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Objective:To investigate the value of jugulo-omohyoid lymph nodes(JOHLN) for the prediction of lateral cervical lymph nodes metastasis behind internal jugular vein in patients with papillary thyroid carcinoma(PTC) and its clinical significance.Methods:The clinical data of 220 patients who underwent lateral neck dissection in our center were retrospectively analyzed, and the early warning effect and clinical significance of JOHLN on lymph node metastasis of the posterior internal jugular vein were analyzed.Results:In this study, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of JOHLN for predicting lymph node metastasis in the posterior group of internal jugular vein were 83.5%, 46.4%, 82.0%, 49.1%, and 74.1%, respectively. The accuracy rate for JOHLN prediction of upper tumor was 84.3%; In this study, side neck skip metastasis was found in 11 cases, all of which were JOHLN metastasis, upper tumors were found in 9 cases and 2 were located in the middle. Among the skip metastases, 6 cases had lymph node metastasis in the posterior group of internal jugular vein, and they were all upper tumors.Conclusions:JOHLN can effectively predict the risk of lateral neck metastasis. Especially for the upper PTC, preoperative evaluation of JOHLN can help decision-making of lateral neck lymph node dissection.
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The incidence of papillary thyroid cancer after liver transplantation is relatively low. This article introduces the treatment and prognosis of a case of papillary thyroid cancer after liver transplantation, and discusses the occurrence and development of thyroid cancer after liver transplantation and perioperative management and the prognosis, in order to further enhance the comprehensive management of such patients, extend the survival period and improve the quality of life.
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Objective To explore the effect of intraoperative parathyroid hormone (IOPTH) examination on parathyroidectomy for primary hyperparathyroidism.Methods The clinical data of 41 PHPT patients who received IOPTH monitoring (IOPTH group) from Jan.2009 to Dec.2014 were retrospectively analyzed.The clinical manifestation,examination and changes of parathyroid hormone and calcium before and after operation were collected.Results There were 12 males and 29 females.36 cases had parathyroid adenoma,and 5 cases were parathyroid carcinoma.23 cases were positive in 24 cases of 99Icm-MIBI parathyroid adenoma radionuclide examination,and 2 cases were positive in 3 cases of parathyroid carcinoma radionuclide 99Tcm-MIBI inspection (P＝ 0.213).10 mins after tumor resection,PTH in all cases decreased by 50％ or more than that before tumor resection except for one case of parathyroid carcinoma.23 cases appeared hypocalcemia in 36 cases of parathyroid adenoma after surgery and 2 cases appeared hypocalcemia in 5 cases of parathyroid cancer patients (P＝0.361).No postoperative hoarseness,cough,bleeding occoured.Patients were followed up from 6 to 72 months.Hypocalcemia symptoms recovered 2 weeks to 3 months after surgery.No permanent hypoparathyroidism occured.One case of parathyroid carcinoma died of hypercalcemia 5 months after surgery.The remaining 40 cases survived without recurrence or death.Conclusions Intraoperative PTH monitoring can help doctors analyze whether all the hyperthyroidism glands have been removed,which can help to avoid miss diagnosis of multiple gland disease and unnecessary bilateral neck exploration.This method is highly accurate so it is recommended for routine use in PHPT surgery.
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Objective To investigate the biological characteristics of papillary thyroid carcinoma(PTC) and to discuss its surgical method.Methods 221 patients of PTC underwent total thyroidectomy and conventional central lymph node dissection from Jul.2009 to Feb.2011 in Department of Thyroid Surgery in the First Hospital of Jilin University.Their clinical data were retrospectively analyzed.Results There was no permanent iatrogenic injury of recurrent laryngeal nerve.Only one patient had permanent hypoparathyroidism.Postoperative pathological results showed that bilateral cancer was found in 69 cases(31.2％).Thyroid membrane invasion was found in 143 cases(64.7％),in which the invasion rate of bilateral cancer was 68.1％ (47/69).Central cervical lymph node metastasis was found in 95 cases(43％),in which central cervical lymph node metastasis rate of bilateral cancer was 46.4％ (32/69),central cervical lymph node metastasis rate of unilateral cancer was 41.5 ％ (63/152),central cervical lymph node metastasis rate of thyroid membrane invasion was 49.7％ (71/143).Thyroid membrane invasion or cervical lymph node metastasis rate in all cases was 75.6％ (167/221).There were 42 cases who were found with suspicious unilateral cancer before surgery but proved to have bilateral PTC by postoperative pathological diagnosis(60.9％).Conclusions Most PTC often occurs bilaterally and the ratio of central cervical lymph node metastasis is very high.We suggest that most patients with PTC should undergo total thyroidectomy,conventional central lymph node dissection,and combine with postoperative Ⅰ131 and hormonal treatment.
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Objective To explore the incidence and pathologic feature of patients with thyroid carcinoma treated at the First Hospital of Jilin University. Methods From January 2000 to July 2010,clinicopathologic data of 1018 patients with thyroid carcinoma treated in the First Hospital of Jilin University were retrospectively analyzed. Results The cases of thyroid carcinoma between 2008 and 2010 were more than 73% higher than that in the preceding 8 years. Cancer cases from January 2009 to July 2010 were more1018 cases reviewed, 976 cases were clearly classified pathologically. Papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma were present in 897 (91.91%), 43(4. 41% ), 22(2. 25% ) and 6(0. 61% ) cases respectively. Of the 1018 cases reviewed,804 cases were recorded with or without lymphnode metastasis. The rate of lymphnode metastasis of male and female patient were 39. 24% and 28. 64% respectively and the difference was significant( χ2 = 6. 71 ,P ＜0. 05). The rate of lymphnode metastasis of age ＜45 years and age ≥45 years were 37.65% and 23. 26%respectively and the difference was significant ( χ2 = 19. 54, P ＜ 0. 05 ). Conclusions In the past ten and a half years, the number of the thyroid carcinoma patients treated in the First Hospital of Jilin University increased year by year. The increase of papillary thyroid carcinoma was the most obvious. Thyroid carcinoma was more common among females. The peak incidence age of males and females was 30 -59. The rate of lymphnode metastasis of males was larger than that of females. The rate of lymphnode metastasis of age ＜45years was larger than that of age≥45 years.
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Objective In order to investigate the influence of reelin deficiency on the hippocampal development, the histochemical characteristics of hippocampal pyramidal cells and granule cells of reeler mice were analyzed, therefore, reelin's function would be better understood with more morphological evidences. Methods With immunofluorescent double labeling, the pyramidal cells, granule cells and mossy cells in hippocampi between wild type and reeler mice were labeled. Results The development and lamination of hippocampal cortical plate were in disorder. Pyramidal cells and granule cells dispersed, and moreover, granule cells proliferated rapidly and migrated into hilus, so that the bound between granule layer and hilus disappeared. Conclusion As a stop signal and regulatory signal, reelin plays important roles in neuronal migration of developing cortical plate, especially in the regulation of granule cell proliferation.
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Objeetive To evaluate imaging appearances of herniation pit of the femoral neck.Methods We retrospectively analyzed the X-ray,CT and MRI findings of 9 patients with herniation pit of the femoral neck.All nine patients were male with the age ranging from 21 to 73 years.They had pain in the hip from two months to two years duration.Results The bilateral hips were affected in six patients,the right hips in the other 3 patients.Of the nine patients,X-ray plain films(2 cases),CT scanning(6 cases),and MR scanning(5 cases)were performed.The size of the lesions ranged from 0.5 cm×0.6 cm to 1.0 cm×1.5 cm,located in the anterosuperior portion of the femoral neck(n=7)or anteroinferior portion(n=2).X-ray plain films showed an osteolytic lesion surrounded by a sclerotic rim.CT scanning showed the lesion just below the cortex of the femoral neck surrounded by a rim of sclerosis or associated with a small cortical break in two patients.MR scanning showed low signal intensity in five patients on T1WI and high signal intensity surrounded by a rim of low signal intensity(n=3)or low signal intensity(n=2)on T2WI,and high signal intensity on fat suppression MR image.A small joint effusion was observed in two cases on T2WI.Conclusion The CT and MRI findings of herniation pit of the femoral neck are characteristic,it is useful in defining the diagnosis of the herniation pit of the femoral neck.
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Objective In order to make a epileptic model in organotypic slice culture and to further investigate the epileptic pathology. Methods Immunohistochemistry, Fluoro-Jade B staining and BrdU labeling were carried out in the hippocampal slices with domoic acid treatment after 7 days of culture.Results Domoic acid could induce a series of pathological changes, such as, dispersion of granule cells(0.105±0.063) mm vs (0.057±0.012) mm, t = 4.8, P<0.01), neurogenesis in granular layer and cell loss of pyramidal cell and Mossy cell as well. Conclusions In hippocampal organotypic slices, domoic acid induced such pathological changes as human temporal lobe epilepsy and epileptic animal model. It is an ideal epileptic model for pathological, pharmacological and electronic physiological studies with great applicable prospect.
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Objective To clone and analyze the MN/CA9 gene sequence in ICR mice and detect the expressions of MN/CA9 gene in various tissues of ICR mice.Methods The fresh tissues of small intesine, uterrus, skin, musle, liver, pancreas, heart, lung, thymus, spleen, kidney, ovary, stomach ,urinary bladder from ICR mice were obtained , the total RNA was extracted by GIT method, the 1st strand and 2nd strand of cDNA were synthesized, the EcoRⅠ adapters were lingated,the EcoRⅠ ends were phosphorylated, digested with XhoⅠ ,cDNA was ligated into the ZAP expression vector, packaged, planted, screened.The expressions of MN/CA 9 gene in various tissues in mice were detected by RT-PCR.Results A fragment of human MN/CA9 gene was used as probe, and 1.47?10~3 clones were screened with radioactive isotopic ~ 32 P labeled probe, after hybridizations, one positive signal of cDNA was detected and the complete nucleotide sequence contained 1 671 bp was determined (GenBank:AB086322), The nucleotide similarity between mouse and human cDNA (GenBank:Z54349) was 69.1%.The MN/CA9 gene detected by RT-PCR assay (primer: P521-P1193) strongly expressed in small intesine,uterus, musle, pancreas, heart, lung, thymus, spleen, kidney, ovary, stomach,and urinary bladder,meanwhile did not express in skin and liver. Conclusion The expressions of MN/CA9 gene in some tissues of ICR mice are similar to that of human, it can be used to further functional analysis of MN/CA9 gene.