2.Efficacy of simple aspiration combined with PTH rapid measurement on non-functional parathyroid cysts
Hao HU ; Xianghui HE ; Qing HE ; Jie ZHANG
Chinese Journal of Endocrine Surgery 2024;18(1):144-146
Currently, the main treatments for nonfunctional parathyroid cysts (NFPC) are fluid aspiration,sclerosing injection and surgical removal. The choice of treatment method is controversial. Eight patients with NFPC who were treated by simple aspiration combined with parathyroid hormone (PTH) rapid determination in General Surgery Department of Tianjin Medical University General Hospital from Dec. 2020 to Oct. 2022 are reported to provide a reference for the choice of treatment, which can also reduce surgical pain and accidental sclerosing injury.
3.Incidence and influencing factors of non-alcoholic fatty liver disease among rural Uyghur ethnic group residents in Xinjiang Production and Construction Corps
Caiyin LI ; Shuxia GUO ; Yu LI ; Heng GUO ; Rulin MA ; Xianghui ZHANG ; Xinping WANG ; Yunhua HU ; Keerman MULATIBIEKE ; Shipeng GAO ; Jia HE
Chinese Journal of Epidemiology 2024;45(8):1149-1157
Objective:To investigate the incidence characteristics and influencing factors of non-alcoholic fatty liver disease (NAFLD) in rural Uyghur ethnic group residents in Xinjiang Production and Construction Corps and to provide scientific evidence for early identification and prevention of NAFLD for residents.Methods:A total of 10 158 participants were included from the Xinjiang Uygur ethnic group population cohort. A prospective cohort study and Cox proportional hazards regression model analysis were used to explore the influencing factors and clustering of NAFLD, and the dose-response relationship between related biochemical indicators and the risk of NAFLD was studied using a restricted cubic spline.Results:The cumulative incidence rate of NAFLD was 6.9%, and the incidence density of NAFLD was 12.06/1 000 person-years. The incidence density of NAFLD in females was higher than in males (14.72/1 000 person-years vs. 9.17/1 000 person-years, P<0.001). The incidence density of NAFLD gradually increased with age in the total population, both men and women (all P<0.001). In the general population, an education level of junior high school or above was a protective factor for NAFLD, while older age, divorce, widowhood, overweight, obesity, hypertension, increased glomerular filtration rate, decreased HDL-C, increased LDL-C, and increased ALT were risk factors for NAFLD. Estimated glomerular filtration rate (eGFR), HDL-C, LDL-C, and ALT were non-linearly correlated with the incidence of NAFLD, and there was a significant dose-response relationship between them. Only 19.1% of residents had no NAFLD risk factors; over 80.9% had ≥1 NAFLD risk factors. The risk of NAFLD increased with the number of risk factors. Conclusions:The incidence of NAFLD in rural Uygur ethnic group residents in Xinjiang Production and Construction Corps was relatively low, but most residents had one or more risk factors for NAFLD. Prevention and control of NAFLD in this population cannot be ignored. In addition, people of older age, divorced or widowed, low education level, overweight or obese, hypertension, and abnormal eGFR, HDL-C, LDL-C, and ALT were the high-risk groups of NAFLD that need to be paid attention to in this population.
4.Clinical analysis of 29 cases of primary hyperparathyroidism with multiglandular disease of the parathyroid glands
Xiwen MAO ; Ziyu LIU ; Fuxin LI ; Ke ZHAO ; Xianghui HE
Chinese Journal of Endocrine Surgery 2024;18(4):494-499
Objective:To investigate the clinical features, diagnostic methods, treatment modalities, and prognosis of parathyroid multiglandular disease (PTMGD) in primary hyperparathyroidism (PHPT) .Methods:The clinical data of 29 patients with PTMGD who underwent surgery at the General Surgery Department of the Tianjin Medical University General Hospital from Dec. 2015 to Jul. 2023 were retrospectively analyzed, including the patients' preoperative and postoperative blood calcium and parathyroid hormone, the main clinical manifestations, the involvement of other systems, the main types of pathology, the accuracy of the various examinations, and the postoperative prognosis, etc., and were compared with the 291 patients who had undergone surgery for single-glandular lesion patients were compared. SPSS25 was used to analyze the data.Results:The age of onset of PTMGD was 52.7±1.9 years compared to 56.6±0.7 years in patients with monoglandular disease, P=0.047. Tumor diameter of PTMGD was (2.05±0.1) cm and (2.34±0.6) cm of monoglandular disease, P=0.006. The preoperative blood calcium was (2.56±0.59) mmol/L in PTMGD and (2.70±0.58) mmol/L in monoglandular disease, P=0.045. Preoperative parathyroid hormone (PTH), blood calcium, and Win values were positively correlated with maximum tumor diameter in patients with PTMGD (R-values of 0.362, 0.223, and 0.352, respectively) .Neck ultrasound, neck-enhanced CT and parathyroid nuclear imaging were used to localize and diagnose the diseased parathyroid glands in this group of cases.The accuracy rates were (14/25) 56%, (10/19) 53% and (11/24) 46% in patients with PTMGD, while in patients with monoglandular disease, the accuracy rates were (233/250) 89%, (131/152) 96% and (223/232) 86%. PTMGD accuracy rate was less than that of monoglandular disease,and was statistically significant ( P-value was less than 0.001 in all cases) .The accuracy of the combined localization diagnosis of the three tests in patients with PTMGD was then improved to (13/18) 72%. The pathology of PTMGD was predominantly parathyroid hyperplasia, 45/72 (63%), compared to that of monoadenopathy 18/291 (6%), P<0.001. Parathyroid adenomas predominated in patients with monoadenopathy compared to that of PTMGD, 237/291 (82%) vs. 24/72 (33%), and the proportion of parathyroid adenomas in patients with monoadenopathy was higher than that in patients with PTMGD, P<0.001. 23 patients with PTMGD were followed up, of whom 9 showed mild elevation of parathyroid hormone postoperatively, and 1 patient showed signs of hypoparathyroidism. Conclusion:The low age of onset of multiglandular lesions in primary hyperparathyroidism, mild biochemical tests, and the difficulty of accurately locating all lesions preoperatively warrant adequate preoperative evaluation to promptly identify patients with familial multiple endocrine adenomas, as well as intraoperative bilateral parathyroid exploration in patients with suspected multiglandular lesions.
5.Department of Clinicopathological analysis of papillary thyroid carcinoma with Hashimoto’s thyroiditis
Zhigang TIAN ; Li CHEN ; Ziyu LIU ; Yuting LE ; Lanning JIA ; Yue HAN ; Xianghui HE
Chinese Journal of Endocrine Surgery 2023;17(1):24-28
Objective:To discuss the effect of Hashimoto’s thyroiditis (HT) on papillary thyroid carcinoma (РТС) .Methods:The clinical features and pathological characteristics of 682 patients who underwent surgical treatment for the first time from Sep. 1st,2019 to May. 1st, 2021 in Department of Thyroid, Breast and Hernia Surgery, and confirmed by postoperative pathology as papillary thyroid carcinoma were retrospectively analyzed. There were 189 male patients, and 493 female patients, 529 patients < 55 years old and 153 patients ≥55 years old. 476 patients were classified as PTC group and 206 patients as PTC combined with HT group. Chi square test was used to compare the difference between two groups in gender, age, thyroglobulin antibody, thyroid stimulating hormone, thyroid peroxidase antibodies, thyroid peroxidase, number of lesions, metastasis lymph node in central region, thyroid stimulating hormone receptor antibody, carcinoembryonic antigen, whether microcarcinoma, vascular invasion, glandular outside violation, capsule and lateral transfer analysis, ultrasonic calcification, etc. At the same time, all patients were divided into the group without central lymph node metastasis (345 cases) and the group with central lymph node metastasis (337 cases) . The χ 2 test was used to compare the differences between the two groups in terms of sex, age, number of lesions, microcarcinoma, vascular invasion, extradular invasion, capsular invasion, lateral cervical lymph node metastasis, ultrasonic calcification and so on, so as to analyze the differences in clinical characteristics between the two groups. Results:There were 206 cases (30.21%) in PTC combined with HT group and 476 cases (69.79%) in PTC without HT group. There were significant differences in gender (12/194 vs 177/299) ( P=0.000) , age (175/31 vs 354/122) ( P=0.002) , TgAb (115/91 vs 455/21) ( P=0.000) ,TSH (13/175/18 vs 33/429/14) ( P=0.004) , TPOAb (90/116 vs 422/54) ( P=0.000) , number of lesions (114/92 vs 325/151) ( P=0.001) and lymph node metastasis in central area (87/119 vs 250/226) ( P=0.014) between the two groups ( P < 0.05) , but there were no significant differences in TRAb (196/10 vs 461/15) ( P=0.171) , CEA (205/1 vs 469/7) ( P=0.478) , microcarcinoma (136/70 vs 309/167) ( P=0.781) , vascular invasion (4/202 vs 16/460) ( P=0.446) , extraglandular invasion (52/154 vs 108/368) ( P=0.470) , capsule invasion (149/57 vs 358/118) ( P=0.429) , lateral neck lymph node metastasis (31/175 vs 72/404) ( P=0.979) or ultrasonic calcification (157/49 vs 392/84) ( P=0.063) . Compared with PTC group, PTC combined with HT group had the characteristics of more women, younger age, high TgAb, high TSH, high TPOAb, multiple lesions and high proportion of non central lymph node metastasis. There were 345 cases (50.59%) without central lymph node metastasis and 337 cases (49.41%) with central lymph node metastasis. Gender (71/274 vs 118/219) ( P=0.000) , age (246/99 vs 283/54) ( P=0.000) , exadular invasion (66/279 vs 94/243) ( P=0.007) , number of lesions (240/105 vs 199/138) ( P=0.004) , microcarcinoma (259/86 vs 186/151) ( P=0.000) , calcification on ultrasound (250/95 vs 299/38) ( P=0.000) , and HT (119/226 vs 87/250) ) ( P=0.014) had statistical significance ( P<0.05) but had no statistical significance in capsule invasion (250/95 vs 257/80) ( P=0.256) or vascular invasion (10/335 vs 10/327) ( P=0.958) . In addition, patients in the group with central lymph node metastasis were more male, younger, with multiple lesions, exadenocarcinoma, less microcarcinoma, and calcification on ultrasound without hashimoto. Univariate analysis showed that gender, age, number of lesions, extraglandular invasion, calcification, microcarcinoma and Hashimoto had significant effects on lymph node metastasis in the central region; Multivariate analysis showed that the presence of microcarcinoma, ultrasonic calcification, Hashimoto and the number of lesions were independent risk factors for central lymph node metastasis. Conclusion:HT may promote the occurrence of PTC, but at the same time inhibit its development, so that PC patients with HT have a better prognosis.
6.Prospective cohort study of the association of cardiovascular disease with triglyceride glucose index and triglyceride glucose-related indicators
Shulin WANG ; Xianghui ZHANG ; Heng GUO ; Jia HE ; Xinping WANG ; Rulin MA ; Shuxia GUO
Chinese Journal of Epidemiology 2023;44(12):1943-1949
Objective:To investigate the association of cardiovascular diseases (CVD) with triglyceride glucose index (TyG) and TyG-related indicators in Uyghur populations of The Xinjiang Production and Construction Corps.Methods:Based on the cohort of the Uygur population of The Xinjiang Production and Construction Corps, 11 833 study subjects were included. The Kaplan-Meier method was used to estimate the cumulative incidence of CVD in each quartile of TyG and TyG-related indicators. Cox proportional hazards regression model was used to evaluate the relationship between TyG and CVD, TyG-related indicators and CVD. Framingham CVD risk score model (Framingham model) was used to evaluate whether the addition of TyG and TyG-related indicators could improve the predictive ability of the model. The potential mediating role of the TyG in the association between obesity and CVD was examined through mediation effect analysis.Results:The average age of the subjects was (37.00±13.67) years-old, and 51.0% were male. The median follow-up time was 5.67 years, with 1 288 CVD events. The cumulative incidence of CVD increased with the increase of TyG and TyG-related indicators quartiles, and compared with the Q1 group, the risk of CVD in the Q4 group of TyG, TyG-BMI, and TyG-WHtR increased by 20% ( HR=1.20, 95% CI: 1.01-1.42), 77% ( HR=1.77, 95% CI: 1.46-2.16) and 68% ( HR=1.68, 95% CI: 1.36-2.09), respectively. After adding TyG, TyG-BMI, and TyG-WHtR to the Framingham model, respectively, the model's area under the curve, net reclassification improvement, and integrated discrimination improvement were improved. In the association between BMI, WHtR, and CVD, the proportion of mediating effects mediated by the TyG index was 10.55% and 11.50%. Conclusions:Elevated levels of TyG and TyG-related indicators were strongly associated with the risk of CVD in the Uyghur population of The Xinjiang Production and Construction Corps, with TyG-BMI being the most closely correlated with CVD. Early monitoring of TyG-BMI helps identify high-risk groups of CVD.
7.Effect of annexin A1 on the proliferation, migration and invasion of papillary thyroid carcinoma
Li CHEN ; Zhigang TIAN ; Lanning JIA ; Yang YANG ; Ke ZHAO ; Yizeng WANG ; Xianghui HE
Chinese Journal of Endocrine Surgery 2022;16(1):23-27
Objective:To investigate the effect of ANXA on biological behavior of papillary thyroid carcinoma (PTC) cells by interfering with the expression of annexin A1 (ANXA1) in PTC cell lines by short hairpin RNA (shRNA) .Methods:The shRNA with specific and high efficiency was designed to specifically interfere with the expression of ANXA1 in TPC-1 and BCPAP cell lines, and transfect the TPC-1 and BCPAP cell lines respectively, including specific ANXA1 interference and negative control virus transfection, and they were divided into shANXA1 group and negative control virus group. Semi-quantitative reverse transcription PCR (Q-PCR) and Western Blot were employed to verify gene expression. The shANXA1 group was used as the experimental group, the untransfected virus group and the negative control virus group were set as the control groups. The expression levels of ANXA1 in the three groups were compared and the shRNA interference efficiency was verified. The effects of ANXA1 knockdown on the proliferation, migration and invasion of TPC-1 and BCPAP cell lines were investigated by scratch, CCK8 and Transwell invasion experiments. Independent sample t test was used to compare the means between the two groups, and one-way analysis of variance was employed to compare multiple groups, with P<0.05 as statistically significant. Results:shRNA could efficiently silence the expression of ANXA1 at the transcription and translation level in PTC cell lines. Compared with the negative control cells, the cells proliferated after successful lentiviral transfection of TPC-1 and BCPAP (BCPAP, 24h: F= 25.15, P<0.001; 48h: F=6.44, P<0.001; 48h: F=46.94, P<0.001; TPC-1, 24h: F=207.50, P<0.001; 48h: F=202.45, P<0.001; 48h: F=55.89, P<0.001) , its migration (BCPAP, F=12511.10, P<0.001; TPC-1, F=3966.10, P<0.001) and invasion ability (BC-PAP: F=94.65, P<0.001; TPC-1: F=681.74, P<0.001) significantly decreased. Conclusion:After shRNA knock-down of ANXA1 gene, the proliferation, migration and invasion ability of TPC-1 and BCPAP cell lines decreased significantly, indicating that silencing this gene can reduce tumor aggressiveness, and initially reveals that ANXA1 may be an important potential in PTC biotherapy Target.
8.One case of recurrent parathyroid carcinoma complicated with lung metastasis after parathyroid adenoma operation and literature review
Zhigang TIAN ; Zipeng XIE ; Li CHEN ; Ziyu LIU ; Yuting LE ; Lanning JIA ; Yue HAN ; Xianghui HE
Chinese Journal of Endocrine Surgery 2022;16(2):253-254
This paper reports the clinical data of a patient with recurrent metastatic parathyroid carcinoma. The causes, clinical manifestation, diagnose, treatment and prognosis of parathyroid carcinoma were discussed in order to perfect the experience of diagnosis and treatment and improve the survival rate of such patients.
9.Correlation between the mean platelet volume and testicular viability in children with testicular torsion
Mujie LI ; Meng HE ; Xianghui XIE ; Weiping ZHANG
Chinese Journal of Applied Clinical Pediatrics 2022;37(3):191-195
Objective:To investigate the correlation between hematological parameters and testicular viability, and to identify potential indicators of intraoperative testicular viability or postoperative testicular atrophy.Methods:Clinical data of 173 children with testicular torsion treated by emergency operation in the Department of Urology, Beijing Children′s Hospital, Capital Medical University from January 2006 to January 2020 were retrospectively analyzed.According to the surgical methods, 90 and 83 cases were included in the orchiectomy group and orchiopexy group, respectively.The duration of onset, spermatic cord torsion degree and hematological parameters of the 2 groups were compared by the independent-samples t test, χ2 test and Mann- Whitney U test.Risk factors for testicular resection were analyzed by multivariate Logistic regression.In addition, 30 children in the orchiopexy group were followed up for bilateral scrotal ultrasound at 6 months postoperatively.They were sub-grouped into testicular atrophy group (13 cases, 43.3%) and non-atrophy group (17 cases). Differences between 2 subgroups were compared by the independent-samples t test and Mann- Whitney U test.Receiver operating characteristic (ROC) curves were plotted to analyze the prognostic potentials of indexes with significant differences in children with the duration of onset of >6-<51 h. Results:Duration of onset (9.3 h vs.51.0 h)( Z=-8.293, P<0.001), spermatic cord torsion degree (360.0° vs. 540.0°)( Z=-5.267, P<0.001), mean platelet volume (MPV) (9.8 fL vs.10.1 fL)( Z=-2.018, P=0.044) and age (147.5 months vs. 143.0 months)( Z=-2.165, P=0.030) were significantly different between the orchiopexy group and the orchiectomy group.The multivariate Logistic regression analysis suggested that the duration of onset ( OR=1.033, P<0.001), spermatic cord torsion degree ( OR=1.004, P<0.001) and MPV ( OR=1.662, P=0.044) were positively correlated with testicular resection.For patients with the duration of onset of >6-<51 h, the area under the curve (AUC) of duration of onset, spermatic cord torsion degree and MPV was 0.753, 0.755 and 0.629, respectively.MPV was significantly different in the postoperative testicular atrophy group and the non-atrophy group [(10.2±0.5) fL vs.(9.8±0.5) fL]( t=2.426, P=0.022). The ROC curve analysis showed that the cut-off value of MPV for predicting testicular atrophy was 9.9 fL, and its sensitivity and specificity were 83.3% and 70.6%, respectively, the AUC was 0.752. Conclusions:The duration of onset, spermatic cord torsion degree and MPV can be used as predictors of intraoperative testicular viability, which are helpful for clinicians to predict and judge the testicular necrosis caused by testicular torsion before operation.In addition, 43.3% of children with testicular torsion eventually developed testicular atrophy after orchiopexy, and only MPV may be used as a predictor of postoperative testicular atrophy.
10.Ferroptosis-related gene and its relationship with prognosis of differentiated thyroid carcinoma patients
Yue HAN ; Zuoyu CHEN ; Lanning JIA ; Xianghui HE
Chinese Journal of Endocrine Surgery 2022;16(4):411-415
Objective:To analyze the marker of ferroptosis-related genes in differentiated thyroid carcinoma (DTC) based on TCGA database.Methods:The mRNA expression profiles and survival information of thyroid cancer patients and normal thyroid samples were downloaded from the TCGA database. The genetic difference analysis added 653 normal thyroid samples from the GETx database. Twenty-two ferroptosis-related genes were selected for univariate Cox regression analysis. Genes associated with prognostic in the TCGA cohort were further screened and prognostic models using LASSO regression was constructed. Adjusted P<0.05 and | log2FC>1" as the threshold, 22 differentially expressed genes were selected. The genes were screened by multivariate Cox regression analysis for prognosis-related genes and displayed in a line diagram. Results:22 of the 24 ferroptosis-related genes were differentially expressed between the tumor and normal tissues, with13 high expression, 9 low expression, 1 gene expression without difference and 1 gene not expressed in half of the samples. Univariate Cox regression analysis found that DPP4 and TFRC were associated with the degree of disease risk (HR was<1 and>1, respectively) . When integrating GPX4, TFRC and DPP4 into the LASSO model screening, it was found to be related to prognosis after dividing the patients into risk groups according to lambda. min=0.0027, Riskscore= (0.7316) * TFRC+ (-0.2539) *DPP4 (Log rank P=0.00635. Multivariate Cox regression analysis found that DPP4 and TFRC were related to the degree of disease risk (HR were<1 and>1, respectively) . Conclusion:The model of TFRC and DPP4 constructed by ferroptosis-related differential expression genes may be potential predictive markers of DTC patients, which still needs further verification and will provide theoretical basis for further clinical treatment.

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