Objective To investigate the clinical diagnosis and treatment for primary hyperparathyroidism with concomitant thyroid diseases. Methods The clinical data of 40 cases diagnosed as primary hyperparathyroidism with concomitant thyroid diseases including manifestation, preoperative qualitation and localization, and surgical treatment and results were retrospectively analyzed. Results The 40 cases were composed of 4 parathyroid adenomas with thyroid papillary carcinomas, 28 parathyroid adenomas with nodular goiters, 6 parathyroid adenomas with thyroid adenomas, 1 parathyroid hyperplasia with nodular goiter, and 1 parathyroid carcinoma with thyroid adenoma. The diagnostic sensitivities of localization for primary hyperparathyroidism with concomitant thyroid diseases by ultrasound, by computerized tomography (CT), and by radioisotope (99Tcm) scanning were 82.5% (33/40), 80.0% (32/40) and 90.0% (36/40), respectively, and the combined sensitivity was 97.5% (39/40). The surgical treatments included resection of parathyroid adenoma with subtotal thyroidectomy in 34 cases, resection of parathyroid adenoma with total thyroidectomy in 3 cases, bilateral exploration of parathyroid with subtotal thyroidectomy in 1 case, and unilateral parathyroidectomy with thyroidectomy and neck lymphonodes clearance in 2 cases. ConclusionFor primary hyperparathyroidism with concomitant thyroid diseases, the sensitivity of preoperative localization could be raised by combining ultrasound, CT with radioisotope scanning, and surgical resection is the main treatment, which includes the main operation of resection of parathyroid adenoma with subtotal or total thyroidectomy.
目的 探讨乳腺叶状囊肉瘤和巨纤维腺瘤的诊断和治疗。方法 回顾分析我院1985～2002年期间外科收治的9例乳腺叶状囊肉瘤和8例乳腺巨纤维腺瘤的临床资料。结果 9例乳腺叶状囊肉瘤中行单纯乳房切除术4例，保留乳头皮下乳房切除术1例，保留乳头和部分压缩腺体＋肿块切除术1例，改良根治术3例; 术后恢复良好，仅1例复发。8例乳腺巨纤维腺瘤中行单纯乳房切除术2例，保留乳头皮下乳房切除术1例，保留乳头和部分压缩腺体＋肿块切除术2例，单纯乳腺肿块切除术3例； 术后恢复良好，术后2例复发。结论 乳腺叶状囊肉瘤和巨纤维腺瘤临床上均表现为无痛性包块，除乳腺叶状囊肉瘤发病年龄较大、肿块范围大及易恶变外，二者主要依据病理检查结果相鉴别； 均以手术治疗为主，根据患者年龄、肿块大小以及病理检查结果选择不同的手术方式。
【Abstract】ObjectiveTo study the current research status of minichromosome maintenance protein 2 (MCM2), the cell cycle proliferation marker, in the diagnosis of colorectal carcinoma. MethodsLiteratures about the application of MCM2 in the study of colorectal carcinoma were collected and reviewed.ResultsMCM2, as a marker of cell dysplasia and malignancy, was usually used in the study of carcinoma. The study on expression of MCM2 in the cell of colorectum in different proliferational stage might help to screen colorectal carcinoma as early as possible. ConclusionAs a relatively specific and sensitive marker of cell proliferation, MCM2 might become a promising mark for diagnosing colorectal carcinoma in the early stage.
目的对高强度聚焦超声（high intensity focused ultrasound, HIFU）治疗乳腺纤维腺瘤的疗效进行评价。方法回顾性分析我科收治的24例乳腺纤维腺瘤患者的治疗资料。结果HIFU治疗术后恢复快，平均于术后1.5 d出院，无并发症发生； 术后随访3~12个月，有2例患者乳房包块消失，5例包块不同程度缩小，未消失包块针吸活检显示为坏死组织。结论HIFU治疗乳腺纤维腺瘤较为安全、有效，既能保持乳房外形美观，又不损害乳房功能，具有良好的应用前景。
目的 了解胰十二指肠切除术中良性病例所占比例,分析其病变类型,探讨术前、术中诊断及其它治疗方式的可行性。方法 回顾性分析我院1996～2001年期间206例术前诊断为胰头或壶腹周围恶性肿瘤而作胰十二指肠切除术病例中，术后病理诊断为良性病变者23例的临床、病理资料。结果 术后病理检查发现慢性胰腺炎14例，胰头囊腺瘤2例，十二指肠乳头异位胰腺1例，十二指肠乳头良性腺瘤4例，胆总管下段炎性狭窄2例。良性病变占整个胰十二指肠切除术病例的11.2%。结论 在作胰十二指肠切除术的良性病变中慢性胰腺炎占大多数。术中取活检作冰冻切片病理检查是鉴别良、恶性病变的最有效方法。对这些良性病变可选择保守治疗或行较小的局部切除术。
目的 探讨结直肠腺瘤的诊断及外科治疗方法。方法 对我院1994年10月至2003年5月收治的323例结直肠腺瘤患者行外科手术治疗的临床资料进行回顾性分析。结果 在直肠镜下行直肠腺瘤局部切除86例，开腹行肠壁楔形及肠段切除202例，行肠段及其系膜的根治性切除35例，治愈率达95.7%(309/323)，本组术后有276例获得1～5年随访，其中术后复发14例，恶变3例。结论 结直肠腺瘤作为癌前病变，一经发现均应完整切除，外科手术治疗可明显减少复发及恶变率，是结直肠腺瘤的最彻底治疗的方法。
bjective To study the change of mucins of expression in lithic cholecystitis and cholecystic adenomatiod polyps. MethodsMUC1 and MUC3 were detected in the mucosa of human normal gallbladders (20 cases, control group), of calcareous cholecystitis (38 cases, calcareous group) and of adenomatoid polyps (18 cases, polyp group) with immunohistochemical stains and Western blotting methods. ResultsThe positive rate and optical density values of MUC1 were increased significantly in calcareous and polyp group vs control group (P＜0.01), otherwise, MUC3 was decreased markedly (P＜0.01). Conclusion The expressions of MUC1, MUC3 were not synchronization in different lesions of cholecyst.
Objective To discuss the molecular structures and functions of βCatenin and APC (Adenomatous polyposis coli) genes, as well as the roles they played during the carcinogenesis and progression of tumors. MethodsAdvances in molecular biology and oncology of βCatenin and APC genes in recent years has been reviewed. ResultsHigh expression of βCatenin and APC genes was an early event during the carcinogenesis due to the abnormal regulation of βCatenin and APC genes. But on the contrary, the low expression of these two genes was probably associated with the progression of tumors. Moreover, βCatenin and APC genes could also regulate the expression of p53,cmyc genes and cyclin D1. Conclusion βCatenin and APC genes may play a key role during the carcinogenesis and progression of tumors and modulate other oncogen/suppressor gene and factors.
Vague preoperative localization and ectopic parathyroid often lead to the failure of operation in primary hyperparathyroidism. From Jun 1989 to March 1998, 11 cases of primary hyperparathyroidism had been treated surgically in the general surgery department of our hospital. Of them, 10 cases were operated successfully with the pathological diagnosis of adenoma and one parathyroid removed was reported normal. Preoperative localization, the knowledge of ectopic parathyroids, careful exploration during operation and the postoperative medical treatment are important for the perioperative management. Postoperative followup has emphasized to benefit the treatment in primary hyperparathyroidism.
FromJune1989toMarch1998,11casesofprimaryhyperparathyroidism(PHP)hadbeentreatedsurgicallyin .thishospital.Thepreoperativelocalizationof9caseswereachievedbyoneortwononinvasivetechniquesincludingultrasonography,computedtomography,colorDopplerimagingand99mTcMIBIscintigraphy.Parathyroidectomyweredonesuccessfullyin10of11caseswiththepathologicalresultsofadenomain10casesandonenormalparathyroid.Theauthorsemphasize①earlyrecognitionanddiagnosiswhichcanbehelpedbythenoninvasivetechniquesmentionedaboveforlocalization,②familiaritywiththelocalanatomyespeciallyfortheectopicparathyroidtogetherwithfrozensectionbiopsyduringoperation,and③intensivemedicalcareaftersurgeryandfollowupsoastoheightenthecapacityofdiagnosisandtreatmentofthisdisease.