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Objective To investigate the anatomical relation between Zuckerkandl's tubercle and recurrent laryngeal nerve and the superior parathyroid glands anatomy in endoscopic thyroidectomy.Methods From Jul.2012 to Jun.2014 implementation of the 120 cases of endoscopic thyroid surgery (at least one side of the line lobectomy) intraoperative Zuckerkandl tubercle of the presence, all the patients from Subei People's Hospital and location of the relationship between anatomy recurrent laryngeal nerve and superior parathyroid glands.Zuckerkandl tubercle identified by intraoperative recunent laryngeal nerve to expose and superior parathyroid glands.Results Zuckerkandl tubercle appear in the vast majority of cases: on the left is 86％ (51/59), 88％ in the right side (65/74), most of superior parathyroid glands were located on the top of Zuckerkandl tubercle.Looking for recurrent laryngeal nerve by Zuckerkandl tubercle method is more direct, can reduce surgical bleeding and shmten the operation time.Conclusion Recurrent laryngeal nerve and superior parathyroid glands and have close anatomical relationship with Zuckerkandl tubercle.In endoscopic thyroidectomy by intraoperative discern Zuckerkandl tubercle can better avoid injury recurrent laryngeal nerve and superior parathyroid glands.
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Objective To study the application of coronary endarterectomy (CE) in coronary artery bypass graft (CABG), and to evaluate the effect of CE plus CABG on patients with chronic total occlusion (CTO) combined with diffuse distal atherosclerosis. Methods Thirty one patients, who underwent coronary endarterectomy in our institution between Oc-tober 2009 and October 2012, were reviewed retrospectively and compared the control group with 31 patients of their age, sex, LV function, and angina class. Results Among the 31 patients, 27 patients underwent one, 4 patient underwent two coronary arteries endarterectomized. Of all these 35 total endarterectomies, 13 (37%) were at left anterior descending artery, 3(9%) were at branches of the circumflex artery, and 19 (54%) involved the right coronary artery. There was no statistical dif-ference between two groups in clinical parameters including aorta cross time, cardiopulmonary bypass time, graft runoff, pul-sation index and mechanism ventilate time (P>0.05). There was no perioperative myocardial infarctions in CE group nor in control group. All patients were followed up and no recurrent angina were present in CE group. In CE group, one patient died of fungal pneumonia and heart failure half a year after operation. Conclusion In current cardiac surgical practice, coronary endarterectomy is an indispensable adjunct to CABG. The operative mortality and major morbidity were comparable or simi-lar to coronary artery bypass grafting, but its short-term and medium-term results were more favorable than to CABG.
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Background and purpose: DNA methylation is an important mechanism for regulating gene expression, and plays an important role in the tumorigenesis. Study shows that DNA methylation is a potentially promising biomarker in tumor diagnosis, prognosis as well as treatment selection. This study aimed to analyze the methylation status and assessed possible clinical value of 3 DNA repair genes BRCA1, GSTP1 and MGMT in breast cancer samples of Chinese women. Methods:Using methylation speciifc PCR (MSP), we analyzed the methylation status of 3 DNA repair genes BRCA1, GSTP1 and MGMT in 106 paired breast tumors and corresponding normal tissues. Results: The methylation rates of BRCA1, GSTP1 and MGMT were 24.5% (26/106), 29.2% (31/106) and 18.9%(20/106) in breast cancer tissues, which were higher than those (7.5%, 11.3%and 4.7%) in paired normal breast tissues, respectively (P<0.01). Methylation in at least one of the genes was found in 50.9%(54/106) of the breast cancer and 19.8%(21/106) in paired normal breast tissues. And the mean number of genes hypermethylated in each tumor and paired normal breast tissues were 0.73 and 0.24, respectively (P<0.000 1). The methylation status of BRCA1 was more frequent in the younger patients than in the older patients (P=0.007) and most BRCA1 methylated patients were ER negative (P=0.020). Methylation status of GSTP1 was signiifcantly correlated with tumor size, lymph node metastasis (P=0.028 and 0.033, respectively). MGMT methylation was significantly correlated with tumor stage, higher tumor grade and lymph node metastasis (P=0.016, 0.025 and 0.030, respectively). High frequency simultaneous methylation of these 3 genes was more often in those with higher tumor stage and lymph node metastasis (P=0.028 and 0.007, respectively). Conclusion:Hypermethylation of BRCA1, GSTP1 and MGMT genes may be linked to various known clinicopathological features of breast cancer in Chinese women, and the increasing multiple gene methylation in tumors may indicate an aggressive phenotype for breast cancer. Detection of the methylation status of these genes may be useful for identifying patients at high risk for breast cancer.
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Background and purpose:Aberrant DNA methylation that leads to the inactivation of tumor suppressor genes plays important roles in development and progression of breast cancer. Clinically, related gene methylation is considered to be a promising biomarker for tumor diagnosis and prognosis. This study aimed to investigate the methylation status ofSox17 gene in breast cancer tissue and its corresponding plasma circulating DNA, as well as to investigate its value in breast cancer early diagnosis and prognosis.Methods:TheSox17 gene promoter methylation status was detected by MSP in 86 cases of breast cancer, 36 normal breast tissues and its paired plasma DNA, the results were analyzed with corresponding clinical and pathological features.Results:The frequency ofSox17 gene methylation rate among 86 breast cancer tissues was 77.9%(67/86), and was 61.6%(53/86)in plasma circulating DNA, however, noSox17 gene methylation was found in normal breast tissues.Sox17 gene promoter methylation in plasma circulating DNA was signiifcantly associated with the methylation status in tumor tissues (r=0.502,P=0.000). In breast cancer tissue specimens,Sox17 methylation status was significantly correlated with tumor stage (χ2=6.18,P=0.041) and lymph node metastasis (χ2=13.54,P=0.001);Sox17 gene methylation rate was signiifcantly correlated with tumor stage (χ2=27.06,P=0.000), tumor size (χ2=9.65,P=0.007) and lymph node metastasis (χ2=20.80,P=0.000) in plasma samples, and there was no signiifcant difference ofSox17 gene methylation between patient age, histological grade and ER, PR, HER-2/neu status.Conclusion:Sox17 gene promoter methylation plays an important role in the carcinogenesis and development of breast cancer, and may be associated with the prognosis of breast cancer. Furthermore, methylatedSox17 gene may be a useful tumor biomarker in plasma circulating DNA for breast cancer detection and disease monitoring.
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Objective To discuss the exposing methods of recurrent laryngeal nerve(RLN)in thyroid surgery for reducing the nerve injury.Methods We analyzed 267 cases with thyroid tumors retrospectively.In all the cases,RLN were anatomically exposed.Results Of all the cases the injury rate of RLN was,0.38%.Conclusion The anatomic relation of RLN is relatively complicated along its journey;the injury of RLN can be reduced with designed exposal during the thyroid surgery.
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Objective To evaluate the rate of residual tumor after local resection of thyroid carcinoma,and provide theoretical basis to determine the indications for re-operation.Methods The clinical data of 56 patients,who had re-operation in our hospital after local resection of thyroid carcinoma,were summarized.Results As confirmed by pathology,the rate of residual tumor of patients was 42.8% at re-operation.When the tumor was larger than 4 cm,or smaller than 2 cm before the first operation,the residual tumor rate was 80% and 11.1% respectively.The residual tumor rate was 86.3% in patients with tumor invading thyroid capsule,14.7% in patients without capsule invasion,47.6% in patients who had only nodule resection,50% after ipsi-lateral partial lobectomy,and 12.5% after subtotal thyroidectomy.The sensitivity of finding residual tumor by CT and doppler ultrasound examiination before re-operation was 64.0% and 60.0% respectively,and the positive predictive value was 80.0% and 30.0% respectively.Conclusions The rate of residual tumor is high in patients with thyroid cancer operated by local resection.And it′s necessary to re-operation.The condition of tumor before the first operation and CT examination are significant for selection of patients to have re-operation.