ABSTRACT
Objective To compare the clinical effect of ERCP and PTCD metal stent implantation in the treatment of malignant obstructive jaundice.Methods 42 patients who were treated successfully with ERCP biliary metal stent implantation in the treatment of malignant obstructive jaundice were selected as the ERCP group,38 patients who were successfully treated with PTCD biliary metal stent implantation in the treatment of malignant obstructive jaundice,were selected as the PTCD group.The changes of alanine aminotransferase,aspartate aminotransferase,direct bilirubin,total bilirubin content and complications of patients were compared between two groups.Results On the third day of the ERCP group after operation,alanine aminotransferase,aspartate aminotransferase,direct bilirubin,total bilirubin levels were (203.94 ±12.53)U /L,(180.94 ±17.53)U /L,(185.63 ±17.53)μmol/L,(240.41 ± 18.79)μmol/L respectively,those of the PTCD group were (230.63 ±13.95)U /L,(209.19 ±19.74)U /L,(192.52 ± 16.93)μmol/L,(266.83 ±20.73)μmol/L respectively,which were significantly lower than before operation(all P <0.05).The incidence rate of complications of ERCP group was 4.76%,which was significantly lower than 23.68% of the PTCD group(χ2 =6.02,P <0.05).Conclusion ERCP and PTCD biliary metal stent placement in the treatment of malignant obstructive jaundice can effectively relieve the obstruction.The incidence of complications of PTCD is slightly higher in both common complications.
ABSTRACT
Objective:We aimed to analyze the clinicopathological characteristics of differentiated thyroid carcinoma (DTC) in women. Methods:The clinical data of 1,034 female patients with thyroid nodules between January 2003 and December 2012 were retrospectively analyzed. These patients were from Yunnan Province, China. A database was established in Excel. Univariate and multivariate conditional logistic regression analyses were conducted by using SPSS 17.0. Results:Female patients with DTC were younger than those with thyroid nodule disease or benign thyroid disease (BTD). The results of univariate conditional logistic regression analysis showed that the preoperative mean level of serum thyrotropin was higher in patients with DTC than in patients with BTD (P=0.034). The positive ratios of thyroid peroxidase antibody, thyroglobulin antibody (TGAb), and thyrotrophin receptor antibody (TRAb) were higher in patients with DTC than in patients with BTD (P<0.001). The positive ratio of the coexistence of DTC with Hashimoto's thyroiditis (HT;13.3%) or with lymphocytic thyroiditis (LT;4.2%) was higher in patients with DTC than in patients with BTD and HT/LT (P<0.001). The ratio of the patients whose age of menarche was≤13 years, with≤2 of births, or were in pre-menopausal condition in the DTC group was higher than that in the BTD group. The results of multivariate conditional logistic regression analysis showed that age<45 years, nodal size<1 cm, and thyroglobulin increase were protective factors of DTC with odds ratios (ORs) of 0.06, 0.377, and 0.431, respectively. An abnormal increase in TGAb and TRAb was an independent risk factor of female patients with DTC with ORs of 4.949 and 23.001, respectively. Conclusion:Female patients aged 35 years to 44 years and with thyroid nodules were included in a high-risk group of DTC. Serous thyroid-stimulating hormone 1evel and coexistence with HT were positively correlated with the risk of DTC in females. Early menarche, late menopause, and low number of births were associated with the incidence of DTC in females. Age<45 years, nodal diameter<1 cm, and increase in thyroglobulin were protective factors of DTC in female. An abnormal increase in TGAb and TRAb was an independent risk factor of female DTC.