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Objective To study the rule of lymph node metastasis rate in cN 0 papillary thyroid microcar-cinoma( cN0-PTMC) and to evaluate an appropriate region of neck dissection .Methods Data of 233 cases of cN0-PTMC were retrospectively analyzed .Univariate analysis with chi-square test was used to analyze the statisti-cal correlation between gender , age, tumor diameter and lymph node metastasis respectively .Results 81 out of 233 patients(34.8%)had cervical lymph node metastasis (30.0%in central region and 9.9%in lateral region). For patients with tumor diameter ( D)≤5 mm and D>5 mm, lymph node metastasis rate in central region was 21.6%and 36.6%(χ2 =6.199,P45 years old was 37.9% and 21.1% respectively (χ2 =7.792, P 5 mm should receive the lateral neck lymphoid tissue exploration during surgery in order to find subclinical metas -tasis.
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OBJECTIVE@#Through preoperative temporary balloon occlusion of internal carotid artery and monitoring of carotid artery stump pressure variation, in order to further predict the risk of carotid artery ligation and resection, evaluation operative risk and provides the reference for the choice of surgical approach.@*METHOD@#Continuous monitoring and recording the carotid artery stump return pressure,before clamping and in the process of blocking, close observation the patients mental state and the nervous systemof all kinds of signs, in the process of blocking, to understand the dynamic change of stump artery pressure return in patients and whether can the smooth passage of carotid artery balloon occlusion test.@*RESULT@#Of the 19 patients, 4 cases were positive, 15 negative cases, Blocking immediate the positive patients and negative patients with stump pressure drop was (57. 35 ± 1. 89) % and (38. 99 ± 12. 23) %, with statistical significance between the two, in the process of blocking, the mean stump pressure of the positive patients and the negative patients was (37. 29 ± 3. 15) mmHg and (61. 36 ± 14. 69) mmHg, with statistical significance between the two.@*CONCLUSION@#Approximately 21. 05% of patients can not tolerate carotid artery balloon occlusion test, theory for carotid artery reconstruction operation. After blocking the stump pressure is less than 40. 44 mmHg, the theory for reconstruction of the internal carotid artery operation. Blocking instant artery stump pressure dropped more than 55. 46%, in theory the need for internal carotid artery reconstruction.
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Humans , Balloon Occlusion , Blood Pressure , Carotid Artery, Internal , General Surgery , Feasibility Studies , Ligation , Preoperative Care , Risk Assessment , Vascular Surgical ProceduresABSTRACT
Objective To study the anatomic landmarks of recurrent laryngeal nerve (RLN) in minimally invasive video-assisted thyroidectomy (MIVAT), and to evaluate the operative skills to avoid nerve injury. Methods 106 patients were enrolled in the study dated between August 2008 and August 2010, in which 8 patients were converted to the conventional thyroidectomy. Intraoperative anatomic landmarks for location of RLN were the gap between trachea and carotid artery (GTC), as well as the middle and posterior portion of tracheal wall. Results 98 RLN were at risk, and 97 (98.98 %) nerves were recognized by means of two landmarks. 1 nerve failed to locate which was non-recurrent laryngeal nerve. Temporary RLN paralysis happened to 1 nerve(1.02 %), and no permanent RLN paralysis appeared. Conclusion GTC combined with middle and posterior portion of tracheal wall are safe and effective anatomic landmarks to locate RLN in MIVAT.
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OBJECTIVE To analyze the incidence of the bifurcation of the facial nerve in mastoid segment and to give the anatomic information for mastoid surgery. METHODS From March 2005 to April 2006, there were 112 patients undergoing the decompress operations which the range included the mastoid segment. The bifurcation of the mastoid segment was recorded and compared with the preoperational High-resolution Computed tomography (HRCT) scans. RESULTS There were 5 cases with the nerve bifurcation. The incidence was 4.5 %. Four of those 5 cases were diagnosed preoperatively by HRCT scans (the accurate rate was 80 %). CONCLUSION Bifurcation of the mastoid segment was not rare. Otologic surgeon should pay attention to this anatomic variation to avoid injuring the branch of the facial nerve. HRCT scans were useful to find this abnormality.
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Scientific physical exercises have good effect on mental health ,and has unique treating function to the patients with anxiety, depression and schizophrenia .The types of physical exercises , intensity, duration and density during pysical exercises have influence on its result.