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Objective To compare the clinical efficacy between air-free trans-axillary laparoscopic thyroidectomy and open thyroidectomy. Methods A retrospective analysis was performed on the data of both 96 patients who underwent air-free trans-axillary laparoscopic thyroidectomy (laparoscopic group) and 232 patients who underwent open thyroidectomy (open group) from August 2015 to July 2020. Comparative analysis were performed on operative data, the postoperative data of recovery and complications between two groups. Results The operative time in laparoscopic group was longer significantly than that in open group [(168±23) min vs. (95±18) min, P=0.022]. There was no significantly difference in the rate of recognition of recurrent laryngeal nerve between two groups (100.0% vs. 99.1%, P=0.138). The rate of recognition of both superior (98.0% vs. 97.0%, P=0.003) and inferior parathyroid glands (95.8% vs. 99.1%, P=0.028) in laparoscopic group was higher significantly than those in open group. The amount of drain of the first day after operation in laparoscopic group was more significantly than that in open group[(42±22) mL vs. (25±10) mL, P=0.006]. The postoperative length of hospital stay in laparoscopic group was longer significantly [(2.8±0.6) d vs. (1.8±1.2) d, P=0.016]. The cost of hospital stay was (13 186±1 015) yuan vs. (12 632±1 456) yuan （P=0.365） and the rate of postoperative complication was 10.4% vs. 9.1%（P=0.126）, which all showed no significant difference between two groups. Conclusions Air-free trans-axillary laparoscopic thyroidectomy could be feasible and safe, and have better appearance. However, both operative time and hospital stay were longer.

Background: Diabetes mellitus‐induced erectile dysfunction (DMED) has become a common disease in adult men that can seriously reduce the quality of life of patients, and new therapies are urgently needed. miRNA‐100 has many targets and can induce autophagy and reduce fibrosis by inhibiting the mTOR pathway and the TGF‐β pathway. However, no research has been conducted with miR‐100 in the field of DMED, and the specific mechanism of action is still unclear. Objectives: To ascertain the effects of miR‐100 on corpus cavernosum tissue of DMED rats and vascular endothelial cells in a high glucose environment and to elucidate the relevant mechanisms in autophagy, fibrosis and inflammation to find a new approach for the DMED therapy. Methods: Thirty rats were divided into three groups: the control group, the DMED group, and the DMED + miR‐100 group. Using intraperitoneal injections of streptozotocin, all rats except the control group were modeled with diabetes mellitus, which was verified using the apomorphine (APO) test. For rats in the DMED + miR‐100 group, rno‐miR‐100‐5p agomir (50 nmol/kg, every 2 days, 6 times in total) was injected via the tail vein. After 13 weeks, the erectile function of each rat was assessed using cavernous manometry, and the corpus cavernosum tissue was harvested for subsequent experiments. For cellular experiments, human coronary microartery endothelial cells (HCMEC) were divided into four groups: the control group, the high‐glucose (HG, 40 mM) group, the HG + mimic group, and the HG + inhibitor group. The cells were cultured for 6 days and collected for subsequent experiments 2 days after transfection. Results: Diabetic modeling impaired the erectile function in rats, and miR‐100 reversed this effect. By measuring autophagy‐related proteins such as mTOR/Raptor/Beclin1/p62/LC3B, we found that miR‐100 could suppress the expression of mTOR and induce autophagy. The analysis of the eNOS/NO/cGMP axis function indicated that impaired endothelial function was improved by miR‐100. By evaluating the TGF‐β1/CTGF/Smad2/3 and NF‐κB/TNF‐α pathways, we found that miR‐100 could lower the level of inflammation and fibrosis, which contributed to the improvement of the erectile function. Cellular experiments can be used as supporting evidence for these findings. Conclusion: MiR‐100 can improve the erectile function by inhibiting mTOR and thus inducing autophagy, improving the endothelial function through the eNOS/NO/cGMP axis, and exerting antifibrotic and anti‐inflammatory effects, which may provide new ideas and directions for the treatment of DMED. [ABSTRACT FROM AUTHOR]

Aim: To determine the association of the presence of diabetes and, among persons with diabetes, the age at type 2 diabetes mellitus (T2DM) onset, BMI and the interactive effect with the subsequent thyroid cancer risk. Materials and Methods: We conducted a population register‐based longitudinal cohort study in Shanghai, including 428 568 persons with new‐onset T2DM matched with the general population. The risk of thyroid cancer among subgroups was calculated based on standardized incidence ratio (SIR), hazard ratio (HR) and Cox proportional hazards models. Results: In total, 1142 thyroid cancer cases were identified during 8 years of follow‐up, with an incidence rate of 59.01/100 000 person‐years and a higher risk (SIR = 1.21) compared with the general population. The earlier age at T2DM onset and higher BMI were associated with an increasing risk of thyroid cancer independently (onset age <50, SIR: 1.46; BMI ≥30.0 kg/m2, SIR: 1.93), with the highest risk in patients with both BMI ≥30.0 kg/m2 and onset age <50 years (SIR = 3.91, HR = 3.04). Among patients with T2DM onset age <60 years, SIR increased with higher BMI, while there were no trends when onset age ≥60 years. Among patients with BMI ≥25.0 kg/m2, SIR increased with an earlier onset age, whereas no trends were shown in the BMI <24.9 kg/m2 groups. Obese (BMI ≥30.0 kg/m2) patients had a significantly higher HR of thyroid cancer only when T2DM onset age <60 years. Conclusions: Both earlier age of T2DM onset (<50 years) and higher BMI (≥30 kg/m2) contributed to the higher risk of thyroid cancer. Patients with young‐onset T2DM and obesity are considered more vulnerable to thyroid cancer development. [ABSTRACT FROM AUTHOR]

The incidence of thyroid cancer is increasing worldwide. Fine-needle aspiration (FNA) cytology is widely applied with the use of extracted biological cell samples, but current FNA cytology is labor-intensive, time-consuming, and can lead to the risk of false-negative results. Surface-enhanced Raman spectroscopy (SERS) combined with machine learning algorithms holds promise for cancer diagnosis. In this study, we develop a label-free SERS liquid biopsy method with machine learning for the rapid and accurate diagnosis of thyroid cancer by using thyroid FNA washout fluids. These liquid supernatants are mixed with silver nanoparticle colloids, and dispersed in quartz capillary for SERS measurements to discriminate between healthy and malignant samples. We collect Raman spectra of 36 thyroid FNA samples (18 malignant and 18 benign) and compare four classification models: Principal Component Analysis–Linear Discriminant Analysis (PCA-LDA), Random Forest (RF), Support Vector Machine (SVM), and Convolutional Neural Network (CNN). The results show that the CNN algorithm is the most precise, with a high accuracy of 88.1%, sensitivity of 87.8%, and the area under the receiver operating characteristic curve of 0.953. Our approach is simple, convenient, and cost-effective. This study indicates that label-free SERS liquid biopsy assisted by deep learning models holds great promise for the early detection and screening of thyroid cancer. [ABSTRACT FROM AUTHOR]

For dielectric capacitors in pulsed power systems, ultrafast charge‐discharge rates and good energy storage performances are essential. The relatively low efficiency η and the low energy density of potassium sodium niobate ceramics will restrict their applications. In this work, a local distortion of the crystal structure of ceramics is made by introducing the Bi and Ce ions, promoting the growth of polar nano‐regions, resulting in more obvious relaxation behavior and lower remnant polarization Pr. The average grain size is reduced, further increasing of breakdown strength. Eventually, fine comprehensive energy storage performances and good mechanical properties are simultaneously obtained. Enhanced recoverable energy storage density Wrec (∼5.30 J/cm3) and a high energy storage efficiency η (∼76.81%) are achieved in 0.970(K0.5Na0.5)NbO3‐0.030CeBiO3 (KNN‐0.030CB) ceramics with an ultrafast discharge rate t0.9 (31 ns) and a high current density (1008.5 A/cm2). All of these results indicate that this work provides a resultful way to design excellent comprehensive properties for advanced energy storage materials. [ABSTRACT FROM AUTHOR]