the total stress of the steel wire in the beam midspan and the ratio of the long-term deflec-tion to the total deflection decreases decreased,but when the number of steel wires exceeded 4,the total stress and long-term deflection was less infuenced;with the pre-tension value increasing,the ratio of the total stress of the steel wire in the beam midspan and the ratio of the long-temm deflection to the total deflec-tion also decreased,but when the prestress force was greater than 3.975 kN,the:total stress and long-term deflection were less affected;with the other parameters unchanged,when the value of the long-term load increased,the total stress of the steel wire decreased,and the long-temm deflection of the beam midspan increased,which shall be more significant with the long-term load greater than 30%of the standard ultimate bearing capacity.After the test,the experimental data were fitted,and the creep coefficient was given.Finally,the long-term stiffness calcula-tion fommula of the pre-stressed GBWB based on creep effect was proposed.The research findings have certain theoretical significance and engineering value.

Resveratrol inhibits angiotensin II-induced ERK1/2 activation by downregulating quinone reductase 2 in rat vascular smooth muscle cells

Our previous studies showed that resveratrol could inhibit the proliferation of vascular smooth muscle cells （VSMCs） and repress mRNA and protein expression of quinone reductase 2 （NQO2）. This study further explored the potential mechanisms whereby resveratrol inhibits the proliferation of rat VSMCs. Lentiviral vectors that incorporated NQO2 small interfering RNA （siRNA） were constructed and transduced into rat VSMCs. The cell proliferation was detected using the bromodeoxyuridine （BrdU） assay. Cultured rat VSMCs were stimulated with angiotensin II and the level of reactive oxygen species （ROS） was measured using a ROS assay kit. A realtime quantitative PCR was used to detect NQO2 mRNA levels. Extracellular signal-regulated kinase （ERK1/2） and NQO2 protein expression were determined by Western blotting analysis. The inhibitory effect of resveratrol （10 and 50 μmol/L） on the proliferation of rat VSMCs in the NQO2 siRNA group was significantly weaker than that in the normal and scrambled siRNA group （P 〈 0.01）. The ROS level in the NQO2 siRNA and resveratrol （50 μmol/L） treatment groups were lower than that in the normal and scrambled siRNA groups （P 〈 0.01 in both）. Compared with the normal and scrambled siRNA group, the phosphorylation of ERK1/2 was significantly decreased in the NQO2 siRNA and resveratrol （50 μmol/L） treatment group （P 〈 0.01 in both）. In conclusion, high concentration of resveratrol inhibits angiotensin II-induced ERK1/2 phosphorylation and subsequent proliferation by down-regulation of NQO2 in cultured rat VSMCs.

Effect of parathyroid hormone on apoptosis of human medullary thyroid carcinoma cells

Objective The aim of the study was to investigate the effect of parathyroid hormone(PTH) on the apoptosis of human medullary thyroid carcinoma(MTC) cells.Methods In vitro cultured medullary thyroid carcinoma cell lines were treated with parathyroid hormone and parathyroid hormone receptor-monoclonal antibody,and the apoptosis of cells was detected by flow cytometry.Results The cell morphology changed significantly after treatment based on the observation using the inverted phase-contrast microscope.Various concentrations of parathyroid hormone and parathyroid hormone receptor-monoclonal antibody effectively induced apoptosis in a time-and concentrationdependent manner.When the concentration of parathyroid hormone was 2.0 μmol/L and that of parathyroid hormone receptor-monoclonal antibody was 1.0 μmol/L,the apoptotic rate was 13.24% and 20.78%,respectively,representing a statistically significant difference from that of the control cells(P < 0.05).Conclusion PTH plays a role in inducing apoptosis of human MTC cells.

Optimal programming management of ventricular tachycardia storm in ICD patients

Ventricular tachycardia storm （VTS） is defined as a life-threatening syndrome of three or more separate episodes of ventricular tachycardia （VT） leading to implantable cardioverter defibrillator （ICD） therapy within 24 hours. Patients with VTS have poor outcomes and require immediate medical attention. ICD shocks have been shown to be associated with increased mortality in several studies. Optimal programming in minimization of ICD shocks may decrease mortality. Large controlled trials showed that long detection time and high heart rate detection threshold reduced ICD shock burden without an increase in syncope or death. As a fundamental therapy of ICD, anti- tachycardia pacing （ATP） can terminate most slow VT with a low risk of acceleration. For fast VT, burst pacing is more effective and less likely to result in acceleration than ramp pacing. One algorithm of optimal programming management during a VTS is presented in the review.

Clinical significance of BRAF^(V600E) and TERT promoter mutation in papillary thyroid microcarcinoma

Objective The objective of this study was to analyze the correlation between BRAF^(V600E) and TERT promoter mutations and papillary thyroid microcarcinoma (PTMC) risk factors, and their importance in the risk assessment of papillary thyroid microcarcinoma.Methods This study retrospectively analyzed 107 cases of PTMC, which were diagnosed after the surgery in the department of head and neck surgery in Gansu Province Tumor Hospital from October 2014to June 2016. The mutations of BRAFV^(600E) and TERT promoter were detected by PCR direct sequencing.We analyzed the data usingχ~2 test and binary Logistic regression analysis.Results Among 107 patients with PTMC, the BRAFV^(600E) and TERT promoter mutation rates were 68.2%and 11.2%, respectively. Single factor analysis showed that there was a significant difference between the presence of membrane invasion, lymph node metastasis, and BRAFV^(600E) mutations (P<0.01). The age,gender, thyroid capsular invasion, poor pathologic subtype, and lymph node metastasis of patients, was significantly associated with the TERT promoter mutation (P<0.05) and the coexistence of the BRAF^(V600E)and TERT promotor mutations; although, there was a difference between the association of these factors with the TERT promoter mutation and the association of these factors with the coexistence of the BRAF^(V600E)and TERT promotor mutations. The multifactorial analysis showed that the factors closely related to the BRAFV^(600E) mutation included capsular invasion (P=0.012) and lymph node metastasis (P=0.000). The following factors were closely associated with the TERT promoter mutant:male (P=0.004), aged <45 years(P=0.026), capsular invasion (P=0.004), pathological subtype (P=0.030), and lymph node metastasis (P=0.043). The following factors were closely related to the simultaneous mutation of BRAFV^(600E) and TERT:male (P=0.022), capsular invasion (P=0.023), poor pathological subtype (P=0.041), and lymph node metastasis (P=0.030).Conclusion The risk of recurrence increases significantly when mutations in BRAFV^(600E) and TERT promoters occur simultaneously in PTMC and may have adverse outcomes. Combined detection of BRAFV^(600E) and TERT promoter mutations is of great value in risk assessment of PTMC.

Correlation between thyroid function and nodular goiter accompanied with gallstone

Objective： The purpose of the study wass to explore the correlation between thyroid function and nodular goiter accompanied with gallstone. Methods： We collected 120 cases about nodular goiter accompanied with gallstone and 128 cases about nodular goiter and establish 50 healthy control groups. Detected t level of hyrotropic hormone （TSH）, total triio- dothyronine （TT3）, total thyroxine in the peripheral venous blood of these cases in the three groups by using electrochemilu- minescenca immunoassay, measure level of total cholesterol （TC）, high-density tipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol （LDL-C） and total bile acid （TBA） levels by using enzymic method, and observed the changes of thyroid function and blood lipid among the three groups. Results： The serum TT3 level in nodular goiter accompanied with gallstone group and the nodular goiter group was significantly lower than that in control group （P 〈 0.01）, and TSH level in the nodular goiter accompanied with gallstone group is significantly higher than that in control group （P 〈 0.01）, There were no statistical significance about difference of TT4 level among the three groups （P 〉 0.05）. Accordingly, TC and LDL-C level in nodular goiter accompanied with gallstone group was significantly higher than that in nodular goiter and control group （P 〈 0.01）, while TBA level in nodular goiter accompanied with gallstone group was significantly lower than that in simple nodular goiter group and control group （P 〈 0.01）. There was no statistical significance about difference of TC and LDL-C level between simple nodular goiter group and control group （P 〉 0.05）. The HDL-C level in nodular goiter accompanied with gallstone group and control group was higher than that in simple nodular goiter group （P 〈 0.01）. Conclusion： The originating etiologic factor of nodular goiter accompanied with gallstone may be related to that the decreased TT3 induced sub-clinical hypothyroidism.

Correlation analysis between serum β2-MG and sodium/iodide symporter in patients with thyroid carcinoma

Objective： The aim of our study was to investigate the correlation between the expression of sodium/iodide symporter, serum levels of β2-MG and prognosis of thyroid carcinoma patients. Methods： Ninty-five cases with thyroid carcinoma, using enzyme-linked immunosorbent assay with double-antibody sandwich to detect the serum β2-MG levels and immunehistochemistry to detect NIS expression of thyroid cancer tissue. Results： Thirty-seven cases showed positive expression of sodium/iodide symporter （38.9%） and 30 cases showed positive expression of β2-MG （31.57%）. There were significant differences of NIS expression （X2 = 8.207, P = 0.017） and β2-MG expression （X2 = 10.121, P = 0.006） between different pathological types of thyroid carcinoma, but there was no correlation between the positive rate of the two research groups （r = -0.546, P = 0.633）. The significant differences was observed in expression of sodium/iodide symporter （X2 = 9.272, P=0.002） and expression of β2-MG （X2 = 4.441, P = 0.035） between the group with neck lymph node metastasis and the group without neck lymph node metastasis and both positive rate was significantly negatively correlated （r = -1.000, P = 0.000）. The significant differences was observed in expression of sodium/iodide symporter （X2 = 9.272, P = 0.002） and expression of β2-MG （X2 = 3.867, P = 0.043） between the group with distant organ metastasis and the group without distant organ metastasis （X2 = 11.985, P = 0.001） and both positive rate was significantly negatively correlated （r = -1.000, P = 0.000）. Conclusion： There are significantly negatively correlated between neck lymph node metastasis, distant organ metastasis and expression of sodium/iodide symporter and expression of β2-MG. Thyroid cancer lymph node and distant organ metastasis, the tumor tissue NIS expression and serum levels of β2-MG is significantly negatively correlated. The detection of serum β2-MG provides clinical reference value for the effects on radionuclide therapy and prognosis assessment of thyroid carcinoma. Serum β2-MG levels is negatively correlated with prognosis in thyroid cancer patients.

Performance optimization for cloud computing systems in the microservice era:state-of-the-art and research opportunities

With the demand of agile development and management,cloud applications today are moving towards a more fine-grained microservice paradigm,where smaller and simpler functioning parts are combined for providing end-to-end services.In recent years,we have witnessed many research efforts that strive to optimize the performance of cloud computing system in this new era.This paper provides an overview of existing works on recent system performance optimization techniques and classify them based on their design focuses.We also identify open issues and challenges in this important research direction.

Attenuation of blast-induced vibration on tunnel structures

The blast-induced vibration during excavation by drilling and blasting method has an important impact on thesurrounding structures. In particular, with the development of tunnel engineering, the impact of blasting vibrationon tunnel construction has attracted extensive attention. In this paper, the propagation attenuation characteristicsof blast-induced vibration (PPV, peak particle velocity) on different tunnel structures were systematically studiedbased on the field monitoring data. Initially, the attenuation characteristics of blasting vibration PPV on the lowerbench surface, the side wall of the excavated tunnel and the closely spaced adjacent tunnel were investigated.Subsequently, the capacity of several widely utilized empirical prediction equations to estimate the PPV on tunnelstructures was examined, along with a comparative analysis of their prediction accuracy. The research findingsindicate that it is feasible to predict the PPV on the tunnel structures using empirical equations. The attenuationcharacteristics of blasting vibration PPV are different in different structures and directions. The prediction accuracy of the empirical equations varies, while the discrepancies are minimal. The principal variation amongthese equations lies in the site-specific coefficients k, β, λ, highlighting the differential impact of structural anddirectional considerations on the predictive efficacy. Based on the empirical equation and safe PPV provided bythe blasting vibration safe standards on tunnels of China (GB6722-2014), and considering the influence of allstructures and directions, it is determined that the safe distance of blasting vibration in the tested tunnel projectshould be larger than 20.28–18.31 m, 18.31–16.16 m, and 16.16–13.75 m for blasting vibration frequency locatedin
10 Hz, 10–50 Hz, and >50 Hz.