ObjectiveTo explore the best timing of thyroid stimulating hormone (TSH) inhibition therapy by analyzing the trend of TSH level changes after unilateral thyroid lobectomy in patients with low-risk papillary thyroid microcarcinoma (PTMC).MethodsThe clinical data of patients with low-risk PTMC who underwent unilateral thyroid lobectomy in the Dongfeng Hospital Affiliated to Hubei Medical College from September 2016 to December 2018 were retrospectively analyzed. The TSH of all patients were measured before operation and in month 1, 3, and 6 after operation, respectively, and the change trend was analyzed.ResultsAccording to the inclusion and exclusion criteria, a total of 271 patients with low-risk PTMC were included in this study. The TSH level in month 1 after operation was higher than that of before operation [(2.93±1.09) mU/L versus (2.05±0.76) mU/L, t=19.9, P<0.001]. Among the 129 patients with TSHlevel ≤2.0 mU/L before operation, 56.6% (73/129) of them still had the TSH level ≤2.0 mU/L in month 1 after operation, 45.0% (58/129) in month 3 after operation and 39.5% (51/129) in month 6 after operation.ConclusionsTSH level of patient with low-risk PTMC is increased after lobectomy, so individualized TSH inhibition treatment should be formulated. For patients with TSH level>2.0 mU/L before operation, oral levothyroxine sodium tablets should be taken immediately after operation. For patients with preoperative TSH level ≤2.0 mU/L, TSH level should be dynamically monitored, and whether and when to start oral TSH inhibition therapy should be decided according to results of TSH level.
ObjectiveTo analyze the clinical and pathological features of multifocal papillary thyroid carcinoma, and to assess the value and safety of total thyroidectomy plus prophylactic central lymph node dissection in the treatment of multifocal papillary thyroid carcinoma. MethodsClinical data of 103 patients with multifocal papillary thyroid carcinoma, who underwent total thyroidectomy plus prophylactic central lymph node dissection in Affliated Dongfeng Hospital from June 2011 to February 2015 were collected retrospectively. Preoperative ultrasound showed that all patients didn't suffered from cervical lymph node metastasis. ResultsAmong 103 patients who underwent total thyroidectomy plus central lymph node dissection, the unilateral multiple lesions were found in 55 patients (53.40%), and the bilateral multiple lesions were found in 48 patients (46.60%). A total of 31 patients (30.10%) were confirmed to have central lymph node metastasis after operation, central lymph node metastasis only located in the same side of multifocal papillary thyroid carcinoma in 16 patients (29.10%), but of 15 patients (31.25%) with 2-side of multifocal papillary thyroid carcinoma, 7 patients suffered from 2-side central lymph node metastasis and 8 patients suffered from 1-side central lymph node metastasis. Thirty patients (12.62%) suffered from transient postoperative hypocalcemia after operation, and returned to normal for longest of 2 weeks; 1 patient (0.97%) suffered from parathyroid permanent damage; 18 patients (17.48%) suffered from transient recurrent laryngeal nerve palsy, no one suffered from permanent recurrent laryngeal nerve injury; 3 patients (2.91%) suffered from postoperative transient drinking cough. All of 103 patients were followed up for 5 months to 4 years, and the postoperative follow-up rate was 100%. During the follow-up period, 3 patients (2.91%) suffered from cervical lymph node metastasis in side region of neck. ConclusionTotal thyroidectomy plus prophylactic central lymph node dissection plays an important role in the treatment of multifocal papillary thyroid carcinoma.
ObjectiveTo discuss the effects of coix seed extract injection on rate of tumor of C57 mice liver cancer model, tumor size, and serum IL-6. MethodsUsing chemical carcinogens diethyl nitrosamine (DEN) to establish the mice model of liver cancer, liver cancer mouse model to coix seed extract was given observation of C57 mice liver cancer model come tumor formation rate, tumor growth, and the change of serum IL-6. ResultsC57 mice after intraperitoneal injection of coix seed extract injection model of liver cancer tumor rate (55.6%) significantly lower than the DEN group (87.5%), P < 0.01; tumor diameter[(0.3±0.05) cm] was lower than that in group DEN[(0.8±0.06) cm], P < 0.01. The serum level of IL-6 in C57 mice after treated with coix seed extract significantly lower than that in group DEN (P < 0.01). ConclusionCoix seed extract can effectively inhibit the tumor rate and the growth of tumor in hepatocellular carcinoma model of C57 mice, and decrease the level of serum IL-6.
ObjectiveTo explore the relationship between the -2548 G/A functional polymorphism in the 5′ promoter region of the leptin gene and gallstones. Methods The -2548 G/A polymorphisms of leptin gene were determined by polymerase chain reactionrestriction fragment length polymorphism technology (PCRRFLP) in 118 patients with cholesterol gallstones and 53 normal control subjects. Then the allele and genotype distribution were studied. Results The distribution of leptin2458 G/A in two groups was statistically significantly different: the genotype frequency of AA+GA of patients in gallstone group was higher than that in control group (χ2=4.251, P=0.039). AA+AG genotype had 2.813 times greater risk for gallstone disease compared with GG genotype (OR=2.813, 95% CI=1.020-7.757). Allele frequency distribution in the two groups was different: the allele frequency of A of patients in gallstone group was higher than that in control group (χ2=5.791, P=0.016). The risk of gallstone disease in the A alleles carriers was 1.777 times as higher as the carriers of G alleles (OR=1.777, 95% CI=1.110-2.844). ConclusionThe -2548 G/A polymorphism in the 5′ promoter region of leptin gene is significantly correlated with the gallstones. The A alleles of leptin may be a genetic factor which contributes to individual susceptibility for gallstone, while the G alleles of leptin may be a genetic factor that prevents people from gallstone.
目的 探讨腹腔镜胆囊切除术中避免胆管损伤新方法的安全性。方法 回顾性分析2008年1月至2012年1月期间笔者所在医院采用Rouviere沟引导定位的方法进行腹腔镜胆囊切除术患者的临床资料，并在手术时间和术后并发症发生率方面与同期传统手术组病例相比较。结果 与传统手术组比较，Rouviere沟引导组患者的手术时间缩短，术后并发症发生率及中转开腹率降低，其差异均有统计学意义（P＜0.05）。结论 采用Rouviere沟引导定位法进行腹腔镜胆囊切除术能有效缩短手术时间，减少胆管损伤的发生概率，值得在临床推广应用。
ObjectiveTo investigate the significance of the expression of vascular endothelial growth factor (VEGF) in portal vein thrombosis after operation in patients with portal hypertension.MethodsThe serum of 146 patients with portal hypertension treated in Dongfeng Hospital Affiliated to Hubei Medicial College from January 2014 to December 2018 and the surgically removed splenic vein and spleen specimens were collected. The serum VEGF level was determined by enzyme-linked immunosorbent assay, and the expressions of VEGF in splenic vein and spleen tissues were detected by immunohistochemistry. According to whether portal vein thrombosis was formed after operation, the patients were divided into thrombosis group and non-thrombosis group, and the differences between the groups were compared.ResultsThe serum VEGF level in the thrombosis group was significantly higher than that in the non-thrombosis group (P<0.05). In splenic vein wall and spleen tissues, VEGF staining indexes in the thrombosis group were significantly higher than those in the non-thrombosis group (P<0.05).ConclusionsPostoperative portal vein thrombosis in patients with portal hypertension may be related to the serum VEGF level. The high expressions of VEGF in splenic vein wall and spleen suggest that VEGF may participate in the formation process of portal vein thrombosis.