Objective To Explore the significance of successful exposing and recognizing Zuckerkandl's tuhercle(ZT)during thyroidectomy.Methods Three hundred and seventy patients(501 sides) underwent lobectomy or total thyroidectomy from January 2009 to June 2011 were included in this study.The ZT was assessed in terms of its presence or absence,size and anatomical association with the recurrent laryngeal nerve(RLN)and superior parathyroid(SP).Results ZTs were found in 412 of 501 sides ( 82.2％ ),among which 368(89.3％ ) ZTs were located in the middle third of the lateral lobe of the thyroid gland.ZTs passed over the RLN in 379 of 412 sides(92.0％ ).When the ZTs were located in the middle or lower third of the lateral lobe of the thyroid gland,the SPs were all located in the cranial portion of ZT.The SP was adhered to the ZT in 80.1％ of the cases.RLN damage rate was 0.40％,and no SP damage occurred.Conclusion Exposing and recognizing Zuckerkandl's tubercle during thyroidectomy is of important clinical significance,which helps to identify and protect RLN and SP,so as to reduce surgical complications.

The expression of human epidermal growth factor receptor 2 (HER2), serine-threonine kinase (Akt), 4E-binding protein (4EBP1), phophorylated ribosomal protein S6 kinasel (p70S6Kl) and ribosomal protein S6 ( S6) were detected with immunohistochemistry in 48 cases of human breast cancer. Tumors high-expressing HER2 showed higher Akt expression as compared to tumors with negative HER2 (P < 0. 01). Levels of Akt were correlated with the downstream molecules 4EBP1 ( P < 0. 01) and p70S6K ( P < 0. 05 ). 4EBP1 was mainly expressed in poorly differentiated tumors (P <0. 01) and correlated with tumor size ( P < 0. 05) , lymph node metastasis ( P < 0. 01) and locoregional recurrences ( P < 0. 01). Results suggest that 4EBPl may be the main factor in PI-phosphoinositide-3-kinase (PI3K)-Akt-mammalian targot of rapanycin signal transduction pathways, which is associated with grade of malignancy and prognosis of breast cancer.