Chronic kidney disease,especially in patients with end-stage renal disease (ESRD),is prone to causing secondary hyperparathyroidism,and part of refractory secondary hyperparathyroidism patients require treatment with parathyroidectomy.Parathyroidectomy makes the thyroid inevitably subject to mechanical stimulation,leading to transient mechanical thyroiditis,hyperthyroxinemia and postoperative transient thyrotoxicosis,causing dysfunction in multiple systems of the body,and even inducing or aggravating water and electrolyte disorders (such as hyperkalemia),arrhythmia and cardiovascular events.However,this complication has not yet received sufficient clinical attention.This article will discuss the prevention and treatment of thyrotoxicosis or hyperthyroidism,one of the postoperative complications,in secondary hyperparathyroidism patients with ESRD,based on the relevant documents and our own clinical practice.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.