[Short-term effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique].

OBJECTIVE: To explore the method and curative effect of double bundle reconstruction of posterior cruciate ligament with total internal short tendon technique. METHODS: From October 2010 to June 2018, 50 patients with simple posterior cruciate ligament rupture were admitted, including 35 males and 15 females, ranging in age from 20 to 45 years old, 16 with acute injury and 34 with old injury. The posterior cruciate ligament (PCL) was reconstructed by double bundle technique with the whole internal short tendon. The two ends of the transplanted ligament were fixed by titanium plate suspended with adjustable loop. The Lysholm knee score and IKDC score were used to evaluate the clinical effects. RESULTS: All the 50 patients were followed up, and the duration ranged from 6 to 60 months, with a mean of (28.84±9.52) months. At the latest follow up, the knee joint activity returned to normal range. The median value of Lysholm knee score was 54 before operation and 100 after operation. According to the IKDC score, there were 0 case of grade A, 0 case of grade B, 20 cases of grade C and 30 cases of grade D before operation;29 cases of grade A, 19 cases of grade B, 1 case of grade C and 1 case of grade D after operation;the difference was statistically significant (P<0.01). CONCLUSION: Arthroscopic double bundle reconstruction of posterior cruciate ligament with short internal tendon is safe and reliable, with less tendon transplantation, more stable fixation, and more bone reserve, which is beneficial for healing and renovation. The short term effect is positive.

[Hurthle cell thyroid tumor: an analysis of 28 cases].

OBJECTIVE: To explore the clinical features and the combined treatment modality of Hurthle cell thyroid tumor (HCT). METHODS: Twenty-eight cases of HCT treated between 2001 and 2009 were analyzed retrospectively. RESULTS: The age of the patients ranged from 18 to 72 years (with a median of 46.5 years); 22 females and 6 males. The main symptoms were thyroid solitary node or mass (22 cases) and multiple nodule (6 cases), 2 cases with cervical lymph node metastasis. All of the patients underwent surgery, 11 cases with thyroid lobectomy, 11 cases with thyroid lobectomy plus isthmusectomy, 4 cases with subtotal thyroidectomy, and 2 cases with thyroid lobectomy plus isthmusectomy and combined with modified radical cervical lymph node dissection. Postoperative pathological examination showed that 22 cases were Hurthle cell adenomas and 6 cases were Hurthle cell carcinomas, 1 of them with cervical lymph node metastasis. Twenty-one patients with Hurthle cell adenomas were followed up for 6 months to 7.5 years (with a median of 45 months) and 6 patients with Hurthle cell carcinomas for 3 to 8 years (with a median of 54 months), with no recurrence and death case. CONCLUSIONS: HCT is a potential malignant neoplasm. There are some difficulties in the diagnosis of HCT by frozen section. Surgery is an effective treatment for HCT. L-Thyroxine can be used to inhibit TSH excretion.

[Primary malignant lymphoma of thyroid gland:clinical analysis of 28 cases].

BACKGROUND & OBJECTIVE: Primary thyroid lymphoma (PTL) is rare, the clinical treatment strategy and prognosis prediction are still to be unified. The objective of this article was to explore the clinical manifestation, diagnosis, treatment and the patients' prognosis, and the main prognostic factors of PTL. METHODS: The general information, clinical and pathologic classification, treatment method of 28 cases of PTL were reviewed retrospectively and analyzed in combination with the follow-up information of 24 cases of this tumor. RESULTS: In spite of 4 cases lost follow-up, 24 cases were followed-up for 1 to 14 years, the median time was 3 years. Clinical classification, all the 3 cases in the group of the age less than 40 years were intraglandular type, 7 of 9 cases in the group of the age of 40-60 years were intraglandular type, 2 cases were extraglandular type, 7 and 9 cases in the group of the age more than 60 years were intraglandular and extraglandular type separately. By the end of this follow-up period, among these 24 cases, 6 of the 9 patients in the clinical extraglandular type group and only 2 of 15 patients of the clinical intraglandular type group died of PTL. Twenty cases whose neck masses were surgically removed completely lived 1 year or more, but all the 4 cases whose neck masses were resected incompletely lived less than 1 year. Pathologically, 11 cases of the B cell type, large lymphocytic group were still survival, the longest survival time was 68 months; but all the 3 cases of the follicular lymphoma II died of PTL within 18 months. The total survival rate of these 24 patients of 1 year,3 year,and 5 year were 61.54%, 43.31%, and 27.35%, separately. CONCLUSION: The proper treatment strategy of primary lymphoma of thyroid gland is complete resection of the tumor followed by the post-operative radical radiotherapy and chemotherapy. The patient's age, clinical classification, and radical resection may be dosely related to the patient's survival. No significant relationship was found between the patient's survival and the pathologic classification of PTL

[Clinical analysis of 44 cases of recurrent thyroid carcinoma].

BACKGROUND & OBJECTIVE: Although the most thyroid cancers are well-differentiated low malignant neoplasms and their prognoses are relatively good generally if they were treated routinely, there are still a few cases of this tumor recurred. This study was designed to sum up and analyze the cause, treatment, and prognosis of these cases to seek for the cause and the proper treatment method of the recurrent cases. METHODS: From 1980 January to 1996 January,44 cases of the recurrent thyroid carcinoma of the total 764 cases of thyroid carcinoma were treated in Department of Head & Neck,Cancer Institute & Hospital, Affiliated Tianjin Medical University. The clinical and follow-up data of these 44 cases were analyzed retrospectively. RESULTS: Forty-four cases of the recurrent thyroid carcinoma accounted for 5.76%(44/764) of 764 cases of thyroid carcinoma treated. Thirty-eight cases of these 44 cases were differentiated thyroid carcinoma (28 cases were papillary thyroid carcinoma,7 cases were follicular thyroid carcinoma, 3 cases were medullary thyroid carcinoma and 6 cases were anaplastic thyroid carcinoma).The percentages of them accounted for the same histopathologic pattern thyroid carcinoma treated in the hospital at the same time were 4.1% (28/676), 18.9%(7/37), 8.1% (3/37), and, 42.9% (6/14), separately. Thirty-three of these 44 cases were lymphatic recurrence (75.0%). In spite of 5 cases were given radiotherapy only, the other 39 cases were treated surgically with extensive dissection of recurrent lesions and post-operative radiotherapy. After treatment, the 3-year survival rates were 85.7%, 71.4%, 100.0%, and 0; the 5-year survival rates were 60.7%, 57.0%, 66.7%, and 0, and the 10-year survival rates were 35.7%, 42.9%, 33.3%, and 0, respectively. CONCLUSION: The clinical and subclinical metastatic lymph nodes left in the previous operations were the main cause of the recurrence of thyroid carcinoma. The recurrent thyroid carcinoma should be treated with surgical operation mainly, as most of them may have a relatively good prognosis after the treatment.