One case report of recurrent primary hyperparathyroidism caused by iatrogenic implant ectopic parathyroid adenoma / 中华内分泌外科杂志

Parathyroid adenoma (PTA) is an important cause of hyperparathyroidism (HPT) . The author reported a case of HPT caused by proliferation of parathyroid cells caused by implantation during surgery, and the formation of adenoma in sternocleidomastoid muscle was detected. The understanding of primary hyperparathyroidism (PHPT) caused by ectopic PTA was analyzed from clinical symptoms, laboratory examination, the neck Doppler ultrasound, imaging ( 99TC m-MIBI SPECT/CT fusion imaging, CT) and pathological examination results, combined with the parathyroidism of the patient during the first operation.

Clinical observation of microwave ablation combined with anhydrous ethanol in the treatment of cystic thyroid nodules inical / 中华内分泌外科杂志

Objective:To observe the therapeutic effect of microwave ablation combined with anhydrous ethanol for cystic thyroid nodules.Methods:From Jan. 2019 to Dec. 2019, 56 patients with thyroid cystic nodules (≥2cm) underwent ultrasound guided thyroid cystic nodule ablation in Department of Thyroid and Breast Surgery, Nanjing Hospital of Traditional Chinese Medicine. According to different ablation methods, the patients were divided into microwave ablation combined with anhydrous ethanol group and microwave ablation group. There were 36 cases in microwave ablation combined with anhydrous ethanol group and 20 cases in microwave ablation group. The volume reduction rate of thyroid nodules, the incidence of postoperative complications and the changes of thyroid function were compared between the two groups after treatment. Statistical analysis were performed using SPSS, version 21.0, the mean±SD deviation ( ± s) was used to describe the statistics, t-test was performed, and the adoption rate of counting data (%) was expressed by χ 2 test. The difference was statistically significant with P<0.05. Results:The nodule volume reduction rates of the microwave ablation combined with anhydrous ethanol group and microwave ablation group were (49.86±6.78) % vs (22.84±1.88) %, (67.57±5.84) % vs (47.25±7.09) % and (75.70±4.51) % vs (71.14±4.65) % at 3 months, 6 months and 12 months after operation, respectively. There was significant difference between the two groups ( P<0.001) . The incidence of postoperative complications in the two groups was 38.89% and 45.00% respectively, and there was no significant difference between the two groups ( P>0.05) , and all complications were cured within 2 months. There was no significant difference in thyroid function (T3, T4, FT3, FT4, TSH) between the two groups before and 12 months after operation ( P>0.05) . Conclusions:Microwave ablation combined with anhydrous ethanol is more effective in treatment of cystic thyroid nodules (≥2cm) than microwave ablation alone. It can significantly improve patients’symptoms and nodule volume reduction, and does not affect thyroid function. It can be used as a recommended option for treatment of cysticthyroid nodules.

The clinical effect of modified arrow flap for nipple reconstruction / 中华内分泌外科杂志

Objective:To investigate the clinical effect of modified arrow flap for nipple reconstruction.Methods:From Jan. 2018 to Oct. 2019, 10 patients in Nanjing Hospital of Traditional Chinese Medicine who received the modified arrow flap for nipple reconstruction were collected. The rate of nipple retraction, patient satisfaction and the incidence of local flap complications were evaluated.Results:The operation time of 10 patients was 13-18 minutes, and the average operation time was (15.10±1.52) minutes. All patients were followed up for 3-24 months, with an average follow-up time of (14.60±1.07) months. The retraction rate of nipple height was 23.5%-33.2%, the average retraction rate of nipple height was (28.53±3.02) %, the diameter retraction rate of nipple was 7.1%-10.5%, and the average diameter retraction rate of nipple was (8.92±1.05) %. The patients’ satisfaction was 96%-100%, with an average of (97.9±1.60) %. None of the 10 patients had complications such as bad wound healing, incision dehiscence or flap necrosis.Conclusion:The design of the improved arrow flap is simple, the operation is simple, the curative effect is satisfactory, and the incidence of postoperative complications is low.

The valuee and short-term efficacy of Miccoli for cervical lymph node dissection / 中华内分泌外科杂志

Objective To evaluate the value and short-term efficacy of Miccoli for cervical lymph node dissection in patients with thyroid papillary carcinoma.Methods From Mar.2017 to Jan.2018,15 patients with thyroid papillary carcinoma received cervical lymph node dissection in Department of Thyroid and Breast Surgery of Nanjing Chinese Traditional Medicine Hospital,and they were divided into open surgery group (8 cases) and Miccoli surgery group (7 cases).The operation time,incision length,intraoperative blood loss,total number of dissection lymph nodes,incidence of postoperative complications and length of hospital stay between the two groups were analyzed.These groups were followed up for 6 months after surgery,in terms of neck comfort,incidence of enlarged lymph nodes in the cervical region and blood thyroglobulin level.Results There was no obvious difference between the two groups in intraoperative blood loss(P=0.651),total number of dissection lymph nodes(P=0.887),the incidence of postoperative complications(P=0.52),incidence of intumescent lymph node(P=1.000) and blood thyroglobulin level(P=0.826) after 6 months.The operation time of Miccoli group was longer than that of the open group(P=0.001),but the incision length(P=0.001),length of hospital stay(P=0.001)and postoperative neck comfort(P=0.001)were superior to those of the open surgery group.Conclusion Miccoli operation can be used to perform cervical lymph node dissection for PTC patients,which can achieve the curative effect of open surgery,without increasing the risk of postoperative complications,and the postoperative neck comfort was better.

Early postoperative serum levels of inflammatory mediators and biliary pressure level after laparocholedochoscopy plus holmium laser lithotripsy / 中华全科医师杂志

Retrospective analyses were performed for the clinical data of 67 patients with biliary calculi.Among them,laparocholedochoscopy plus holmium laser lithotripsy (n =31) and laparocholedochoscopy (n =36) were performed.As compared with laparocholedochoscopy,early postoperative serum inflammatory mediators of holmium laser lithotripsy were obviously lower,biliary pressure dropped faster and less volatile[(8.5±1.5)-(12.2±4.1) vs.(8.1 ±1.6)-(16.5±4.7) mmHg(1 mmHg=0.133 kPa)],operative duration [(93.5 ± 13.4) vs.(127.6 ± 34.5) min],conversion into laparotomy rate[3％ (1/31) vs.11％ (4/36)],postoperation SIRS rate[23％ (7/31) vs.42％ (15/36)],length of hospital stay [(8.5 ± 3.5) vs.(12.6 ± 3.9) days] and postoperative biliary residual stones rate [0％ (0/31) vs.8％ (3/36)]were also better than.

Expression and significance of vascular endothelial growth factors C and D in the tissue and serum of patients with gastric cancer / 中华消化外科杂志

Objective To investigate the expressions of vascular endothelial growth factor-C (VEGF-C) and vascular endothelial growth factor-D (VEGF-D) and their relationship with lymph node metastasis in gastric cancer. Methods Eighty patients with gastric cancer had been admitted to our department from January 2005 to December 2005, including 48 with local lymph node metastasis and 32 without local lymph node metastasis. Ten specimens of normal gastric mucosa from patients with gastric ulcer were used as control. The expression of VEGF-C and VEGF-D in serum and tissues were detected. Results The senun levels of VEGF-C and VEGF-D in patients with gastric cancer were significantly higher than those in the control group (χ2= 8.39, P < 0.05). The positive rate of the VEGF-C expression in the sermn of patients with gastric cancer was influenced by the lymph node metastasis (χ2 = 7.01, P < 0.05). The positive rates of the expressions of VEGF-C and VEGF-D in the gastric cancer tissue were 53% (42/80) and 63% (50/80), which were significantly higher than those in the normal gastric mucosa (χ2 =6.44, 6.58, P <0.05). The positive rate of the VEGF-C expression in the tissue of patients with gastric cancer was influenced by the lymph node metastasis (χ2=11.25, P <0.05). Conclusions The expression of VEGF-C is closely related to lymph node metastasis of gastric cancer. The serum levels of VEGF-C can be used as biologic markers in detecting lymph node metastasis of gastric cancer preoperatively.