Objective:To compare surgical-related indicators between non-inflated subclavian endoscopic surgery and axillary and traditional open surgery for the treatment of right lobe thyroid cancer,as well as their effects on postoperative anterior cervical function and cosmetic outcomes.Methods:This retrospective cohort study analyzed 151 cases of thyroid cancer patients who underwent surgical treatment at the Department of Thyroid Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2024 to October 2024. Based on the surgical approach,patients were divided into three groups:56 cases of traditional open surgery group, 44 cases of non-inflated axillary approach group,and 51 cases of non-inflated subclavian approach group. Comparative indicators included surgical time, parathyroid autotransplantation rate,complete exposure rate of central area, number of lymph node dissections, number of positive lymph nodes, anterior cervical function, and satisfaction with incision beauty. One-way analysis of variance,non-parametric test,Kruskal-Wallis test,Pearson χ2 test and Fisher′s exact probability method were used to compare the results of the three groups and subsequent pairwise comparisons,respectively. Results:All laparoscopic surgeries were successfully completed without conversion to open surgery. (1) Surgical time:the traditional open surgery group had the shortest operative time ( M(IQR))(71.5(16.0)minutes), significantly shorter than both endoscopic groups (both P<0.01); among the endoscopic approaches, the non-inflated subclavian approach group (97.0(10.0)minutes) had a significantly shorter operative time than the non-inflated axillary approach group (115.0(11.0)minutes)( P<0.01). (2) Parathyroid autotransplantation rate:the rates were 53.6%(30/56) in the traditional group, 70.5%(31/44) in the non-inflated axillary approach group, and 66.7%(34/51) in the non-inflated subclavian approach group, with no statistically significant differences ( P>0.05). (3) Complete exposure rate of the central area:the exposure rate was 100%(56/56) in the traditional open surgery group, 86.4%(38/44) in the non-inflated axillary approach group, and 96.1%(49/51) in the non-inflated subclavian approach group. A significant difference was observed between the traditional open surgery group and the non-inflated axillary approach group ( χ2=8.124, P<0.01), but not observed between other groups. (4) Number of lymph node dissection:no significant difference was found among the three groups (8(6)(range:2 to 17) in the traditional open surgery group,7(3)(range:2 to 16) in the non-inflated axillary approach group,7(4)(range:2 to 16) in the non-inflated subclavian approach group)( P=0.078).(5) Number of positive lymph nodes:no significant differences were observed among the three groups( P=0.923). (6) Postoperative anterior cervical function:① Visual analogue scale: there was no significant difference between the non-insufflation transaxillary approach group and the non-insufflation subclavian approach group at 3 days and 1 month postoperatively ( P>0.017). However, the two groups had significantly lower scores than the traditional open group (both P<0.01). ② Neck disability index:at 3 days post-surgery, there were significantly lower in the axillary and subclavian groups compared to the traditional open group ( P<0.01), with no significant difference between the two endoscopic groups( P>0.017); at 1 month postoperatively, the traditional open surgery group, gasless axillary approach group, and gasless subclavian approach group, with statistically significant differences between each group (both P<0.01). ③ Swallowing disorder index: no significant differences were observed at 3 days post-surgery( P>0.05); however, at 1 month post-surgery, the endoscopic groups showed significantly lower scores compared to the traditional open group(both P<0.01).(7) Satisfaction with incision beauty:significant differences were found among the three groups in terms of vancouver scar scores, patient scar assessment scores, and observer scar assessment scores(all P<0.01). Conclusions:Compared to the non-inflated axillary endoscopic thyroidectomy, the non-inflated subclavian approach offers a technically simpler procedure, better exposure of the central lymph node dissection area, and superior protection of anterior cervical function, although it results in less favorable cosmetic outcomes. Under strict preoperative evaluation and appropriate indications,both non-inflated subclavian and axillary approaches can achieve outcomes comparable to traditional open surgery for cN0 thyroid cancer,demonstrating good clinical application value.

Objective:To compare surgical-related indicators between non-inflated subclavian endoscopic surgery and axillary and traditional open surgery for the treatment of right lobe thyroid cancer,as well as their effects on postoperative anterior cervical function and cosmetic outcomes.Methods:This retrospective cohort study analyzed 151 cases of thyroid cancer patients who underwent surgical treatment at the Department of Thyroid Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2024 to October 2024. Based on the surgical approach,patients were divided into three groups:56 cases of traditional open surgery group, 44 cases of non-inflated axillary approach group,and 51 cases of non-inflated subclavian approach group. Comparative indicators included surgical time, parathyroid autotransplantation rate,complete exposure rate of central area, number of lymph node dissections, number of positive lymph nodes, anterior cervical function, and satisfaction with incision beauty. One-way analysis of variance,non-parametric test,Kruskal-Wallis test,Pearson χ2 test and Fisher′s exact probability method were used to compare the results of the three groups and subsequent pairwise comparisons,respectively. Results:All laparoscopic surgeries were successfully completed without conversion to open surgery. (1) Surgical time:the traditional open surgery group had the shortest operative time ( M(IQR))(71.5(16.0)minutes), significantly shorter than both endoscopic groups (both P<0.01); among the endoscopic approaches, the non-inflated subclavian approach group (97.0(10.0)minutes) had a significantly shorter operative time than the non-inflated axillary approach group (115.0(11.0)minutes)( P<0.01). (2) Parathyroid autotransplantation rate:the rates were 53.6%(30/56) in the traditional group, 70.5%(31/44) in the non-inflated axillary approach group, and 66.7%(34/51) in the non-inflated subclavian approach group, with no statistically significant differences ( P>0.05). (3) Complete exposure rate of the central area:the exposure rate was 100%(56/56) in the traditional open surgery group, 86.4%(38/44) in the non-inflated axillary approach group, and 96.1%(49/51) in the non-inflated subclavian approach group. A significant difference was observed between the traditional open surgery group and the non-inflated axillary approach group ( χ2=8.124, P<0.01), but not observed between other groups. (4) Number of lymph node dissection:no significant difference was found among the three groups (8(6)(range:2 to 17) in the traditional open surgery group,7(3)(range:2 to 16) in the non-inflated axillary approach group,7(4)(range:2 to 16) in the non-inflated subclavian approach group)( P=0.078).(5) Number of positive lymph nodes:no significant differences were observed among the three groups( P=0.923). (6) Postoperative anterior cervical function:① Visual analogue scale: there was no significant difference between the non-insufflation transaxillary approach group and the non-insufflation subclavian approach group at 3 days and 1 month postoperatively ( P>0.017). However, the two groups had significantly lower scores than the traditional open group (both P<0.01). ② Neck disability index:at 3 days post-surgery, there were significantly lower in the axillary and subclavian groups compared to the traditional open group ( P<0.01), with no significant difference between the two endoscopic groups( P>0.017); at 1 month postoperatively, the traditional open surgery group, gasless axillary approach group, and gasless subclavian approach group, with statistically significant differences between each group (both P<0.01). ③ Swallowing disorder index: no significant differences were observed at 3 days post-surgery( P>0.05); however, at 1 month post-surgery, the endoscopic groups showed significantly lower scores compared to the traditional open group(both P<0.01).(7) Satisfaction with incision beauty:significant differences were found among the three groups in terms of vancouver scar scores, patient scar assessment scores, and observer scar assessment scores(all P<0.01). Conclusions:Compared to the non-inflated axillary endoscopic thyroidectomy, the non-inflated subclavian approach offers a technically simpler procedure, better exposure of the central lymph node dissection area, and superior protection of anterior cervical function, although it results in less favorable cosmetic outcomes. Under strict preoperative evaluation and appropriate indications,both non-inflated subclavian and axillary approaches can achieve outcomes comparable to traditional open surgery for cN0 thyroid cancer,demonstrating good clinical application value.

Objective:To explore the clinical characteristics and prognostic influencing factors of multiple primary lung cancer (MPLC), and to construct a prognostic prediction model.Methods:The clinical data and prognostic information of MPLC patients diagnosed by pathological examination included in the Surveillance, Epidemiology, and End Results (SEER) database from January 2010 to December 2020 were retrospectively analyzed. Patients were randomly divided into training and validation sets according to a 7:3 ratio using R software. Survival curves were plotted by using the Kaplan-Meier method and log-rank test was used for comparison between groups. The independent influencing factors of overall survival (OS) of MPLC patients in the training set were screened using univariate and multivariate Cox proportional hazards models, and accordingly, the nomogram predicting the survival rate of patients at 3, 5 and 8 years were plotted. In the training and validation sets, using the actual survival as the gold standard, the receiver operating characteristic (ROC) curves of the constructed models for predicting the patients' 3-, 5- and 8-year OS rates were plotted, the area under the curve (AUC) was obtained, and C-index of the model was analyzed by using R software. The calibration curves of 3-, 5- and 8-year OS rates predicted by the models and the actual OS rates were plotted.Results:A total of 5 495 MPLC patients were included, 3 846 in the training set and 1 649 in the validation set. The differences in the composition of patients of different ages and AJCC stages between the training and validation sets were statistically significant (both P < 0.05), and the differences in the comparison of other clinicopathological characteristics were not statistically significant (all P > 0.05). The results of multivariate Cox regression analysis showed that males (compared with females, HR = 1.256, 95% CI: 1.144-1.379, P < 0.001), age ≥ 70 years old (compared with 50-59 years old, HR = 1.201, 95% CI: 1.030-1.400, P = 0.019), FPLC with pathological types of squamous cell carcinoma or other types (compared with adenocarcinoma, HR = 1.275, 95% CI: 1.137-1.431, P < 0.001; HR = 1.208, 95% CI: 1.041-1.403, P = 0.013), and SPLC with pathological types of squamous cell carcinoma, small cell lung carcinoma, or other types (compared with adenocarcinoma, HR = 1.270, 95% CI: 1.121-1.440, P < 0.001; HR = 1.978, 95% CI: 1.642-2.384, P < 0.001; HR = 1.246, 95% CI: 1.090-1.424, P = 0.001), and AJCC stage Ⅲ and Ⅳ (compared with stage Ⅰ, HR = 1.645, 95% CI: 1.447-1.869, P < 0.001; HR = 2.078, 95% CI: 1.669-2.587, P < 0.001), FPLC without operation (compared with operation, HR = 1.263, 95% CI: 1.038-1.536, P = 0.020), SPLC without operation (operation vs. no operation, HR = 0.680, 95% CI: 0.579-0.799, P < 0.001), FPLC without lymph node dissection or with clearance of 1-3 regional lymph nodes (compared with clearance of ≥4, HR = 1.225, 95% CI: 1.016-1.477, P = 0.034; HR = 1.314, 95% CI: 1.103-1.566, P = 0.002), FPLC with maximum diameter 3-5 cm or >5 cm (compared with <3 cm, HR = 1.181, 95% CI: 1.053-1.324, P = 0.005; HR = 1.232, 95% CI: 1.069-1.420, P = 0.004), and SPLC with maximum diameter 3-5 cm or >5 cm (compared with <3 cm, HR = 1.560, 95% CI: 1.362-1.786, P < 0.001; HR = 1.727, 95% CI: 1.451-2.054, P < 0.001), and FPLC without chemotherapy (chemotherapy vs. no chemotherapy or unknown, HR = 0.744, 95% CI: 0.655-0.845, P < 0.001) were the independent risk factors of patients' poor OS (all P < 0.05). The results of Kaplan-Meier survival analysis showed that the OS of patients with different gender, race, age, two tumor locations, AJCC staging, pathological type of two lung tumors, maximum diameter of two tumors, and whether two tumors were treated surgically or not, and whether two tumors were treated with chemotherapy or not in the training set were compared, and the differences were all statistically significant (all P < 0.05). Based on the independent factors affecting the OS of MPLC patients screened by the results of multivariate Cox regression analysis, nomogram predicting the 3-, 5- and 8-year OS rates of MPLC were plotted. The results of ROC curve analysis showed that the C-index of the training set's nomogram was 0.679 (95% CI: 0.649-0.701), and the AUC values for predicting the 3-, 5- and 8-year OS rates were 0.601, 0.595 and 0.586, respectively; the C-index of the validation set was 0.678 (95% CI: 0.633-0.720), and the AUC values for predicting 3-, 5- and 8-year OS rates were 0.643, 0.631 and 0.626, respectively. The calibration curves showed that the 3-, 5- and 8-year OS rates of patients predicted by the nomogram models in both the training and validation sets were in good agreement with the actual results with a high goodness-of-fit. Conclusions:The established prognostic model has good predictive value and can effectively assess the prognosis of patients.

Objective: To understand the status of pinworm infection in rural children aged 3-9 years in Anhui Province, and to provide scientific basis for the prevention and control strategy of pinworm disease. Methods: According to the National Surveillance Program of Liver Fluke Disease and Soil Transmitted Nematodiasis(Trial), no less than 10% counties(cities and districts) in Anhui Province were selected as mobile surveillance sites every year. Each surveillance site was divided into 5 areas on the basis of geographical location(east, west, south, north and middle), from each of the areas, one administrative village was selected from one township(town, community) for conducting surveillance. Children at age 3-9 years from each site were examined for pinworm infection with the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method. Chi square test was used to compare the infection rate. Results: From 2017 to 2021, the 5 year average infection rate of pinworm in rural Anhui was 1.34%(128/9 557), and there was no significant difference in the infection rate over the years( P >0.05). The detection rates of the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method were 0.28% and 1.23%, respectively, the difference was statistically significant( χ 2=72.97, P <0.01). In different regions, the 5 year average infection rate of Fuyang City was the highest(4.27%), and the rate of each city was positively correlated with the number of local resident population( r =0.54, P <0.05). There was no significant sex difference in the 5 year average infection rates( P >0.05). The 5 year average infection rate of children aged 3 to 9 years in rural areas were 0.62%, 1.10%, 1.44%, 1.57%, 0.94%, 2.09% and 1.57%, respectively, showed an increasing trend with the increase of age( χ 2=14.41, χ 2 trend =6.70, P <0.05). There was no significant difference in the average infection rate between scattered children and collectively living children( P >0.05). Conclusion From 2017 to 2021, the infection rate of pinworm among children in rural Anhui province remains at a low level. In the future, health education and monitoring should be strengthened.

Objective:To investigate the effect of endoscopic thyroidectomy and open thyroidectomy on parathyroid function in patients with thyroid cancer.Methods:The clinical data of 73 patients with thyroid cancer who met the inclusion criteria in Zhengzhou Central Hospital Affiliated to Zhengzhou University from July 2018 to September 2019 were retrospectively analyzed, including 17 males and 56 females, aged 19-55 years. The patients underwent routine thyroidectomy (group A, n=31), oral endoscopic thyroidectomy by vestibular approach (group B, n=19) or transthoracic thyroidectomy (group C, n=23), and all patients received central neck dissection. The levels of parathyroid hormone (PTH) and serum calcium after operation were compared among three groups. SPSS 21.0 software and GraphPad Prism v6.01 were used for statistical analysis. Results:After operation, the mean levels of PTH and serum calcium in three groups were significantly decreased (all P<0.05). On the first day after operation, the mean level of PTH in group C was lower than that in group A [(12.3±9.0) vs. (22.2±13.2) pg/ml, t=3.04, P=0.004] or group B [(12.3±9.0) vs. (20.0±14.1) pg/ml, t=2.09, P=0.043], and also the level of serum calcium in group C was lower than that in group A [(1.89±0.11) vs. (2.02±0.16) mmol/L, t=3.24, P=0.002] or group B [(1.89±0.11) vs. (2.01±0.15) mmol/L, t=2.72, P=0.010], with no significant difference in the mean levels of PTH or serum calcium between group A and group B ( t=0.54, 0.29, respectively, both P>0.05). The incidences of permanent hypoparathyroidism/persistent hypocalcemia were 3.2% (1/31) in group A, 5.3% (1/19) in group B and 21.7% (5/23) in group C, and the incidence of group C was significantly higher than that (4%, 2/50) of both group A and group B (χ 2=5.251, P=0.022). Conclusion:The postoperative parathyroid function and serum calcium level have different degrees of change and they are significantly associated with thyroidectomy approaches, the protection of parathyroid by oral endoscopic thyroidectomy and routine thyroidectomy can achieve the same effect, and is better than that of transthoracic thyroidectomy.

Objective To study the expression of mitochondrial tumor suppressor gene 1 (MTUS1) mR-NA in papillary thyroid carcinoma(PTC).Methods Reverse transcription polymerase chain reaction(RT-PCR) was used to detect MTUS1 mRNA level in 68 cases of human PTC and the adjacent non-cancerous epithelium (NCE) specimens.Results The relative expression value of MTUS1 mRNA in PTC was 0.31 ± 0.09,while it was 0.65 ±0.12 in NCE.The difference had statistical significance between the 2 groups(t =2.39,P ＜0.05).In PTC,mRNA expression of MTUS1 gene was related to the pathological grade,and lymph node metastasis(P ＜ 0.05)while it was not related to patients' age,sex,differentiation degree,tumor size or TNM stage(P ＞ 0.05).Conclusion mRNA expression of MTUS1 gene is lower in PTC than in NCE,which may play an important role in carcinogenesis and progression of PTC.

Objective Methylation of anti-oncogene can be demethylated by related drugs which can help the inactivated gene to express again .This study aims to study the effects of the demethylating agent 5-Aza-2′-deoxycytidine on the growth of human thyroid papillary cancer cell line TPC-1 and mRNA and protein expres-sion of KLF4.Methods TPC-1 cells were treated with different concentration of 5-Aza-CdR.MTT was used to detect the influence of 5-Aza-CdR on cell proliferation .RT-PCR was used to detect mRNA and protein expression levels of KLF4.Results After being treated with 5-Aza-CdR for 24 hours, 48 hours, and 72 hours, the growth of TPC-1 cells was inhibited and the inhibition was in time and concentration depended manner .After treatment with 5-Aza-CdR, mRNA and protein expression levels of KLF 4 were increased, and the difference had statistical significance(P<0.05).Conclusion 5-Aza-CdR can inhibit the cell viability of TPC-1 cells through upregulat-ing KLF4 expression , which may provide experimental basis for 5-Aza-CdR in treating thyroid cancer .

OBJECTIVETo investigate the expression of proliferating cell nuclear antigen (Ki-67) in stage III cervical squamous cell carcinoma (SCC) and its correlation with the effect of chemotherapy on sensitivity to radiotherapy.

METHODSIn 50 patients with stage III cervical squamous cell carcinoma (SCC), 25 patients were treated with radiotherapy and 25 patients were treated with chemoradiotherapy. The expression of Ki-67 in the biopsy specimens of cervical SCC was detected by immunohistochemistry at diagnosis and after 10 Gy radiotherapy. The correlation of Ki-67 positive cells percentage and chemotherapy with sensitivity to radiotherapy was analyzed.

RESULTSIn 25 patients with more than 48% Ki-67 positive cells at diagnosis, the rate of complete response (CR) was 72.0% (18/25). In 25 patients with less than 48% Ki-67 positive cells at diagnosis, the CR rate was 40.0% (10/25), with a significant difference between them (P = 0.023). In 26 patients with more than 31% decrease of Ki-67 positive cells after 10 Gy radiotherapy, the CR rate was 84.6% (22/26). In 24 patients with less than 31% decrease of Ki-67 positive cells after 10 Gy radiotherapy, the CR rate was 25.0% (6/24), showing a significant difference between the two groups (P < 0.001). In the cases of Ki-67<48%, decrease of Ki-67 positive cells of chemoradiotherapy group after 10 Gy radiotherapy was significantly higher than that of the radiotherapy group (P = 0.023). In the cases of Ki-67 ≥ 48%, no difference in the decease of Ki-67 positive cells between the chemoradiotherapy and radiotherapy groups was found (P = 0.173). For the radiotherapy-sensitive patients with CR recently, the 2-year progression free survival (PFS) rate and overall survival (OS) rate were 85.7% and 92.9%, respectively, both were significantly higher than those of radiotherapy-insensitive patients (18.2% and 40.9%, P < 0.05 for both).

CONCLUSIONSIn stage III cervical SCC, the expression of Ki-67 before and after treatment with 10 Gy radiotherapy may be used as a biomarker to predict tumor response to radiation, and guide the choice of therapeutic strategies. Yet, the effect of chemotherapy as a radiosensitizer is unconspicuous.

Carcinoma, Squamous Cell ; metabolism ; radiotherapy ; Chemoradiotherapy ; Disease-Free Survival ; Epithelial Cells ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Neoplasm Staging ; Radiotherapy Dosage ; Remission Induction ; Survival Rate ; Uterine Cervical Neoplasms ; metabolism ; radiotherapy