Objective: To better understand the high-resolution ultrasound features of normal parathyroid glands for making correct diagnosis of parathyroid abnormalities and performing interventional therapy. Methods: Fifty normal adult volunteers were enrolled in this investigation on out-patient base. A high-resolution transducer (10 MHz) was used to scan their necks bilaterally from the upper pole of thyroid downwards closely to the clavicle. The shape, size, location, number and internal echoes of parathyroid gland were carefully documented. Results: One hundred and forty parathyroid glands were detected. Eight people had 4 glands detected(16%), 33 people 3 glands (66%), 7 people 2 glands(14%) and 2 had only 1 gland(4%) found. Among the 140 glands, 78(55.7%) were superior parathyroid glands(right 42 and left 36) and the rest 62(44.3%)were inferior parathyroid glands(right 33 and left 29). Conclusion: (1) 10 MHz high-resolution ultrasound can be used for detection of normal parathyroid glands. (2) In most cases the ultrasound findings are 3 parathyroid glands. The superior glands are more easily found than the inferior glands, and those inferior glands deep in the mediastinum can not be detected by ultrasound. (3) The knowledge of small size, oval or round shape, internal hypoechoes and the anatomic site of parathyroid gland helps the ultrasonographer to determine appropriately.

Objective: To investigate the ultrasonographic features of hyperplastic parathyroid glands in patients with secondary hyperparathyroidism. Methods: Fifty-nine uremic patients accompanied with hyperparathyroidism underwent high resolution parathyroid ultrasonography. On 3 of them ultrasound-guided parathyroid biopsies were performed. The ultrasonographic manifestations of the hyperplastic parathyroids were compared with the optical histology from biopsy. Results :(1) The overall detection rate of parathyroid glands was 83.1% by high resolution ultrasonography, and among those 93. 9% were found to have 1 to 2 glands detectable. (2) Five kinds of manifestations were found, among which the homogeneous internal hypoechoes and multiple hyperechoic rings of calcification in the parathyroid parenchyma were characteristic. (3) One patient showed coexistence of adenoma hyperechoes and hyperplasia hypoechoes in a single parathyroid gland. (4) Lithonephria occured in the transplanted kidney in a patient received renal treated by a successful transplantation, which was indicative of tertiary hyperparathyroidism. Conclusion: High resolution ultrasonography is sensitive and specific to detect the abnormalities of parathyroid glands in the patients with secondary hyperparathyroidism. It is complementary to the laboratory tests of serum parathyroid hormone and serum calcium, and it is valuable for the diagnosis and followup evaluation of hyperparathyroidism. It may be used for the screening of presence or future development of secondary hyperparathyroidism in uremic candidates.

Objective To observe the effect of daidzein on extracellular matrix of uremic rats and to discuss its mechanism.Methods Uremic rat model were established by 5/6 nephrectomized. Model rats were devided into daidzein group, control group. Rats with sham-operation were regarded as the normal control. At time of baseline, 4th and 8th week after operation, urinary protein and biochemical detection were measured. The pathologic changes, fibronectin (FN) and typeⅣcollagen (ColⅣ) were investigated at 8th week. The Western-Blot and RT-PCR were used to measure protein expression and mRNA transcription of TGF-β1. Results At 8th week after operation, the urinary protein (12.35 ± 2.13 mg/24 hvs. 19.93 ± 3.19 mg/24 h), serum urea (10.11 ± 0.65 mmol/Lvs.12.09 ± 0.78 mmol/L) and creatinine (68.10 ± 2.51μmol/Lvs.77.63 ± 3.20μmol/L) in the daidzein group decreased significantly than those in the control group (P<0.01). The deposition of ColⅣ (16.33% ± 2.14%vs. 24.68% ± 3.97%) and FN (19.17 ± 2.68 vs. 29.35 ± 4.15) in the daidzein group decreased significantly than those in the control group (P<0.01). Compared with control group, the pathological lesion in the daidzein group was less serious. The mRNA transcription (0.37 ± 0.06vs. 0.64 ± 0.08) and protein expression of TGF-β1 (0.28 ± 0.09vs. 1.40 ± 0.13) in the daidzein group were attenuated significantly than those in the control group (P<0.05). ConclusionsDaidzein had a beneficial effect on uremic rats. It may be associated with a decrease of extracellular matrix accumulation.

Objective To investigate the effect of genistein on deposition of extracellular matrix(ECM) in uremic rats and its mechanism.Methods The uremic rat model was established by 5/6 nephrectomy.The model rats were divided into the genistein group(G) and control group (C).The sham-operation group served as the normal control(S).Urinary protein and biochemical indexes before operation,at postoperative 4,8 weeks were measured in various groups.The pathologic changes of renal tissue were observed.The glomerular sclerosis index(GSI) was evaluated by the semi-quantitative method.fibronectin(FN) and type Ⅳ collagen (ColⅣ) deposition situation were detected by using the immunohistochemical method.Western blot and RT-PCR were used to measure the protein expression and mRNA transcription of TGF-β1.Results Comparing postoperative 4 weeks with the group C,the urinary protein excretion amount was decreased[(11.63 ± 2.07) mg/d vs.(19.93 ± 3.19) mg/d,all P＜ 0.01],serum urea nitrogen and creatinine levels of the group G were decreased[(9.39±0.59)mmol/L vs.(12.09±0.78)mmol/L,(65.11±3.79)mmol/L vs.(77.63±3.20)μmol/L,all P＜0.01].Until postoperative 8 weeks,the urinary protein excretion amount was decreased and the decrease of serum urea nitrogen and creatinine levels was more obvious.The deposition of ColⅣ and FN in renal glomerulus was lower than that of the control group[(17.30±1.96)％ vs.(24.68±3.97)％;(18.26±2.31)％ vs.(29.35±4.15)％,all P＜ 0.01].Glomerular sclerosis was significantly alleviated.The TGF-β1mRNA and protein expression were attenuated (P＜0.05).Conclusion Genistein can reduce the deposition of ECM in uremic rats and has a protective effect on kidney.