Hashimoto's disease concomitant with thyroid carcinoma / 中华普通外科杂志

Objective To investigate the diagnosis and treatment of Hashimoto's diseaseconcomitant with thyroid carcinoma. Methods Clinical data of 74 cages of thyroid carcinoma occuring on the background of Hashimoto's disease were retrospectively analyzed. Results All cases were papillary carcinoma pathologically.The serum TGAb and McAb level elevated in 56 and 68 cases,respectively.While TPOAB level was all elevated.45 cages underwent unilateral thyroideetomy and contralateral subtotal thyroidectomy,1 case did bilateral near total thyroidectomy,26 cases did unilateral thyroidectomy.and 2 cases with bilateral thyroidectomy.All cases underwent combined central region lymph nodes dissection(positive rate was 27%,20/74),10 cases underwent modied lymph node resection.69 cases were followed up rangins from 1 month to 7 years,with median length of 29 months.4 cases were re-admired for modified lymph nodes resection. Conclusion TGAb、McAb、FNAB and ultrasound is the main procedure forscreening Hashimoto's disese accompanied with thyroid carcinoma preoperatively.Radical thyroideetomy iS the therapy of choice.

Whether the impairment of grafted liver was induced by the inflammatory cells in cold and warm ischemia after transplantation / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether the impairment of grafted liver after transplantation was induced by the same inflammatory cells in cold and warm ischemia.</p><p><b>METHODS</b>Male SD rats were divided into two groups randomly, 24 grafted livers in each group were stored for 120 or 240 min at 4 degrees Centigrade Ringer's solution. Also male SD rats were divided into three groups, in which 24 grafted livers in each group were experienced warm ischemia ranged from 90, 120 to 150 min from non-heart-beating donor. The recipients were killed after 1, 3, 6, and 24 hours of transplantation for sample collection.</p><p><b>RESULTS</b>Along with the prolongation of cold and warm ischemia time, the serum ALT and AST levels were increased gradually after transplantation. Light microscopy showed some necroses in hepatocytes after 3 and 6 hours of transplantation in cold ischemia, and some neutrophilic infiltration in sinusoids. There were a large number of hepatocytes necroses after 3, 6 hours of transplantation in warm ischemia from non-heart-beating donor and a lot of lymphocytic infiltration in sinusoids. The findings in electron microscopy were as the same as those found in light microscopy, and the lymphocytes which infiltrated in sinusoids in warm ischemia were identified as T lymphocytes in electron microscopy.</p><p><b>CONCLUSIONS</b>The impairment of grafted livers after transplantation seems to be induced by two different inflammatory cells in cold and warm ischemia, that is, neutrophils mediate the cold ischemia-reperfusion, and T lymphocytes mediate the warm ischemia-reperfusion from non-heart-beating donor.</p>

Diagnosis and surgical treatment of bilateral thyroid carcinoma / 中国普通外科杂志

0.05).Seventy patients were followed up from 3 months to 8 years post-operatively,with tumor-free survival in 67 cases,and cervical lymph nodes metastasis in 3 cases.No permanent hypo-parathyroidism or paralysis of recurrent laryngeal nerves occurred.Conclusions Total thyroidectomy is advised for bilateral thyroid carcinoma.It is necessary to emphasize the importance of resection of the central region lymph nodes.

Diagnosis and treatment of thyroid micro-carcinoma:a report of 52 cases / 中国普通外科杂志

Objective To analyze the clinical characteristics,diagnosis and treatment of thyroid micro-carcinoma.Methods The clinical data of 52 cases of thyroid micro-carcinoma operated from 2003 to 2008 were analyzed retrospectively.Results All of the 52 cases were confirmed as thyroid micro-carcinoma by postoperative pathologic exam;30 cases(57.7%) were discovered by intraoperative frozen section and 22 cases were not.Micro-calcification ratio on ultrasound was 35.19%.11 cases were diagnosed as malignant tumor on ultrasound scan preoperatively.Lobectomy of involved lobe with subtotal thyroidectomy of contra-lateral lobe was performed in 38 cases,3 cases of bilateral total thyroidectomy,3 cases of unilateral lobectomy and isthmectomy,5 cases of ipsilateral subtotal lobectomy and 3 cases of ipsilateral lobectomy with isthmectomy were performed.Combined central region lymph nodes dissection was adopted in 27 cases(positive 11/27,40.74%).Follow-up rate was 96.2%,with time ranging from 3 months to 5 years.No recurrence or mortality was discovered.Conclusions(1)B type ultrasound is the first choice for preoperative screening.(2) lpsilateral thyroid lobectomy with contralateral subtotal thyroidectomy combined with central region lymph node dissection is advocated.

Clinical significance of perioperative alternations of platelet, coagulation,and fibrinolysis in patients with portal hypertension / 中国普通外科杂志

Objective To study the clinical significance of platelet, coagulation ,and fibrinolysis alteration in perioperative period in patients with different Child classifications of cirrhosis. Methods Alterations on the platelet count and the indices of coagulation and fibrinolysis in 17 cases of Child B class who underwent portal-systemic shunt, and 6 cases of Child C class who underwent portal-azygus vein disconnection were detected. Results Before operation,except the decrease in platelet count, there as no significant difference in the indices of other platelet function, coagulation and fibrinolysis in patients with Child B class compared with control group. While in patients with Child C class, the platelet count decreased, and GMP-140, FPA and D-dimer increased greatly. After operation, GMP-140 increased in patients with Child B class, while decreased in patients with child C class. The platelet count and factorⅧ:C in patients with Child C class decreased significantly compared with those with Child B class. Conclusions Operation may induce DIC in patients with Child C class, so it is necessary to determine the fibrinogen and factorⅧ:C during the operation.