Objective To investigate the role of expression in the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma. Methods Seventy cases of thyroid lesions (including 15 cases of follicular adenomas, 15 cases of adinomatous goiters, 30 cases of papillary carcinomas and 10 cases of follicular carcinomas) were collected, and CD10 expression was detected by means of immunohistochemistry in above thyroid lesions. Results Seven of 9 cases of follicular variant of papillary carcinoma were CD10 positive (77.8%), and 8 of 10 cases of follicular carcinoma were CD10 positive (80.0%). However, CD10 was negative in all cases of non-follicular variant of papillary carcinoma, follicular adenoma, adinomatous goiter and normal thyroid tissue. Conclusion The detection of CD10 expression is useful to the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma.
【Abstract】Objective To study the significance of expression of p27 in thyroid follicular tumors. Methods The tumor samples were obtained from 53 thyroid follicular tumors, and 10 normal thyroid tissues were used as a control group. p27 was detected by the immunohistochemical staining S-P method. Results The normal thyroid group had the highest expression of p27.There were significant differences in the expression of p27 between thyroid follicular adenomas (FA) and follicular carcinomas (FTC), FA had much higher expression of p27 than FTC did. There were no significant differences in the p27 staining indexes between minimally and widely invasive FTC nor between metastized and non-metastized FTC. Logistic regression showed that p27 were effective in distinguishing FA from FTC(P=0.0048). Conclusion It appears that p27 may be necessary for the malignant transformation of the thyroid follicular epithelium, which might relate to a decrease in p27. p27 detection may be helpful in distinguishing FA from FTC.
Objective To explore the clinical significance on protection of parathyroid and recurrent laryngeal nerve （RLN） by meticulous capsular dissection and exposure of RLN in thyroid lobectomy. Methods Clinical data of 452 patients who underwent thyroid lobectomy by meticulous capsular dissection and exposure of RLN in our hospital from Jan. 2010 to Dec. 2012 were retrospectively analyzed. Results All of the 452 cases underwent thyroid lebectomy successfully without death， and the operative time was 45-110min （average 60 min）， the blood loss was 5-100mL （average 20mL）. The pathological results showed that there were thyroid adenoma in 193 cases， nodular goiter in 175 cases， Hashimoto thyroiditis in 38 cases， thyroid cancer in 46 cases. After operation， 4 cases suffered RLN injury， 1 of the 4 cases recovered after removal of drainage tube， and other 3 cases recovered during 0.5 to 3.0 months. In addition， 2 cases suffered laryngeal nerve injury whose symptoms disappearred within 1 week， 5 cases suffered parathyroid founctional damage without permanent hypocalcemia whose symptom had kept 1-5 days after treatment. Three cases were reoperated because of bleeding， including branch of anterior venous bleeding in 1 case， thyroid side arterial tube bleeding in 1 case， and thyroid stump bleeding in 1 case. Twenty one cases suffered hypothyroidism in 1 month after operation， and no recurrence happened during the followed up period. Conclusions Meticulous capsular dissection can effectively protect function of parathyroid and reduce the injury probability of RLN. Exposure of RLN is safe and feasible， which plays an important role in avoiding serious RLN injury.
Endocrinology is closely related to lipid metabolism. Lipotoxicity affects the abnormal function of various endocrine organs, and leads to diabetes, fatty liver, metabolic syndrome and other endocrine and metabolic diseases. It is an important strategy to prevent the lipid toxicity. Endocrine disorders can also cause dyslipidemia. Studies have found that thyroid and gonadal glands play an important role in lipid metabolism. Their molecular mechanisms are gradually revealed and will be a new therapeutic target for dyslipidemia. Lipid metabolism disorders play an important role in the development of endocrine and metabolic diseases.
Objective To investigate ultrasonography features of primary thyroid non-Hodgkin lymphoma (PT-NHL). Methods Ultrasonographic data of patients with PT-NHL(PT-NHL group) and non-Hodgkin lymphoma (control group) who were treated in our hospital from May. 2002 to Jul. 2014 were collected and analyzed. Results Compared with control group, enhancement of posterior echoes was more common in PT-NHL group (P=0.000), and difference values of transverse diameters, anteroposterior diameters, and sagittal diameters of more involved lobe to another lobe were bigger(P < 0.05), but echo pattern of gland, ultrasonographic classification of lesions, classification of vascularity, and condition of cervical lymph nodes were found no statistical difference(P > 0.05). In patients with nodular-type lesions(37 patients in PT-NHL group and 12 patients in control group), length of nodule lesions was larger in PT-NHL group (P=0.000), but there was no statistical difference in shape, boundary, orientation, and echoes of nodules between 2 groups(P > 0.05). In Pulsed-Wave(PW) Doppler between 2 groups(17 patients in PT-NHL group and 4 patients in control group), vascular resistance index(RI) was higher in PT-NHL group than those of control group (P=0.024). Conclusion The enhancement of posterior echoes was a feature in ultrasonography images of PT-NHL. Asymmetrical volume, high value of RI, and big nodule might link to PT-NHL, but diffuse heterogeneous echo with hypoechoic lesions might result in wrong diagnosis as PT-NHL.
Some Chinese traditional medicines were found to inhibit rejection of graft. The antirejection effects of chuanxiong, LCH and HXI in thyroid allografts of rabbits were studied for selecting an immune depressor from Chinese traditional medicine with efficient and less sideeffect. The rabbits were divided into 5 groups in the study, with 7 in each group. Group I: The control group, no drug was used. Group II: dexamethason 0.25mg/kg/day, intramuscularly. Group III: chuanxiong water solution, 5g/kg/day, orally. Group Ⅳ： LCH water solution, 10g/kg/day, orally. Group Ⅴ： HXI water solution, 6g/kg/day, orally. The medication was given for 28 days. The grafted thyroids were removed for histopathological examination on the 28th day postoperatively and were scored and classified. The rejection and the survival of grafts were scored and classfied according to the La Rosa and Warrens criterion. The histopathological findings were as following: in Group I, follicles were badly damaged with much lymphocytes infiltration and fibrosis; in Gracup Ⅱ， two rabbits died, the other three showed damaged of the thyroid tissue and much lymphocytes infiltration; in group Ⅲ and Ⅴ, three cases showed damage of thyroid tissue, however, better revascularization was evident in Group Ⅲ; in Group Ⅳ, there was one case with much lymphocytes infiltration. It seemed that the degree of damage of grafts in the experimental groups was better than that in the control group, and had less lymphocytes infiltration, especially in Group Ⅳ. It was suggested that chuanxiong, LCH, HXI and dexamethason could protect the grafted thyroid, but the sideeffect of dexamethason was more than the other three. The antirejection of LCH was the best of the three. It was worth doing more research. HXI.
ObjectiveTo investigate the clinical significance of lengthened Trocars in endoscopic thyroidectomy. MethodsThere were 102 cases of endoscopic thyroidectomy via the areola approach, which were divided into two groups:33 patients via lengthened Trocar, and 69 patients via normal Trocar. The operative time, blood loss, wound drainage, hospital stay, and postoperative complications in two groups were comparatively analyzed. ResultsCompared with the normal Trocar group, the operative time was shorter, subcutaneous separation area was smaller, blood loss was less, and postoperative drainage was less in the lengthened Trocar group(P < 0.05). The postoperative complications of lengthened Trocar group was less than normal Trocar group(P < 0.05). ConclusionsApplication of lengthened Trocars in endoscopic thyroidectomy brings benefits of less subcutaneous damage, shorte operative time, and better operation experience. This procedure is worth popularizing in clinical use.
ObjectiveTo investigate the clinical value of cervical vascular color Doppler ultrasound for dignosis of nonrecurrent laryngeal nerve before thyroid surgery. MethodsThere were 1931 cases of thyroid patients treated between January 2010 to Jule 2014, group these patients according to the results of preoperative chest radiograph examination, the chest radiograph shows abnormal vessels image were group A (45 cases), no abnormalities were group B (1886 cases). Before operaton, made patients of group A to have routine carotid duplex ultrasound to identify whether the right subclavian artery abnormalities. All patients were exposed to conventional methods of recurrent laryngeal nerve during surgery. ResultsThe 45 patients of group A, chest angiography showed 17 cases with right subclavian artery abnormalities, they were confirmed that all the 17 patients were nonrecurrent laryngeal nerve by surgery, no damage cases. The other 28 cases showed a normal right subclavian artery and no cases of nonrecurrent laryngeal nerve. The 1886 patients in group B, surgical exploration found four cases with nonrecurrent laryngeal nerve, injury in 1 case. The 21 patients whose nonrecurrent laryngeal nerve were on the right side, there were no left side with nonrecurrent laryngeal nerve and no co-exist cases of nonrecurrent and recurrent laryngeal nerve. The average exposure time of nonrecurrent laryngeal nerve in patients of group A (17 cases) was significantly shorter than that group B[(4.28±1.08) min vs. (15.50±2.08) min, t=-15.978, P=0.000]. ConclusionsThe cervical vascular color Doppler ultrasound examination before thyroid surgery can be adjuvant used, if there is the right subclavian artery abnormalities, it showes that there is the right side nonrecurrent laryngeal nerve. So as to effectively prevent the damage of nonrecurrent laryngeal nerve during thyroid surgery.
ObjectiveTo investigate the variation regularity about volume of drainage after initial thyroidectomy, and to find out the time points of safety extubation and the time points of risk extubation. MethodsBetween September 2013 and April 2014, the clinical date of 71 cases of thyroid tumor who underwent thyroidectomy were prospectively analyzed and completely random designed. The patients were indwelling drain after thyroidectomy, the volume of drainage liquid were registered at each point of time in period of 48 hours after operation and analyzed its the variation regularity. ResultsThe volume of drainage fluid in 48 h after operation was gradually decreased in 71 patients. The reduce speed of volume of drainage fluid in the 12 h after operation was faster, then was significantly slower, and gradually stabilized. The amount of the drainage fluid reached the peak in 2 h after operation in 22 cases, and then gradually decreased and reached the stabilization. ConclusionsThe 2 hours after thyroidectomy is the risk drainage removing time when is relatively safe. The 12 hours after thyroidectomy is the safety drainage removing time, after that there is no longer any meaning to keep drainage tube.
Objective To evaluate the safety and effectiveness of interventional therapy for hyperthyroidism. Methods From 1995 to 2000, 38 cases underwent bilateral super-selective superior thyroid arteries embolization with brown-algae microballs.Results There was no misembolization and mortality. Hyperthyroidism crisis developed in 2 cases. Thirty eight cases were followed-up for 0.5～5 years (the median time was 2.2 years). Medications were needed only in one patient because of relapse and the others were cured. Conclusion This procedure features miniinvasive trauma, less complications and quick recovery. It may be a safe and rational treatment for hyperthyroidism.