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.

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 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 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.

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.

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 investigate expression,significance and relationship of IMP3 and CD44v6 protein in papillary thyroid carcinoma.Methods Immunohistochemical method was used to investigate the expression of IMP3 and CD44v6 protein in 30 cases PTC(10 follicular variant of papillary carcinoma cases,20 conventional papillary thyroid carcinoma cases),20 PTC with lymph node metastasis cases,20 benign tissues of thyroid cases.Quantitative analysis of the detection was conducted by Biosens Digital Imaging System vl.6 (professional image analysis software),and the target integral optical density (IOD) was used for the judgement parameter.Results IMP3 and CD44v6 expression in the PTC is higher than in benign group,the difference was statistically significant (P ＜ 0.05) ; IMP3 and CD44v6 expression in PTC with lymph node metastasis was higher than without lymph node metastasis in the organization to express,the difference was statistically significant (P ＜ 0.05) ; There was a positive correlation between IMP3 and CD44v6 expression and metastasis in PTC (r =0.903,P ＜ 0.05).Conclusions The expression of IMP3 and CD44v6 protein was closely correlated with the invasion and metastasis of PTC.IMP3 and CD44v6 protein might be considered as molecular markers for PTC.

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.

Objective To analyze the clinicopathological features and prognosis of patients with occult breast cancer ( OBC) , as well as to explore the best treatment .Methods The clinical data of 72 patients with OBC confirmed by pathology were retrospectively analyzed , while 320 cases with other kind of breast cancer were the control group .Results Axillary mass was the first sign of the 72 patients with OBC.The diagnosis rate of MRI was higher than mammary graphy ( 71.4% vs 53.5%) .The difference had statistical significance (χ2 =11.876, P=0.001) .The characteristics of OBC with axillary lymph node metastasis was mainly moderately or low differenti -ated, usually with diffuse infiltrative cancer cells , flaky, like large Apocrine cells.Compared with the control group, the positive rate of CK7, CK20 and TTF-1 had no statistical differences (χ2 =0.058, P=0.810).The posi-tive rate of ER and PR was 46.7% and 36.7%, lower than the control group (χ2 =4.535, P=0.033).Clinical stage, operating method and the number of lymph node metastasis may be the independent factors influencing prog -nosis.Conclusions Axillary mass is the first symptom of OBC .To combine MRI with immunohistochemistry is helpful in diagnosis and differential diagnosis of the disease .The positive rate of ER and PR for OBC patients is low.Modified radical mastectomy combined with adjuvant therapy may be the better choice .