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 diagnostic value of PIgP/SC in diagnosis of primary hepatic cancer.Methods 58 patients with primary hepatic cancer,60 patients with liver cirrhosis and 60 healthy volunteers were studied.4 ml fasting venous blood was collected from all subjects.Serum level of AFP was detected with electrochemical chemiluminescence immunoassay system and plasma PIgR/SC level was detected by ELISA method.The level of PIgR/SC and AFP was detected at one week after surgical resection in patients with hepatic cancer.Results The levels of AFP and PIgR/SC in the three groups were significantly different (P＜0.01),and PIgR/SC was higher than that in patients with cirrhosis and volunteers (P＜0.01).There was no significant difference between patients with liver cirrhosis and liver cirrhosis(P＞0.05).AFP was higher in patients with HCC than patients with cirrhosis and volunteers.AFP was higher in patients with cirrhosis than volunteers,and the difference was statistically significant(P＜0.01).Sensitivity of PIgR/SC and AFP was 89.3％ and 54.8％,specificity was 84.6％ and 91％,Youden index was 0.751 and 0.458,AUC was 0.920 and 0.761,respectively.There was significant difference in AUC (Z=3.251,P＜0.05) of the two detection indexes for detection of primary hepatic cancer.Conclusion The value of PIgR/SC in diagnosis of primary liver cancer may by higher than that of AFP.

Objective To investigate the application effect of glucocorticoids on perioperative period of complicated thyroid cancer surgery.Methods All patients were from Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University.A total of 373 patients with thyroid surgery longer than 3 hours from Jan.2017 to Dec.2017 were as the control group.386 patients with thyroid surgery longer than 3 hours from Jan.2018 to Dec.2018 were included in the observation group.Patients in the control group were not treated with glucocorticoids during perioperative period,and patients in the observation group were treated with glucocorticoids during perioperative period.Several factors were compared between the two groups,including postoperative drain removal time,postoperative hospitalization time,postoperative complication rate,the incidence of postoperative infection and delayed wound healing.Results The postoperative drain removal time [(2.5±0.42) vs (3.2±0.63),t=25.72,P＜0.001)] and the postoperative hospitalization time [(3.6±0.57) vs (4.8±0.71),t=18.07,P＜0.001)] in the observation group was shorter than in the control group.The incidence of complications in the observation group was lower than that in the control group,such as postoperative coarse respiratory sounds (3.1％ vs 6.7％,x2=4.790,P=0.029),mild to moderate dyspnea (1.0％ vs 3.2％,x2=4.191,P=0.041),cough (8.3％ vs 14.2％,x2=5.366,P=0.021),sore throat (4.9％ vs 9.4％,x2=4.952,P=0.026),headache (8.8％ vs 11.5％,x2=4.392,P=0.036) and nausea (3.6％ vs 8.6％,x2=7.235,P=0.007),however,the incidence of hoarseness between the two groups was statistically significant (1.6％ vs 2.1％,x2=0.352,P=0.553).There was no significant difference in the incidence of postoperative infection (2 cases vs 1 case,x2=0.299,P=0.585) or delayed wound healing (3 cases vs 3 cases,x2=0.002,P=0.964) between the two groups.Conclusion The application of glucocorticoids in patients with complicated thyroid cancer surgery can effectively reduce the incidence of complications and shorten the hospitalization time of patients.

Objective:To explore the skin damage, oxidative damage and DNA damage of welding workers caused by ultra violet.Methods:From 1 May to 30 June 2017, 125 welding workers were selected as the contact group, which was divided into 2, 4, 6, 8 and 10-year-working age groups with 25 workers in each group and 25 healthy volunteers as the control group. The workers in the contact group were investigated with questionnaires on the distribution and wearing of protective equipment; the subjects in the two groups were examined in dermatology, and the peripheral blood was collected to detect the total antioxidant capacity (T-AOC) and DNA damage of mononuclear cells, and the influence of ultraviolet on the above indexes was analyzed.Results:The distribution rates of welding mask, dust mask and goggles were 100.0% (125/125) , 96.0% (120/125) , 98.4% (123/125) , respectively, and the distribution rates of welding gloves were 64.8% (81/125) ; the wearing rates of welding mask and goggles were 100.0% (125/125) , 90.4% (113/125) , and the wearing rates of dust mask and welding gloves were 89.6% (112/125) and 64.0% (80/125) , respectively. The acute skin injuries such as hand and face peeling and skin pruritus were serious in the 2-year-working age group, and the chronic skin injuries such as insensitive and numbness and verrucous vegetations were the main manifestations in the 10-year-working age group. Compared with the control group, T-AOC in peripheral blood of workers exposed to 6, 8 and 10 years decreased significantly, and DNA content in comet tail of workers exposed to various working years increased significantly ( P<0.05) , while DNA content in comet tail increased with working years ( F=1501.130, P<0.05) . Conclusion:UV welding can cause skin damage, reduce the antioxidant capacity of the body, and increase DNA damage with the increase of working age.

Objective:To explore the skin damage, oxidative damage and DNA damage of welding workers caused by ultra violet.Methods:From 1 May to 30 June 2017, 125 welding workers were selected as the contact group, which was divided into 2, 4, 6, 8 and 10-year-working age groups with 25 workers in each group and 25 healthy volunteers as the control group. The workers in the contact group were investigated with questionnaires on the distribution and wearing of protective equipment; the subjects in the two groups were examined in dermatology, and the peripheral blood was collected to detect the total antioxidant capacity (T-AOC) and DNA damage of mononuclear cells, and the influence of ultraviolet on the above indexes was analyzed.Results:The distribution rates of welding mask, dust mask and goggles were 100.0% (125/125) , 96.0% (120/125) , 98.4% (123/125) , respectively, and the distribution rates of welding gloves were 64.8% (81/125) ; the wearing rates of welding mask and goggles were 100.0% (125/125) , 90.4% (113/125) , and the wearing rates of dust mask and welding gloves were 89.6% (112/125) and 64.0% (80/125) , respectively. The acute skin injuries such as hand and face peeling and skin pruritus were serious in the 2-year-working age group, and the chronic skin injuries such as insensitive and numbness and verrucous vegetations were the main manifestations in the 10-year-working age group. Compared with the control group, T-AOC in peripheral blood of workers exposed to 6, 8 and 10 years decreased significantly, and DNA content in comet tail of workers exposed to various working years increased significantly ( P<0.05) , while DNA content in comet tail increased with working years ( F=1501.130, P<0.05) . Conclusion:UV welding can cause skin damage, reduce the antioxidant capacity of the body, and increase DNA damage with the increase of working age.

Objective To clarify the role of BRAFV600E and TERT promoter mutations in cervical lymph node metastasis in papillary thyroid carcinoma.Methods The data of 432 patients with thyroid papillary carcinoma who underwent surgery from February 2017 to September 2017 at the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.The mutation of BRAFV600E and TERT promoter was detected by Sanger sequencing.The effect of BRAFV600E and TERT on cervical lymph node metastasis in patients with papillary thyroid carcinoma was analyzed by Chi-square test.Results The mutation rates of BRAFV600E and TERT promoter were 77.8％ (336/ 432) and 5.3％ (23/432) respectively in 432 papillary thyroid carcinoma patients.The probability of cervical lymph node metastasis in patients with BRAFV600E mutation was significantly higher than that in non-mutation patients (P ＜ 0.05).The probability of cervical lymph node metastasis in patients with TERT promoter mutation was significantly higher than that in non-mutated patients (P ＜ 0.05).Patients with both BRAFV600E and TERT promotermutation had a significantly higher incidence of cervical lymph node metastases than patients with the BRAFV600E mutation alone (P ＜ 0.05).Conclusions The mutations of BRAFV600E and TERT promoter are closely relevant to the occurrence of cervical lymph node metastasis in papillary thyroid carcinoma.Preoperative fine-needle aspiration cytology and postoperative routine pathological molecular diagnosis can help clinicians to develop a more rational treatment strategy,and a more accurate assessment of the risk of relapse.