Differentiated thyroid cancer usually has a good prognosis;however,recurrence occurs in 5％to 20％of patients after initial treatment,which causes physiopsychological and financial burdens for the patients.In the meantime,it complicates the treatment decision-making for clinicians.Different from initial treatment,the management of recurrent thyroid cancer should take comprehensive consideration of factors such as risks and benefits.Surgery is considered to be the first choice of treatment while radioactive iodine therapy is recommended for radioiodine-avid recurrent disease.Smaller lesions can be managed with active surveillance temporarily,and thermal ablation should only be applied to patients not suitable for additional surgery.In contrast,external beam radiotherapy and systemic therapies are considered only after all therapy options have been exhausted.

Objective:To compare and evaluate the quality of wild and different cultivation methods of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai through analysis on UPLC characteristic atlas and multi-component content determination results. Methods:UPLC was used to establish the characteristic chromatogram and multi-component content determination method of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai, and clustering analysis, orthogonal partial least squares - discriminant analysis method were used for chemical pattern recognition analysis. Results:The results showed that there were 10 common peaks in 18 batches of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai. Five components were identified, erythrothioneine(peak 1), protocatechuic acid (peak 2), protocatechualdehyde (peak 3), caffeic acid (peak 4) and Hispidin (peak 5). HCA and OPLS-DA could distinguish Sanghuang porus vaninii (Ljub.) with different cultivation methods. Conclusion:Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai in wood is closer to wild Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai than in substitute cultivation. The UPLC characteristic atlas and multi-component content determination method established in this study can provide reference for the quality evaluation of Sanghuang porus vaninii (Ljub.) L.W. Zhou & Y.C. Dai.

Objective A stable model of acute obstructive suppurative cholangitis was established in rats to detect pathophysiological indexes and provide a reliable standardized animal model for the study of acute cholangitis and cholestasis.Methods SPF-grade male SD rats were selected,and the model was constructed via the injection of toxoid into the lower bile duct,followed by ligation of the common bile duct.Changes in body weight,mortality,major indexes of liver function,and histopathological changes in the liver were evaluated before and after modeling.Results After modeling,the body weight of rats in the model group decreased significantly.There were no deaths and no abnormalities of liver function in the sham-operation group.Three rats died in the model group,and the mortality rate of the model group was 12％.The main indexes of liver function and liver pathology showed obvious cholestasis and injurious changes to hepatic function in the model.Conclusions In this study,an acute obstructive suppurative cholangitis model rat was successfully established.The model has the advantages of ease of operation,minimal injury,low mortality,and a highly successful modeling rate,and it can provide a standardized experimental animal model for studying the mechanisms of and developing drugs for these common diseases.

Objective:To investigate surgical treatment of carotid artery diseases in neck tumor surgery. Methods:A retrospective analysis of the clinical data on carotid artery treatment was conducted in the five cases of neck tumor surgeries treated at Department of Surgical Oncology, the First Peoples Hospital of Lanzhou from March 2010 to May 2020. Surgical methods, including carotid artery resection and ligation, tumor-involved artery resection and vascular reconstruction, and tumor peeling and carotid rupture repairing were used, respectively. Results:Five cases were successfully operated on. One case of carotid artery ligation was followed by intermittent dizziness and decreased contra-lateral limb strength after the surgery. The remaining patients exhibited no neurological complications. A patient with cervical low-grade myofibroblastoma developed into lung metastases 8 months after the surgery. Another patient with cervical lymph node metastases in papillary thyroid cancer developed into lung metastases 24 months after the surgery. Conclusion:Currently, surgical methods for clinical treatment of diseased carotid arteries include carotid artery resection and ligation, simple tumor peeling, tumor invasion artery resection and vascular reconstruction, and interventional therapy. Each surgical method has its own advantages and disadvantages. Therefore, the choice of treatment depends on the patient's specific conditions, physician's clinical experience, and the equipment available.
Humans ; Retrospective Studies ; Carotid Arteries/pathology* ; Head and Neck Neoplasms/pathology* ; Thyroid Neoplasms/surgery* ; Lung Neoplasms/pathology*

Objective:To establish the fingerprint and stoichiometric analysis mode of Ultra Performance Liquid Chromatography Tandem Quadrupole Time-of-Flight Mass Spectrometry (UPLC-Q-TOF-MS) of Fritillaria anhuiensis Bulbus, so as to provide reference for its quality evaluation and standard formulation. Methods:By setting the CORTECS C18 column at 4.6 mm×150 mm, 2.7 μm with the mobile phases of acetonitrile-0.1% formic acid and 10 mmol/L aqueous ammonium formate for gradient elution at a flow rate of 0.4 ml/min and an injection volume of 2.0 μl. The TCM fingerprint similarity evaluation system (2012 version) was used to evaluate 9 batches of Fritillaria anhuiensis Bulbus samples. By using Liquid Chromatography-Mass Spectrometry (LC-MS) technique to make quantity analysis and by combining cluster analysis, principal component analysis and orthogonal least squares-discriminant analysis to make overall quality evaluation. Results:The fingerprint profiles of different batches of Fritillaria anhuiensis Bulbus were established and 21 common peaks were identified, and 12 of them were initially identified. Cluster analysis, principal component analysis and orthogonal least squares-discriminant analysis were used to cluster the nine batches of Fritillaria anhuiensis Bulbus into three categories. Conclusion:The fingerprint established in this study combined with the chemical pattern recognition method are highly sensitive and specific, which could reflect the overall characteristics and differences of Fritillaria anhuiensis Bulbus, providing reference for the quality evaluation of Fritillaria anhuiensis Bulbus and standardization of it.

Acute and chronic cholecystitis is often complicated by gallstones.With the rapid development of modern surgery,especially the renovation in surgical concepts,techniques,and methods represented by noninvasive surgery,surgery becomes the most important method for the treatment of such disease.However,surgical treatment is also limited by different disease stages,disease onset status,and individual factors.As an indispensible part of the whole treatment system for such disease,non-surgical treatments,especially integrated traditional Chinese and Western medicine therapy,still have unique advantages.This article briefly summarizes the history of the treatment of acute and chronic cholecystitis and related hot topics and controversies,as well as the concepts and methods of integrated traditional Chinese and Western medicine therapy.

Objective To evaluate the value of CTA in assessing congenital heart disease and related heterotaxy syndrome.Methods A total of 20 patients with congenital heart disease and heterotexy syndrome underwent CTA and 3-dimensional reconstructions.And intracardiac and extracardiac abnormalities were assessed.Results Three cases were left isomerism,two of which were bi-lobed left lungs and trilobed right lungs,and another one was bi-lobed lungs.The most common associated cardiovascular anomalies included single ventricle (n=2),atrial septal defect (n=2),ventricular septal defect (n=1),transposition of the great arteries (n=2),pulmonary artery stenosis (n=2),atresia (n=1),persistent left superior vena (n=1),no hepatic segment of inferior vena cava (n=1).The rest 17 cases were right isomerism.All of them were trilobed lungs.Associated cardiovascular anomalies included single ventricle (n=9),double outlet of right ventricle (n=2),endocardial cushion defect (n=6),atrial septal defect (n=10),patent foramen ovale (n=1),ventricular septal defect (n =8),transposition of the great arteries (n =14),pulmonary artery stenosis (n =16),atresia (n =1),pulmonary venous drainage (n=6),persistent left superior vena (n=7),no hepatic segment of inferior vena cava (n=2).Conclusion CTA can clearly show the structure of heart,great vessels,chest and abdomen which is a useful tool to accurately assess congenital heart disease and related heterotaxy syndrome for medical or surgical management.

Objective:To evaluate the clinical outcomes of patients after intensity modulated radiation therapy (IMRT) for hepatocellu-lar carcinoma (HCC) with portal vein tumor thrombosis (PVTT) or inferior vena cava tumor thrombosis (IVTT). Methods:A registry data-base of 41 patients treated with IMRT for HCC with PVTT or IVTT in Radiotherapy Center of No.3 Hospital of Beijing Chinese People Armed Police Forces between January 2013 and May 2015 were analyzed retrospectively. The biological effective dose of radiation was ranged 48-94Gy. Short-term effects and prospective efficacy were observed. Log-rank test, Cox regression were used for survival analysis and prognostic factor identification. Results: Grade 2 or higher level gastrointestinal reaction was observed in 12 patients (29.3%). Hematological toxicity was observed in 11 patients (26.8%), and radiation-induced liver disease was observed in 6 patients (14.6%). We found that 29.3%of patients achieved a complete response and 31.7%of patients achieved a partial response. The stable and progressive disease rates were 39.0%and 0.0%, respectively. Median patient survival was 11 months, and the 1-year survival rate was 34.1%. The significant independent variables associated with the overall survival included Child-Pugh grade, AFP test, and CHE lev-el. Conclusion:IMRT is a safe and effective treatment for PVTT or IVTT in patients with HCC.

OBJECTIVETo investigate the changes in methylation levels of the promoters of the tumor suppressor gene Wilms' tumor gene on the X-chromosome (WTX) and its possible role in gastric cancer.

METHODSWTX promoter methylation levels were detected in 20 pairs of specimens of gastric cancer and matched normal tissues and in 3 gastric cancer cell lines (MGC803, SCG7901, and BGC823) using the Sequenom MassARRAY quantitative analysis system. The gastric cancer cell line BGC823 was treated with 5-aza-2'-deoxycytidine (5-aza-dC) for demethylation and the changes in the level of WTX promoter methylation were investigated.

RESULTSWTX promoter methylation levels were very low and showed no significant differences among normal gastric tissues, gastric cancer tissues and the 3 gastric cancer cell lines. In BGC823 cells, treatment with 5-aza-dC did not obviously affect the promoter methylation levels of WTX.

CONCLUSIONHigh methylation levels of WTX promoters are rare in gastric cancer.