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Objective To discuss the safety and feasibility of single-incision laparoscopic appendectomy ( SILA ) . Methods A retrospective analysis was made on clinical data of patients diagnosed as having appendicitis by clinical manifestations , ultrasound or computer tomography at our department from June 2009 to December 2014.There were 189 cases of transumbilical SILA ( transumbilical group ) and 123 cases of traditional three-port laparoscopic appendectomy ( three-port group ) .Patients with incomplete records, combination with other surgery , pregnancy appendicitis , acute appendicitis over 72 hours were excluded .Intraoperative and postoperative data of two groups were compared . Results No conversion to open surgery was required in both groups .The operation time, postoperative exhaust time , and postoperative hospital stay had no significant differences between the transumbilical group and the three-port group [(45.5 ±12.7) min vs.(46.3 ±17.8) min, t=-0.461, P=0.650; (1.4 ±0.5) d vs.(1.5 ±0.6) d, t=-1.588, P=0.112;(3.8 ±1.6) d vs.(4.1 ±1.9) d, t=-1.554, P=0.121].The cosmetic scores at 3 months after surgery was higher in the transumbilical group than that in the three-port group [(4.5 ±0.6) points vs.(4.2 ±0.5) points, t=4.585, P=0.000].No significant differences were identified in the incidence of complications and pathological types between the two groups . Conclusion SILA is technically feasible and safe with better cosmetic effects .
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Prognostic factors of differentiated thyroid carcinomas ( DTC ) were analyzed and the related literatures were systematically reviewed in order to justify the diagnostic and therapeutic modalities for improving the patient′s survival.150 patients ( female,n =113 ; male,n =37 ) with histopathologically diagnosed DTC,including papillary thyroid carcinoma ( n =131,87.3％ ) and follicular thyroid carcinoma ( n =19,12.7％ ),were postoperatively followed up and their clinical data were retrospectively reviewed.Patients were followed up for 4.15-31 years wherein 140 patients( 93.3％ ) survived but with relapse in 30 patients( 20.0％ ),and 10 patients( 6.7％ ) died.Surgical procedures consisted of near-total or subtotal thyroidectomy ( n =83,55.3％ ),partial thyroidectomy ( n =64,42.7％ ),and total thyroidectomy ( n =3,2.0％ ).Out of the patients receiving lymph node dissection ( n =63 ),45 patients( 71.4％ ) had detectable lymph node metastasis.Age of onset,tumor size at initial visit,and early metastasis showed the statistically significant difference between mortality group and survival group (P＜ 0.05 ),as well as between relapse group and relapse-free group( P＜0.05 ).Age of onset,tumor size at initial visit,and early metastasis are prognostic factors for DTC.
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Objective To evaluate whether ultrasonographic features of thyroid nodules are associated with histological malignancy, and to set up helpful criteria in identifying those who should accept subsequent fine-needle aspiration biopsy (FNAB). Methods 146 thyroid nodules of 123 patients accepted ultrasonographic evaluation and FNAB. All patients but one with suspicious or malignant cytology were operated. Results Out of total 146 nodules, 43 were histologically malignant, 102 were cytologically benign, and 1 nodule with suspicious cytology was not followed. Hypoechoic pattern, blurred margins, irregular shape, microcalcification, and type Ⅲ vascularity were significantly more frequent in malignant than benign nodules (P ＜ 0. 05). No one of the ultrasonographic features could independently predict malignant nodules. A better compromise is probably to apply FNAB in nodules with at least one or two malignant ultrasonographic signs. Conclusion No single parameter could satisfactorily identify a subset of patients to be selectively examined by FNAB. A cost-effective approach to FNAB should depend on combination of specific ultrasonographic features.
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Objective To explore the value of thyroid-stimulating antibody(TSAb) and degree of goiter in predicting the outcome of Graves'disease after antithyroid drug treatment. Methods Seventy-one patients with Graves'disease were given antithyroid drugs for (2. 8±1. 4)years and then followed up for(22±6.0)months.Finally,age,gender,thyroid function,TSAb and goiter size at the time of drug withdrawal were compared between the relapsed and relieved groups. TSAb was measured in all patients by using HEK-hTSHR cells. Results Eleven of 71 patients relapsed during the follow-up after drug withdrawal. The relapse rate (42. 9% ,6/14)in patients with positive TSAb was significantly higher than that (8.8%, 5/57) in patient with negative TSAb (X2 = 9.97, P<0.01). The relapse rates in patients with normal size thyroid, Ⅰ degree goiter,Ⅱ degree goiter were 6.25%, 12.2%,35.7% respectively. TSAb activity, positive rate and goiter size of the relapsed patients at the time of drug withdrawal were significantly higher than those of relieved patients (P<0.05 or P<0. 01). Conclusion TSAb activity and goiter size at the time of drug withdrawal are two effective prognostic markers of relapse in Graves' disease treated with antithyroid drugs.
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Objective To evaluate clinical significance of the CEA, CA19-9, CA242, AFP, CA724,SCC, TPA, TPS combined detection for the clinical diagnosis of gastrointestial cancer. Methods 373 cases of upper digestive tract malignant tumor patient and 50 cases of healthy serum sample were detected for eight markers, evaluating the relationship between the level of markers and illness. Results 8 marker diagnostic positive rates were: CEA 26.80 %, CA19-9 27.34 %, CA242 34.14 %, AFP 2.84 %, SCC 19.72 %, CA724 12.13 %, TPA 34.15 %, TPS 30.89 %. The total positive rate of joint detection of 8 markers was 89.05 %.Preoperative CEA, CA242, SCC-positive patients had a shorter survival time. CA242 and CA19-9 levels with upper gastrointestinal malignancies were positively correlated. Conclusion The combined detection of a number of markers in different pathological type and clinical staging is statistically significant, and the positive rate is much higher than any single marker test results. CA19-9 and CA242 may be the best combination of monitoring the disease. CA724, CA242 and SCC can be as adverse prognostic indicators for cardia, stomach,esophageal malignant tumors, respectively.
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Objective To investigate the effect of Ligu Capsules in preventing and treating menopausal osteoporosis in ovariectomized rats.Methods Rat models with osteoporosis were established by ovariectomy. Bone mineral density of femur,dry and wet bone weight and blood biochemical parameters were measured before and after treatment.Results Compared with the model group, Ligu Capsules increased femur bone mineral density,elevated the serum levels of Ca,P,Mg ,Zn and CT, decreased serum BGP level and hydroxyproline/creatinine(Hyp/Crea)ratio,increased dry weight, wet weight and ash weight of femur, as well as the bone length, bone volume, and bone diameter.Conclusion Ligu Capsules can prevent and treat osteoporosis in ovariectomized rats.