目的:观察深圳市第二人民医院医务工作者的甲状腺结节检查情况,并分析其相关影响因素.方法:回顾性分析深圳市第二人民医院医务工作者2020年1月至2020年12月期间的体检资料,纳入体检资料完备的医务工作者749例,统计分析医务工作者甲状腺结节超声检查情况与甲状腺功能、血糖、血脂、血压、体质量指数(BMI)、工作岗位及职称等因素的相关性.结果:深圳市第二人民医院职工甲状腺结节超声检出率为43.66％,女性甲状腺结节检出率高于男性,高级职称员工的检出率高于初、中级职称;45～55岁组与＜35岁组相比,甲状腺结节检出率更高,＞55岁组分别与＜35岁组、35～45岁组相比,甲状腺结节检出率检均更高,差异均具有统计学意义(P＜0.05);多因素logistic回归分析结果显示,年龄、舒张压(DBP)、BMI及总胆固醇(TC)为甲状腺结节的独立危险因素(P＜0.05).结论:深圳市第二人民医院医务工作者的甲状腺结节检出率与年龄、血脂、血压及BMI相关,高级职称者的甲状腺结节检出率更高,可能与其承受着更多的精神与工作压力相关.因此有必要针对不同层次的医务工作者制定适宜的随访计划,并给予生活指导及压力疏导.

目的 探索超声造影联合图像定位对甲状腺癌颈部淋巴结清扫的应用价值. 方法 回顾性分析2017年6月～2019年1月于深圳市第二人民医院接受双侧甲状腺切除+颈侧区淋巴结清扫的甲状腺乳头状癌患者126例,其中72例接受超声联合CT检查评估颈部淋巴结状况(超声联合CT组),54例接受超声造影联合图像术前定位(超声造影联合图像组).对两组病例的淋巴结清扫数目及转移数目、手术时长、术后并发症发生率及术后淋巴结转移复发情况进行对比分析. 结果 超声造影联合图像组手术时间短于超声联合CT组,分别为(125.31±17.37)min和(143.28±22.83)min,t=5.016,P<0.01;Ⅲ/Ⅳ区、Ⅴ区、Ⅱ区淋巴结清扫个数亦少于超声联合CT组[(Ⅲ/Ⅳ区:(9.61±1.90)枚VS(11.5±3.15)枚,t=4.178,P<0.01,Ⅴ区:(2.89±1.21)枚VS(3.39±1.24)枚,t=2.265,P=0.025),Ⅱ区:(2.15±0.99)枚VS(3.46±1.22)枚,t=6.620,P<0.01)],但淋巴结转移个数无统计学差异.术后乳糜漏发生率超声造影联合图像组为1.9％(1/54),超声联合CT组为6.9％(5/72),无统计学差异,P=0.365.超声造影联合图像组中位随访时间18个月,超声联合CT组中位随访时间19个月,两组累积无淋巴结转移复发生存率无统计学差异(P=0.701). 结论 超声造影联合图像术前定位应用于甲状腺乳头状癌手术可使术者更为精准地清扫颈侧区淋巴结,从而提高手术效率.

目的 探讨甲状腺乳头状癌组织FoxM1、Ki-67、VEGF、p27表达与其病情和预后关系.方法 选取甲状腺乳头状癌术后组织及其癌旁正常甲状腺组织80例,采用免疫组织化学(SP)法检测甲状腺乳头状癌组织及癌旁正常甲状腺组织的 FoxM1、Ki-67、VEGF、p27 表达情况.结果 甲状腺乳头状癌组织FoxM1、Ki-67、VEGF、p27表达明显高于癌旁正常甲状腺组织,差异有统计学意义(P＜0.05);单因素分析结果显示,FoxM1、Ki-67、VEGF、p27表达与临床分期、淋巴结转移、病理分级等有关(P＜0.05).随访1年后,死亡患者FoxM1、Ki-67、VEGF、p27表达明显高于生存患者,差异有统计学意义(P＜0.05).结论 FoxM1、Ki-67、VEGF、p27表达与甲状腺乳头状癌的发生发展有关,检测FoxM1、Ki-67、VEGF、p27表达对评估患者病情发展及预后具有重要的价值.

目的 探讨过表达miR-202对甲状腺癌细胞恶性表型的影响及作用机制.方法 选取2017年1月至2018年12月间深圳大学附属第一医院收治的行手术治疗的甲状腺癌患者的癌组织及癌旁正常组织各32例,用qRT-PCR检测miR-202在甲状腺癌组织中的表达,对甲状腺癌细胞进行miR-202模拟物转染或miR-202模拟物与ROCK1表达载体共转染,采用qRT-PCR检测转染效率,用CCK8实验和Caspase-3实验检测转染后甲状腺癌细胞的增殖和凋亡能力.采用qRT-PCR检测miR-202模拟物转染后ROCK1、E-cadherin、Twist、N-cadherin和MMP2的表达.采用双荧光素酶报告基因法检测ROCK1与miR-202之间的靶向关系.结果 miR-202在甲状腺癌组织中下调,miR-202的上调可抑制甲状腺癌细胞增殖,促进甲状腺癌细胞凋亡.miR-202上调促进E-cadherin表达,抑制N-cadherin、Twist和MMP2的表达.ROCK1是miR-202的靶基因,miR-202通过靶向ROCK1调控甲状腺癌细胞的增殖和凋亡能力及相关基因表达.结论 miR-202通过靶向ROCK1基因调节甲状腺癌细胞的增殖和凋亡.

目的 研究甲状腺乳头状癌组织中增殖细胞核抗原(proliferating cell nuclear antigen,PCNA) Ki-67、血管内皮生长因子(vascular endothelial growth factor,VEGF)在甲状腺乳头状癌中的表达,及其与临床病理特征的关系. 方法 采用回顾性病例对照研究,选取在深圳大学第一附属医院手术治疗的139例甲状腺乳头状癌患者的石蜡病理切片,分别对癌组织和癌旁组织进行Ki-67及VEGF的免疫组化染色,并分析其与临床病理特征之间的关系. 结果 癌组织中Ki-67及VEGF阳性表达率分别为74.82％和78.42％,高于癌旁组织的0和13.67％,差异具有统计学意义(P=0.000).Ki-67、VEGF的表达与甲状腺乳头状癌患者的年龄、性别、肿瘤大小无显著相关(P＞0.05),但与TNM分期及有无淋巴结转移有关,在TNM分期高的和有淋巴结转移的病例中Ki-67和VEGF阳性表达率均较高(P＜0.05).Ki-67及VEGF共同表达率达77.98％,两者明显相关(P＜0.05). 结论 甲状腺乳头状癌组织中Ki-67及VEGF阳性表达率高,与癌旁组织比较有明显差异,与甲状腺乳头状癌的生物学行为密切相关.

目的 探讨肉芽肿性乳腺炎的病因及保守治疗方法.方法 回顾性分析2011年1月至2012年12月期间我院乳腺外科门诊接诊的120例肉芽肿性乳腺炎患者的临床资料,对其予以药物封闭治疗辅以手法疏通及乳管灌洗治疗的方法进行总结分析.结果 120例肉芽肿性乳腺炎患者经2～8周保守治疗后,其中101例(84.2％)痊愈,19例(15.8％)因保守治疗效果不佳而进行手术治疗.对101例保守治疗痊愈患者随访30 ～ 42个月(中位时间为38.6个月),有9例(8.9％)出现复发.结论 对肉芽肿性乳腺炎采取药物封闭保守治疗,避免了全乳房切除术,复发率较低,疗效较好.

The expression and functions of microRNA (miR)-411 have been investigated in several types of cancer. However, until now, miR-411 in human breast cancer has not been examined. The present study investigated the expression, biological functions and molecular mechanisms of miR-411 in human breast cancer, discussing whether it offers potential as a therapeutic biomarker for breast cancer in the future. The expression levels of miR-411 in human breast cancer tissues and cells were measured using reverse transcription-quantitative polymerase chain reaction analysis. Following transfection with miR-411 mimics, an MTT assay, cell migration and invasion assay, western blot analysis and luciferase assay were performed in human breast cancer cell lines. According to the results, it was found that miR-411 was significantly downregulated in breast cancer, and associated with lymph node metastasis and histological grade. Additionally, it was observed that miR-411 suppressed cell growth, migration and invasion in the breast cancer cells. The present study also provided the first evidence, to the best of our knowledge, that miR-411 was likely to directly target specificity protein 1 in breast cancer. These findings indicated that miR-411 may be used a therapeutic biomarker for the treatment of breast cancer in the future.

目的：探讨高龄Luminal A型乳腺癌内分泌治疗的临床应用。方法该院收治的高龄Luminal A型乳腺癌患者11例，均采用内分泌治疗8～42个月，方案为依西美坦，25 mg／d，评估近期疗效。结果11例患者中临床完全缓解（cCR）2例，部分缓解（PR）6例，稳定（PR）3例，无疾病进展（PD）病例，内分泌治疗总有效率（OR）为72.7％（8／11）；所有患者均未出现严重毒副反应或因无法耐受而停止用药。结论内分泌治疗对于高龄Luminal A型乳腺癌患者安全、有效，尤对年迈、体弱、伴其他重要疾病而不能耐受化疗和手术的患者是很好的治疗选择。

目的:探讨在甲状腺癌手术中采用纳米碳淋巴示踪剂保护甲状旁腺的作用.方法:245例甲状腺癌患者随机均分为常规组和纳米碳组,比较两组中央区淋巴结脂肪组织中误切的甲状旁腺检获情况及术后血钙、甲状旁腺素(PTH)改变情况.结果:纳米碳组一过性低钙血症症状发生率13.33％明显低于常规组32.90％,差异具有统计学意义(P＜0.05);纳米碳组永久性低钙血症发生率0,常规组1.29％,差异无统计学意义(P＞0.05);纳米碳组PTH暂时性减低发生率11.11％低于常规组29.68％,差异具有统计学意义(P＜0.05).PTH永久性减低纳米碳组未发生,常规组1.29％,差异无统计学意义(P＞0.05).病理检查证实纳米碳组检获误切甲状旁腺率4.44％明显低于常规组12.90％,差异具有统计学意义(P＜0.05).结论:应用纳米碳负显影在甲状腺癌手术中可起到辨认和保护甲状旁腺的作用.

The aim of the present study was to observe the efficacy of neoadjuvant trastuzumab combined with docetaxel and carboplatin (TCH), and docetaxel, epirubicin and cyclophosphamide (TEC) chemotherapy in human epidermal growth factor receptor-2 (HER-2)-overexpressing breast cancer. The total cohort of 64 cases of HER-2-overexpressing breast cancer patients was divided into two groups according to their treatment preferences: The TCH group, consisting of 39 patients, and the TEC group, consisting of 25 patients. The neoadjuvant chemotherapy was continued for six cycles prior to comparison of the treatment efficacy. The TCG and TEC groups exhibited an overall response rate of 94.9 and 72.0% (37/39 and 18/25 cases; P<0.05), respectively, and a pathological complete response (pCR; defined as the presence of no invasive or in situ residual tumors in the breast) rate of 69.2 and 32.0% (27/39 and 8/25 cases; P<0.05), respectively. Furthermore, no significant differences were identified between the two groups of patients in terms of adverse reactions, such as cardiac dysfunction, bone marrow suppression and liver function impairment. In the present study, the treatment of HER-2-overexpressing breast cancer patients with TCH neoadjuvant chemotherapy demonstrated more favorable efficacy and a higher pCR rate when compared with the TEC-treated group.

PURPOSE:Breast cancer is a heterogeneous disease usually including four molecular subtypes such as luminal A, luminal B, HER2-enriched, and triple-negative breast cancer (TNBC). TNBC is more aggressive than other breast cancer subtypes. Despite major advances in ER-positive or HER2-amplified breast cancer, there is no targeted agent currently available for TNBC, so it is urgent to identify new potential therapeutic targets for TNBC.METHODS:We first used microarray analysis to compare gene expression profiling between TNBC and non-TNBC. Furthermore an integrated analysis was conducted based on our own and published data, leading to more robust, reproducible and accurate predictions. Additionally, we performed qRT-PCR in breast cancer cell lines to verify the findings in integrated analysis.RESULTS:After searching Gene Expression Omnibus database (GEO), two microarray studies were obtained according to the inclusion criteria. The integrated analysis was conducted, including 30 samples of TNBC and 77 samples of non-TNBC. 556 genes were found to be consistently differentially expressed (344 up-regulated genes and 212 down-regulated genes in TNBC). Functional annotation for these differentially expressed genes (DEGs) showed that the most significantly enriched Gene Ontology (GO) term for molecular functions was protein binding (GO: 0005515, P = 6.09E-21), while that for biological processes was signal transduction (GO: 0007165, P = 9.46E-08), and that for cellular component was cytoplasm (GO: 0005737, P = 2.09E-21). The most significant pathway was Pathways in cancer (P = 6.54E-05) based on Kyoto Encyclopedia of Genes and Genomes (KEGG). DUSP1 (Degree = 21), MYEOV2 (Degree = 15) and UQCRQ (Degree = 14) were identified as the significant hub proteins in the protein-protein interaction (PPI) network. Five genes were selected to perform qRT-PCR in seven breast cancer cell lines, and qRT-PCR results showed that the expression pattern of selected genes in TNBC lines and non-TNBC lines was nearly consistent with that in the integrated analysis.CONCLUSION:This study may help to understand the pathogenesis of different breast cancer subtypes, contributing to the successful identification of therapeutic targets for TNBC.

Objective:To study the diagnostic value of quantitative T1WI MR parametric perfusion-weighted imaging based on DCE-MRI in duct-borne breast cancer.Methods:16 cases of female were performed the DCE-MRI examination before surgical operation,and the time-intensity curve(TIC) were acquired,then the parameters perfusion images of Wash-in,Wash-out,TTP,MIPt and PEI were drawn out by the special software for breast.And then measured the parameters of perfusion,analyzed the features of perfusion of duct related breast cancers.Results:13 cases invasive ductal carcinoma and 3 cases ductal carcinoma in situ were confirmed by pathology in the 16 cases.13 cases were non-mass-like enhancement,such as 7 cases duct-like,5 cases patchy,1 case spot-like.Another 3 cases were mass enhancement.All of the 16 cases TIC were the type II.13,10,9,15 and 16 lesions were found in the five kinds of parametric images.The detection rates were 81.25%,62.50%,56.25%,93.75% and 100%,respectively.We found the parameters between lesions and normal breast tissue were significant difference(P0.001).Moreover,the parameters between periphery and centre of lesions was also significant(P0.001),except in the TTP.But there's no significant difference between the invasive ductal carcinoma and the ductal carcinoma in situ.Conclusion:Quantitative T1WI MR parametric perfusion-weighted imaging based on DCE-MRI has a high detection rate of the duct-borne breast cancers,and might provide important additional information for its diagnosis and differential diagnosis.

Docetaxel and Carboplatin. In the group treated with the TAC regimen, 25 patients underwent therapy using Docetaxel, Epirubicin, and Cyclophosphamide. Neo-adjuvant chemotherapy was continued for six cycles until a comparison of the therapeutic effects was made. Results: The overall responses (OR) of patients in the two groups-TCG and TAC-were 94.9% (37/39) and 72% (18/25), respectively, P< 0.05. The pathologic complete responses (pCR) were 69.2% (27/39) and 32.0% (8/25), respectively, P<0.05. No significant differences were observed between the two groups in terms of adverse reactions, such as cardiac dysfunction, bone marrow suppression, and liver function impairment. Conclusion: During the treatment of HER-2 over-expressing breast cancer patients with neoadjuvant chemotherapy, Trastuzumab combined with Docetaxel and Carboplatin showed a favorable efficacy and a high pCR rate.

Objective To investigate the etiology and novel treatment of plasma cell mastitis (PCM).Methods 145 cases of PCM undergoing massage dredge,ductal lavage and local amalgesic injection from Jan.2011 to Dec.2012 were retrospectively analyzed.Results 145 cases of PCM underwent conservative treatment for 2 to 8 weeks,among whom 128 cases were cured and the other 17 cases underwent surgical treatment for poor outcome.Among the 128 cases undergoing conservative treatment,9 cases had relapse during the follow-up of 12 to 36 months.Conclusions The combined treatment of massage dredge,ductal lavage and partial closed treatment is effective for patients with PCM,and it can keep patients from having mastectomy and reduce the recurrent rate.

目的：探讨实施临床路径与个案管理在乳腺癌患者治疗中的意义。方法选择行乳腺癌手术的278例患者入组。分为观察组186例（顺利完成治疗181例，5例因变异因素退出）和对照组92例。观察组患者实施临床路径与个案管理治疗模式，对照组接受传统治疗模式。对比两组的住院时间、住院费用、手术并发症发生率及患者满意度。结果观察组与对照组的住院时间分别为（13.27±0.32）和（18.53±0.46） d（ t＝8.84，P＜0.05）；住院费用分别为（12984.73±325.42）和（16703.22±798.56）元（t＝11.75，P＜0.05）；患者满意度分别为（98.39±0.32）％和（82.61±1.25）％（ t＝8.24，P＜0.05）；手术并发症的发生率分别为2.69％和17.39％（礸2＝4.92，P＜0.05）；两组比较差异均有统计学意义。结论在乳腺癌手术住院治疗阶段实施临床路径与个案管理模式，可以明显缩短住院时间，降低医疗成本，减少手术并发症，提高患者满意度，值得临床推广。

PURPOSE:Synuclein-γ (SNCG), which was initially identified as breast cancer specific gene 1, is highly expressed in advanced breast cancers, but not in normal or benign breast tissue. This study aimed to evaluate the effects of SNCG siRNA-treatment on breast cancer cells and elucidate the associated mechanisms.METHODS:Vectors containing SNCG and negative control (NC) siRNAs were transfected into MDA-MB-231 cells; mRNA levels were determined by real-time polymerase chain reaction. Cell proliferation was evaluated using the MTT assay, cell migration was assessed by the Transwell assay, apoptosis and cell cycle analyses were conducted with the flow cytometer, and Western blot analysis was performed to determine the relative levels of AKT, ERK, p-AKT, and p-ERK expression.RESULTS:SNCG mRNA levels were significantly reduced in MDA-MB-231 cells transfected with SNCG siRNA. Our results indicate that in SNCG siRNA-treated cells, cell migration and proliferation decreased significantly, apoptosis was induced, and the cell cycle was arrested. Western blot analysis indicated that the protein levels of p-AKT and p-ERK were much lower in the SNCG siRNA-treated groups, than in the control and NC groups.CONCLUSION:SNCG siRNA could decrease the migration and proliferation of breast cancer cells by downregulating the phosphorylation of AKT and ERK.

Objective To investigate the value of exposure of the recurrent laryngeal nerve(RLN) in thyroid surgery for the prevention of the RLN injury.Methods The clinical data of 2 481 cases with thyroid diseases undergoing thyroid surgery from January 2004 to December 2011 were retrospectively reviewed.The patients were divided into two groups: 1 425 cases had the recurrent laryngeal nerve exposed(RLN exposed group) and 1 056 cases unexposed the recurrent laryngeal nerve(RLN unexposed group).Injuries of the RLN were observed.Results There were 31 cases(2.18%) of temporary nerve injuries in the RLN exposed group but no permanent nerve injury case was found.There were 39 cases of temporary nerve injuries and 5 cases of permanent nerve injuries in the RLN unexposed group(4.17%).There was significant difference between the two groups(P0.01).Conclusion Exposure of RLN in thyroid surgery is a safe and effective way to protect the RLN.It is very helpful to prevent the iatrogenic recurrent laryngeal nerve injury.

Objective To investigate the expression of estrogen receptor,progesterone receptor,HER-2,Ki-67 in breast cancer and their clinical significance.Methods The expression of ER,PR,HER-2 and Ki-67 was detected in 372 patients with breast cancer and their correlations with clinicopathological features were analyzed.Results ER,PR positive expression rates were significantly lower in patients with lymph node metastasis than those in patients with no lymph node metastasis(P0.05),while HER-2 and Ki-67 positive expression rates were higher(P0.05).ER,PR positive expression rates were lower in patients with tumor size20 mm than those in patients with tumor size20 mm(P0.05),while HER-2 and Ki-67 positive expression rates were higher(P0.05).Expression of ER,PR was negatively correlated with HER-2,Ki-67 expression(P0.05).Conclusion ER,PR and HER-2,Ki-67 are valuable for predicting the breast cancer prognosis and providing the individualized treatment.

Based on plasma cell mastitis and idiopathic granulomatous lobular mastitis.To nonlactation mastitis of etiology and pathology,clinical manifestations,diagnosis and treatment were discussed.Nonlactation mastitis diagnosis and medical history,clinical manifestation and pathological auxiliary examination carries on the comprehensive analysis.Grasp and analysis of different types of nonlactation mastitis characteristics and evolution law.Adopt the principle of individualized treatment.