Metastasis of liver cancer to the thyroid after surgery: A case report.

BACKGROUND: Secondary thyroid malignancies are rarely reported, especially thyroid metastasis after resection of hepatocellular carcinoma (HCC). We report a patient with thyroid metastasis after resection of HCC. CASE SUMMARY: A 42-year-old female underwent partial hepatectomy for HCC three years ago. She attended hospital because of neck discomfort. After various examinations, she was diagnosed with metastatic HCC. She survived after surgical resection of the affected side of the thyroid. CONCLUSION: Although secondary malignant tumor of the thyroid is classified as distant metastasis, surgical resection is still necessary according to the patient's condition.

Gastric plexiform fibromyxoma: A case report.

BACKGROUND: Plexiform fibromyxoma (PF) is a rare mesenchymal tumor of the stomach. The clinical features of PF frequently include upper abdominal pain, abdominal discomfort, hematemesis, melena, pyloric obstruction and an upper abdominal mass. We herein report a case of PF resected by laparoscopic radical distal gastrectomy plus Roux-en-Y gastrojejunostomy. CASE SUMMARY: The patient was admitted to hospital, due to a 1-wk history of an abdominal space-occupying lesion identified during a health examination. He underwent complete resection by laparoscopic radical distal gastrectomy plus Roux-en-Y gastrojejunostomy. During the operation, the tumor was located in the anterior wall of the gastric antrum (approximately 7 cm × 6 cm × 5.5 cm) and did not show evidence of invasion of the serosa. Histology showed that the tumor cells were oval fibroblast-like and spindle-shaped cells, with numerous thin-walled blood vessels and abundant myxoid stroma. Cellular atypia and mitosis were both rare. Immunohistochemistry showed that the tumor cells were immunoreactive for smooth muscle actin, S-100 and CD-10, but were negative for CD-117, CD-34, DOG-1, and ALK. In this case, S-100 was positive and no significant disease was observed during the follow-up period. CONCLUSION: The fact that PF is a rare tumor with only a few cases in this region can lead to misdiagnosis of this entity and pose a real diagnostic challenge for general surgeons and pathologists when encountering such patients and differentiating PF from other primary tumors of gastric mesenchymal origin. Our report may help increase awareness of this rare, but important new disease entity.

[An ambispective cohort study of the natural history of HIV infection among former unsafe commercial blood and plasma donors].

OBJECTIVE: Discussing the natural history and the influencing factors of HIV infection among former commercial blood and plasma donors engaged in unsafe blood donation practices in China. METHODS: Using ambispective cohort study, with data obtained from ten counties (districts) from six provinces in the National AIDS Control Demonstration Area. HIV/AIDS cases were found and confirmed prior to July 24, 2006 being former commercial blood. Plasma donors were selected and data regarding infection, incidence, death, and influencing factors was collected. Analysis was performed using SPSS 12.0 statistical analysis software. RESULTS: (1) In 7551 cases of HIV infection, there were 6533 typical progressors (86.52%, 4757 cases of AIDS), 108 rapid progressors (1.43%), 910 long-term non-progressors (12.05%) with 4865 cases progressed to AIDS (64.43%). The median incubation period for HIV progression to AIDS was nine years (95% CI:8.96-9.04). (2) According to data, from a total of 1157 AIDS cases without ARV therapy (23.78% of total AIDS cases), there were 283 confirmed AIDS-related deaths, of which the median survival time was 6 months (95% CI:4-7) and the two and three year fatality rates were 95% and 99%, respectively. (3) The duration of HIV incubation period was irrespective to gender and age at the time of HIV infection (P > 0.05). Length of survival for untreated AIDS showed correlation to gender (P < 0.05) but no correlation with culture, marital status or age at the time of diagnosis of AIDS (P > 0.05). CONCLUSION: Compared with the UNAIDS theory regarding slow disease progressors among adults, our study showed a longer AIDS incubation period and shorter outlook for untreated survival, but a similar incubation period for other routes of HIV infection.

Chinese pediatric highly active antiretroviral therapy observational cohort: a 1-year analysis of clinical, immunologic, and virologic outcomes.

BACKGROUND: Few data are available on the outcomes of pediatric antiretroviral therapy (ART) in the developing world. METHODS: Eighty-three children were followed prospectively in China from July 2005 to August 2006 and received (zidovudine or stavudine) plus lamivudine plus (nevirapine or efavirenz). RESULTS: Fifty-one children were ART naive at enrollment, and 32 were ART experienced. After 12 months, median weight increased by 0.3 weight for age z-score, median CD4 count increased from 116 to 340 cells/mm (P < 0.0001), and median viral load decreased from 5.53 to <2.60 log10 copies/mL (P < 0.0001) in the previously ART-naive children. In the ART-experienced children, median CD4 count increased from 193 to 318 cells/mm (P = 0.13), despite little change in median viral load (4.85 to 4.58 log10 copies/mL; P = 0.83). The viral load was <400 copies/mL in 55% of the previously ART-naive children and in 16% of the ART-experienced children. CONCLUSIONS: Weight and CD4 cell counts improved, and more than half of previously ART-naive patients had undetectable viral loads at 1 year. Future efforts should focus on improved virologic suppression through improved adherence and access to second-line regimens.

[Study on the seropositive prevalence of human immunodeficiency virus in a village residents living in rural region of central China].

OBJECTIVE: To study the human immunodeficiency virus (HIV) prevalence of residents living in a village located in rural region of central China where the paid blood donors used to be popular. METHODS: All residents of one village "ZY" were asked to participate in HIV serologic screening test. Those over the age of 16 and participated in HIV serologic test was followed to undergo an indoor interview a week later, to finish a questionnaire, which including information on demography, marital status, smoking and drinking habits, history of blood donation, sexual behavior and history of drug use. Names on those either died from AIDS or having HIV serologic testing before were collected from local hospitals and the Center of Disease Control and Prevention. RESULTS: There were in total 2364 residents in 527 households in "ZY" village including 1551 residents participated in the HIV serologic screening test, and 926 completed questionnaires. A total of 115 HIV seropositive residents were found in the HIV screening. 5 had been undergone HIV screening tests before, and 24 died of AIDS. The HIV prevalence of the whole population was 9.1% (CI: 7.7% - 10.6%). There were 19.6% households had at least one member living with HIV, out of which 25% had over two HIV seropositive members. No significant difference was found between genders with respect to HIV prevalence. 40 - 50 years old group had the highest HIV prevalence, significantly differed from other age groups. The HIV prevalence among former paid blood donors was 22.4%. The proportions of getting HIV infection through routes of blood transfusion, sex and mother-to-child, were 0.9%, 9.6% and 5.2% respectively among 115 HIV seropositive residents. CONCLUSION: Some villages in the rural regions of central China showed high HIV prevalence. Former paid blood donation was responsible for the main transmission route in these villages. However, sexual transmission and mother-to-child transmission were becoming dominant routes in general population which called for effective action be taken to contain the spread of HIV.