OBJECTIVE To summarize the clinical experience of endoscopic thyroidectomy via suprasternal approach. METHODS Endoscopic thyroidectomy via suprasternal approach was performed in 35 patients with ultrasonic scalpel. RESULTS Operations were successfully performed in 35 patients. The mean operation times were 130 (105～190) minutes in 24 cases with subtotal lobectomy and 4 case with total lobectomy, 60 (50～70) minutes in 2 cases with isthmectomy, 228 (185～270) minutes in 2 case with bilateral subtotal lobectomy, 163 (140～215) minutes in 3 case with subtotal lobectomy and the contralateral ademona resection .The bleeding during operation was 5 to 40ml and the average hospital stay time was 4 (3～5) days. CONCLUSION Endoscopic thyroidectomy via suprasternal approach is a safe way with good cosmetic value.

Objective: To analyze the clinicopathological features of primary hyperthyroidism complicated with thyroid carcinoma. Methods: From January 2010 to July 2018, 418 patients complicated with thyroid cancer underwent thyroidectomy in the First Affiliated Hospital of Xiamen University were retrospectively analyzed.According to thyroid function, 418 patients were divided into two group: A group(n=39) had hyperthyroidism with thyroid carcinoma, and B group(n=379) had normal thyroid function.The clinicopathological features of the two groups were analyzed and compared. Results: There were no statistically significant differences in age, sex, tumor stage and tumor diameter between the two groups(all P>0.05). The lymph node metastasis rate in A group was 17.9%(7/39), which was higher than that in B group[6.1%(23/379)](χ²=5.814, P=0.016). The incidence rate of temporary hypoparathyroidism in A group was 28.2%(11/39), which was higher than that in B group[13.2%(50/379)](χ²=6.394, P<0.05). The local recurrence rate in A group was 5.1%(2/39), which was higher than that in B group[2.4%(9/379)], but there was no statistically significant difference(χ²=0.248, P=0.619). The 5-year disease-free survival rate in A group was 84.6%(33/39), which was lower than that in B group [95.8%(363/379)](χ²=6.740, P<0.05). Conclusion Hyperthyroidism complicated with thyroid carcinoma has high aggressive behavior and should be treated actively.

Objective To discuss the clinical characteristics of benign paroxysmal vertigo of childhood (BPVC) with frequent episodes,in order to further improve the level of diagnosis and treatment.Methods The clinical data of 25 cases with frequent episodes of BPVC were analyzed retrospectively.All cases were treated with regimen for migraine.Results Aspirin combined with propranolol had the best effect,quick effect,short period of treatment and minimal side effect.Conclusion Aspirin and propranolol are commonly used drugs in the treatment of migraine,which can effectively treat frequent episodes of BPVC,and is economical and practical,and it is conducive to promotion at the grass-roots level.It also confirms the homology of children with benign paroxysmal vertigo and migraine.

Objective:To investigate the effects of airborne fine particle on cell viability and inflammation in human bronchial epithelial cells.Methods:Atmospheric PM2.5 samples were collected by PM2.5 sampler.PM2.5 morphology was observed by scanning electron microscope (SEM).Human bronchial epithelial cells (BEAS-2B) were treated with PM2.5 at different concentrations (0,50,100,200,400,800 μg/mL) for 12,24 or 48 hours,and the cell activity were evaluated by cell counting kit-8 (CCK-8).The mRNA expression levels of (granulocyte-macrophage colony stimulating factor,GM-CSF) and TNF-α were detected by quantitative real-time PCR (qRT-PCR).Western blot was used to detect the protein expressions of GM-CSF and TNF-α.Results:According to SEM,the shape of PM2.5 varied,and the diameter was different and mostly equal to or less than 2.5 μm.CCK-8 assay showed that different concentrations of PM2.5 exposure for 12 hours,24 hours and 48 hours resulted in loss of cell viability of BEAS-2B cells (P＜0.05).Different concentrations of PM2.5 increased the mRNA and protein expression of GM-CSF and TNF-α,and the higher concentration of PM2.5 induced higher expression,which have statistical significant difference between the groups (P＜0.05).Conclusion:Atmospheric PM2.5 can cause inflammatory response in human bronchial epithelial cells.They can reduce cell viability,which may be related to the PM2.5 trigger and aggravation of bronchopulmonary inflammatory diseases.

OBJECTIVETo study the application value of fine needle aspiration and cell block combined with molecular markers in early diagnosis of thyroid cancer and discriminate follicular tumor before operation.

METHODSFine needle biopsy of thyroid nodules was guided by color ultrasound, then the sample acquired was used to make smear and the rest to make cell block. The pathological diagnosis on smear, cell block or combination of both was made respectively. Then, the Envision immunohistochemical method was employed to detect the expressions of CK19, Galectin-3 in cell block samples, which had been used for the diagnosis of papillary thyroid carcinoma or thyroid nodules from benign lesions after operation and to detect the expressions of DDIT3, ki-67 of cell block that had been used for the diagnosis of follicular tumor nodules.

RESULTSThe sensitivity, specificity, positive predictive value, negative predictive value and accuracy of cytopathology for the diagnosis of malignancy were 95.3%, 94.7%, 92.7%, 96.6% and 95.0% respectively; and the sensitivity, specificity and accuracy of the diagnosis used cell block alone or combined with smear were 88.1%, 95.3%, 92.3% and 95.3%, 94.7%, 95.0% respectively, which were higher than 53.8%, 83.7%, 71.3% from smear correspondingly. The positive expression rate of CK19 and Galectin-3 of papillary thyroid carcinoma cell block were 100% and 98.0% respectively, higher than the value 17.7% and 23.3% of thyroid benign lesions (P < 0.01); the positive expression rate of DDIT3 of thyroid follicular cancer cell block was 84.6%, higher than the value 35.1% of follicular adenoma (P < 0.01), there was no statistical significance of Positive expression rate of Ki-67 between thyroid follicular carcinoma and follicular adenoma cell block (P > 0.05).

CONCLUSIONSIt was conducive to early diagnose thyroid cancer with detection of CK19, Galection-3 of cell block made by ultrasound-guided fine needle biopsy of thyroid nodules. And it was also significant for DDIT3 detection to early discriminate follicular neoplasm before operation.

Adenocarcinoma, Follicular ; diagnosis ; Biomarkers, Tumor ; metabolism ; Biopsy, Fine-Needle ; Carcinoma ; diagnosis ; Carcinoma, Papillary ; Galectin 3 ; metabolism ; Humans ; Immunohistochemistry ; Keratin-19 ; metabolism ; Ki-67 Antigen ; metabolism ; Preoperative Period ; Sensitivity and Specificity ; Thyroid Neoplasms ; diagnosis ; Thyroid Nodule ; diagnosis ; Transcription Factor CHOP ; metabolism