Objective To investigate the causes and treatment of recurrent laryngeal nerve （RLN） injury during the operation of thyroidectomy. Methods Clinical data of 48 patients that RLN were injured during thyroidectomy in and out of our hospital from Jun. 2003 to Mar. 2007 were reviewed. Results No patient died while operation and staying in hospital. There were 47 cases of unilateral RLN injury, 1 case of bilateral RLN injury; 21 cases （43.7%） were injured because of suture or scar adhesion, 13 cases （27.1%） were partly broken with formed scar, 14 cases （29.2%） were completely cut off; The locations of RLN injuries were closely adjacent to the crossing of the inferior thyroid artery and RLN in 13 cases （27.1%） and 35 cases （72.9%） were within 2 cm below the point of RLN entering into throat. The injured RLN were repaired surgically in 43 cases, among which 39 cases’ phonation and vocal cord movement were restored completely or had their vocal cord movement recovered partly; There were only 4 cases that the phonation and vocal cord movement were not recovered. Another 5 cases that did not take any repair did not recovered naturally. Conclusion The location of most RLN injuries caused by mechanical injury during thyroid surgery is closely adjacent to the entrance of RLN into throat. Early nerve exploratory operation should be performed once the RLN is injured, and the method of repair should be decided according to concrete conditions of injury．
【摘要】 目的 探讨高原地区腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）患者的特点，以便更好地进行围手术期处理。 方法 对2009年2月-2010年5月收治的长期生活在西藏高原地区的患者（高原组）367例和非高原地区患者（非高原地区组）167例的一般资料、术前诊断、合并症情况进行回顾性分析，两组患者性别、年龄及病程比较，差异无统计学意义（Pgt;0.05），有可比性。两组患者诊断均以胆囊结石为主，其次为胆囊息肉，诊断构成比较，差异无统计学意义（Pgt;0.05）；两组患者合并症比较，高原组患者高血压、冠心病、血红蛋白增多症及窦性心动过缓的发生率高于非高原地区组（Plt;0.05）；肺部疾病、肝硬化、糖尿病及脑梗死的发生率两组患者比较差异无统计学意义（Pgt;0.05）。两组患者均采用常规LC进行治疗，对两组患者术后临床结果、并发症等进行统计学分析。 结果 高原组患者手术中转开腹率（7.1%）高于非高原地区组（2.4%）患者（Plt;0.05）；高原组患者较非高原地区组患者住院时间长、手术时间长、术中出血量多（Plt;0.05）；术后并发症比较差异无统计学意义（Pgt;0.05）。 结论 高原地区LC患者宜及时中转开腹，其围手术期处理得当将有助于减少术后并发症的发生。【Abstract】 Objective To explore the characteristics of patients undergoing laparoscopic cholecystectomy in highland area, in order to carry out better perioperative management. Methods We collected and analyzed the general information, preoperative diagnosis and complications of 367 patients living in highland area and 167 patients living in inland between February 2009 and May 2010. There was no significant difference between the two groups in sex, age and course of disease (Pgt;0.05). Cholecystolithiasis was the main disease followed by gallbladder polyps, and there was no difference between them in the kind of diseases (Pgt;0.05). The incidence of hypertension, coronary heart disease, hereditary persistence of fetal hemoglobin and sinus bradycardia was higher in patients in highland area than that in patients in non-highland area (Plt;0.05). There was no significant difference in the incidence of lung disease, liver cirrhosis, diabetes mellitus and cerebral infarction between the two groups (Pgt;0.05). Conventional laparoscopic cholecystectomy was conducted in both two groups. Comparative analysis of treatment outcome and postoperative complications was done. Results The rate of conversion from laparoscopic surgery to laparotomy in Tibetan patients (7.1%) was higher than that in patients in non-highland area (2.4%) (Plt;0.05). Hospitalization time, operation time and blood loss in Tibetan patients were significantly higher than those in patients in non-highland area (Plt;0.05), but there was no significant difference in postoperative complications between the two groups of patients (Pgt;0.05). Conclusions Laparoscopic cholecystectomy for patients in highlardarea should be converted to laparotomy when necessary. Appropriate perioperative management is helpful in reducing the incidence of postoperative complications.
Objective To understand the effect of estradiol in different concentrations on proliferation of diverse mammary primary cells in vitro. Methods The primary cells of cancer tissue, the adjacent tissue to tumors and normal mammary tissue from patiens with breast cancer were obtained using collagenase digesting method. All the tissue samples were cultivated in vitro, and were given estradiol in different concentrations. The effect of estradiol on the proliferation of those primary cells was measured by MTT. Results Estradiol remarkedly promoted the proliferation of primary cells of cancer tissue and peritumor tissue in vitro, whose ER expression were positive. Whereas, the promotion effect of estradiol on the proliferation of normal mammary primary cells was relatively weak, and there was no correlation between the promotion effect with the expression of ER in cancer tissue. Conclusion The risks of occurrence and relapse of breast cancer would increase significantly when the concentration of estradiol is no less than 103 pmol/L in vivo.
ObjectiveTo investigate the effects of thyroid globulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) statuses on central lymph node (CLN) metastasis in patients with differentiated thyroid cancer (DTC).MethodsA retrospective analysis was performed on 526 patients with DTC confirmed by pathology from nine participating institutions, who underwent the bilateral thyroidectomy plus bilateral CLN dissection. The clinicopathologic characteristics of different TGAb and TPOAb statuses of patients with DTC were compared, and whether the TGAb and TPOAb statuses were the independent risk factors of CLN metastasis in DTC patients or not was analyzed.ResultsAll of 526 patients with DTC were included in this study, 152 were males and 374 were females. The age was (44±11) years old. There were 63 cases of TgAb＋TPOAb＋, 60 cases of TgAb＋TPOAb－, 30 cases of TgAb－TPOAb＋, and 373 cases of TgAb－TPOAb－. It was found that there was a significant difference in the gender among the four different antibody statuses of patients, that was, women with abnormal antibodies were more common (P<0.001), not found that there were related to the tumor size, blood vessel invasion, nerve invasion, CLN metastasis, tumor multifocality, and bilateral tumor or not (P>0.050). In this study, there were 389 cases of CLN with metastasis and 137 cases of CLN without metastasis. The results of multivariate analysis found that the age and gender of the patients were the independent risk factors (P<0.001), but didn’t find the TgAb and TPOAb Statuses and other factors were related to the CLN metastasis (P>0.050).ConclusionsStatuses of TGAb and TPOAb aren’t obviously associated with CLN metastasis in patients with DTC, which is inconsistent with other studies. It needs to be further researched after expanding existing sample size and determining new predictive factors.
【Abstract】 Objective To study the effects of different levels estradiol on inhibitory of tamoxifen on human mammary cancer cells(ER+) in vitro. Methods Estrogen receptor (ER) positive MCF7 human breast cancer cell line was treated by the same level of tamoxifen and different levels of estradiol in vitro. Cell proliferation was evaluated by MTT assay. Results E2 at concentrations between 1 × 10-12 mol/L to 1× 10-7 mol / L significantly stimulated the growth of MCF 7 . TAM (10 μmol/ L) inhabited the growth of MCF7 significantly. E2 at different levels may influence inhibitory of tamoxifen on MCF7 cell lines. E2 (1×10-8 mol/L) makes inhibitory of tamoxifen on MCF7 cell lines valueless.Conclusion E2 is the risk factor of breast cancer, and the concentration around breast cancer cells may influence the effects of TAM.