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1.
Chinese Journal of Endocrine Surgery ; (6): 510-512, 2022.
Article in Chinese | WPRIM | ID: wpr-954629

ABSTRACT

In this paper, the clinical case, pathological and immunohistochemical analyses were performed on 10 patients with intrathyroidal thymic carcinoma admitted to our hospital.Combined with relevant literature, it was found that tumour cells expressing CD5 and CD117 had differential diagnostic significance. Surgical resection of the tumour was the first choice for treatment, whether radiotherapy, chemotherapy and monotherapy were administered remained controversial.

2.
Chinese Journal of Endocrine Surgery ; (6): 377-381, 2021.
Article in Chinese | WPRIM | ID: wpr-907810

ABSTRACT

Objective:To investigate the risk factors related to extrathyroidal extension (ETE) of differentiated thyroid carcinoma (DTC) and the specific effects on the prognosis.Methods:The clinical data of 592 patients with newly diagnosed DTC admitted to our hospital from Jun. 2015 to Jun. 2016 were retrospectively analyzed. The data including the maximum tumor diameter and lymph node metastasis were collected, and the survival data were followed up. Chi-square test and Logistic regression were used to analyze the risk factors associated with ETE. Kaplan-Meier method and Cox proportional risk model were used to analyze the effect of ETE on disease-free survival.Results:There were 100 ETE of 592 DTC patients (16.9%) . Univariate analysis showed that the risk factors for ETE were the largest tumor diameter ≥2 cm, multiple lesions, and lymph node metastasis in the lateral cervical region ( P<0.01) . The follow-up time was 29 to 64 months, and the median follow-up time was 60 months. The 3-year and 5-year DFS rates of patients with DTC and ETE were 86.9% and 83.2% respectively, which were significantly lower than those of patients without ETE ( P<0.001) . Univariate analysis showed that ETE ( P<0.001) was a risk factor for postoperative recurrence in patients with DTC. Cox multivariate regression showed that ETE (HR: 10.564, 95% CI 3.712-30.063, P<0.001) was an independent risk factor for postoperative recurrence in patients with DTC. Conclusions:DTC accompanied by ETE is associated with risk factors such as large tumor diameter and multiple lesions, which has a lower 5-year DFS. Patients with the above characteristics should consider the possibility of ETE before surgery, and focus on long-term follow-up after surgery.

3.
Chinese Journal of Endocrine Surgery ; (6): 208-210, 2021.
Article in Chinese | WPRIM | ID: wpr-882741

ABSTRACT

Thyroid carcinoma (TC) is one of the most prevalent endocrine malignancies worldwide. Patients with TC have high overall survival, but TC experienced the largest increase in incidence. Therefore, it is necessary to get further understanding of the mechanism involved in the development and progression of TC. The concept of the competing endogenous RNA (ceRNA) further illuminates the mechanism of tumorigenesis. Current studies indicate that psedugenic RNA, lncRNA, circRNA and mRNA, all of which may take part in the construction of ceRNETs as ceRNAs. These ceRNAs harbour the same miRNA response element (MRE) as mRNAs. Thus, ceRNAs can also competitively inhibit mRNA binding to the miRNAs, which results in affecting mRNA expression to exerts a pro-oncogenic or tumor-suppressive influence in tumor. Recently, a large number of studies have shown that ceRNA molecules play an important role in the malignant behavior of thyroid cancer. Therefore, it is necessary to summarize these studies. The purpose of this paper is to classify these ceRNA molecules in thyroid cancer and to elaborate the functions of these molecules in thyroid cancer.

4.
Chinese Journal of Endocrine Surgery ; (6): 21-26, 2021.
Article in Chinese | WPRIM | ID: wpr-882704

ABSTRACT

Objective:To investigate the effects of miR-497 on cytobiology behaviors of papillary thyroid carcinoma (PTC) by targetingly regulating the expression of Yes-associated protein 1 (YAP1) .Methods:Human TPC-1 cells were divided into control group, miR-497 group, si-YAP1 group and miR-497+si-YAP1 group. The liposome transfection was conducted by LipofectamineTM3000. The targeted relationship between miR-497 and YAP1 was validated by Luciferase Reporter Assay. The cell proliferation activity in each group was detected by MTT method. The apoptosis rates were analyzed by flow cytometry. The number of invasion cells was detected by Transwell. The cell migration rates were detected by scratch assay. The expression of Cyclin D1, matrix metalloproteinase 2 (MMP-2) , MMP-9, matrix metalloproteinase inhibitor-1 (TIMP-1) and activated caspase 3 (cleaved Caspase-3) was detected by Western blot. SPSS 22.0 was used to analyze data, and normally distributed measurement data were expressed as ( ± s) . One-way ANOVA was analyzed for the difference between multiple groups, and SNK-q were analyzed for the difference between two groups. Results:Compared with the control group, the expression of YAP1 mRNA and protein was decreased in miR-497 group and si-YAP1 group ( q=14.682, 14.597; 23.743, 23.571; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=4.724, 4.568, 3.841; 4.216, 3.952, 3.274; P<0.05) , apoptosis rate was increased ( q=3.783; 4.336; P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=5.823, 5.981, 6.036, 6.485; 5.934, 6.110, 6.573, 6.614; P<0.05) , and expression of TIMP-1 protein was increased ( q=6.071; 6.148; P<0.05) . Compared with si-YAP1 group, miR-497 level was increased in miR-497+si-YAP1 group ( q=14.726, P<0.05) , the expression of YAP1 mRNA and protein was decreased ( q=3.089, 3.126; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=2.654, 2.537, 2.246; P<0.05) , apoptosis rate was increased ( q=2.875, P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=4.371, 4.365, 4.383, 4.368; P<0.05) , and expression of TIMP-1 protein was increased ( q=4.275, P<0.05) . Conclusion:MiR-497 can negatively targetingly regulate the expression of YAP1, inhibit proliferation, invasion and migration of TPC-1 cells.

5.
International Journal of Surgery ; (12): 179-184,F4, 2021.
Article in Chinese | WPRIM | ID: wpr-882464

ABSTRACT

Objective:To observe the relationship between the occurrence of symptomatic hypocalcemia (SH) and various potential influencing factors in patients after thyroidectomy, stratify according to the scope of thyroidectomy, and explore the predictive value of intact parathyroid hormone (iPTH) for postoperative SH.Methods:Among 3 379 patients with thyroidectomy who admitted into the First Affiliated Hospital of Zhengzhou University from January 2020 to February 2021, 122 patients with SH after thyroidectomy were collected retrospectively and set as SH group. 100 patients of the remaining 3 200 patients who did not suffer from SH in the same year were selected by systematic sampling method and set as control group. Pearson correlation analysis was used to analyze the potential influencing factors such as age, preoperative calcium, postoperative calcium, preoperative iPTH, postoperative iPTH, central lymph node number, blood loss, operation duration, gender, lymph node dissection method, thyroidectomy range, postoperative pathological type and other. Among them, the measurement data of normal distribution were expressed by mean±standard deviation( Mean± SD), t-test was used for the comparison between the two groups, and Chi-square test was used for count data. By drawing the receiver operating characteristic curve (ROC), the iPTH levels in patients with and without SH before/after operation (different surgical methods) were studied, and the diagnostic threshold, sensitivity and specificity of iPTH were predicted. Results:Among 3 379 patients, 122 patients suffered from SH after thyroidectomy, with the incidence rate of 3.6%. There were significant differences in gender (8 males and 114 females in SH group; 27 males and 73 females in control group), whether lateral area dissection was performed (58 cases with dissection and 64 cases without dissection in SH group; 7 cases with dissection and 93 cases without dissection in control group), thyroidectomy range (14 cases with one side and 108 cases with both sides in SH group; 73 cases with one side and 27 cases with both sides in control group), age (40.1 years old vs 43.2 years old), dissection number of central lymph nodes (8.6 vs 4.6), dissection number of cervical lymph nodes (12.3 vs 0.7), blood loss (22.8 mL vs 11.0 mL), operation duration (1.7 h vs 0.8 h), postoperative iPTH (16.4 pg/mL vs 41.9 pg/mL), preoperative iPTH (39.4 pg/mL vs 47.8 pg/mL) in SH group; and postoperative calcium level (1.9 mmol/L vs 2.2 mmol/L). There was significant differences between the two groups ( P<0.05). However, there was no significant differences between them with postoperative pathological type (4 cases with toxic goiter, 3 cases with medullary thyroid carcinoma, 1 case with thyroid follicular carcinoma, 114 cases with papillary thyroid carcinoma in SH group; 1 case with medullary thyroid carcinoma, 1 case of thyroid follicular carcinoma, 98 cases with papillary thyroid carcinoma in control group, P=0.25) and preoperative calcium (2.3 mmol/L vs 2.3 mmol/L, P=0.10). For patients with bilateral thyroidectomy, SH was easy to occur when postoperative iPTH < 20.08 pg/mL, and its sensitivity and specificity were 74.07% and 96.30%; however, for patients with unilateral thyroidectomy, SH was easy to occur when iPTH < 24.00 pg/mL after operation. Conclusions:Gender, age, postoperative calcium, preoperative iPTH, postoperative iPTH, central lymph node number, blood loss, operation duration, lymph node dissection method and thyroidectomy range are important factors affecting the occurrence of SH after thyroidectomy. With the expansion of surgical range, the postoperative iPTH level gradually decreases, which predicts the occurrence of symptomatic hypocalcemia. In order to avoid the occurrence of symptomatic hypocalcemia after operation, it is necessary to supplement calcium in time according to the range of operation and postoperative iPTH level.

6.
International Journal of Surgery ; (12): 114-119, 2021.
Article in Chinese | WPRIM | ID: wpr-882450

ABSTRACT

Objective:To investigate the difference of radiofrequency ablation combined with ethanol ablation and radiofrequency ablation in the treatment of benign cystic solid thyroid nodule.Methods:A total of 80 patients who visited the Thyroid Surgery Department of the First Affiliated Hospital of Zhengzhou University from January 2015 to July 2018 were selected. All selected patients are required to meet the following criteria: (1)Color doppler ultrasonography of the neck revealed a cystic solid thyroid nodule greater than 20 mm in diameter. (2) The results of fine needle aspiration cytology of thyroid nodules were benign. (3)The patients is to undergo radiofrequency ablation of thyroid nodule. According to the condition and patients′ wishes, radiofrequency ablation (Group A, n=40) and combined ethanol and radiofrequency ablation(Group B, n=40) were performed respectively to observe the changes of nodule volume and maximum diameter at 3, 6 and 12 months after surgery.The difference of intraoperative radiofrequency ablation energy, postoperative complications and patient satisfaction at 12 months after operation were also observed. The respective clinical effects of the two groups and the difference of curative effects between the two groups were analyzed. Two-factor repeated measurement analysis of variance or independent sample t test was used to compare the measurement data in line with normal distribution between groups. Friedman′s rank sum test was used for comparison of measurement data groups that did not conform to normal distribution, and Bonferroni correction was used for pairwise comparison. Chi-square test was used to compare the counting data between groups. Results:On the 12th months after operation, the volume reduction of of nodules in group B was greater than that of group A, and the difference was statistically significant[(7.0±5.1) mL vs (5.5±4.9) mL, P<0.05]. The maximum diameter reduction of nodules in group B was greater than that of group A and the difference was statistically significant [(1.5±0.6) cm vs (1.4±0.8) cm, P<0.05]. During the period of 6 to 12 months after operation, the trend of nodular shrinkage in group B was more obvious than that in group A ( P<0.05). The radiofrequency ablation energy of group was lower than that of group A, and the difference was statistically significant [(2.37±1.18) kJ vs (3.89±1.17) kJ, P<0.05]. Voice reduction occurred in 2 cases and recovered within 2 weeks.Local bleeding occurred in 1 case during the operation, which was stopped after ablation. There was no statistical significance in the satisfaction of patients in group A and group B (87.5% vs 90%, P>0.05). Conclusion:Compared with radiofrequency ablation, radiofrequency ablation combined with ethanol ablation for benign cystic solid thyroid nodules can achieve better nodule reduction effect and reduce the ablation energy.

7.
International Journal of Surgery ; (12): 73-77, 2021.
Article in Chinese | WPRIM | ID: wpr-882442

ABSTRACT

Medullary thyroid carcinoma(MTC) is a rare neuroendocrine neoplasm caused by the malignant hyperplasia of thyroid parafollicular cells, accounting for 4% of all diagnosed thyroid cancer. Patients with MTC have a relatively poor outcome. Distant metastasis, especially in liver, is usually found at the time of diagnosis and the effect of chemotherapy is unsatisfactory in most cases. Due to its highly progressive characteristic and poorer prognosis compared with other subtypes of thyroid cancer, MTC has always been the focus and difficulty of clinical research. In the era of precision therapy, the classification of MTC is more accurate with the application of genetic testing technology and various kinds of individual treatments, such as targeted therapy and peptide receptor radionuclide therapy have been developed. This review will describe the latest development in MTC in the era of precision therapy.

8.
International Journal of Surgery ; (12): 15-19, 2021.
Article in Chinese | WPRIM | ID: wpr-882429

ABSTRACT

Objective:To discuss the feasibility and value of open treatment for small and middle abdominal incision hernia repair.Methods:Retrospective analysis of 110 patients with abdominal wall incision hernia repair in our hospital from January 2016 to January 2018. They were divided into two groups according to the different operation, including open treatment group ( n=57)and laparoscopic treatment group ( n=53), the VAS efficacy scores, anal exhaust time, defecating time, removal of gastric tube time, removal of drainage tube time, first feed time, postoperative hospital stay time, hospitalization expenses were observed and analyzed respectively, measurement date with normal distribution were expressed as ( Mean± SD), comparisons between groups were analyzed using t test. Comparisons of count date between groups were analyzed using chi-square test. Results:All the patients were discharged, the VAS efficacy scores in open treatment about one day or three day and five day were (4.02±0.19), (2.21±0.26), (1.39±0.98) scores, the VAS efficacy scores in laparoscopic treatment were (4.68±0.62), (2.76±1.18), (1.84±0.62) scores, there were differences in complications between the two groups( P<0.05). The anal exhaust time, defecating time, removal of gastric tube time, removal of drainage tube time, first feed time of open treatment group were (50.73±14.69) h, (87.21±13.75) h, (9.64±3.92) h, (3.42±1.22) d, (37.11±9.76) h, and the laparoscopic treatment group were (65.14±9.54) h, (89.73±11.56) h, (11.43±5.61) h, (2.81±1.39) d, (38.92±7.59) h, there were differences complications between the two groups( P<0.05). The postoperative hospital stay time of open treatment group were (9.14±0.03) d, the postoperative hospital stay time of laparoscopic treatment group were (9.74±0.49) d, there were not differences in complications between the two groups( P<0.05). The hospitalization expenses in open treatment group were (1.51±0.36) ten thousand yuan, the hospitalization expenses in laparoscopic treatment group were(2.13±1.06) ten thousand yuan, there were differencesin complications between the two groups( P<0.05). Conclusion:Application of open treatment is feasible and effeetive for small and middle abdominal wall incision hernia.

9.
International Journal of Surgery ; (12): 743-747, 2020.
Article in Chinese | WPRIM | ID: wpr-863425

ABSTRACT

Objective:To investigate the risk factors of central lymph node metastasis for thyroid microcarcinoma (PTMC) combined with Hashimoto thyroiditis (HT).Methods:A total of 572 patients with PTMC were admitted to the Thyroid Surgery Department of the First Affiliated Hospital of Zhengzhou University from January to December 2018. Their all pathological features were retrospectively analyzed. A total of 140 PTMC patients combined with HT were screened. The software of SPSS 23.0 was used to analyze risk factors related to lymph node metastasis in central region, which included gender, age, tumor size, number of lesions, mutated BRAFV600 E gene, external invasion. Results:Single factor analysis of these 140 patients showed, tumor size 6 mm or higher ( χ2=5.376, P=0.020), multifocal ( χ2=7.986, P=0.005), BRAFV600 E mutation positive ( χ2=5.072, P=0.024) and external invasion ( χ2=7.778, P=0.005) were statistically significant ( P<0.05). Multivariate logistic regression analysis showned, multifocal ( OR=2.473, P=0.018) and external invasion ( OR=3.608, P=0.048) were independent risk factors for lymph node metastasis in central region of patients who had PTMC combined with HT. Conclusion:In patients who have PTMC combined with HT, the risk of central lymph node metastasis increased when patients had multifocal or external invasion before surgery, at this time, preventive central lymph node dissection was recommended.

10.
International Journal of Surgery ; (12): 45-48, 2020.
Article in Chinese | WPRIM | ID: wpr-863269

ABSTRACT

Surgical treatment is still an important treatment method for comprehensive breast cancer treatment.The surgical method of breast cancer has also changed from traditional radical surgery to breast-conserving radical surgery.In recent years,the safety and effectiveness of breast-conserving radical mastectomy for breast cancer have been widely recognized;plastic surgery after breast-conserving radical mastectomy can help patients reshape their appearance and return to normal life with confidence.With the renewal of the treatment concept and the progress of life,breast cancer surgical treatment has entered the era of individualized plastic surgery.This article discusses the hot issues of breast cancer surgery in recent years.

11.
International Journal of Surgery ; (12): 45-48, 2020.
Article in Chinese | WPRIM | ID: wpr-799276

ABSTRACT

Surgical treatment is still an important treatment method for comprehensive breast cancer treatment. The surgical method of breast cancer has also changed from traditional radical surgery to breast-conserving radical surgery. In recent years, the safety and effectiveness of breast-conserving radical mastectomy for breast cancer have been widely recognized; plastic surgery after breast-conserving radical mastectomy can help patients reshape their appearance and return to normal life with confidence. With the renewal of the treatment concept and the progress of life, breast cancer surgical treatment has entered the era of individualized plastic surgery. This article discusses the hot issues of breast cancer surgery in recent years.

12.
International Journal of Surgery ; (12): 857-861, 2019.
Article in Chinese | WPRIM | ID: wpr-800687

ABSTRACT

Exosomes are tiny vesicles produced in cells which sizes between 40 to 100 nm. Exosomes are carriers of cell signal transduction. Thyroid cancer is the common malignant tumor in endocrine system. Exosomes show the regulatory role in thyroid cancer about occurrence, development and metastasis. This review focuses on the relevant characteristics of exosomes and the research progress of exosomes in thyroid cancer.

13.
International Journal of Surgery ; (12): 814-818, 2019.
Article in Chinese | WPRIM | ID: wpr-800678

ABSTRACT

Objective@#To explore the effectiveness and safety of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules.@*Methods@#We analyze 573 patients with thyroid benign nodules from June 2014 to September 2017 treated by RFA at Department Ⅱof Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University. Among these patients, there were 75 males and 498 females, with a median age of 45 years old. All patients were diagnosed as thyroid benign nodules by ultrasound-guided fine needle aspiration biopsy before RFA. A total of 750 benign tumors were treated. To evaluate the thyroid function of the patients before RFA and 3 months after it, and to observe the changes of thyroid benign nodules by ultrasound at 3, 6, 12 months after RFA. The paired t-test was used to compare the measurement data with normal distribution, and Wilcoxon's signed rank test was used to compare the measurement data with non-normal distribution. To calculate the volume change and reduction rate of thyroid benign nodules.@*Results@#RFA was successfully completed in all patients, the volume reduction rate was 67%(48%, 83%) in the 3rd month after RFA, in the 6th month was 81%(67%, 91%), in the 12th month was 89%(80%, 95%). Eighteen patients felt pain during RFA, but the pain was alleviated after stopping ablation. Three patients′ tone decreased, but recovered in a week. Hoarseness occurred in 6 patients and recovered in 3 months. Three patients had neck hemorrhage, which was managed with simple compression of the neck.@*Conclusions@#RFA is an effective and safe treatment for thyroid benign nodules and has obvious advantages such as less invasiveness, having no influence in thyroid functions. It is clinically prospective for application.

14.
Chinese Journal of Endocrine Surgery ; (6): 419-422, 2019.
Article in Chinese | WPRIM | ID: wpr-789235

ABSTRACT

Objective To investigate the clinical prognostic features of pediatric differentiated thyroid carcinoma (DTC).Methods A retrospective analysis of clinical data of 56 cases of pediatric differentiated thyroid carcinoma under 14 years old admitted in our hospital from Aug.2009 to Oct.2018 was performed.KaplanMeier method and COX proportional hazards model were used to analyze the factors affecting the disease-free survival of patients.Results The follow-up period was from 6 months to 82 months,and the median follow-up time was 28 months.Recurrence occurred in 15 patients,with a survival rate of 100%.The 3-and 5-year disease-free survival rate was 67.4% and 63.5%.Univariate analysis showed that tumor diameter >2 cm (P=0.046),multiple lesions (P<0.001),cervical lymph node metastasis (P=0.008),and extra thyroidal extension (ETE) (P=0.035) were related factors affecting postoperative recurrence,while gender,age,Hashimoto's thyroiditis,tumor TNM stage,central lymph node metastasis and surgical approach were not related to postoperative recurrence.COX multivariate analysis showed that multiple lesions (HR:8.815,P=0.010) was the independent factor influencing the prognosis of pediatric differentiated thyroid carcinoma.Conclusions Multiple lesion is an independent influencing factor for the recurrence of pediatric differentiated thyroid carcinoma patients after surgery.Meanwhile,total thyroidectomy and long-term follow-up should be followed.Although the metastasis rate of lymph node and distant organ are high,overall prognosis is good in pediatric DTC.

15.
International Journal of Surgery ; (12): 857-861, 2019.
Article in Chinese | WPRIM | ID: wpr-823542

ABSTRACT

Exosomes are tiny vesicles produced in cells which sizes between 40 to 100 nm.Exosomes are carriers of cell signal transduction.Thyroid cancer is the common malignant tumor in endocrine system.Exosomes show the regulatory role in thyroid cancer about occurrence,development and metastasis.This review focuses on the relevant characteristics of exosomes and the research progress of exosomes in thyroid cancer.

16.
International Journal of Surgery ; (12): 814-818, 2019.
Article in Chinese | WPRIM | ID: wpr-823533

ABSTRACT

Objective To explore the effectiveness and safety of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules.Methods We analyze 573 patients with thyroid benign nodules from June 2014 to September 2017 treated by RFA at Department Ⅱ of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University.Among these patients,there were 75 males and 498 females,with a median age of 45 years old.All patients were diagnosed as thyroid benign nodules by ultrasound-guided fine needle aspiration biopsy before RFA.A total of 750 benign tumors were treated.To evaluate the thyroid function of the patients before RFA and 3 months after it,and to observe the changes of thyroid benign nodules by ultrasound at 3,6,12 months after RFA.The paired t-test was used to compare the measurement data with normal distribution,and Wilcoxon's signed rank test was used to compare the measurement data with non-normal distribution.To calculate the volume change and reduction rate of thyroid benign nodules.Results RFA was successfully completed in all patients,the volume reduction rate was 67% (48%,83%) in the 3rd month after RFA,in the 6th month was 81% (67%,91%),in the 12th month was 89% (80%,95%).Eighteen patients felt pain during RFA,but the pain was alleviated after stopping ablation.Three patients' tone decreased,but recovered in a week.Hoarseness occurred in 6 patients and recovered in 3 months.Three patients had neck hemorrhage,which was managed with simple compression of the neck.Conclusions RFA is an effective and safe treatment for thyroid benign nodules and has obvious advantages such as less invasiveness,having no influence in thyroid functions.It is clinically prospective for application.

17.
Chinese Journal of Endocrine Surgery ; (6): 139-143, 2019.
Article in Chinese | WPRIM | ID: wpr-743415

ABSTRACT

Objective To analyze the clinical features of medullary thyroid carcinoma(MTC) and the risk factors of cervical lymph node metastasis.Methods A retrospective analysis of 84 cases of thyroid surgery in the First Affiliated Hospital of Zhengzhou University from Jan.2012 to Jun.2018 and confirmed by routine pathology as MTC patients was performed.Chi-square test and logistic regression were used to analyze patients' age,gender,clinical features such as tumor diameter,number of lesions,and invasion of the capsule and risk factors associated with cervical lymph node metastasis.Results Statistical analysis found that the incidence of lymph node metastasis significantly increased in patients with central region ≥ 1 cm (x2=4.196,P=0.041),multiple lesions (x2=5.946,P=0.015),and thyroid capsule invasion (x2=15.277,P<0.001) and the difference was statistically significant.The incidence of cervical lymph node metastasis was significantly higher in patients with the tumor diameter ≥ 1 cm(x2=5.269,P=0.022),multiple lesions(x2=4.550,P=0.033),and thyroid capsule invasion(x2=19.253,P<0.001) and the difference was statistically significant.Logistic regression analysis showed that thyroid capsule invasion was an independent risk factor for central lymph node metastasis (OR=7.551,P=0.001) and cervical lymph node metastasis (OR=8.067,P<0.001).Of the 84 patients who received calcitonin before surgery,56 patients had preoperative calcitonin>200 pg/ml,and the cervical lymph node metastasis rate was 55.4% (31/56).28 patients had preoperative calcitonin<200 pg/ml,and the cervical lymph node metastasis rate was 28.6% (8/28).The former increased and the difference was statistically significant.Of the 18 patients who underwent preoperative detection of carcinoembryonic antigen (CEA),8 patients had CEA>30 ng/ml,cervical lymph node metastasis was 75% (6/8);10 patients had CEA<30 ng/ml,and the cervical lymph node metastasis was 60%(6/10).Conclusions Higher cervical lymph node metastasis is a clinical feature of MTC.For patients with thyroid capsule invasion,the risk of cervical lymph node metastasis is significantly increased,and prophylactic cervical lymph node dissection is required.Preoperative detection of calcitonin and CEA can be used to diagnose MTC and predict lymph node metastasis.The cervical lymph node dissection can be considered with reference to the concentration.

18.
Chinese Journal of Endocrine Surgery ; (6): 9-12, 2019.
Article in Chinese | WPRIM | ID: wpr-743387

ABSTRACT

Objective To study the association between serum thyroglobulin antibody(TgAb) and the risk of thyroid cancer (TC) in patients with thyroid nodule (TN).Methods The determination of benign and malignant TN was based on routine pathological biopsy of postoperative thyroid tissues.Serum TgAb level of 1257 patients with TN undergoing surgery from 1st Sep.2015 to 31st Dec.2016 was determined by electrochemiluminescence immunoassay.A retrospective cohort analysis was performed.The correlation between the serum TgAb level and the benign or malignant rate of thyroid nodule was determined by Pearson Chi-square test.Results Among the 1257 patients,there were 196 patients whose TgAb level was high.Among these 196 patients,there were 94 patients with benign TN,with the benign rate of 47.96% and there were 102 patients with malignant TN,with the malignant rate of 52.04%.There were also 1061 patients whose TgAb level was normal,among these 1061 patients,there were 654 patients with benign TN,with the benign rate of 61.64% and there were 407 patients with malignant TN,with the malignant rate of 38.36%.For papillary thyroid carcinoma(PTC)patients,x2=23.101 9,OR=1.7218,the 95% CI of OR was(1.382 9,2.375 4).For follicular thyroid carcinoma(FTC) patients,x2=0.287 5,P>0.01.For medullary thyroid carcinoma (MTC) patients,P=0.048 9>0.01.Conclusions Among patients with TN,PTC rate of the patients whose serun TgAb level is high is higher than patients whose serum TgAb level is normal.But among the patients with TN,we do not think that FTC and MTC rate of patients whose serun TgAb level is high is higher than patients whose serum TgAb level is normal.

19.
Chinese Journal of Trauma ; (12): 260-265, 2018.
Article in Chinese | WPRIM | ID: wpr-707301

ABSTRACT

Objective To investigate the protective effect of thyroid hormone on spinal cord injury neurons and its molecular mechanism.Methods A DMEM culture medium with a volume fraction of 10% fetal bovine serum was cultured with the dorsal ridge neurons of RN-dsc rats.The neurons were inoculated in the culture plate after the digestion of trypsin and treated differently as follows:(1) control group:DMEM treatment with no drugs or serum;(2) H2O2 group:serum-free DMEMtreatment containing 100 μmol/L H2O2;(3) H2O2 + 10-6 mol/L triiodothyronine (T3) group:serumfree DMEM treatment containing 100 μnol/L H2O2 and 10-6mol/L T3;(4) H2O2 + 10-5 mol/L T3 group:serum-free DMEM treatment containing 100 μ mol/L H2O2 and 10-5 mol/L T3;(5) negativecontrol group:transfection of negative control mimics with LipofectamineTM2000 reagent;(6) miR-210 group:transfection of miR-210 mimics with LipofectamineTM 2000 reagent.Cell viability,apoptosis number,and expressions of nuclear factor E2 correlation factor 2 (Nrf-2) antioxidant pathway molecules and miR-210 were determined.After transfection of miR-210 mimics and negative control mimics,expressions of Nrf-2 antioxidant pathway molecules were determined.Results The cell proliferation activity and protein expressions of Nrf-2,antioxidant reaction elements (ARE),superoxide dismutase 2 (SOD2),and heme oxygenase (HO-1) in H2O2 group (0.39 ±0.06,0.52 ±0.08,0.31 ±0.08,0.25 ± 0.05,respectively) were significantly lower than those in control group (1.00 ± 0.15,1.00 ± 0.17,1.00 ± 0.13,1.00 ± 0.11,respectively) (P < 0.05),while the apoptosis numbers and the expressions of miR-210 were significantly higher than those in control group (P < 0.05).The cell proliferation activity and protein expressions of Nff-2,ARE,SOD2,HO-1 in H2O2 + 10-6mol/L T3 group and H2O2 +10-5 mol/L T3 group were significantly higher than those in the H2O2 group (P < 0.05),while apoptosis numbers and expressions of miR-210 were significantly lower than those in H2O2 group (P < 0.05).The cell proliferation activity and protein expressions of Nrf-2,ARE,SOD2,HO-1 in H2O2 + 10-5mol/L T3 group (0.88 ±0.14,0.84 ±0.12,0.72 ±0.09,0.69 ±0.09) were significantly higher than those in H2O2 + 10-6mol/L T3 group (0.73 ±0.09,0.71 ±0.08,0.58 ±0.09,0.52 ±0.08) (P<0.05),while apoptosis numbers and expressions of miR-210 were significantly lower than those in H2O2 + 10-6mol/L T3 group.The protein expressions of Nrf-2,ARE,SOD2,and HO-1 in miR-210 group (0.37 ±0.06,0.24 ±0.05,0.45 ± 0.08,0.49 ± 0.07,respectively) were significantly lower than those in negative control group (1.00±0.13,1.00±0.19,1.00±0.15,1.00±0.14,respectively) (P<0.05).Conclusion Thyroid hormone can inhibit the expression of Nrf-2 in oxidative stress injury process of neurons by inhibiting the expression of miR-210,and hence reduce the oxidative stress injury of spinal cord neurons.

20.
International Journal of Surgery ; (12): 269-272, 2018.
Article in Chinese | WPRIM | ID: wpr-693232

ABSTRACT

Objects To investigate the therapeutic schemes and factors that influences survival of the patients with anaplastic thyroid carcinoma (ATC).Methods The clinical data of 21 cases with ATC admitted in First Affiliated Hospital of Zhengzhou University from Jan.2009 to Nov.2013 were analyzed retrospectively.Explored patients survival rates according to the age,the gender,the white cell count,the therapeutic scheme (surgery plus radiotherapy,surgery alone),the operation mode (radical surgery,palliative surgery).SPSS 21.0 software was used for statistical processing,and Kaplan-Meier was used to calculate the survival rate,the Log-Rank was uesd for the difference test.Results The overall survival rates of the 1-,3-and 5-year were 42.9%,28.6%,and 4.8% respectively.A significant difference had been found in the 5-year survival rate between the group of surgery coupled with postoperative chemoradiotherapy(7.1%) and the group of surgery alone(0) (P < 0.05).So it was the same between the group of radical surgery (8.3%) and the group of palliative surgery (0) (P <0.05).And a clear break point of the white blood cell count(1.0 × 1010/L) had demonstrated the significant difference of the 5-year survival rate between the groups of both sides,while the lower group (11.1%) could be much higher (P <0.05).Conclusions The prognosis of ATC is very poor,and the group the patients with higher white cell count (≥ 1.0 × 1010/L) can be even poorer.Compared with palliative surgery,radical surgery can improve the survival rate.Compared with surgery alone,surgery coupled with postoperative chemoradiotherapy can improve the survival rate signifantltly.

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