Predictive value of PTH level on day 1 after surgery for papillary thyroid carcinoma in patients with permanent hypoparathyroidism / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the relationship between parathyroid hormone（PTH） level and permanent hypoparathyroidism（PHPP） on the first day after radical papillary thyroidectomy, and its predictive value. Methods:A total of 80 patients with papillary thyroid cancer who underwent total thyroid resection and central lymph node dissection were collected and analyzed from January 2021 to January 2022. According to whether PHPP occurred after surgery, the patients were divided into hypoparathyroidism group and normal parathyroid function group, and univariate and binary logistics regression were used to analyze the correlation between PTH and serum calcium levels and PHPP on the first day after surgery in two groups. The dynamic changes of PTH at different time points after operation were analyzed. The area under the receiver operating characteristic was used to evaluate the predictive power of PTH on the development of PHPP after surgery. Results:Among the 80 patients with papillary thyroid cancer, 10 cases developed PHPP, with an incidence rate of 12.5%. Binary logistics regression analysis showed that PTH on the first postoperative day（OR=14.534, 95%CI: 2.377-88.858, P=0.004） was an independent predictive risk factor for postoperative PHPP. Taking PTH=8.75 ng/L on the first postoperative day as the cut-off value, the AUC of the area under the curve was 0.874（95%CI: 0.790-0.958, P<0.001）, the sensitivity was 71.4%, the specificity was 100%, and the Yoden index was 0.714. Conclusion:PTH level on the first day after total thyroid papillary carcinoma surgery is closely related to PHPP, and is an independent predictor of PHPP.

Metal implant fixation and repair for fresh unstable distal radial fractures with scaphoid fracture：half-year follow-up / 中国组织工程研究

BACKGROUND:Healing time and plaster used in fixed position and fixed time are different between distal radius fractures and scaphoid fracture. When both fractures occur simultaneously, you cannot choose a fixed position and determine a fixed time. One-stage internal fixation for the distal radial fractures and scaphoid fractures simultaneously can obtain a good function. OBJECTIVE:To retrospectively analyze the effects of titanium locking compression plate and Herbert screw fixation for fresh unstable distal radial fractures with scaphoid fracture. METHODS:A total of 12 patients with fresh unstable distal radial fractures combined with scaphoid fracture were treated in the Shanxi Dayi Hospital from November 2011 to June 2014. Al cases received open reduction and locking compression plate fixation of the distal radius, open reduction of scaphoid fracture or percutaneous Herbert screw fixation. Fracture healing was observed during folow-up. At 6 months after treatment, wrist joint function was evaluated with modified McBride score. Range of motion of palmar flexion, dorsiflexion, ulnar deviation, radial deviation, pronation and supination and grip strength were measured. The distal radial shortening (difference in height of styloid process of radius and ulna), and angles of ulnar deviation and palmar tilt were measured with X-ray films. The data of healthy side and affected side were compared. RESULTS AND CONCLUSION:(1) 12 cases were folowed up for 6-24 months. (2) The distal radius and scaphoid fractures healed. The healing time of distal radius was 6-12 weeks, with an average of seven weeks. Healing time of scaphoid fracture was 3-6 months, with an average of 4.2 months. (3) Wrist score was evaluated using modified McBride scoring criteria at 6 months after treatment. There were excelent in 5 cases, good in 6 cases, and average in 1 case, with the excelent and good rate of 92%. (4) No significant difference in range of motion of palmar flexion, dorsiflexion, ulnar deviation, radial deviation, pronation and supination and grip strength, angles of ulnar deviation and palmar tilt, difference in height of styloid process of radius and ulna and modified McBride score was detected between healthy side and affected side (P > 0.05). (5) The median nerve injury in two patients was recovered within 6 months after postoperative exploration decompression. No complications appeared, such as infection, dorsal muscle tendon irritation symptoms, carpal tunnel syndrome, and internal fixation failure. (6) These findings confirm that fresh unstable distal radial fractures with scaphoid fractures can be treated with open reduction of the distal radius and locking plate fixation, open reduction of scaphoid bone or percutaneous Herbert screw fixation, with reliable fixation, high fracture healing rate, and good wrist function recovery rate; the repair effect is satisfactory.

Gamma nailversus locking titanium plate fixation for unstable intertrochanteric fracture in the elderly：hip function / 中国组织工程研究

BACKGROUND:With the diversification of the choice of internal fixation for femoral intertrochanteric fracture, the fixation method for the same kind of fracture can be selected according to surgeon’s habit, and there is no unified standard. OBJECTIVE:To compare Gamma nail and proximal femoral locking plate fixation for repair of femoral intertrochanteric fractures. METHODS: A total of 94 elderly patients with unstable intertrochanteric fractures were treated in the Shanxi Armed Police Corps Hospital from April 2009 to September 2012. They were divided into two groups according to fixation methods. Gamma nail group contained 46 cases. Proximal femoral locking plate group contained 48 cases. The two fixation methods were compared and analyzed from the folowing aspects: incision length, intraoperative bleeding volume, operation time, postoperative hip function recovery, loading time and complications. RESULTS AND CONCLUSION:Incision length, intraoperative bleeding volume, loading time and complications were better in the Gamma nail group than in the proximal femoral locking plate group (P 0.05). The excelent and good rate of hip function was 96% (44/46) in the Gamma nail group and 92% (44/48) in the proximal femoral locking plate group at 1 year after treatment, and no significant difference was detectable between the two groups (P > 0.05). These findings suggest that Gamma nail and proximal femoral anatomic locking plate for the treatment of unstable intertrochanteric fractures can reach good recovery of hip function, but Gamma nail showed obvious advantages in incision length, intraoperative bleeding volume, loading time and complications.

Two kinds of decompression and implant internal fixation for the treatment of cervical spinal stenosis:C5 nerve root palsy and stability / 中国组织工程研究

BACKGROUND:Some scholars suggest that the nerve root palsy after cervical spinal stenosis treated with decompression and implant internal fixation is related with the cervical stability and cervical lordosis, but there is controversial. OBJECTIVE:To explore the C 5 nerve root palsy and stability after cervical spinal stenosis treated with posterior laminectomy lateral mass fixation and single-door decompression laminoplasty. METHODS:Twenty-nine cervical spinal stenosis patients were selected and treated with posterior decompression and implant internal fixation. Posterior laminectomy lateral mass fixation for the treatment of cervical spinal stenosis:C3-6 lateral mass and C7 pedicel screw internal fixation was performed and caused rough surface on the facet joint;the unstable segment was confirmed according to the preoperative anteraposterior plain film and dynamic radiographs combined with MRI and CT images, and then the corresponding segments were treated with lateral mass internal fixation, single-door decompression laminoplasty and laminoplasty. RESULTS AND CONCLUSION:Al the 29 cervical spinal stenosis patients were fol owed-up for 8 months to 2.3 years. Among them, 14 cases were treated with posterior laminectomy lateral mass fixation, two cases had nerve root palsy in the early stage after implantation, three cases had incomplete paralysis after long-term symptom recurrence and treated with second surgery of scar remove and decompression;15 cases were treated with single-door decompression laminoplasty, and one case had C 5 never root palsy and shoulder abduction dysfunctionafter treatment, no preoperative symptom recurrence. The nerve root palsy wil restored in 6 weeks for shortest and 9 months for longest. As the limitation of the case number, it is not clear whether there were significant differences in the correlation between C 5 nerve root palsy and segmental stability, cervical lordosis, spinal decompression degree and the range for spinal cord shift, as wel as the nerve root palsy degree and the cervical spinal stenosis recurrence caused by forward scar between two treatment methods, so accumulation observation of the cases and clinical experience are needed.

Feasibility study of Shuyisha as hemostasis and repair material for liver wound / 中华创伤杂志

Objective To discuss the feasibility of Shuyisha as hemostasis and repair material for liver wound. Methods Hemolysis rate, acute toxicity and eytotoxicity of Shuyisha were measured. A hemorrhage model was established by making an open wound (5 mm× 3 nun ×2 mm) on the left liver lobe of mice. Hemostasis was performed with Shuyisha in experimental group and with Surgicel in control group, when the hemostatic time and total blood loss (TBL) were accurately recorded and regular macro-scopic and histological observation carried out. Results The hemolysis rate of Shuyisha was 2.33%, with maximum tolerance does of over 0.48 g/kg and the eytotoxicity at zero. The hemostatie time of Shuy-isha was (5.00 ±0.00) s, with total blood loss of (0.88±0.18) g/kg, better than Surgicel (P< 0.05). Shuyisha was degraded completely within 14 days, with the wound healed within 21 days in ex-perimental group, much better than Surgieel. Conclusions The hemolysis rate, acute toxicity and cy-totoxicity of Shuyisha are up to the requirement of biomedical materials. Shuyisha has effective hemosta-sis, which may be related to its molecular structure and adhesion.