Objective：To investigate the diagnosis and treatment of thyroid carcinoma, and prevention of surgical complications.
Methods：Clinical data of 487 cases of thyroid carcinoma in our hospital from March 1990 to July 2006 were analyzed retrospectively.
Results：Among them, 279（57.3%） and 162（33.3%） patients were diagnosed before and during operation respectively, and 46 patients were diagnosed after operation. Reoperation was performed in 140 patients（28.7%） and residual carcinoma  was found in 79 patients（56.4%）. No hospital deaths occurred in the 487 cases after operation. A total of 17 cases showed temporary vocal cord paralysis, 2 cases showed permanent vocal cord paralysis, and 14 cases had convulsion or limb numbness due to hypocalcemia. Follow-up of 413 cases showed cervical lymph node tumor recurrence in 33 patients, local tumor recurrence in 24 patients and remote metastasis in 17 patients. The 5-year survival rate after operation of differentiated, medullary and undifferentiated thyroid carcinoma was 99.8%, 95.8% and 87.0%, respectively.
Conclusions：The thyroid nodule with calcification should be considered to be thyroid carcinoma, and intra-operative frozen section is helpful for the diagnosis and the choice of operative method. The first thyroid operation should not be taken lightly. Patients should take thyroxine tablets for prophylaxis of tumor recurrence and metastasis.

Objective：To explore the indications and attention points in one-stage thyroidectomy and bilateral neck dissection for thyroid carcinoma.
Methods：The clinical and pathological data of 68 thyroid carcinoma patients treated with one-stage thyroidectomy and bilateral neck dissection from Jan 1990 to Dec 2005 were reviewed retrospectively.

Results：There was no operative death in this series. Of the 68 patients, 60 had bilateral and 4 had unilateral positive lymph nodes; 4 had negative lymph nodes. The metastatic rate of patients who had unilateral thyroid cancer with contralateral cervical enlarged lymph nodes, bilateral thyroid cancer with unilateral cervical lymph nodes and  isthmus cancer with lymph nodes was 100%(7/7), 90%(9/10) and 66.67%(4/6) respectively. Postoperative complications include 7 cases of facial and flap edema, 2 headache, 5 postoperative hoarseness, 7 temporary hypoparathyroidism, 1 permanent hypoparathyroidism, 1 left chylus fistula, and 3  unilateral accessory nerve injury.
Conclusions：The patients with unilateral thyroid cancer and enlarged contralateral neck lymph nodes, with bilateral thyroid cancer and unilateral cervical lymph nodes， and with isthmus cancer and enlarged lymph nodes are high-risk patient of bilateral neck metastasis, and should be treated with one stage thyroidectomy and bilateral cervical lymph node dissection. The procedure is safe, no serious postoperative complications occurred, and the survival rate and life quality can be improved.

Objective：To investigate the diagnosis and treatment of nodular goiter with thyroid carcinoma.
Methods：The clinical data of forty cases of nodular goiter with thyroid carcinoma admitted to our hospital from January 2005 to December 2007 were retrospectively analyzed.
Results：Among the 40 cases, only four cases were preoperatively diagnosed as nodular goiter with thyroid carcinoma. All cases received operation and the diagnosis were comfirmed by frozen section examination. Various modes of thyroidectomy were performed according to the pathological results, including four cases had unilateral total thyroidectomy, 27 had unilateral total thyroidectomy combined with opposite subtotal thyroidectomy, one case had bilateral subtotal thyroidectomy, and eight cases of bilateral total thyroidectomy. Of all 40 cases, 11 cases received unilateral cervical lymph node dissection. There were only three cases occurred convulsion or numbness, and no hoarseness occurred postoperatively. Compared to simple nodular goiter, the incidence of calcification in nodular goiter with thyroid carcinoma was significantly increased (P＜0.05). The incidence of carcinoma in single thyroid nodules was higher than that in unilateral multiple nodules(P＜0.01).
Conclusions：When an unilateral solitary nodule or a thyroid nodule with calcification is found, the possibility of malignancy should be highly considered and aggressive surgery is mandated. The patients with nodular goiter suspected of thyroid carcinoma should have intraoperative frozen section examination to confirm the diagnosis. Nodular goiter with thyroid carcinoma should be treated according to the  principles of thyroid carcinoma.

Objective：To investigate expression of C-MET in palliary thyroid carcinoma (PTC) detected by rapid immunohistochemical analysis and its clinical significance to predicting lymph node metastases.
Methods：The expression level of C-MET was examined by rapid immunohistochemical analysis with C-MET-EPOS antibody in 85 cases of PTC.
Results：The rate of cervical lymph node metastates in PTC with strong positive stain expression(95.0%, 23/25) was significantly higher than in PTC with positive stain expression(13.4%, 8/60) (P＜0.001).
Conclusions：Intense c-Met expression is an indicator of the presence of the cervical lymph node metastases. C-Met expression by rapid immunohistochemical analysis is a significant indicator for estimation  of cervical lymph node metastates and  choice of operative methods.

Objective：To study the effect of exposure of recurrent laryngeal nerve(RLN) in prevention of RLN injury during thyroid surgery under general anesthesia. 
Methods：The clinical data of 389 patients who underwent thyroid operations under general anesthesia were retrospectively reviewed. The RLN was exposed in 163 cases and was not exposed in 226 cases. 
Results：Two cases (1.10%) suffered from temporary RLN injury in exposure group and 12 cases (5.30%) suffered from RLN injury in non-exposure group (temporary nerve injury in 7 cases and permanent nerve injury in 5 cases)(P＜0. 05).
Conclusions：Exposure of RLN can greatly decrease the RLN injury rate in thyroid surgery under general anesthesia.

Objective：To investigate the role of neoadjuvant chemotherapy（NAC）and breast-conserving surgery for stage II,III breast cancer.
Methods：Forty-six patients with stage II,III breast cancer underwent breast-conserving surgery after neoadjuvant chemotherapy were reviewed and followed-up. The control group included 59 patients who underwent radical mastectomy only. Neoadjuvant chemotherapy protocol was as follows: intravenous injection with epirubicin 60 mg/m on day 1 and paclitaxel 150mg/m continuous intravenous infusion for 3 hours on day 2. One course of neoadjuvant chemotherapy was 21 days. Patients eligible for breast-conserving therapy in study group were given quadrantectomy or wide local excision of tumor with axillary lymph node dissection.  The breast cosmetic status, local recurrence and metastasis rate were followed up after surgery.
Results：In study group, after neoadjuvant chemotherapy, 9 cases achieved clinical complete response (CR) and 37 cases achieved partial response (PR). The post-operative pathological examination showed varying degrees of apomorphosis and necrosis of tumor cell, intercellular substance edema, fibrous hyperplasia and inflammatory cell invasion. Four cases had pathological complete response. Assessment of cosmetic results, 1 year after combined therapy(chemotherapy plus radiotherapy), was carried out in 31 cases who had received breast-conserving therapy, and excellent results were obtained in 19.4% (6/31), good in 58.1% (18/31), and poor in 22.6% (7/31) of the patients. The local recurrence rate was 8.7% (4/46) in study group, and 6.8%(4/59) in control group,there was no significant difference between the two groups(P＞0.05). The metastasis rate in study group was 6.5%（3/46） and in control group was 15.3%（9/59）(P＞0.05).
Conclusions：Neoadjuvant chemotherapy followed by breast-conserving surgery for stage II and III breast cancer is safe and can achieve the results of radical operation. Neoadjuvant chemotherapy, strict adherence to standerdize surgical technique and use of postoperative radiotherapy and chemotherapy are crucial to breast-conserving therapy for these patients.

Objective：To study the method and significance of preserving anterior thoracic nerve (ATN) and intercostobrachial nerve (ICBN) during breast-conserving operation for breast cancer.
Methods：A total of 382 cases with breast-conserving operation for breast cancer in recent 5 years were reviewed. In 312 cases the opeeration was performed by preserving ATN and ICBN, and in 70 cases the ATN and ICBN were not preserved. The patients were followed-up postoperatively.
Results：Among the patients whose operation was performed by preserving ATN and ICBN, skin sensation of armpit and upper arm was normal in 80.4％(251/312)  and abnormal in 19.6％ (61/312) of patients, but in most of them, it recovered in 2-3 months. Among the patients with out preservation of ATN and ICBN, skin sensation was normal in only 16 cases(22.9％), and had varying degrees of abnormal sensation in 54 cases(77.1％).
Conclusions：Preservation of ATN and ICBN during breast-conserving surgery for breast cancer is feasible, can decrease the incidence of hypoesthesia of axilla and upper arm and atrophy of pectoralis muscles, and the quality of life of patients after operation is improved.

Objective：To investigate the efficacy and safety of zoledronic acid combined with taxotere in treatment of breast cancer patients with multiple bone metastases and negative hormone receptors.
Methods：Thirty-six breast cancer patients with multiple bone metastases were randomized devided into two groups: Group A(zoledronic acid plus taxotere) and Group B(zoledronic acid alone).The effect in the two groups was compared.
Results：Relief of bone pain, improvement in quality of life, and toxic side effects between the two groups showed no significant difference. The effect on bone metastases was 66.7%（12/18）in group A, which was significantly higher than that in group B(11.1%,2/18) (P＜0.05).
Conclusions：Zoledronic acid combined with taxotere for breast cancer patients with bone metastases has favorable therapeatic efficacy.

Objective：To compare the efficacy of carbon nanoparticles suspension and methylene blue for the detection of axillary sentinel lymph nodes in rabbits with breast cancer, to provide a method for the clinical application of treatment of breast cancer.
Methods：The model of breast cancer was established in 40 rabbits by intramammary injection of VX2 tumor tissue suspension 1ml. The successful model was divided into two groups. Carbon nanoparticles suspension and methylene blue were used in staining sentinel lymph node. The staining time, stain fading time of SLN, number of stained SLN, total number of the stained lymph node and the staining effect were observed.
Results：The staining time of SLN and number of stained SLN had no significant difference between the 2 groups, total number of the stained lymph nodes was 3.25±0.56 and 2.3±0.21 respectively in carbon nanoparticles suspension group and methylene blue group(t=6.99, P＜ 0.05), while the stain fadeing time was more than 180 min in carbon nanoparticles suspension group and 105.75 min(average) in methylene blue group. The staining effect in carbon nanoparticles suspension group was much better than that in the methylene blue group.
Conclusions：This study confirms that the rabbit metastatic model of breast cancer set up by intramammary injection of VX2 tumor tissue suspension is an ideal model. Carbon nanoparticles suspension is superior to methylene blue for sentinel lymph node staining, and is a more ideal lymphatic tracer for breast cancer cancer surgery.

Objective：To explore the alterations of  Cdc42 in adriamycin(Adr)-sensitivity and adriamycin-resistance MCF-7 human breast cancer cell line and the effect of Cdc42 on cells drug resistance.

Methods：Cdc42 siRNA was transfected  into MCF-7/Adr cells. Then, RT-PCR and Western blot were employed to examine the expression of Cdc42 protein and mRNA in MCF-7, MCF-7/Adr and MCF-7/Adr treated with Cdc42 siRNA; and multiple drug-resistance was detected by MTT colorimetric assay. Fluorospectorphotometer was used to detect the concentration of ADM in cells. 
Results：The expression of Cdc42 protein and mRNA in MCF-7/Adr was significantly higher than in MCF-7(P＜0.05), and MCF-7/Adr treated with siRNA  inhibited the expression of Cdc42 protein and mRNA; the IC50 in siRNA group was lower than that in MCF-7/Adr group, and the concentration of ADM  in siRNA group was significantly increased.
Conclusions：Cdc42 siRNA can significantly inhibit the expression of Cdc42 protein and mRNA and reverse multidrug resistance (MDR).

Objective：To evaluate the clinical application of ultrasound diagnosis for breast neoplasm.
Methods：The ultrasound examination in 137 cases with pathologically proved breast neoplasm was done and the clinical data were retrospectively analyzed.
Results：The main sonogram of breast neoplasm showed hypoechoic masses. The benign and malignant breast tumors were significantly different in shape, boundary, capsules, rear echo, detection rates of minute calcification and blood flow display rates (P＜0.05). The ultrasonographic characteristics of axillary metastatic lymph node were enlarged and low internal-echo.
Conclusions：The preoperative diagnosis rate of breast neoplasm can be improved by color Doppler flow imaging on the basis of two dimensional ultrasonography combined with axillary lymph node examination.

Objective：To study the reversal effecy of small interfering RNA (siRNA) on multidrug resistance and chemotherpy sensitivity of xenografts human breast cancer tumor, and  chemotherpy sensitivity in nude mice.
Methods：siRNA targeted on multidrug resistance protein(MRP) was transfected into MCF-7 cell xenografts tumors of mice, then the expression level of the MRP mRNA and protein was determined, and the chemotherapeutic sensitivity of the breast cancer tissues was evaluated.
Results：The RT-PCR and immunohistochemistry results showed that the level of MRP mRNA and protein decreased in the experimental group 24 h after the siRNA was transfected (P＜0.05). The tumor inhibitory rate of epirubicin was significantly increased in the siRNA transfection group compared to the control group(42.2% vs. 11.9%).
Conclusions：siRNA targets to MRP gene can inhibit the expression of MRP mRNA and protein in xenograft breast cancer in nude mice,  results in the txenograft tumor sensitivity to epirubicin is obviously increase, and the multidrug resistance of tumor is reversed partially.

Objective：To investigate the inhibitory effect of let-7a on human breast cancer cells in vitro and its possible mechanism.
Methods：Human breast cancer MCF-7 cells were transfected with let-7a(experimental group) and siRNA(siRNA group) and lipofectamine(control group) by using lipofectamineTM2000. The cell transfection efficiency was observed by fluorescence microscope, cell proliferation inhibitory rate was measured using CCK-8 assay, mRNA expression of IMP-1 of each group was detected using semi-quantitive reverse transcription-polymerase chain reaction(RT-PCR), and the level of IMP-1 protein expressions was measured by Western blot 48 hours after transfection.
Results：The cell transfection was efficiency and no significant difference between the let-7a group and siRNA group. Let-7a inhibited the proliferation of MCF-7 cells in a dose-and time-dependent manner(both P＜0.05). Apoptotic index in let-7a group was obviously higher than that in the siRNAgroup and control groups(both P＜0.05). The expression of IMP-1 mRNA in let-7a group was significantly lower than those in the siRNA group and control group（P＜0.01）. Expression of IMP-1 protein in MCF-7 cells was confirmed and it was clear that the specific band in let-7a group was obviously weaker than that in siRNA group and control groups.
Conclusions： let-7a can inhibit the proliferation of MCF-7 cells by reducing the IMP-1 gene expression in vitro.

Objective：To investigate the effect of 5-Aza-CdR on experimental lung metastasis of breast cancer  and the possible mechanisms.
Methods：MDA-MB-231 cells were divided into control group and 5-Aza-CdR-treated group. The mRNA expressions and promotor methylation status of BRMS1 and CXCR4 of the MDA-MB-231 cells were evaluated by SqRT-PCR and MSP respectively. Then, the MDA-MB-231 cells of control group and 5-Aza-CdR-treated group were injected into BALB/c nude mice through lateral tail veins, respectively. five weeks later, the mRNA abundance of the target gene HPRT and internal control gene GAPDH of the lung tissues from the mice were evaluated by FqRT-PCR.
Results：5-Aza-CdR upgraded the BRMS1 mRNA expression significantly than that in control group（0 versus 0.39±0.001,P＜0.05） and demethylated the methylated CpG island B in promotor, while the CXCR4 mRNA expression (0.58±0.003 versus 0.58±0.01,P＞0.05) and the status of unmethylated CXCR4 CpG island 1 in promotor were not changed significantly.The Ct values of HPRT and GAPDH in control and 5-Aza-CdR-treated groups were 24.75±1.55,16.19±0.69 versus 27.61±1.67,17.48±0.96 respectively,2-ΔΔCt=0.34. The mRNA abundance of the HPRT was lower and there were fewer metastases in the lungs of 5-Aza-CdR-treated group compared with control group.
Conclusions： 5-Aza-CdR can activate tumor metastasis suppressor gene BRMS1 by demethylation mechanism,and thus, decreased the ability of breast cancer MDA-MB-231 cells for experimental metastasis to lungs.

Objective：To explore the expression of brain-derived neurotrophic factor (BDNF) and its receptor (TrkB) protein in primary liver cancer and  the effects of exogenous BDNF on biological behavior  of liver cancer Bel-7402 cell line.
Methods：(1)The expression of BDNF and  TrkB was detected by immunohistochemistry in 8 cases of normal liver tissue, 48 cases of liver cancer(LC) and their respective surrounding tissue to analyze the relationships between BDNF, TrkB expression and the clinicopathological features, recurrence and survival rate in liver cancer; (2) cell proliferation, anoikis rate, adhesion, invasion and mobility ability as well as expression level of mRNA and protein of BDNF, TrkB, Bcl-2 in liver cancer cell line Bel-7402 and normal liver cell line L-02 were investigated.
Results：(1)Normal liver tissues showed negative expression for BDNF and  TrkB protein, however, in liver cancer, the positive rate of BDNF and TrkB protein was 69.0%(29/48) and 52.1%（25/48）, respectively, which was higher than those in their surrounding tissues（P＜0.05）. BDNF and  TrkB  positive rate had  significant  relations with Edmondson Grade, capsule formation and multiple nodules of tumor respectiverly（P＜0.05）. There was positive correlation of expressin BDNF and TrkB(r=0.332，P＜0.05). High expression of BDNF and TrkB in LC  significantly increased two year′s recurrence rate （P＜0.05） and decreased survival time(P＜0.01) ； (2)MTT and adhesion assay showed that BDNF can promote cell proliferation and ability of adhesion（P＜0.01）；(3) Flow cytometry showed that BDNF can enhance the ability to resist anoikis（P＜0.01）； (4) Transwell chamber assay and scrape migration assay showed that BDNF can enhance the ability of invasion and mobility of Bel-7402 in nonconcentration-dependent manner（P＜0.01）；(5)RT-PCR and Western Blot showed that BDNF can up-regulate the expression of mRNA and protein of Bcl-2 in Bel-7402 cells, respectively(P＜0.05).
Conclusions： (1) BDNF and TrkB protein are highly expressed  in liver cancer and may be related to recurrence and survival time; (2)  BDNF can modulate cell proliferation, adhesion, mobility and invasion in liver cancer Bel-7402 cell line; (3) BDNF can up-regulate the expression of Bcl-2 to inhibit the anoikis of Bel-7402 cell line.

Objective：To investigate the role of detection of circulation alpha-fetoprotein (AFP) mRNA and telomerase activity in peripheral blood mononuclear cells (PBMC) of patients with hepatocellular carcinoma (HCC).
Methods：In patients with HCC, benign liver tumors, chronic liver diseases, and healthy volunteers, expression of circulation AFP mRNA and telomerase activity in PBMC were detected using nest reverse transcriptase-PCR (Nest RT-PCR) or PCR-ELISA respectively.
Results：(1) All the patients with benign liver tumors (n=10), chronic liver diseases (n=30), and healthy volunteers (n=30) had negative expression of circulation AFP mRNA, and the positive rate of circulation AFP mRNA in patients with HCC (73.3%, 22/30) (all P＜0.001). (2) In patients with HCC, the positive rate of telomerase activity in PBMC (93.3%，28/30) was significantly higher than those in patients with benign liver tumors (40.0%，4/10), chronic liver diseases (6.7%, 2/30), and healthy volunteers (0) (P＜0.01, <0.001 and <0.001, respectively). (3) In patients with HCC, circulation AFP mRNA was significantly positively correlated to telomerase activity in PBMC (r=0.6742, P＜0.05).
Conclusions：AFP mRNA represents a specific indicator of circulation HCC cells. However, detection of telomerase activity appears to be more sensitive. Combined detection of AFP mRNA and telomerase activity can have important clinical significance.

Objective：To explore the correlation between E-cadherin, VEGF-C,D expression,  and blood and lymphatic microvessel density with recurrence of primary tumors of node-negative colon cancer patients.
Methods：Thirty-six cases of disease recurrence within 5 years(observation group) and 61 cases of no disease recurrence for at least 5 years(control group) were selected in this study. Tumor samples were stained by antibodies E-cadherin, VEGF-C, VEGF-D, CD31 (BMVD) and D2-40 (LMVD) using immunohistochemistry, E-cadherin mRNA was detected by reverse transcription polymerase chain reaction, and the relationship between clinico-pathological features and recurrence of colon cancer was analyzed.
Results：The results showed that there were no significant differences in the clinico-pathological features, expression of VEGF-C and BMVD, and lymphatic and blood vessel tumor invasion between observation group and control group(P＞0.05), but there were significant differences in expression of E-cadherin, VEGF-D and LMVD between the 2 groups(P＜0.05). Logistic regression analysis showed the absent expression of E-cadherin and high LMVD (odds ratio 4.3 and 3.1 respectively) to be independent factors predicting disease recurrence.
Conclusions：High-risk of recurrence for patients with node-negative colon cancer can be identified by assessment of E-cadherin expression and LMVD in primary tumor.

Objective：To compare the clinical efficacy of traditional excision of involved lymph nodes and functional neck dissection in the treatment of patients with multiple cervical tuberculous lymphadenopathy(MCTLP). 
Methods：From Jan 2006 to May 2008, 76 patients with MCTLP who presented with focal liquefaction or sinus formation after ineffective conservative therapy were randomly divided into study group(functional neck dissection) and control group. Data regarding the 3-month recurrence rate, postoperative neck function, the mean hospitalization days and medical costs of the 2 groups were compared.
Results：There was significant difference in relapse rate 3 months postoperatively between study group(1 case, 2.56％) and control group(7 cases, 16.22%)(<0.05). Neck function 3 months postoperatively was normal in all of the patients of study group, but was abnormal in 6 cases of control group  (P＜0.05).  The mean medical expenses during hospitalization showed no significant difference (7000 yuan vs. 6700 yuan). There was marked difference  in mean hospitalization days between the study group (11 days) and control group (28day) (P＜0.05). 
Conclusions：Functional neck dissection is a better surgical approach than traditional regional excision for the treatment of patients with MCTLP after ineffective conservative therapy.

Objective：To study the effect of extended Whipple′s resection for carcinoma of head of pancreas.
Methods：Seventy-five patients who underwent surgery for carcinoma of head of pancreas were divided into control group (traditional Whipple′s operation,n=38) and study group (extended Whipple′s operation, n=37). The survival, complication, mortality and recurrence rates were compared between the 2 groups.
Results：In control group and study group, the complication rate was 60.53%and 29.73%;  the  mortality rate was 5.26% and 2.70%; the recurrence rate was 78.95% and 35.14%; and 3-year survival rate was 15.79% and 35.14%, respectively.
Conclusions：Extended Whipple′s resection for carcinoma of head of pancreas can decrease postoperative recurrence rate and  increase 3-year survival rate.

Objective：To study the therapeutic effects and prognosis of advanced pancreatic carcinoma treated with iodine-125 seeds implantation.
Methods：The records of 98 patients with unresectable advanced pancreatic carcinoma admitted from Mar. 2004 to Oct. 2008 were analyzed. There were 53 cases treated by supportive treatment, 24 cases by palliative operation and 21cases by palliative operation combined with iodine-125 seed implantation.
Results：Pain partial and complete relief rate in palliative operation combined with iodine-125 seeds implantation radiotherapy group(84.21% and 15.79%,respectively) was better than other two treatment groups(P＜0.05). The median survival time in combined group was 8.6 months, which was significantly longer than that of other two groups (4.5 month and 5.7 months respectively)(P＜0.05).
Conclusions：Palliative operation combined with iodine-125 seeds implantation could improve the prognosis of advanced pancreatic carcinoma. This combined therapy has certain therapeutic effects for advanced pancreatic carcinoma  in releiving pain, improving life quility and increasing survival time.

Objective：To study the effects of emergency radical resection and primary anastomosis for colorectal cancer with acute intestinal obstruction.
Methods：Retrospective investigation of the clinical data of 112 patients with colorectal cancer with acute intestinal obstruction, between Feb 1997 and Feb 2009, was made. All the 112 patient received emergency operation of radical resection and primary anastomosis.
Results：All the 112 patients recovered and were discharged. In 44 cases a right rectus abdominis incision was made, 2 of these 44 cases had incision wound infection and 6 had both incision wound infection and anastomotic leakage. A left rectus abdominis incision was made in 68 cases, and only 1 of 68 had both incision wound infection and anastomotic leakage (P＜0.05).
Conclusions：Preoperative determination of the cause and the location of intestinal obstruction, and adoption of the left rectus abdominis incision are the critical factors for success in colorectal cancer with acute intestinal obstruction treated by radical resection and primary anastomosis.