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With the widespread use of mobile phones, laptops, and WIFI, the effects of radio frequency radiation (RFR) on human health are of increasing concern, and there are particular concerns about its reproductive toxicity. Studies have shown that the reproductive system is a sensitive target for RFR. In males, RFR is associated with decreased sperm quality and serum testosterone levels, but there are few studies on the biological effects of RFR by altering physical parameters on the male reproductive system. This paper introduced common sources of RFR, reviewed the toxic effects and mechanisms of RFR targeting male reproductive system from the aspects of spermatogenic cells, sperm structure, blood-testicular barrier, and testicular function, and analyzed male reproductive system related toxic effects of RFR by varying physical parameters including frequency, treatment duration, and specific absorption rate, so as to provide a theoretical basis and scientific basis for the safe and reasonable use of radio frequency electromagnetic field by humans and subsequent in-depth research.
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Objective:To study the risk factors of postoperative permanent hypoparathyroidism after total thyroidectomy.Methods:In this retrospective study ,the receiver operating characteristic (ROC) curve of postoperative 24 h parathyroid hormone(PTH) values was used to predict the risk of permanent hypoparathyroidism.The clinical and pathological features that related to postoperative permanent hypoparathyroidism were studied by χ2 test and multivariate Logistic regression analysis. Results:Eight hundred and eighty-nine patients were enrolled, the incidence of postoperative transient and permanent hypoparathyroidism was 33.3% and 4.0%, respectively. When 24 h PTH levels less than or equal to 5.84 pg/ml were used as cut off value, the sensitivity of the prediction of permanent hypoparathyroidism was 100%, the specificity was 72%, and the positive predictive value was 22.5%. The presence of parathyroid gland in the pathologic specimen, parathyroid autotransplantation and PTH≤5.84 pg/ml at 24 h after operation were statistically significant risk factor for permanent hypoparathyroidism in multivariate analysis( χ2=10.900, P=0.001; χ2=4.415, P=0.044; χ2=13.576, P=0.000). Group analysis found that the lower 24 h PTH the higher incidence of permanent hypoparathyroidism. Conclusions:For patients undergoing total thyroidectomy, when parathyroid gland is involved and/or the PTH value is low at 24 h after surgery, the occurrence of permanent hypoparathyroidism is high.
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Objective@#To investigate the diagnostic performance of fine-needle aspiration (FNA) cytology for the detection of lateral lymph node metastases in patients with papillary thyroid carcinoma (PTC).@*Methods@#A total of 109 lateral lymph nodes with suspicious metastases from 85 patients were retrospectively subjected to FNAC, fine-needle aspiration thyroglobulin measurement (FNATg), and FNATg/SerumTg measurement. Lymph node pathological results after surgery were taken as the gold standard. Using Mann-Whitney U test, Pearson linear model and ROC curve were used for data analysis.@*Results@#The sensitivity, specificity and accuracy of FNATg for the diagnosis of lateral neck lymph node metastasis were respectively 93.7%, 90.0% and 93.3% and those of FNATg/SerumTg were respectively 89.9%, 90.0% and 93.2% respectively, the threshold values for FNATg and FNATg/SerumTg were 0.925 ng/ml and 1.007, respectively. The sensitivity, specificity and accuracy of FNATg combined with FNAC were respectively 91.0%,93.5% and 94.4%. The existence of thyroid tissue and the expression of serum Tg did not affect the expression of lymph node FNATg. The FNATg cutoff value of 0.925 ng/ml showed the best diagnostic performance in patients with a thyroid gland, while the FNATg/SerumTg cutoff ratio of 14.95 showed the best diagnostic performance in patients without a thyroid gland. The serum TgAb significantly interfered with the expression of FNATg in the lateral neck metastatic lymph nodes (P=0.049).@*Conclusions@#FNATg alone or the combination of FNATg with FNAC are highly reliable in the diagnosis of lateral neck lymph node metastases in patients with PTC. The expression of TgAb may interfere with the accuracy of the diagnostic performance of FNATg.
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Objective@#To study the diagnostic value of a multi-gene molecular testing in cytologically indeterminate thyroid nodules.@*Methods@#From February 2018 to September 2018, patients with thyroid nodules who underwent fine needle aspiration(FNA) at Peking University Cancer Hospital were enrolled. Three hundred and sixty patients were included, consisting of 86 men and 274 women, with a mean age of 45.8 years (between 13 and 89 years old). Among 391 nodules, 141 were cytologically inderminate and 75 were resected. FNA samples underwent prospective testing using a next-generation sequencing (NGS) assay, which included 16 genes for point mutations and 26 types of gene fusions. The testing results of indeterminate nodules were compared with surgical outcomes, to determine the diagnostic performance. The results were compared with the BRAF V600E single gene mutation analysis by χ2 test.@*Results@#The multi-gene testing showed a sensitivity of 73.2%, specificity of 96.8%, positive predictive value of 96.8%, and negative predictive value of 73.2%. The diagnostic accuracy of multi-gene testing was significantly higher than the BRAF V600E mutation test (83.3% vs 73.6%, χ2=31.588, P<0.01).@*Conclusion@#Multi-gene testing in FNA samples is an effective method to diagnose cytologically indeterminate thyroid nodules, which has a higher accuracy than BRAF V600E mutation detection.
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<p><b>OBJECTIVE</b>To evaluate the protection of parathyroid glands in bilateral papillary thyroid cancer patients who underwent total thyroidectomy and bilateral central compartment dissection.</p><p><b>METHODS</b>The clinical data of 78 patients undergoing total thyroidectomy and bilateral central compartment dissection between May 2013 and May 2014 were analyzed retrospectively.</p><p><b>RESULTS</b>Among 78 patients, 131 superior parathyroid glands were protected in situ, among those, 112 parathyroid glands located at the level of inferior edge of parathyroid cartilage; 19 parathyroid glands located in the superior 1/3 part of the back sides of the thyroid glands. All the superior parathyroid glands located in the superior and lateral-superior part of the 2 cm part down from the entrance of recurrent laryngeal nerve. A total of 110 inferior parathyroid glands were protected in situ, among those, 57 glands located in the superior of inferior thyroid artery; 24 glands located just on the surface of inferior thyroid artery; 29 glands located below the superior of inferior thyroid artery. Three parathyroid glands were found in the dissected tissues and were implanted immediately. Seven parathyroid glands were found with post-operative pathologic examinations. During surgery, four parathyroid glands was found in 27 patients, three in 30 patients, two in 16 patients, and one in 5 patients.</p><p><b>CONCLUSION</b>For papillary thyroid cancer patients who underwent total thyroidectomy and bilateral central compartment dissection, identification of parathyroid glands and protection of blood supply to glands are the most effective methods to prevent hypoparathyroidism.</p>
Subject(s)
Humans , Carcinoma , General Surgery , Carcinoma, Papillary , Hypoparathyroidism , Organ Sparing Treatments , Parathyroid Glands , General Surgery , Recurrent Laryngeal Nerve , Retrospective Studies , Thyroid Neoplasms , General Surgery , ThyroidectomyABSTRACT
Objective To evaluate the salvage surgery for papillary thyroid cancer patients with residual neck metastatic lymph nodes after thyroidectomy.Methods Clinical data of 97 patients undergoing salvage neck dissection between September 2007 to June 2010 were analyzed retrospectively.Results Among 97 patients,residual metastatic lymph nodes were found in 80 patients in lateroposterial neck,overall residual rate was 82.47％.Residual rate was 85.71％ in 56 patients who underwent initial lateroposterial neck dissection in other hospitals:100％ in 8 patients who underwent berry-picking; 93.33％ in 30 patients who underwent partial dissection; 66.67％ in 18 patients who underwent whole neck dissection.Residual rate was 78.05％ in 41 patients who did not undergo initial lateroposterial neck dissection.The number of dissected lymph nodes was 15-45,with an average of 23 nodes removed and 8.21 metastatic lymph nodes per case.Residual metastatic lymph nodes were found in 67 patients in central neck,overall residual rate was 82.47％,residual rate was 53.85％ in 13 patients who underwent initial central neck dissection,and 71.42％ in 84 patients who did not undergo initial central neck dissection.Conclusions Correct imaging diagnosis decreases cervical residual metastatic lymph nodes in patients with papillary thyroid cancer.Successful salvage operation lies in choosing correct mode of neck dissection and carrying out sufficient dissection.
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Objective To evaluate radical resection for thyroid carcinoma in patients without lateral neck lymph node metastasis.Methods Clinical data of 132 thyroid carcinoma patients without lateral neck lymph node metastasis undergoing radical thyroidectomy were retrospectively analyzed.Results There were 35 male and 97 female patients.Age ranged from 18 to 62 years,median age was 34.2 years.All patients underwent ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection.The rate of recurrent laryngeal nerve injury was 4.5% (6/132).Taking into account of tumor invaded nerve,the rate of dissection procedure caused injury was 1.6% (2/128).Conclusion Combination of ipsilateral lobectomy plus isthmectomy and Ⅵ level dissection constitutes radical thyroidectomy in papillocarcinoma of the thyroid gland without lateral neck lymph node metastasis,recurrent laryngeal nerve exposure is the key for this en bloc resection.
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Objective To evaluate different laryngeal recurrent nerve dissections in thyroidectomy for benign and malignant thyroid diseases. Methods The chnical data of 572 patients undergoing thyroideetomy with at least one side nerve exposure were retrospectively analyzed.Results Among 572 cases,a total of 652 nerves were exposed,among those 451 were by lateral exposure,144 by inferior exposure,57 by superior exposure.Two non-recurrent laryngeal nerves were found in 572 cases.There were 6 cases referred to our department for postthyroidectomy hoarseness undergoing reexploration and it Was found that the laryngeal recurrent nerve were legated in 3 cases and severed in the other 3 cases.In this series,among those suffering from postoperative hoarseness at our own hospital,there were 3 cases in which the nerve was invaded by the tumor and it was unable to dissect the nerve intact from the tumor,while the other 4 were cases referred to our hospital for incomplete thyroidectomy and undergoing a difficult extensive second operation.Conclusions The use of lateral、inferior and superior exposure of laryngeal recurrent nerve dissection can ensure the safety and integrity of the nerve.
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Objective To detect the isoniazid (INH) and rifampin (RIF) resistance of Mycohaeterium tuberculosis isolates in the single tube with multiplex-polymerase chain reaction-single strand conformation polymorphism(muhi-PCR-SSCP) system. Methods According to the sequences of inhA, katG and rpoB genes of the Mycohacterium tuberculosis, three pairs of oligonucleotide primes were designed to examine the INH and RIF resistance with the multi-PCR-SSCP. The validity of the newly developed method was evaluated with 116 clinical isolates of Mycohacterium tuberculosis( 70 isolates that were INH-resistant and 66 isolates that were RIF-resistant). Results The validity of the method was assessed with multiplex PCR-SSCP with the bacteria culture with susceptibility test as golden standard. The three genes, katG, inhA and rpoB, in the 116 clinical isolates and H37Rv strain were amplified successfully in single PCR reactions,except 4 isolates with katG deletion mutants. Compared with strain H37Rv, forty-six isolates had katG gene mutations, thirteen had inhA mutations and fifty-eight had rpoB mutations. Thirty-eight isolates had simultaneous katG and rpoB mutations and 4 isolates had both inhA and rpoB mutations. Four isolates had inhA and katG mutations and 2 isolates had mutations in all three genes simultaneously. The sensitivity of the newly developed multiplex-PCR-SSCP assay was 80% and 82% for INH and RIF, respectively. The specificity of the assay was 100% and 92% for INH and RIF, respectively. Conclusion Muhiplex-PCRSSCP provides a rapid, specific and cost-effective method of detecting multidrug-resistant TB. It laid a solid foundation for the further study of drug resistant gene.
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Objective To evaluate the level of serum cholesterol in patients with progressive gastric cancer and gastric ulcer before and after operation, and the relationship between the level of serum cholesterol and the clinical differential degree of progressive gastric cancer . Methods To measure the content of serum cholesterol in patients with progressive gastric cancer and gastric ulcer before operation and after operation 10 day. The size of tumor, infiltration, metastasis and the pattern of the operation were studied statistically. Results The level of serum cholesterol in group of progressive gastric cancer was significant lower than that of normal control group(P 0.05 ) in group A, but there was significant difference in group B after the operation(P
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HMGB-1, an ubiquitously expressed 25-KD nucleoprotein among mammals, belongs to the HMG family. Recent studies have identified that HMGB-1 is secreted by activated monocytes/macrophages via a non-classical ,vesicle-mediated secretory pathway. Extracellular HMGB-1 is an important proinflammatory cytokine. It participates in the pathogenesis of many diseases such as rheumatoid arthritis, sepsis , acute lung injury, and even leads animals death. Further studies of the mechanism and function of extracellular HMGB-1 may provide a novel strategy for the diagnosis and treatment of these diseases.
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Aim To study the content and clinical significance of serum endothelin-1(ET-1)in patient with malignant tumors. Methods The contents of serum ET-1 in 85 patients with malignant tumors,30 patients with benign diseases and 30 normal indivaduals were detected by radioimmunoassay. Results (1)The mean concentrations of serum ET-1 in normal individuals and in non-tumor patients were (46.9± 23.1)μ g/L and (51.1± 30.9)μ g/L,respectively, while in patients with malignant tumors it was (190.1± 135.2～ 382.4± 190.1)μ g/L. (2)There was no significant difference between the mean serum contents of ET-1 in normal individuals and non-tumors pstients(P∧ 0.05),but the level of serum ET-1 in patients with malignant tumors were significantly higher than that in above two groups(P∨ 0.001). (3)When the mean content plus twice standard deviation of serum ET-1 in normal individuals was as a threshold value,that is ,the value was defined as the positive clinical value to diagnose cancer, the positive rates of patients with different malignant tumours were 72％ ～ 100％ . Conclusion Serum ET-1 contents could be used as a better tumor index for maligant tumor screening and accessory diagnosis.
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Objective In this study,we determine whether Survivin antisense oligonucleotide (ASODN) down-regulates the expression of Survivin mRNA,induces apoptosis,and enhances the sensitivity of pancreatic cancer cells to a chemotherapy agent Gemcitabine. Methods Lipofectin was used to encapsulate ASODN in transfection. Viability of pancreatic cell line BxPC-3 cells treated with ASODN was assessed by MTT method,the expressions of Survivin mRNA were detected by RT-PCR;Flow cytometry and electron microscopy were used to demonstrate apoptotic changes in ASODN treated cells. Result Cell viability was inhibited in dose-dependent and time-dependent manner with an IC 50 of 400 nM at the time of 24 h,Survivin mRNA was down-regulated by 3.38 fold compared to control group. The cell apoptotic ratio was 24.93%?2.97%,early apoptotic morphology was demonstrated by electron microscopy. In combination with Gemcitabine,at the time of 48 h and 72 h,cell viability decreased by 2.76 and 4.58 fold compared to when Gemcitabine was used alone. Conclusion Survivin ASODN down-regulates Survivin mRNA ,induces apoptosis,inhibits proliferation and enhances the sensitivity of pancreatic cancer cells to Gemcitabine.
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Objective To investigate the results of laparoscopy and small incision splenectomy in the treatment of Idiopathic Thrombocytopenic Purpura (ITP). Methods Under CO2 pneumoperitoneum, laparoscopy and small incision splenectomy was performed in 13 patients . After freeing of the spleen with laparoscopy , we performed a small incision under the left costal margin. The splenic pedicle was 1-igated under direct vision, and the spleen was excised and extracted. Analysis was made of the pre-and post-operative platelet counts, and the complication rate and recovery condition of the patients. Results No complications occurred in the 13 palients, and the effect-iveness of ITP treatment was 100%.Conclusions Laparoscopy and small incision splenectomy is a safe and effective method to treat ITP.
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AIM: To observe the inhibitory effect of antisense eukaryotic expression vectors for c-myc on rat airway smooth muscle cells. METHODS: Antisense and sense eukaryotic expression vectors for c-myc pcDNA3-myc-antisense and pcDNA3-myc-sense were constructed. Lipofectin was used to introduce antisense and sense eukaryotic expression vectors for c-myc into rat. The inhibitory effect was assayed by MTT cell proliferation assay. Cell cycles were detected by flow cytometry technology. The expression of c-Myc was detected by immunohistochemistry. RESULTS: The results showed that antisense eukaryotic expression vector for c-myc inhibited rat airway smooth muscle cells proliferation. Rat airway smooth muscle cells were prohibited in S phase and the expression of c-Myc was decreased after antisense eukaryotic expression vectors for c-myc were transfected into cells. CONCLUSION: Antisense eukaryotic expression vectors for c-myc inhibit rat airway smooth muscle cell proliferation. [
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Objective To evaluate the feasibility and effect of the treatment of hematopathy by laparoscopy plus small incision splenectomy. Methods Dissection and separation of the ligaments of the spleen with laparoscopy first. And then made a small abdominal incision to ligate and divid the pedicle of spleen to finish splenectomy. Sixteen cases of idiopathic thrombocytopenic purpura(ITP) and 4 cases of heriditary spherocytosis(HS), who were treated by medication but no effect or recurrence, were treated by this procedure. Results All the patients recovered smoothly without infection of the wound ,without fluid collection in the spleen fossa,and without great intraoperative blood loss.The operating time was 1.5～2.5h(average 2.2h), intraoperative blood loss was 30～85ml(average 65ml).Hospital stay was 4～7d( average 6d). No recurrence was found during the follow-up for 0.5 to 2.5 years in this series. Conclusions Laparoscopy plus small incision splenectomy in the treatment of some hematopathy has many advantages,such as less trauma, safety, effective and quick recovery.
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Objective:To compare dexamethasone and granisetron for the prevention of PONV(Postoperative nausea and vomiting) after LC(Laparoscopic cholecystemy).Methods:A total of 80 patients were randomly divided into four groups(n= 20 each).A:dexamethasone 8 mg group;B:granisetron 3 mg,C:combined application group,D were the control group.All patients were given the similiar standardized anesthesia and operative treatment.PONV were assessed during the first 24 h after operations.Results:Group A,B and C got higher scores of PONV than the control group(P
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ObjectiveTo evaluate the influence of laparoscopic operation on pH value, phagocytic function of neutrophil, immunoadhesion activity of RBC CR 1 (complement receptor typeⅠ) in abdominal cavity. Methods Determination of the pH value, phagocytic function of neutrophil, immunoadhesion of RBC CR 1 in abdominal exudatives during laparoscopic procedures was undertaken and results were compared with the relative indexes detected in peripheral vein blood. Results The average pH value was 7.41, the percentage of the phagocyte was 74.6%, phagocytic index 55.7, and immunoadhesion activity of RBC CR 1 was 58% in blood during laparoscopic operation. While the average pH value was 7.14, the percentage of the phagocyte 65.6%, phagocytic index 47.6,and immunoadhesion activity of RBC CR 1 50% in the abdominal exudatives. Conclusion Compared with the peripheral vein blood indexes, the intraabdominal pH value, phagocytic function of neutrophil and immunoadhesion activity of RBC CR 1 decreased significantly during laparoscopic operation. The intraabdominal inflammation may diffuse with the effect of CO 2 pneumoperitoneum when patients with serious inflammation receive laparoscopic operation.
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The expression of nm23-H1 and p53 genes were studied with ABC immunohistochemical method in 54 cases of gastric cancer and 57 cases of colorectal cancer. The result showed that the expression of nm23-H1 was 72.2% in gastric cancer and 64.9% in colorectal cancer, respectively. No significant difference was found between the expression of this gene and lymph node metastasis of the cancers. The mutant p53 protein expression was 53.7% and 52.6% in gastric and colorectal cancers, respectively. Although it was not correlated with lymph node metastasis, its expression was significantly higher in cancers with distant metastases, suggesting that the mutant p53 protein expression may be indicative of poor prognosis in gastrointestinal cancers.
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ObjectiveTo evaluate the feasibility of endoscopic thyroid adenoma excision. Methods Dogs were used to practice endoscopic thyroid surgery under anesthesia. On the basis of animal experiment, endoscopic technique was introduced into dissection of follicular nodule of the thyroid lobe. One male and 11 females, aging between 23～52, underwent endoscopic enucleation of thyroid tumors from March 2002 to October 2002. Results The procedure was successful in 11 cases with 1 case converted to open surgery. The average time of operation was 70*!min, and intraoperative blood loss was 5～20*!ml. The patients had minimal pain. The cosmetic result was excellent. The incisions were completely hidden even with open necked skirt. Conclusions The cosmetic result of endoscopic thyroidectomy is satisfactory.