Objective To investigate the risk for recurrent thyroid carcinoma.Methods Clinical data of 56 cases of recurrent thyroid carcinoma were retrospectively analyzed and summarized possible causes of relapse.Results Student's test revealed that age,initial operative approach,pathological types,postoperative medication and radionuclide therapy were associated with recurrence (P ＜ 0.05),but gender was not associated with recurrence (P =0.240),and resection of single gland was associated with recurrence (P =0.006),but resection of both gland was not so (P =0.153).Multivariate analysis indicated that initial operative approach was the dependent factors for recurrence(P ＜ 0.05).Conclusion Some patients that prone to recurrence should be strengthened regular follow-up.Standard treatment should be used for The recurrences diagnosed.

Papillary thyroid microcarcinoma (PTMC) is a subtype of papillary thyroid cancer,and there are many debates about its treatments,including extent of thyroidectomy,necessity of prophylactic central-neck nodal dissection,risk-benefit ratio of thyroid-stimulating hormone suppression and indications of observation therapy,et al.The epidemiology and treatment programs of thyroid PTMC were reviewed in this article.

Medullary thyroid carcinoma(MTC) is a rare neuroendocrine neoplasm caused by the malignant hyperplasia of thyroid parafollicular cells, accounting for 4% of all diagnosed thyroid cancer. Patients with MTC have a relatively poor outcome. Distant metastasis, especially in liver, is usually found at the time of diagnosis and the effect of chemotherapy is unsatisfactory in most cases. Due to its highly progressive characteristic and poorer prognosis compared with other subtypes of thyroid cancer, MTC has always been the focus and difficulty of clinical research. In the era of precision therapy, the classification of MTC is more accurate with the application of genetic testing technology and various kinds of individual treatments, such as targeted therapy and peptide receptor radionuclide therapy have been developed. This review will describe the latest development in MTC in the era of precision therapy.

Objective Investigated the clinical features and risk factors of pulmonary metastasis in children with papillary thyroid carcinoma aiming to provide guide for clinical work.Methods Collected the informations of 40 patients with under the age of 14,who underwent surgery in the Thyroid surgery of the First Affiliated Hospital of ZhengZhou University and confirmed for the papillary thyroid carcinoma by the postoperative pathology.At the same time,excluded studies with history of head and neck malignancy or lyphoma or secondary thyroid cancer,papillary thyroid carcinoma with hyperthyroidism and cases of imcomplete informations.The age of the 40 patients was 3 to 14 years old,12 were boy and 28 were girl.The largest tumor diameter was 7.5 cm,and the smallest was 0.3 cm.Tumor lesions were solitary in 22 cases and multiple lesions were in 18 cases.There were 33 cases of cervical lymph node metastases and 7 cases of no cervical lymph nodes.There were 10 cases of pulmonary metastasis and 30 cases of non-pulmonary metastasis.This research adopted chi-square test and Logistic regression statistical analysis of related risk factors and clinical features,including patients' age,gender,tumor diameter,number of lesions,surgical methods,neck lymph node metastasis,and pulmonary metastasis.Results The positive rate of plumonary metastsis in children with papillary thyroid carcinoma was 25％ (10/40),statistical analysis found that the positive rate of children with lung metastasis (x2 =8.620,P =0.003),tumor diameter over 2 cm (x2 =5.763,P =5.763) and the difference was statistically significant higher.Logistic regression analysis showed that the number of risk factors was multifocal papillary thyroid carcinoma in children lung metastasis (OR =13.058,P =0.028).Conclusions Higher lung metastasis is a clinical feature of thyroid papillary carcinoma in children.The risk of lung metastasis was significantly higher for children with thyroid papillary carcinoma who had multiple lessions.

Objective To study the relationship between plasma lipids and gallbladder stones(GD).Methods The plasma lipids levels were determined and GD was diagnosed by ultrasonic instrument in 5 982 subjects,then the occurrence of GD was compared between hyperlipemia and no-hyperlipemia.Results The detectable rate of GD of the hyperlipemia was 9.86% and that of the no-hyperlipemia was 7.00%,the difference was significant(P0.05,OR=1.223,95%CI:1.127-2.748).Conclusion The prevalence rate of GD in hyperlipemia patients is higher than that in normal plasma lipids subjects.The sick risk of GD in patients with hypercholesterolemia is much higher than that in persons with normal total cholesterol levels.Sex has no influence on the formation of GD in hyperlipemia patients.

Objective To evaluate the diagnosis and surgical treatment of primary hyperparathyroidism (PHPT). Methods 53 patients with PHPT who were treated in our hospital from 1997 to 2009 were analyzed retrospectively. Results All patients showed hypercalcemia and elevated parathyroid hormone (PTH). Among them, 43 were diagnosed as parathyroid adenoma, 6 were parathyroid hyperplasia and 4 were parathyroid cancer.The accuracy rate of parathyroid tumor localization was above 94. 3%. All patients presented temporary hypocalcemia after surgery. Conclusions Parathyroidectomy is an effective approach for patients with PHPT. Preoperative localization is essential to the surgery.

OBJECTIVETo explore the clinical effect of using dorsal two wing-shaped flap to reconstruct finger web for treatment of congenital syndactyly.

METHODSThis technique has been used in 19 children with congenital syndactyly. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle were designed and was just sewed up with an anchor-shaped incision at the palm. The web was primarily reconstructed without skin graft at base of fingers. Distal end of fingers were separated by using serrated flap and were closed after removal of fatty tissue. At some cases with tight skin connection. The defect area at lateral and distal end of fingers was closed by small pieces of skin graft.

RESULTSAll the webs were reconstructed primarily without skin graft at the base of fingers. 7 cases with tight skin connection had small pieces of skin graft at lateral and distal end of fingers. Primary healing was achieved in all cases. After 1 to 6 months of follow-up, both the appearance and function were satisfactory without conspicuous scar. The reconstructed finger webs were in normal depth and width.

CONCLUSIONSPrimary web space can be achieved by dorsal two wing-shaped flap without skin graft at base of fingers. It is one of the best choices for treatment of congenital syndactyly.

Adipose Tissue ; surgery ; Child ; Cicatrix ; Dermatologic Surgical Procedures ; methods ; Fingers ; surgery ; Humans ; Skin Transplantation ; Surgical Flaps ; transplantation ; Syndactyly ; surgery ; Wound Healing

Objective:To observe the relationship between the occurrence of symptomatic hypocalcemia (SH) and various potential influencing factors in patients after thyroidectomy, stratify according to the scope of thyroidectomy, and explore the predictive value of intact parathyroid hormone (iPTH) for postoperative SH.Methods:Among 3 379 patients with thyroidectomy who admitted into the First Affiliated Hospital of Zhengzhou University from January 2020 to February 2021, 122 patients with SH after thyroidectomy were collected retrospectively and set as SH group. 100 patients of the remaining 3 200 patients who did not suffer from SH in the same year were selected by systematic sampling method and set as control group. Pearson correlation analysis was used to analyze the potential influencing factors such as age, preoperative calcium, postoperative calcium, preoperative iPTH, postoperative iPTH, central lymph node number, blood loss, operation duration, gender, lymph node dissection method, thyroidectomy range, postoperative pathological type and other. Among them, the measurement data of normal distribution were expressed by mean±standard deviation( Mean± SD), t-test was used for the comparison between the two groups, and Chi-square test was used for count data. By drawing the receiver operating characteristic curve (ROC), the iPTH levels in patients with and without SH before/after operation (different surgical methods) were studied, and the diagnostic threshold, sensitivity and specificity of iPTH were predicted. Results:Among 3 379 patients, 122 patients suffered from SH after thyroidectomy, with the incidence rate of 3.6%. There were significant differences in gender (8 males and 114 females in SH group; 27 males and 73 females in control group), whether lateral area dissection was performed (58 cases with dissection and 64 cases without dissection in SH group; 7 cases with dissection and 93 cases without dissection in control group), thyroidectomy range (14 cases with one side and 108 cases with both sides in SH group; 73 cases with one side and 27 cases with both sides in control group), age (40.1 years old vs 43.2 years old), dissection number of central lymph nodes (8.6 vs 4.6), dissection number of cervical lymph nodes (12.3 vs 0.7), blood loss (22.8 mL vs 11.0 mL), operation duration (1.7 h vs 0.8 h), postoperative iPTH (16.4 pg/mL vs 41.9 pg/mL), preoperative iPTH (39.4 pg/mL vs 47.8 pg/mL) in SH group; and postoperative calcium level (1.9 mmol/L vs 2.2 mmol/L). There was significant differences between the two groups ( P<0.05). However, there was no significant differences between them with postoperative pathological type (4 cases with toxic goiter, 3 cases with medullary thyroid carcinoma, 1 case with thyroid follicular carcinoma, 114 cases with papillary thyroid carcinoma in SH group; 1 case with medullary thyroid carcinoma, 1 case of thyroid follicular carcinoma, 98 cases with papillary thyroid carcinoma in control group, P=0.25) and preoperative calcium (2.3 mmol/L vs 2.3 mmol/L, P=0.10). For patients with bilateral thyroidectomy, SH was easy to occur when postoperative iPTH < 20.08 pg/mL, and its sensitivity and specificity were 74.07% and 96.30%; however, for patients with unilateral thyroidectomy, SH was easy to occur when iPTH < 24.00 pg/mL after operation. Conclusions:Gender, age, postoperative calcium, preoperative iPTH, postoperative iPTH, central lymph node number, blood loss, operation duration, lymph node dissection method and thyroidectomy range are important factors affecting the occurrence of SH after thyroidectomy. With the expansion of surgical range, the postoperative iPTH level gradually decreases, which predicts the occurrence of symptomatic hypocalcemia. In order to avoid the occurrence of symptomatic hypocalcemia after operation, it is necessary to supplement calcium in time according to the range of operation and postoperative iPTH level.

Objective:To investigate the effects of miR-497 on cytobiology behaviors of papillary thyroid carcinoma (PTC) by targetingly regulating the expression of Yes-associated protein 1 (YAP1) .Methods:Human TPC-1 cells were divided into control group, miR-497 group, si-YAP1 group and miR-497+si-YAP1 group. The liposome transfection was conducted by LipofectamineTM3000. The targeted relationship between miR-497 and YAP1 was validated by Luciferase Reporter Assay. The cell proliferation activity in each group was detected by MTT method. The apoptosis rates were analyzed by flow cytometry. The number of invasion cells was detected by Transwell. The cell migration rates were detected by scratch assay. The expression of Cyclin D1, matrix metalloproteinase 2 (MMP-2) , MMP-9, matrix metalloproteinase inhibitor-1 (TIMP-1) and activated caspase 3 (cleaved Caspase-3) was detected by Western blot. SPSS 22.0 was used to analyze data, and normally distributed measurement data were expressed as ( ± s) . One-way ANOVA was analyzed for the difference between multiple groups, and SNK-q were analyzed for the difference between two groups. Results:Compared with the control group, the expression of YAP1 mRNA and protein was decreased in miR-497 group and si-YAP1 group ( q=14.682, 14.597; 23.743, 23.571; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=4.724, 4.568, 3.841; 4.216, 3.952, 3.274; P<0.05) , apoptosis rate was increased ( q=3.783; 4.336; P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=5.823, 5.981, 6.036, 6.485; 5.934, 6.110, 6.573, 6.614; P<0.05) , and expression of TIMP-1 protein was increased ( q=6.071; 6.148; P<0.05) . Compared with si-YAP1 group, miR-497 level was increased in miR-497+si-YAP1 group ( q=14.726, P<0.05) , the expression of YAP1 mRNA and protein was decreased ( q=3.089, 3.126; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=2.654, 2.537, 2.246; P<0.05) , apoptosis rate was increased ( q=2.875, P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=4.371, 4.365, 4.383, 4.368; P<0.05) , and expression of TIMP-1 protein was increased ( q=4.275, P<0.05) . Conclusion:MiR-497 can negatively targetingly regulate the expression of YAP1, inhibit proliferation, invasion and migration of TPC-1 cells.

Objective To explore the clinical results of benign thyroid nodule by ultrasound guided interventional radiofrequency ablation(RFA).Methods The radiofrequency ablation therapy was utilized to treat 129 patients with 149 thyroid nodules.The size and the related complications were observed during the follow-up.Using the t-test of paired design,the nodules volume decreased rate were calculated.Results At the 3rd and the 6th month after operation,all thyroid nodules in size to differert degree (P ＜0.05).Six patients felt pain in the neck.The pain was alleviated after ablation.Two patients had skin puncture site redness,which was cured after anti-inflammation treatment.There was no skin burn,perforation of the esophagus,trachea injury,hoarseness,bucking and other complications.Conclusions Ultrasound-guided RFA may be an effective and useful nonsurgical alternative in the treatment of thyroid nodules.It is clinically prospective for application.