Objective To evaluate the application of u lt rasound guided Mammotome minimally invasive biopsy system in the diagnosis and t reatment of breast mass. Methods B-ultrasound guided stereotac tic core breast biopsy using the Mammotome system was conducted in 221 breast ma sses of 132 patients. Unilateral solitary masses were found in 79 patients and u nilateral or bilateral multiple masses, in 53 patients. The mass was 0.5~5.2 cm (mean, 1.4 cm) in diameter. Of the 221 masses, 149 were clinically palpable. Results All the lesions were removed by using the Mammotome syste m. The stereotactic excisional biopsy was performed for a mean of 24 times, last ing a mean of 36 min (range, 10~40 min). No failed procedure occurred. All the m asses were pathologically confirmed as benign lesions in 129 patients and invasi ve ductal carcinomas in 3 patients (a modified radical mastectomy was then perfo rmed). Postoperatively, the incision scar was barely visible and no complication s happened except for mild subcutaneous hemorrhage in 10 patients. Conc lusions Use of B-ultrasound guided stereotactic core breast biopsy usin g the Mammotome system for the removal of benign breast lesions is convenient, e ffective, and minimally invasive.

Uremia caused secondary hyperparathyroidism is one of the common and serious complications caused by uremia. Surgery treatment is effective. Total parathyroidectomy plus forearm transplantation is more commonly used because of exact outcomes and easy monitoring. It is necessary to be fully prepared be-fore operation,particularly to clarify the location of parathyroid gland. Yet each surgical method has its re-lapse rate.

Objective To investigate the diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy(FNA-Tg).Methods This study included 63 patients with thyroid cancer or with enlarged lymph nodes during the follow-up from Aug.2010 to Jun.2012.Ultrasound-guided fine-needle aspiration was done in the 63 patients with 79 suspicious enlarged lymph nodes.Then thyroglobulin(Tg) in FNA washout fluid and serum Tg were assayed with electrochemiluminescenceimmunoassay(ECLIA).Diagnostic sensitivity,specificity and area under the ROC curve were evaluated according to 5 predetermined threshold levels:FNA-Tg/serum-Tg ＞ 1,mean + 2SD of node-negative patients,10 ng/ml,optimal operating point of ROC curve and 1000 ng/ml.Results The sensitivity value was 90.70％,90.70％,95.35％,90.70％ and 65.12％ respectively on the 5 threshold level,significantly lower than those on the threshold level of 1000 ng/ml(P ＜0.05).The specificity value was 97.22％,91.67％,72.22％,97.22％ and 100％ (P ＞0.05) on those threshold levels,significantly lower than those on the threshold level of 10 ng/ml (P ＜0.05).The area under the ROC curve was 0.940,0.912,0.838,0.940 and 0.826 respectively.There was no statistical difference(P ＞0.05).Conclusion Selecting FNA-Tg/serum-Tg ＞ 1 as a positive threshold value can be a secondary diagnosis of lymph nodes metastasis in patients with papillary thyroid cancer.

Objective To define the expression of Shh/Gli1,the key elements of Hedgehog signaling pathway in papillary thyroid carcinoma(PTC) and to explore the relationship between the expression of Shh/Gli1 and clinical significance.Methods The expression of Shh and Gli1 was examined in 142 cases of PTC tissues and adjacent tumor thyroid tissues as control by immunohistochemistry.The relationship between the expression of Shh/Gli1 and clinical characteristics of PTC patients was analyzed.Results The positive rate of the cytoplasm Shh expression and the nuclear Gli1 expression was 64.1% and 47.9% ,respectively.Significant difference was found between normal thyroid tissues and PTC.The research showed that the expression of Shh/Gli1 was related to the tumor size,clinical stages and lymph node metastasis,Shh was more significantly related to the tumor size(P ＜0.01) and Gli1 was more significantly related to the lymph node metastasis (P ＜ 0.01).Conclusions Varying expression of the main ligand Shh and transcription factor Gli1 in Hedgehog signaling pathway was found in PTC.The expression of Shh/Gli1 was related to the tumor size,clinical stage and lymph node metastasis,indicating that the aberrant activation of Shh signaling pathway plays some roles in PTC.Shh/Gli1 may be indicators for prognosis and ideal targets for therapy against PTC.

Objective To approach the guide of ultrasound-guided minimally invasive biopsy technique in diagnosis and treatment of thyroid diseases. Methods One hundred and seventeen cases (a total of 131 nodules, nodules 0. 5-1.5 cm in diameter, with an average diameter of approximately 0. 8 cm) with thyroid nodules , under Ultrasound-guided minimally invasive biopsy techniques from October 2008 to July 2009 were analyzed. Result One hundred and seventeen cases of patients with biopsy derived satisfaction were not ap-parent discomfort and complications after biopsy. Across 59 cases of surgical treatment in patients with biop-sy, and preoperative biopsy and postoperative pathologic is not fully consistent in only two cases, 58 patients without surgical treatment, who is combined with symptoms, palpation, serum thyroxine and color Doppler ultrasound and other laboratory examinations, and regularly review treated with symptomatic treatment, the symptoms, and color Doppler ultrasound imaging were much better under the treatment. 8 cases of patients in 117 cases of minimally invasive biopsy have cervical lymph node biopsy at the same time, biopsy patholo-gy and postoperative results are consistent with postoperative pathologic (7 cases of metastatic carcinoma, 1 case of reactive hyperplasia), accuracy was 100%. Conclusion Uhrasound-guided minimally invasive bi-opsy technique have important guiding for diagnosis and treatment of thyroid diseases, consistent with the high rate of clinical, especially for the preoperative diagnosis of small nodules, to avoid unnecessary over-treatment, can also reduce the misdiagnosis of thyroid cancer. While this technology is simple, safe and ac-curate, which have clinical value in the thyroid surgery.

A method for rapid determination of semicarbazide in water by hydrophilic interaction chromatography-quadrupole / electrostatic field orbitrap high resolution mass spectrometry was developed. The sample was extracted with acetonitrile after 0. 1 mol/ L NaOH was added in the sample and then excessive amounts of Na2 SO4 was added to stratify acetonitrile from the mix solution. The acetonitrile extraction solution was dehydrated with anhydrous sodium sulfate. The preparation was separated by an amide column using as hydrophilic interaction column, and gradient elution program was employed by using water and acetonitrile containing 0. 1% formic acid as mobile phase, then it was detected in positive and selected ion monitoring mode by a quadrupole / electrostatic field orbitrap high resolution mass spectrometry. Internal standard method was used for quantitative analysis. The linear correlation coefficient of semicarbazide was 0. 997 in the concentration range of 0. 2 -20 μg / L under the optimal conditions. The limit of detection was 0. 09 μg / L, while the limit of quantitation was 0. 30 μg / L. The recoveries were 82. 3% to 92. 0% , and the relatively standard deviations were less than 7. 6% at the spiked levels of 0. 5, 1. 0 and 5. 0 μg / L using river water and sea water as blank samples. The developed method is suitable for the analysis of trace semicarbazide in environment water samples.

Objective To discuss the effective factors and metastasis rules of cervical lymph node of papillary thyroid microcarcinoma,aimed to provide references for indications and range of lymph node dissection.Methods Reviewed the clinical information and pathological material of primary treatment of 1 180 cases of papillary thyroid microcarcinoma patients in China-Japan Union Hospital of Jilin University from June 2008 to December 2011 by retrospective analysis,futher summared cervical lymph node metastasis rules and effective factors.Results The lymph node metastasis rate of 1 180 patients with papillary thyroid microcarcinoma was 29.6％,which of these of the central and lateral region were 26.4％ and 15.2％.Central region lymph nodes metastasis rates in male and female were respectively 44.9％,21.8％ (P ＜ 0.05),and were 39.8％,9.0％ in lateral region (P ＜ 0,01).Lymph node metastasis rates of patients whose age ≤45years old and ＞45 years old were 30.3％,17.9％ (P ＜0.05).The lymph mode metastasis rate which diameter of tumour(D) ≤0.5 cm or 0.5 cm ＜ D ≤ 1 cm in central region were 20.2％,33.2％ (P ＜ 0.05).The lymph node metastasis rate of single and more nidi respectively were 15.7％,45.0％ in central region.The lymph node metastasis rate of tumors invasion or not were 44.4％ and 14.2％ in central region (P ＜0.05).The metastasis rates were 45.5％ and 4.3％ in the lateral region when the lymph node infringe or not in central region.Conclusions Lymph node metastasis happens relatively more common in papillary thyroid microcarcinoma patients with the factors such as male,young age,multiple nidi,long diameter of tumor and invasion of tumor envelope.So when doctors establish the indications and range of lymph node dissection,it's need to pay attention to the high risk factors seriously which effect lymph node metastasis of papillary thyroid carcinoma,and establish the lymph node dissection strategy individually.

Secondary hyperparathyroidism(SHPT)is one of the common complications in patients with advanced chronic kidney disease.Since the surgical procedure of total parathyroidectomy with autotransplantation(TPTX+AT)was proposed in 1977,there has been no consensus on some issues related to autotransplantation.This article reviews the basis and clinical value of autotransplantation,transplantation site,transplantation method,transplant survival,and function monitoring,diagnosis and management of recurrence,etc.