Objective To summarize the development, clinical application, advantages and disadvantages, and future prospects of parathyroid autofluorescence in recent years. MethodThe literatures related to the research progress of parathyroid autofluorescence in recent years were searched, and launched a specific discussion. Results Autofluorescence of parathyroid gland was still in its infancy at home and abroad. The existing studies had shown that this technique was superior to visual recognition and could reduce the incidence of postoperative complications. Autofluorescence technology had shown some advantages in identifying parathyroid gland during operation, and its mechanism research and related equipment improvement should be focused in the future. ConclusionAutofluorescence technique is of great value in the identification of parathyroid glands in patients undergoing thyroidectomy or parathyroidectomy.
From Jan. 1980 to Dec. 1996, 138 cases of papillary adenocarcinoma of thyroid gland were surgically treated. To minimize the local recurrence and complication, resection of the involved lobe and the isthmus is an ideal surgical operation. Modified neck lymph node dissection should be performed, if the diameter of primary tumor is larger than 1.5 cm; whether the lymph node is palpable or not. Functional or classical radical neck lymph node excision should be taken, if the neck lymph node can be palpable.
Objective To explore the significance of parathyroid micro vascular anatomy in thyroid lobectomy with capsular technique. Methods The pertinent literatures in recent thirty years were screened with key words “parathyroid micro vascular anatomy， capsular technique， and protection”and reviewed. Results There were many types of number， origin， and length of parathyroid vascular， and specific measurements should be taken in thyroid lobectomy with capsular technique. Conclusion Fully awareness of parathyroid micro vascular anatomy will benefit to ensure preservation of their function during thyroid lobectomy with capsular technique.
42 cases of hyperthyroidism had been operated from 1990-1993.In the preoperative treatment,antithyroid drugs were used togather with thyroxine.Some advantages have been observed,which are better than drugs were used togather with thyroxine.Some advantages have been observed,which are better than thoes of the usual preoperative preparaton.①Patient can be prepared to a complete euthyroid state.②The vascularity of the gland can be reduced to a least degree so that the operative risk of bleeding is will small.③The serum thyroid hormone will not be raised,therefore no thyroid crisis occurs.
To diagnose and treat a patient with rare lupus erythematosus-like syndrome and antineutrophil cytoplasmic antibodies (ANCA) positive vasculitis with graves’ disease by applying the approach of evidence-based medicine. Clinical problems were raised based on the patient condition and PubMed (1966-2003), CBM (1978-2003), EMBASE (1974-2003) were searched for the related information. We found that the best explaination for this case was antithyroid drugs’ side effect, and the patient was obvious better after treatment.
ObjectiveTo investigate the value of central lymph node dissection in patients with cN0 papillary thyroid carcinoma.
MethodThe clinical data of 128 patients with cN0 papillary thyroid carcinoma who had been performed central lymph node dissection during their hospitalization from December 2010 to July 2012 in Chinese PLA General Hospital were analyzed retrospectively.
ResultsThe central neck lymph node metastasis rate was 35.94%(46/128) in 128 patients with cN0 papillary thyroid carcinoma, which in the patients with aged less than 45 years, with the tumor diameter larger than 1 cm, and with capsule or extrathyroidal invasion were significantly higher than those in the patients with aged larger than 45 years, with the tumor diameter less than 1 cm, and without capsule or extrathyroidal invasion (P < 0.05). After the operation, there were 22(17.19%) patients with temporary hypoparathyroidism as well as 3(2.34%) patients with temporary recurrent laryngeal nerve injury. However, no permanent recurrent laryngeal nerve injury and permanent hypoparathyroidism occurred. During the 14-32 months follow-up with an average 23.4 months, 2 cases of lateral neck lymph node metastases were observed.
ConclusionAs an essential, effective, and safe operation to the patients with cN0 papillary thyroid carcinoma, central lymph node dissection should be performed by experienced hands.
Vague preoperative localization and ectopic parathyroid often lead to the failure of operation in primary hyperparathyroidism. From Jun 1989 to March 1998, 11 cases of primary hyperparathyroidism had been treated surgically in the general surgery department of our hospital. Of them, 10 cases were operated successfully with the pathological diagnosis of adenoma and one parathyroid removed was reported normal. Preoperative localization, the knowledge of ectopic parathyroids, careful exploration during operation and the postoperative medical treatment are important for the perioperative management. Postoperative followup has emphasized to benefit the treatment in primary hyperparathyroidism.
Ultrasonic examination is a common method in thyroid examination, and the results are mainly composed of thyroid ultrasound images and text reports. Implementation of cross modal retrieval method of images and text reports can provide great convenience for doctors and patients, but currently there is no retrieval method to correlate thyroid ultrasound images with text reports. This paper proposes a cross-modal method based on the deep learning and improved cross-modal generative adversarial network: ①the weight sharing constraints between the fully connection layers used to construct the public representation space in the original network are changed to cosine similarity constraints, so that the network can better learn the common representation of different modal data; ②the fully connection layer is added before the cross-modal discriminator to merge the full connection layer of image and text in the original network with weight sharing. Semantic regularization is realized on the basis of inheriting the advantages of the original network weight sharing. The experimental results show that the mean average precision of cross modal retrieval method for thyroid ultrasound image and text report in this paper can reach 0.508, which is significantly higher than the traditional cross-modal method, providing a new method for cross-modal retrieval of thyroid ultrasound image and text report.
Objective
To evaluate whether the classification of parathyroid can be used to evaluate how difficult it is that the parathyroid glands get preserved in situ during thyroid surgery.
Methods
Clinical date were retrospectively collected from the patients with thyroid nodules, who had undergone the initial thyroidectomy in the Department of Thyroid Surgery, West China Hospital of Sichuan University between January 2014 and June 2016. The number of parathyroid glands was counted according to the classification of parathyroid. It got comparative analysis that the rates of parathyroid glands in situ among the different types.
Results
A total of 996 patients were included in the study, and 3 269 pieces of parathyroid glands were identified. The mean number of parathyroid identification was 3.3 pieces. These parathyroid glands consisted of 77.5% (2 532/3 269) type A and 22.5% (737/3 269) type B. The rate of parathyroid glands in situ was 77.1% (1 951/2 532) in type A, and 80.7% (595/737) in type B, the difference was significant (P=0.03). And the rate of parathyroid glands in situ in type A1 was significantly higher than that in type A2 (80.5%vs 21.4%,P<0.001). The parathyroid of type A3 couldn’t get preserved in situ. The rate of superior parathyroid glands in situ in type B1 was higher than that in type A1 (97.5%vs 93.7,P<0.01). But the rate of inferior parathyroid glands in type B1 was closed to that in type A1 (62.2%vs 65.7%,P=0.23), and both the rates were significant less than that in type B2 (86.0%) and in type B3 (90.2%),PA1vs B2=0.001,PA1vs B3<0.001,PB1vs B2=0.004,PB1vs B3=0.001.
Conclusion
The classification of parathyroid can be used to evaluate effectively how difficult it is that the parathyroid glands get preserved in situ during thyroid surgery.
Objective To investigate the efficacy of fine needle aspiration-thyroglobulin (FNA-Tg) with colloidal gold immunochromatographic assay (CGICA) on the assessment of lymph node metastasis during surgery in papillary thyroid carcinoma (PTC) patients. Methods Seventy-eight patients with PTC who underwent surgery in the Department of Thyroid Surgery of West China Hospital of Sichuan University from August to December 2019 were selected as the research objects, 289 neck lymph node specimens cleaned during the operation were prepared into eluent after lymph node FNA within 10 minutes in vitro, and then the FNA-Tg level was detected rapidly and quantitatively by CGICA. The specimen of washout fluid was labeled and sent to the laboratory for FNA-Tg detection by Roche electrochemiluminescence immunoassay. The lymph nodes in the whole group were divided into central region group and lateral cervical region group according to their location. According to the long diameter of lymph nodes, they were divided into <5 mm group, 5–10 mm group and >10 mm group. With postoperative pathological report as the gold standard, the receiver operating characteristic (ROC) curve of the whole group of data subjects was drawn, and the area under curve (AUC) was compared to calculate the best cut-off value of FNA-Tg in diagnosing PTC lymph node metastasis. The sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of FNA-Tg CGICA method and Roche method in the whole group and different subgroups were compared. The data of 55 lymph nodes detected by FNA-Tg CGICA method and rapid frozen pathology were collected, and the diagnostic efficacy indexes of CGICA method and rapid frozen pathology in the diagnosis of lymph node metastasis were compared. Results The ROC curves AUC of FNA-Tg detected by CGICA method and Roche method was 0.850 and 0.883, respectively, the difference was not statistically significant (Z=1.011, P>0.05). The sensitivity was 77.7% and 79.6% respectively (χ2=0.05, P>0.05), specificity was 84.9% and 93.5% respectively (χ2=7.50, P<0.05). Using McNemar test, there was no significant difference in the diagnostic results between the CGICA method and Roche method of FNA-Tg in the whole group (P>0.05). The diagnostic efficacy of FNA-Tg CGICA method was better in the lateral cervical region group than that in the central region group, and the diagnostic efficacy of the group with the long diameter of lymph nodes >10 mm was better than those of the groups with the long diameter of lymph nodes <5 mm and 5–10 mm. There was no significant difference in diagnostic results between FNA-Tg CGICA method and rapid frozen pathology (P>0.05). Conclusions The FNA-Tg CGICA method has high value in diagnosing PTC cervical lymph node metastasis, and has the characteristics of rapidity and convenience. The diagnostic efficiency is similar to that of Roche method.
