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Objective:To evaluate the safety and long-term effect of total parathyroidectomy in patients with secondary hyperparathyroidism.Methods:One hundred fifty-four patients with secondary hyperparathyroidism who underwent total parathyroidectomy in Zhongshan Hospital,Dalian University from Mar 2012 to Mar 2018 were followed up for 3-9 years,including the level of iPTH, serum calcium and phosphorus and dosing of calcium supplement.Results:Among the 154 patients, the iPTH level in 149 patients fluctuated within 15-60 pg/ml. After oral calcium carbonate, the blood calcium fluctuated in 1.8-2.4 mg/ml, and serum phosphorus was 0.8-1.6 mg/ml. The level of iPTH in 5 patients was between 80-150 pg/ml, which was higher than the normal value 10-70 pg/ml. The clinical symptoms of all patients were significantly relieved.Conclusion:Total parathyroidectomy is safe and reliable in the treatment of secondary hyperparathyroidism with low recurrence rate and stable long-term effect.
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Objective Discusses the peeling carotid endarterectomy tcchnique(CEA) operation methods and main points,around the time of surgery to reduce the incidence of stroke and postoperative restenosis rate.Methods Retrospectively analyzed and summarized for the CEA 21 cases in vascular surgery in our hospital from March 2006 to November 2011.Conventional Doppler ultrasonography,preoperative CTA.All the patients were under general anesthesia CEA,conventional set neck artery bypass tube surgery and vascular patch for carotid angioplasty.Results Around the time of surgery and postoperative 30 d were no deaths and stroke occurred and the follow-up both not again hair.In 3 6 months after mild carotid artery stenosis (＜40％),patients were no more than the carotid artery stenosis again.Conclusion Carotid endarterectomy exfoliative procedure the routine use carotid artery flow pipe and the blood vessels to patch do artery figuration,which can effectively improve the safety of the procedure and reduce postoperative restenosis happen.
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Objective Study of the effects of hepatocyte growth factor on inhibit Intimal hyperplasia of the anastomotic stoma after carotid artery bypass grafting.Methods Thirty-two New Zealand white rabbits were randomly divided into control group and the experimental group.The veins were pretreated with saline solution(control group)only or pretreated with HGF(experimental group ;100ng/ml).The vein grafts were harvested at 14 days,28days after operation,HE Stain and Elastic fibrin Stain,The thickness of Intima and media in the vein grafts,intima-media ratio(I/M) was calculated by computer image analysis system.PCNA Immunohistochemistry was performed.Results The thickness of Intima and media in the vein grafts of control group surpassed experimental group significantly(P ＜0.01).At 14d I/M in the vein grafts of control group (0.81 ± 0.05) surpassed experimental group (0.47 ± 0.05) (P ＜ 0.01),At 28d I/M in the vein grafts of control group(0.73 ± 0.01)surpassed experimental group (0.65 ± 0.01) (P ＜ 0.01).The vascular smooth muscle cell proliferation in experimental group was significantly lower than that in control group (P ＜ 0.01).Conclusion Treatment of veins grafts with HGF can significantly inhibit intimal hyperplasia in a rabbit carotid artery bypass grafting model.