Objective To evaluate the clinical value and experience of endoscopic thyroidectomy.Methods Thyroidectomy with endoscopic instruments through chest-wall approach was done for 52 patients who had thyroid adenoma nodular goiter or thyroid cancer.We observed the results and complications of these operations.Results All 52 cases of operation were successful with no conversion.There was no nerve damage or postoperative hemorrhage.Average operation duration was (100 ± 22) min.The mean time of hospitalization after operation was (3 ± 0.5) d.Conclusion With the advantages of minimal and hidden incision,sooner recovery and satisfactory cosmetic effect,the endoscopic thyroidectomy will prevail in selected cases in the future.

Objective The aim of this study was to evaluate the individual and combined diagnostic value of five tumor markers in the elderly patients with pleural effusion. Methods Serum and pleural levels of cytokeratin fragment19(CYFRA21 1), neuron specific enalase(NSE), carbohydrate antigen15 3(CA15 3), carbohydrate antigen19 9(CA19 9) and carbohydrate antigen 125(CA125) were assayed in 32 elderly patients with malignant pleural effusions resulting from advanced lung cancer and in 30 elderly patients with benign pleural effusions by ELISA. Results Serum levels of CYFRA21 1, NSE, CA15 3, CA19 9 and CA125 in patients with malignant pleural effusions were (12 84?6 48) ?g/L, (22 07?11 25) ?g/L, (65 74?30 26) kU/L, (56 32?25 67)kU/L and (71 86?31 45) kU/L, respectively and were significantly higher than those patients with benign pleural effusions (P

0. 05). However, the serum CYFRA21-1 level was related to the histologic classification (P

ObjectiveTo evaluate the effectiveness and safety of high frequency electronic associating stents insertion and subsequent radiotherapy guided by fiberoptic bronchoscope in treating tracheobronchial stenosis caused by lung and esophagus carcinoma.MethodsFifty-two patients which were ascertained with serious stenosis in trachea or bronchi by fiberoptic bronchoscope were subjected to the study.Fiberoptic bronchoscope was used to investigate the location,extent,blood supply and the degree of tracheobronchial stenosis before the study.After the focus in the airways was cleared up with high frequency electronic,electrocoagulation and snare under the guide of the euthyphoria of fiberoptic bronchoscope,Ni-Ti memory alloy stents were placed into the stenosis airways.The 52 patients were divided into two groups with 26 cases each:the stent group and the stent associating radiotherapy group(radiotherapy group).The later group accepted subsequent radiotherapy after the therapy.The following indexes of the two groups were investigated:short-time clinical effect,dyspnea index class,rate and average time of airway restenosis,life span and survival rate.ResultsAfter therapy,the 52 patients had obvious improvements in dyspnea and the diameter of the stenosis airways.The short-time total effective rate was 100.0％ (52/52),but there was not significant difference between the two groups(P＞ 0.05 ).After therapy,there was significant difference in two groups in dyspnea index class(P ＜ 0.01 ).Although there was not significant difference in the rate of airway restenosis between the two groups(P＞0.05),the average time of airway restenosis in the radiotherapy group was obviously longer than that in the stent group(P＜ 0.01 ).The survival rate of the radiotherapy group in the 6th and 9th month after therapy was higher than that in the stent group (P ＜ 0.05),but there was no significantdifferenee in the 3rd and 12th month (P ＞0.05).ConclusionHigh frequency electronic associating stents insertion and subsequent radiotherapy guided by fiberoptic bronchoscope is an effective and safe treatment for the patients suffering tracheobronchial stenosis caused by lung and esophagus carcinoma.

Objective To evaluate the diagnostic value of ultrasonography (USG) and contrast-enhanced computer tomography (CT) for thyroid carcinoma.MethodsThe results of the review of the preoperative CT and those of the original US reports were compared with the histopathologic results in 73 cases of thyroid carcinoma who underwent radical operation and central compartment dissection from November 2009 to November 2011.ResultsThe final diagnostic rate of thyroid carcinoma with USG was 69.9％,CT of that was 80.8％.There were no significant difference between them (P =0.077).The diagnostic rate of metastatic lymph node in the central compartment with USG was 61.6％,positive predictive value was 64.0％,negative predictive value was 60.4％.The diagnostic rate of metastatic lymph node in the central compartment with CT was 67.1％,positive predictive value was 61.7％,negative predictive value was 76.9％.There were not significant difference between them(P =0.848,P =0.152,P =0.489).Conclusion There was no significant difference between USG and CT in The final diagnostic rate of thyroid carcinoma and its lymph node metastasis in the central compartment.

The present study intended to provide some informations about the relationship between the supraependymal structures (SES) and the periventrieular neural tissue (PVNT), and with gross dissection and scanning electron microscopy the anterior medullary velum (AMV) was observed on 20 adult rabbits. The AMV may be divided into three portions: 1. the posterior membraneous wall of the recess of the inferior colliculus; 2. the anterior roof of the fourth ventricle; and 3. the transiional portion between the two portions mentioned above. On the ependymal surface of the entire AMV. There were numerous microvilli and cilia, except for the second portion of AMV, there were also some spherical-like structures, which were 2-6?m in diameter and had lace-like processes on its surface, and supraependymal cells(SEC) which were stellate, triangular, and spindle in shape. On the cellular surface with very few SEC, the secretory granules may be seen, which were 0.1-0.3?m in diameter. The SEC often extended out 2-5 processes, and the distal parts of which expanded into a flattened shovel-like structure, which lay on or inserted into the ependymal surface. The SEC here are similar to type Ⅱ SEC seen in the third and fourth ventricles, but they may differ significantly in structures on cellular surface, e.g. the secretory granules, and in shapes of their processes. Thus, it may suggest that the SEC here may play an intermediary role between PVNT and CSF, and be another route of neurohumoral modulation.

Objective To analyze the clinical efficacy of the laparoscopic breast-conserving surgery combined with radiofrequency ablation to treat the early-stage breast cancer.Methods We collected 55 patients diagnosed early-stage breast cancer in retrospect,which started from January 2014 to December 2016.Twenty-seven of them were performed the laparoscopic breast-conserving surgery combined with radiofrequency ablation while others went through laparoscopic breast-conserving surgery without radiofrequency ablation.Meanwhile,we adopted the student t-test and the chi-square test to compare results of two groups.More specific,the main indexes of this study are including the post-operative local recurrence,the incidence of fat liquefaction or the incision-infection,operation time,post-operative hospital stay and the hospitalization expense.Results The laparoscopic breast-conserving surgery combined with radiofrequency ablation group had low local-recurrence than the laparoscopic breastconserving surgery group (0 and 7.69％).Additionally,there were no statistical differences between two groups in the incidence of fat liquefaction.However,The laparoscopic breast-conserving surgery combined with radiofrequency ablation group had more hospitalization expense than the laparoscopic breast-conserving surgery group [(4.1 ± 0.7) ten thousand yuan and (2.3 ± 0.6) ten thousand yuan,P ＜ 0.05].Conclusions Although the laparoscopic breast-conserving surgery combined with radiofrequency ablation group remarkably increased the hospitalization expense because of the utility of the radiofrequency ablation related apparatus,it may provide the probability of shaving more residual tumor cell and may low down the recurrence,especially not rising up the incidence of the post-operative fat liquefaction.Therefore,this surgery method might be one of the potential developments in the minimal-invasive of early stage breast cancer.

Objective To analyze clinical characteristics of invasive Luminal subtype breast cancer.Methods The data of 162 invasive Luminal subtype breast cancer patients receiving operation in Cancer Hospital of Chinese Academy of Medical Science from January 1 st to September 30th in 2002,were collected and the clinical characteristics,recurrences,metastasis and survivals were retrospectively analyzed.Results The median time of follow-up was 92 months,ranging from 4 to 98 months.41 cases (25.3％,41/162) presented local recurrence or metastasis including 32 cases with metastasis ( 19.8％,32/162),2 cases with local recurrences (1.2％,2/162) and 7 cases with both local recurrence and metastasis (4.3％,7/162) ;Disease-free survival (DFS) and the 5-year DFS were 73.1％ and 79.6％,respectively.27 patients ( 16.7％,27/162) died of breast cancer,the overall survival (OS) and 5-year OS were 82.5％ and 85.3％,respectively.According to Kaplen-Meier survival analysis,tumor size,lymph node status and clinical stage were correlated to overall survival time ( P ＜ 0.05 ) ; and rumor size,lymph node starus,grade,clinical stage and PR status were correlated to disease-free survival time ( P ＜ 0.05 ).By multivariate analysis,TNM stage,PR and PCNA were independent prognostic factors correlated to overall survival time (OR=0.633,95％ CI:0.411 -0.976,P＜0.05; OR =0.823,95％ CI:1.012-3.283,P ＜ 0.05) ; TNM stage and PR was independent prognostic factors correlated to disease-free survival time (OR =3.273,95％ CI:1.719 - 6.232,P ＜ 0.01 ; OR =0.599,95％ CI:0.423 - 0.850,P ＜ 0.01 ).Conclusions In invasive Luminal subtype breast cancers,PR is correlated to fine prognosis,and PCNA is correlated to overall survival time.

Objective:To compare the diagnostic efficiency of colloidal gold dipstick method (PTH dipstick method) with that of doctors’ experience method based on nano-carbon method for rapid identification of parathyroid gland in thyroidectomy of thyroid cancer.Methods:From March to July 2020, 90 patients underwent thyroid surgery in the Friendship Hospital, Capital Medical University participated in the experimental study, and 155 samples underwent empirical judgment, parathyroid dipstick and pathological examination. All operations were performed by senior specialists. SPSS statistics 17.0 software was used for statistical analysis.Results:Seventy-four cases of parathyroid gland confirmed by both pathology and empirical judgment, and 81 cases of non-parathyroid gland confirmed by pathology; 130 cases of parathyroid glands confirmed by both PTH dipstick method and pathology, and 22 cases of non-parathyroid glands confirmed by pathology. The accuracy rate of PTH dipstick method was 85.53% which was much higher than that of empirical judgment method (47.74%). The data were statistically significant ( χ2=49.14, P<0.05). The sensitivity of PTH method was 95.89%, the specificity of PTH method was 75.94%, and the Youden index was 0.7183. The sensitivity of empirical judgment method was 81.3%, the specificity of empirical judgment method was 47.74%, and the Youden index was 0.2904. Conclusions:The diagnostic efficiency of the PTH method is higher than that of empirical judgment method to identify parathyroid gland in thyroid surgery. The two methods can be used together to increase the protection of parathyroid gland during operation.

OBJECTIVETo compare the efficacy and safety of 5 mg perindopril arginine salt and 4 mg perindopril tert-butylamine salt for patients with mild to moderate essential hypertension.

METHODSThe study was designed as multicenter, randomized, double-blind, active controlled trial with two parallel groups enrolling 524 participants with mild to moderate essential hypertension. After 2-week run-in period, 186 patients were enrolled and randomly treated with 5 mg perindopril arginine salt and 183 patients were enrolled and randomly treated with 4 mg perindopril tert-butylamine salt. The random sequence was generated by the I.R.I.S., and a balance was made in each center. After double-blind treatment for 8 weeks, the dose could be doubled for patients with uncontrolled BP ((SBP) &ge; 140 mmHg (1 mmHg = 0.133 kPa) or diastolic blood pressure (DBP) &ge; 90 mmHg) and patients were treated for another 4 weeks.

RESULTSThe sitting SBP was similarly decreased by (19.9 ± 17.2) mmHg in perindopril arginine group and (18.5 ± 14.7) mmHg (P = 0.000 5) in perindopril tert-butylamine group post 8 weeks treatment. Dose was doubled in 109 patients (59.9%) in perindopril arginine group and 116 patients (63.7%) in perindopril tert-butylamine group. At 12 weeks post therapy, the sitting SBP decreased by (19.8 ± 16.2) and (19.6 ± 16.3) mmHg respectively in the 2 groups. The decrease of sitting DBP was also similar in both groups (-12.0 ± 10.0) mmHg and (-11.0 ± 8.9) mmHg (P < 0.000 1), respectively. The control rate or response rate was also similar between the two groups (control rate over 8 weeks was 38.5% vs. 31.3%, 95% CI (-2.6-16.9), control rate over 12 weeks was 36.3% vs. 35.7%, 95% CI (-9.3-10.4), response rate over 8 weeks was 64.3% vs. 63.2%, 95% CI (-8.8-11.0), response rate over 12 weeks was 65.9% vs. 64.8%, 95% CI (-8.7-10.9)). Incidence of adverse events was low and similar in both therapy groups.

CONCLUSIONSThe results show that perindopril arginine salt 5 mg is as efficient as perindopril tert-butylamine 4 mg on lowering BP for patients with mild to moderate essential hypertension. Both drugs have good safety profile and are well tolerated by patients in this cohort.

Antihypertensive Agents ; Arginine ; Blood Pressure ; Butylamines ; Double-Blind Method ; Essential Hypertension ; Humans ; Hypertension ; Perindopril ; Sodium Chloride