OBJECTIVE To explore risk factors of cervical lymph node metastasis in cN0 papillary thyroid carcinoma. METHODS The clinical data of 537 patients with cN0 papillary thyroid carcinoma were analyzed retrospectively in Beijing Tongren hospital from Jan 2009 to Dec 2015. Patients' gender, age, multifocal lesion, carcinoma complicated with Hashimoto's thyroiditis, capsule breakthrough and tumor size were counted. RESULTS The lymph node metastasis rate of 537 patients with cN0 papillary thyroid carcinoma was 30.9%(166/537). The incidences of lymph node involvement were 24.95%(166/537) at only level VI, 5.21%(28/537) at level VI plus lateral part of neck and 0.74%(4/537) at only skip metastasis, respectively. Chi square test and multivariate logistic regression analysis showed that cervical lymph node metastasis was statistically associated with male, age<45 years, capsule breakthrough and tumor diameter>1 cm (P<0.05). After the operation, there were 17 patients with temporary hoarseness, accompanied with 1 loss to follow-up and 1 failure to return to normal after 1.5 years. There were 61 patients with temporary hypocalcemia, 2 patients failed to follow-up and 2 patients with calcium supplements after respective 1.5 and 4 years. CONCLUSION To stratify the risk of patients with cN0 papillary thyroid carcinoma, male, age<45 years, capsule breakthrough and tumor diameter>1 cm are risk factors for cervical lymph node metastasis. And we suggest that prophylactic central lymph node dissection may be appropriate.

In recent years, the incidence of sleep disorders is increasing gradually, and sleep disorder has become a common and frequently-occurring disease in community. While drugs bring a series of side effects, non-pharmacological therapy has become a hotspot in sleep quality study field. It is found that"Gua sha" therapy has a significant effect in improving sleep quality as one of the traditional Chinese medicine (TCM) care techniques by literature review. This paper summarized the current situation and analyzed the deficiencies of "Gua sha" in sleep improvement basing on the theoretical foundation of Chinese medicine and biological mechanism, so as to provide references for future research and provide guidance for promoting the application of "Gua sha" therapy in community.