Evaluation of the clinical value of carbon nanoparticles as lymph node tracer in differentiated thyroid carcinoma requiring reoperation.

BACKGROUND: The incidence of parathyroid injury in patients with differentiated thyroid carcinoma (DTC) who underwent reoperation is significantly higher than that incurred from the initial surgery. The aim of this study was to investigate the clinical value of carbon nanoparticles (CN) as tracers for lymph nodes to guide cervical lymph node dissection and protect the parathyroid during reoperation for DTC. METHODS: Our study recruited 116 patients with DTC who previously underwent thyroidectomy and later received remedial surgical treatment at the Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital, China, between February 2011 and February 2014. Those patients were randomly divided into the experimental group (the CN group) with 64 cases and the control group with 52 cases. Carbon nanoparticle suspension (CNS, 0.1-0.3 ml) was intraoperatively injected into the residual thyroid or enlarged lymph nodes in the CN group; in the control group, CNS was not applied intraoperatively. The differences in identification of the parathyroid glands, the number of lymph nodes resected intraoperatively, and the incidence of common complications after thyroidectomy in both groups were recorded and analyzed. RESULTS: The accuracy of identification of the parathyroid in the CN group and control group was 92.2 % and 28.8 %, respectively, and the identification rate of three glands or more in both groups was 75 % and 36.5 %, respectively; those differences were statistically significant between the two groups (P < 0.05). There was also a significant difference between the two groups in the number of lymph nodes removed in the central and lateral cervical compartments (P < 0.05). There was no increase in common complications after the second surgery compared with the previous surgery; in addition, there was a decline in the incidence of transient hypoparathyroidism (HPT) (P < 0.05). CONCLUSIONS: By tracing the thyroid and cervical regional lymph nodes with carbon nanoparticles, the parathyroid glands can be easily identified and protected to reduce the complications of transient hypoparathyroidism resulting from reoperation for residual or missed DTC. Carbon nanoparticle tracers also facilitate radical resection of lymph nodes at the central and lateral compartments of the neck.

The expression and clinical significance of CXCR3/CXCL10 in human breast cancer / 中国医师杂志

Objective To investigate the expression and clinical significance of CXCR3/CXCL10in human cancer.Methods CXCR3 and CXCL10 were detected in 60 paraffinic tissues of patients with primary breast cancer,20 of mammary fibroma and 20 of mastopathy by immunohistochemistry S-P method and two stage method.Results The expression of CXCR3 (40/60,66.7％ ) and CXCL10 (45/60,75％)in breast cancer was higher than that in mastopathy [CXCR3(8/20,40％ )x2 =4.44,P =0.035 ;CXCL10( 10/20,50％ )x2 =4.36,P =0.037)].The expression of CXCR3 was related to status of axillary lymph node metastasis,clinical stage and the expression of HER-2 (x2 =4.15,P =0.042; x2 =7.74,P =0.021 ;x2 =4.27,P =0.039).The expression of CXCR3 had positive relationship to the number axillary lymph node metastasis( rs =0.375,P =0.003 ),clinical stage ( rs =0.451,P =0.000).Conclusions CXCR3 may be related to the progression and metastasis of breast cancer,and it may be used as a marker of breast cancer prognosis.

Early diagnosis of colonic anastomotic leakage by detecting bacterial DNAs in rots with PCR / 中国医师杂志

Objective To asses the value of detecting bacterial DNAs in rat's blood with PCR for early diagnosis of colonic anastemotic leakage.Methods 48 healthy female Wistar rats were random divided into three groups: Group A(n=8,sham operation group),Group B(n=20,colonic anastomosis group),Group C(n=20,colonic anastomotic leakage group).Group B and C rats underwent standardized colon resection 3cm away from the ileocecal junction 10cm,Group B rats were done with a complete anastomosis(end-to-end single layer anastomosis with 0# silk sutures) while Group C rats were done with an anastomosis leaving a 5mm opening in colonic anterior wall.lml and 3ml venous blood samples were collected from Group A,B and C.DNAs were extracted from these blood samples and PCR techniques were used to amplify lacZ genes from Escherichia coli and 16S ribosomal RNA genes(16SrRNA genes) 3 days after operation.The data were analyzed by chi square test.Specimens of the experimental intestine were HE stained for pathological studies.Results The positive ratios of expressing lacZ genes in peripheral blood(PB) with PCR in Group C were significantly higher than that in Group B(P<0.05),hut there were no differences between the two groups in expressing 16SrRNA genes(P>0.05).Conclusions It could be a useful way to detect lacZ genes of Escherichia coli from PB by PCR but not 16SrRNA genes for diagnosis of colonic anastomotic leakages.

Predictable value of PCR in detecting bacterial DNAs for early diagnosis of jejunal anastomotic leakage and ileal anastomotic leakage in rats / 中国普通外科杂志

0.05),but the positive ratio of 16SrRNA genes expression in PB in Group C and Group E was significantly higher than that in group B and Group D respectively(P0.05).Conclusions(1)Detecting 16SrRNA genes from PB with PCR has certain significance for early diagnosis of jejunal anastomotic leakage and ileal anastomotic leakage,(2)PCR might be a useful tool for early diagnosis of jejunal anastomotic leakages and ileal anastomotic leakages by detecting lacZ genes or 16SrRNA genes from ascites.