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Background and purpose: Nonrecurrent laryngeal nerve (NRLN) is rare but important for thyroid surgery. This study aimed to explore the anatomical characteristics of NRLN and the clinical significance of intraoperative neuromonitoring (IONM), so that surgeons could better protect the function of NRLN during surgery and reduce the risk of nerve injury. Methods: A total of 1 600 patients with recurrent laryngeal nerve (RLN) exposure in thyroid surgery who were treated at Department of General Surgery in First People's Hospital of Anqing, from January 2015 to September 2020, were selected as the study subjects. The exposure and injury of NRLNs were analyzed retrospectively. IONM of vagus nerve and RLN was used for detecting the function of nerves. Results: The total number of RLNs exposed during the operation was 2 312 in 1 600 patients, of which 5 patients with NRLNs (0.31%) were found. All NRLNs were found on the right side, including 2 cases of type I, 1 case of type H A and 2 cases of type H B. The exposure time of NRLN was (11.38±1.59) minutes. All the 5 patients had aberrant subclavian artery that arose directly from the aortic arch detected by preoperative CT scanning. No related postoperative complication occurred. Conclusion: The incidence of NRLN is low, and most of them exist on the right side. If preoperative examination indicates the variation of subclavian artery, the existence of NRLN should be considered. With the help of IONM, NRLN can be found in time, and complications can be effectively avoided. [ABSTRACT FROM AUTHOR]

Isoproterenol (ISO)-induced myocardial ischemia animal model has been widely applied to the study of myocardial ischemia and evaluation of drug efficacy. Metabolic profiling of endogenous compounds can make a deep insight into biochemical process of the ISO-induced myocardial ischemia rats. Herein, rats were treated with ISO (2 mg x kg(-1)) for 10 days. After the model was established by measuring myocardial histopathology and plasma creatine kinase, GC/TOF-MS was used to determine endogenous metabolites in plasma and cardiac muscle of rats, and pattern recognition was used to process the data. Results showed that the plasma metabolic profiling of ISO-induced myocardial ischemia rats was significantly different from that of the control, and it had the tendency to the normal state after the discontinue of ISO injection. Besides, the cardiac muscle of rats treated with ISO for 10 days and the normal cardiac muscle could also be separated clearly. The potential biomarkers in plasma and cardiac muscle of model rats had homogeneity and their own specialty. Biochemical metabolic pathway analysis indicated that this myocardial ischemia model was involved in the alternation of energy metabolism, saccharometabolism, lipid metabolism, nucleoside metabolism and amino acid metabolism, and in relationship with oxidative stress. These findings revealed that metabonomics may be a promising tool to evaluate myocardial ischemia rat model induced by ISO and could further extend the study of pharmacodynamic action of drugs at the molecular level.

In order to explore the scientific connotation of "Fangzhengduiying (formula corresponding to pattern types)", "Qiyinliangxuzheng (Qi and Yin deficiency pattern)" of myocardial ischemia rat model and GC-TOF/MS based metabonomic method were used for comparing the effects of Sheng-mai injection, Salvia injection and propranolol in the present study. After data processing and pattern recognition, Sheng-mai injection showed better efficacy than the other two drugs in accordance with not only visual observation from PLS-DA scores plots but also the number of abnormal endogenous compounds restored to the normal level. Further studies showed that Sheng-mai injection could normalize the level of plasma endothelin-1, the index related to cardiovascular diseases and sleep disorders, which verified the results of metabonomics. Finally, the regulated metabolites and related metabolic pathways were analyzed, and it was supposed that the effects of Sheng-mai injection involved in the alternation of energy metabolism, lipid metabolism, amino acids metabolism, and so on. These findings provided scientific evidence to Shengmai "Fang" used for "Qi and Yin deficiency pattern" correspondingly, indicating that metabonomics has great potential in traditional Chinese medical research, which provides a novel approach and way to modernization of traditional Chinese medicine.