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Objective:To compare the clinical effect of transaxillary non-inflatable endoscopic surgery and traditional open thyroid surgery in the treatment of PTC. Methods:A retrospective analysis was performed on 342 patients with PTC treated in the Otorhinolaryngology Department of Qilu Hospital of Shandong University from December 2020 to December 2022. There were 73 males and 269 females, aged 16-72 years, who underwent unilateral non-inflatable transaxillary endoscopic thyroid surgery（endoscopic group） and unilateral traditional open thyroid surgery（open group）. There were 108 patients in the endoscopic group and 234 in the open group. Results:The endoscopic group was lower in age（37.1±9.4 vs 43.5±11.2） years and BMI（23.4±3.4 vs 25.7±3.8 ）kg/m² than that in the open group, and the difference was statistically significant（t was 5.53, 5.67 respectively, P<0.01）. There was no significant difference in hospitalization days between the two groups（P>0.05）. The logarithmic curve of the operation time showed a smooth downward trend, and the overall operation time of the endoscopic group was relatively consistent. There was no significant difference in intraoperative blood loss between the endoscopic group（13.3±3.2） mL and the open group（14.7±6.3） mL（P>0.05）, but the operation time（130.1±37.9） min was longer than that in the open group（57.4±13.7） min, and the difference was statistically significant（t=19.40, P<0.01）. There was no significant difference in complications such as temporary recurrent laryngeal nerve injury within 3 days after operation between the two groups（P>0.05）. The aesthetic satisfaction score of the surgical incision and the incision concealment effect score in the endoscopic group were higher than those in the open group, and the difference was statistically significant（P<0.05）. Conclusion:Compared with traditional open thyroidectomy, transaxillary non-inflatable endoscopic thyroidectomy has more advantages in the concealment and aesthetics of postoperative incision. Although the former has longer operation time and more drainage, it is still a safe and feasible surgical method with good postoperative clinical effect.
Subject(s)
Male , Female , Humans , Thyroid Neoplasms/surgery , Retrospective Studies , Neck , Thyroidectomy/methods , Endoscopy/methodsABSTRACT
In the past 20 years, with the development of molecular biology, the treatment of non-small cell lung cancer (NSCLC) has been developing. Targeted therapy has improved the survival period of patients with positive mutation of tumor driver gene. More and more targets have been found gradually. Drugs targeting different driving genes have brought the treatment of NSCLC into a promising target era. Among the many driving genes of NSCLC, the fusion of transfection proto oncogene (RET) is the addition of the epidermal growth factor receptor (EGFR), analytic lymphama kinase (ALK) and c-ros oncogene 1-receptor tyrosine kinase (ROS1) are emerging targets. Targeted drugs for RET gene fusion have been constantly updated. Recently, new high selective RET inhibitors blu-667 and loxo-292 have made important breakthroughs. This paper will review the review of the fusion mutation of RET gene in NSCLC, the detection methods, clinicopathological characteristics, targeted treatment and the research progress after drug resistance. .
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"Liquid biopsy" have been intensively studied in recent decades. The exosomes carry their maternal partial functional proteins and genes. As a form of intercellular vesicular transport, exosome-mediated intercellular communication participates in a variety of physiological and pathological processes. The information transmission mediated by exosomes is associated with pathophysiological status and plays an important role in the pathogenesis of cancer. Their detection may be beneficial for the diagnosis and treatment of tumor. This article reviews advances in knowledge on the exosome properties, the effect of exosomes on malignant tumorigenesis, and their clinical application. The data will provide a reference for clinical practitioners.
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Objective To study the influence of multidrug resistance gene (MDR)1 C3435T genetic polymorphism on the eradication of gastric ulcer with Helicobacter pylori (Hp) infection.Methods A total of 106 gastric ulcer patients with positive Hp were randomly divided into two groups by lot with 53 cases each.One group was assigned with 20 mg esomeprazole,0.5 g clarithromycin,1.0 g amoxicillin twice one day(EAC group),and the other group was assigned with 20 mg omerprazole,0.5 g clarithromycin,1.0 g amoxicillin twice one day (OAC group).The therapy of two groups was one week.Hp was detected at least 4 weeks after the end of treatment.MDR1 C3435T genetic polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism assay.The influence of MDR1 C3435T genetic polymorphism on the eradication of Hp was recorded and analyzed.Results The Hp eradication rate was 84.9％ (45/53) and 77.4％ (41/53) in EAC group and OAC group,and there was no significant difference between two groups (P ＞ 0.05).There was no significant difference in the Hp eradication rate in patients with different MDR1 C3435T genotypes in two groups (P ＞ 0.05).The Hp eradication rate was 66.7％(16/24),86.3％(44/51),83.9％(26/31) in TT,CT,CC genotype,and there was significant difference(P＜ 0.05).The Hp eradication rate in patients with TT genotype was lower than that in patients with CT,CC genotype,and there was significant difference (P＜ 0.05).Conclusion There is significant relationship between the effect of gastric ulcer with Hp eradication and MDR1 C3435T genetic polymorphism,and the Hp eradication rates of patients with TT genotype are more lower.