Objective To explore the clinical therapeutic effects of Ⅰ-stage or delayed Ⅰ-stage cervical plexus reinnervation for recurrent laryngeal nerve(RLN)injuries. Methods During the process of neck dissection of papillary thyroid carcinoma,18 cases with recurrent laryngeal nerve deficit underwent cervical plexus reinnervation on Ⅰ-stage or delayed Ⅰ-stage RLN prosthosis basis.Therapeutic effects were evaluated by fibrolaryngoscope and voice evaluation preoperatively and postoperatively. Results All the cases were followed-up for 3 months to 2 years(average 8 months).Abductory motion of the vocal cords of 16 patients totally or partly restored,and not improved in 2 patients,with the recovery rate of abductory motion of the paralyzed vocal cords of 88.9%(16/18).Patient's phonation was restored totally or partially in 16 cases and the hoarseness was ameliorated significantly. Conclusions Cervical plexus-RLN reinnervation should be considered as a suitable treatment for unilateral vocal cord paralysis.One stage or delayed one stage cervical plexus reinnervation for recurrent laryngeal nerve injury is convenient and easy to perform.Postoperatively the abductory motion of vocal cord could be restored by this reinnervation satisfactorily.

Objective To introduce the processes of vascularized parathyroid gland reservation and parathyroid autotransplantation applied in thyroidectomy. Methods In 46 cases who underwent total/near total thyroidectomy, in situ vascularized parathyroid gland reservation was performed in 24 cases,isolated parathyroid autotransplantation was performed in 5 cases, in situ vascularized parathyroid gland reservation of 1～2 parathyroid glands combined with immediately transplantation of the remaining isolated parathyroid glands were performed in 17 cases. Results Five cases suffered from transient hypocalcaemia, including 2 cases of vascularized parathyroid gland reservation and 3 cases of vascularized parathyroid gland reservation in 1～2 parathyroid glands combined with immediately transplantation of other parathyroid glands. Two cases who received parathyroid autotransplantation suffered from hypocalcaemia and received conservative treatment with activated vitamin D3 and caleium for 4 weeks or 8 weeks. Permanent hypoparathyroidism occurred in 1 case of 46 cases which undergone the total/near total thyroidectomy(2.2%). Conclusion Application of vascularized parathyroid gland reservation and parathyroid autotransplantation in total/near total thyroidectomy could reduce the incidence rate of post-operative hypoparathyroidism.

Objective To find a method for building a human head parameter model. Method Raw data of human head were acquired and filtered, a linear regression equation was formulated, and a parameter model was established. Result A human head parameter model was built. Conclusion A human head parameter model can be built by using the linear regression equation of human head to adjust the initial CT data, and a three-dimensional and human head parameter model can be built by OpenGL.

Objective To investigate the regulatory effects of Zishen Yutai Pills on the expression levels of homeboxA10 (HOXA10) and its downstream target gene empty spiracles homebox 2 (EMX2) in the endometria of ovulation-inducing mice at different implantation stages. Methods Seventy-five estrous female Kunming mice were randomly divided into 5 groups, namely normal group, model group 1, model group 2, treatment group 1, treatment group 2, 15 mice in each group. The model group 1 was given short-term protocol for ovulation induction; the model group 2 was given long-term protocol for ovulation induction; the treatment group 1 was given Zishen Yutai pills (at the dose of 0.4 g/mL) on the basis of the protocol for the model group 1; the treatment group 2 was given Zishen Yutai Pills (at the dose of 0.4 g/mL) on the basis of the protocol for the model group 2; the normal group was given intragastric administration or intraperitoneal injection of the same volume of normal saline. The mRNA and protein expression levels of HOXA10 and EMX2 in mouse uterus were detected by real-time fluorescent quantitative polymerase chain reaction (qPCR) and Western blot method, respectively. Results Compared with the normal group, the mRNA and protein expression levels of HOXA10 were decreased, and the mRNA and protein expression levels of EMX2 were increased in model group 1 and model group 2(P< 0.01). Compared with the corresponding model group 1 and 2, the mRNA and protein expression levels of HOXA10 were significantly up-regulated (P < 0.01) , and the mRNA and protein expression levels of EMX2 were decreased in the treatment group 1 and 2 (P < 0.01), respectively. Conclusion Zishen Yutai Pills may improve mouse endometrial receptivity by up-regulating HOXA10 expression and inhibiting EMX2 expression.

Objective To analyze the clinical and pathological features of follicular variant of papillary thyroid carcinoma (FVPTC).Methods Clinical data of 131 FVPTC patients diagnosed and treated between January 2006 and June 2012 were retrospectively analyzed.Results Of the 131 FVPTC patients,the median age at diagnosis was 45 years and 74.0％ patients were female.Pathologically 29％ (38 patients) of the FVPTC patients were encapsulated,and 71％ (93 patients) were nonencapsulated.Compared with classical papillary thyroid carcinoma (CPTC),FVPTC patients were more likely to have lower ultrasound diagnostic accuracy rate,frozen section accuracy rate,tumor muhicentricity,tumor bilaterality,lymph node metastasis,lateral lymph node metastasis rate,N staging,TNM stage,ATA risk and higher M staging and concomitant chronic thyroiditis rate (all P ＜ 0.05).Moreover,there were significant differences between nonencapsulated and encapsulated follicular variant of papillary thyroid carcinoma in tumor size,TSH level,ultrasound diagnostic accuracy rate,extrathyroid invasion,T staging,lymph node metastasis,N staging,TNM staging,ATA risk and recurrence rate (all P ＜ 0.05).Conclusions Compared with CPTC,FVPTC have different clinical and biological features.It's necessary for different management strategies for different FVPTC patients.

ObjectiveTo investigate the clinical biocharacteristics,treatment,prognosis and the factors that influence prognosis of anaplastic thyroid carcinoma(ATC). MethodsThe clinical data of 108 ATC patients treated at our institution from January 1981 to April 2009 and follow-up results were retrospectively reviewed.ResultsThe median survival time of 108 patients was 6 months.The overall 1-year,2-year,5-year survival rate was 40.3％,30.9％ and 21.9％ respectively.Univariate analysis showed the factors influencing the prognosis of ATC patients were tumor size, distant metastases, stage,leukocytosis, radiotherapy, localresection, postoperativeradiotherapyandmultimodalitytherapy.Multivariate analysis indicated that tumor size,stage,leukocytosis and radiotherapy were independently associated with the prognosis.ConclusionsAnaplastic thyroid carcinoma is rare but highly aggressive malignancy with poor prognosis. ATC patients should receive multimodality therapy,especially local resection and postoperative radiotherapy.Even inoperable patients could benefit from radiotherapy.

Objective To explore the clinico-biological characteristics, treatment and prognosis of salivary duct carcinoma. Methods This study included 12 cases of salivary duct carcinoma treated in our hospital. Clinical data were retrospectively analyzed for patients admitted between April 1995 and October 2006. The clinical characteristics, histological features, imaging, therapy methods and prognosis were analyzed. Results Of 12 salivary duct carcinoma, there were 10 males, 2 females. The age of onset ranged from 53 to 73 year old and the average was 56 year old. Physical examination revealed a firm and unboundary mass accompanied by nerve infiltrating symptom. The histological appearance was characterized by solid cell nests with ductal structures and central comedonecrosis. Extensive resection and radical neck dissection was performed in 11 patients, postoperation radiation done in 10 patients and chemotherapy in 3 patients. One year survival rate was 83. 33% , that of 3 years was 41. 67% , and of 5 years was 25. 00% , the median survival time was 36 months. Conclusion Salivary duct carcinoma is a rare malignant salivary tumor and most patients are men. Regional extensive resection and postoperative radiation or chemotherapy are the mainstay of therapy. Lymph node metastases in level Ⅰ ,Ⅱ , Ⅲ are a common finding in patients with SDC and the prognosis is poor.

Objective:To determine the clinical features of papillary thyroid microcarcinoma (PTMC) and the risk factors for central compartment lymph node (CCLN) metastasis in PTMC. Methods:Data of 1 401 patients with PTMC who were treated in Tianjin Medi-cal University Cancer Institute and Hospital between January 2014 and December 2014 were retrospectively analyzed. Chi-square test and multivariate Logistic regression analysis were used to study the risk factors. Results:With regard to clinicopathological features, the sex ratio is 1:3.4 in patients with PTMC. CCLN metastasis affected 427 (30.5%) of the total 1 401 patients. Age (χ2=14.587, P<0.01), sex (χ2=21.636, P<0.01), tumor multifocality (χ2=35.505, P<0.01), tumor size (χ2=58.868, P<0.01), tumor site (χ2=8.385, P<0.05), and extracapsular/extraglandular invasions (χ2=26.481, P<0.01) were significantly correlated with CCLN metastasis. For patients with a soli-tary primary tumor, tumor location in the lower third of the thyroid lobe was associated with a higher risk of CCLN metastasis (48.1%). The male gender, age<45 years, tumor size>6 mm, extracapsular spread, and tumor bilaterality were independently correlated with CCLN metastasis. Conclusion:A prophylactic neck dissection of the central compartment must be considered particularly in male PT-MC patients with age<45 years, tumor size>6 mm, extracapsular spread, and tumor bilaterality.

Objective:To investigate the BRAF(V600E)gene mutation of pediatric papillary thyroid carcinoma (PTC) and refine their clinicopathological correlates. Methods:Tumor tissue samples of pediatric PTCs (≤18 years old) were collected from tumor tissue bank of Tianjin Medical University Cancer Institute and Hospital from January 2012 to December 2016.The medical records of 22 patients with pediatric PTC were reviewed retrospectively.The frequencies of BRAF(V600E) mutation were evaluated and the correlation between BRAF(V600E) mutation and clinical characteristics were analyzed. Results:BRAF(V600E) mutations were present in 45.5% of cases (10 cases). BRAF(V600E) mutation in pediatric PTC was obviously lower than that in adults PTC(77.7%) ( χ2=11.250, P=0.001). BRAF(V600E) mutation in>12-year-old group (66.7%) was remarkably higher than that in ≤12-year-old group (20.0%) ( P<0.05). BRAF(V600E) mutation in female (69.2%) was greatly higher than that in male (11.1%) ( P<0.05). There was no significant correlation with BRAF(V600E) mutation and multiple tumor, tumor size, highly invasive subtype, extrathyroidal extension, lymph node metastasis and radiological history of infants (all P>0.05). The median follow-up time was 45 months.No patients died and BRAF(V600E) mutation was not associated with the increase of recurrence rate ( P>0.05). Conclusions:BRAF(V600E)gene mutation in pediatric PTC is lower than that in adults. BRAF(V600E) mutation does not portend a more aggressive clinical biological behavior in pediatric PTC.

Objective:To evaluate the role of Tg in diagnosis of lateral cervical lymph node recurrence in papillary thyoid cancer(PTC)after radioactive iodine(RAI) therapy.Methods:From Jan 2012 to Aug 2018, 22 PTC patients who received RAI therapy after operation were reoperated for lateral cervical lymph node recurrence. The clinical data was retrospectively analyzed.Results:The median recurrence time was 30.5 (5-86) months. All 22 patients received RAI therapy after the first operation, and the median dose of RAI was 250mCi(100-700 mCi) and the episode of RAI therapy ranged from 1 to 4. All 22 PTC patients underwent neck reoperation, among which 20 cases were identified to have lymph node metastasis. The median number of lymph nodes dissected was 31 (8-83) and median number of metastatic lymph nodes was 4 (1-19) . The diagnostic accuracy of ultrasonography in detecting lymph node metastasis was 90.9%. Before reoperation, the median Tg was 1.305 (0.10-99.51) μg/L, with the cutoff value of Tg being 0.2 μg/L, and its sensitivity and specificity were 80.0% and 100%, respectively. The median stimulated Tg was 5.89 (0.14-255.80) μg/L in the 10 patients, with the cutoff value of stimulated Tg of 2 μg/L, and its sensitivity and specificity were 88.9% and 100%, respectively.Conclusions:The serum Tg level is helpful for monitoring the recurence of PTC, but recurrence cannot be completely ruled out for those with low Tg.