Background and purpose:There is controversial about dissecting the laryngeal nerve in operation of thyroid tumour in clinic. We adopted the methods of exposure of recurrent laryngeal nerve(RLN) to study their deficiencies and benefits. Methods:We reviewed review 456 cases of thyroid tumour who were operated. In 266 cases, RLN was unveiled generally. In 190 cases that RLN was not exposed, had subtotal thyroidectomy with protection of amatomical region.Results:RLN injury did not occur in the exposure group. 4 cases occurred in non-exposure group(3 cases of temporary RLN injury and 1 case of permanent RLN injury). Among the 3 cases of temporary RLN injury, one was caused by the large size of tumour, the other two were caused by the location of thyroid tumor. One case of permanent RLN injury was a case of reoperation for recurrence.Conclusions:The familiarity of the anatomy and variation of RLN, and the exposure of RLN in thyroid operation, can reduce the rate of the RLN injury.

Purpose:To study the determining prognostic factors that affect the survival of patients with bilateral breast cancer. Methods:The records of 21 women with bilateral breast cancer were analyzed.4(19%) presented simultaneous bilateral tumor.17(81%)developed bilateral breast cancer with interval in between. Patients were treated with surgery, radiation treatment and chemotherapy. Analysis of high risk factors of breast cancer and possible relation to postoperative survival was carried out.Results:The size of the tumor, the number of involved axillary nodes, and the adequacy of the initial treatment still remain the major prognostic factors ,correlated with the time interval between two cancers. 2 year, 5 year, 10 year, survival was recorded to be 90%, 71.4%, 66.7%. Conclusions:If treatment is correct for bilateral breast cancers, its 5 year survival rate still rather high. Time interval between two breast cancers was the most prominent prognostic factor, correlated with the overall survival. The early diagnosis and prompt adequate treatment of the seconed primary breast cancer are still the key to longer survival rates of bilateral breast cancer.

0.05).However,50.0% of T1 patients with TNBCs had lymph node metastasis,which was much higher than the other 2 groups.The recurrence rate in TNBC,non-TNBC or Her-2 positive patients were 57.1%,40.5% and 44.2%,respectively.The triple negative group had higher tumor recurrence rate than the other two groups(P=0.03).The overall 3 year survival rate of the TNBC group was 58.9%,which was much lower than the other two groups(76.4% for the luminal a and b group and 74.8% for the Her-2 positive group(P=0.04).Conclusion:The TNBCs was higher in premenopausal patients well as a higher lymph nodes metastasis rate with small tumor size.Moreover,three years recurrence and mortality rates in this group is higher than the non-TNBC groups.

Objective : To examine the association between dietary patterns during pregnancy and gestational diabetes mellitus (GDM), so as to provide the evidence for guiding the establishment of healthy and balanced dietary patterns and reducing the prevalence of GDM. Methods: Pregnant women who underwent oral glucose tolerance tests in Hangzhou Obstetrics and Gynecological Hospital from 2020 to 2021 were enrolled, and their demographic information were collected using questionnaires. Pregnant women's diets during the past three months were collected using Food Frequency Questionnaires (FFQs), and dietary patterns were extracted using principal component analysis. In addition, the association between dietary patterns and risk of GDM was examined using a multivariable logistic regression model. Results: A total of 1 689 pregnant women were included, with a median age of 28.53 (interquartile range, 2.47) years and a median gestational age of 26.00 (interquartile range, 2.00) weeks. Five dietary patterns were identified according to pregnant women's types of diets, including meat-based diets, dessert-fruit-refined grain diets, plant-based diets, eggs-milk-nut diets and whole-grain diets, with a cumulative contribution rate of 58.76%. The prevalence of GDM was 24.57% (415 cases) among the study subjects. Multivariable logistic regression analysis showed that pregnant women with scores in the highest quartile (Q4) of the meat-based diets had an increased risk of GDM (OR=1.372, 95%CI: 1.043-2.055) relative to those with scores in the lowest quartile (Q1), and pregnant women with Q4 scores of the dessert-fruit-refined grain diets had an increased risk of GDM (OR=1.743, 95%CI: 1.397-2.432) relative to those with Q1 scores, while pregnant women with Q4 scores of the plant-based diets had a reduced risk of GDM (OR=0.382, 95%CI: 0.346-0.613) relative to those with Q1 scores. Conclusion A plant-based dietary pattern may reduce the risk of GDM, while meat-based and dessert-fruit-refined grain dietary patterns may increase the risk of GDM.

【Objective】 To investigate the improvement of motor function recovery and the activation of endogenous neural stem cells (eNSCs) via voluntary exercise in mice with hyperlipidemia after intracerebral hemorrhage (ICH). 【Methods】 Four-month-old male Nestin-CreERT2: tdTomato transgenic mice were fed with high-fat diet (HFD) for eight weeks. Type Ⅳ collagenase was micro-injected into the corpus striatum to construct mouse ICH model with the help of stereotaxic apparatus. Voluntary exercise (wheel running) was initiated on the second day after ICH and monitored daily for seven days. Neurological severity score (NSS) and beam walking test were applied to evaluate motor function and coordination. Liver and brain tissues were collected at day 9 after ICH and sliced for staining. Then the Nestin-labeled cells, Ki67⁺, and doublecortin (DCX)⁺ in subventricular zone (SVZ) were counted to evaluate eNSCs activation. 【Results】 ① Compared with those of mice fed by chow diet (CD), the body weight, blood glucose level, concentration of lipid metabolism factors and the number of Nile Red positive cells in liver tissue were significantly higher in HFD-fed mice, confirming hyperlipidemia. ② Compared with the sham group, NSS score increased and the distance of cross-beam walking of ICH mice significantly decreased, showing the deficiency of motor function. It could be rescued by 7-day wheel running, as shown by a lower NSS score and a longer cross-beam walking distance. ③ Compared with the sham group, the number of Nestin⁺/Ki67⁺ cells decreased and Nestin⁺/DCX⁺ cells increased after ICH. After 7-day voluntary exercise, the number of Nestin⁺/Ki67⁺ cells decreased but that of Nestin⁺/DCX⁺ cells further increased significantly. However, compared with ICH, the increase of Nestin⁺/DCX⁺ cells in ICH+Ex was not significant. 【Conclusion】 Short-term voluntary exercise during the acute stage of ICH improved the recovery of motor function and enhance the proliferation of eNSCs in mice with hyperlipidemia. This provides a new idea for further developing ICH accelerated rehabilitation strategy based on eNSCs.