Surgery is now still the first choice for treatment of thyroid cancer.Long-term post-operative follow-up and thyroid hormone treatment are of great importance in reducing recurrence,early detection of metastases or recurrence,and improving patients' quality of life.This article reviews the recent advancement in post-operative follow-up and hormone treatment in thyroid cancer patients.

Objective To assess the prevalence,development and prognosis of thyroid disorders in adult healthy subjects aged over 60 years.Methods We performed a cross-sectional study in 1999 and a 5-year follow-up study in 2004.A total of 102 men and 147 women aged 60 to 88 years from rural communities in north China were studied.Serum thyrotropin(TSH),thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)were determined by an immunochemiluminometry assay in all participants.Free triiodothyronine(FT_3)and free thyroxine(FT_4)were determined in subjects with abnormal TSH results.Results We dropped the reference range for TSH into 0.28~4.75 mU/L.The prevalence of thyroid dysfunction,positive TPOAb and TgAb was 10.84%,12.85%and 11.65%,respectively.six newly diagnosed patients were found in the follow-up study,3 cases(all women)with hypothyroidism and 3(all men)with hyperthyroidism.Conclusion The high prevalence of thyroid dysfunction in the elderly indicates screening is necessary.Most elderly patients with subclinical dysfunction can recover spontaneously.The strategy should be focused on whether we monitor these patients.

ObjectiveTo summarize the recent therapeutic effects of mesh-plug tension-free hernioplasty in elderly inguinal hernia. MethodsAll cases were performed with mesh-plug case-hardened products, which are manufactured by American Bard Company. ResultsAll the operative procedures were performed smoothly. Postoperative complications were:6 cases of urinary retention,4 scrotal hydroceles,2 persistent wound pain,2 local lightly projections with foreign body sensation,2 hypoincisional haematoma. 1～24 months of follow-up were taken,2 recent recurrences were reported. ConclusionMesh-plug tension-free hernioplasty is a perfect surgical operation. Its main characteristics are:simple performance, less trauma, tension-free, time-saving, good recent therapeutic effect, and fewer recent recurrence. It is especially suitable to the elderly patients and/or Patients with other diseases.

Objective To investigate the value of MRI for the preoperative diagnosis of breast cancer.Method 45 patients with breast mass were evaluated by MRI preoperatively, 17 cases were further inspected by dynamic MRI, and the time intensity curves were analyzed.Results Postoperative pathology revealed carcinoma in 24 cases, and benign lesions in 21. The correct preoperative diagnosis rate of MRI for breast cancer was 96%(23/24), and its false-positive rate was 2%(1/45).Conclusions MR imaging of breast has practical value in preoperative diagnosis for breast cancer.

Objective To discuss the technical skills and the contraindication of transjugular intrahepatic portosystemic shunt stent (TIPSS) in portal vein cancercous thrombosis (PVCT) complicated with portal hypertension. Methods There were 16 cases of PVCT with portal hypertension, and average age of 53.6 yr. There were 9 cases with complete occlusion of portal vein trunk and 7 cases with incomplete thrombosis. There were 5 cases with cavernous transformation of the portal vein(CTPV). 1 case of simple upper gastro intestinal tract (GIT) massive bleeding, 4 with refractory ascites and 11 with upper GIT massive bleeding and refractory ascites. Results The procedure of TIPS was successful in 11 cases, the successful rate reached about 68.8%. The mean portal vein pressure was reduced from 4.9kPa to 2.4kPa with average 2.5kPa reduction. Ascites decreased, bleeding stopped and the clinical symptoms disappeared. The average survival period was 136 days. The procedure failed in 5 cases. Conclusions TIPSS is an effective method to control the bleeding and ascites caused by PVCT. The PV cavernous transformation was the contraindication of TIPSS.

Objective:To explore strategies of improving patients' stereotyping of nurses, by analyzing patients′ stereotypes of nurses.Methods:The phenomenological analysis method in qualitative research was used to conduct semi-structured interviews with 12 inpatients by objective sampling method.Results:The patients′ stereotype of nurses could be summarized into three topics, it mainly consisted of three aspects: patients′ cognition of the role of nurses, patients′ stereotype of nurse-patient relationship and factors affecting nurse-patient relationship from patients′ perspective, among which factors affecting nurse-patient relationship included doctors′ attitude towards nurses, public opinion effect of media reports and patients′ negative psychological experience.Conclusions:The prejudice of patients to the relationship between nurses and patients is not optimistic, it is suggested to improve patients′ stereotyping of nurses by reconstructing the ideal role of nurses, building harmonious trusting relationships and providing friendly support from the "others".

Objective To analyze the prognostic factors for patients with hepatic encephalopathy (HE) in acute-on-chronic liver failure(ACLF).Methods A retrospective analysis was performed on 159 ACLF patients with HE.The hepatic encephalopathy was determined to baseline,the patients were divided into survivors(n =13) and nonsurvivors(n =146),The 32 factors affecting the prognosis were analyzed by Cox proportional hazard model with SPSS.Results One-month,three-month,and six-month survival rates were 20.13％,10.06％ and 8.18％,respectively.Cox regression analysis of prognostic factors showed that it could the stage of hepatic encephalopathy and HRS significantly improve the survival rate of the patients with HE in acute-on-chronic liver failure.The stage of hepatic encephalopathy and HRS could significantly decrease the survival rate of the patients(x2 =18.344,11.368,all P ＜ 0.05),elevated the levels of hepatic encephalopathy (relative risk (RR) =1.591) and HRS (RR =1.809) indicate worse prognosis with hepatic encephalopathy in acute-on-chronic failure.Conclusion The stage of hepatic encephalopathy and HRS were independent risk factor sof prognosis in acute-on-chronic liver failure.

Background and purpose:This study aimed to explore the inlfuences on quality of life of patients with breast cancer in different stages undergone different styles of operations. Methods:During Apr. 2012 and Apr. 2013, a total number of 207 patients with breast cancer, including 61 patients undergone breast conserving surgery (BCS), 60 patients undergone immediate breast reconstruction (IBR) and 86 patients undergone modiifed radical mastectomy (MRM) reviewed or admitted in Beijing Tongren Hospital Afifliated to Capital Medical University were included in the research, in which FACT-B, SAS and SDS were used to assess the quality of life and negative emotions performing as the paired design. Results:The physical well-being, emotional well-being and the level of negative emotions such as anxiety and depression revealed signiifcant differences compared the patients who undergone BCS or IBR with those who undergone MRM in preoperative period (P<0.05), and there was no statistical difference in terms of other quality of life (P>0.05). At two and ifve years postoperatively, there was no signiifcant in the physical well-being, emotional well-being and negative emotions (P>0.05), whereas there was signiifcant differences in the other quality of life (P<0.05). Conclusion:BCS and IBR compared with MRM can obviously reduce the levels of preoperative negative emotions such as anxiety and depression, and improve the quality of life in long-term (two and ifve years postoperatively) to some degree.

Objective To investigate expression of glutathione S-transferase(GST) mRNA in peripheral blood of the population in coal-burning fluorosis area and to evaluate the effect of comprehensive control intervention. Methods Fifty samples of peripheral blood from patients in the coal-buring fluorosis area in Bijie county of Guizhou province were selected as fluorasis group and 50 samples of peripheral blood from patients in area with comprehensive management were selected as intervention group, respectively. Fifty samples from non-endemic fluorosis area were selected as the control group. Total RNA from blood was extracted and purified by the Trizol- Phenol-Chloroform one-step method. Expression of GST mRNA was detected by using SYBR Green I real-time fluorescence quantitative PCR. Results The data of GST mRNA in fluorosis group, intervention group and control group was 38.28±27.22,70.56±37.23 and 103.46 ± 46.62, respectively. There was a significant difference between the groups(F = 3.75, P < 0.05). Decreased expression of GST mRNA in fluorosis group and intervention group as compare to control was detected(all P < 0.05), and the expression of GST mRNA in intervention group was higher than that in fluorosis group(P < 0.05). Conclusion Coal-burning fluorosis possibly led to the decreased expression of GST mRNA in peripheral blood, and comprehensive control maybe prevent the decreased expression of GST in mRNA level.

Objective To explore imaging features of Zinner syndrome.Methods Eight male patients with clinically diagnosed Zinner syndrome performed abdominal and pelvic CT and /or MRI scan.The radiological data was studied retrospectively.Results Eight cases showed seminal vesicle cyst with ipsilateral renal agenesis on CT and/or MR imaging ( left side, n =5; right side, n =3).The maximal diameter of seminal vesicle cysts varied from 4.2 to 7.0 cm, and appeared as oval cystic lesion with irregular contour or tube-like dilatation , which appeared low density on CT image and hypo-or hyperintensity on T 1 WI and hyperintensity on T 2 WI.Bladder compression was found in 6 cases.Fuild-fuild level in the cysts was seen in 2 cases.Remnants of ureter structure were seen in only 1 case.There was no other accompanying abnormality of urinary system.Conclusions Zinner syndrome presents with characteristic imaging features , and the key issue is differential diagnosis of seminal vesicle cysts.