Thyroid cancer is one of the most common malignant tumors in the human endocrine system . It is one of the common diseases in head and neck ,thyroid and breast surgery .Its incidence rate is increasing year by year .With the development of ultrasonography and fine needle aspiration biopsy ,as well as the auxiliary exami-nation of gene detection technology ,the detective rate of early diagnosis of papillary thyroid microcarcinoma ( PT-MC) is getting higher and higher .Compared with conventional surgery , highlighting the advantages of minimally invasive surgery , endoscopic and ultrasound guided percutaneous ablation and other new surgical methods are gradually applied in clinical treatment .Combined with the new guideline ,the present paper reviews the progress in the diagnosis and treatment of papillary thyroid microcarcinoma .

Objective To investigate the clinical characteristics and therapy of acute perforation of gastric carcinoma(APGC) to improve the diagnosis,treatment and prognosis of APGC. Methods Forty cases of APGC admitted to Gong liao hospital of Zhenping county.Of the forty patients,ten underwent repair of perforation,twenty-one cases underwent palliative gastrectomy (six of them underwent lymphadenectomy three weeks after previous gastrectomy );five subjected to radical gastrectomy. two underwent gastrostomy or jejunostomy for nutrition.One underwent drainage and peritoneal lavage only;1 received non-operative therapy.Results Four patients died in this series.The 1-,2-,3-years survival rate was 83.3%(30/36),52.8%(19/36),27.8%(10/36)respectively. Conclusions Early diagnosis and adopting resection of gastric cancer plus comperhensive treatment can improve the prognosis of patients with APGC.

There are many kinds of research methods in proteomics of breast cancer,one of them is mass spectrometry and have made a great progress.With more progress in proteomics studies,diagnosis and prognosis of the specific markers for breast cancer continue to be found,there would be great benefits for patients with breast cancer in diagnosis and prognosis.

Objective To determine the inhibitive effect of interferon-a on hepatic metastasis of colon cancer. Methods Metastatic model of human colon cancer was established by orthotopic implantation of histologically intact human tumor tissue into the colon wall of nude mice.The mice were randomly divided into 4 groups:(1)Control group(receiving saline solution only);(2)5-FU treatment group;(3) IFN-?-2b treatment group;and(4)5-FU combined with IFN-?-2b treatment group(combined group). 5-FU and IFN-?-2b were given via peritoneum injection 1 time/2 days for eight weeks.The mice were killed at nine weeks.The tumors were weighed,the microvessel density(MVD) was detected,and the liver was examined histologically in order to discover the micrometastasis. Results In control group, 5-FU group,IFN-2b group and combined group,the tumor weight was(1.53?0.78)g,(0.87?0.59)g,(0.81?0.43)g and ( 0.23?0.09)g, respectively;the tumor inhibition rate was 0,43.1%,47.1% and 84.9%, respectively;the hepatic metastasis rate was 85.7%,78.6%,21.4% and 0 respectively.MVD in IFN-? group and combined group was significant lower than that in control group and 5-FU group. Conclusions IFN-? can inhibit the growth and hepatic metastasis of orthotopic implanted human colon cancer by inhibiting the tumor angiogenesis.It may be more effective when INF-? combined with cyotoxic agents.

Objective To summarize clinical experience in removal of residual metallic foreign body in the soft tissue.Methods Clinical data of 742 cases with residual metallic foreign body in the soft tissue were analyzed.All the patients were forward from other hospitals with failed removal of the foreign body.Second surgery was performed in our hospital by grasping forceps using 3D-locator under the guidance of the C-shaped arm X-ray machine.Results Foreign body,such as scrap-iron,broken needle,nails,wine and so on located at different regions of soft tissues including neck,chest and abdomen,pelvis,and the four limbs were all successfully taken out.Removal rate of the foreign body was 100％.No complications such as bleeding,infection and nerve damage was occurred.The mean time of the procedures and radiation exposure for the removal surgery was 5 minutes.Conclusion Using 3D-locator and grasping forceps under the guidance of the X-ray,the residual metallic foreign bodies can be removed safely and efficiently.

Objective To investigate the expression of osteopontin(OPN) mRNA in breast tissues containing microcalcifications and the significance of OPN in tumor pathogenesis and metastasis of breast cancer.Methods The expression of OPNmRNA in 128 samples of tissues of breast lesions and adjacent breast tissues and 9 samples of metastatic lymph nodes were examined.Results The expression of OPNmRNA was highest in(calcified) foci of breast cancer tissues and in metastatic lynph nodes,lower in calcified foci of benign breast tissues and lowest in breast tissues adjacent to breast cancer and in benign tissues without calcification.The differences between the defferent tissues were significant(all P

Objective To investigate the value of free thyroxine (FT4) and free triiodothyronine (FT3) ratio (FT4/FT3) combined with thyrotropin (TSH) in predicting differentiated thyroid carcinoma (DTC). Methods The clinical data of 109 thyroid nodules patients having underwent surgery were retrospectively analyzed. Postoperative pathological findings showed 61 cases of DTC (malignant group) and 48 cases of benign thyroid nodules (benign group). The independent risk factors of DTC were screened out by univariate analysis and multivariate Logistic regression analysis. The receiver operating characteristic (ROC) curve was drawn. The area under the curve (AUC) was calculated, and the best cut-off value was obtained. Results There was no significant difference in the sex composition and FT4 between malignant group and benign group (P ＞ 0.05). The age and FT3 levels in malignant group were significantly lower than those in benign group: (44.48 ± 12.07) years vs. (52.81 ± 12.99) years and (4.31 ± 0.61) pmol/L vs. (4.73 ± 1.05) pmol/L, the FT4/FT3 and TSH were significantly higher than those in benign group: 3.70 ± 0.62 vs. 3.26 ± 0.70 and 2.15 (1.42, 2.78) mU/L vs. 1.63 (1.05, 2.19) mU/L, and there were statistical differences (P＜0.01 or ＜0.05). Multivariate unconditional Logistic regression analysis result showed that FT4/FT3 and TSH levels were risk factors for DTC ( OR = 2.398 and 1.804, 95% CI 1.084 - 5.306 and 1.130 - 2.880, P = 0.031 and 0.013). The AUC of FT4/FT3, TSH and FT4/FT3 combined with TSH were 0.661 (95% CI 0.556-0.766, P=0.004), 0.663 (95% CI 0.561-0.764, P=0.004) and 0.726 (95% CI 0.632-0.820, P=0.000). The best cut-off values of FT4/FT3 and TSH were 3.346 and 1.845 mU/L. The sensitivities were 70.5% and 62.3% , and the specificities were 60.4% and 64.6%. The sensitivity and specificity of FT4/FT3 combined with TSH were 85.2% and 50.0%. Conclusions FT4/FT3 and TSH levels are risk factors for DTC. The greater the FT4/FT3 level, the higher the TSH level, the higher the risk of DTC. When FT4/FT3＞3.346 and/or TSH＞1.845 mU/L, the clinical value of combined prediction for DTC is higher.

Objective:To investigate the effect of tofacitinib combined with methotrexate on disease activity, rheumatoid factor (RF) level and morning stiffness time in patients with refractory rheumatoid arthritis (RA).Methods:A total of 120 patients with refractory RA diagnosed and treated in the First Affiliated Hospital of Hebei North University from June 2019 to June 2020 were selected as the study subjects, and they were randomly divided into three groups by random number table method: etanercept group, etanercept+ methotrexate group, and tofacitinib+ methotrexate group, with 40 patients in each group. The etanercept group was given etanercept treatment, the etanercept+ methotrexate group was given etanercept combined with methotrexate treatment, and the tofacitinib+ methotrexate group was given tofacitinib combined with methotrexate treatment. The clinical efficacy (12 W, 24 W and 48 W of treatment), disease activity, RF level, morning stiffness time and incidence of adverse reactions were compared among the three groups.Results:Comparison of the total clinical effective rate of the three groups: the total clinical effective rate of the etanercept+ methotrexate group and the tofacitinib+ methotrexate group was higher than that of the etanercept group (both P<0.05), and the tofacitinib+ methotrexate group was higher than that of the etanercept+ methotrexate group ( P<0.05). After treatment, the clinical symptoms and disease activity scores (DAS28) in the etanercept+ methotrexate and tofacitinib+ methotrexate groups were significantly improved compared with the etanercept group (all P<0.05), and the improvements in the tofacitinib+ methotrexate group were more significant than those in the etanercept+ methotrexate group ( P<0.05). After treatment, the erythrocyte sedimentation rate (ESR), RF and C-reactive protein (CRP) levels were lower in the etanercept+ methotrexate and tofacitinib+ methotrexate groups than those in the etanercept groups (all P<0.05), and the ESR, RF and CRP levels in the tofacitinib+ methotrexate groups were lower than those in the etanercept+ methotrexate group (all P<0.05). There was no significant difference in the incidence of total adverse reactions among 3 groups (7.50% vs 12.50% vs 12.50%) ( P>0.05). Conclusions:Tofacitinib combined with methotrexate can effectively improve the disease activity, RF level and morning stiffness time in patients with refractory RA, with high safety, which is worthy of clinical application and promotion.

Objective To analyze the changes in the expression levels of serum Dickkopf-related protein 1(DKK-1)and latent transforming growth factor binding protein 2(LTBP2)in patients with connective tissue disease(CTD)related interstitial pneumonia(IP)of different disease activity levels before and after treatment.Methods A total of 121 CTD patients who visited the First Affiliated Hospital of Hebei North University from January 2022 to October 2023 were collected and separated into an observation group(CTD-related IP patients,n=62)and a reference group(CTD without IP patients,n=59)based on the incidence of IP.The observation group was separated into a stable phase group(n=26)and an acute exacerbation phase group(n=36)based on disease activity.Enzyme-linked immunosorbent assay(ELISA)detected DKK-1 and LTBP2 levels.Pearson or Spearman were used to analyze correlations between DKK-1 and LTBP2 levels with clinical data.Logistic regression was applied to analyze influencing factors of acute exacerbation in CTD-related IP patients.Results The serum levels of DKK-1(14.98±3.32 ng/ml)and LTBP2(32.64±4.01 ng/ml)in the observation group were higher than those in the reference group(2.21±0.67 ng/ml,8.73±2.15 ng/ml),the differences were statistically significant(t=28.983,57.518,all P＜0.05).The proportions of patients with ground glass opacity(66.67%)and honeycomb opacity(52.78%),serum DKK-1(19.67±4.10 ng/ml),LTBP2(38.76±4.92 ng/ml)and C-reactive protein(CRP)(32.46±3.12 mg/L)in the acute exacerbation group were higher than those in the stable phase group(30.77%,23.08%,8.48±1.37 ng/ml,24.17±3.65 ng/ml,22.05±2.80 mg/L),the differences were statistically significant(t/x2=7.790,5.534,13.362,12.781,13.524,all P<0.05).The serum levels of DKK-1 and LTBP2 in patients with acute exacerbation of CTD-related IP after treatment were positively correlated with ground glass opacities,honeycomb opacities,CRP and different disease activity(r=0.526,0.518,0.513,0.548;0.499,0.514,0.520,0.561,all P<0.05).As the treatment time extended,the serum levels of DKK-1 and LTBP2 in CTD-related IP patients in the stable and acute exacerbation groups decreased,and the serum levels of DKK-1 and LTBP2 in the acute exacerbation group were higher than those in the stable group before treatment,1 month after treatment,and 3 months after treatment,the differences were statistically significant(t=13.355,13.206,15.913;12.781,12.263,11.161,all P<0.05).DKK-1[OR(95%CI):2.458(1.297～4.657)],LTBP2[OR(95%CI):2.739(1.567～4.789)]were independent risk factors for acute exacerbation of CTD related IP patients(all P<0.05).Conclusion The serum levels of DKK-1 and LTBP2 in CTD-related IP patients are increased,and closely related to disease activity.Both decrease after 3 months of treatment and can monitor the treatment efficacy of patients to a certain extent.

To investigate the expression of miR-133a and miR-424 in the serum of patients with connective tissue disease(CTD)and interstitial lung disease(ILD)and their relationship with T lymphocyte subpopulations,total of 96 CTD-ILD patients treated in our hospital from December 2019 to December 2022 were selected as CTD-ILD group,while 96 CTD patients without ILD were as the control group.The real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect serum levels of miR-133a and miR-424;flow cytometry was applied to detect the levels of T lymphocyte subpopulations.Pearson method was applied to analyze the relationship of miR-133a and miR-424 with T lymphocyte subpopulations.Compared with the control group,the level of serum miR-133a in the CTD-ILD group was obviously reduced,while the expression level of miR-424 was obviously increased(P＜0.05).Under different degrees of pulmonary ventilation disorders,the expression level of miR-133a in the serum of mild,moderate,and severe patients decreased obviously,while the expression level of miR-424 increased obviously(P＜0.05).Under different grades of pulmonary diffusion dysfunction,the expression level of miR-133a in the serum of mild,moderate,and severe patients reduced obviously,while the expression level of miR-424 increased obviously(P＜0.05).Furthermore,the levels of CD4+and CD4+/CD8+in the CTD-ILD group were obviously increased,as compared to the control group,while the levels of CD8+and CD3+were obviously reduced(P＜0.05).In addition,miR-133a was negatively correlated with CD4+,and positively correlated with CD8+and CD3+;miR-424 was positively correlated with CD4+,and negatively correlated with CD8+and CD3+(P＜0.05).In conclusion,the expression level of miR-133a in serum of CTD-ILD patients is decreased,while the expression level of miR-424 is increased,and both of them are related to the T lymphocyte subpopulations.