ABSTRACT
Objective To analyze clinical features of primary hyperparathyroidism(PHPT)and to evaluate the diagnosis and treatment for PHPT.Methods 115 patients with PHPT undergoing surgery and confirmed by pathology from Jan.2006 to Mar.2014 were retrospectively analyzed.Results The clinical manifestations of PHPT were various.The rate of misdiagnosis was 70.0％(77/115).The positive rate of ultrasonography was 61.0％ (64/105),99Tcm-MIBI 88.3％(68/77)and CT 75.4％(46/61),respectively.The difference among the 3 tested methods had statistical significance (P＜0.05).89 cases with parathyroidoma underwent unilateral neck exploration,6 cases of parathyroid hyperplasia underwent bilateral neck exploration,3 cases with parathyroid carcinoma underwent carcinoma resection,ipsilateral thyroid lobe resection and ipsilateral central lymph node dissection,and 21 cases with thyroid benign or malignant lesions underwent suitable operations.97 cases developed hypocalcaemia of various degrees after operation,and the symptoms were relieved after use of calcium gluconate.Conclusions PHPT can be diagnosed according to the lever of serum calcium and PTH.Ultrasonography and 99Tcm-MIBI should be the first choice for preoperative localization.Unilateral neck exploration can be used for parathyroidoma with accurate localization.
ABSTRACT
ObjectiveTo investigate synergistic effect of donor livers blocked by recipient blood serum (RS) and cobra venom factor (CVF) treatment to inhibit hyperacute rejection (HAR) happened in liver xenotransplantation.MethodsThe SD rat blood serum was prepared for pre-perfusing the donor livers before experiment.24 pairs of guinea-pig (GP) and Sprague-Dawley (S.D.) rats were choiced respectively and pair-matched between GP donor and rat recipient randomly.Before transplantation,donor livers of GPs were pre-perfused by 0.5％ SD rat serum.Paired animals were divided into 4 groups randomly such as donor liver perfused by RS,recipient treated by CVF,RS+ CVF performed and Ringer solution as a control.The orthotopic liver xenotransplantations was performed with two-cuff technique.The survival time and liver function of recipients,morphological and pathological changes of rat livers were observed.ResultsThere was no piebaldism change on the recipient liver from experimental group.The survival time of recipients from RS+CVF group [(161.5±30.9) min]was longer than that of control[(45.2 ± 13.9) min] and CVF[(125.2 ± 25.5) min] or RS groups [(88.1±19.7) min] (P＜0.05).The ALT in serum of recipients from RS+CVF [(63.2±13.9)U/L]was lower than that from congtrol group [(126.1±23.3)U/L](P＜0.01) and CVF group [(79.9±18.1)U/L](P＜0.05) or RS group [(106.1±19.3)U/L](P＜0.01) The histological damages including thrombosis,interstitial bleeding and edema of recipient liver from RS+CVF group were alleviated markebly than that of other groups (P＜0.05).ConclusionThere was a synergistic effect to inhibit HAR happened in liver xenotransplantation by blocking the donor liver with recipient blood serum and CVF treatment significantly.
ABSTRACT
ObjectiveTo investigate a new way to prevent hyperacute rejection (HAR) during liver xenotransplantation through blocking the xenograft with recipient blood serum before transplantation.MethodsTwenty guinea-pig (GP) and Sprague-Dawley (SD) rats were pair-matched as donor and recipient randomly.Before transplantation,blood serum collected from other SD rats was inactivated at 45 ℃ in water bath for 30 minutes.Guinea-pig donor livers from experimental group ( n =10 ) were pre-perfused by 0.1％ solution of this blood serum,and donor livers from control group (n =10) were treated by Ringer solution.Then orthotopic liver xenotransplantations were performed by the modified two-cuff technique immediately.Liver morphology changes and survival rate and time of recipients were observed,and histopathological lesions were detected by HE staining,and liver ALT level was evaluated.ResultsThe operation time and anhepatic phases between two groups were not different significantly ( P ＞ 0.05 ).The survival rate of recipients from experimental group was higher,and its survival time was longer than that of control group significantly (P ＜ 0.01 ).The liver histological changes such as thrombosis and interstitial bleeding in experimental group was less severe than that in control group (P ＜0.01 ).The level of ALT in blood serum of rats from experimental group were lower than that from control group significantly ( P ＜ 0.05).ConclusionsThe results suggested that blocking the donor graft with recipient blood serum inhibits HAR during liver xenotransplantation.