Objective Previously, there was an argument on the surgery way of unilateral papillary thyroid microcarcinoma(PTMC).The purpose of this study was to investigate the predictive factors of occult thyroid carcinoma in unilateral thyroid papillary microcarcinoma, and to compare the surgical methods of unilateral thyroid papillary microcarcinoma.Methods We retrospective analyzed 327 cases of unilateral PTMC patients confirmed by preoperative color Doppler ultrasound examination from January 2014 to January 2016 in Department of Breast Surgery, First Affiliated Hospital of Harbin Medical University.According to the presence of occult cancer, patients were divided into unilateral glandular foci (n=278) and bilateral glandular foci(n=49);according to whether carry out the prevention of central lymph node dissection, patients were divided into lymph node dissection(n=117) and without lymph node dissection(n=210) to further analyze the predictive factors of contralateral gland occult cancer and postoperative complications of preventive central lymph node dissection.Results 55 cases had central lymph node metastasis in 117 cases with lymph node dissection, the metastasis rate was 47.0%.The multiple foci in the ipsilateral gland is a risk factor for the presence of occult foci in the contralateral gland (OR=4.924, 95%CI: 1.605~15.107).There was no significant difference in postoperative complications between lymph node dissection and without lymph node dissection(P>0.05).Conclusion multiple foci in the unilateral thyroid papillary thyroid microcarcinoma can help us to predict the contralateral gland occult cancer, and the central lymph node metastasis rate is higher, therefore, for the unilateral glands of multiple tumors in the papillary thyroid microcarcinoma, we recommended the total thyroidectomy+prophylactic central lymph node dissection surgery way.

Thyroidectomy is an effective treatment for thyroid diseases,especially thyroid malignancies.The postoperative phonological disturbances in patients with recurrent laryngeal nerve injury caused by vocal cord paralysis have been recognized.However,in clinical work,many patients in the absence of recurrent laryngeal nerve injury in the case of postoperative speech changes.With the development of modern electronic acoustics detection technology,the quality of postoperative recurrent laryngeal nerve injury patients with quantitative research,to explore and found that recurrent laryngeal nerve injury after thyroid surgery is not the voice of the factors.

Objective:To investigate the clinical efficacy of parathyroidectomy for secondary hyperparathyroidism (SHPT), and to analyze the changes and trends of perioperative intact parathyroid hormone (iPTH), serum calcium and serum phosphorus, and the predictive value of intraoperative parathyroid hormone (ioPTH) measurement for surgical completion. To provide practical theoretical basis and reference for postoperative treatment of SHPT.Methods:Data of 479 SHPT patients admitted to the First Hospital of Harbin from Dec. 2012 to Dec. 2022 were retrospectively analyzed. According to the admission criteria, 457 patients were screened out and divided into PTX group and incomplete PTX group based on whether the level of postoperative parathyroid hormone was reduced to the normal standard. The levels of iPTH, serum calcium and phosphorus during the perioperative period in the two groups were statistically analyzed. SPSS 26.0 statistical software was used for data processing. P<0.05 indicated statistically significant difference. Results:In the analyzed group of 457 patients, the average age was (45.43±11.25) years and the average dialysis age was (90.3±35.8) months. Hypercalcemia, hyperphosphatemia, hyperkalemia and high alkaline phosphatase levels accounted for 41.79%, 94.31%, 20.35% and 75.50%, respectively. Bone loss and osteoporosis accounted for 35.45% and 62.36%, respectively. The incidence of restless leg syndrome was 7.67%. IoPTH and post-operative iPTH level in the PTX group were significantly lower than those in the incomplete PTX group ( P=0.001, P<0.001). IoPTH≤150 pg/mL can predict surgical success, and 58.33% of cases can predict surgical failure by ioPTH being 30% higher than preoperative iPTH. There were significant differences in serum calcium and phosphorus levels between the two groups at 3 hours and 2 days after operation. The incidence of hypocalcemia was 43.19% and 82.49% on the day of operation and within 3 days after operation, and the incidence of hungry bone syndrome was 62.12% in the PTX group. The incidence of postoperative hyperkalemia, arteriovenous fistula thrombosis, temporary hoarseness, bleeding and in-hospital mortality was 43.33%, 1.75%, 0.66%, 0.44% and 0.22%, respectively. Conclusions:Parathyroidectomy is an effective and safe treatment for secondary hyperparathyroidism, and ioPTH plays an important role in predicting the success of surgery. Timely and effective calcium supplementation is an important measure to prevent the serious occurrence and morbidity of bone hunger syndrome.

Objective:To evaluate the effect of linaclotide combined with compound polyethylene glycol (PEG) on bowel preparation for colonoscopy.Methods:This trial was a multicenter randomized controlled study. Subjects scheduled for colonoscopy in 3 digestive endoscopy centers of The First Affiliated Hospital of Naval Medical University, Shanxi Province People's Hospital and the 900th Hospital of Joint Logistics Support Force from November 2021 to March 2022 were randomly assigned to 3 groups using completely random method. The bowel preparation of group A was 3-day linaclotide with 3 L PEG, that of group B was only 3 L PEG, and group C was 3-day linaclotide with 2 L PEG. The primary outcome was the rate of adequate bowel preparation, and the secondary outcomes were the rate of excellent bowel preparation, the completion rate of bowel preparation and the willingness to repeat the corresponding bowel preparation regimen.Results:A total of 130 subjects were enrolled, including 46 in group A, 43 in group B, and 41 in group C. There was no significant difference among the 3 groups in the rate of adequate bowel preparation [95.7% (44/46), 93.0% (40/43) and 95.1% (39/41), χ2=0.465, P=0.893], the rate of excellent bowel preparation [43.5%(20/46), 25.6% (11/43) and 34.1% (14/41), χ2=3.151, P=0.207], or the completion rate of bowel preparation [95.7% (44/46), 95.3% (41/43) and 100.0% (41/41), χ2=1.909, P=0.544]. However, there were significant differences in the willingness to repeat the corresponding bowel preparation regimen among the 3 groups [89.1% (41/46), 74.4% (32/43) and 100.0% (41/41), χ2=12.862, P=0.002]. The bowel preparation completion and willingness rate of subjects in group C were both 100.0%, which were higher than those in group A and group B. Conclusion:Linaclotide is able to improve the quality of bowel preparation and reduce the amount of PEG.