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OBJECTIVE To investigate the clinical value of the lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN, right VI-2) dissection in papillary thyroid carcinoma (PTC). METHODS We studied the relationships between LN-prRLN metastasis and the clinicopathological characteristics in 408 patients with right or bilateral PTC who underwent LN-prRLN dissection. RESULTS Right VI-2 lymph node metastasis was 16.67％. Single factor analysis showed that there were statistically significant correlations between right VI-2 metastasis and gender, age, size and number of right thyroid lobe tumor, capsular invasion, right VI-1 lymph node metastasis and their size, and also metastatic lymph node in the right cervical lateral compartment. Multivariate Logistic regression analysis showed that Right VI-2 lymph node metastasis was related to right tumor size, capsular invasion, the right VI-1 metastasis and right lateral lymph node metastasis(P＜0.05). The receiver-operator characteristic (ROC) analysis showed that the risk factors of LN-prRLN: age ＜35.5 years, right tumor size ＞0.85 cm, lymph node (right VI-1) number ＞1.5, metastatic lymph node (right VI-1) size ＞0.45 cm, lymph node number in the right cervical lateral compartment ＞0.5 and the areas under the ROC curves were 0.585, 0.787, 0.788, 0.725, 0.719. CONCLUSION The dissection of LN-prRLN should be considered when patient with the risk factors such as male, age ＜35.5 years, right tumor size ＞0.85 cm, capsular invasion, lymph node (right VI-1) number ＞1.5, metastatic lymph node (right VI-1) size ＞0.45 cm, lymph node number in the right cervical lateral compartment ＞0.5.
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OBJECTIVE To explore the feasibility of detection for mutated BRAF V600E gene based on amplification refractory mutation system(ARMS),and to evaluate its clinical significance of BRAF V600E gene mutation in thyroid nodules.METHODS The method of ARMS was used to detect BRAF V600E mutation status in 179 patients with PTC and 115 patients with benign lesions.The diagnosis index of BRAF V600E mutation status for identifying the nature of the thyroid nodule was calculated.The potential correlation between BRAF V600E mutation and PTC clinicpathological characteristics was also analyzed.RESULTS Detection of BRAF V600E mutation status in thyroid lesions based on ARMS was feasible and believable.The positive rate of mutated BRAF V600E gene in PTC was 82.68％,whereas the rate in benign lesions was only 1.74％,indicating statistical differences between the two groups(x2=183.568,P＜0.01).The diagnostic sensitivity of BRAF V600E mutation was 82.68％,specificity was 98.26％,accuracy was 88.76％,and Youden index was 0.8094.There was no associations between the BRAF V600E mutation status and PTC clinicpathological characteristics(eg.gender,age,tumor size,numbers of lesions,bilateral lesions,extrathyroidal extension and lymph node metastasis).CONCLUSION Detection of BRAF V600E mutation based on ARMS has higher sensitivity and specificity in distinguishing PTC from benign lesions,indicating BRAF V600E gene is an ideal marker of PTC for clinical early diagnosis.
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OBJECTIVE The objective of this study is to discuss when to dissect the lymph nodes behind the right recurrent laryngeal nerve (LN-prRLN) from the standpoint of the right cervical level Ⅵ-1 (superficial layer to the recurrent laryngeal nerve) lymph nodes in papillary thyroid carcinoma (PTC) patients.METHODS The clinical data of 306 bilateral or right PTC patients from the Hangzhou First People's Hospital who underwent dissection of level Ⅵ-1 lymph nodes and LN-prRLN between March 2014 and September 2015 were analyzed. We measured the number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci to predict the metastasis of LN-prRLN.RESULTS The number of level Ⅵ-1 metastatic lymph nodes and size of level Ⅵ-1 lymph nodes metastasis loci were risk factors of LN-prRLN metastasis(P<0.05). When the number of the level Ⅵ-1 metastatic lymph nodes was greater than 1.5, the AUC was 0.813 (the sensitivity was 78.43%, the specificity was 76.65%). The ROC showed that when the size of level Ⅵ-1 lymph nodes metastasis loci were more than 0.45 cm, the AUC was 0.726 (sensitivity was 90.20%, specificity was 48.90%).CONCLUSION In bilateral or right PTC patients with metastasis of level Ⅵ-1 lymph nodes, especially when the number of level Ⅵ-1 metastatic lymph nodes was greater than 2cm and the metastasis loci were more than 0.45 cm, we should dissect the LN-prRLN.
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Objective To study the changes of serum interleukin-8 (IL-8) and interleukin-10 (IL-10) in preterm infants delivered from mothers with chorioamnionitis (CA) and the possible effects on bronchopuhmonary dysplasia (BPD) and brain injury of preterm infants.Method From October 2014 to October 2015,clinical data from mothers without clinical manifestations of CA giving birth to a preterm baby (gestational age:26 to 33 weeks) were collected in Changzhou Maternal and Child Health Hospital and Suzhou Municipal Hospital.The infants were assigned to CA group and non-CA group according to their mother's placenta pathology.The levels of serum IL-8 and IL-10 were measured using enzyme-linked immunosorbent assay (ELISA) on day 1 and day 7,while the levels of WBC,CRP and PCT were measured at birth.The incidences of BPD and brain injury were also reviewed.Result A total of 67 preterm infants were included,with 51 in the CA group and 16 non-CA group.The levels of IL-8 were significantly higher in the CA group than the non-CA group on both day 1 and day 7 [(21.6 ±9.7) ng/L vs.(7.3 ±2.3) ng/L,(26.6 ± 12.9) ng/L vs.(7.3 ± 2.1) ng/L].The IL-10 levels were significantly lower on day 1 [(1.92±0.17) ng/Lvs.(2.04±0.18) ng/L] and higher on day 7 [(2.42±0.60) ng/L vs.(2.03 ±0.18) ng/L] in the CA group.Significant differences existed on the incidences of BPD (54.9％ vs.25.0％) and brain injury (74.5％ vs.43.8％) between the two groups (P ＜ 0.05).The levels of CRP and PCT were higher in CA group (P ＜ 0.05) and the WBC was similar between the two groups (P ＞ 0.05).In CA group,on both day 1 and day 7,infants with BPD had similar IL-8 and IL-10 levels comparing with infants without BPD(P ＞ 0.05),also were infants with brain injury comparing with infants without brain injury.Conclusion Chorioamnionitis in pregnant women may affect serum cytokines levels in premature infants and lead to high incidences of BPD and brain injury.
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Long non-coding RNA(lncRNA) is non-protein coding transcripts longer than 200 nucleotides,which plays an important role in the development of the metabolic process.Thyroid cancer is the most common cancer of the endocrine system,and as reported,lncRNA is related to the occurrence and development of thyroid tumors.Therefore,this paper reports the latest domestic and foreign research progress about lncRNA in thyroid tumor,in order to provide new ideas for molecular diagnosis and treatment of thyroid cancer.
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Objectives:This study aims to provide a full picture of how Health Policy and Systems Research ( HPSR) in Chinese universities. Based on the current situation, analysis of problems and challenges of the HPSR capacity has been conducted and suggestions on personnel training have been proposed. Methods: Quantitative sur-veys and qualitative interviews have been conducted among personnel engaged in HPSR from 8 representative univer-sities. Results:Most HPSR researchers in the universities are young, of which 75. 26% have doctorates and the ma-jority is trained in health care management and public health sciences. Among the current HPSR projects, health in-formation and evidence is the main research direction in this field, and both the capital investment and attention of re-searchers are high. However, research resources and funding are still currently focused on senior researchers, with limited efforts to support young scholars. HPSR has interdisciplinary and multidisciplinary characteristics, but cur-rently the collaboration among institutions and individuals is relatively limited. In addition, only 5. 81% of undertak-en HPSR projects have been translated into health policy. Discussion and Suggestions:HPSR researchers in Chinese universities are not sufficient and have similar backgrounds, resulting in limited collaboration. Investment in HPSR projects is still shallow and young researchers are vulnerable in acquiring funding resources. The ability to translate research results into policy is weak. Therefore, this paper suggests to mainstream undergraduate and postgraduate teaching, enhance the training, funding and technical support for young researchers, and to establish the mechanism of dissemination of research findings and their translation into policy.