Objective To explore the risk factors of early hypocalcemia after endoscopic thyroidectomy by breast approach(ETBA)and establish a predictive model to evaluate its occurrence risk.Methods A total of 155 patients with thyroid nodules who underwent ETBA were selected.Patients were divided into the low calcium group(＜2 mmol/L,n=41)and the normal group(≥2 mmol/L,n=114)according to the serum calcium level 24 hours after the operation.Before the operation,thyroid function and parathyroid hormone(PTH)were detected,and ultrasound was performed to evaluate cervical lymph node enlargement.Meanwhile,nodule location,maximum tumor diameter,nodule adhesion to the capsule,calcification and the edge of the nodule were also detected.The surgical conditions such as gland resection(unilateral or bilateral),operation time and misresection of parathyroid glands were recorded.PTH and serum calcium were detected 24 hours after the operation.Pathological assessment was used to evaluate benign and malignant conditions,Hashimoto's thyroiditis,multifocal lesions,thyroid capsule invasion and lymph node metastasis.Results Compared with the normal group,the cervical lymph node metastasis,malignant nodules,multifocal lesions,cervical lymph node enlargement,bilateral gland resection,parathyroid gland resection by mistake,combined Hashimoto's thyroiditis,maximum tumor diameter and operation time were increased in the hypocalcemia group,but PTH at 24 hours after the operation was decreased(P＜0.05).Multivariate Logistic regression analysis showed that cervical lymph node metastasis,long operation time,parathyroid resection by mistake,combined Hashimoto's thyroiditis and maximum tumor diameter were independent risk factors for early hypocalcemia in ETBA.Based on this,a visual nomogram model was constructed,with excellent discrimination[the area under the receiver operating characteristic(ROC)curve was 0.920(95%CI:0.834-0.971)],and the calibration curve showed that the predicted values were highly consistent with the measured values(Hosmer-Lemeshow χ2=0.007,P=0.087).Conclusion The nomogram model constructed based on multivariate Logistic regression can effectively predict the risk of early hypocalcemia after ETBA.

Objective To explore the risk factors of early hypocalcemia after endoscopic thyroidectomy by breast approach(ETBA)and establish a predictive model to evaluate its occurrence risk.Methods A total of 155 patients with thyroid nodules who underwent ETBA were selected.Patients were divided into the low calcium group(＜2 mmol/L,n=41)and the normal group(≥2 mmol/L,n=114)according to the serum calcium level 24 hours after the operation.Before the operation,thyroid function and parathyroid hormone(PTH)were detected,and ultrasound was performed to evaluate cervical lymph node enlargement.Meanwhile,nodule location,maximum tumor diameter,nodule adhesion to the capsule,calcification and the edge of the nodule were also detected.The surgical conditions such as gland resection(unilateral or bilateral),operation time and misresection of parathyroid glands were recorded.PTH and serum calcium were detected 24 hours after the operation.Pathological assessment was used to evaluate benign and malignant conditions,Hashimoto's thyroiditis,multifocal lesions,thyroid capsule invasion and lymph node metastasis.Results Compared with the normal group,the cervical lymph node metastasis,malignant nodules,multifocal lesions,cervical lymph node enlargement,bilateral gland resection,parathyroid gland resection by mistake,combined Hashimoto's thyroiditis,maximum tumor diameter and operation time were increased in the hypocalcemia group,but PTH at 24 hours after the operation was decreased(P＜0.05).Multivariate Logistic regression analysis showed that cervical lymph node metastasis,long operation time,parathyroid resection by mistake,combined Hashimoto's thyroiditis and maximum tumor diameter were independent risk factors for early hypocalcemia in ETBA.Based on this,a visual nomogram model was constructed,with excellent discrimination[the area under the receiver operating characteristic(ROC)curve was 0.920(95%CI:0.834-0.971)],and the calibration curve showed that the predicted values were highly consistent with the measured values(Hosmer-Lemeshow χ2=0.007,P=0.087).Conclusion The nomogram model constructed based on multivariate Logistic regression can effectively predict the risk of early hypocalcemia after ETBA.

Objective:To compare the efficacy of traditional open thyroidectomy and modified Miccoli in the treatment of benign thyroid diseases.Methods:The data of 343 patients with benign thyroid disease in Xi′an Central Hospital and Xi′an Third Hospital were retrospectively analyzed. According to the surgical method, the patients were divided into the observation group (modified Miccoli operation, n=169) and the control group (traditional open operation, n=174). The operation effect, postoperative recovery, patient satisfaction, postoperative complications and recurrence within 1 year of follow-up were compared between the two groups.Count data were represented by n(%), measurement data consistent with normal distribution were represented by Mean± SD, and non-normal data were represented by M( P25, P75). T test or Wilcoxon rank sum test were used to compare the measurement data between groups according to their distribution characteristics. Comparison of statistical data between groups was made by chi-square test. Results:The intraoperative blood loss and postoperative drainage volume of the patients in the observation group were 26.2 (6.9, 40.8) ml and (33.4±8.6) ml, respectively, which were significantly less than those in the control group 50.6 (37.5, 63.7) ml and (35.7±9.5) ml (all P<0.05). The postoperative recovery time in the observation group was (3.9±2.8) d, which was significantly shorter than that in the control group (5.1±2.4) d ( P=0.001). Postoperative complications such as hoarseness, subcutaneous ecchymosis, scar formation and decreased parathyroid function were significantly different between the two groups ( P<0.05). The recurrence rate of 7.69% in the observation group was significantly lower than that of 19.54% in the control group 12 months after operation ( P<0.05). Conclusions:The modified Miccoli in the treatment of benign thyroid diseases not only has the advantages of less trauma, faster postoperative recovery, less pain and higher patient satisfaction, but also has lower postoperative complications and recurrence rate, which is worthy of clinical promotion and application.

Objective To discuss the clinical effect of transurethral cystitis glandularis electrocision combined with treating the diseases under bladder outlet in female.Methods One hundred and two female cases of cystitis glandularis who received transurethral electrical resection of the bladder mucosa combined with treating the diseases under bladder outlet were selected as experimental group,and another 78 female cases were selected as control group,who only received transurethral electrical resection of the bladder mucosa.The visual analogue score (VAS) was observed before and after a 12-week treatment,and the efficacy was evaluated by analysis of non parameter RIDIT.Results The operation time in experimental group and control group were 15-40 (26 ± 13) min and 8-19 (13 ± 5) min,respectively,and there was significant difference between two groups (P ＜ 0.05).Two groups cases urinated smoothly after the removal of catheter,without the occurrences of urinary fistula and incontinence.During the 12-weeks of follow-up,44 cases were cured,31 cases improved,15 cases were effective and 12 cases unimproved in experimental group; 26 cases were cured,21 cases improved,16 cases were effective and 15 cases unimproved in control group.There was significant difference between two groups (R =0.576,95％ CI0.519-0.633,P＜ 0.05).Conclusion Although the operation time is lengthened by transurethral cystitis glandularis electrocision combined with treating the diseases under bladder outlet in female,this method obviously improves curative effect.

Objective To evaluate the changes of urodynamics in female patients with diabetic cystopathy.Methods Fifty six female patients with diabetic cystopathy were enrolled in the study , including 31 cases with diabetic course <15 years ( groupⅠ) and 25 cases with diabetic course ≥15 years ( group Ⅱ) .Urodynamic examination was performed in all patients and the urodynamic parameters were compared between two groups.Results The average residual urine volume , the volume of first bladder sensation and the max bladder capacity in groups ⅠandⅡwere (35 ±16)ml and (65 ±24) ml,(220 ± 76)ml and (330 ±88) ml, (380 ±92) ml and (580 ±122) ml, respectively; 3 out 31 and 16 out of 25 patients in groups Ⅰ and Ⅱ showed low compliance .The above indexes between two groups were statistically significant ( P<0.01).Conclusion Urodynamics can indicate the severity of functional damage of urinary bladder in patients with diabetic cystopathy .

Chitosan has natural abundance, unique bioactivity and attractive physicochemical properties. Recent years, the synthesis of chitosan-based metal nanomaterials has attracted increasing attention. The synthesis of metal nanoparticles utilizing biomolecular or organism offers a mild medium, and thus a greater degree of control over the nanoparticles produced, along with higher reproducibility. In particular, preparation of metal nanoparticles based on biomolecular or organism has its unique facility in integrating "minimum feature sizes" into labile biological components to an excellent synergy and bifunctional effect and consequently a more broad application. Herein, we review the new development of chitosan, chitosan-based synthesis of metal nanomaterials, and their application.
Catalysis ; Chitosan ; chemistry ; Metal Nanoparticles ; chemistry ; Oxidation-Reduction