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Abstract Background It is difficult to determine the lymph node metastasis of patients with clinically negative lymph nodes (cN0) non-small cell lung cancer (NSCLC) before surgery. The purpose of this study is to investigate risk factors of lymph node metastasis in cN0 NSCLC, thereby to identify the surgical indications for lymph node dissection in cN0 NSCLC. Methods We conducted a retrospective study of patients with tumor size ≤ 30 mm who underwent radical resection of NSCLC. Binary logistic regression analysis was applied to predict risk factors for lymph node metastasis, and subject operating characteristics (ROC) curve was used to evaluate the independent risk factors. Results Overall, 44 patients (6.8%) with cN0 NSCLC had lymph node metastasis. Factors of tumor consolidation diameter (p 16.5 mm had lymph node metastasis. Conclusion Tumor consolidation diameter and preoperative serum CEA are independent factors to predict cN0 NSCLC with tumor size ≤ 30 mm. For patients with tumor parenchyma > 16.5 mm, the probability of lymph node metastasis is higher and lymph node dissection is recommended. For patients with tumor parenchyma ≤ 16.5 mm, the probability of lymph node metastasis is lower and lymph node sampling is feasible.

Objective To investigate the clinical efficacy and safety of different therapeutic regimens of alendronate in the treatment and prevention of senile osteoporosis. Methods A random parallel controlled study was performed. Six hundred consecutive senile patients with osteoporosis were included. All the patients were divided into 2 groups according to the interval of drug administration. Patients in Group A had regular interval, taking an oral medication of 70mg alendronate once a week, while patients in Group B had long interval, taking an oral medication of 70mg alendronate once 2 weeks. Patients in both groups also took 600mg Caltrate D per day simultaneously. Bone mineral density (BMD) in both groups was detected before the treatment and at the 26th week and the 52nd week after the treatment, respectively. The serum levels of serum calcium, phosphorus, ALP, and urinary calcium/creatine were also detected before the treatment and at the 13th week and 52nd week after the treatment. The adverse events and the occurrence of new fractures were also observed. Results Compared with that before the treatment, BMD at the 26th week and the 52nd week after the treatment increased significantly (P < 0.05), while the changing rate of BMD in both groups showed no significant difference (P > 0.05). Compared with that before the treatment, the serum levels of ALP and urinary calcium/creatine decreased significantly (P < 0. 01), while the serum levels of calcium and phosphorus showed no significant changes. The effective rate after 52-week treatment in Group A and Group B was 85. 31% and 84. 89%, respectively, and no significant difference was observed (P > 0.05). The rate of adverse events was 9.09% and 3.60%, respectively, and the difference was significant (P < 0.01). No new fractures were observed in both groups. Conclusion The application of alendronate in the treatment and prevention of senile osteoporosis is safe and effective. Compared with that with regular interval, the clinical efficacy of medication with longer interval is similar, but the rate of adverse events is lower, and the treatment is much more convenient and economical. Therefore, the intermittent, lose-dosage therapeutic regimen of alendronate should be recommended in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To investigate the risk factors for metastasis and clinical indications for dissection of lymph node posterior to right recurrent laryngeal nerve (LN-prRLN) in papillary thyroid carcinoma (PTC)., Methods: A prospective analysis including 283 consecutive patients with PTC who underwent total thyroidectomy with routine central lymph node dissection (CLND) in our hospital from Jan. 2010 to Jan. 2012 was performed. The right paratracheal lymph nodes in the central compartment lymph nodes (CCLN) were divided into the anterior (level VIa) and posterior (level VIb) compartments by recurrent laryngeal nerve (RLN), and were removed respectively. The complications and recurrences were recorded with a follow-up of 3 months to 3 years., Results: CCLN metastases were present in 47.7% (135/283) of the patients, and level VIb metastases were present in 27.2% (77/283) of the patients. The incidence of level VIb metastasis was 20.5% (58/283) in level VIa-positive patients, while 6.7% (19/283) in level VIa-negative patients. Complications of level VIb dissection were found in 4.9% (14/283) of all patients. 2.1% (6/283) of all patients were diagnosed with regional recurrence during the 3-year follow-up. Univariate analysis revealed that level VIb metastasis was significantly associated with tumor size, number, extrathyroidal invasion, clinical nodal stage, level VIa and lateral lymph node metastases. Multivariate analysis revealed that tumor larger than 1 cm, multifocality, extrathyroidal invasion, level VIa and lateral lymph node metastases were independent risk factors for level VIb metastasis., Conclusions: Lymph node posterior to right recurrent laryngeal nerve can be the only site of metastasis from PTC without other cervical compartment involvements. Therefore, routine intraoperative detection of these nodes may be necessary for patients with right PTC, and dissection should be considered when a right-side PTC tumor is larger than 1 cm, multifocality, with extrathyroidal invasion or cervical nodal metastases.