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Objective:To explore whether endoscopic surgery can achieve the same effect on thyroid cancer as open surgery.Method:44 cases were selected to endoscopic thyroidectomy with breast areola approach, who were prepared to accept the surgical treatment of thyroid cancer with cT1N0 stages, female, ≤60 years old, no history of neck surgery and beauty desire. Fifty patients with the same conditions undergoing thyroid open surgery were as the control group.Results:Operative time of endoscopic group[ (170.0±28.0) min] was longer than that of the open operation group[ (90.0±21.0) min ( t=15.610, P=0.000) ]. There was no significant difference between the two groups in surgical complications ( P>0.05) . There was no statistical difference between the number of paratracheal and anterior tracheal lymph nodes of endoscopic group (6.0 ±4.2) and open surgery group (5.5 ±3.7) ( t=0.692, P>0.05) . There was no statistical difference between the number of anterior laryngeal lymph nodes of endoscopic group (0.7 ±1.1) and open surgery group (0.5 ±0.9) ( t=1.186, P>0.05) . Conclusion:The breast areola approach endoscopic thyroidectomy is safe and reliable in treatment of thyroid cancer, and the central cervical lymph node dissection is sufficient, which can be used as the choice of operation mode for thyroid cancer patients in cT1N0 stage.
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Metabolic disease is a cluster of metabolic abnormalities,including hypertension,diabetes,obesity,dyslipidemia,hyperuricemia,etc.The incidence rate of metabolic disease has increased in recent years.Metabolic diseases are closely related to the occurrence,development and prognosis of renal carcinoma.This article aims to summarize research progress on the correlation between metabolic diseases and renal carcinoma so that we could provide valuable information for the prevention,treatment and prognosis of renal carcinoma.
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Objective To investigate the efficacy of microsurgical subinguinal varicocelectomy for unilateral varicocele.Methods One hundred and five cases with left side varicocele were enrolled from August 2012 to October 2016.Thirty one cases suffered from varicocele in Ⅱ degree,and other seventy four cases in Ⅲ degree.Clinical data including operation time,sperm quality,testosterone level,complications and natural pregnoncy rate were retrospectively analyzed.The measurement data were expressed by (x) ± s.Sperm concentration,sperm motility,the rate of sperm normal morphology and serum testosterone levels were compared before and after operation with paired t test.Results The average operative time of varieocele was (58 ± 9) minutes in the outer ring of the microscope.Compared with preoperation's,sperm concentration,sperm motility,the rate of sperm normal morphology was remarkable improved after 3 month.However,serum testosterone levels were steady.In the outpatient follow-up,there were no complications,such as orchiatrophy,hydrocele of tunica vaginalis or recurrence of varicocele.The rate of natural pregnoncy in one year was 46.7％.Conclusions Microsurgical subinguinal varicocelectomy can remarkably improve sperm quality for patients,who suffer from varicocele in Ⅱ or Ⅲ degree.The complication of microsurgical subinguinal varicocelectomy is rare.Male infertility patients resulted from varicocele will get favorable natural pregnoncy rate.
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ObjectiveTo evaluate the diagnostic value of ultrasound or CT guided percutaneous Trucut needle biopsy on the diagnosis of pancreatic tumors.Methods One hundred and twenty-four patients clinically diagnosed as pancreatic cancer without pathological diagnosis underwent percutaneous pancreatic biopsy by using Trucut needle under ultrasound or CT guidance.ResultsOne hundred and nine procedures of ultrasound-guided biopsy and 15 procedures of CT-guided biopsy were performed,and one patient received 2.3times of punctures.Tissue samples were obtained in all 124 patients,the diagnostic accuracy was 95.2％,among them 115 were adenocarcinoma,5 were cystadenoma,2 were metastasis cancer,1 was cancer of unknown origin and 1 was normal.The sensitivity,specificity,and accuracy were 99.2％ 100％,and 99.2％,respectively.Transient serum amylase increase was observed in 3 patients; 5 patients' abdominal pain aggravated,but all recovered with conservative management.One patient was found to have tumor seeding on the spot of insertion after 34 days.No other major complications occurred.ConclusionsUltrasound or CTguided percutaneous pancreatic 16 ～ 18G Trucut needle biopsy is a safe and simple procedure with excellent diagnostic value for pancreatic cancer.
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Objective To observe the adverse reaction, tumor response and short term outcomes of percutaneous cryoablation for locally advanced pancreatic cancer, and investigate its feasibility. Methods Fifty-nine consecutive patients with locally advanced, unresectable pancreatic cancer underwent percutaneous cryoablation at our hospital from Sept. 2008 to Sept. 2009, were prospectively studied. Percutaneous cryoablation was performed with an argon/helium-based cryosurgical system under the guidance of ultrasound.Freezing probe was inserted into the center of pancreatic mass and two cycles of freezing were performed with each cycle for 5 min and temperature at-160℃, then the temperature was returned to normal for 10 min.Serum amylase was detected before operation and 1 to 7 days postoperatively. CT or PET-CT scanning was performed for evaluation of tumor response every 4 to 6 weeks after cryoablation. Survival was assessed by Kaplan-Meier method. Results 59 patients had a total of 76 biopsy-proven tumors, which were located at the pancreas head (n = 56), body (n = 7), and tail (n = 13). The median size of tumor was 4.5 cm (range 3 ～6 cm). Nineteen patients had liver metastases. Postoperative abdominal pain occurred in 45 cases (76.3%),fever occurred in 29 cases (49.2%) and elevation of serum amylase occurred in 34 cases (57.6%). Severe complications including intra-abdominal bleeding, pancreatic leaks, ileus, and metastasis by probe tract occurred in 5 cases (8.5%). There was no death associated with cryoablation. The median hospital stay was 21 days. 2 patients (3.4%) achieved complete response, 23 patients (39.0%) achieved partial response,30patients (50.8%) had stable disease, 4 patients(6.8%) had progressive disease. The median survival was 8.4 months. The overall survival at 3, 6 and 12 months was 89.7%, 61.1% and 34.5%, respectively.Conclusions Ultrasound-guided percutaneous cryoablation appears to be a safe and feasible, minimally invasive technique for locally advanced pancreatic cancer.
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ObjectiveTo explore and establish pre-hospital scoring system (respiration, pulse,motor and burn, RPMB) for evaluation of coal mine gas explosion injury. MethodsAfter analysis of characteristics of blast injury caused by coal mine gas explosion, a new pre-hospital scoring system,RPMB, for evaluation of blast injury was established on the basis of pre-hospital evaluation of coal mine injuries (respiration, pulse and motor, RPM). From January 2003 to December 2009, 251 patients with blast injury caused by coal mine gas explosion were collected in this study for a retrospective study. ISS≥16 points was set as the gold standard for severe wound. All the injuries were assessed by RPMB, RMP,pre-hospital index (PHI) and trauma triage rule (TTR). The consistency and detection rate of severe wounds were compared. The sensitivity and specificity were also calculated. ResultsOf 251 patients,41 patients were evaluated as severe, with high consistency rate between AIS-ISS and RPMB (kappa =0.985). The sensitivity of RPMB, RPM, PHI and TTR was 97.6％, 26.8％ , 22.0％ and 17.1％ respectively and the specificity of those was 88. 1 ％ , 97.6％ , 87.6％ and 95.7％ respectively. ConclusionRPMB is a simple and easy scoring method, with high detection rate of severe wound and potential of clinical applications.
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Objective To explore the clinical value of peripheral blood albumin gene and alpha-fetoprotein gene in early diagnosis and differential diagnosis ofhepatocellular carcinoma(HCC).Methods Two gene fragments were amplified by nested reverse transcription polymerase chain reaction(RT-PCR)with the samples from patients.Results The positive tales of peripheral blood gene fragments from patients with HCC were 53.7％in AFP and 59.7％in Alb.respectively.The former Wag signifieantly higher than that in liver cirrhosis(LC),chronic hepatitis(CH),acute hepatitis(AH)and extrahepatic tumor(ET).The latter Wag also significantly higher than that in LC,CH and ET(P<O.01),but there were no remarkably difference in the positive rate of Alb.mRNA between HCC and AH.The presenee of AFP-mRNA and AIb-mRNA were correlmed with the stage of HCC and intrahepatic metastasis.Conclusion The results suggest that gene fragments of peripheral blood AFP and Alb are useful marker8 for diagnosis of HCC,differentiating extrahepatic metastasis of HCC and monitoring recurrence after HCC operation.
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Objective To explore the effects of selective intra arterial chemotherapy for preoperative gastric cancer. Methods 35 cases of gastric cancer treated by selective intra arterial perfusion of chemrotherapy before operation, together with clinical manifestations、findings in operation, pathological changes and clinical effects were retrospectively reviewed. Results The total effective rate proved by pathology was 81%, of them slight efficiency was in 14 patients(45%), moderate in 11 patients(36%). The clinical relieve rate was 77%, complete relieve in 5 patients(14%), partial relieve in 14 patients(45%). Conclusions Interventional intra arterial perfusion chemotherapy of gastric cancer before operation is an effective method for elevating resection rate of gastric cancer.