ABSTRACT
Objective:To investigate the clinicopathological characteristics and metastatic risk factors for patients with lymph node metastasis in central region of differentiated thyroid cancer, and to provide a basis for clinical treatment.Methods:A total of 200 patients with differentiated thyroid cancer from January 2017 to October 2018 in Jiangmen Central Hospital of Guangdong Province were selected. According to the central lymph node metastasis, the patients were divided into metastasis group and non-metastasis group. The clinicopathological features of the two groups were compared, including gender, age, tumor diameter, lesion gland lobe, the number of tumors, TNM staging, capsular infiltration, thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (TG-Ab), operation mode, blood flow grading, microcalcification, thyroid peroxidase antibody (TPO-Ab) and pathological type. The relationship between central lymph node metastasis and clinical characteristics was analyzed. The risk factors of central lymph node metastasis were analyzed by using logistic regression model.Results:Of the 200 patients, 52 (26.00%) patients had central region lymph node metastasis and 148 (74.00%) patients had no central region lymph node metastasis. The tumor diameter ≥ 2 cm, capsule infiltration, microcalcification and grade Ⅲ blood flow in the metastasis group were all higher than those in the non-metastasis group, and the differences were statistically significant [86.5% (45/52) vs. 68.2% (101/148), 40.4% (21/52) vs. 16.9% (25/148), 34.6% (18/52) vs. 11.5% (17/148), 23.1% (12/52) vs. 7.4% (11/148), all P < 0.05]. There were no statistically differences in the proportion of patients stratified by other clinicopathological factors (all P > 0.05). Logistic regression model suggested that tumor diameter ≥ 2 cm ( OR = 1.424, 95% CI 1.041-1.948, P = 0.009), capsular infiltration ( OR = 3.541, 95% CI 1.378-9.099, P = 0.009), microcalcification ( OR = 4.058, 95% CI 1.693-9.727, P = 0.002) and grade Ⅲ of blood flow ( OR = 5.174, 95% CI 2.148-12.463, P < 0.01) were independent risk factors for lymph node metastasis in central region. Conclusion:Central lymph node metastasis in patients with differentiated thyroid cancer is related to tumor diameter, capsular infiltration, microcalcification and grade Ⅲ of blood flow, which should be paid more attention in clinic.
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Objective:To observe the clinical effect of acupuncture therapy to support yang and consolidate the constitution for cervical spondylosis of vertebral artery type (CSA). Methods:A total of 72 patients with CSA were randomly divided upon the random digital table into an acupuncture- moxibustion group and an acupuncture group, 36 cases in each group. The acupuncture-moxibustion group was treated by electroacupuncture (EA) at bilateral Fengchi (GB 20) and C4-6 Jiaji (EX-B 2), in combination of moxibustion at Baihui (GV 20), Shenshu (BL 23) and Mingmen (GV 4) to support yang and consolidate constitution. The acupuncture group was given by routine EA at bilateral Fengchi (GB 20), cervical Jiaji (EX-B 2), Tianzhu (BL 10), Jianjing (GB 21), Houxi (SI 3), Hegu (LI 4) and Waiguan (TE 5). The treatment was given once every day and continuous six sessions made one course. After 2-course treatment, the improved situation of clinical symptoms and clinical effect were observed in the two groups. Results:The total effective rate was 91.7% in the acupuncture-moxibustion group and 61.1% in the acupuncture group. The difference of the total effective rate between the two groups was statistically significant (P<0.05). After treatment, the scores of the clinical symptoms in the two groups were obviously decreased than those of the same group before treatment (P<0.01). The differences in the scores between the two groups were statistically significant (P<0.05). Conclusion:Acupuncture-moxibustion treatment to support yang and consolidate constitution is better than the routine acupuncture therapy in the therapeutic effect for CSA.
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Objective To establish a serological diagnostic method about NSCLC by investigating the expres-sion of 3 tumor markers of the sulfate glycosaminoglyean fragments(SGF), TSGF and CEA in NSCLC patients' serum. Methods To assay the level of SGF,TSGF and CEA in 50 NSCLC patients with latex particleagglutiation test,colori-metry of biochemistry and CLIA, respectively. Compared the clinical value of different examination combination way in NSCLC diagnosis value. Results There was high difference value between the Ⅰ - Ⅱ stage and the Ⅲ time,the Ⅲ time and the Ⅳ time about the level of SGF(P <0.05) in NSCLC patients. The specificity between SGF,TSGF and CEA each single item and the SGF and TSGF combination examination were not significant(P > 0.05). The semitivity between the SGF and TSGF combination and the SGF,TSGF and CEA combination was not significant(P >0.05), its specificity had significant difference(P <0.05). Conclusions There are higher expression about the 3 tumor mark-ers in NSCLC patients' serum. In the different combination examination, SGF and TSGF combined has great clinical value than other combinations to diagnosis NSCLC.
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Objective To study the influence of infection again to hepatifis B sufferer get disease turn into by human cytomegalovirus(HCMV)afterbirth incubates-activate. Methods The serum levels of HCMV-DNA and HBV-DNA were determined by real-time fluorescent ration PCR, and the HCMV-IgG, IgM level were determined by ELISA in 162 serums from hepatitis patients HBsAg reported the masculine. Results The masculine rate of HCMV-DNA and HCMV-IgM, and the mean vahe of HCMV-DNA ration were much consilient: controls＜hepatitis B sufferer＜hepatocirrhosis＜liver cancer. The masculine rate of HCMV-DNA and HCMV-IgM in hepatitis B HBV-DNA positive patients was higher in hepatitis B HBV-DNA negative patients(P＜0.01). Conclusion Under the multiple infection appearance, it has the certain association with connection which HCMV afterbirth incubates-activate the infection again to hepatitis B get disease turn into.