Objective To analyze the risk factors of permanent hypoparathyroidism(pHPP)after total thyroidectomy in patients with thyroid cancer and establish a nomogram prediction model.Methods A total of 245 patients with thyroid cancer who received total thyroidectomy in our hospital were enrolled between January 2020 and January 2024.According to presence or absence of postoperative pHPP,patients were divided into the pHPP group and the non-pHPP group.The influencing factors of postoperative pHPP in patients with thyroid cancer were analyzed by univariate and multivariate Logistic regression analysis.The nomogram prediction model for postoperative pHPP in patients with thyroid cancer was constructed and varified,and efficiency of the model was evaluated.Results In 245 patients with thyroid cancer,the incidence of pHPP within 6 months after surgery was 10.20%(25/245).Univariate analysis showed that there were significant differences in tumor size,surgical method,central lymph node dissection,use of nano carbon tracer,envelope invasion,parathyroid excision by mistake,Hashimoto thyroiditis,serum calcium and parathyroid hormone at 1 d after surgery between the two groups(P＜0.05),but there were no significant differences in gender,age,smoking,drinking,extraglandular invasion,parathyroid autologous transplantation,preoperative vitamin D or serum phosphorus at 1 d after surgery between the two groups(P＞0.05).Multivariate analysis showed that maximum tumor diameter≥4 cm,routine and open total thyroidectomy,central lymph node dissection,no use of nano carbon tracer and parathyroid excision by mistake were all independent risk factors for postoperative pHPP in patients with thyroid cancer(P＜0.05).Results of nomogram prediction model showed that C-index was 0.921,the corrected curve was close to ideal curve,and AUC of nomogram model for predicting postoperative pHPP was 0.926(95%CI:0.871-0.981).Conclusion The nomogram prediction model constructed based on independent risk factors of postoperative pHPP has good predictive efficiency in patients with thyroid cancer.

Objective To analyze the risk factors of permanent hypoparathyroidism(pHPP)after total thyroidectomy in patients with thyroid cancer and establish a nomogram prediction model.Methods A total of 245 patients with thyroid cancer who received total thyroidectomy in our hospital were enrolled between January 2020 and January 2024.According to presence or absence of postoperative pHPP,patients were divided into the pHPP group and the non-pHPP group.The influencing factors of postoperative pHPP in patients with thyroid cancer were analyzed by univariate and multivariate Logistic regression analysis.The nomogram prediction model for postoperative pHPP in patients with thyroid cancer was constructed and varified,and efficiency of the model was evaluated.Results In 245 patients with thyroid cancer,the incidence of pHPP within 6 months after surgery was 10.20%(25/245).Univariate analysis showed that there were significant differences in tumor size,surgical method,central lymph node dissection,use of nano carbon tracer,envelope invasion,parathyroid excision by mistake,Hashimoto thyroiditis,serum calcium and parathyroid hormone at 1 d after surgery between the two groups(P＜0.05),but there were no significant differences in gender,age,smoking,drinking,extraglandular invasion,parathyroid autologous transplantation,preoperative vitamin D or serum phosphorus at 1 d after surgery between the two groups(P＞0.05).Multivariate analysis showed that maximum tumor diameter≥4 cm,routine and open total thyroidectomy,central lymph node dissection,no use of nano carbon tracer and parathyroid excision by mistake were all independent risk factors for postoperative pHPP in patients with thyroid cancer(P＜0.05).Results of nomogram prediction model showed that C-index was 0.921,the corrected curve was close to ideal curve,and AUC of nomogram model for predicting postoperative pHPP was 0.926(95%CI:0.871-0.981).Conclusion The nomogram prediction model constructed based on independent risk factors of postoperative pHPP has good predictive efficiency in patients with thyroid cancer.

Objective To investigate the clinical pathological characteristics,immunohistochemistry,diagnosis and differential diagnosis,treatment and prognosis of malignant melanoma.Methods The data of 5 cases were reviewed.Results Out of 5 patients,1 patient was female and 4 were males,aged 48 from 92 years (mean age of 67.2 years).Tumors originated from different sites,such as nose,skin and esophagus.Microscopically,the tumor cells were various in morphology from spindle,epithelioid,nevus alike cells to foam alike cells,arranged in nests,stripes or loose nets.Immunohistochemical stain showed positive expressions in S-100,HMB45 in some extent,Melan-A or Vimentin,individually expression CD56 and CgA.However,the levels of CK,EMA,CEA,Desmin,NSE,LCA,CD3,CD20,SMA,MyoD 1,Myogenin and Syn were negatively expressed.Braf and C-kit gene tests were applied in all cases,however,only one case was detected with Braf gene V600E mutation.No case was found with C-kit gene mutations.Conclusion Malignant melanoma is a kind of highly invasive tumor,which is characterized by highly changed morphology and easily misdiagnosis or missed diagnosis.Immunohistochemistry and genetic testing are of great significance in diagnosis and targeted therapy.

Objective To investigate the clinical pathological characteristics,immunohistochemistry,diagnosis and differential diagnosis,treatment and prognosis of malignant melanoma.Methods The data of 5 cases were reviewed.Results Out of 5 patients,1 patient was female and 4 were males,aged 48 from 92 years (mean age of 67.2 years).Tumors originated from different sites,such as nose,skin and esophagus.Microscopically,the tumor cells were various in morphology from spindle,epithelioid,nevus alike cells to foam alike cells,arranged in nests,stripes or loose nets.Immunohistochemical stain showed positive expressions in S-100,HMB45 in some extent,Melan-A or Vimentin,individually expression CD56 and CgA.However,the levels of CK,EMA,CEA,Desmin,NSE,LCA,CD3,CD20,SMA,MyoD 1,Myogenin and Syn were negatively expressed.Braf and C-kit gene tests were applied in all cases,however,only one case was detected with Braf gene V600E mutation.No case was found with C-kit gene mutations.Conclusion Malignant melanoma is a kind of highly invasive tumor,which is characterized by highly changed morphology and easily misdiagnosis or missed diagnosis.Immunohistochemistry and genetic testing are of great significance in diagnosis and targeted therapy.