OBJECTIVE: To explore the changes of parathyroid hormone (PTH) and serum calcium alter total thyroidectomy and summarize the methods to prevent and treat the hypoparathyroidism and hypocalcernia. METHOD: Seventy-three patients with total thyroidectomy in our hospital were divided into three groups according to the scope of the operation. The serum concentrations of PTH and calcium were measured and compared before surgery and after surgery 1 h, 1 d, 3 d and 5 d. RESULT: In three groups, the serum concentrations of PTH and calcium were significantly decreased (P<0. 05) after surgery and low serum PTH and hypocalcemia occured. The severity of low serum PTH and hypocalcemia was as follows: total thyroidectomy with bilateral compartment lymph node dissection (CLND)>total thyroidectomy with unilateral CLND>total thyroidectomy. The differences were statistically significant. The levels of PTH after surgery 1 hour and 1 day were effective to predict hypocalcemia. CONCLUSION Total thyroidectomy can affect the parathyroid function. The greater the scope of surgery, the higher the possibility of postoperative hypoparathyroidism. The reasonable operative procedures and more protection of parathyroid during operation can reduce the incidence of hypoparathyroidism. The level of postoperative PTH can be used as a predictive index of hypocalcemia.
Calcium ; blood ; Humans ; Hypocalcemia ; blood ; Hypoparathyroidism ; blood ; surgery ; Incidence ; Lymph Node Excision ; Parathyroid Glands ; physiology ; Parathyroid Hormone ; blood ; Postoperative Period ; Thyroidectomy

Objective To compare the value for predicting prognosis between ENETS and AJCC TNM staging system in G-NEC patients.Methods Clinical data of 28 G-NEC cases from January 2005 to September 2015 in Tianjin Medical University General Hospital were analyzed and follow-up data were staged by he ENETS and AJCC TNM staging system.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by Log-rank test.Results Evaluated by ENETS TNM staging system on these 28 G-NEC patients,5 cases (18％) were classified at stage Ⅱ,20 cases (71％) were at stage Ⅲ,3 cases (11％) at stage Ⅳ,and significant difference in survival time was found between the three stages (P ＜ 0.05).By the AJCC TNM staging system,1 case (4％) was classified at stage Ⅱ,24 cases (86％) were at stage Ⅲ,and 3 cases (11％) at stage Ⅳ,and significant difference in survival time was found between three stages.Conclusions AJCC TNM staging system is more valuable for predicting prognosis of G-NEC,while the ENETS TNM staging system is more accurate in evaluating G-NEC biologic behavior.

This study is to investigate the transportation of scutellarin in cell and live models and study on mechanism of absorption and transport of scutellarin in mouse liver. The concentration of scutellarin in plasma and liver from control and pretreated groups was determined by high performance liquid chromatography. The uptake of scutellarin was examined in control hepatocytes group, induced hepatocytes group and induced hepatocytes plus pravastatin group. Pravastatin can affect the pharmacokinetics of scutellarin in mouse: CL is decreased while AUC is increased. The scutellarin absorption of hepatocyte induced group was higher than that of control group, but was decreased in the group with pravastatin added. The research showed that there was potential drug interaction between pravastatin and scutellarin. The drugs may compete for oatp2 mediated transport pathway consisted in the uptake of scutellarin in liver.

Objective:To investigate the role of TCF7L2 gene polymorphism and related mechanisms in postmenopausal women with type 2 diabetes mellitus (T2DM) who are at high risk for osteoporosis (OP) .Methods:148 postmenopausal women with T2DM from Jan. 2019 to Jun. 2020 were selected as study subjects. Among them, 86 patients combined with OP (T2DM+OP group) and 62 patients without OP (T2DM group) were included, and 100 healthy postmenopausal women who underwent physical examination in our hospital during the same period were included as the control group. Fasting venous blood was extracted to detect clinical and bone metabolism indicators. Two SNP sites of TCF7L2, rs7901695 (T>C) and rs290487 (C>T) , were genotyped by capillary electrophoresis and section analysis (SNaPshot) . The relative mRNA expression of TCF7L2 gene was determined by quantitative real-time fluorescence quantitative PCR assay. To investigate the effects of overexpression and silencing of TCF7L2 on proliferation of rat osteoblasts, lentiviral vectors were constructed.Results:For rs7901695, TT, TC and CC genotypes in T2DM+OP group, T2DM group and control group were significantly different ( χ2=12.545, P=0.014) , and the frequency distribution of T and C alleles was significantly different among the three groups ( χ2=17.089, P<0.001) . For RS290487, CC, CT and TT genotypes of T2DM+OP group, T2DM group and control group were significantly different ( χ2=10.500, P=0.033) , and the frequency distribution of C and T alleles was significantly different among the three groups ( χ2=14.665, P=0.001) . For rs7901695, FPG and TG levels in T2DM+OP patients with CC+TC genotype were significantly higher than those with wild-type TT genotype (FPG: t=2.559, P=0.014; TG: t=2.034, P=0.036) , while serum calcium and 25OHD3 levels were significantly lower than those with Wild-type TT genotype (calcium: t=3.889, P<0.001; 25OHD: t=4.112, P<0.001) . For rs290487 site, serum calcium, BGP and 25OHD3 levels in T2DM+OP patients with TT+CT genotype were significantly lower than those with wild-type CC genotype, and the difference was statistically significant (calcium: t=3.751, P<0.001; BGP: 2.731, P=0.007; 25OHD3: t=3.225, P=0.002) . The relative mRNA expression level of TCF7L2 gene in T2DM+OP patients was significantly lower than that in T2DM group and the control group ( F=5.735, P<0.05) . With the increase of Allele C at rs7901695, the relative mRNA expression level of TCF7L2 gene decreased gradually ( F=5.723, P<0.05) . In addition, the proliferation rate of rat osteoblasts overexpressed by TCF7L2 was significantly increased, while the proliferation level of TCF7L2 silenced osteoblasts was significantly decreased ( F=7.846, P<0.05) . Conclusion:In postmenopausal WOMEN with T2DM, the variation of TCF7L2 gene will lead to the decrease of gene expression level, and the suppression of osteoblasts proliferation, thus participate in the pathogenesis of OP.

Clinical records of a patient with olfactory neuroblastoma presented with hyponatremia as initial symptoms were analyzed and the literatures were reviewed. At initial onset, the patient presented with hyponatremia. After pathological examination, the diagnosis was olfactory neuroblastoma. The blood sodium has been normal after operation and radiotherapy. The incidence rate of olfactory neuroblastoma is low, and it is easily misdiagnosed. Its diagnosis relies on pathological examination. We should pay more attention to the unspecific symptoms of patients with hyponatremia, which can help to improve early diagnosis and the prognosis.
Esthesioneuroblastoma, Olfactory ; complications ; pathology ; Humans ; Hyponatremia ; etiology ; Nasal Cavity ; pathology ; Nose Neoplasms ; complications ; pathology ; Prognosis

ObjectiveTo observe the clinical efficacy of electroacupuncture plus herbal-partitioned moxibustion in treating temporomandibular joint disorder.MethodNinety patientswith temporomandibular joint disorder were randomized into a treatment group of 45 cases and a control group of 45 cases. The treatment group was intervened by electroacupuncture plus herbal-partitioned moxibustion, while the control group was by medication. The therapeutic efficacy was evaluated after 3 treatment courses by a specially-assigned person.ResultThe recovery rate and total effective rate were respectively 64.4% and 97.8% in the treatment group versus 37.8% and 82.2% in the control group, andthe total effective rate and recovery rate in the treatment group were significantly higher than that in the control group (P<0.05); regarding the comparison of the efficacy and treatment duration of the recovered subjects, the recovery rates at the end of the 1st course, 2nd course and 3rd course in the treatment group were all markedly higher than that in the control group (P<0.05), indicating that electroacupuncture plus herbal-partitioned moxibustion can shorten the period of treatment for temporomandibular joint disorder. The therapeutic efficacy of the treatment group was significantly superior to that of the control group(P<0.05).ConclusionElectroacupuncture plus herbal-partitioned moxibustion can produce a significant efficacy in treating temporomandibular joint disorder.

Objective To observe early histopathological changes in explosive wounds at canine limbs after seawater inmersion.Methods Forty adult dogs,weighing 10 to 15 kg each,were assigned into 2 equal groups.The left hind limb of each dog in both groups was injured by a man-made explosion.The explosive wound was first washed by normal sodium.The 20 injured limbs in the experimental group (EG)were immersed in seawater for one hour while those in the control group (CG) were only exposed naturally for one hour without seawater immersion.All the wounds were covered with sterile dressing without suture.The pus and soft tissue at the wound were taken for pathological examination,bacterial culture and drug sensitivity test on day 3.The time of wound healing was recorded.Tissue sections were taken from the wounds for pathological examination at 4 and 8 weeks.Results Fifteen wounds (75％) were infected in the EG,significantly more than the 8 wounds infected (40％) in the CG( P ＜ 0.05).The wounds healed in a mean time of 38.4 days in the EG,significantly longer than the mean time for wound healing (23.1 days) in the CG ( P ＜ 0.05).In the EG,Vibrio infection caused more serious tissue necrosis and inflammatory reaction than Bacillus and coccus did.At 4 and 8 weeks,tissue necrosis and inflammatory reaction in the EG were worse than those in the CG.Conclusion Seawater immersion can lead to increased infective tissue necrosis and inflammatory reaction in an explosive wound,as well as longer time for wound healing.

[Objective]To investigate the clinical effects of the treatment of thoracolurnbar fracture with pedicle screw system under endoscopy assisted X-tube system.[Method]Twenty-one cases of pure thracolumbar fracture without neural impairment were treated with pedicle screw system under endoscopy assisted X-tube system.With the image intensifier,the pedicle based in the affected segments were localized and exposed through 4 small incisions(3cm).Transpedicular fixation and reduction by endoscopy assisted X-tube system were performed through the 4 small incisions.[Result]Twenty-one cases were followed up for 12-18 months(averaged,14 months).Radiography showed good reduction fixation of the vertebral bodies,good correction of the kyphosis deformities and good restoration of lumbar motion.[Conclusion]The treatment of thoracolumbar fracture with pedicle screw system under endoscopy assisted X-tube system is indicated for thoracolumbar fracture without neural impairment.This technique has advantages of minimal invasion and early functional recovery.

Objective To explore the significance of peritubular capillary C4d deposition in the diagnosis, treatment and prognosis of the patients with acute renal allograft rejection.Methods 86 allograft biopsies obtained from 78 kidney transplants were examined by immunohistochemistry on routine paraffin sections using anti-C4d polyclonal antibody. The relationship of C4d and functions, therapies and prognoses of allografts was analyzed. Results There were 32 allograft biopsies with Banff type Ⅰ rejection, 51 with Banff type Ⅱ rejection and 3 with Banff type Ⅲ rejection. Thirty biopsies were positive in C4d deposition. For 28 patients, at least one biopsy exhibited peritubular C4d deposition. There was no significant difference between type Ⅰ and type Ⅱ rejection ( 21.9 % vs 39.2 % , P= 0.101 ). The C4d~ + group had proportionately more patients with pregnant history (P= 0.020 ), more patients with high panel-reactive antibody levels (P= 0.013 ), and more retransplanted patients (P= 0.016 ). Mean serum creatinine was significantly higher in C4d positive patients than in negative patients[( 312.56 ? 196.26 ) ?mol/L vs ( 210.97 ? 136.59 ) ?mol/L, P= 0.0115 ]. Patients with C4d deposition were more commonly resistant to antirejection therapy with bolus steroids ( 75.0 % vs 28.0 % , P= 0.000 ) and ATG ( 66.7 % vs 12.5 % , P= 0.027 ). More patients with peritubular C4d deposition lost their grafts during the study period (64.3 % vs 90.0 %, P= 0.006 ).Conclusion Acute rejection with C4d deposition were resistant to antirejection therapy with steroids and/or ATG, and associated with inferior graft outcome.