Surgery is now still the first choice for treatment of thyroid cancer.Long-term post-operative follow-up and thyroid hormone treatment are of great importance in reducing recurrence,early detection of metastases or recurrence,and improving patients' quality of life.This article reviews the recent advancement in post-operative follow-up and hormone treatment in thyroid cancer patients.

Objective To assess the prevalence,development and prognosis of thyroid disorders in adult healthy subjects aged over 60 years.Methods We performed a cross-sectional study in 1999 and a 5-year follow-up study in 2004.A total of 102 men and 147 women aged 60 to 88 years from rural communities in north China were studied.Serum thyrotropin(TSH),thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)were determined by an immunochemiluminometry assay in all participants.Free triiodothyronine(FT_3)and free thyroxine(FT_4)were determined in subjects with abnormal TSH results.Results We dropped the reference range for TSH into 0.28~4.75 mU/L.The prevalence of thyroid dysfunction,positive TPOAb and TgAb was 10.84%,12.85%and 11.65%,respectively.six newly diagnosed patients were found in the follow-up study,3 cases(all women)with hypothyroidism and 3(all men)with hyperthyroidism.Conclusion The high prevalence of thyroid dysfunction in the elderly indicates screening is necessary.Most elderly patients with subclinical dysfunction can recover spontaneously.The strategy should be focused on whether we monitor these patients.

Objective To discuss the technical skills and the contraindication of transjugular intrahepatic portosystemic shunt stent (TIPSS) in portal vein cancercous thrombosis (PVCT) complicated with portal hypertension. Methods There were 16 cases of PVCT with portal hypertension, and average age of 53.6 yr. There were 9 cases with complete occlusion of portal vein trunk and 7 cases with incomplete thrombosis. There were 5 cases with cavernous transformation of the portal vein(CTPV). 1 case of simple upper gastro intestinal tract (GIT) massive bleeding, 4 with refractory ascites and 11 with upper GIT massive bleeding and refractory ascites. Results The procedure of TIPS was successful in 11 cases, the successful rate reached about 68.8%. The mean portal vein pressure was reduced from 4.9kPa to 2.4kPa with average 2.5kPa reduction. Ascites decreased, bleeding stopped and the clinical symptoms disappeared. The average survival period was 136 days. The procedure failed in 5 cases. Conclusions TIPSS is an effective method to control the bleeding and ascites caused by PVCT. The PV cavernous transformation was the contraindication of TIPSS.

Objective:To explore strategies of improving patients' stereotyping of nurses, by analyzing patients′ stereotypes of nurses.Methods:The phenomenological analysis method in qualitative research was used to conduct semi-structured interviews with 12 inpatients by objective sampling method.Results:The patients′ stereotype of nurses could be summarized into three topics, it mainly consisted of three aspects: patients′ cognition of the role of nurses, patients′ stereotype of nurse-patient relationship and factors affecting nurse-patient relationship from patients′ perspective, among which factors affecting nurse-patient relationship included doctors′ attitude towards nurses, public opinion effect of media reports and patients′ negative psychological experience.Conclusions:The prejudice of patients to the relationship between nurses and patients is not optimistic, it is suggested to improve patients′ stereotyping of nurses by reconstructing the ideal role of nurses, building harmonious trusting relationships and providing friendly support from the "others".

Objective To investigate the value of MRI for the preoperative diagnosis of breast cancer.Method 45 patients with breast mass were evaluated by MRI preoperatively, 17 cases were further inspected by dynamic MRI, and the time intensity curves were analyzed.Results Postoperative pathology revealed carcinoma in 24 cases, and benign lesions in 21. The correct preoperative diagnosis rate of MRI for breast cancer was 96%(23/24), and its false-positive rate was 2%(1/45).Conclusions MR imaging of breast has practical value in preoperative diagnosis for breast cancer.

ObjectiveTo summarize the recent therapeutic effects of mesh-plug tension-free hernioplasty in elderly inguinal hernia. MethodsAll cases were performed with mesh-plug case-hardened products, which are manufactured by American Bard Company. ResultsAll the operative procedures were performed smoothly. Postoperative complications were:6 cases of urinary retention,4 scrotal hydroceles,2 persistent wound pain,2 local lightly projections with foreign body sensation,2 hypoincisional haematoma. 1～24 months of follow-up were taken,2 recent recurrences were reported. ConclusionMesh-plug tension-free hernioplasty is a perfect surgical operation. Its main characteristics are:simple performance, less trauma, tension-free, time-saving, good recent therapeutic effect, and fewer recent recurrence. It is especially suitable to the elderly patients and/or Patients with other diseases.

Objective To analyze the effects of the mumps virus on testicular function and evaluate the value of blood testosterone in acute orchitis condition and prognosis by observing the testosterone levels of peripheral blood in the mumps orchitis patients.Methods Thirty patients with acute mumps orchitis (mumps orchitis group)and 28 patients with mumps only without any major complications (mumps group)were enrolled in the study.At the same time,we selected 20 healthy males in our hospital as healthy controls.All cases were treated by ribavirin (10mg/kg). The testosterone was tested by chemiluminescence method,in 0,7,14 days respectively.The variance analysis and LSD -t test were used to compare differences of blood testosterone in each group,and Pearson method was used to analyze the correlation of blood testosterone and testicular swelling day times,blood amylase,level of neutrophils,IL -6 and CRP.Results The testosterone of acute orchitis [(1.51 ±0.26)ng/mL]was lower than mumps group and healthy controls.The difference was significant(F =99.36,P <0.01).The level of blood testosterone was significantly increased in the treatment for 14 days (t =13.03,P <0.01),and there was no significant difference compared with healthy controls (t =1.23,P =1.23).Pearson correlation analysis found that blood testosterone levels were negatively correlated with the days of testicular swelling,the levels of IL -6 and CRP(r =0.678,P <0.01 and r =0.528,P =0.000;r =0.442,P =0.000).Conclusion This study showed that MuV infection inhibited testosterone synthesis in Leydig cells.In other words,the level of blood testosterone is related to the severity of the orchitis,which can be widely used in clinical.

The general clinical abilities of attending doctors are closely linked with the overall quality of patient care in a hospital. A set of quality standards for ward rounds by attending doctors were formulated in the author's hospital and an intensive evaluation was conducted by the experts team of the results of inspection and assessment. It is suggested that the hospital should tighten the quality control of ward rounds by attending doctors and pay serious attention to various problems that may occur. In particular, the hospital should set strict assessment standards for post qualification for attending doctors and strive to cultivate their clinical abilities after their post assumption. In addition, it should bring their talent into full play on the basis of vigorous management and assessment and discover and correct their shortcomings in ward rounds in a timely manner.

Objective To investigate expression of glutathione S-transferase(GST) mRNA in peripheral blood of the population in coal-burning fluorosis area and to evaluate the effect of comprehensive control intervention. Methods Fifty samples of peripheral blood from patients in the coal-buring fluorosis area in Bijie county of Guizhou province were selected as fluorasis group and 50 samples of peripheral blood from patients in area with comprehensive management were selected as intervention group, respectively. Fifty samples from non-endemic fluorosis area were selected as the control group. Total RNA from blood was extracted and purified by the Trizol- Phenol-Chloroform one-step method. Expression of GST mRNA was detected by using SYBR Green I real-time fluorescence quantitative PCR. Results The data of GST mRNA in fluorosis group, intervention group and control group was 38.28±27.22,70.56±37.23 and 103.46 ± 46.62, respectively. There was a significant difference between the groups(F = 3.75, P < 0.05). Decreased expression of GST mRNA in fluorosis group and intervention group as compare to control was detected(all P < 0.05), and the expression of GST mRNA in intervention group was higher than that in fluorosis group(P < 0.05). Conclusion Coal-burning fluorosis possibly led to the decreased expression of GST mRNA in peripheral blood, and comprehensive control maybe prevent the decreased expression of GST in mRNA level.

Breast-contour preservation(BCP)encompasses all strategies to preserve the contour of the breast following breast-conserving surgery (BCS) and immediate postmastectomy breast reconstruction (IBR). With the continuous advancement of breast surgery, postoperative outcomes and quality of life of breast cancer patients have been significantly improved. Previous studies reported on BCP as a new comprehensive parameter for evaluating outcomes of breast cancer treatment. Based on preoperative comprehensive evaluation of patients′ general condition, characteristic of breast tumor, and breast morphology, individualized surgical strategy is formulated to improve BCP for early-stage breast cancer and improve postoperative outcomes of patients. Combined with the morphological characteristics of Chinese women′s breasts, breast contour can be preserved not only by BCS and IBR, but also by nipple-areola complex-sparing mastectomy in some breast cancer patients, thereby reducing psychosomatic impact as a result of losing breast mound.