Comparison of the efficacy and safety of anterior small incision approach and modified Miccoli endoscope assisted thyroidectomy in the treatment of benign thyroid tumor / 临床外科杂志

Objective To compare and analyze the clinical efficacy and safety of anterior small incision approach and modified Miccoli endoscope assisted thyroidectomy in the treatment of benign thyroid tumor.Methods A total of 66 cases with benign thyroid tumor were enrolled in our hospital from Apiil 2014 to April 2017,and divided into two groups according to different surgical methods.The 31 patients who underwent modified Miccoli endoscope assisted surgery was made as the observation group and the 35 patients who underwent anterior neck small incision approach was made as the control group.The operation,cosmetic satisfaction,visual analogue scale (VAS) at 6 hour,12 hour and 24 hour after operation,the incidence of postoperative complications and the voice handicap index (VHI) of the two groups were recorded and analyzed.Results ①The operation time,hospitalization time,intraoperative blood loss in the observation group were(44.68 ± 23.30) mins,(3.28 ± 1.69) dsys and (43.57 ± 23.73) mL,respectively,which were lower than those[(59.43 ± 30.61) mins,(4.36 ± 1.42) days and (59.43 ±30.61)mL] in the control group(P ＜ 0.05).The hospitalization expense in the observation group was (9.73 ± 1.22) KRMB,which was higher than that [(5.83 ± 1.35) KRMB] in the control group (P ＜0.05).②The degree of cosmetic satisfaction in the observation group was 96.77％,which was significantly higher than 80％ in control group(P ＜0.05).③The score of VAS at 12 hour and 24 hour in the observation group were(3.11 ± 0.55)and (1.63 ± 0.21)respectively,which were significantly lower than those [(4.17 ± 0.73) and (2.59 ± 0.36)] in the control group (P ＜ 0.05).④The incidence of postoperative complications in the observation group was 6.45％,which was statistically insignificant when compared with that (11.43 ％) in the control group (P ＞ 0.05).⑤The VHI in the observation group was (0.70 ±0.45),which was statistically insignificant when compared with that(0.65 ± 0.39) in the control group (P ＞ 0.05).Conclusion For patients with benign thyroid tumors,the modified Miccoli endoscope assisted surgery and anterior small incision approach are both safe and effective.The former has the advantages in shortening the operation time and hospitalization time,reducing the blood loss and promoting the cosmetic effect,but it may increase the hospitalization expenses.

Inflammation-related signaling pathways of differently-methylated DNA from benign and malignant ;thyroid tumors in one patient / 实用医学杂志

Objective To determine the possible differences in DNA methylation of benign and malignant thyroid tumors and its role in tumorgenesis and tumor progression. Methods Infinium human methylation 450 bead chip platform was utilized to screen the whole-genome of benign and malignant thyroid tumor tissues surgically removed from a patient for the determination of their DNA methylation levels. The genes with significant differences in methylation were analyzed for their functional pathways with bioinformatics. Results There were significant differences in DNA methylation between benign and malignant thyroid tumor. The inflammation-related pathways, such as T cell, Jak-STAT and cytokine-cytokine receptor signaling pathways involved in the biological process of tumorgenesis and tumor progression. Conclusions The differences in DNA methylation between benign and malignant reveal a close relationship between inflammation and tumorgenesis and tumor progression and provide a novel method for investigation of thyroid cancer development and target drug discovery.

The serum TSH,TgAb,TpoAb value to the diagnosis of thyroid diseases / 重庆医学

Objective To investigate the serum levels of Thyroid stimulating hormone (TSH ) ,Thyroglobulin antibody (TgAb) and Peroxidase antibodies(TpoAb) in patients with different thyroid diseases and to explore the relationship between the 3 indexes with thyroid diseases .Methods 383 cases of thyroid diseases were divided into six groups ,simple adenoma of throid group(TA , n=30) ,nodular goiter group(NG ,n=59) ,papillary thyroid hyperplasia group(PTH ,n=36) ,nodular goiter with adenoma group (NG+ TA ,n=196) ,hashimoto′s thyroiditis(HT ,n=13) ,throid carcinoma group(TC ,n=49) .The relationship between concentra-tion of FT3 ,FT4 ,TSH ,TgAb ,TpoAb in serum and thyroid diseases incidence was analyzed .Results (1)The serum TSH concen-tration had statistically sinificance between group HT with group TA and NG ,group PTH and TA+NG group(P<0 .05) .Despite the concentration of serum TSH in TC group was in a high level near to the upper limit ,there was no statistically significance ver-sus other groups .(2)In group HT and TC ,the increased rate of TSH and positive rate of TgAb and TpoAb were significantly high-er than in group BT (P<0 .05) .(3)The double positive rate of TgAb and TpoAb ,the single positive rate of TpoAb in group HT and TC were higher than those in group BT (P<0 .05) .Conclusion There was a close correlation between serum TSH ,TgAb , TpoAb concentration and thyroid disease ,especially closely associated with HT and TC .Raised TSH and TpoAb positive have im-portant reference value in diagnosis of TC .

Research on the efficacy of endoscopic resection of thyroid benign tumor / 中国基层医药

Objective To observe the efficacy of endoscopic resection with thyroid benign tumor. Methods 60 cases of thyroid benign tumor were randomly divided into the endoscopic group and the traditional group, 30 cases in each group. The operation time, blood loss ,drainage volume, postoperative hospital stay, postoperative complications and hospitalization expenses in two groups were compared. Results There was no significant difference ( P >0. 05) between the two groups of postoperative hospital stay; endoscopic group blood loss (25.3 ± 15.6) ml significantly less than the traditional group (57. 2 ± 33. 8) ml, the difference was statistically significant ( P < 0. 05); endoscopic postoperative drainage volume ( 85.6 ± 53.2) ml significantly more than the traditional group ( 23. 5 ±37.2) ml (P < 0. 05); endoscopic operative time of ( 105.3 ± 23. 5) min, while the traditional group ( 80. 4 ±25. 3 ) min, the difference was significant ( P < 0. 05 ); hospitalization costs were significantly higher than conventional endoscopy group ( P < 0. 05). Both groups were not have obvious complications postoperation. Conclusion Compared with traditional open surgery, endoscopic surgery for benign thyroid tumors has advantages of superior cosmetic results and less bleeding,it is a good choice for the treatment of the disease.