Objective To explore the clinical significance of occult breast lesions biopsy,determine the operating methods of ultrasound-guided precisie resection of occult breast lesions,improve early diagnosis rate of breast cancer.Methods Forty-eight occult breast lesions of 44 patients were reviewed by localization-needle and skin markers method under ultrasound-guided,and the lesions were removed surgically according to the fixed steps.Results It was confirmed that all the impalpable mammary masses were exactly excised without localization-needle fracture or prolapse through postoperative pathological diagnosis.Breast appearance had no change after the operation.No nipple-areola necrosis occurred.The pathology results showed 4 cases of invasive ductal carcinoma (Ⅰ stage),the incidence rate being 8.3％,and 15 cases of atypical hyperplasia,the incidence rate being 31.3％.The other types were benign disease such as adenosis,intraductal papilloma,fibroadenoma and mammary duct ectasia.Conclusions Ultrasound-guided precise resection of occult breast lesions is a safe and effective diagnosis and treatment method,which needs some surgical skills.It has positive significance in improving breast cancer early diagnosis rate,reducing medical costs and decreasing breast biopsies complications.

Objective To investigate the protection of the parathyroid in thyroid cancer operation,reduce the postoperative complications of hypoparathyroidism.Methods Selected 107 cases of thyroid cancer patients from Mar.2013 to Fed.2014 who were underwent thyroid total excision + Ⅵ lymphadenectomy.Identified and preserve in situ of parathyroid according to the typical appearance.Identified the parathyroid on the surface of thyroid and Ⅵ lymph node specimen carefully.Sented a part of the suspected tissue to intraoperative frozen section examination,transplant residual tissue to stemocleidomastoid muscle after confirmed.According to postoperative pathological diagnosis,determined the specimen of thyroid and Ⅵ lymph node with or without removed parathyroid.Monitored serum calcium and symptomatic treatment for 1 to 3 days after operation.Results Error cut rate of parathyroid was 11.4％.In vitro parathyroid autograft rate was 54.4％.Hypocalcemia occurred in 32.7％.Symptomatic hypocalcemia occurred in 16.8％.Permanent hypocalcemia did not happen.Conclusions In thyroid cancer operation,accurate identification of parathyroid is the precondition of preservation in situ and self transplantation,is the effective methods to reduce error removal and decrease postoperative hypocalcemia.

Objective To investigate the technology learning curve of thyroid cancer intraoperative nerve monitoring aiming to reduce the recurrent laryngeal nerve injury complication.Methods Eighty-two cases of thyroid cancer accepted thyroid cancer radical mastectomy or combined radical operation,dissected 147 recurrent laryngeal nerve,used intraoperative nerve monitoring technology,monitored recurrent laryngeal nerve function with four steps method.The recurrent laryngeal nerve injury can be diagnosed when the intraoperative signal decay rate was more than 50％.The damage point and reason can be judged.Results The recurrent laryngeal nerve search time was 0.5 to 2 minutes.The recurrent laryngeal nerve damage rate was 2.7％.Recurrent laryngeal nerve damage cases were all diagnosed during the operation.Recurrent laryngeal nerve damage points were all located in the throat or approaching into the throat.The damage reasons were pull,tumor adhesion,thermal damage and clamp.The technology learning curve of thyroid cancer intraoperative nerve monitoring formatted through search time and injury cases of each group according to the time sequence.Recurrent laryngeal nerve search time and injury cases were obviously downtrend.Conclusions The technology learning curve of thyroid cancer intraoperative nerve monitoring existed.It can be used to protect recurrent laryngeal nerve.

ObjectiveTo study the therapeutic effect and feasibility of endoscopic thyroidectomy via breast areola approach. MethodEndoscopic thyroidectomy via breast areola approach was performed in 62 patients, including 16 cases of adenoma, 43 cases of nodular goiter, and 3 cases of thyroid carcinoma.ResultsEndoscopic thyroidectomy was succeeded in 62 patients, 2 cases of cutaneous emphysema, 1 case of light skin bum which diameter was 0.5 cm, 1 case of transient hoarse voice,and 1 case of puncture sinus tract bleeding. There was no converted to open surgery,no hypercapnia, no damage of recurrent laryngeal nerve or parathyriod glands. ConclusionEndoscopic thyroidectomy via breast areola approach is safe and effective,and has good cosmetic results.

Objective To investigate the Allelic and haplotype frequency distribution of seventeen short tandem repeat loci of Y chromosome in Heiyi Zhuang ethnic groups in Guangxi province.Methods Seventeen Y-STR loci,of which the template DNAs were extracted from blood samples of 184 unrelated male individuals in Heiyi Zhuang population,were amplified by using the AmpFlSTR YfilerTM.The PCR products were genotyped with ABI PRISM 310 genetic analyzer.Results The Gene diversity ranged from 0.4910 to 0.9727 at DYS456、DYS389Ⅰ、DYS390、DYS389Ⅱ、DYS458、DYS19、DYS385a\b、DYS393、DYS391、DYS439、DYS635、DYS392、Y-GATA-H4、DYS437、DYS438、DYS448.A total of 180 different haplotypes were observed,The haplotype diversity value calculated from all 17 loci was 0.99976.The significant difference of the allelic frequency distribution in Y-STR loci was found between Heiyi Zhuang population and other observed populations.Conclusion The 17th Y-STR loci in Heiyi Zhuang population of Guangxi province are highly affluent genetic polymorphic and can offer valuable genetic datas for paternity testing and paternal genetic lineages evolution.

Objective To evaluate the clinical value and experience of endoscopic thyroidectomy.Methods Thyroidectomy with endoscopic instruments through chest-wall approach was done for 52 patients who had thyroid adenoma nodular goiter or thyroid cancer.We observed the results and complications of these operations.Results All 52 cases of operation were successful with no conversion.There was no nerve damage or postoperative hemorrhage.Average operation duration was (100 ± 22) min.The mean time of hospitalization after operation was (3 ± 0.5) d.Conclusion With the advantages of minimal and hidden incision,sooner recovery and satisfactory cosmetic effect,the endoscopic thyroidectomy will prevail in selected cases in the future.

Objective To evaluate the diagnostic value of ultrasonography (USG) and contrast-enhanced computer tomography (CT) for thyroid carcinoma.MethodsThe results of the review of the preoperative CT and those of the original US reports were compared with the histopathologic results in 73 cases of thyroid carcinoma who underwent radical operation and central compartment dissection from November 2009 to November 2011.ResultsThe final diagnostic rate of thyroid carcinoma with USG was 69.9％,CT of that was 80.8％.There were no significant difference between them (P =0.077).The diagnostic rate of metastatic lymph node in the central compartment with USG was 61.6％,positive predictive value was 64.0％,negative predictive value was 60.4％.The diagnostic rate of metastatic lymph node in the central compartment with CT was 67.1％,positive predictive value was 61.7％,negative predictive value was 76.9％.There were not significant difference between them(P =0.848,P =0.152,P =0.489).Conclusion There was no significant difference between USG and CT in The final diagnostic rate of thyroid carcinoma and its lymph node metastasis in the central compartment.

Objective To observe the effect of Arm Spasticity Inhibitor worn in rehabilitation training on patients with upper extremities spasticity and shoulder subluxation after stroke. Methods 80 stroke patients with flexor spasm in upper extremities complicated with subluxation of shoulder were divided into treatment group and control group equally. Both groups accepted routine medicine and rehabilitation, and the treatment group wore the Arm Spasticity Inhibitor developed ourselves during the rehabilitation training. Their acromio-humeral interval (AHI) was measured with the X- ray; and they were assessed with modified Ashworth Scale (MAS), range of motion of shoulder (ROM) and elbow before and 2 months after treatment. Results It improved more in the AHI, score of MAS and ROM in the treatment group than in the control group after treatment (P<0.001). Conclusion Wearing Arm Spasticity Inhibitor during rehabilitation training may release the spasticity of upper extremities and shoulder subluxation, and improve shoulder function in patients after stroke.

Objective To analyze the clinical efficacy of the laparoscopic breast-conserving surgery combined with radiofrequency ablation to treat the early-stage breast cancer.Methods We collected 55 patients diagnosed early-stage breast cancer in retrospect,which started from January 2014 to December 2016.Twenty-seven of them were performed the laparoscopic breast-conserving surgery combined with radiofrequency ablation while others went through laparoscopic breast-conserving surgery without radiofrequency ablation.Meanwhile,we adopted the student t-test and the chi-square test to compare results of two groups.More specific,the main indexes of this study are including the post-operative local recurrence,the incidence of fat liquefaction or the incision-infection,operation time,post-operative hospital stay and the hospitalization expense.Results The laparoscopic breast-conserving surgery combined with radiofrequency ablation group had low local-recurrence than the laparoscopic breastconserving surgery group (0 and 7.69％).Additionally,there were no statistical differences between two groups in the incidence of fat liquefaction.However,The laparoscopic breast-conserving surgery combined with radiofrequency ablation group had more hospitalization expense than the laparoscopic breast-conserving surgery group [(4.1 ± 0.7) ten thousand yuan and (2.3 ± 0.6) ten thousand yuan,P ＜ 0.05].Conclusions Although the laparoscopic breast-conserving surgery combined with radiofrequency ablation group remarkably increased the hospitalization expense because of the utility of the radiofrequency ablation related apparatus,it may provide the probability of shaving more residual tumor cell and may low down the recurrence,especially not rising up the incidence of the post-operative fat liquefaction.Therefore,this surgery method might be one of the potential developments in the minimal-invasive of early stage breast cancer.

Objective To analyze clinical characteristics of invasive Luminal subtype breast cancer.Methods The data of 162 invasive Luminal subtype breast cancer patients receiving operation in Cancer Hospital of Chinese Academy of Medical Science from January 1 st to September 30th in 2002,were collected and the clinical characteristics,recurrences,metastasis and survivals were retrospectively analyzed.Results The median time of follow-up was 92 months,ranging from 4 to 98 months.41 cases (25.3％,41/162) presented local recurrence or metastasis including 32 cases with metastasis ( 19.8％,32/162),2 cases with local recurrences (1.2％,2/162) and 7 cases with both local recurrence and metastasis (4.3％,7/162) ;Disease-free survival (DFS) and the 5-year DFS were 73.1％ and 79.6％,respectively.27 patients ( 16.7％,27/162) died of breast cancer,the overall survival (OS) and 5-year OS were 82.5％ and 85.3％,respectively.According to Kaplen-Meier survival analysis,tumor size,lymph node status and clinical stage were correlated to overall survival time ( P ＜ 0.05 ) ; and rumor size,lymph node starus,grade,clinical stage and PR status were correlated to disease-free survival time ( P ＜ 0.05 ).By multivariate analysis,TNM stage,PR and PCNA were independent prognostic factors correlated to overall survival time (OR=0.633,95％ CI:0.411 -0.976,P＜0.05; OR =0.823,95％ CI:1.012-3.283,P ＜ 0.05) ; TNM stage and PR was independent prognostic factors correlated to disease-free survival time (OR =3.273,95％ CI:1.719 - 6.232,P ＜ 0.01 ; OR =0.599,95％ CI:0.423 - 0.850,P ＜ 0.01 ).Conclusions In invasive Luminal subtype breast cancers,PR is correlated to fine prognosis,and PCNA is correlated to overall survival time.