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Objective To investigate the effects of overexpression of miR3753p on the proliferation and invasion of thyroid papillary carcinoma cells, and to clarify the mechanism. Methods The miR3753p expression in the human thyroid epithelial cell line Nthyori31 and human thyroid papillary carcinoma cell lines TPC1, BHP516, BHP27, and K1 was detected by RTqPCR. Thyroid papillary carcinoma cell line TPC1 which had the lowest expression of miR375 3p was taken and divided into the transfected group and negative control group. In the transfected group, we upregulated the expression of miR3753p in thyroid cancer cell line TPC1 by transfecting miR3753p mimics, while cells in the the negative control group were transfected with negative control sequences （scramble）. The cell proliferation capacities of two groups were observed by MTT assay. Invasion capacities were observed by Transwell assay. The expression levels of PI3K/ AKT signaling pathwayrelated proteins pPI3K and pAKT and epithelialmesenchymal transition （EMT）related proteins Ecadherin, Ncadherin, and Vimentin were detected by Western blotting. PTC cells were randomly divided into the nega tive control group, miR3753p overexpression group, and miR3753p overexpression+IGF1 group. Cells in the miR3753p overexpression group and negative control group were transfected with miR3753p mimics （miR3753p mimics） and negative control sequence （scramble） through LifefectamineTM3000, respectively. Cells in the miR3753p overex pression+IGF-1 group were treated with miR-375-3p mimics and the PI3K/AKT signal pathway agonist insulin-like growth factor-1（IGF-1). The proliferative and invasive capacities of cells in the three groups were observed. Results The ex pression levels of miR-375-3p in cell lines TPC-1, BHP5-16, BHP2-7 and K-1 were significantly lower than that of normal human thyroid epithelial cell line Nthy-ori3-1（all P<0. 05). The OD values of the miR-375-3p over-expression group were significantly lower than those of the negative control group at 24，48 and 72 h after transfection （all P<0. 05）, and the number of invasive cells was smaller （P<0. 05). Compared with the negative control group, the expression levels of pPI3K and p-AKT in the miR-375-3p over-expression group decreased, the expression levels of E-cadherin increased, and the expression levels of N-cadherin and Vimentin decreased （all P<0. 05). After adding IGF-1, compared with the miR375-3p over-expression group, the proliferative OD value and the number of invasion cells in the miR-375-3p over-expres sion+IGF-1 group increased （all P<0. 05). Conclusion MiR-375-3p is down-regulated in thyroid carcinoma cell lines； over-expression of miR-375-3p can inhibit cell proliferation and invasion, and the mechanism may be related to the inhibi tion of PI3K/AKT/EMT signaling pathway. [ABSTRACT FROM AUTHOR]

Objective To predict the probability of occult lymph node metastasis (OLM) in the central region of the neck by analyzing the dual-energy CT energy spectrum curve of thyroid papillary carcinoma (PTC）. Methods Patients with PTC confirmed by pathology before and after operation were retrospectively collected. CT images were analyzed by radiologists. There were 140 cases without cervical lymph node metastasis. Among them， 88 patients with occult lymph node metastasis in the central group (OLM+) and 52 patients without metastasis (OLM−) were confirmed by pathology. The CT value of PTC on each single energy image was measured and the slope (k) of the energy spectrum curve was calculated. The differences in parameters between the two groups were analyzed. Results (1) the karterial，40 keVarterial，40 keVvenous，160 keVvenous and 180 keVvenous of PTC between OLM+ group and OLM− group in arterial and venous phase were significantly different (P < 0.05) . (2) The AUC of 40 keVarterial，karterial，40 keVvenous，160 keVvenous and 180 keVvenous in PTC were 0.590，0.622，0.590，0.429 and 0.424 respectively. When karterial = 2.563，the sensitivity and accuracy of diagnosing PTC with OLM in the central group were 93.2% and 69.3%. When 40 keVvenous = 370.25，the specificity of PTC with OLM was 86.5%. Conclusion The energy spectrum curve of PTC has a certain reference value in predicting occult lymph node metastasis in the central region of the neck. karterial has the highest sensitivity and 40 keVvenous has the highest specificity. [ABSTRACT FROM AUTHOR]

Thyroglossal duct papillary carcinoma is extremely rare in clinical practice.This article reports a case of a thyroglossal duct cyst complicated by thyroid papillary carcinoma,while also reviewing the relevant literature.It summarizes the clinical manifestations,imaging characteristics,and pathological features of thyroglossal duct papillary carcinoma and discusses the relationship between thyroglossal duct cysts,malignant transformation of thyroglossal duct cysts,and thyroid papillary carcinoma.

Objective To explore the feasibility of totally endoscopic thyroidectomy (TET) for thyroid papillary carcinoma in cT1N0 stage. Methods Clinical data of 287 patients with primary cT1N0 thyroid papillary cancer underwent thyroidectomy in our hospital from March 2016 to June 2018 were collected and retrospectively analyzed, including 145 patients undergoing TET (TET group) and 142 patients by open thyroidectomy (OT group). The intraoperative conditions, complications, recurrence and cosmetic effect were compared between the 2 groups. Results There were no significant differences in the general data of the patients in the TET group and OT group, including mean age (P=0.283), sex ratio (P=0.344), tumor size (P=0.265) and tumor distribution (P=0.872). In terms of surgical effects, no significant differences were observed in the numbers of central neck lymph node dissections (CNLN) (P=0.847) and metastatic lymph nodes (P=0.839) between the 2 groups for the patients with lateral lobectomy and lateral central neck dissection. The TET group had significantly smaller volume of intraoperative bleeding (P < 0.001), and longer operation time (P < 0.001) when compared with the OT group. For those with bilateral lobectomy and lateral central neck dissection, there were no significant differences in the numbers of central neck lymph node dissections (P=0.092) and metastatic lymph nodes (P=0.241) between the 2 groups. The amount of intraoperative bleeding was smaller (P < 0.001) and the operation time were longer in the TET group (P < 0.001) than the OT group. For surgical complications, there were no significant differences in the incidences of temporary/permanent hyperparathyroidism and recurrent laryngeal nerve injury between the 2 group (P>0.05). No hemorrhagic subcutaneous fluid or wound infection occurred in the TET group. The TET group had significantly better cosmetic effect than the OT group (P < 0.001). The patients were followed up for 6 to 30 months, and no recurrence was observed. Conclusion TET treatment is safe and feasible for cT1N0 thyroid papillary cancer. TET treatment might be an optional approach for the patients with cosmetic demand.

Objective To investigate the effect of inhibiting FoxM1 gene expression on glucose uptake and lactic acid production in papillary thyroid carcinoma (PTC) cells, and to explore the correlation between FoxM1 and PTC cell glycolysis pathway. Methods The expression of FoxM1 mRNA and protein in PTC TPC-1 cells were detected after lentiviral rLv-hFoxM1 transfection. The effect of inhibiting FoxM1 gene expression on TPC-1 cell viability was detected by MTT method. The changes of glucose intake and lactic acid production in TPC-1 cells transfected with lentiviral rLv-hFoxM1 and the content of the key enzymes of hexokinase isoform 1 (HK1), hexokinase isoform 2 (HK2) and glucose transporter 1 (Glut1) were detected by Western blot. Results In TPC-1 cells, lentiviral rLv-hFoxM1 transfection significantly inhibited the expression of FoxM1 mRNA and protein in TPC-1 cells and the activity of TPC-1 cells was significantly decreased (P < 0.05). After the FoxM1 gene was inhibited, the glucose intake and the lactic acid production of TPC-1 cells were significantly decreased (P < 0.01). The levels of Glut1, HK1 and HK2 were also significantly decreased (P < 0.01). Conclusion Inhibition of FoxM1 gene expression could reduce the level of glycolysis in PTC cells.

Thyroid cancer is the most common endocrine malignancy, and thyroid carcinoma (PTC) has the highest incidence rate, accounts for about 85%~90% of thyroid carcinoma. There are many markers of PTC, such as murine sarcoma viral oncogene homolog B1 (BRAF), telomerase reverse transcriptase, Ki-67, microRNA-146b, PDZ and LIM domain 5 (PDLIM5). Among them, BRAF plays an important role in the carcinogenesis, development and prognosis of PTC. This article summarizes the research progress of BRAF signaling pathway, its role in the carcinogenesis, development and prognosis of PTC, its clinical correlation with the clinical pathological characteristics of PTC, and its application in the diagnosis and treatment of PTC to provide the references to readers. [ABSTRACT FROM AUTHOR]

Objective: To analyze the radiomic and clinical features extracted from 2D ultrasound images of thyroid tumors in patients with Hashimoto's thyroiditis (HT) combined with papillary thyroid carcinoma (PTC) using machine learning (ML) models, and to explore the diagnostic performance of the method in making preoperative noninvasive identification of cervical lymph node metastasis (LNM)., Methods: A total of 528 patients with HT combined with PTC were enrolled and divided into two groups based on their pathological results of the presence or absence of LNM. The groups were subsequently designated the With LNM Group and the Without LNM Group. Three ultrasound doctors independently delineated the regions of interest and extracted radiomic features. Two modes, radiomic features and radiomics-clinical features, were used to construct random forest (RF), support vector machine (SVM), LightGBM, K-nearest neighbor (KNN), and XGBoost models. The performance of these five ML models in the two modes was evaluated by the receiver operating characteristic (ROC) curves on the test dataset, and SHapley Additive exPlanations (SHAP) was used for model visualization., Results: All five ML models showed good performance, with area under the ROC curve (AUC) ranging from 0.798 to 0.921. LightGBM and XGBoost demonstrated the best performance, outperforming the other models ( P <0.05). The ML models constructed with radiomics-clinical features performed better than those constructed using only radiomic features ( P <0.05). The SHAP visualization of the best-performing models indicated that the anteroposterior diameter, superoinferior diameter, original&#95;shape&#95;VoxelVolume, age, wavelet-LHL&#95;firstorder&#95;10Percentile, and left-to-right diameter had the most significant effect on the LightGBM model. On the other hand, the superoinferior diameter, anteroposterior diameter, left-to-right diameter, original&#95;shape&#95;VoxelVolume, original&#95;firstorder&#95;InterquartileRange, and age had the most significant effect on the XGBoost model., Conclusion: ML models based on radiomics and clinical features can accurately evaluate the cervical lymph node status in patients with HT combined with PTC. Among the 5 ML models, LightGBM and XGBoost demonstrate the best evaluation performance., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Office of Journal of Sichuan University (Medical Sciences).)

Objective: To study the clinical value of ultrasonography in diagnosis of cervical lymph node metastasis of thyroid papillary carcinoma (PTC), and to analyze the correlation between blood flow parameters and lymph node metastasis. Methods: From January 2014 to September 2019, 78 patients with PTC who were treated in our hospital were selected for study. All subjects were divided into the metastatic group (42 cases) and the non-metastatic group (36 cases) according to cervical lymph node metastasis. The ultrasonographic image characteristics of the two groups were compared, and the sensitivity, specificity and accuracy of ultrasonographic diagnosis of PTC cervical lymph node metastasis were analyzed. In addition, the color doppler ultrasound blood flow parameters of the two groups were compared, the correlation between color doppler ultrasound blood flow parameters and lymph node metastasis was analyzed. Results: The proportion of lymphatic hilum and aspect ratio ≥ 2 in the metastatic group were lower than those in the non-metastatic group, while the proportion of calcification and cystic degeneration were higher than those in the non-metastatic group (all P<0.05). With pathological diagnosis as the gold standard, the sensitivity, specificity and accuracy of ultrasonic diagnosis of PTC cervical lymph node metastasis were 95.24%, 97.22% and 96.15%, respectively. There was no significant difference in acceleration time (AT) between the metastatic group and the non-metastatic group (P>0.05). Peak systolic velocity (PSV), pulsatility index (PI) and resistance index (RI) in the metastatic group were all higher than those in the non-metastatic group (all P<0.05). Pearson correlation analysis showed that PSV, PI and RI were positively correlated with lymph node metastasis (all P<0.05). Conclusion: Ultrasonography in diagnosis of PTC cervical lymph node metastasis is of high clinical value, and its blood flow parameters are closely related to lymph node metastasis. Detection of blood flow parameters is helpful to determine lymph node metastasis in patients with PTC. [ABSTRACT FROM AUTHOR]

Objective To observe the effects of high expression of microRNA-124 on the invasion and migration of thyroid papillary carcinoma (TPC) cell line K1 and to discuss its mechanism. Methods K1 cells in the logarithmic phase were divided into three groups. The observation group was transfected with microRNA-124mimics which promoted the expression of microRNA-124, the control group was transfected with microRNA independent sequence, and the blank group was not treated. After 24-hour culture， Transwell assay was used to observe the invasion number of three groups; the migra­tion cells were detected by Scratch test; the IQ motif-containing GTPase-activating protein 2 (IQGAP1 ) mRNA and pro­tein, and microRNA-124 in cells were analyzed by the real-time PCR; Luciferase reporter assay was applied to detect the luciferase activity of the reporting plasmid containing the 3- Untranslated Region (UTR) of IQGAP1 gene. Results After 24-hour culture, the number of invasion cells of the observation group, the control group and the blank group was 104. 32 土 11.21, 304. 27 ± 20. 83 and 299. 38 ± 18. 32, respectively. The number of invasion cells in the observation group was low­er than that in the control group and the blank group (all P < 0. 05 ). After 24 h culture, the migration number of cells in the observation group, the control group and the blank group was 62. 16 ± 3. 21, 104. 27 ± 6. 83 , and 99. 38 ± 5. 32, re­spectively. Healing percentage in the observation group was lower than that in the control group and the blank group ( P < 0. 05 ) . The relative expression levels of IQGAP1 RNA and protein in the observation group was lower than those in the con-trol group and the blank group ( both P <0. 05 ). The relative expression level of microRNA-124 in the observation group was higher than that in the control group and the blank group (P <0.05). After 48 h culture, the relative luciferase activi­ty in the observation group, the control group and the blank group was 0. 24 ± 0. 06，1.06 ± 0. 15 and 1. 10 ± 0. 17，re­spectively， and the relative luciferase activity in the observation group was lower than that in the control group and the blank group ( P <0. 05 ) . Conclusion High expression of microRNA-124 could inhibit the cell invasion and migration by down­regulating the IQGAP1 expression. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of silencing forkhead box transcription factor Ml ( FoxMl ) on the proliferation, migration, and invasion of human papillary thyroid carcinoma cell line Kl. Methods Using liposome Lipo-fectamine™2000 to separately transfect the FoxMl-siRNA and control-siRNA into the human thyroid carcinoma cell line Kl , as the transfection group and meaningless sequence group; another cell line Kl was added with PRS solution as the blank control group. The expression of FoxMl protein was detected by Western blotting; the cell proliferation ability was determined by MTT assay; the cell migration in each group was detected by single cell scratch test; the cell invasion ability in each group was detected by Transwell invasion test. Results The relative expression of FoxMl protein in the blank control group, the meaningless sequence group, and the transfection group were 0.96 ±0.01,0.95 ±0.01 and 0. 27 ±0. 03; significant difference was found between tin; transfection group and the blank control group and the meaningless sequence group (all P < 0. 05 ) , but no significant difference was found between the blank control group and the meaningless sequence group ( P > 0. 05 ). The cell growth of the transfection group was inhibited, and significant difference was found between the meaningless sequence group and the blank control group (P < 0. 05 ) , but no significant difference was found between the blank control group and the meaningless sequence group (P>0.05). At 24 h, the relative ratios of scratch area in the blank control group, meaningless sequence group, and transfection group were 0. 83 ±0. 01,0. 82 ±0. 01 , and 0. 93 ±0.01 , respectively; the number of cells passing through the back of the upper chamber in the blank control group, the meaningless sequence group , and the transfection group were (92. 40 ± 3. 05 ) , ( 85.40 ± 5. 13 ) , and (37. 20 ± 3. 96 ) / field; significant difference was found between the transfection group and the blank control group and the meaningless sequence group (all P < 0. 05) , hut no significant difference was found between the blank control group and the meaningless sequence group (P > 0. 05). Conclusion Silencing FoxMl inhibits the proliferation of human papillary thyroid carcinoma K1 cells, and reduces the cell invasion and migration. [ABSTRACT FROM AUTHOR]

Objective To study the inhibitory effect of ursolic acid on the proliferation of human papillary thyroid carcinoma cell line TPC-1 in vitro. Method TPC-1 cells were treated with different concentrations of ursolic acid （control group:0μM，experimental group:3μM， 6μM， 12μM）; MTT assay was used to observe the effect of the growth of TPC-1 cells on different concentrations of ursolic acid at the same time; Apoptosis and cell cycle distribution of TPC-1 cells were treated with ursolic acid by flow cytometry; The expression of Bcl-2， Bax and Caspase-9 mRNA in TPC-1 cells were treated with ursolic acid by QRT-PCR; The expression of Bcl-2， Bax and Caspase-9 protein in TPC-1 cells were treated with ursolic acid by Western blot. Results MTT assay showed that ursolic acid inhibited the proliferation of TPC-1 cells in a concentration and time-dependent manner， and the IC50 at 24 h， 48 h and 72 h was 14.21 μM， 10.56 μM， 10.39 μM; Flow cytometry showed that ursolic acid inhibited the apoptosis of TPC-1 cells in a concentration-dependent manner， and the growth of TPC-1 cells was arrested in S phase; QRT-PCR showed that Bcl-2， Bax and Caspase-9 mRNA were expressed in the control and experimental groups，ursolic acid inhibited the expression of Bcl-2 mRNA in a concentration-dependent manner and up-regulated the expression of Bax and Caspase-9 mRNA; Western blot results showed that Bcl-2， Bax and Caspase-9 were expressed in the control and experimental groups， ursolic acid inhibited the expression of Bcl-2 protein in a concentration-dependent manner and up-regulated the expression of Bax protein and Caspase-9 protein. Conclusion Ursolic acid can significantly inhibit the proliferation and induce apoptosis of human papillary thyroid TPC-1 cells，providing some ideas for the treatment of thyroid cancer. [ABSTRACT FROM AUTHOR]

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Objective: To evaluate the diagnostic value of thyroid peroxidase (TPO) mRNA in peripheral blood of papillary thyroid carcinoma (PTC) patients. Methods: Postoperative histopathology as the diagnostic standard, the expression of circulating TPO mRNA was measured by nested RT-PCR in PTC patients. Results: 41 PTC patients accepted total/subtotal thyroidectomy and cervical lymph node dissection, 16 (39.0 ％) had cervical lymph node metastasis, none had distant metastasis. The positive rate of TPO mRNA had no significant difference among the gender, ages, the levels of TPOAb, tumor size, the numbers of tumor in PTC patients (P＞0.05), but had significant difference between patients with and without central lymph node metastasis (68.8％ vs 36.0％,P＜0.05). TPO mRNA expression showed no significant difference among patients of different TNM staging (P＞0.05), but it did exhibit significantly different between low-risk patients and Intermediate/high-risk patients for recurrence (31.8％ vs 68.8％,66.7％, P＜0.05). Conclusions: The expression of TPO mRNA in peripheral blood could serve as a potential molecular marker to predict PTC metastasis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of bosutinib on the malignant behavior of thyroid papillary carcinoma B-CPAP cells and its possible mechanisms. Methods: Thyroid papillary carcinoma B-CPAP cells were cultured in vitro with a concentration gradient of(1、2、3、4 and 5 μmol/L)bosutinib intervened for 24 hours, DMSO was used as the control group. Five parallel compound holes were set in each group. Cell counting kit (CCK-8 method) method was used to detect cell proliferation. Transwell assay and cell wound healing assay were used to detect cell invasion and migration. TUNEL staining assay and flow cytometry were used to detect cell apoptosis. Western blot was used to detect the expressions of autophagic proteins (Beclin-1, LC3, p62) and signal pathway proteins (SIK2, p-mTOR, mTOR, p-ULK1, ULK1). Results: Compared with the control group, the cell proliferation activity, migration ability and invasion ability were decreased ( P ＜0.01), while the cell apoptosis rate was increased ( P ＜0.01) in the bosutinib concentration groups of 2, 3, 4 and 5 μmol/L . In the concentration groups of 4 and 5 μmol/L, the expression of Beclin-1 ( P ＜0.05), LC3- Ⅱ/LC3- Ⅰ ( P ＜0.05), SIK2 ( P ＜0.01) and p-ULK1 ( P ＜0.01) protein was decreased, while the expression of p62 ( P ＜ 0.05) and p-mTOR ( P ＜0.01) protein was increased. Conclusion: Bosutinib may inhibit the autophagy of thyroid papillary carcinoma cells through SIK2-mTOR-ULK1 signaling pathway to inhibit their proliferation, invasion and migration and promote apoptosis, thereby weakening their malignant behavior.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound(CEUS)in thyroid extrathyroidal extension(ETE)of papillary thyroid carcinoma(PTC).Methods Totally 172 PTC patients(184 thyroid nodules)were examined by conventional ultrasound(US)and CEUS before operation.Sonographic features of thyroid nodules and the relationship between nodules and thyroid capsule were retrospectively evaluated.The diagnostic efficacy of these two methods for ETE was compared,and the effect of nodule enhancement level on the diagnosis of ETE was analyzed.Results The sensitivity,specificity,and accuracy of CEUS were 78.9%,89.4% and 84.2% in diagnosing ETE,while those of US were 60.0%,86.2%,and 73.4%,respectively.Among them,the sensitivity( P =0.000)and accuracy( P =0.009)of CEUS in diagnosing ETE were significantly higher than those of US,but there was no statistically significant difference in specificity( P =0.375).The area under the receiver operator characteristic curve of CEUS(0.84)was significantly larger than that of US(0.73)( Z =2.24, P =0.01).The diagnostic value of CEUS in ETE was related to the enhancement level of nodules.The sensitivity,specificity,and accuracy of CEUS in the diagnosis of ETE were highest in hypo-enhanced nodules,followed by hyper-enhanced nodules and the iso-enhanced nodules.Conclusion CEUS has higher performance than US in detecting ETC of PTC.

Thyroid papillary carcinoma(PTC) is the most common type of thyroid cancer. The 2017 NCCN guidelines reported that PTC accounts for 89.4% of thyroid cancer, and papillary thyroid cancer is well known to most head and neck surgeons due to its weak invasiveness, good surgical excision rate and low recurrence rate. However, as the treatment progresses, we may also touch the rapidly progressing PTC, or even the paropharyngeal metastasis in a short period of time, and the reported rate is 0.43% to 2.5%., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Thyroid cancer is a common malignancy derived from the endocrine system and the incidence of thyroid cancer is on the rise. Papillary thyroid carcinoma (PTC) is the most common type, and 90% of PTC patients have long-term survival, but the recurrence rate is still as high as 30%. Current diagnostic and postoperative monitoring techniques have been developed, but their negative rates and interfering factors also occupy an absolute proportion, and lack specific markers for the prognosis of PTC. Studies have shown that microRNAs (miRNAs) are associated with the development, metastasis and invasiveness of PTC and as a biomarker to aid in the diagnosis and monitoring of recurrence, and to determine the prognosis for specific markers. The future of PTC diagnosis, treatment and improve prognosis has broad prospects. This review mainly describes the development of miRNA as biomarkers for the diagnosis, recurrence and prognosis of PTC., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To understand the clinical manifestation, imaging characteristics and outcomes of pulmonary malignant tumors in children. Method: We retrospectively collected information about seven cases of pulmonary malignant tumors in children in our hospital from Jan 2010 to Dec 2016. The information included clinical manifestation, imaging characteristics, pathologic results, and treatment. Result: (1) All the seven patients firstly visited pediatric internal medicine departments. Symptoms included cough ( n =6), dyspnea ( n =4), fever ( n =2), anorexia ( n =2), chest tightness ( n =1), chest pain ( n =1), lameness ( n =1), abdominal distension and constipation ( n =1). We did not find hemoptysis, wheezing or weight loss in those patients. Physical examinations revealed unilateral reduced breath sounds ( n =5), moist rales and wheezes ( n =1), and normal ( n =1). Extrapulmonary signs included abdominal distension ( n =2), left hip tenderness ( n =1), and mass in left scrotum. We did not identify clubbing finger, anemic appearance, lymph node enlargement, or hepatosplenomegaly etc. (2) Laboratory examination results: complete blood count showed white blood cells in normal range except one case (17.44×10(9)/L). Neutrophil percentage ranged from 0.348 to 0.767. C reactive protein ranged between<1 and 162 mg/L. Hemoglobin was normal. Three out of four cases had abnormal blood tumor markers.(3) Imaging results showed multiple nodes ( n =3), multiple cystic lesions in lungs ( n =2) (both with pleuropulmonary blastoma), endobronchial soft tissue mass ( n =1), pulmonary round-shaped mass ( n =1), and mediastinal mass ( n =1). Imaging results also found atelectasis ( n =3), pneumonia ( n =2), pneumothorax ( n =2), longitudinal diaphragmatic hernia ( n =2), pleural effusion ( n =1), subcutaneous emphysema ( n =1). (4) All the patients underwent tumor puncture biopsy or tumor resection. Pathology revealed the final diagnosis of pleuropulmonary blastoma ( n =3), endodermal sinus tumors ( n =2), squamous cell carcinoma of lung ( n =1), and thyroid papillary carcinoma ( n =1). All of them were malignant tumors. We followed up them. Two patients died (both with pleuropulmonary blastoma) after their parents refused any medical help. Two cases were lost to follow-up. Three patients survived (followed up for 19 months, 11 months and tow months, respectively). One case with thyroid papillary carcinoma pulmonary metastasis underwent right thyroid cancer radical plus left thyroid lobe resection plus modified selective central lymph node dissection, then iodine (131) treatment. One case with endodermal sinus tumor pulmonary metastasis underwent three times of chemotherapies, resection of left retroperitoneal tumor and left testicular tumor, and six additional chemotherapies. Another one case of endodermal sinus tumor pulmonary metastasis underwent three times of chemotherapies and was discharged. Conclusion: Pulmonary malignant tumors are rare diseases in children. Clinical signs are often non-specific. For those with chest CT showing multiple cystic lesions, endobronchial soft tissue mass or multiple nodes, but no significant infection manifestation or no response to anti-infection therapy, pulmonary malignant tumors should be considered. Biopsy may be needed to confirm the final diagnosis.

thyroid carcinoma is a common tumor in the endocrine system. There are four common types of thyroid carcinoma: papillary carcinoma; follicular cancer; medullary carcinoma; undifferentiated carcinoma. Thyroid papillary carcinoma is derived from follicular epithelial cells, which is different from that of medullary thyroid carcinoma. If both occur in the same side of the thyroid gland, this is very rare. In this paper we report a case in which papillary thyroid carcinoma and papillary carcinoma occurr on the same side., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)