Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy / 中国医师进修杂志

Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.

Successful xenotransplantation of microencapsulated newborn pig parathyroid cells in the treatment of hypoparathyroidism in rats / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the effect of xenotransplantation with pig parathyroid cells, which was prepared using cell microencapsulation technique, on the treatment of hypoparathyroidism in rats without immunosuppressor.</p><p><b>METHODS</b>Parathyroid cells were isolated from 10 healthy newborn pigs and encapsulated in alginate-polylysine-alginate (APA) membranes. Thirty-two aparathyroid Wistar rats were randomly allocated to microcapsule, non-microcapsule, empty microcapsule, and control groups. Each rat was injected intraperitoneally with encapsulated porcine parathyroid cells, free porcine parathyroid cells, empty capsules or 0.9% NaCl, respectively. Total serum calcium and parathyroid hormone levels were monitored continuously for 40 weeks. And then, the transplant beds were retrieved and subjected to morphologic and electron microscopic examination.</p><p><b>RESULTS</b>In those animals xenotransplanted with microencapsulated porcine parathyroid cells, the calcium and PTH levels were consistently within the normal range during the 40 weeks. In contrast, no therapeutic effects were observed in rats in the non-microcapsule group. Furthermore, neither empty capsules nor 0.9% NaCl were shown to have any effect on the recipient's serum calcium or PTH levels. After 40 weeks, electron microscopic examination demonstrated that the parathyroid cells within the microcapsules had survived well in vivo.</p><p><b>CONCLUSIONS</b>Xenotransplantation of microencapsulated newborn pig parathyroid cells can successfully treat hypoparathyroidism in rats without using immunosuppressive drugs. The results of this study show the possible clinical use of microencapsulated porcine parathyroid cells.</p>

Cyst carcinoma after internal drainage operation for congenital choledocal cyst: a reports of 25 cases / 中国普通外科杂志

Objective To detective the carcinogenesis and operation principle of cyst canceration after internal drainage(ID) operation for congenital choledocal cyst (CCC).Methods The clinical data of 25 patients with cyst carcinoma after ID operation for CCC in the past 28 years were analysed retrospectively.Results The total canceration rate after internal drainage of CCC were 30.49%(25/82); after cystoduodenostomy was 35.29%(14/51),after cystojejunostomy was 22.58%(11/31), respectively. In the 25 cases, three of them were operated with Wipple operation , 4 with tumour resection plus biliary reconstrustion operation, 4 local resection with external drainage ,14 with external drainage only. Conclusions Internal drainage of CCC should be aborted becaus of the high canceration rate after the operation.

Treatment of murine hypoparathyroidism with transgenetic hemopoietic stem cell transplantation / 中华器官移植杂志

Objective To investigate the gene therapy of hypoparathyroidism (HPT) with hemopoietic stem cell s(HSCs) integrated with parathyroid hormone (PTH) gene.Methods Human PTH gene was amplified by polymerase chain reaction from pcDNA 3.1 -PTH templates and inserted into murine stem cell virus (MSCV) vectors. The plasmids recombinated with PTH gene were transfected into PA317 packaging cells and screened for positive clones with Geneticin. The condensed recombinant retroviruses were obtained and used to infect HSCs coming from umbilical cord blood. The infected HSCs were injected into the mice suffering from HPT. The change of symptoms and serum level of PTH and calcium in each group of mice was observed.Results Human PTH gene was proved to be inserted into MSCV vectors and the titres were up to 2?10 7 colony forming unit (CFU)/ml in condensed retroviral solution. The secretion of PTH reached 15 ng per 10 6 cells per 48 h. The wild type viruses were not detected by PCR amplification. The mice suffering from HPT recovered quickly and the serum level of calcium and PTH remained normal for about 3 months after the HSCs recombinated with PTH gene were injected into them. In the groups of mice subject to the injection of the recombinant retroviruses containing PTH gene, the serum level of PTH and Calcium was significantly increased in a short time, and then declined slowly. And the mice took on the manifestation of hypoparathyroidism again. The mice only subject to the implantation of HSCs were all dead within 20 days.Conclusion A long term therapeutic effect could be obtained by infusing the HSCs which were integrated with PTH gene into the mice suffered from hypoparathyroidism.