ObjectiveTo analyze the clinical effective of differentiated thyroid cancer and approach the correct treatment methods for it. MethodThe clinical and postoperative follow-up data of 137 patients with differentiated thy-roid cancer treated in this hospital from 2002 to 2012 were analyzed retrospectively. ResultsOne hundred and thirty-seven patients accepted individualization surgery, conventionalⅥregion lymph node dissection, and postoperative com-prehensive therapy.The rate of lymph node metastasis was 53.28%(73/137).Ⅵregion lymph node was confirmed to be positive by pathology which performedⅡ+Ⅲ+Ⅳregion lymph node dissection, the rate of lymph node metastasis was 41.10%(30/73).Multivariate analysis showed that penetrate capsule, pathologic type, and TNM stage were the independent risk factors for lymph nodes metastasis (P < 0.05).No death occurred perioperative period.The temporary hoarseness was found in 4 cases (2.92%), short-term hypocalcemia in 11 cases (8.03%).During postoperative average 6.5 years of follow-up, there were 5 cases (3.65%) of local recurrence, 11 cases (8.03%) of cervical lymph node meta-stasis, 3 cases (2.19%) of distant metastasis including 1 case of bone metastasis and 2 cases of pulmonary metastasis, and 16 cases (11.68%) of reoperation. ConclusionIndividualized surgical options, conventionalⅥregion lymph node dissection, and close follow-up management could reduce the postoperative complications and guarantee the treatment effect of differentiated thyroid cancer.
ObjectiveTo investigate the expression of ubiquitin-specific protease 9X (USP9X) in pancreatic cancer, and to evaluate the correlation of USP9X with the survival of patients with pancreatic cancer. MethodThe expression of USP9X was detected in 55 pieces of surgically resected primary pancreatic cancer tissues and adjacent nontumorous pancreatic tissues by streptavidin-perosidase immunohistochemical method. ResultsThe rate of USP9X high expression in the 55 pieces of the primary pancreatic cancer tissues was 58.2% (32/55), which in the adjacent nontumorous pancreatic tissues was zero. The expression of USP9X was not correlated with the gender, age, tumor position, or tumor size (P > 0.05), while which was significantly correlated with the differentiation degree, lymph node metastasis, or TNM stage (P < 0.05). By using Cox proportional hazard model, the multivariable analysis revealed that the differentiation degree, lymph node metastasis, and USP9X expression were the independent risk factors. Survival of the patient with USP9X high expression was significantly shorter than that with USP9X low expression (P < 0.05), and there was the same result in the patients with stageⅡ, with lymph node negative, or intermediate differentiation degree (P < 0.05). ConclusionThe results indicate that USP9X might play an important role in the pathogenesis and prognosis of pancreatic cancer.
ObjectiveTo present the safety and efficiency of laparoscopic Nissen fundoplication for hiatal hernia in elderly patients. MethodsClinical data of 35 elderly patients with hiatal hernia who underwent laparoscopic Nissen fundoplication in The Affiliated Hospital of Xuzhou Medical College between August 2013 and March 2014 was retrospectively analyzed. ResultsAll patients underwent laparoscopic Nissen fundoplication. The operation time was 72-minute in average (65-105 minutes) and intraoperative blood loss was 30 mL in average (10-120 mL). The mean value of postoperative hospital stay was 5-day (3-23 days). Patients' stomachs and esophagus were restored to normal position after surgery. No complication was noted except 2 patients had mild gastroesophageal reflux after operation, and 1 patient suffered from transient dysphagia after operation, all the symptoms subsided after conservative treatment. Afterwards, 33 of them achieved follow-up for 6 to 12 months (mean of 8.5 months), the other 2 patients were lost to follow-up. During the follow-up period, a questionnaire regarding to the criteria for Reflux Diagnostic Questionnaire (RDQ) score were conducted in the 33 patients, and the results showed that the symptoms including acid reflux, heartburn, chest pain, cough, dyspnea, lump sensation in the pharynx, and hoarseness were improved significantly in 6 months after operation (P<0.05), and no recurrence was found during the follow-up period. ConclusionLaparoscopic Nissen fundoplication is a safe operation for elderly patients with hiatal hernia, and it can achieve good clinical result.