Background and purpose: The diagnosis of thyroid papillary carcinoma sometimes is difficult, metastasis of lymph node is the major reason of local relapse and influence prognosis.This study explores the immunohistochemical expression and their diagnostic value of CK19,HBME-1,galectin3,p27 and cyclinD1 in thyroid papillary carcinoma and the relations between p27,cyclinD1 and lymph node metastasis of papillary carcinoma.Methods: Immunohistochemical staining was used on 50 specimens of benign lesions (40 speciments of nodular goiters and 10 cases of follicular adenomas) and 50 specimens of papillary carcinomas (40 specimens of classic variants and 10 specimens of follicular variants) operated in our hospital from January of 2005 to December of 2008. Results: CK19,HBME-1 and galectin3 were expressed in cytoplasm or on the membrane, but p27 and cyclinD1 were expressed on the nucleus. The expressions of CK19,HBME-1 and galectin3 in thyroid papillary carcinoma were middle to strong positive, the positive ratios were 100%,96% and 100%, respectively;their expressions in benign lesions were negative or low positive, the positive ratios were 10%,10% and 6%, respectively;there were statistical differences between them (P<0.01). The expression of p27 in thyroid papillary carcinoma was low positive or negative, the positive ratio was 14%, but the expression of p27 in benign lesions was middle to strong positive, the ratio was 84%, there was also significant difference between them(P<0.01). The expression of CyclinD1 were similar in benign and malignant lesions of thyroid, the positive ratios were 68% and 78%, respectively, there was no statistical difference between them(P>0.05). There were significant differences(P<0.01) between the benign lesions and the papillary carcinomas in terms of the combination of CK19,HBME-1 and galectin3 expression and there were no significant differences(P>0.05) in the group of the former with underexpression of p27 between the two groups. The differences were not statistically significant (P>0.05) between the underexpression of p27 with the expression of cyclinD1 (the positive ratios in metastasis group and no metastasis group are 72.7% and 71.4%) in the lymph node metastasis. Conclusion: The combined immunohistochemical stainings of CK19,HBME-1 and galectin3 are useful on the diagnosis and differential diagnosis of thyroid papillary carcinoma, there is no predicted value of the underexpression of p27 with the expression of cyclinD1 for lymph node matastasis of thyroid papillary carcinoma.

OBJECTIVE To observe the clinical efficacy of Yangyin Jiedu Decoction in the prevention and treatment of acute ra-diation-induced oral mucositis(RTOM).METHODS A total of 80 inpatients who were diagnosed with head and neck tumors by pathological examination and received radiotherapy in the Department of Radiotherapy,Affiliated Hospital of Nanjing University of Chi-nese Medicine from November 2021 to September 2023 were selected and randomly divided into an observation group and a control group with 40 cases in each group.The control group was given mouthwash treatment from the onset of RTOM symptoms until the symp-toms disappeared;the observation group was given Yangyin Jiedu Decoction from the first day of radiotherapy on the basis of the treat-ment of the control group until the end of radiotherapy.During the treatment,the onset time,duration and incidence of grade Ⅱ-ⅣRTOM in the two groups were observed;the pain numerical rating scale(NRS)score,Karnofsky performance status(KPS)score,body mass index(BMI)changes were evaluated;and the levels of serum inflammatory factors[C-reactive protein(CRP),interleukin 6(IL-6),interleukin 1β(IL-1β),tumor necrosis factor α(TNF-α)]were detected.RESULTS After radiotherapy,RTOM ap-peared in both groups to varying degrees.The incidence of grade Ⅱ-Ⅳ RTOM,the onset time,duration and NRS score of RTOM in the observation group were significantly better than those in the control group(P<0.05,P<0.01).After radiotherapy,the levels of se-rum CRP,IL-6,IL-1β and TNF-α in the observation group were lower than those in the control group(P<0.05,P<0.01).After radiotherapy and 1 month of follow-up,the KPS score and BMI in the observation group were higher than those in the control group(P<0.05,P<0.01).CONCLUSION Yangyin Jiedu Decoction can decrease the incidence and severity of RTOM in patients with head and neck tumors,shorten its duration,improve the quality of life of patients,downregulate the level of inflammatory cytokines,and has a preventive effect on RTOM caused by radiotherapy in patients with head and neck tumors.