Objective:To analyze the relations between BRAFV600E mutation and some pathological parameters in papillary thyroid carcinoma(PTC),and to investigate BRAFV600E mutation in PTC coexisting with Hashimoto's thyroidi tis or nodular goiter.Methods:To retrospectively analyze data of 179 cases of post-operation PTC patients.Clinical datas were reviewed and evaluated by SPSS 21.0 statistical software package.Results:Among the 179 PTC patients,the presence of BRAFV600E mutation was 61.5％.There is a correlation between BRAFV600E mutation rate and age or numbers of lymph node metastasis (P ＜ 0.05 respectively).And age is a risk factor of BRAFV600E mutation(OR =1.064).The BRAFV600E mutation rate was higher in PTC patients coexisting with nodular goiter than patients without nodular goiter (P =0.024).And nodular goiter is also a risk factor (OR =2.349).Conclusion:The BRAFV600E mutation rates have correlation with age,numbers of lymph node metastasis and whether coexisting with nodular goiter.

目的:探讨分化型甲状腺癌术后131I治疗患者的健康宣教与辐射防护措施.方法:选择DTC术后行131I治疗的患者806例,经过1-6次131I治疗对患者主要进行以下工作:131I治疗前的健康宣教及心理护理;治疗隔离期的心理调适及辐射防护;治疗后的用药指导及随访.结果:806例患者131I治疗后一周内有11例出现恶心,食欲减退;9例出现失眠,多梦等症状.2例患者治疗后因未按要求含服Vit C而出现腮腺肿胀伴痛疼,以上患者经过心理调适和及时对症治疗后症状明显好转并安全度过治疗隔离期.结论:在实施131I治疗DTC前对患者进行健康宣教、心理疏导,使患者消除紧张、焦虑及恐惧的心理.治疗隔离期采取有效的辐射防护措施,强化监测、严格管理及时发现并积极处理放射性不良反应,有效地帮助患者度过隔离期.治疗后密切随访,做好患者的心理、饮食以及治疗用药等方面的指导,对保障患者治疗的顺利进行及取得良好的临床疗效有重要的价值.

患儿女,10岁,因左颈部无痛性结节2个月就诊.体格检查:左侧甲状腺可触及直径约3 cm包块,质硬,边界不清,随吞咽活动;双侧颈部可触及多枚肿大淋巴结,质硬,与周围组织粘连.甲状腺超声示:左叶内见4.6 cm×3.0 cm×3.1 cm肿块,右叶未见异常;双侧颈部多发肿大淋巴结,左侧较大者3.5 cm× 1.5 cm,右侧较大者3.2 cm×1.9 cm.颈、胸部CT示:甲状腺左叶及峡部、左颈部及颈前胸廓入口等处见多发软组织团块影,双肺见多发散在小结节灶,考虑甲状腺癌伴多发颈部淋巴结及双肺转移.甲状腺99TcmO4-(北京原子高科股份有限公司提供)显像示:甲状腺左叶"冷"结节.血清甲状腺功能检查:除Tg＞300.00(正常参考值1.70 ～ 55.60)μg/L外,其余指标均正常.2009年8月10日于本院外科行"甲状腺根治性切除+双侧颈部淋巴结清扫"术.

Objective: To investigate the clinical efficacy and side effects of P-32 radiation treatment in infantile hemangiomas. Methods: Thirty eight cases of infant treated by P-32 radiation therapy were observed. Results: Once cure rate was 76.3% and the effective rate was 100% in P-32 radiation treatment of infantile hemangioma. Conclusion: P-32 radiation treatment of infantile hemangioma is effective and with few side effects.