Objective To investigate the distinct clinicopathological characteristics among different variants of papillary thyroid microcarcinoma(PTMC).Methods The clinicopathological data of 600 PTMC patients treated in Tianjin Medical University Cancer Hospital from July 2015 to December 2015 were analyzed retrospectively.Chi-square test was used to compare the distinct clinicopathological features among different variants and multivariate Logistic regression analysis was performed for independent predictors for lymph node metastasis (LNM).Results Conventional variant (43.0％),follicular variant (46.7％),and encapsulated variant (7.7％),accounted for 97.3％ of all cases.Follicular variant had the largest tumor size and encapsulated variant had highest rate of calcification and no extrathyroidal extension.The incidence of LNM was the highest in conventional variant followed by follicular variant and then by encapsulated variant.Maleness,age ＜ 45,calcification,minimal extrathyroidal extension and multifocality were independent risk predictors for LNM.Conclusions Follicular variant are the most common in PTMC,whose aggressiveness is far below conventional variant PTMC patients.Independent risk predictors for cervical LNM were maleness,age ＜ 45,tumor calcification,minimal extrathyroidal extension and multifocality.

Objective To explore the clinical therapeutic effects of Ⅰ-stage or delayed Ⅰ-stage cervical plexus reinnervation for recurrent laryngeal nerve(RLN)injuries. Methods During the process of neck dissection of papillary thyroid carcinoma,18 cases with recurrent laryngeal nerve deficit underwent cervical plexus reinnervation on Ⅰ-stage or delayed Ⅰ-stage RLN prosthosis basis.Therapeutic effects were evaluated by fibrolaryngoscope and voice evaluation preoperatively and postoperatively. Results All the cases were followed-up for 3 months to 2 years(average 8 months).Abductory motion of the vocal cords of 16 patients totally or partly restored,and not improved in 2 patients,with the recovery rate of abductory motion of the paralyzed vocal cords of 88.9%(16/18).Patient's phonation was restored totally or partially in 16 cases and the hoarseness was ameliorated significantly. Conclusions Cervical plexus-RLN reinnervation should be considered as a suitable treatment for unilateral vocal cord paralysis.One stage or delayed one stage cervical plexus reinnervation for recurrent laryngeal nerve injury is convenient and easy to perform.Postoperatively the abductory motion of vocal cord could be restored by this reinnervation satisfactorily.

Objective To compare the difference in constituents from different parts of wild and cultivated Ephedra sinica. Methods Using the solvent of 50% methyl alcohol to extract from the stems and roots of wild and cultivated E. sinica under heating reflux, respectively and then determine the content of ephedrine in each extractions by HPLC. The volatile oil was extracted by stream-distillation and analyzed by GC-MS method. Results The content of the ephedrine in extraction of stems and roots of wild E. sinica was 0.55% and 0.000 57% while the content of the cultivated was 0.26% and 0.001 7%. Forty-five compounds in the volatile oil were identified by GC-MS method, among them 13 compounds existed in both wild and cultivated E. sinica. Conclusion The content of the ephedrine is about two times of the cultivated in wild E. sinica′s stems, while it is very low in the roots of two kinds of herbs. And ephedrine is not found in the volatile oil.

Aurora-A is a mitotic serine/threonine kinase that is evolutionally conserved and localized at the centrosome. Aurora-A activation is required for mitotic entry, centrosome maturation, and centrosome separation. Aurora-A is frequently amplified and/or over-expressed in breast, ovarian, esophageal, colon, lung, and bladder cancers. Aurora-A has recently become a new target of malignant tumors. The Aurora-A inhibitor can be combined with other chemotherapeutic drugs to provide a new way for cancer treatment. In this study, we review the function and inhibitor of Aurora-A kinase.

Objective To introduce the processes of vascularized parathyroid gland reservation and parathyroid autotransplantation applied in thyroidectomy. Methods In 46 cases who underwent total/near total thyroidectomy, in situ vascularized parathyroid gland reservation was performed in 24 cases,isolated parathyroid autotransplantation was performed in 5 cases, in situ vascularized parathyroid gland reservation of 1～2 parathyroid glands combined with immediately transplantation of the remaining isolated parathyroid glands were performed in 17 cases. Results Five cases suffered from transient hypocalcaemia, including 2 cases of vascularized parathyroid gland reservation and 3 cases of vascularized parathyroid gland reservation in 1～2 parathyroid glands combined with immediately transplantation of other parathyroid glands. Two cases who received parathyroid autotransplantation suffered from hypocalcaemia and received conservative treatment with activated vitamin D3 and caleium for 4 weeks or 8 weeks. Permanent hypoparathyroidism occurred in 1 case of 46 cases which undergone the total/near total thyroidectomy(2.2%). Conclusion Application of vascularized parathyroid gland reservation and parathyroid autotransplantation in total/near total thyroidectomy could reduce the incidence rate of post-operative hypoparathyroidism.

Objective To analyze and compare the ultrasound characteristics in different pathologic classifications of thyroid carcinoma.The ultrasound characteristics of thyroid carcinoma were investigated in order to determine the clinical diagnosis and clinical stasing of thyroid carcinoma.Methods In this study,407 cases of thyroid carcinoma were enlisted for ultrasonic typing of thyroid carcinoma according to the ultrasound features.The resuh was used for clinical staging of thyroid carcinoma. Results Combined ultrasound mediated clinical stage has a higher accuracy rate and specificity,its accuracy rate of T stage is 93.9%,for No stage is 86.1%,for N1a stage is 80%,for Nlb stage is 74.9%.Preoporative US detected 51.5% occult metastatic LN.Conclusion Ultrasound has a very important effectiveness for the evaluation.staging,location of thyroid carcinoma and cervical lymph node metastasis.

ObjectiveTo investigate the clinical biocharacteristics,treatment,prognosis and the factors that influence prognosis of anaplastic thyroid carcinoma(ATC). MethodsThe clinical data of 108 ATC patients treated at our institution from January 1981 to April 2009 and follow-up results were retrospectively reviewed.ResultsThe median survival time of 108 patients was 6 months.The overall 1-year,2-year,5-year survival rate was 40.3％,30.9％ and 21.9％ respectively.Univariate analysis showed the factors influencing the prognosis of ATC patients were tumor size, distant metastases, stage,leukocytosis, radiotherapy, localresection, postoperativeradiotherapyandmultimodalitytherapy.Multivariate analysis indicated that tumor size,stage,leukocytosis and radiotherapy were independently associated with the prognosis.ConclusionsAnaplastic thyroid carcinoma is rare but highly aggressive malignancy with poor prognosis. ATC patients should receive multimodality therapy,especially local resection and postoperative radiotherapy.Even inoperable patients could benefit from radiotherapy.

Objective To investigate the biological characteristics and management of multifocal papillary thyroid carcinoma. Methods Clinical data of 86 patients who underwent thyroidectomy and were pathologically diagnosed as progressive multifocal papillary thyroid carcinoma from 1995 to 1997 in Tianjin Cancer Hospital were retrospectively analyzed. Results There were 86 cases of multifocal papillary thyroid carcinoma, accounting for 23.4% of all papillary thyroid carcinoma of the same period. In the 86 cases of multifocal papillary thyroid carcinoma, there was unilateral in 12 cases and bilateral in 74 cases; cervical lymph node metastasis in 51 cases ( 59. 3% ); combined microcarcinoma of 46 cases ( 53.5% );Hashimoto's thyroiditis was concomitant in 23 cases (26.7%); local invasion was found in 19 cases (22. 1% ); distant metastasis occurred in 1 case ( 1.2% ); 10-year survival rate was 95.3%. American Joint Committee on Cancer ( AJCC ) stage was associated with prognosis significantly ( x2 = 63. 395, P =0.000). Conclusions Multifocal papillary thyroid carcinoma often occurs bilaterally, concomitant microcarcinoma and Hashimoto's thyroiditis is common with a comparatively favorable prognosis. AJCC stage is still the best prognostic factor.

Objective To explore the clinico-biological characteristics, treatment and prognosis of salivary duct carcinoma. Methods This study included 12 cases of salivary duct carcinoma treated in our hospital. Clinical data were retrospectively analyzed for patients admitted between April 1995 and October 2006. The clinical characteristics, histological features, imaging, therapy methods and prognosis were analyzed. Results Of 12 salivary duct carcinoma, there were 10 males, 2 females. The age of onset ranged from 53 to 73 year old and the average was 56 year old. Physical examination revealed a firm and unboundary mass accompanied by nerve infiltrating symptom. The histological appearance was characterized by solid cell nests with ductal structures and central comedonecrosis. Extensive resection and radical neck dissection was performed in 11 patients, postoperation radiation done in 10 patients and chemotherapy in 3 patients. One year survival rate was 83. 33% , that of 3 years was 41. 67% , and of 5 years was 25. 00% , the median survival time was 36 months. Conclusion Salivary duct carcinoma is a rare malignant salivary tumor and most patients are men. Regional extensive resection and postoperative radiation or chemotherapy are the mainstay of therapy. Lymph node metastases in level Ⅰ ,Ⅱ , Ⅲ are a common finding in patients with SDC and the prognosis is poor.

Objective:To determine the clinical features of papillary thyroid microcarcinoma (PTMC) and the risk factors for central compartment lymph node (CCLN) metastasis in PTMC. Methods:Data of 1 401 patients with PTMC who were treated in Tianjin Medi-cal University Cancer Institute and Hospital between January 2014 and December 2014 were retrospectively analyzed. Chi-square test and multivariate Logistic regression analysis were used to study the risk factors. Results:With regard to clinicopathological features, the sex ratio is 1:3.4 in patients with PTMC. CCLN metastasis affected 427 (30.5%) of the total 1 401 patients. Age (χ2=14.587, P<0.01), sex (χ2=21.636, P<0.01), tumor multifocality (χ2=35.505, P<0.01), tumor size (χ2=58.868, P<0.01), tumor site (χ2=8.385, P<0.05), and extracapsular/extraglandular invasions (χ2=26.481, P<0.01) were significantly correlated with CCLN metastasis. For patients with a soli-tary primary tumor, tumor location in the lower third of the thyroid lobe was associated with a higher risk of CCLN metastasis (48.1%). The male gender, age<45 years, tumor size>6 mm, extracapsular spread, and tumor bilaterality were independently correlated with CCLN metastasis. Conclusion:A prophylactic neck dissection of the central compartment must be considered particularly in male PT-MC patients with age<45 years, tumor size>6 mm, extracapsular spread, and tumor bilaterality.