Carcinoma ; diagnosis ; Carcinoma, Papillary ; diagnosis ; Family ; Humans ; Thyroid Neoplasms ; diagnosis

Objective To investigate the correlation between serum proprotein convertase subtilisin/kexin 9 (PCSK9) level and the severity of angiographic coronary artery disease (CAD) in elderly patients with acute myocardial infarction (AMI) complicated with type 2 diabetes mellitus (T2DM). Methods The patients over the same period were divided into three groups:the elderly patients with AMI and T2DM (observation group, n=46), the elderly non diabetic patients with AMI (positive control group, n=34) and patients with chronic stable coronary heart disease (negative control group, n=33). The serum PCSK9 level was detected by enzyme-linked immunosorbent (ELISA) in three groups. The correlation between serum PCSK9 level and low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), total cholesterol (TC), glycosylated hemoglobin (HbA1c), high sensitive C reactive protein (Hs-CRP) and Gensini score were analyzed. Results The levels of PCSK9, HbA1c, Hs-CRP and Gensini score showed a gradually increased tendency in negative control group, positive control group and observation group. Multiple comparison differences between groups were statistically significant (P<0.05). The serum PCSK9 level was positively correlated with Hs-CRP and Gensini score in observation group (P<0.05), and showed no correlation with HbA1c, TG, TC, LDL-C and HDL-C (P>0.05). Conclusion The serum level of PCSK9 is positive correlated with the severity of CAD, which can be used to determine the severity of coronary artery lesions in elderly patients with AMI complicated with T2DM.

Objective To evaluate the curative effects of carbon nanoparticles on central lymphnode dis -section in papillary thyroid carcinoma ( PTC) .Methods 72 PTC patients were randomly divided into two groups:carbon nanoparticle group(n=32)and the control group(n=32).Patients in the carbon nanoparticle group were injected with carbon nanoparticles during surgery .Patients in the control group had conventional surgery .The number of lymph nodes being dissected ,lymph node metastasis , and the rate of hypoparathyroidism were compared between the two groups .Results The number of lymph nodes dissected in nanoparticle group ( n =312 ) was much bigger than that in the control group (n=189)(P<0.01;t=8.476).The incidence of hypoparathyroidism in nanoparticle group(n=1)was much lower than that in the control group (n=8)(P<0.05;χ2 =4.571).The metastasis of lymph nodes has no significant difference between the two groups (P>0.01;χ2 =1.048).Conclu-sions The lymphatic tracer technique may improve the number of lymph nodes dissected in central region of PTC and reduce parathyroid gland damage .

Objective To investigate the related factors of postoperative hypocalcemia after thyroid carc-er surgery.Methods 346 cases of thyroid carcer patients undergoing surgery from Jan .2013 to Dec.2013 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed .Results 129 cases developed hepocalcemia after thyroid surgery .Among the related factors that may cause postoperative hypocalcemia , the scope of surgery , parathyroid injury and secondary surgery might play important roles .Conclusions The inci-dence of postoperative hypocalcaemia is high after total thyroidectomy .Patients with reoperation and lymph node dissection have an increased rate of postoperative hypocalcaemia .In order to reduce hypocalcaemia incidence ,sur-gons need to protect parathyroid blood supply in thyroid surgery and give calcium after surgery .

Carcinoma ; diagnosis ; surgery ; Chylothorax ; diagnosis ; Humans ; Lymph Node Excision ; Thyroid Neoplasms ; diagnosis ; surgery

Objective Study and analyze the benefits and risks of unilateral thyroidectomy for 1 to 4 cm thyroid cancer in primary surgery.Methods The patients who underwent thyroidectomy for 1 to 4 centimeters WDTC (May 2014 to June 2015) were retrospectively reviewed,and the patients with preoperatively known high-risk characteristics were excluded.One hundred and seventy-one patients would have been eligible for lobectomy as the initial operation based on current American Thyroid Association guidelines.The proportion of patients who need secondary surgery was estimated basing on pathological characteristics.Result In this group,49％ patients would have to undergo a secondary surgery if they took lobectomy as the initial operation.Conclusions Patients with 1 to 4 centimeters WDTC who accept unilateral thyroidectomy may take the risk of secondary surgery.Surgeons and patients need to balance the relative benefits and risks of initial TT versus lobectomy before the operation.

Objective To investigate the application of intraoperative neuromonitoring (IONM) during thyroidectomy for non-recurrent laryngeal nerve (NRLN).Methods From Oct.2013 to Apr.2016,2846 patients underwent thyroidectomy with the application of IONM,and 11 patients with non-recurrent laryngeal nerve were analyzed.Results 11 cases of NRLN were all accurately identified by IONM,and no injury of NRLN occurred during thyroid surgery.Conclusions NRLN is uncommon in clinical and it is difficult to be predicted before surgery and easy to be injured.The application of IONM can reduce the possibility of NRLN injury remarkably.

Objective To study the expression of mitochondrial tumor suppressor gene 1 (MTUS1) mR-NA in papillary thyroid carcinoma(PTC).Methods Reverse transcription polymerase chain reaction(RT-PCR) was used to detect MTUS1 mRNA level in 68 cases of human PTC and the adjacent non-cancerous epithelium (NCE) specimens.Results The relative expression value of MTUS1 mRNA in PTC was 0.31 ± 0.09,while it was 0.65 ±0.12 in NCE.The difference had statistical significance between the 2 groups(t =2.39,P ＜0.05).In PTC,mRNA expression of MTUS1 gene was related to the pathological grade,and lymph node metastasis(P ＜ 0.05)while it was not related to patients' age,sex,differentiation degree,tumor size or TNM stage(P ＞ 0.05).Conclusion mRNA expression of MTUS1 gene is lower in PTC than in NCE,which may play an important role in carcinogenesis and progression of PTC.

Objective Methylation of anti-oncogene can be demethylated by related drugs which can help the inactivated gene to express again .This study aims to study the effects of the demethylating agent 5-Aza-2′-deoxycytidine on the growth of human thyroid papillary cancer cell line TPC-1 and mRNA and protein expres-sion of KLF4.Methods TPC-1 cells were treated with different concentration of 5-Aza-CdR.MTT was used to detect the influence of 5-Aza-CdR on cell proliferation .RT-PCR was used to detect mRNA and protein expression levels of KLF4.Results After being treated with 5-Aza-CdR for 24 hours, 48 hours, and 72 hours, the growth of TPC-1 cells was inhibited and the inhibition was in time and concentration depended manner .After treatment with 5-Aza-CdR, mRNA and protein expression levels of KLF 4 were increased, and the difference had statistical significance(P<0.05).Conclusion 5-Aza-CdR can inhibit the cell viability of TPC-1 cells through upregulat-ing KLF4 expression , which may provide experimental basis for 5-Aza-CdR in treating thyroid cancer .

Objective To study fragile histidine triad gene(FHIT) gene mRNA expression in 60 samples of papillary thyroid carcinoma(PTC) and matched adjacent non-concerous tissues (NCE),and to explore the role of FHIT gene in the development in PTC.Methods Reverse transcription polymerase chain reaction(RT-PCR) was used to detect FHIT gene mRNA expression in 60 samples of PTC and matched NCE.Results In PTC tissues,the positive rate of FHIT gene mRNA expression was 45.0％ (27/60),lower than that in NCE tissues (100.0％,60/60).FHIT gene mRNA expression was correlated with pathology stage,TNM stage and lymph node metastasis (P ＜ 0.05).Conclusion FHIT loss and transcript abnormality might play important roles in proliferation and metastasis of PTC,and might be a useful marker for evaluating the biological behavior of PTC.