hsa_circ_0000285 facilitates thyroid cancer progression by regulating miR‐127‐5p/CDH2

Thyroid cancer (THCA) is a leading endocrine cancer and becomes the fifth most commonly diagnosed malignancy in females. It is confirmed that circular RNAs (circRNAs) perform regulatory potencies in the pathological progress of THCA. Our purpose was to certify the trait of hsa_circ_0000285 (circ_0000285) and investigate its modulatory mechanism in THCA progression. We identified the expression profile of hsa_circ_0000285 in THCA by conducting qRT‐PCR assay. Therewith, the potential of hsa_circ_0000285 in THCA development was determined with a set of functional experiments, including CCK‐8, wound healing assay, Western blot, and xenograft model. The molecular mechanism underlying hsa_circ_0000285 was investigated with bioinformatic analysis, RIP and dual‐luciferase reporter experiments. As opposed to normal samples and cells, hsa_circ_0000285 level was overtly increased in THCA specimens and cells. The downregulation of hsa_circ_0000285 weakened the proliferative and migratory capacity of THCA cells and promoted cell apoptosis. In addition, hsa_circ_0000285 silence suppressed the tumor growth of xenograft model mice in vivo. Notably, we demonstrated that hsa_circ_0000285 might target miR‐127‐5p/CDH2 axis in THCA. Afterward, our findings manifested that miR‐127‐5p attenuation blocked the function of hsa_circ_0000285 depletion in THCA cells. In the final step, CDH2 was proven to mediate the repressive potency of miR‐127‐5p in the malignant behaviors of THCA. Mechanistically, hsa_circ_0000285 induced the development of THCA via functioning as a competing endogenous RNA (ceRNA) of miR‐127‐5p to enhance CDH2 expression, which provided a new perspective for THCA therapy.     

Future research directions to improve fistula maturation and reduce access failure

With the increasing prevalence of end-stage renal disease, there is a growing need for hemodialysis. Arteriovenous fistulae (AVF) are the preferred type of vascular access for hemodialysis, but maturation and failure continue to present significant barriers to successful fistula use. AVF maturation integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes in the setting of uremia, systemic inflammation, oxidative stress, and pre-existent vascular pathology. AVF can fail due to both failure to mature adequately to support hemodialysis and development of neointimal hyperplasia that narrows the AVF lumen, typically near the fistula anastomosis. Failure due to neointimal hyperplasia involves vascular cell activation and migration and extracellular matrix remodeling with complex interactions of growth factors, adhesion molecules, inflammatory mediators, and chemokines, all of which result in maladaptive remodeling. Different strategies have been proposed to prevent and treat AVF failure based on current understanding of the modes and pathology of access failure; these approaches range from appropriate patient selection and use of alternative surgical strategies for fistula creation, to the use of novel interventional techniques or drugs to treat failing fistulae. Effective treatments to prevent or treat AVF failure require a multidisciplinary approach involving nephrologists, vascular surgeons, and interventional radiologists, careful patient selection, and the use of tailored systemic or localized interventions to improve patient-specific outcomes. This review provides contemporary information on the underlying mechanisms of AVF maturation and failure and discusses the broad spectrum of options that can be tailored for specific therapy.     

SFE-AFCE-SFMN 2022 consensus on the management of thyroid nodules: Epidemiology and challenges in the management of thyroid nodules

The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment.The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This section deals with epidemiology and challenges in the management of thyroid nodules.     

庄河市医疗机构设备配置及医疗环境现况调查

目的了解庄河市内各级医疗机构医疗器械配置现状,探究该市现行的医疗卫生政策、会诊中心、远程平台建设、使用及相关医保政策对本地医疗资源配置的原始作用,为该地区开展国产创新医疗设备的推广应用提供科学、合理的理论依据。方法采用"辽宁省创新诊疗设备区域应用示范项目"统一制定的访谈提纲与庄河市卫计局(包含医保部门)、二、三级医疗机构主管医疗设备配置、医疗卫生信息、会诊中心建设、医保政策等相关方面的相关领导进行面对面的交流、访谈。结果庄河市医疗器械配置上仍存在较大缺口,尤其是资金短缺的一级医疗机构;当地医保政策方面严格执行大连市制定标准,暂无其他政策引导支持;目前已完成了医联体及相关远程会诊中心的建设,但使用情况良莠不齐。结论就目前状况来看,庄河市医疗资源配置情况不容乐观,有必要加快推进"辽宁省创新诊疗设备区域应用示范项目"在本地区的实施,促进国产医疗设备向基层医院的投放,改善医疗环境,提升区域整体医疗服务能力和水平。     

全腔镜胸乳入路右侧甲状腺叶切除加中央区淋巴清扫术

建立操作空间,切开颈白线,显露甲状腺。分离峡部下缘显露气管,并以气管为辨识,靠左侧横断峡部,分离椎状叶同时清扫Ⅵa区LN,分离部分硬固定,增加腺体游离度。显露并脱帽法离断上极血管,沿真假被膜间游离腺体外侧,分离右甲状腺下极血管,显露右喉返神经,显露下甲状旁腺。分离Berry韧带,显露保护喉返神经外上方的上甲状旁腺,完整切除右甲状腺叶。取出标本,展示并保留标本,右下甲状旁腺自体移植。分离气管左侧清扫Ⅵc区左侧界,切开胸腺上部清扫Ⅵc下界,沿右颈总动脉表面清扫Ⅵb区外侧界,沿右喉返神经表面分离清扫Ⅵb区LN。进一步游离喉返神经下段,分离并清扫Ⅵb区喉返神经后方LN,中央区清扫结束展示清扫后右甲状腺区域。缝合颈白线,放置引流。     

预防性口服抗生素在无张力疝修补的应用

目的探讨腹股沟疝术后应用口服抗生素对预防切口感染的影响。 方法回顾性分析2015年1至12月,广东省人民医院收治的306例择期行单侧腹股沟疝患者的临床资料,术后口服抗生素患者151例为试验组,选取同期未口服抗生素患者155例为对照组,观察2组术后切口感染发生情况。 结果所有疝手术患者均实施临床路径,术后随访时间1周,术后切口感染和对照组比较,差异无统计学意义（P>0.05）。 结论术后应用抗生素对腹股沟疝患者未能起到预防切口感染的作用。     

腔镜Dunhill术式治疗甲状腺功能亢进的临床应用

目的探讨胸乳入路腔镜Dunhill术式治疗甲状腺功能亢进(甲亢)的效果。方法回顾分析我科2010年1月~2018年12月采用Dunhill术式治疗41例甲亢,根据患者意愿选择术式,腔镜Dunhill术式18例(腔镜组),开放Dunhill术式23例(开放组)。比较2组手术时间、术中出血量、术后24 h引流量、住院时间、住院费用、术后并发症、术后1个月甲状腺功能等指标。结果41例手术均成功完成,腔镜组与开放组住院时间、术后1个月甲状腺功能(TSH、FT3、FT4)及并发症比较,差异无统计学意义(P>0.05),但腔镜组住院费用明显高于开放组[(18349.22±938.07)元vs.(15929.13±875.45)元,t=8.514,P=0.000],手术时间明显长于开放组[(171.3±5.2)min vs.(163.5±7.9)min,t=3.637,P=0.001],术中出血量[(28.7±9.7)ml vs.(37.3±7.8)ml,t=-3.146,P=0.003]、术后24 h引流量[(44.1±10.8)ml vs.(58.0±15.0)ml,t=-3.317,P=0.002]明显少于开放组。结论胸乳入路腔镜Dunhill术式治疗甲亢是安全、有效、可行的,有一定的美容效果的方法。