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Objective To compare the efficacy,safety and cost between ultrasound-guided percutaneous microwave ablation and surgical resection in patients with papillary thyroid microcarcinoma.Methods A total of 89 patients highly suspected papillary thyroid microcarcinoma by cervical ultrasonography were proved by ultrasound guided fine-needle aspiration biopsy in The Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to February 2017.Totally 49 patients underwent microwave ablation(microwave group)while 40 patients underwent surgical resection(surgical group).T test was used to compare operation time,hospitalization expenses and the hospitalization time between the microwave group and the surgical group.Chi-squared test was applied to compare complications rate between the two groups.T test was used to compare the level of thyroid-related hormone before and after operation in the two groups.Results In the microwave group,the operation time,the hospitalization expenses and the hospitalization time were less [(55.85±5.05)min vs(25.73±9.46)min,(25435.91±5763.35)CNY vs(11307.48±3884.62)CNY and(6.78±3.03)d vs(2.92±0.78)d].These differences were statistically significant(t=-18.985,-13.084 and-7.747,P＜0.001).No severe complications occurred in the two groups.The difference of complications rate between the two groups was not statistically significant [6.1%(3/49)vs 10.0%(4/40),χ 2=-0.452,P=0.779].The level of 3'-triiodothyronine(FT3)and 4'-triiodothyronine(FT4)were higher after the operation in the microwave group,but these differences were not statistically significant.The level of FT3 and FT4 were lower [(4.5±0.50)pmol/L vs(3.90±0.72)pmol/L,(13.94±2.41)pmol/L vs(12.69±2.88)pmol/L],while the level of TSH was higher [(3.66±6.29)mIU/L vs(10.12±15.61)mIU/L] after operation in the surgical group.These differences were statistically significant(t=6.214,P＜0.001; t=2.808,P=0.008; t=-3.035,P=0.004).Conclusions Ultrasound-guided percutaneous microwave ablation is characterized by minimal invasion,good cosmetic effect,low cost and definite curative effect.It offered a new choice for the patients who refuse to undergo surgical resection.
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Objective To investigate the effect of local mild hypothermia on the cerebral hemodynamic parameters,plasma Endothelin-1 (ET-1s) and calcitonin gene-related peptide (CGRPs) of the subarachnoid hemorrhage patients (SAH).Methods Sixty patients were divided randomly into local mild hypothermia group and control group (n =30 patients each group).The middle cerebral artery average blood flow rates (VMCAs) and pulse index (PIs) were detected with transcranial Doppler (TCD),plasma ET-1 s and CGRPs were tested on the D1,D7,D10,and D14,respectively.Results The VMCAs in the mild hypothermia group were lower on the D7,D10,and D14 [7 d:(95.46 ±22.48)cm/s vs (110.35 ±32.38) cm/s,t =2.07,P ＜ 0.05 ; 10 d:(85.57 ± 17.47) cm/s vs (97.64 ± 20.55) cm/s,t =2.45,P＜0.05 ;14 d:(57.16 ± 14.36)cm/s vs (70.56 ± 19.42) cm/s,t =3.04,P ＜ 0.01],PIs and plasma ET-1s were lower on the D10 and D14 compared with the control group [PIs:10 d:0.76 ±0.21 vs 0.88±0.25,t =2.01,P ＜0.05;14 d:0.72±0.18 vs 0.84 ±0.19,t =2.51,P ＜0.05] [ET-1s:10 d:(71.37 ± 16.63) pg/ml vs (81.46 ±21.38)pg/ml,t =2.04,P ＜0.05 ;14 d:(55.73 ± 15.18) pg/ml vs (68.28 ± 20.57) pg/ml,t =2.69,P ＜ 0.01].Plasma CGRPs were higher compared with the control group on the D7,D10,and D14 [7 d:(26.55 ±6.45)pg/ml vs (23.64 ±4.56)pg/ml,t =2.02,P ＜0.05;10 d:(24.15 ±7.35)pg/ml vs (20.52 ±6.18) pg/ml,t =2.07,P ＜0.05;14 d:(30.37 ±6.28)pg/ml vs (26.88 ± 4.39) pg/ml,t =2.49,P ＜ 0.05].Conclusions The mild hypothermia treatment could reduce the plasma ET-1s,improve plasma CGRPs,and improve the prognosis of the patients.
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Objective To observe the curative effect of simvastatin to treat carotid atheroma. Methods 106 patients with carotid atheroma were randomly divided into two groups. The treatment group( n=56) was given orally 20 micro-gram of simvastatin every night, while the matched control group( n = 50) was given 100 microgram of aspirin enteric-coated everyday for 4 months. Results After four months of follow-up, the carotid artery inner-intermediate thickness and the speckle's size,examined by the color Doppler, were obviously decreased ( P 0.05). Conclusion Simvastatin can obviously ameliorate the carotid atheroma. It can be served as one of the normal selections for treating the carotid atheroma.