RÉSUMÉ
Objective To explore the application value of nanocarbon parathyroid lymph negative development technique in the operation of the patients with chronic kidney disease(CKD) secondary hyperparathyroidism(SHPT).Methods Twenty cases of CKD stage 5 SHPT in our center from June 2014 to December 2015 were treated by parathyroidectomy(PTX) and forearm autotransplantation,using nanocarbon suspension local injection combined with preoperative parathyroid ultrasonography,enhanced CT and neck 99Tcm-MIBI and iPTH rapid determination.Results Thyroid and lymph node were quickly dyed black after nanocarbon suspension injection,while the target parathyroid did not develop with flesh color or pale yellow,clear vision in operation,fast stripping parathyroid and small surgical injury;postoperative serum calcium,phosphorus and iPTH were decreased significantly,postoperative follow-up lasted for 6 months,serum calcium,phosphorus,alkaline phosphatase and iPTH had statistically significant differences between before and after operation(P＜0.05).The symptoms of pain,myalgia and pruritus after operation were significantly relieved,and 20 cases had no reccurrence during follow up period.Conclusion The nanocarbon mixed suspension tracer agent can achieve real-time and accurate resection in the PTX of the patients with CKD stage 5 SHPT and can be used in clinic.
RÉSUMÉ
BACKGROUND:Dialysis membrane is the most important part of a dialyzer, which directly affects the therapeutic efficacy of hemodialysis. OBJECTIVE:To study the permeability, adsorbability and biocompatibility of high- and low-flux hemodialysis membrane in maintenance hemodialysis process. METHODS:Forty-six hemodialysis patients due to chronic renal failure were selected, including 24 males and 22 females, aged 26-78 years. These patients were randomized into two groups: FX8 and FX60 groups. Dialog+ dialyzer and bicarbonate dialysate (Braun, Germany) were used in the two groups, and polysulfone membranes FX8 and FX60 were respectively used in the two group. Al the patients received hemodialysis three times per week, 4 hours once. After 4 months of dialysis, blood levels of toxins and inflammatory cytokines were detected in the two groups. RESULTS AND CONCLUSION:After dialysis, there were no differences in the blood urea nitrogen, serum creatinine, blood phosphorus levels between the two groups. The clearance rates of β2-microglobulin and parathyrin were significantly higher in the FX60 group than the FX8 group (P < 0.05); the plasma levels of albumin and hemoglobin were significantly higher in the FX60 group than the FX8 group (P < 0.05); but the serum levels of interleukin-8 and tumor necrosis factor-a were lower in the FX60 group than the FX8 group (P < 0.05). These findings indicate that high-flux polysulfone membrane FX60 is superior to low-flux polysulfone membrane FX8 in the clearance of macromolecule toxins and biocompatibility.