1.Diagnosis and treatment of aberrant thyroid cancer
Mingbo WEN ; Yunyang WU ; Youjiang CHEN ; Xiangfei DING ; Binhua TANG ; Kuiping ZHOU
Chinese Journal of General Surgery 2000;0(11):-
Objective To study the pathogenic features, diagnosis and treatment of aberrant thyroid cancer.Methods A retrospective analysis of clinical and pathological data of 29 cases of aberrant thyroid cancer was made.Results All of the 29 patients underwent operative treatment and postoperative adjuvant radiation therapy and chemotherapy. On postoperative follow up, the 5-year survival rate was 52.0%. The longest survivor patient was alive 24 years after operation.Conclusions The key to increase the survival rate of patients is early detection and timely surgical treatment. Postoperative adjuvant radiation therapy and chemotherapy are conducive to increase survival rate.
2.Effects of fluid restriction in combination with small dose of norepinephrine on cerebral oxygen metabolism in elderly patients undergoing gastrointestinal surgery
Xiaodong QIU ; Binhua JU ; Hui YE ; Xinjian LU ; Liang JING ; Wenhao TANG
Chinese Journal of Anesthesiology 2015;35(6):656-659
Objective To evaluate the effects of fluid restriction in combination with small dose of norepinephrine on cerebral oxygen metabolism in elderly patients undergoing gastrointestinal surgery.Methods Forty elderly patients of both sexes,aged 65-80 yr,with body mass index of 18-24 kg/m2,of ASA physical status Ⅰ or Ⅱ (NYHA Ⅰ or Ⅱ),with left ventricular ejection fraction≥50%,undergoing elective gastrointestinal surgery,were randomly divided into 2 groups (n =20 each) using a random number table:routine fluid administration group (group S) and restricted fluid administration + small dose of norepinephrine group (group RN).In group S,lactated Ringer's solution was given routinely,ephedrine 5 mg (per time) was injected intravenously,and MAP was maintained ≥ 65 mmHg during operation.In group RN,lactated Ringer's solution was infused intravenously at 5 ml · kg-1 · h-1 starting from 30 min before anesthesia,norepinephrine was infused intravenously at 0.01-0.03 μg · kg-1 · min-1 after induction of anesthesia,and MAP was maintained ≥ 65 mmHg.Intraoperative blood loss was replaced with the equal volume of 6% hydroxyethyl starch 130/0.4 sodium chloride injection in both groups.At 5 min before skin incision,1 and 2 h after skin incision and postanesthesia care unit discharge time,arterial and jugular bulb venous blood samples were obtained for blood gas analysis,and arterial oxygen content,jugular bulb venous oxygen content,arteriovenous oxygen content difference,cerebral oxygen extraction rate,and the ratio of cerebral blood flow to cerebral oxygen metabolic rate were calculated.Results There were no significant differences between the two groups in arterial oxygen content,jugular bulb venous oxygen content,arteriovenous oxygen content difference,cerebral oxygen extraction rate,and the ratio of cerebral blood flow to cerebral oxygen metabolic rate.Conclusion Fluid restriction combined with small dose of norepinephrine produces no effects on cerebral oxygen metabolism in elderly patients undergoing gastrointestinal surgery.