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    25 November 2021, Volume 26 Issue 06 Previous Issue    Next Issue
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    Editorial
    Standardization in diagnosis and treatment of thyroid carcinoma
    YAO Jing, LI Chen, TIAN Wen
    2021, 26 (06):  467-471.  DOI: 10.16139/j.1007-9610.2021.06.001
    Abstract ( 292 )   HTML ( 4 )   PDF (646KB) ( 247 )  
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    Experts forum
    Robotic lateral neck lymph node dissections for thyroid surgery
    WANG Tiantian, Xie Qiuping, WANG Ping
    2021, 26 (06):  476-481.  DOI: 10.16139/j.1007-9610.2021.06.003
    Abstract ( 300 )   HTML ( 0 )   PDF (1508KB) ( 173 )  
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    Interpretation of more aggressive papillary thyroid microcarcinoma
    WANG Xudong
    2021, 26 (06):  486-492.  DOI: 10.16139/j.1007-9610.2021.06.005
    Abstract ( 209 )   HTML ( 3 )   PDF (680KB) ( 167 )  
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    New adjuvant treatment of locally advanced thyroid carcinoma in era of targeted therapy
    HUANG Naisi, CHEN Jiaying, Jl Qinghai, QANG Yu
    2021, 26 (06):  493-496.  DOI: 10.16139/j.1007-9610.2021.06.006
    Abstract ( 206 )   HTML ( 1 )   PDF (458KB) ( 118 )  
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    Making strange new norm: clinical approaches to children andadolescent with differentiated thyroid carcinoma
    WANG Zhuoying, SHI Yuan, GUO Kai, QIAN Kai
    2021, 26 (06):  497-499.  DOI: 10.16139/j.1007-9610.2021.06.007
    Abstract ( 183 )   HTML ( 2 )   PDF (349KB) ( 74 )  
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    Thyroid ultrasonography in era of artificial intelligence: application and prospect
    ZHAN Weiwei, HOU Yiqing
    2021, 26 (06):  500-503.  DOI: 10.16139/j.1007-9610.2021.06.008
    Abstract ( 217 )   HTML ( 8 )   PDF (429KB) ( 134 )  
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    Original article
    Retrospective study on Bethesda Ⅴ thyroid nodule in diagnosis of papillary thyroid carcinoma: retrospective study
    YAN Shouyi, CHEN Hongbin, ZHANG Liyong, WANG Bo, CAI Shaojun, LIN Siying, ZHAO Wenxin
    2021, 26 (06):  512-516.  DOI: 10.16139/j.1007-9610.2021.06.011
    Abstract ( 814 )   HTML ( 4 )   PDF (542KB) ( 254 )  
    Objective To study on preoperative diagnosis of papillary thyroid carcinoma (PTC) with Bethesda Ⅴ thyroid nodules retrospectively and to explore the differences of clinical parameters between Bethesda Ⅴ and Ⅵ thyroid nodules. Methods The clinical data of 430 patients were analyzed. Results Univariate analysis showed that there were significant differences of Bethesda Ⅴ nodules in nodule boundary, tumor size and echo between PTC group of 159 cases and benign group of 20 cases (P<0.05). It was shown from multivariate analysis that nodule boundary, tumor size and echo were risk factors for malignant diagnosis of BethesdaⅤnodule. The differences were present significantly in TI-RADS grade, aspect ratio and echo between Bethesda ⅤPTC group of 159 case and Bethesda Ⅵ thyroid nodule group of 251 cases (P<0.05). Further multivariate analysis showed that TI-RADS grade, aspect ratio, relation of nodule with capsule, thyroid peroxidase antibody level and echo were the risk factors for the diagnosis of PTC. Conclusions Bethesda Ⅴ nodules with higher grade of TI-RADS are malignant more possibly and those with lower grade of TI-RADS need to be evaluated such as thyroid nodules sizes, relation of nodules with capsule and thyroid peroxidase antibody level.
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    Preoperative evaluation and preparation of Graves′ disease: a report of 126 cases
    SUN Hanxing, SHEN Xiaohui, GAO Haoji, LIU Zhuoran, CHEN Xi, QIU Weihua, YAN Jiqi
    2021, 26 (06):  517-521.  DOI: 10.16139/j.1007-9610.2021.06.012
    Abstract ( 225 )   HTML ( 0 )   PDF (645KB) ( 82 )  
    Objective To analyze retrospectively preoperative evaluation and preparation in Graves′ disease patients with surgical treatment. Methods A total of 126 cases of Graves′ disease in our department from January 2015 to May 2021 were reviewed. Patient information including preoperative preparation, operative mode, postoperative pathological results and complications were collected. Results There were 27 males and 99 females with an average age of(42.4±14.3) years. Surgical indications were Graves′ disease with malignant tumour, airway compression and stenosis, retrosternal goiter, drug intolerance or hyperparathyroidism. There were 75 cases with thyroid papillary carcinoma including 47 cases with papillary microcarcinoma， and 2 cases with follicular carcinoma. Short-term postoperative complications were 11 cases with hoarseness among which 1 case was permanent, and 35 cases with hypocalcemia among which 1 case was permanent. Conclusions It is indicated that preoperative preparation for Graves′ disease requires individualization and refinement, which include iodine preparation, examination of airway condition and neural monitoring, the evaluation of parathyroid function, recurrent laryngeal nerve variation and malignant nodules.
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    Association between RET genotype and disease phenotype in patients with hereditary medullary thyroid carcinoma
    ZHANG Gang, ZHANG Zhe, ZHANG Shu, LI Zhirong, TIAN Wuguo, HUANG Qi, WANG Lingli, XU Yan
    2021, 26 (06):  522-527.  DOI: 10.16139/j.1007-9610.2021.06.013
    Abstract ( 252 )   HTML ( 1 )   PDF (556KB) ( 227 )  
    Objective To investigate the association between RET genotype and disease phenotype in the patients with hereditary medullary thyroid carcinoma (HMTC). Methods A total of 13 patients diagnosed as HMTC and undergoing surgical treatment for thyroid carcinoma in this hospital from March 2015 to September 2019 were analyzed retrospectively with follow-up cutoff at September 2021. The patient risk stratification was performed according to American Thyroid Association (ATA) guidelines. The association between RET genotype and disease phenotype including biochemical results, TNM stage, both biochemical [normal serum calcitonin(CT)] cure and clinical cure was analyzed. Results There were 1 (7.69%) case, 6(46.15%) cases, and 6(46.15%) cases with the highest risk mutation (RET M918T), high-risk mutation (RET C634Y and C634S), and moderate-risk mutation (RET C618G and C611Y), respectively. One case with the highest risk mutation was at TNM stage Ⅳ. There were 4 cases (66.67%) at stageⅠand 2 cases (33.33%) at stage Ⅲ among 6 cases with high-risk mutation. For 6 cases with moderate-risk mutation, stage Ⅰ and stage Ⅱ had 1 case(16.67%) respectively, and stage Ⅲ and stage Ⅳ with 3 cases (50%) and 1 case (16.67%) respectively. The highest preoperative CT and carcinoembryonic antigen were detected in 1 case with highest risk mutations (20 000 ng/L, 831.8 μg/L), and those lower in 6 cases with moderate-risk mutations (1 221.4 ng/L, 62.3 μg/L). The lowest of them were in 6 cases with high-risk mutations (537.7 ng/L, 41.7 μg/L). Similarly, both clinical cure rate and biochemical cure rate were found poorer in the cases with the highest risk mutation, and better in the case with high-risk mutation, and less better in the cases with moderate-risk mutation. Conclusions RET gene could be associated with HMTC risk of ATA. The patients of RET genotype with high-risk mutations would have higher clinical cure rate and biochemical cure rate than the cases with moderate-risk mutations.
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    Clinicopathological analysis of papillary thyroid microcarcinoma in isthmus
    FAN Jinfang, SHEN Yi, ZHAN Weiwei, TAO Lingling, LI Weiwei, KUANG Lijun, ZHOU Wei
    2021, 26 (06):  528-531.  DOI: 10.16139/j.1007-9610.2021.06.014
    Abstract ( 207 )   HTML ( 0 )   PDF (425KB) ( 60 )  
    Objective To evaluate the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) located in the isthmus. Methods The clinical and pathological data of 477 cases with PTMC diagnosed pathologically were retrospectively analyzed. Differences in PTMC between isthmus and lateral lobe were compared. Results Multivariate analysis showed that there were significantly difference in cancer capsule contact (30.5% vs. 10.4%, P=0.001) and lymph node metastasis (LNM) (42.7% vs. 18.7%, P<0.001) of PTMC between isthmus and lateral lobe. When compared with PTMC in lateral lobe, PTMC in isthmus was more prone to in ipsilateral central LNM (41.5% vs. 17.5%, P<0.001), ipsilateral lateral LNM (8.5% vs. 2.8%, P=0.022) and bilateral central LNM (12.2% vs. 0.2%, P<0.001), and contralateral lateral LNM (3.7% vs. 0, P<0.001). Conclusions PTMC in isthmus had capsular contact and LNM with higher proportion compared with PTMC in lateral lobe. It should suggest bilateral central lymph node dissection for PTMC located in isthmus.
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    Prognotic significance of plasma procalcitonin and C⁃reactive protein in evaluation of multiple trauma patients
    MU Yang, CHEN Xin
    2021, 26 (06):  532-536.  DOI: 10.16139/j.1007-9610.2021.06.015
    Abstract ( 183 )   HTML ( 0 )   PDF (562KB) ( 83 )  
    Objective To explore prognotic significance of plasma procalcitonin (PCT) and C?reactive protein (CRP) in evaluation of multiple trauma patients. Methods The clinical data of 331 multiple trauma patients were collected in Department of Emergency, the Third Affiliated Hospital of Soochow University from January 2016 to December 2019. Patients were divided into survival group at day 28 survived after admission and death group. Plasma PCT and CRP levels at admission associated with prognosis were compared between two groups. Results Of 331 patients with more males than females (247 vs. 84), 306 (92.4%) were in survival group and 25(7.6%) in death group. Systolic pressure, diastolic pressure, hemoglobin, and albumin levels were lower in death group than those in survival group(P<0.05). Heart rate, prothrombin time, D-dimers, alanine aminotransferase, aspartate aminotransferase, glucose, creatinine, creatine kinase, lactic acid, lactate dehydrogenase, CRP, and PCT in serum were all higher in death group than those in survival group (P<0.05). The difference in mortality was statistically significant among the patients grouping based on PCT or CRP levels (P<0.05). Trend test showed an upward trend of mortality of patients when PCT and CRP levels increased (Ptrend<0.001). PCT level correla-ted positive with CRP indicated by correlation analysis(r=0.176, P=0.001). Receiver operating characteristic curve showed that prediction on risk of death in multiple trauma patients was greater when using PCT combined with CRP [area under curve (AUC)=0.874] than PCT (AUC=0.795) and CRP (AUC=0.733). Conclusions PCT and CRP levels would have good predictive power in the evaluation of severity and prognosis of multiple trauma patients and would be important in clinical practice.
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    Study on acupuncture with thoracic paravertebral block for patients with intercostal nerve transfer and general anesthesia
    YU Shijian, WANG Xuehu, ZHANG Lin, LIN Weiwei, CUI Wei
    2021, 26 (06):  537-542.  DOI: 10.16139/j.1007-9610.2021.06.016
    Abstract ( 169 )   HTML ( 2 )   PDF (810KB) ( 67 )  
    Objective To analyze the clinical effect of acupuncture combined with thoracic paravertebral block (TPVB) in the treatment of pain and complications of the patients with intercostal nerve transfer and general anesthesia. Methods Eighty-eight patients with intercostal nerve transfer were randomized into three groups: 34 cases with patient controlled intravenous analgesia (PCIA) just after operation in group A, 28 cases with TPVB given when entering the operation and(PCIA) at the end of operation in group B, and 26 cases with TPVB and(PCIA) combined with acupuncture in group C. Acupuncture analgesia was used in group C with electroacupuncture stimulated for 20 minutes on points of Zhigou, Houxi, Hegu and bilateral Neiguan just the day before operation. Incidence of postoperative nausea and vomiting and the postoperative dosage of analgesic fentanyl were recorded. The indices related with analgesia including β-endorphin (β-EP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), 5-hydroxytryptamine (5-HT) and cortisol were detected using ELISA method before and after operation and compared among 3 groups. Results The dosage of fentanyl was lower in group C than those in group A and B significantly (P<0.05) and the incidence of nausea and vomiting lower than those in group A and B (P<0.05). Only serum IL-6 concentration 2 hours after operation in group B decreased significantly compared with that in group A (P<0.05). When compared those in group A, β-EP increased and IL-6, TNF-α and cortisol decreased in group C significantly (P<0.05). The concentration of β-EP increased and cortisol decreased significantly in C group(P<0.05) compared with those in B group. Comparing with that of 1 day before operation, The concentrations of serum β-EP, 5-HT and cortisol decreased and IL-6 increased in C group significantly (P<0.05) after acupuncture intervention. The concentration of β-EP, 5-HT and TNF-α in serum decreased significantly 2 hours after operation than before, while the concentrations of IL-6 in serum increased significantly (P<0.05). The concentration of TNF-α in patients 2 hours after operation decreased significantly (P<0.05). Conclusions Acupuncture combined with TPVB and general anesthesia could have good analgesic effect, which increases the concentration of β-EP and inhibits the release of pro-inflammatory factors such as IL-6, TNF-α and cortisol.
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    Expression of chemokine CXCL5 and programme death ligand 1 in colorectal cancer tissues are associated with prognosis of patients
    LIU Shiguang, ZHAO Jingkun, LU Aiguo, MAO Zhihai
    2021, 26 (06):  543-549.  DOI: 10.16139/j.1007-9610.2021.06.017
    Abstract ( 220 )   HTML ( 0 )   PDF (1260KB) ( 68 )  
    Objective To analyze the expression of CXCL5 (C-X-C motif ligand 5) and programme death ligand 1 (PD-L1) in colorectal cancer tissues and explore two chemokines associated with clinical characteristics and prognosis. Methods The specimens of tumor tissues and adjacent normal tissues were collected from 78 patients with colorectal cancer who had laparoscopic resection from 2010 to 2011. The clinical data were gotten and follow-up were done for prognosis. Tissue microarrays were made from all specimens and immunohistochemical staining was performed. Expression of CXCL5 and PD-L1 was evaluated using immune risk scoring and analyzed with the association of clinical pathological parameters and prognosis of patients. Results Expression of CXCL5 and PD-L1 was associated with tumor size and TNM stage, and was higher in colorectal cancer tissues than in adjacent normal tissues. Cox univariate regression analysis showed that TNM stage, high expression of both CXCL5 and PD-L1 were the prognostic risk factors for overall survival of colorectal patients. It was shown with multivariate regression analysis that TNM stage and high expression of PD-L1 were the independent prognostic risk factors for overall survival rate. Patients with higher expression of both CXCL5 and PD-L1 had the worst prognosis. Conclusions CXCL5 combined with PD-L1 could stratify the risk of patients with colorectal cancer and predict the prognosis of patients.
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    Clinical analysis on tissue structure and treatment option of venous malformation
    XIAO Li, WANG Yanlin, DONG Changxian, SUN Bin
    2021, 26 (06):  550-554.  DOI: 10.16139/j.1007-9610.2021.06.018
    Abstract ( 319 )   HTML ( 2 )   PDF (1072KB) ( 63 )  
    Objective To divide the patients with venous malformation (VM) into three groups based on tissue structure and histopathological characteristics, and analyze results from different treatment scheme in three groups for direction of treatment option according to tissue structure. Methods A retrospective analysis was performed on 170 cases with VM including 73 male and 97 female with mean age of (23.4±9.9) years in Department of Hemangioma this hospital from January 2015 to December 2019. There were 141 cases in enveloped group, 22 cases in non-enveloped group and 7 cases in ossification group with different type of tissue structure of specimens in each group. Patients were examined with image using ultrasonography, magnetic resonance imaging, X-rays and CT angiography. Patients were treated for VM with surgery or minimal invasive techniques. Intraoperative observation and postoperative pathological examination were performed on VM tissue. Visual analogue scale (VAS) and Oswestry disability index (ODI) were detected preoperatively and after discharge. Follow-up was done 163 cases after 1 year discharge and 7 cases lost. Results The data of image, tissue structure, histopathological features, treatment scheme and efficacy evaluation were gotten in three groups. There were 101 cases in enveloped group treated by surgery with 78 (77.2%) cases cured and 2 (2.0%) cases recurred. Remaining 40 cases were treated by minimal invasive operation including sclerotherapy intervention and radiofrequency ablation, in which 23 (57.5%) cases were cured and 2 (5.0%) cases were recurred. The patients in enveloped group had best pattern of tissue structure with best prognosis. Fifteen cases in non-enveloped group were operated with 3 (20.0%) cases cured and 4 (26.7%) cases recurred. Remaining 7 cases were treated by minimal invasive operation with 1 cured case and 3 (42.9%) recurred cases. The recurrence rate was high in non-enveloped group. In ossified group, 7 cases were all treated by surgery and cured without any recurrence. VAS of patients in both enveloped group and non-enveloped group were significantly lower than those before treatment. All patients had lower ODI at discharge than before treatment. There were 6 cases with complication such as delayed incision healing. Conclusions Tissue structure could be an effective index for treatment option and prognosis judgment for VM. The patients in enveloped group would have best results of treatment, while treatment results of patients in non-enveloped group are poor. Ossification of tissue structure is suitable only using surgical treatment.
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    Retrospective study on oral administration of rifampicin combined with ultrasound-guided puncture in treatment of granulomatous lobular mastitis
    QIU Yier, WU Yingjie, QIU Qianhui, LU Guowen
    2021, 26 (06):  556-560.  DOI: 10.16139/j.1007-9610.2021.06.019
    Abstract ( 163 )   HTML ( 0 )   PDF (802KB) ( 57 )  
    Objective To study the efficacy of oral administration of rifampicin combined with ultrasound-guided puncture for granulomatous lobular mastitis (GLM). Methods From January 2017 and January 2019，10 GLM patients with median age of 34 years confirmed by pathology were included in this study and treated with oral administration of rifampicin, 300 mg twice daily for a period of 9 months, combined with ultrasound-guided puncture. The symptoms and ultrasound manifestations of GLM patients were investigated at 3, 6, 9, 12 months, respectively. Results All patients had a history of breast feeding and manifestation of acute stages of breast infection, 5 cases with breast abscess. After 12 months therapy, the symptoms disappeared in all patients with normal ultrasonic manifestation and no patient relapsed. Conclusions Oral administration of rifampicin combined with ultrasound-guided puncture could be effective in the treatment of GLM patients.
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    Case report
    Modified Kraske procedure in treatment of huge presacral cyst:a case report
    YAN Meiyue, YANG Xiangyang, DAI Tingting, ZHANG Shuxin, LI Jingxiang
    2021, 26 (06):  561-563.  DOI: 10.16139/j.1007-9610.2021.06.020
    Abstract ( 139 )   HTML ( 1 )   PDF (617KB) ( 60 )  
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    Review
    Recent advances in study on plasmacyloid dendritic cell and tumor immunity
    YANG Zheyu, LU Chenghao, CAl Wei
    2021, 26 (06):  568-572.  DOI: 10.16139/j.1007-9610.2021.06.022
    Abstract ( 148 )   HTML ( 3 )   PDF (541KB) ( 164 )  
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