Objecfive:To investigate the clinical characteristics and surgical management of tumor invasion on recurrent laryngeal nerve at the entrance of larynx in thyroid cancer.Methods:The clinical data of 30 patients with recurrent laryngeal nerve invasion by thyroid cancer from Aug 2012 to Aug 2018 in Cangzhou Central Hospital were analyzed retrospectively. Patients were divided into groups A (14 cases ,nerve was invaded at the larynx) and group B (16 cases,nerve was involved in other parts).Results:Between the two groups, operation time, intraoperative blood loss, number of tumor focus, adhesion and infiltration were not statistically different ( P>0.05). The tumor size in group A was smaller ( t=-3.614, P=0.001), the lymph node metastasis rate was lower ( χ2=5.593, P=0.018), and the microcancer rate was higher ( χ2=4.051, P=0.044).Follow up data up to 24 months showed there were no significant difference in postoperative hoarseness , laryngoscope abnormality and recurrence rate between the two groups (all P>0.05). Conclusion:Patients of thyroid cancer with recurrent laryngeal nerve invasion at the larynx had relatively small tumor size, higher proportion of microcancer, lower rate of lymph node metastasiss.

Cytology in China developed from nothing and underwent a long journey from gynecologic cytology to that of all organs, laying a solid foundation for new developments in the 21st century. Thyroid fine-needle aspiration (FNA) was primarily developed in an endocrinology department and then in the clinical laboratory department or pathology department in the 1970–80s. Wrights staining is popular in endocrine and clinical laboratory departments, while hematoxylin and eosin staining is common in pathology. Liquid based cytology is not common in thyroid FNA cytology, while BRAF(V600E) mutation analysis has been the most popular molecular test. The history and practice of thyroid FNA practice in China were reviewed based on retrospective study of the practice in Qilu Hospital of Shandong University.
Biopsy, Fine-Needle* ; China* ; Endocrinology ; Eosine Yellowish-(YS) ; Hematoxylin ; Pathology ; Retrospective Studies* ; Thyroid Gland*

Objective To evaluate the safety and effects on blood transfusion of modified minimally cardiopulmonary bypass(CPB).Methods From April 2013 to February 2016,1103 elective cardiac surgery cases in National Center for Cardiovascular Diseases China,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College were prospectively enrolled in the study.Patients undergoing modified minimally CPB were assigned to mini-CPB group(n=553),the others undergoing conventional CPB were assigned to conventional group(n=550).In mini-CPB group,oxygenator with integrated arterial filter,modified minimized circuit,mini-cardioplegia and vacuum assisted venous drainage(VAVD)were used.In conventional group,conventional CPB was composed with conventional oxygenator from the same manufactory,conventional circuit and 1:4 blood cardioplegia.Analysis was performed with t test,t'test,Wilcoxon rank-sum test,x2 test,and Fisher exact test.Results No CPB accidents and perioperative stroke were observed.There was no statistical difference in postoperative mechanical ventilation time,length of ICU stay,postoperative complications and mortality between the two groups.The incidence of erythrocyte transfusion(13.7％vs.27.6％,x2=32.458,P=0.000)and the incidence of ultrafilter(11.0％vs.33.7％,x2=76.019,P=0.000)were lower in the mini-CPB group.Postoperative hematocrit(M(QR):32.9(5.7)vs.32.2(5.7),Z=3.403,P=0.001)and 12-hour chest drainage((228±154)ml vs.(260-±197)ml,t'=3.004,P=0.003)of mini-CPB were imporved compared with conventional group.Conclusions Modified minimally CPB is safe.It might reduce erythrocyte transfusion for adult cardiac surgery,warranting widely adoption.

Objective To evaluate the safety and effects on blood transfusion of modified minimally cardiopulmonary bypass(CPB).Methods From April 2013 to February 2016,1103 elective cardiac surgery cases in National Center for Cardiovascular Diseases China,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College were prospectively enrolled in the study.Patients undergoing modified minimally CPB were assigned to mini-CPB group(n=553),the others undergoing conventional CPB were assigned to conventional group(n=550).In mini-CPB group,oxygenator with integrated arterial filter,modified minimized circuit,mini-cardioplegia and vacuum assisted venous drainage(VAVD)were used.In conventional group,conventional CPB was composed with conventional oxygenator from the same manufactory,conventional circuit and 1:4 blood cardioplegia.Analysis was performed with t test,t'test,Wilcoxon rank-sum test,x2 test,and Fisher exact test.Results No CPB accidents and perioperative stroke were observed.There was no statistical difference in postoperative mechanical ventilation time,length of ICU stay,postoperative complications and mortality between the two groups.The incidence of erythrocyte transfusion(13.7％vs.27.6％,x2=32.458,P=0.000)and the incidence of ultrafilter(11.0％vs.33.7％,x2=76.019,P=0.000)were lower in the mini-CPB group.Postoperative hematocrit(M(QR):32.9(5.7)vs.32.2(5.7),Z=3.403,P=0.001)and 12-hour chest drainage((228±154)ml vs.(260-±197)ml,t'=3.004,P=0.003)of mini-CPB were imporved compared with conventional group.Conclusions Modified minimally CPB is safe.It might reduce erythrocyte transfusion for adult cardiac surgery,warranting widely adoption.

Objective To measure HPSE and VEGF-C expression in pancreatic cancer tissues and to observe the effect of small interfering RNA targeting heparanase gene on VEGF-C expression and malignant biological behavior of pancreatic cancer cell lines BxPC-3.Methods We measured the relative mRNA levels of HPSE and VEGF-C in 34 pancreatic ductal cell adenocarcinoma(PDAC) specimens by RT-qPCR.The recombinant plasmid GV230/HPSE was constructed.BxPC-3 was transiently transfected with GV230/HPSE and HPSE-siRNA.The expression levels of HPSE and VEGF-C were measured by performing florescent real-time quantitative PCR (RT-qPCR) and immunoblotting.The invasion and migration potential of treated BxPC-3 was evaluated by transwell invasion assay and Scratch-wound assay.Results Spearman rank correlation analysis indicated a positive correlation between HPSE and VEGF-C (r =0.812,P ＜0.01)in pancreatic cancer tissues.HPSE and VEGF-C overexpression was correlated with tumor differentiation,lymph node metastasis and TNM stage(all P ＜0.01).RT-qPCR and Western blot showed high expression of HPSE mRNA and VEGF-C mRNA in GV230/HPSE group than that in control group,compared to low expression of HPSE mRNA and VEGF-C mRNA in siRNA group (all P ＜ 0.01).Invasion chamber assay and Scratch-wound assay showed higher invasion in GV230/HPSE group than that in control group,while lower invasion in siRNA group (all P ＜ 0.01).Conclusions Joint detection of HPSE and VEGF-C may be of significance in predicting prognosis of patients with pancreatic cancer.HPSE regulates the expression of VEGF-C and facilitates invasion and migration of BxPC-3 in vitro.

Objective To analyze the advantages and disadvantages of minimally invasive video -assisted thyroidectomy(MIVAT)and totally endoscopic thyroidectomy (TET).Methods The study included 70 patients undergoing MIVAT and TET at Qilu Hospital of Shandong University and Yantai Yuhuangding Hospital from Jan . 2012 to Dec.2012.46 patients undergoing MIVAT(MIVAT group)and 24 patients undergoing TET(TET group) were analyzed retrospectively .Data of gender,age,operative data,intraoperative and postoperative complications , length of stay , feelings of patients and cosmetic effect were collected and analyzed .MIVAT and TET were com-pared in terms of safety ,trauma and cosmetic effect .Results ①About safety:no permanent recurrent laryngeal nerve(RLN)palsy and parathyroid injury occurred in either group .One case in MIVAT group and no case in TET group was converted to open surgery (2.2%vs 0%,P>0.05) .②About trauma:the intraoperative blood loss and postoperative drainage amount in the MIVAT group were significantly less than those in the TET group ( P <0.05).Postoperative VAS score at 6 hours was similar,but MIVAT group showed lower postoperative VAS score than TET group at 12 hours and 24 hours ( P<0.05 ) .No significant difference was observed between the 2 groups about C reactive protein (CRP)on the 1st day before operation,the 1st and 3rd day after operation(P>0.05).③About cosmetic effect:the 2 groups had similar patient satisfaction index .Conclusions The study shows similar results in safety and trauma .The 2 approaches are both safe and valid .Patients using the two ap-proaches are equally satisfied with the cosmetic effect .

10.3969/j.issn.2095-4344.2013.24.002

BACKGROUND:Studies have shown that low-intensity and short-time vibration with a certain frequency can reduce the absorption of bone tissue and increase the quantity and quality of bone through promoting the proliferation and differentiation of osteoblasts.
OBJECTIVE:To investigate the effects of different frequencies of vibration strains on cycle, proliferation and differentiation potency of RAW264.7 cel s cultured in vitro.
METHODS:Passage 6 RAW264.7 cel s in good conditions were randomly divided into six groups, and each group was induced cultured with Dulbecco’s modified Eagle’s medium containing receptor activator of nuclear factor kappa B ligand. The final concentration of receptor activator of nuclear factor kappa B ligand was adjusted to 50μg/L, and then kept without changes. The non-loading group did not loaded with vibration strain, and the other five groups were loaded with 3-10 Hz, 15-35 Hz, 35-45 Hz, 50-70 Hz and 70-90 Hz vibration strains on the RAW264.7 cel s respectively. The other vibration parameters were consistent;the vibration time was 15 min/time with the vibration intensity of 0.3 g, twice per day. The cel cycle and cel proliferation were detected at 3 and 6 days after loading of vibration strains.
RESULTS AND CONCLUSION:After composite vibration loading for 6 days, the cel cycle phase in the vibration groups was changed to some extent when compared with the non-loading group. Compared with non-loading group, the cel number in the G 1 phase of the vibration group was significantly increased (P<0.01);the cel number in the S phase and G 2+M phase of the vibration group was significantly decreased (P<0.01);the vibration parameters in the vibration group were significantly decreased (P<0.01). The results indicate that different frequencies of vibration strains can affect the cel cycle and proliferation, and can inhibit the proliferation and differentiation of osteoblasts.

ObjectiveTo investigate the modification method of Cervical Spine Injury Severity Score System and discuss diagnosis and treatment strategy of lower cervical spine injuries.Methods Treatments of lower cervical spine injuries were selected according to the injury severity graded by the modified Moore' s classification system.Conservative therapy could be adopted for the patients with stability quantification rating ＜ 3 points or for the those with stability quantification rating =3 points but without spinal cord or nerve root compression.Surgical treatment was recommendable for the patients with stability quantification rating =3 points and with spinal cord or nerve root compression.Surgical therapy could be required for the patients with stability quantification rating ≥4 points and with risk of lower cervical instability.The higher the stability quantification score implied the stronger the surgical indications.Lower cervical spine injury combined with spine cord or nerve root compression had absolute surgical indications.At the same time,therapies were selected based on patients' other factors.ResultsBased on basic principles of the modified Moore' s classification system together with opinions of the patients and their relatives,14 patients were managed with surgical treatment and 16 with conservative treatment.Among the patients with complete spinal cord injury (Grade A),two patients treated surgically showed no obvious signs of spinal function recovery,but their nerve root irritation symptoms disappeared; the other one patient who needed surgery but received conservative treatment had no change of the spinal cord function and nerve root irritation.The patients with incomplete spinal cord injury (Grades B,C and D) treated surgically obtained certain degree of spine cord function recovery,with their American Spinal Injury Association (ASIA) score raised by 0.5 grade on average.However,the patients who needed surgery but received conservative treatment gained average increase of ASIA score for 0.5 grade.Imaging examination showed that patients without combined spinal injuries obtained interbody fusion after surgery,with normal alignment and height of the cervical vertebra but without presence of vertebral shift or instability. ConclusionsThe modified Moore' s classification system takes patients' spiaal injury condition and other factors into consideration in selection of conservative or surgical treatment,which improves the Cervical Spine Injury Severity Score System to some extent and has prospect of clinical application.

[Objective] To evaluate the effect of fast rehabilitation nursing pathway in patients after artificial hip replacement.[Methods] 86 patients underwent artificial hip replacement were randomly divided into the control group and the experimental group with 43 cases in each group.The control group received routine care,while the experimental group was given fast rehabilitation nursing pathway.Anxiety and pain at 48h after operation were evaluated,and hip joint function(Harris score)was evaluated six months after operation.[Results] Compared with the control group,anxiety and pain score at 48h after operation decreased markedly,and Harris score six months after operation increased significantly.[Conclusions] Fast rehabilitation nursing pathway can reduce both the short-term and long-term efficacy of patients after artificial hip replacement.