Objective To detect twenty types/subtypes of respiratory viruses with the GeXP (genomelab genetic analysis system) based mRT-PCR (multiplex reverse transcription-polymerase chain reaction) assay,and discuss its value in pediatric respiratory viral infection.Methods A retrospective study was conducted on a total of 1 305 inpatient children (0-6 years old) admitted to the Department of Respiratory in Children's Hospital of Hebei Province from May 2014 to November 2014.The sputum samples were collected and the viral DNA or RNA was extracted.After examining the specificity and sensitivity,the GeXP-based mRT-PCR assay was performed to test 20 types/subtypes of respiratory viruses.The obtained results were evaluated in comparison with those of fluorescence real-time PCR and direct sequencing.Chisquare test was conducted by SPSS16.0.Results Among 1 305 hospitalized children,the positive rate of respiratory virus was 58.31％ (761/1 305).The positive rate of respiratory syncytial virus (RSV,17.32％,226/1 305) was the highest followed by the parainfluenza virus 3 (PIV-3,16.02％,209/ 1 305),human rhinovirus (HRV,11.95％,156/1 305),adenovirus (ADV,5.06％,66/1 305),human bocavirus (HBoV,3.14％,41/1 305) and the parainfluenza virus 1 (PIV-1,2.07％,27/1 305).Multiple virus infection was found in 92 children (7.05％).The highest positive rate of respiratory virus was observed in 1-2 years old children (83.28％,249/299);the lowest rate was found in 5-6 years old children (37.68％,26/69).Conclusions The proposed GeXP-based mRT-PCR assay possessed the advantage of high throughput,sensitivity,specificity and rapidity in the detection of twenty types/subtypes of respiratory viruses.It provided a thorough investigation of viral pathogens involved in acute respiratory infection thus could satisfy the clinic requirement and provide epidemic data on the disease prevention.

Objective To evaluate the protection of parathyroid glands in bilateral papillary thyroid cancer patients who underwent total thyroidectomy and bilateral central compartment dissection.Methods The clinical data of 78 patients undergoing total thyroidectomy and bilateral central compartment dissection between May 2013 and May 2014 were analyzed retrospectively.Results Among 78 patients,131 superior parathyroid glands were protected in situ,among those,112 parathyroid glands located at the level of inferior edge of parathyroid cartilage;19 parathyroid glands located in the superior 1/3 part of the back sides of the thyroid glands.All the superior parathyroid glands located in the superior and lateral-superior part of the 2 cm part down from the entrance of recurrent laryngeal nerve.A total of 110 inferior parathyroid glands were protected in situ,among those,57 glands located in the superior of inferior thyroid artery;24 glands located just on the surface of inferior thyroid artery;29 glands located below the superior of inferior thyroid artery.Three parathyroid glands were found in the dissected tissues and were implanted immediately.Seven parathyroid glands were found with post-operative pathologic examinations.During surgery,four parathyroid glands was found in 27 patients,three in 30 patients,two in 16 patients,and one in 5 patients.Conclusion For papillary thyroid cancer patients who underwent total thyroidectomy and bilateral central compartment dissection,identification of parathyroid glands and protection of blood supply to glands are the most effective methods to prevent hypoparathyroidism.

Objective:To study the risk factors of postoperative permanent hypoparathyroidism after total thyroidectomy.Methods:In this retrospective study ,the receiver operating characteristic (ROC) curve of postoperative 24 h parathyroid hormone(PTH) values was used to predict the risk of permanent hypoparathyroidism.The clinical and pathological features that related to postoperative permanent hypoparathyroidism were studied by χ2 test and multivariate Logistic regression analysis. Results:Eight hundred and eighty-nine patients were enrolled, the incidence of postoperative transient and permanent hypoparathyroidism was 33.3% and 4.0%, respectively. When 24 h PTH levels less than or equal to 5.84 pg/ml were used as cut off value, the sensitivity of the prediction of permanent hypoparathyroidism was 100%, the specificity was 72%, and the positive predictive value was 22.5%. The presence of parathyroid gland in the pathologic specimen, parathyroid autotransplantation and PTH≤5.84 pg/ml at 24 h after operation were statistically significant risk factor for permanent hypoparathyroidism in multivariate analysis( χ2=10.900, P=0.001; χ2=4.415, P=0.044; χ2=13.576, P=0.000). Group analysis found that the lower 24 h PTH the higher incidence of permanent hypoparathyroidism. Conclusions:For patients undergoing total thyroidectomy, when parathyroid gland is involved and/or the PTH value is low at 24 h after surgery, the occurrence of permanent hypoparathyroidism is high.

Objective To study the risk factors for postoperative hypoparathyroidism or hypocalcemia.Methods Totally 414 patients with thyroid diseases who underwent total or near total thyroidectomy at Department of Head and Neck Surgery,Peking University Cancer Hospital and Institute from June 2007 to June 2014 were studied retrospectively.There were 119 male and 295 female patients with a median age of 47 years.The clinical and pathological features that related to post-operative hypoparathyroidism were studied by x2 test and multivariate Logistic regression analysis.Results Of the 414 patients,36.2％ developed transient hypocalcemia,36.5％ developed transient hypoparathyroidism,2.2％ developed permanent hypoparathyroidism.In regression analysis,unilateral or bilateral center lymph node dissection were associated with mild transient hypocalcemia after surgery (OR =2.366,P =0.022;OR =5.216,P =0.000);unilateral or bilateral center lymph node dissection as well as surgical options were significant risk factors for severe transient hypocalcemia (OR =4.029,P =0.001;OR =8.384,P =0.000;OR=2.073,P =0.017) and hypoparathyroidism (OR =1.755,P =0.040;OR =4.144,P =0.000;OR =2.287,P =0.000).The parathyroid hormone concentration on postoperative day 1 was an independent risk factor for permanent hypoparathyroidism (OR =2.011,P =0.014).The concentration of parathyroid hormone threshold ＜ 5.28 ng/L was a predictor to permanent hypoparathyroidism with accuracy of 95.0％.Conclusions Bilateral center lymph node dissection is a risk factor of permanent hypoparathyroidism in patients received total thyroidectomy should be taken thoughtfully.The parathyroid hormone concentration on postoperative day 1 provides better prediction for persistent hypoparathyroidism.

Objective To study the risk factors for postoperative hypoparathyroidism or hypocalcemia.Methods Totally 414 patients with thyroid diseases who underwent total or near total thyroidectomy at Department of Head and Neck Surgery,Peking University Cancer Hospital and Institute from June 2007 to June 2014 were studied retrospectively.There were 119 male and 295 female patients with a median age of 47 years.The clinical and pathological features that related to post-operative hypoparathyroidism were studied by x2 test and multivariate Logistic regression analysis.Results Of the 414 patients,36.2％ developed transient hypocalcemia,36.5％ developed transient hypoparathyroidism,2.2％ developed permanent hypoparathyroidism.In regression analysis,unilateral or bilateral center lymph node dissection were associated with mild transient hypocalcemia after surgery (OR =2.366,P =0.022;OR =5.216,P =0.000);unilateral or bilateral center lymph node dissection as well as surgical options were significant risk factors for severe transient hypocalcemia (OR =4.029,P =0.001;OR =8.384,P =0.000;OR=2.073,P =0.017) and hypoparathyroidism (OR =1.755,P =0.040;OR =4.144,P =0.000;OR =2.287,P =0.000).The parathyroid hormone concentration on postoperative day 1 was an independent risk factor for permanent hypoparathyroidism (OR =2.011,P =0.014).The concentration of parathyroid hormone threshold ＜ 5.28 ng/L was a predictor to permanent hypoparathyroidism with accuracy of 95.0％.Conclusions Bilateral center lymph node dissection is a risk factor of permanent hypoparathyroidism in patients received total thyroidectomy should be taken thoughtfully.The parathyroid hormone concentration on postoperative day 1 provides better prediction for persistent hypoparathyroidism.

Objective: To investigate the diagnostic performance of fine-needle aspiration (FNA) cytology for the detection of lateral lymph node metastases in patients with papillary thyroid carcinoma (PTC). Methods: A total of 109 lateral lymph nodes with suspicious metastases from 85 patients were retrospectively subjected to FNAC, fine-needle aspiration thyroglobulin measurement (FNATg), and FNATg/SerumTg measurement. Lymph node pathological results after surgery were taken as the gold standard. Using Mann-Whitney U test, Pearson linear model and ROC curve were used for data analysis. Results: The sensitivity, specificity and accuracy of FNATg for the diagnosis of lateral neck lymph node metastasis were respectively 93.7%, 90.0% and 93.3% and those of FNATg/SerumTg were respectively 89.9%, 90.0% and 93.2% respectively, the threshold values for FNATg and FNATg/SerumTg were 0.925 ng/ml and 1.007, respectively. The sensitivity, specificity and accuracy of FNATg combined with FNAC were respectively 91.0%,93.5% and 94.4%. The existence of thyroid tissue and the expression of serum Tg did not affect the expression of lymph node FNATg. The FNATg cutoff value of 0.925 ng/ml showed the best diagnostic performance in patients with a thyroid gland, while the FNATg/SerumTg cutoff ratio of 14.95 showed the best diagnostic performance in patients without a thyroid gland. The serum TgAb significantly interfered with the expression of FNATg in the lateral neck metastatic lymph nodes (P=0.049). Conclusions FNATg alone or the combination of FNATg with FNAC are highly reliable in the diagnosis of lateral neck lymph node metastases in patients with PTC. The expression of TgAb may interfere with the accuracy of the diagnostic performance of FNATg.

Objective: To study the diagnostic value of a multi-gene molecular testing in cytologically indeterminate thyroid nodules. Methods: From February 2018 to September 2018, patients with thyroid nodules who underwent fine needle aspiration(FNA) at Peking University Cancer Hospital were enrolled. Three hundred and sixty patients were included, consisting of 86 men and 274 women, with a mean age of 45.8 years (between 13 and 89 years old). Among 391 nodules, 141 were cytologically inderminate and 75 were resected. FNA samples underwent prospective testing using a next-generation sequencing (NGS) assay, which included 16 genes for point mutations and 26 types of gene fusions. The testing results of indeterminate nodules were compared with surgical outcomes, to determine the diagnostic performance. The results were compared with the BRAF V600E single gene mutation analysis by χ² test. Results: The multi-gene testing showed a sensitivity of 73.2%, specificity of 96.8%, positive predictive value of 96.8%, and negative predictive value of 73.2%. The diagnostic accuracy of multi-gene testing was significantly higher than the BRAF V600E mutation test (83.3% vs 73.6%, χ²=31.588, P<0.01). Conclusion Multi-gene testing in FNA samples is an effective method to diagnose cytologically indeterminate thyroid nodules, which has a higher accuracy than BRAF V600E mutation detection.