Objective To investigate the safety and efficiency of enhanced recovery after surgery (ERAS) concept combined with precise hepatectomy (EP) in the treatment of hepatocellular carcinoma (HCC).Methods 393 HCC patients admitted to the Affiliated Provincia Hospital of Anhui Medical University were divided into group EP (n =73),precise hepatectomy group P (n =55),group ERAS (n =118) and conventional hepatectomy group C (n =147).Outcome measures were postoperative length of stay (LOS),hospital charges,postoperative complication,numerical rating scale (NRS) on postoperative 24 h,48 h,time to ambulation and first passage of flatus,readmission rate,mortality.Results Compared to group P,patients in group EP had significantly shorter postoperative LOS (F =4.573,P ＜ 0.05),less hospital charges(F =3.090,P ＜ 0.05),lower NRS on postoperative 24 h,48 h (F =5.235,7.456,P ＜ 0.05),shorter time to ambulation (x2 =41.387,P ＜ 0.05) and first passage of flatus (F =0.387,P ＜ 0.05).Compared with the group ERAS,the group EP had significantly lower general postoperative complications (x2 =2.967,P ＜ 0.05).Conclusion ERAS concept combined with precise hepatectomy could optimize surgical treatment of patients with hepatocellular carcinoma.

Objective:To investigate the occurrence of inadequate specimens of thyroid nodule fine needle non-aspiration cytology and its possible influencing factors.Methods:Clinical data of 1571 patients with FNAC of 1638 thyroid nodules were analyzed retrospectively, according to whether the FNAC specimen were adequate or not, all cases were divided into adequate group and inadequate group. The related influencing factors on inadequate specimen were analyzed by univariate analysis and multivariate logistic regression.Results:Inadequate specimens occurred in 301 of 1638 (18.4%) nodules. Logistic regression analysis showed that the influencing factors of overall specimen adequacy included operator experience ( P=0.00) , nodules size≤0.5 cm ( P=0.00) , eggshell calcification ( P=0.00) , and cystic ( P=0.00) . Excluding the impact of operator experience, the influencing factors of specimen adequacy included nodules size≤0.5 cm ( P=0.00) , eggshell calcification ( P=0.00) , and cystic ( P=0.00) . Conclusions:Operator experience, nodules size≤0.5 cm, cystic, together with eggshell calcification are influencing factors of specimen adequacy of fine needle non-aspiration cytology in thyroid nodules. For experienced operators, what restrict specimen adequacy is the limitation of FNAC technique. For inexperienced operators, what restrict specimen adequacy is operator’s experience.