ObjectiveTo compare the efficacy and safety of Huaier and Sorafenib in treatment of small hepatocellular carcinoma(HCC)following radical resection. MethodsEighty-two patients with small HCC accepted radical liver resection and then taken Huaier or Sorafenib were collected retrospectively. These patients were divided into Huaier group(51 cases)and Sorafenib group(31 cases)according to the different administration drugs after operation. The baseline characteristics, tumor characteristics, survival rate, tumor recurrence rate, and side effects were compared between two groups. Results①There were no significant differences on the baseline demographic characteristics, liver function, and tumor characteristics between two groups(P > 0.05).②The overall survival rate and tumor-free survival rate had no significant differences between the Huaier group and the Sorafenib group(P=0.737, P=0.699).③The rate of recurrence or metastasis had no significant difference between the Huaier group and Sorafenib group(37.3% versus 32.3%, P=0.648). The most common site of the recurrence or metastasis was the liver and the lung followed.④There were only 5 cases suffered side effects after taking Huaier and no case needed Huaier discontinuance. However, 11 cases suffered side effects after taking Sorafenib and 3 cases needed Sorafenib discontinuance, and the rate of the side effect in the Sorafenib group was much higher than that in the Huaier group(35.5% versus 9.8%, P=0.026). ConclusionFor the small HCC who accepted radical liver resection, Huaier seems to be an effective and safe drug.
ObjectiveTo evaluate donor safety in living donor liver transplantation. MethodsThe clinical data of 356 donors underwent living liver donation in our center from January 2001 to September 2015 were retrospectively analyzed. These patients were divided into pre-2008 group(before January 2008) and post-2008 group(after January 2008). The donor safety was evaluated with regard to three aspects, i.e. complications, liver function, and quality of life. Results①There was no donor death in our center.②The overall complications rate was 23.3%(83/356). The proportion of ClavienⅠ, Ⅱ, Ⅲ, andⅣcomplications was 50.6%(42/83), 26.5%(22/83), 21.7%(18/83), and 1.2%(1/83), respectively. In all the donors, the incidence of ClavienⅠ, Ⅱ, Ⅲ, andⅣcomplications was 11.8%(42/356), 6.2%(22/356), 5.1%(18/356), and 0.3%(1/356), respectively. The overall complications rate in the post-2008 group was significantly lower than that in the pre-2008 group〔18.1%(41/227) versus 32.6%(42/129), P < 0.01〕. The most common complication was the biliary complication with an incidence of 8.4%(30/356).③The postoperative liver dysfunction was transient and generally retur-ned to normal level within a week.④The donor's quality of life was generally satisfied as assessed by the SF-36 tool, and 94.8%(239/252) of them would donate again if necessary. ConclusionEver improving surgical and anesthetic techniques, together with strict donor selection and specialized perioperative management, could guarantee a low donor morbidity and a satisfactory long-term prognosis.
ObjectiveTo investigate diagnosis, gene detection, and treatment principle of medullary thyroid carcinoma.Method The relevant literatures and guidelines about diagnosis and treatment of medullary thyroid carcinoma were summarized and analyzed retrospectively. Resultsmedullary thyroid carcinoma was given priority to surgical treatment. hereditary medullary cancer could be prophylactic thyroidectomy by the RET gene test results. advanced progressive medullary thyroid carcinoma, could be treated by palliative surgery, external radiotherapy, or systemic treatment with the tyrosine kinase inhibitor. ConclusionsPrognosis of medullary thyroid carcinoma is worse, and occurrence of early metastasis is easy. so the first operation should be thoroughgoing. and the operation timing of prophylactic total thyroidectomy for hereditary medullary cancer could be determined by the results of RET gene detection to achieving early cure.
ObjectiveTo evaluate whether strategic parathyroid autotransplantation can decrease the incidence of hypoparathyroidism after central lymph node re-dissection in patients with papillary thyroid carcinoma. MethodsData were retrospectively collected from the patients with papillary thyroid carcinoma, who had undergone unilateral or bilateral central lymph node re-dissection in the Department of Thyroid Surgery, West China Hospital of Sichuan University between January 2009 and October 2015. The patients were divided into transplantation group and non-transplantation group according to the history of strategic parathyroid autotransplantation in the primary surgery. Data concerning patient demographics (age, sex, comorbidities, the leval of Ca2+ and parathyroid hormone, previous surgical manners and complications before reoperation), surgical manners of reoperation, and postoperative factors (laboratory examination and postoperative complications) were collected. ResultsA total of 74 patients, 35 in the transplantation group and 39 in the non-transplantation group, were included in the study. Significantly higher levels of Ca2+ and parathyroid hormone were observed in the transplantation group than in the non-transplantation group on one day after surgery (P < 0.05). Recurrent laryngeal nerve injury newly occurred in 2 patients in the transplantation group and 5 patients in the non-transplantation group, respectively (5.7% vs. 12.8%, P > 0.05). Transient hypoparathyroidism was documented in 4 patients in the transplantation group and in 12 patients in the non-transplantation group. Permanent hypoparathyroidism was documented in 1 patient in the transplantation group and in 4 patients in the non-transplantation group. The incidence of hypoparathyroidism was significantly lower in the transplantation group compared with the non-transplantation group (5 vs. 16, P < 0.05). The mean number of central lymph node identified pathologically was significantly more in the transplantation group (2.1±1.3 vs. 1.4±0.7, P < 0.05). ConclusionStrategic parathyroid autotransplantation can effectively decrease the incidence of hyperparathyroidism after central lymph node re-dissection in patients with papillary thyroid carcinoma, which greatly improves the surgical safety and thoroughness.