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find Author "刘晓莉" 13 results
  • Prevention of Recurrent Laryngeal Nerve Injury During The Reoperation for Recurrent Thyroid Carcinoma

    Release date:2016-09-08 10:35 Export PDF Favorites Scan
  • Rational Management of Thyroid Cancer Incidentally Found During and after Thyroid Nodule Surgery

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • 室间隔缺损修补术后并发胆囊炎一例

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Investigation of Succession Model for Goiter in Iodine Deficiency Area

    ObjectiveTo investigate the succession model for hyperthyroidism and thyroid carcinoma secondary to nodular goiter in iodine deficiency area. MethodsA total of 216 specimens of goiter patients from iodine deficiency area were collected in the former 3rd hospital of Norman Bethune Medical College from January 1980 to December 1994. Twentyfour heteroploid samples were selected by the method of Hedley with Flow cytometry (FCM) analysis. Paraffin-embedded tissues from the same position were used to perform immunohistochemical staining for proliferating cell nuclear antigen (PCNA), laminin (LN), factor Ⅷ related antigen (FⅧ-RAg), and p53. The proliferative activity, stroma change, and angiogenesis were observed. ResultsPCNA label index (PCNA-LI) and proliferation index (PI) consistent in 24 heteroploid samples with PCNA staining were significantly higher value. PCNA positive cells were mainly distributed over nonfollicular parenchymatous structures, small follicles, and multilayered structures with large bubbly follicles. Destroyed basement membrane and necrosis were found by LN staining in PCNA positive position with vigorous reproductive capacity. Combining FⅧ-RAg staining with LN staining, interstitial proliferation and angiogenesis were obvious in follicular epithelial cells with vigorous reproductive capacity, providing nutrition and superior environment for them. ConclusionsThe reproduction of thyroid follicular epithelial cells, interstitial proliferation, and angiogenesis are all involved in tuberosis and hyperthyroidism, forming precancerous lesion, which suggest the succession model of goiter in iodine deficiency area.

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • The Application of Intraoperative Nerve Monitoring in Assessing The Function of The Recurrent Laryngeal Nerve before and after Central Lymph Node Dissection

    ObjectiveTo discuss whether central lymph node dissection (CLND) should be performed for papillary thyroid cancer (PTC) patients. MethodsThe related domestic and foreign literatures were retrieved, the necessity of CLND and the risk of recurrent laryngeal nerve (RLN) injury in CLND were reviewed, and the application value of intraoperative nerve monitoring (IONM) in CLND were analyzed. Results① CLND can reduce the recurrence rate of PTC, improve postoperative survival rate, ease the difficulty of reoperation, and help to clarify tumor stage. ② CLND can increase the risk of RLN injury. ③ Application of INOM can decrease the risk of RLN injury. ConclusionsThe application of IONM during CLND effectively decrease the risk of RLN injury for surgeons, especially low seniority surgeons, and improve the survival quality and the prognosis. This combination will promote the implementation of routine CLND therapeutic strategy in thyroid cancer patients.

    Release date:2016-10-25 06:10 Export PDF Favorites Scan
  • 原发性甲状腺淋巴瘤1例报道及文献复习

    目的探讨原发性甲状腺淋巴瘤(PTL)的临床诊疗经验 方法回顾性分析笔者所在医院收治的1例原发性甲状腺淋巴瘤病例的临床资料和诊疗经过,并进行相关文献复习。 结果患者颈部肿物进行性增大且伴有压迫症状,术前行粗针穿刺活检(CNB)及免疫组化检查提示不除外肿瘤性病变,未能明确诊断,遂采取手术治疗,术后确诊为弥漫性大B细胞淋巴瘤,进一步行化学治疗。结合文献复习,PTL好发于中老年女性,因其常伴有慢性甲状腺炎,故容易被混淆。对于中老年人、短期内甲状腺明显增大、超声提示弥漫性或局限性低回声病变,应高度警惕PTL可能。对于诊断困难、局部有压迫症状的患者,可行手术治疗明确诊断及解除局部症状,对于诊断明确的病例,放化疗是主要的治疗手段。 结论PTL是一种较为少见的甲状腺恶性肿瘤,临床诊断较困难,不断总结病例,结合多种诊断学方法,注意慢性甲状腺炎与PTL的鉴别诊断,对早期诊断、早期治疗、提高患者生活质量有很大帮助。

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  • Clinical Application of Recurrent Laryngeal Nerve Protection and Monitoring During Thyroidectomy

    Objective To investigate the clinical significance of visual identification and intraoperative neuromonitoring of recurrent laryngeal nerve (RLN) during thyroidectomy. Methods Totally 1 664 patients underwent thyroidectomy with RLN protection from January 2009 to December 2009 were included in this study, in which 1 447 cases were protected by visual identification only, and 217 complex thyroidectomy cases were protected by visual identification and intraoperative monitoring. Results By the “multisites, three steps” RLN exposure method, 1 417 cases (85.16%) were successfully recognized and the recognition time was (3.57±1.26) min. The recognition time in the rest 30 complex cases (2.07%) without intraoperative neuromonitoring was (17.02±5.48) min. By this method, the temporary RLN injury occurred in 23 cases (1.54%) and 15 cases (65.22%) recovered within 2 weeks. In patients undewent intraoperative neuromonitoring, the recognition rate was 100% (217/217) and recognition time was (2.18±0.67) min. The temporary RLN injury occurred in 4 cases (1.84%) and 3 cases (75.00%) recovered within 2 weeks. All temporary RLN injuries recovered within 1 month and no persistent RLN injury occurred. Conclusions Conventional visual identification can reduce the RLN injury, but not meet the needs of the RLN protection during complex thyroidectomy. The combination of visual identification and intraoperative neuromonitoring can further improve the recognition rate and shorten the recovery time of vocal cord dyskinesia.

    Release date:2016-09-08 10:54 Export PDF Favorites Scan
  • The Function of Recurrent Laryngeal Nerve and Movement of Vocal Cords in Thyroid Surgery

    ObjectiveTo research the relevancy between the amplitudes of EMG signal of recurrent laryngeal nerve (RLN) during thyroidectemy with the movement of vocal cords after operation by applying the intraoperative neuromonitoring (IONM) and verify the proper warning criterion. MethodsFrom April 2013 to October 2013, 130 patients (214 nerves at risk) underwent complex thyroidectomy with the application of IONM. According to the degree of amplitude changing on different sites of RLN (proximal site and distal site) before closing incision, all the patients were divided into 10 groups. Every patient's vocal cords movement after operation by laryngoscopy and simulated the neural function in real time were compared. ResultsSeven patients got abnormal movement of vocal cords, the corresponding amplitudes of the EMG signal of RLN were in the range between 0 to 50%, 1 case from Group 6 (40%≤Rp/Rd<50%), 1 case from Group 8 (20%≤Rp/Rd<30%), 1 case from Group 9 (10%≤Rp/Rd<20%), 4 cases from Group 10 (0≤Rp/Rd<10%), and there's no permanent RLN palsy. ConclusionThe final amplitude of RLN decrease below 50%R1 would probably lead to vocal cords' abnormal movement, and when it decrease below 30%R1, the possibility of abnormal movement would increase; 50% decrease of EMG amplitude can be used as a warning criterion to prevent nerve function damage.

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  • 甲状腺癌术后再发甲状旁腺癌1例诊治分析并文献复习

    目的探讨甲状旁腺癌的临床诊疗经验。 方法回顾性分析笔者所在医院收治的1例甲状腺癌术后再发甲状旁腺癌病例的临床资料和诊疗经过,并进行文献复习。 结果患者第1次因甲状腺癌行手术治疗,术前甲状旁腺素(PTH)及血钙水平轻度升高,但未见甲状旁腺肿瘤,术后PTH及血钙降至正常水平。患者第2次以颈部肿物、甲状旁腺功能亢进症、高钙血症入院行手术治疗后,PTH及血钙再次降至正常水平,石蜡切片病理标本经专家会诊明确甲状旁腺癌的诊断。第2次术后1年患者的甲状旁腺癌复发,行微创消融治疗,术后PTH及血钙有所下降,但未达理想范围,现仍在随访中。 结论甲状腺癌并发甲状旁腺癌临床罕见,其术前诊断困难,根据术后石蜡病理检查及免疫组化检查可以确诊。手术是其最有效的治疗方法,术后局部复发率较高,故术后应长期监测血钙和血PTH水平,尽早发现肿瘤复发或转移情况,尽早治疗,以求提高生存率和延长无瘤生存期。

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  • Research and Design of Respiratory Impedance Measurement System Based on Forced Oscillation Technique

    Forced oscillation technique (FOT) is an active method to test pulmonary function, which can derive the mechanical characteristics of the respiratory system with liner system identification theory by pushing in an oscillation air signal and measuring the changes of output pressure and flow. A pulmonary function determination system was developed based on the FOT in this paper. Several critical technologies of this determination system were analyzed, including the selection criteria of oscillation air generator, pressure and flow sensor, the signal design of oscillation air generator, and the synchronous sampling of pressure and flow data. A software program on LabVIEW platform was set up to control the determination system and get the measuring data. The performance of sensors and oscillation air generator was verified. According to the frequency response curve of the pressure, the amplitude of driving signal to the oscillation air generator was corrected at the frequency range between 4~40 Hz. A simulation experiment was carried out to measure the respiratory impedance of the active model lung ASL5000 and the results were close to the setting values of the model lung. The experiment testified that the pulmonary function determination system based on FOT had performance good enough to provide a tool for the in-depth research of the mechanical properties of the respiratory system.

    Release date:2016-12-19 11:20 Export PDF Favorites Scan
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