A prospective study was conducted for 91 cases of fever patients after neurosurgical procedures during the period of January-December 2013.They were divided into non-infection (n =42) and infection (n =49) groups according to whether there was infection complication.And another 51 nonsurgical hospitalized patients without fever or infection were selected as control group.The levels of procalcitonin (PCT),C-reactive protein (CRP) and white blood cell (WBC) were detected respectively.Statistical analysis showed that the level of PCT had no significant difference between non-infection and control groups (P ＞ 0.05).However,it was markedly elevated in infection group than non-infection group (P ＜ 0.01).The level of CRP was significantly different between non-infection and control groups (P ＜ 0.01).And it was the same between infection and non-infection groups.The level of WBC had significant difference between non-infection and control groups (P ＜ 0.05) and infection and non-infection groups (P ＜ 0.01).The receiver operating characteristic (ROC) curve showed that either sensitivity or specificity of PCT was the highest.Compared with CRP and WBC,PCT may identify more accurately the causes of fever after neurosurgical procedures.

Objective Hypothyroidism during pregnancy has been associated with impaired cognitive development and increased fetal mortality.In this retrospective study we attempt to identify the timing and adjustment of levothyroxine during pregnancy.Methods 20 women planning pregnancy after thyroidectomy because of thyroid cancer were observed before and throughout their pregnancies.Their thyroid function was measured before conception,and approximately every 4 weeks during pregnancy.The dose of levothyroxine was increased to maintain the thyrotropin concentration at preconception values throughout pregnancy.Results 21 pregnancies occurred in the 20 women and resulted in 20 full-term births.One woman had abortion.Their basal dose was all 100 μg.The dose increased by 12.5 μg a time to target the thyrotropin concentrations (0.1-0.25 mU/ml).The mean levothyroxine requirement increased 50 percent during the first half of pregnancy and plateaued by the 16th week.This increased dose was required until delivery.All the newborns and their mothers were healthy according to the follow-up.Conclusions We propose that women after thyroid cancer surgery should increase levothyroxine dose as soon as pregnancy is confirmed.Thereafter,serum thyrotropin level should be monitored and the levothyroxine dose adjusted accordingly.The adjustment dose is set at 12.5 μg and the maternal thyrotropin concentration is between 0.10 and 0.25 mU/ml,which guarantees healthy growth of fetus while suppresses thyroid tumor growth simultaneously.

Objective To evaluate the surgical effect of the surgical removal of both medial temporal lobe lesion and hippocampus amygdala for treating epilepsy. Methods Retrospectively analyzed 18 cases of epilepsy induced by the medial temporal lobe lesion and their hippocampal epileptic discharge was recorded by the deep electrode. Removed both medial temporal lobe lesion and hippocampus amygdala through medial temporal gyrus by modified pterional approach. The lesion had been totally removed in all of these 18 cases in naked eye. Evaluated the effect of surgery for epilepsy by Engel grading scale. Results These cases were followed up for average 2.8 years. Engel Ⅰ for 13 cases, Engel Ⅱ for 4 cases, Engel Ⅲ for 1 cases, Engel Ⅳ for none after operation. But there were lateral 1/4 quadrantanopsia in 2 cases, recent memory decreasing in 3 cases and none of death or any other complication. Conclusion Surgical removal of both medial temporal lobe lesion and hippocampus amygdala is a safe and effective method for treating epilepsy with less complication.

OBJECTIVE: Discuss the clinical features of primary ectopic thyroid carcinoma. METHOD: The clinical data of three cases diagnosed of primary ectopic thyroid carcinoma in our department since 1990 were analyzed ret respectively and related literature was reviewed. RESULT: All three patients were young females that had cervical lumps before surgery. The pathology results confirmed the diagnosis of ectopic thyroid papillary carcinoma. All cases had followed up till now and no relapse signs occurred. CONCLUSION Ectopic thyroid tissue is resulting from developmental defects at early stages of thyroid gland embryogenesis. They can cancerization, the treatment of ectopic thyroid carcinoma is also controversial. Here,we report 3 cases of primary ectopic thyroid papillary carcinoma, all of which were removed by surgery, take thyroxin orally after surgery and have a great prognosis.
Adult ; Carcinoma ; diagnosis ; therapy ; Carcinoma, Papillary ; Female ; Humans ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnosis ; therapy

OBJECTIVEThis study aimed to explore the differences of membrane thickness and pressure on the paranasal sinus membrane in goats and analyze their causes. The results can provide theoretical basis and guidance for the issues of the maxillary sinus floor augmentation related to the membrane.

METHODSThe membrane was cut into two sizes from every sinus membrane. The membrane was fixed in formalin to obtain tissue specimens for the membrane thickness study and pressure study. The correlation between the two parameters was then analyzed, and appropriate statistical methods and software were selected.

RESULTSThe top of maxillary sinus, the bottom of maxillary sinus and the frontal sinus membrane thickness were (410.03 ± 65.97), (461.33 ± 91.37), (216.90 ± 46.47) µm. The pressure were (260.08 ± 80.12), (306.90 ± 94.37), (121.72 ± 31.72) kPa. The mean differences of the membrane thickness between the top of the maxillary sinus and the frontal sinus, bottom and frontal, and top and bottom were statistically significant (P < 0.05). The mean differences in membrane pressure were also statistically significant (P < 0.05).

CONCLUSIONThe membrane thickness and pressure of the top and bottom of the maxillary sinus are higher than those of the frontal sinus membrane. However, the thickness and pressure of the bottom membrane are slightly higher than those of the top membrane. Pressure and membrane thickness are positively correlated in the sinus membrane.

Objective:To investigate the recurrence of the neck and survival incidence of clinically possible pos-itive lateral cervical nodes in patients with well-differentiated papillary thyroid cancer and the essentiality of the performation of modified radical neck dissection. Method: Retrospective datum of 267 cases of papillary thyroid car-cinoma were collected and ananlyzed. They were divided into two groups with time; selective neck dissection with VI area was performed in 151 cases of group A and selective neck dissection was performed without VI area in 116 cased of group B. They were received the same treatment in the thyroid-total thyroidectomy on initial part and subtotal thyrodectomy on the other, and total thyroidectomy on both parts if both were invated. Incidence of posi-tive lateral cerivcal nodes of VI area in group A and the recurrence in the neck and survival incidence in groups B were analyzed. Result: Fiftynine patients in group A were treated with the modified radical neck dissection, and 22 patients of them were found metastasis in lateral cervical nodes with Ⅵ area. The other 92 patients were treated with neck dissection of Ⅱ,Ⅲ,Ⅳ,Ⅵ VI area, and 31 patients weren't metastasis, 33 patients were metastasis in both Ⅵ area and the others(35.8%), 17 patients were metastasis only in Ⅵ area(18.4%), 11 patients weren't metastasis only in Ⅵ area(11.9%). Thus, the incident of metastasis in Ⅵ area was 47.70% in group A(72/151). 47 patients in group B had metastasis in lateral cervical nodes though without performing VI area neck dissection (40.5%), and the survival rate of 5 years was 99.3%. The recurrence rate in the neck of group two was 6.0% (7/116). The metastasis rate of neck lymph node was higher in group A (54.9%) than group B(40.5%). Conclu-sion : Pretracheal and peripheral recurrent nerve lymph node are very susceptible to the metastasis of well-differenti-ated papillary thyroid cancer. The neck dissection of VI area could be performed as routine.

OBJECTIVE: To explore the significance of p63 expression in thyroid carcinoma, thyroid papillary carcinoma, thyroid follicular carcinoma, squamous cell carcinoma and medullary thyroid carcinoma in order to find the possible causes of such thyroid-related diseases and if there is some kind of relation among them. METHOD: The expression of p63 was examined in 10 thyroid carcinomas, 20 thyroid papillary carcinomas, 4 thyroid follicular carcinomas, 2 squamous cell carcinomas and 2 medullary thyroid carcinomas using direct immunofluorescence. RESULT: It was shown that p63 expressed in all the thyroid-related diseases mentioned above. In squamous cell carcinoma, p63 has the highest expression and the expression of p63 in thyroid papillary carcinoma has no obvious relationship with the patients age, sex, the size and location of tumor and neoplasm metastasis. CONCLUSION The p63 masculine stem cells in thyroid could be one of the causes of some thyroid papillary carcinomas and thyroid follicular carcinomas. Thyroid papillary carcinoma, thyroid follicular carcinoma and squamous cell carcinoma may have similar origins.
Adenocarcinoma, Follicular ; metabolism ; pathology ; Adenocarcinoma, Papillary ; metabolism ; pathology ; Biomarkers, Tumor ; Carcinoma, Medullary ; metabolism ; pathology ; Carcinoma, Papillary ; metabolism ; pathology ; Humans ; Neoplastic Stem Cells ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology ; Trans-Activators ; metabolism ; Transcription Factors ; Tumor Suppressor Proteins ; metabolism

OBJECTIVE: To investigate the effect of VI region neck dissection in thyroid papillary carcinoma surgery and to prompt the key matters in such surgery. METHOD: Retrospectively analyzed 213 cases of thyroid papillary carcinoma treated by Renji ENT Department from 2003 to 2009. Under each case, we implemented the VI region neck dissection after marking recurrent laryngeal nerve with middle thyroid vein. RESULT: Among the 213 cases of thyroid papillary carcinoma performed with VI region neck dissection, 82 cases were positive, 3 cases incurred recurrent laryngeal nerve injury with 2 cases of permanent RLN injury and 2 case of temporary injury, 2 cases showed permanent Hypoparathyroidism, and 6 cases showed temporary Hypoparathyroidism. In 3 cases the metastasis of neck lymph arose within 3 years. CONCLUSION Marking recurrent laryngeal nerve with middle thyroid vein not only helps to lower the possibility of injuring RLN and parathyroid glands in thyroidectomy, but also makes the VI region neck dissection an feasible treatment for thyroid papillary carcinoma.
Adolescent ; Adult ; Aged ; Carcinoma ; Carcinoma, Papillary ; Female ; Humans ; Male ; Middle Aged ; Neck Dissection ; methods ; Recurrent Laryngeal Nerve ; anatomy & histology ; surgery ; Retrospective Studies ; Thyroid Cancer, Papillary ; Thyroid Gland ; blood supply ; Thyroid Neoplasms ; surgery ; Veins ; anatomy & histology ; Young Adult

OBJECTIVE: To investigate the characteristic of non-thyroid-related neck cyst for the purpose of im proving the accuracy of diagnosis of neck cyst preoperatively. METHOD: Retrospectively analyzed 122 cases of non thyroid related neck cyst during 1999 2005 in our department. RESULT: Congenital mass (n=84) constitute the main part of total cases (n 122), among which thyroglossal cyst is the most common reason. Infective cyst is the second cause of neck cyst (n=30), among which the number of submaxillary gland cyst is 25. Tumor is the most rare cause of neck cyst (n=8). Timing and position of cysts, auxiliary examination of physical sign and puncture cytological analysis lead to more accurate diagnosis preoperatively. CONCLUSION Accurate diagnosis of neck cyst reduce the blindness and minimize the risk preoperatively.
Cysts ; etiology ; Humans ; Neck ; Retrospective Studies ; Submandibular Gland Diseases ; Thyroglossal Cyst

Objective: To investigate the relationship between enteral nutrient albumin supply and prognosis in patients with mechanical ventilation. Methods: The clinical data of 418 mechanically ventilated patients receiving enteral nutrition support treatment in intensive care unit (ICU) of the First Hospital of Jiaxing from January 2016 to June 2019 were retrospectively analyzed. According to whether the daily albumin supply was up to standard, the patients were divided into the standard group (albumin supply was ≥1.2 g·kg^-1·d^-1) and the non-standard group (albumin supply was < 1.2 g·kg^-1·d^-1). Prealbumin, transferrin levels before and after treatment, 28-day mortality, mechanical ventilation time and the length of ICU stay were compared between the two groups. Results: A total of 418 patients were included, including 225 in the standard group and 193 in the non-standard group. There were no significant differences in gender, age and disease composition between the two groups, and the baseline data were comparable. There was no significant difference in daily calories between the standard group and the non-standard group (kJ/d: 119.73±31.55 vs. 110.05±28.98, P > 0.05), but the daily albumin supply of the standard group was significantly higher than that of the non-qualified group (g·kg^-1·d^-1: 1.38±0.83 vs. 0.95±0.75, P < 0.05). There was no significant difference in the levels of prealbumin, transferrin between the two groups before treatment. The levels of prealbumin, transferrin in standard group and non-standard group were significantly higher after treatment than before [prealbumin (mg/L): 188.53±69.25 vs. 119.44±57.62, 145.18±56.92 vs. 108.81±69.50; transferrin (g/L): 2.99±0.87 vs. 1.85±0.76, 2.09±0.81 vs. 1.52±0.76, all P < 0.05]. Moreover, prealbumin and transferring in the standard group were further improved than the non-standard group [prealbumin (mg/L): 188.53±69.25 vs. 145.18±56.92, transferrin (g/L): 2.99±0.87 vs. 2.09±0.81, both P < 0.05]. In addition, mechanical ventilation time, the length of ICU stay of the standard group were significantly shorter than those of the non-standard group (hours: 147.2±7.5 vs. 216.6±8.2, 198.8±9.5 vs. 295.4±8.9, both P < 0.05), but there was no statistically significant difference in 28-day mortality [11.56% (26/225) vs. 15.03% (29/193), P > 0.05]. Conclusion Under the condition of standard enteral nutritional calories, increased of the albumin supply can improve the clinical nutritional status of patients with mechanical ventilation, shorten mechanical ventilation time and hospital stay.