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.

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 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.

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 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 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 possible pathological role of mitochondrial apoptosis pathways and its factors in fluorosis-induced apoptosis of human hepatocellular carcinoma cell strain (HepG2).Methods Under the stimulation of 1,3,6 and 9 mmol/L concentrations of NaF in vitro for 24 h (n =5),while normal control group was cultured under normal condition,the cytotoxicity was measured with MTT.The mitochondrial apoptosis inducing factor (AIF) was measured at both mRNA (n =5) and protein levels (n =6),respectively,by real-time PCR and Western blotting.The mitochondrial apoptosis related factors,such as B-cells lymphoma-2 (Bcl-2),Bcl-associated X protein (Bax),cytochrome C,caspase-9 and caspase-3 were measured at protein levels (n =6).Results After treated with 0,1,3,6 and 9 mmol/L NaF for 24 h,the cell absorbance of HepG2 cells was 0.307 ± 0.031,0.333 ± 0.028,0.230 ± 0.011,0.178 ± 0.001 and 0.152 ± 0.003,respectively,and the differences were statistically significant among groups (F =82.224,P ＜ 0.01).After treated with 3 mol/L NaF for 24 h,the mRNA level of AIF was [(153.14 ± 5.41)％] which was increased compared to the control group [(100.00 ± 4.70)％,t =-4.73,P ＜0.05].Under the same condition,the protein levels of AIF,Bcl-2,cytochrome C in cytoplasm,caspase-9 and caspase-3 were (152.16 ± 47.30)％,(171.90 ± 51.52)％,(458.00 ± 19.48)％,(527.17 ± 200.67)％ and (432.70 ±64.27)％,which were increased compared to those of the control groups [(100.00 ± 48.86)％,(100.00 ± 34.44)％,(100.00 ± 116.59)％,(100.00 ± 19.58)％ and (100.00 ± 137.16)％,t =-3.80,-3.96,-15.76,-4.64,-5.06,all P ＜ 0.05],while the protein levels of Bax and cytochrome C in mitochondrion were (24.66 ± 26.04)％,(72.99 ±45.34)％,which were decreased compared to those of the control groups [(100.00 ± 44.01)％,(100.00 ± 34.14)％,t =6.35,0.68,all P ＜ 0.05].Conclusion The mitochondrial apoptosis pathway and related factors may be involved in NaF-induced cell death in HepG2 cells.

Objective To evaluate the application of totally implantable central venous access ports. Methods A retrospective a-nalysis of 217 cases was made on the application and complication of totally implantable central venous access ports from October 2003 to May 2008. Results Venous access ports, which were connected to central venous system via subclavian vein in 199 cases and jugularis interna vein in 17 cases, were implanted into subcutaneous of chest wall. The success rate of implantation was 99.6% (216/217). The ports worked well in 207 cases (95.8%), and 9 ports (4.2%) were removed due to complications. Associated complications included subclavi-ana arterial puncture in 3 cases (1.4%) and local hematoma in one patient. Ventricular tachycardia occurred in one patient due to catheter was inserted into the right ventricle (0.4%). Five patients had soft tissue infections around ports (2.3%) and the ports were removed in 2 eases due to anti-infections therapy failure. Catheter dislocation happened in 2 cases (0.9%). The catheter obstruction was observed as a complication, which comprised three instances of catheter distortion and three of catheter-associated venous thrombosis, the ports in these six patients were removed (2.8%). The overall complication was 7.8%. Conclusions Totally implantable central venous access ports can provide a long-term and safe intravenous access to patients who need long-term intravenous infusion, especially for cancer patients received chemotherapy. Although the operation is simple, there are some complications and need to be carefully monitored.

Objective To evaluate magnetic resonance imaging (MRI) for breast-conserving surgery. Methods In this study, 52 cases of breast cancer eligible for breast-conserving surgery judged by traditional screening methods from May 2004 to December 2007 were inspected preoperatively with MRI in order to detect the cases of muhicentric breast cancer. At the same time, tumor size and invasive extent was measured accurately with enhanced magnetic resonance sequence combined with fat-suppression to determine the minimally extent of the surgical excision required. Results In the 52 cases of breast cancer patients, 3 cases of multicentric breast cancer and 49 cases of single breast cancer were diagnosed by MRI ,there were 3 cases with extensive intraductal carcinoma in the cases of single breast cancer. The primary negative margin rate was 93.6% (44/47) in the 47 cases with breast-conserving surgery. Conclusions MRI has thesuperiority to detect the muhicentric disease and the extensive intraductal carcinoma of breast cancer.Therefore MRI is useful in determining the indication and the extent of surgical excision of breast-conservingsurgery.

Objective To explore imaging features of Zinner syndrome.Methods Eight male patients with clinically diagnosed Zinner syndrome performed abdominal and pelvic CT and /or MRI scan.The radiological data was studied retrospectively.Results Eight cases showed seminal vesicle cyst with ipsilateral renal agenesis on CT and/or MR imaging ( left side, n =5; right side, n =3).The maximal diameter of seminal vesicle cysts varied from 4.2 to 7.0 cm, and appeared as oval cystic lesion with irregular contour or tube-like dilatation , which appeared low density on CT image and hypo-or hyperintensity on T 1 WI and hyperintensity on T 2 WI.Bladder compression was found in 6 cases.Fuild-fuild level in the cysts was seen in 2 cases.Remnants of ureter structure were seen in only 1 case.There was no other accompanying abnormality of urinary system.Conclusions Zinner syndrome presents with characteristic imaging features , and the key issue is differential diagnosis of seminal vesicle cysts.