Background: The characteristics of level VII lymph nodes were explored and the advantages of using carbon nanoparticles (CNs) in papillary thyroid cancer (PTC) surgeries were examined. This was a retrospective study investigating the clinical data of patients with PTC who underwent surgical treatment. Methods: From September 2019 to December 2020, a total of 191 consecutive patients with PTC were retrospectively analyzed. The patients were randomly divided into the CNs group and the control group. CNs were used in the CNs group during the operation. There were 103 cases in the CNs group, including 25 males and 78 females, and 88 cases in the control group, including 21 males and 67 females. Parameters, including the characteristics of dissected lymph nodes in level VII, metastatic rate, postoperative complications, and other inpatient-related indicators, were compared between the two groups.Results: The number of lymph nodes dissected in level VII in the CNs group was significantly greater than that in the control group, and the metastatic rate of black-stained lymph nodes was significantly higher than that of non-black-stained lymph nodes (P<0.05). The postoperative hypoparathyroidism rate in the CNs group was significantly lower than that in the control group (P<0.05). There were no differences in the operation duration, intraoperative blood loss, postoperative drainage duration, or hospitalization days between the two groups (P>0.05). Conclusions:The application of CNs for patients with PTC significantly increased the number of lymph nodes dissected in level VII and helped to protect the parathyroid glands (PGs). Moreover, the use of CNs did not increase the rate of postoperative complications. Thus, CNs may be a simple and safe approach when performing surgery in PTC patients.

ObjectiveTo investigate the expression of ITGA3 and its association with clinical outcomes in papillary thyroid carcinoma (PTC).MethodsThe expression level, association with clinicopathologic characteristics, co-expressed genes, signaling pathways of ITGA3 in thyroid cancer were comprehensively analyzed using bioinformatics analysis through multiple public gene databases. PTC specimens and cell lines were used to verify the results of bioinformatics analysis.ResultsData mining based on the Oncomine database revealed that ITGA3 expression in classical PTC and tall cell variant PTC was much higher than that in normal thyroid tissue except the follicular variant PTC. Analysis based on The Cancer Genome Atlas (TCGA) database showed that the expression of ITGA3 varies greatly in pathological stages, pathological types, tumor invasion stages, and lymph node metastasis stages of thyroid carcinoma. High expression level of ITGA3 was correlated with tumor regional invasion and lymph node metastasis. Multivariate analysis using logistic regression model showed that high expression of ITGA3 was a risk factor that associated with PTC recurrence and lymph node metastasis. Survival analysis showed that patients with high expression of ITGA3 in PTC had a poorer relapse-free survival (RFS) than patients with low expression of ITGA3 (P &lt; 0.05). Immunohistochemistry experiments showed that the expression of ITGA3 in recurrent thyroid cancer tissues was stronger than that in no-recurrent thyroid cancer tissues (P &lt; 0.05). Knockdown of ITGA3 by sh-RNA in PTC cell lines suppresses cell viability and invasive and migrating capacity.ConclusionITGA3 is overexpressed in PTC, especially in those with higher tumor invasion grades and lymph node metastasis, and was associated with recurrence and poor RFS of PTC. High expression of ITGA3 may have the potential role of predicting PTC recurrence and lymph node metastasis.

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The objective of this study was to explore the feasibility and safety of transoral endoscopic thyroidectomy via vestibular approach (TOETVA) compared with endoscopic thyroidectomy via bilateral areola approach (ETBAA) in the treatment of patients with benign thyroid nodules.Materials and Methods: From January 2017 to December 2018, 60 patients who received TOETVA were enrolled as the research group; 65 patients who underwent ETBAA were included as the control group. A retrospective study was performed using the clinical data for these cases. All patients were diagnosed with benign nodules by preoperative examinations. Parameters including surgical trauma, complications, cosmetic satisfaction, and postoperative discomfort were compared between the 2 groups.Results: All operations were completed without incident. There were significant differences in operation time (137.8 ± 18.7 vs. 95.7 ± 17.2 min), intraoperative blood loss (16.8 ± 9.1 vs. 24.6 ± 16.6 mL), drainage volume (123.1 ± 20.9 vs. 153.6 ± 40.2 mL), C-reactive protein level (7.2 ± 5.2 vs. 9.0 ± 4.7 mg/L), drainage time (3.2 ± 0.6 vs. 3.9 ± 1.3 d), postoperative hospital stay (3.3 ± 0.8 vs. 4.1 ± 1.5 d), and sense of skin tension on the neck (0% vs. 10.8%) between the TOETVA and ETBAA groups (P < 0.05). There were no significant differences in pain score, incidence of recurrent laryngeal nerve injury, transient hypoparathyroidism, infection, inadvertent parathyroidectomy, or swallow discomfort between the 2 groups. The cosmetic satisfaction score in the TOETVA group was significantly higher than that in the ETBAA group at 1 month after surgery (9.8 ± 0.5 vs. 9.4 ± 0.9, P < 0.05), but at 3 months after the operation, the difference was not statistically significant.Conclusions: TOETVA was accompanied by less surgical trauma and skin tension on the neck than ETBAA, and the cosmetic effect of this approach was better than that of ETBAA in the early postoperative period. TOETVA for benign thyroid nodules is safe and feasible. However, there are disadvantages with TOETVA, such as a long surgical period. More cases and further research are needed to delve further into this approach.

Purpose: To study the effect of budesonide aerosol inhalation on postoperative complications and foreign-body sensation in the throat of patients who underwent goiter resection.Methods: One hundred and twenty patients who underwent goiter resection at The Affiliated Hospital of Putian University (Fujian, China) from January 2019 to January 2020 were included in the study, and then equally and randomly assigned to groups A and B. During the perioperative period, group A patients were given budesonide aerosol inhalation, while group B patients received aerosol inhalation of equivalent volume of normal salineectively. Postoperative complication rate (CR), complication pain scores, scores on mucosal response in the throat, and scores on foreign body sensation in the throat were determined for both groups.Results: Postoperative complications in patients were hoarseness, sore throat and cough. Group A had significantly lower postoperative CR, lower complication pain scores, lower scores on mucosal response in the throat, and lower scores on foreign body sensation in the throat, when compared to group B (p < 0.001).Conclusion: Budesonide aerosol inhalation in patients who underwent goiter resection is effective in relieving throat injury from general anesthesia, minimizing likelihood of postoperative complications, and easing foreign-body sensation in the throat. Thus, this strategy may be suitable for the management of postoperative complications.