ABSTRACT
Objective:To explore the key factors affecting the formulation of treatment and prognosis of medullary thyroid carcinoma.Methods:Patient data, clinical characteristics and the results of follow-up of typical cases of 23 patients with medullary thyroid carcinoma admitted to Hunan Provincial People’s Hospital Breast and Thyroid Surgery from Apr. 2007 to Mar. 2020 were retrospectively analyzed. The therapeutic schedule and prognosis of medullary thyroid carcinoma were discussed in combination with ATA guidelines and others.Results:Of the 23 patients with MTC, 22 (95.65%) had elevated serum calcitonin, 15 (65.22%) had elevated carcinoembryonic antigen, 3 (13.04%) had suspected abnormal lymph nodes, and 2 (8.70%) had capsule invasion. Thyroid lobectomy, thyroid lobectomy with lateral lymph node dissection in level VI, total thyroidectomy, total thyroidectomy with lateral lymph node dissection in level VI, total thyroidectomy with bilateral lymph node dissection in level VI, total thyroidectomy with bilateral lymph node dissection in level VI with lymph node dissection in level I, II, III, IV, V or VII were performed in 1, 2, 3, 1, 13, 3 cases respectively. 8 cases had postoperative recurrence (34.78%) , of which 7 cases were caused by the first operation. The level of Ctn increased significantly in 2 cases before operation, who underwent total thyroidectomy with bilateral lymph node dissection in level VI, and no recurrence was found after operation.Conclusions:The key to the biological cure of medullary thyroid carcinoma is standardized surgical treatment. The surgery method cannot be determined simply by calcitonin. The modern treatment of medullary thyroid carcinoma needs to follow the principle of standardization and individualization at the same time.
ABSTRACT
Objective To investigate the distribution status of cytochrome CYP2C19 polymorphisms among patients with cardio-vascular diseases in Dongguan area .Methods A total of 1662 patients with cardiovascular diseases (CVD) in our hospital were se-lected .The peripheral blood was collected for extracting genomic DNA .The CYP2C19 genotype was detected by the polymerase chain reaction (PCR) combined with gene chip technology .The allele frequency and metabolic phenotype of CYP2C19 were com-pared between the CVD patients aged lower than 45 years and aged higher than 45 years old .Results Among 1662 cases ,713 cases (42 .90% ) were CYP2C19 extensive metabolizer ,740 cases(44 .52% ) were moderate metabolizer and 209 cases (12 .58% ) were poor metabolizer .The allele frequencies of CYP2C19﹡1 ,CYP2C19﹡2 and CYP2C19﹡3 were 65 .16% ,30 .08% and 4 .75% re-spectively .One hundred and four cases (40 .00% ) of extensive metabolisms were detected in the lower than 45 years old group ,104 cases(45 .38% ) of moderate metabolisms and 38 cases (14 .62% ) were detected .In the higher than 45 years old group ,609 cases (43 .44% ) of extensive metabolisms ,622 cases of moderate metabolisms and 171 cases(12 .20% ) of poor metabolism were detec-ted .The proportion of various genotypes had no statistical difference between the lower than 45 year old group and higher than 45 year old group(P>0 .05) .Conclusion Detecting CYP2C19 genotype for determining the genetic characteristics can evaluate the clopidogrel resistance risk and formulate the personalized anti-platelet therapeutic scheme .
ABSTRACT
Objective To analyze the correlation between apolipoprotein E(ApoE) gene polymorphisms and the incidence rate of chronic cardiovascular disease as well as the blood lipid levels of patients.Methods ApoE gene polymorphism and lipid levels were measured by suing gene chip analysis system and biochemical analyze in 1 414 cases of chronic cardiovascular disease patients(experimental groups) and 374 cases of healthy subjects(control group).Results Compared with control group,E3/4 genotype frequency was increased in experimental group,while E2/E3 genotype frequency decreased(P<0.05).Compared with control group,the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C) were obviously increased and the level of HDL-C was decreased in experimental group(P<0.05).Compared with patients with E2/E3 genotype,the level of HDL-C in patients with E3/E4 genotype was decreased and the levels of TC,LDL-C were increased significantly(P<0.05).Proportions of different ApoE genotypes in patients with cerebral infarction,cerebral hemorrhage,hypertension,coronary heart disease,type-2 diabete and fatty liver were different.Compared with the E2/E3 genotype,the proportion of the E3/E4 genotype in patients with cerebral infarction,cerebral hemorrhage,hypertension,coronary heart disease,type-2 diabete and fatty liver were increased(P<0.05).Conclusion ApoE gene polymorphism might be important cause of the individual difference of lipid levels and a risk factor for the occurrence and development of chronic cardiovascular diseases.
ABSTRACT
Objective To investigate the drug resistance tendency of Klebsiella pneumoniae isolated from the clinical samples during 2012-2014 to provide reliable evidence for clinical treatment .Methods The Klebsiella pneumoniae strains isolated from the submitted specimens were collected and identified according to the national clinical test procedures ,and the drug sensitivity test was performed by using MIC method .The confirmation test of ESBLs was conducted by using K‐B method and the phenotype of carbap‐enemases producing was confirmed by using the improved Hodge test .Results Totally 410 strains of Klebsiella pneumoniae were i‐solated ,55 .87% of which were derived from sputum ,and the rest was derived from pus(9 .53% ) ,secretion(9 .47% ) and blood (8 .78% );Klebsiella pneumoniae was mainly originated from ICU ,respiration department and oncology department ,accounting for 16 .10% ,9 .02% and 7 .80% respectively ;the resistance rates of Klebsiella pneumoniae against imipenem was 0 .74% ,the resist‐ance rates of Klebsiella pneumoniae against ampicillin/sulbactam ,cafazolin ,cefepime ,cefotaxime ,cefatriaxone ,ceftazidine ,compound sulfamethoxazole were decreased year by year ,while which against amoxicillin/clavulanic acid showed the increasing trend as a whole .Conclusion Timely conducting the identification and drug susceptibility analysis on local Klebsiella pneumoniae and tracking its drug resistance trend can guide the rational and standardized use of antibacterial drugs ,reduces the pressure for selecting anti‐bacterial drugs in order to reduce the generation of drug resistant strains .
ABSTRACT
Objective To study the expression and significance of CD10, SMA, P63 on human breast myoepithelial cells. Methods SP immunohistochemical method was used to examine the expression of CD10, SMA, P63 on human breast myoepithelial cells from 68 breast diseases samples, including breast fibroadenoma, breast fibroadenesis, breast atypical ductal hyperplasias, ductal carcinomas in situ and breast invasive carcinomas. Results 2 +/3 + circumferential CD10, SMA and P63 staining of MEC was seen in 10 patients with breast fibroadenoma, breast fibroadenoma and 13 patients with atypical ductal hyperplasias. In an analysis of total ducts by 15 patients with breast ductal carcinomas in situ, 3 + circumfenrential staining was seen in 92 of 384 ducts(23.96%) stained for CD10 versus 185 of 384 ducts (48. 18%) stained for SMA and 80 of 384 ducts(20. 83%) stained for P63. All differences among percentage positively stained of these three antibodies was significant, p-values was lower 0. 05. MECs were not found with immunohistochemistry in 170 of 384 duets (44. 27%)with anti-CD10,74 of 384 ducts(19.27%) with anti-SMA and 127 of 384 ducts(33.07%) with anti-P63. MECs were not found with CD10,SMA and P63 in 30 patients with breast invasive carcinomas. Conclusion We concluded that CDIO could be another useful marker of breast myoepithelial cells after SMA and P63. It provided more sophisticated information about presence or absence of breast myoepithelial cells in confusing breast lesions.
ABSTRACT
Objective To analyze the imaging characteristics of pulmonary sclerosing hemangioma(PSH) and to improve the accurate rate of its diagnosis before surgery.Methods Imaging findings in 11 cases pathologically proved sclerosing hemangiomas were retrospectively analyzed in comparison with pathology.Results The imaging findings of PSH mostly were solitary masses with homogeneous density,and with smooth margin in 10 cases and irregular margin in 1 case;1 case with slight calcification and 1 case with air-meniscus sign were found.7 cases were homogeneous enhancement and 4 were heterogeneous enhancement on contrast-enhanced scan.The high and low attenuation areas on CT corresponded with angiomatous and cystic areas respecitvely on pathology.Conclusion Chest roentgenogram and unenhanced CT scan of PSH are not of remarkable characteristics,contrast-enhanced CT scan plays an important role in diagnosis and differential diagnosis of PSH.