0.05).The infiltration of tumor to the muscularis mucosa or serosa layers was significantly correlated with the risk of GISTs(?~2=4.87,P

Objective To evaluate the clinical application of endoscopic thyroidectomy(ESTC) via the approach of areola of breast.Methods The clinical data of 46 cases of endoscopic thyroidectomy via the breast areola approach from October 2004 to November 2006 were retrospectively analyzed.Results The operation was successfulmy completed endoscopically in 44 cases,including 18 cases of unilateral partial thyroidectomy,26 cases of bilateral partial thyroidectomy,and 2 cases were converted to open operation for thyroid cancer neck dissection.The operation time of ESTC was 80~160minutes(mean 110min),and the intraoperative blood loss was 25~45ml,(mean,33?9.5ml).Pathological findings showed 25 cases of thyroid adenoma,16 cases of nodular goiter,and 3 cases of Graves disease.The length of postoperative hospital stay was 3~6day(mean4.5d).Complications occurred in 2 cases,including 1case of bleeding from left puncture tract,and 1 case of temporary hoarseness.Conclusions Endoscopic thyroidectomy via breast areola approach is a technically feasible and safe procedure,and has the advantage of minimal trauma,and with excellent cosmetic outcomes.

Objective To look into the effect of ubiquitin (Ub) in muscles of gastric cancer patients on their nutritional status and prognosis.Methods Abdominal rectus muscles of 102 patients with gastric cancer and 53 patients with benign abdominal diseases were studied.The expressions of Ub mRNA and protein were assessed through real time-PCR and Western blot.Results The relative expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients (4.10± 1.04) was significantly upregulated compared with the control group (3.17±0.32) (t =7.386,P=0.000).The expression of Ub protein in rectus abdominis muscles of patients with gastric cancer was upregulated compared with the controls (0.151 ±0.058 vs.0.084±0.046,t =7.275,P =0.000).The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was significantly associated with decreases in weight,body mass index,prognostic nutritional index,serum albumin and hemoglobin (x2 =11.780,6.557,11.849,15.742,8.360;P=0.001,0.010,0.001,0.000,0.004).The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was not correlated with the patients'sex,age,tumor size or Borrmann type (x2 =0.038,1.978,0.486,1.483;P=0.774,0.160,0.486,0.223),but it was related to the pathologic type,lymph node metastasis and TNM staging of gastric carcinoma (x2 =11.260,9.362,20.517;P=0.004,0.002,0.000).The survival rate of gastric cancer patients with high expression of Ub mRNA was lower than those with low expression (x2 =5.775,P =0.016).Conclusions Ub mRNA and protein were upregulated in rectus abdominis muscles of gastric cancer patients.The high expression of Ub mRNA in these patients was related to their nutritional status and prognosis,which might play an important role in the development of cachexia.