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Methods:The clinical data and follow-up results of 56 patients with refractory hyperthyroidism who underwent laparoscopy or open surgery in Affiliated Nanhua Hospital of University of South China from January 2019 to August 2020 were retrospectively analyzed.Results:Among the 56 patients, there were 6 men and 50 women. Thirty-six (64.3%) patients underwent endoscopic surgery and twenty (35.7%) patients underwent open surgery. The operation time was (132.0 ± 32.0) minutes. Intraoperative blood loss was (32.4 ± 27.8) mL. Postoperative parathyroid hormone level was (27.8 ± 18.3) ng/L. Forty-nine (87.5%) patients showed benign pathology results after surgery. After surgery, 14 (25.0%) patients had hypothyroidism, including 7 (12.5%) patients with hyperthyroidism combined with thyroid cancer. There were no patients with permanent hypothyroidism or recurrent laryngeal nerve paralysis. All patients had a good prognosis and satisfactory surgical results.Conclusion:With the update of preoperative preparation methods for hyperthyroidism, the increasing maturity of thyroid surgery technology, and the use of new energy instruments and technologies, surgical treatment is undoubtedly a good treatment method for patients with refractory hyperthyroidism or a suspected malignant tumor.Objevtives:To investigate the indications and clinical efficacy of surgical treatment in patients with refractory hyperthyroidism.
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Objective: To investigate the expression of microRNA-23a (miR-23a) in breast cancer tissues and the relationship between miR-23a expression and prognosis of patients with breast cancer. Methods: The expressions of miR-23a in 120 breast cancer tissue samples and adjacent para-cancerous tissue samples were detected by fluorescence in situ hybridization and real-time fluorescent quantitative PCR, respectively. The relationships between the expression of miR-23a and the clinicopathologic features and prognosis of patients with breast cancer were analyzed. Results: The results of fluorescence in situ hybridization and real-time fluorescent quantitative PCR showed that the expression level of miR-23a in breast cancer tissues was higher than that in adjacent para-cancerous tissues (both P < 0.01). Of 120 breast cancer tissue samples, 72 (60.00%) had high expression of miR-23a. The high expression of miR-23a was significantly associated with gynecological disease history (P = 0.01), tumor size (P = 0.02), lymph node metastasis (P = 0.01), TNM stage (P = 0.01) and tumor differentiation (P = 0.04). The median survival time of breast cancer patients with high expression of miR-23a was shorter than that of the patients with low expression of miR-23a (P = 0.003). Lymph node metastasis, advanced TNM stage, poor tumor differentiation and high expression of miR-23a were independent negative prognostic factors for patients with breast cancer (all P < 0.05).Conclusion: The miR-23a is highly expressed in breast cancer. The high expression of miR-23a is an independent factor indicating poor prognosis of patients with breast cancer.
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<p><b>OBJECTIVE</b>To investigate the efficacy and safety of half-dose Zenapax for prevention of acute rejection after renal transplantation.</p><p><b>METHODS</b>According to the immunosuppressive regimen and renal function after transplantation, patients were divided into 4 groups, namely groups A, B, C, and D of 90, 73, 11 and 13 patients, respectively. Blood creatinine measured 1 week after operation was <176.6 micromol/L in groups A and B, and was >353 micromol/L in groups C and D. Patients in groups A and C were given 25 mg Zenapax (0.5 mg/kg) and MMF 0.75 g before operation, and those in groups B and D had only MMF of 0.75 g. All patients were given Pred, CsA and MMF after operation, and the rejection episodes, the time of acute rejection onset, the rate of rejection reversal and complications were analyzed in the time period of 6 months after operation.</p><p><b>RESULTS</b>After the operation, 13 patients (14.4%) developed acute rejection in group A, 18 (24.6%) in group B, 6 (54.5%) in group C and 7 (53.8%) in group D (P<0.01). The incidence of acute rejection in group B was significantly lower than that in groups C and D groups (P<0.01), and the latter two groups had similar incidence. The time of acute rejection onset ranged from 3 to 9 days postoperatively (mean 6.2-/+3.2 days) in group A, significantly delayed as compared with that in group B (range 2-8 days, mean 4.7-/+3.1 days), group C (range 2-7 days, mean 4.3-/+4.2 days) and group D group (range 2-9 days, mean 3.9-/+3.5 days), but the time was similar between groups B, C, and D (P>0.05). All acute rejection cases in group A was reversed, and the rate of reversal was 88.9% (16/18) in group B, 83.3% in group C, and 71.4% in group D. No significant differences were noted in such complications as infection, vascular injuries or gastrointestinal reactions between the 4 groups (P>0.05).</p><p><b>CONCLUSION</b>Zenapax at the dose of 25 mg can safely decrease the risk of acute rejection in patients with good postoperative renal function recovery, but dose not seem effective in patients with delayed graft function recovery.</p>