Objective The investigate the clinical significance of serum anti-thyroid peroxidase antibody(TPOAb)monitoring in therapeutic effect judgment and prognosis evaluation during 131I treatment in patients with Graves disease.Methods A total of 112 patients with Graves disease(hyperthyroidism group)and 50 healthy controls(healthy control group)were enrolled in the investigation.Serum concentration of TPOAb was measured with chemiluminescent immunoassay(CLIA)in healthy control group and hyperthyroidism group(at time points of 0,3,6,12 and 24 months after 131I treatment,i.e.T0,T3,T6,T12 and T24).Variance analysis and t test were adopted.Results The mean level of TPOAb was significantly higher in patients with Graves' disease before 131I treatment than that in healthy controls(P＜0.01).In hypenthyroidism group,serum concentration of TPOAb was evidently higher at T3[(108.94±70.15)IU/mL]than T0[(81.95±47.64)IU/mL](P＜0.01);TPOAb level began to decline at T6[(42.78±28.68)IU/mL],but still higher than that of healthy control group;while where was no statistical difference in TPOAb level between hyperthyroidism group at T24[(7.89±4.01)IU/mL]and healthy control group(F＞0.05).Conclusion Serum level of TPOAb before treatment may be used as an auxiliary indicator of 131I dosage.Posttreatment TPOAb level monitoring contributes to therapeutic effect evaluation,follow-up visit and immunorcaction state understanding.

Objective To investigate the optimal operative approach for esophageal and cardiac carcinoma,in order to obtain favorable exposure and to diminish trauma.Methods A method of median-rib-Section were performed in 207 cases of esophageal and cardiac carcinoma:the 6th and 7th ribs were cut intermediately,then we peeled and cut the rib periosteum.stretching the costal interspace with a prop until the exposure was optimal.Items including traumatic degree,exposure extend and conditions of thoracic cavity closure were compared with that of traditional antemposterior-rib-section method.Results The exposure result was similar in the two methods,but the traumatic de-grce WaS less when anteroposterior-rib·section was applied,due to its avoiding cutting intercostal muscles which caused more blood loss.The median-rib-section method led to more satisfactory anatomy paratope and external appearance,less trawma and incision pain.Conclusion The method of median-rib-section is worthy of generalization because of its satisfactory exposure,less trauma,better paratope and absence of postoperative costal malformation.

Objective To examine the practicability and security of the LigaSureTM vessel-sealing system in radical gastrcctomy.Methods Seventy patients of stage Ⅰ～Ⅲ gastric cancer undergone radical gastrectomy were analyzed retrospectively.Thirty-five radical gastrectomy were performed with LigaSureTM vessel-sealing system,the other 35 eases were performed without LigaSureTM.The operative duration,volume of intraoperative hemorrhage,and postoperative complications were analyzed.Results There were significant difference in both operative duration[(159.9±24.7)min vs(172.6±23.7)min,P＜0.05]and volume of intraoperative hemorrhage[(335.7±40.3)ml vs(371.7±43.2)ml,P＜0.01].There was no significant difference in the postoperative complications between LigaSureTM group and conventional method group.All patients recovered without severe postoperative complications.Conclusion Radical resection of gastric cancer using LigaSureTM instead of conventional hand tie method appears to he shorten operative duration,decreased volume of intraoperative hemorrhage.And the technique is convenient and safe.

Objective:To examine the clinical value of combining indocyanine green (ICG) fluorescence navigation with blue dye in sen-tinel lymph node biopsy (SLNB) for patients with breast cancer. Methods:A total of 89 patients with early-stage breast cancer who met the inclusion criteria were admitted at Shantou Central Hospital, Guangdong from May 2013 to April 2014. In phase one, ICG and blue dye were applied in all 53 patients, and then SLNB and axillary lymph node dissection (ALND) were performed based on fluores-cence signal or visual sense of the lymph nodes. In phase two, 36 patients with early-stage breast cancer were included. ALND was omitted when sentinel lymph nodes were frozen showing negative result. Rates of detection, accuracy, and false-negative were calcu-lated. Results:A total of 89 patients were monitored, of which the total rate of SLNB detection was 96.6%(86/89). In the validation pe-riod, the rates of detection, accuracy, and false-negative were 94.3%(50/53) 98.0%(49/50), and 2.6%(1/38), respectively. In the alter-ative period, the rates of detection reached 100%. Of the 196 sentinel lymph nodes, 179 showed fluorescence signal, 142 exhibited blue dying, 54 only demonstrated fluorescence signals, and 45 demonstrated metastasis with five signaling fluorescence. About 24.7%of patients were diagnosed with SLN metastasis (22/89), where SLNB in two patients showed fluorescence signal but without blue dye. No ipsilateral lymph node relapsed were observed during a median follow up of 25 months. Conclusion:Combination of ICG fluores-cence navigation with blue dye in SLNB is safe for patients with breast cancer.