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 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 analyze and compare the ultrasound characteristics in different pathologic classifications of thyroid carcinoma.The ultrasound characteristics of thyroid carcinoma were investigated in order to determine the clinical diagnosis and clinical stasing of thyroid carcinoma.Methods In this study,407 cases of thyroid carcinoma were enlisted for ultrasonic typing of thyroid carcinoma according to the ultrasound features.The resuh was used for clinical staging of thyroid carcinoma. Results Combined ultrasound mediated clinical stage has a higher accuracy rate and specificity,its accuracy rate of T stage is 93.9%,for No stage is 86.1%,for N1a stage is 80%,for Nlb stage is 74.9%.Preoporative US detected 51.5% occult metastatic LN.Conclusion Ultrasound has a very important effectiveness for the evaluation.staging,location of thyroid carcinoma and cervical lymph node metastasis.

Objective To investigate the biological characteristics and management of multifocal papillary thyroid carcinoma. Methods Clinical data of 86 patients who underwent thyroidectomy and were pathologically diagnosed as progressive multifocal papillary thyroid carcinoma from 1995 to 1997 in Tianjin Cancer Hospital were retrospectively analyzed. Results There were 86 cases of multifocal papillary thyroid carcinoma, accounting for 23.4% of all papillary thyroid carcinoma of the same period. In the 86 cases of multifocal papillary thyroid carcinoma, there was unilateral in 12 cases and bilateral in 74 cases; cervical lymph node metastasis in 51 cases ( 59. 3% ); combined microcarcinoma of 46 cases ( 53.5% );Hashimoto's thyroiditis was concomitant in 23 cases (26.7%); local invasion was found in 19 cases (22. 1% ); distant metastasis occurred in 1 case ( 1.2% ); 10-year survival rate was 95.3%. American Joint Committee on Cancer ( AJCC ) stage was associated with prognosis significantly ( x2 = 63. 395, P =0.000). Conclusions Multifocal papillary thyroid carcinoma often occurs bilaterally, concomitant microcarcinoma and Hashimoto's thyroiditis is common with a comparatively favorable prognosis. AJCC stage is still the best prognostic factor.

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 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.

OBJECTIVETo study the expression of angiotensin-2 (Ang-2), Tie-2 and vascular endothelial growth factor receptor-2 (VEGFR-2) in colorectal cancer and analyze their relationship with the occurrence, recurrence, metastasis, angiogenesis and prognosis of colorectal cancer.

METHODSImmunohistochemistry with SP method was used to detect the expressions of Ang-2, Tie-2 and VEGFR-2 in 118 colorectal cancer, 40 adjacent normal tissue and 40 benign colorectal lesion specimens.

RESULTSThe positivity rates of Ang-2, Tie-2 and VEGFR-2 in colorectal cancer tissue were 74.58%, 69.49%, and 61.02%, respectively, significantly higher than those in the adjacent normal tissues (25.00%, 17.50%, and 17.50%, P<0.05) and benign colorectal lesion tissues (35.00%, 32.50%, and 32.50%, P<0.05). The rates of two or three coexpression were significantly higher than that of a single expression in the cancer tissues (61.02% vs 15.25%). The microvascular density (MVD) of colorectal cancer tissues was 31.43∓10.50, significantly higher than that of the adjacent normal tissues (10.61∓3.76) and benign colorectal lesions (16.89∓3.83) (P<0.05). The expressions of Ang-2, Tie-2, and VEGFR-2 were positively correlated with carcinoembryonic antigen (CEA) and MVD (P<0.05). The expression of Ang-2, but not Tie-2 and VEGFR-2, was positively correlated with CA199. Ang-2, Tie-2, and VEGFR-2 expressions showed significant differences between cases with tumor recurrence/metastasis and those without 5 years after radical mastectomy, and were all positively correlated with the 5-year survival rates (P<0.05).

CONCLUSIONAng-2, Tie-2 and VEGFR-2 are involved in the development, invasion, metastasis, and prognosis of colorectal cancer, and play important roles in the angiogenesis of the tumors.

Adolescent ; Adult ; Aged ; Angiopoietin-2 ; metabolism ; Colorectal Neoplasms ; blood supply ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic ; metabolism ; Prognosis ; Receptor, TIE-2 ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism ; Young Adult

Objective:To explore the application of the pioneering TEBMCL (task based evidence-based laboratory medicine team cooperative learning) teaching mode in the teaching of Clinical Biochemical Laboratory Technology. Methods:A total of 336 undergraduates of medical laboratory from 3 classes of Batch 2014 were selected as research objects, and 112 students in class 1 were randomly selected as the teaching reform class, 113 students in class 2 were randomized into control class 1 and 111 students in class 3 into control class 2. The teaching effects achieved by applying the TEBMCL teaching mode to the teaching of Clinical Biochemical Laboratory Technology in the three classes were compared comprehensively and the TEBMCL teaching mode was also evaluated. The Access 2010 and SPSS 17.0 statistical analysis methods were used for statistical analysis. Results:Learning effect: ①Compared with the basic test of the three classes, there was no statistical differences ( P > 0.05); but the in-class test after each chapter showed that the results of the teaching reform class were better than those of the other two classes ( P < 0.05). It was also found that the performance of the control class 1 was better than that of the control class 2 after applying the new TEBMCL teaching mode in the second chapter ( P < 0.05). ②In a number of indicators, it was found that the scores of the reform class were better than those of the control class 1 and the control class 2 ( P < 0.05); ③In the terms of excellent grade and good grade, the teaching reform class was ahead of the control class 1 and the control class 2, and none of students in the teaching reform class failed the graduation design (thesis). In the terms of questionnaires and seminars: TEBMCL teaching mode was carried out for juniors who had professional basic knowledge, with short prcoess and high efficiency, while this method still needed to be improved. Conclusion:The new TEBMCL teaching mode has significant advantages compared with the traditional teaching mode, which can better promote the cultivation of students' abilities and improve the degree of knowledge mastery.