Potential protection of indocyanine green on parathyroid gland function during near-infrared laparoscopic-assisted thyroidectomy: A case report and literature review

BACKGROUND In recent decades,significant advances have been made in protecting the parathyroid glands and recurrent laryngeal nerves during thyroidectomy.However,reliable and convenient technical means are still lacking.In this study,the reliability,safety and feasibility of near-infrared(NIR)laparoscopyassisted thyroid lobectomy with isthmectomy and prophylactic central lymph node dissection(CLND)were reported.CASE SUMMARY A 63-year-old female patient with a free previous medical history,was admitted to our department due to multiple thyroid nodules.Ultrasonic examination suggested diffuse thyroid changes and one thyroid nodule in the right upper lobe with the largest diameter of 1.5 cm adjacent to the trachea and Breast Imaging Reporting and Data System grade 4B.Imaging examination of the neck showed no obvious enlarged lymph nodes.Fine needle aspiration biopsy suggested a papillary thyroid carcinoma.Combined with thyroid function examination,the patient was diagnosed with papillary thyroid carcinoma and Hashimoto's thyroiditis.Considering the risk of invading the capsule and the patient's extreme anxiety,a right thyroid lobectomy with isthmectomy and prophylactic CLND was planned.No significant abnormalities were found during preoperative examinations,except for an increased thyroid stimulating hormone level.The patient underwent NIR laparoscopy-assisted thyroid lobectomy with isthmectomy and prophylactic CLND.During the operation,two right parathyroid glands(PGs)adjacent to the thyroid gland capsule and the right recurrent laryngeal nerve(RLN)were examined by indocyanine green(ICG)fluorescence using a NIR fluorescence camera,and the PGs and RLN were reliably preserved.Considering the ICG-positive PG,prophylactic CLND was performed.The postoperative parathyroid hormone level was in the normal range and no significant hypocalcemia symptoms were observed.CONCLUSION During NIR laparoscopy-assisted thyroidectomy,ICG fluorescence may aid PG identification and protection.

CHOLESTERIC LIQUID CRYSTALLINE CHARACTER ON THE SURFACE OF CHITOSAN/POLYACRYLIC ACID COMPOSITES

The cholesteric liquid crystalline structure in chitosan/polyacrylic acid composite films was studied by surface techniques. A periodical lamellar-like structure was observed in the permanganic acid etched film surface by both scanning electron microscopy (SEM) and atomic force microscopy (AFM), instead of the thumb-print texture which can be detected with polarized optical microscopy. It is suggested that the periodical lamellar-like structure is induced by the etching selectivity between cholesteric layers due to different molecular arrangement on the film surface. Four kinds of perpendicular disclinations, i.e. chi --> tau (-) + lambda (+), chi --> lambda (-) + tau (+), chi --> tau (-) + tau (+) and chi --> lambda (-) + lambda (+) were found in the composite films from SEM observations. The smallest periodicity of lamellar-like structure (equals to half pitch) is 20 similar to 40 nm measured with AFM.

INFLUENCE OF MOLECULAR WEIGHT OF CHITIN AND ITS THREE DERIVATIVES ON CRITICAL CONCENTRATION OF LYOTROPIC LIQUID CRYSTALLINE PHASE TRANSITION

The critical concentration of lyotropic liquid crystalline phase transition for chitin derivatives was determined using a polarization microscope. The influence of molecular weight on critical concentration of liquid crystalline solution for chitin, chitosan, cyanoethyl chitosan and propionyl chitin successively increases as the chain rigidity decreases. Therefore it can be used as an indicator of the chain rigidity.

Neoadjuvant targeted therapy for apocrine carcinoma of the breast:A case report

BACKGROUND Apocrine carcinoma of the breast is a special type of invasive ductal carcinoma of the breast that is rare in clinical practice.Neoadjuvant therapy,especially neoadjuvant targeted therapy,has rarely been reported for apocrine carcinoma of the breast.CASE SUMMARY A 63-year-old woman presented with apocrine carcinoma of the left breast underwent core needle biopsy.The patient was diagnosed with apocrine carcinoma by immunohistochemical staining and negative hormone status(estrogen receptor and progesterone receptor)but showed overexpression of human epidermal factor receptor 2(HER-2).Moreover,positive expression of androgen receptor(approximately 60%)and gross cystic disease fluid protein 15 was observed.The patient was treated with neoadjuvant targeted therapy consisting of the TCH regimen(docetaxel,carboplatin area under curve 6 and trastuzumab)every 21 d.The mass in the left breast was significantly reduced,and pain in the breast and left upper arm also improved.CONCLUSION HER-2 positive apocrine carcinoma of the breast can be improved by neoadjuvant chemotherapy combined with targeted therapy.

SPOP negatively regulates Toll-like receptor-induced inflammation by disrupting MyD88 self-association

Toll-like receptor(TLR)signaling pathways need to be tightly controlled to avoid excessive inflammation and unwanted damage to the host.Myeloid differentiation primary response gene 88(MyD88)is a critical adaptor of TLR signaling.Here,we identified the speckle-type POZ protein(SPOP)as a MyD88-associated protein.SPOP was recruited to MyD88 following TLR4 activation.TLR4 activation also caused the translocation of SPOP from the nucleus to the cytoplasm.SPOP depletion promoted the aggregation of MyD88 and recruitment of the downstream signaling kinases IRAK4,IRAK1 and IRAK2.Consistently,overexpression of SPOP inhibited the TLR4-mediated activation of NF-κB and production of inflammatory cytokines,whereas SPOP depletion had the opposite effects.Furthermore,knockdown of SPOP increased MyD88 aggregation and inflammatory cytokine production upon TLR2,TLR7 and TLR9 activation.Our findings reveal a mechanism by which MyD88 is regulated and highlight a role for SPOP in limiting inflammatory responses.