<strong>Background:</strong> We aimed to investigate the ability of carbon nanoparticles to identify parathyroid glands with vasculature during thyroid surgery. <strong>Material and methods:</stro...<strong>Background:</strong> We aimed to investigate the ability of carbon nanoparticles to identify parathyroid glands with vasculature during thyroid surgery. <strong>Material and methods:</strong> Totally 42 patients with various thyroid diseases were selected for the prospective research of carbon nanoparticle injection used in thyroidectomy. Another 42 patients without receiving carbon nanoparticle injection were selected as the control group. All cases underwent total or subtotal bilateral thyroidectomy. Before the ligation of the superior and inferior poles of the thyriod lobes, 0.1 mL of a carbon nanoparticle suspension was injected into the two poles. Important tissues such as the recurrent laryngeal nerve, parathyroid gland with blood supply and the inferior thyroid artery were identified and protected. <strong>Results:</strong> The parathyroid glands with vasculature were not stained and thus remained the primary color in all cases, while abnormal thyroid tissues were stained black. After 5 minutes, thyroid lobes were injected with the carbon nanoparticle suspension and the original color of parathyroid glands was unchanged. Even the parathyroids with blood supply can be identified and protected. The number of parathyroid glands for autotransplantation was one in the test group and six in the control group. At one day after the thyroid surgery, hypocalcemia became detectable in four patients of the test group and in five of the control group. Twenty-four instances of hypoparathyroidism occurred at 1 day after surgery in the control group, while ten instances in the test group. <strong>Conclusion:</strong> Intraoperatvie carbon nanoparticle suspension injection is an effective and safe technique for guiding thyroid surgery. The carbon nanoparticle suspension plays an important role in identifying the vasculatural parathyroid glands, while protecting the physiologic function of the parathyroid glands during surgery.展开更多
Donor rat parathyroid gland(PTG)was first transplanted into the nude mouse interim hostsystem.After 100 days the PTG was re-transplanted into eligible recipients.The resultsshow that mean survival time of recipient ra...Donor rat parathyroid gland(PTG)was first transplanted into the nude mouse interim hostsystem.After 100 days the PTG was re-transplanted into eligible recipients.The resultsshow that mean survival time of recipient rats may be remarkably prolonged.展开更多
Background: Primary hyperparathyroidism (pHPT) is one of the most common endocrine diseases and the most common cause of hypercalcemia. Since routine laboratory testing, the prevalence of the disease has increased fro...Background: Primary hyperparathyroidism (pHPT) is one of the most common endocrine diseases and the most common cause of hypercalcemia. Since routine laboratory testing, the prevalence of the disease has increased from 0.1% to 0.4% worldwide. The only curative treatment is parathyroidectomy. Nowadays, preoperative localization studies have become standard before surgical treatment, and the first stage imaging methods are cervical ultrasonography (US) and/or Sestamibi scintigraphy. Objectives: To describe the accuracy of US and Sestamibi for detection of hyperfunctioning parathyroid adenomas preoperatively in patients with confirmed pHPT from our medical institution. Results: This is a retrospective study from a prospectively kept database that included thirty-one patients with the confirmed diagnosis of pHPT clinically and biochemically. The average age was 57.8 years old. Preoperative US and surgery findings were compared with a sensitivity of 51%. Preoperative Sestamibi and surgery findings were compared resulting in a sensitivity of 71%. Both imaging methods combined, resulted in a sensitivity of 80%. Conclusion: In patients with pHPT, Sestamibi is an effective method for localizing parathyroid pathology preoperatively, but the false negative rate can be high. US tends to have a wider range explained by the operator-dependent factor. The combination of US and Sestamibi reduces the rate of false negatives, as reported in international literature. It is important to mention that these studies cannot be used as a confirmatory test for this disease. It should only be used as an adjunct to help plan the operation.展开更多
目的 探讨近红外自体荧光显像(NIRAF)技术辅助识别甲状旁腺的有效性及对术后甲状旁腺保护和甲状旁腺激素表达的影响。方法 选择2020年1月至2022年9月在邢台医学高等专科学校第二附属医院收治的122例甲状腺癌患者,其中男性95例,女性27例...目的 探讨近红外自体荧光显像(NIRAF)技术辅助识别甲状旁腺的有效性及对术后甲状旁腺保护和甲状旁腺激素表达的影响。方法 选择2020年1月至2022年9月在邢台医学高等专科学校第二附属医院收治的122例甲状腺癌患者,其中男性95例,女性27例;年龄39~51岁,平均年龄45.23岁;病理类型,乳头状癌105例,滤泡性腺瘤17例;单侧切除术46例,双侧切除术76例。按照随机数表法将患者分为对照组和研究组,对照组患者行常规甲状腺癌手术,研究组患者在NIRAF技术辅助下行甲状腺切除术。比较两组患者甲状旁腺识别率、围术期指标、氧化应激指标、甲状腺功能、血钙、甲状旁腺激素(PTH)、免疫功能和并发症等参数。结果 研究组患者伤口长度、术中出血量、手术时间、术后引流量和住院时间与对照组比较,差异无统计学意义(P> 0.05)。两组患者均出现感染、发音困难和声音嘶哑等并发症,但差异无统计学意义(P> 0.05),而研究组患者术后低血钙和PTH减退比例明显低于对照组(22.95%vs 44.26%,6.56%vs 19.67%。P=0.013、0.032)。术后7 d两组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显提高,两组患者CD3^(+)CD8^(+)水平明显降低,且研究组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显高于对照组(43.83±4.59 vs 40.23±3.78,1.93±0.21 vs 1.73±0.13。P=0.000、0.000),研究组患者CD3^(+)CD8^(+)水平明显低于对照组(22.61±2.31 vs 23.81±2.62。P=0.008)。术后7 d两组患者血钙和PTH明显降低,且研究组患者血钙和PTH明显高于对照组(2.26±0.18 vs 2.15±0.25,36.98±5.16 vs 27.28±4.99。P=0.000、0.000)。研究组患者甲状腺被膜解剖前检出率为56.19%,明显高于对照组的31.19%(P=0.000);研究组患者甲状旁腺总检出率和总体准确度与对照组比较,差异无统计学意义(P> 0.05)。结论 NIRAF技术辅助识别甲状旁腺组织,可有效提高甲状腺被膜解剖前检出率,减小血钙和PTH减退幅度,增强术后甲状旁腺保护,改善免疫机能,值得临床进一步研究并推广。展开更多
文摘<strong>Background:</strong> We aimed to investigate the ability of carbon nanoparticles to identify parathyroid glands with vasculature during thyroid surgery. <strong>Material and methods:</strong> Totally 42 patients with various thyroid diseases were selected for the prospective research of carbon nanoparticle injection used in thyroidectomy. Another 42 patients without receiving carbon nanoparticle injection were selected as the control group. All cases underwent total or subtotal bilateral thyroidectomy. Before the ligation of the superior and inferior poles of the thyriod lobes, 0.1 mL of a carbon nanoparticle suspension was injected into the two poles. Important tissues such as the recurrent laryngeal nerve, parathyroid gland with blood supply and the inferior thyroid artery were identified and protected. <strong>Results:</strong> The parathyroid glands with vasculature were not stained and thus remained the primary color in all cases, while abnormal thyroid tissues were stained black. After 5 minutes, thyroid lobes were injected with the carbon nanoparticle suspension and the original color of parathyroid glands was unchanged. Even the parathyroids with blood supply can be identified and protected. The number of parathyroid glands for autotransplantation was one in the test group and six in the control group. At one day after the thyroid surgery, hypocalcemia became detectable in four patients of the test group and in five of the control group. Twenty-four instances of hypoparathyroidism occurred at 1 day after surgery in the control group, while ten instances in the test group. <strong>Conclusion:</strong> Intraoperatvie carbon nanoparticle suspension injection is an effective and safe technique for guiding thyroid surgery. The carbon nanoparticle suspension plays an important role in identifying the vasculatural parathyroid glands, while protecting the physiologic function of the parathyroid glands during surgery.
文摘Donor rat parathyroid gland(PTG)was first transplanted into the nude mouse interim hostsystem.After 100 days the PTG was re-transplanted into eligible recipients.The resultsshow that mean survival time of recipient rats may be remarkably prolonged.
文摘Background: Primary hyperparathyroidism (pHPT) is one of the most common endocrine diseases and the most common cause of hypercalcemia. Since routine laboratory testing, the prevalence of the disease has increased from 0.1% to 0.4% worldwide. The only curative treatment is parathyroidectomy. Nowadays, preoperative localization studies have become standard before surgical treatment, and the first stage imaging methods are cervical ultrasonography (US) and/or Sestamibi scintigraphy. Objectives: To describe the accuracy of US and Sestamibi for detection of hyperfunctioning parathyroid adenomas preoperatively in patients with confirmed pHPT from our medical institution. Results: This is a retrospective study from a prospectively kept database that included thirty-one patients with the confirmed diagnosis of pHPT clinically and biochemically. The average age was 57.8 years old. Preoperative US and surgery findings were compared with a sensitivity of 51%. Preoperative Sestamibi and surgery findings were compared resulting in a sensitivity of 71%. Both imaging methods combined, resulted in a sensitivity of 80%. Conclusion: In patients with pHPT, Sestamibi is an effective method for localizing parathyroid pathology preoperatively, but the false negative rate can be high. US tends to have a wider range explained by the operator-dependent factor. The combination of US and Sestamibi reduces the rate of false negatives, as reported in international literature. It is important to mention that these studies cannot be used as a confirmatory test for this disease. It should only be used as an adjunct to help plan the operation.
文摘目的 探讨近红外自体荧光显像(NIRAF)技术辅助识别甲状旁腺的有效性及对术后甲状旁腺保护和甲状旁腺激素表达的影响。方法 选择2020年1月至2022年9月在邢台医学高等专科学校第二附属医院收治的122例甲状腺癌患者,其中男性95例,女性27例;年龄39~51岁,平均年龄45.23岁;病理类型,乳头状癌105例,滤泡性腺瘤17例;单侧切除术46例,双侧切除术76例。按照随机数表法将患者分为对照组和研究组,对照组患者行常规甲状腺癌手术,研究组患者在NIRAF技术辅助下行甲状腺切除术。比较两组患者甲状旁腺识别率、围术期指标、氧化应激指标、甲状腺功能、血钙、甲状旁腺激素(PTH)、免疫功能和并发症等参数。结果 研究组患者伤口长度、术中出血量、手术时间、术后引流量和住院时间与对照组比较,差异无统计学意义(P> 0.05)。两组患者均出现感染、发音困难和声音嘶哑等并发症,但差异无统计学意义(P> 0.05),而研究组患者术后低血钙和PTH减退比例明显低于对照组(22.95%vs 44.26%,6.56%vs 19.67%。P=0.013、0.032)。术后7 d两组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显提高,两组患者CD3^(+)CD8^(+)水平明显降低,且研究组患者CD3^(+)CD4^(+)和CD4^(+)/CD8^(+)水平明显高于对照组(43.83±4.59 vs 40.23±3.78,1.93±0.21 vs 1.73±0.13。P=0.000、0.000),研究组患者CD3^(+)CD8^(+)水平明显低于对照组(22.61±2.31 vs 23.81±2.62。P=0.008)。术后7 d两组患者血钙和PTH明显降低,且研究组患者血钙和PTH明显高于对照组(2.26±0.18 vs 2.15±0.25,36.98±5.16 vs 27.28±4.99。P=0.000、0.000)。研究组患者甲状腺被膜解剖前检出率为56.19%,明显高于对照组的31.19%(P=0.000);研究组患者甲状旁腺总检出率和总体准确度与对照组比较,差异无统计学意义(P> 0.05)。结论 NIRAF技术辅助识别甲状旁腺组织,可有效提高甲状腺被膜解剖前检出率,减小血钙和PTH减退幅度,增强术后甲状旁腺保护,改善免疫机能,值得临床进一步研究并推广。
