【Abstract】ObjectiveTo investigate the effect of xenotransplantation of microencapsulated rabbit parathyroid tissue in different sites in rats for the treatment of hypoparathyroidism. MethodsThe parathyroid glands from Wistar rats were removed to make them aparathyroid. Ultimately, sixteen rats were included because their serum calcium values were continuously below 1.6 mmol/L. We also encapsulated the cultured rabbit parathyroid tissue with alginateBaCl2 microcapsule. According to the transplantation sites, rats were randomly divided into two groups: renal adipose microcapsule group and peritoneal microcapsule group, eight in each group. Encapsulated rabbit parathyroid tissues were then transplanted accordingly to different microcapsule groups. The calcium serum contents were examined on 5，15，25，35，45，55 and 65 d respectively after transplantation and the grafts were observed through electron microscope on the 65 d in particular. ResultsThe calcium contents after transplantation in renal adipose microcapsule group restored to normal and the observation outcomes of grafts showed that they survived well. The calcium contents of posttransplantation in peritoneal group also restored to normal with an exception that it dropped to a level lower than 1.6 mmol/L on the 65 d. Electron microscope also showed that there were necrotic tissues in the center and only a few cells survived on the edge of the grafts. Within peritoneal microcapsule group, the values were significantly lower than others taken at different phases. ConclusionMicroencapsulated rabbit parathyroid tissue that was xenotransplanted into rats can survive and function without administration of immunodepressant. There are significant differences of calcium contents at varying phases between two transplantation sites, which demonstrate that renal adipose may be an optimal site for microcapsule xenotransplantation.
In order to reduce the immunogenicity of parathyroid allografts and induce immunotolerance, we depleted Ⅰa＋ donor cells of rat parathyroid allografts by anti-Ⅰa monoclonal antibody plus complement, transplanted the treated glands underneath the capsule of the recipient kindey,and observed the median survival time (MST) of the allografts. Our results showed that the MST of the treated group were 60 days, compared with control group (MST:14 days), Ｐ＜0.01. This results indicate that rat parathyroid allografts survival can be prolonged dramatically by depletion of Ⅰa＋ donor cells.
Objective To introduce the advanced diagnostic technologies and share the surgical experience of parathyroid adenoma. Methods From November 1986 to August 2000, 9 patients with parathyroid adenoma who underwent operations were analyzed retrospectively. Out of them, there were 3 males and 6 females and their ages ranged from 12 to 55 years with an average of 32 years. The average disease course was 4 years and 9 months. General decreased density of the bone cortex and subperiosteum absorption were found in all 9 cases, while multi bone cyst lesion in 3 cases; obsolete fracture in 5 cases, in\cluding 2 cases of nephrolithiasis. Before operation, one child bore claudication and the other 8 patients suffered from disability. Serum parathyroid hormone (PTH) level increased markedly in 5 patients examined (633.87-1017.40 pmol/L, normal value: 28.50-90.50 pmol/L. Radionuclide scan showed tha imagings of parathyroid adenoma appeared in 4 patients. Results Parathryriod adenoma was resected via neek approach in 7 cases, and by way of sternum in the other 2 of the adnomas located in the chest, Parathyroid adenoma was diagnosed pathologically in 9 cases. All the 9 patients had no relapse during the 2-16 years of follow-up, with apparent relief of ostealgia and the normal serum PTH level, and roentgenogram showed fracture healing, great allevation of the osetopathia. Conclusion PTH examination as an advanced technique plays an important role in the differential diagnosis of hypercalcaemia. Color Dopperler and radionuclide scan can locate the lesion. It is vital to judge the nature of the lesion by naked eyes, while frozen slices serves as a necessity to confrrm. Enough parathyroid tissue should to be remained to assure normal parathyroid function. The variable number and ectopic possibility of parathyroid glands should be consiered. Both the short-term and long-term surgical outcome of parathyroid adenoma are satisfactory.
ObjectiveTo investigate the significance of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT in the diagnosis of primary hyperparathyroidism, and its relationship with the level of serum calcium (CA). MethodsThe clinical data of 73 patients with parathyroid dysfunction (serum parathyroid hormone (PTH) > 130 pg/mL) were retrospectively analyzed. The 99Tcm-MIBI SPECT double phase imaging were performed in 73 cases, 63 cases underwent cervical B-ultrasound examination, and 16 cases underwent CT examination. According to the serum calcium (CA) levels, the patients were divided into CA < 2.7 mmol/L group and CA > 2.7 mmol/L group, and the postoperative pathological examination and followed-up results were as the standard, the sensitivity, specificity, positive predictive value, and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT for diagnosis of PHPT in different serum CA levels were compared. ResultsThe sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.6%, 81.8% and 35.7%, respectively; the specificity was 87.5%, 75.5% and 50.0%, respectively; the positive predictive value was 98.2%, 93.7% and 83.3%, respectively; and the negative predictive value was 46.7%, 33.3% and 10%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT were significantly higher than those of CT examination(P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging for diagnosis of PHPT were higher than those of B-ultrasound examination, but the difference was not statistically significant (P > 0.05). In the CA < 2.7 mmol/L group, the sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 91.1%, 84.7% and 37.9%, respectively; the specificity was 80.2%, 72.9% and 49.7%, respectively; the positive predictive value was 96.8%, 96.0% and 79.4%, respectively; and the negative predictive value was 50.0%, 37.5% and 10.0%. In the CA > 2.7 mmol/L group, The sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.9%, 83.9% and 42.8%, respectively; the specificity was 83.3%, 79.2% and 50.0%, respectively; the positive predictive value was 96.9%, 94.1% and 75.0%, respectively; and the negative predictive value was 50.0%, 40.5% and 20.0%. There were no significant difference in the diagnostic accuracy between the 3 methods and the level of serum CV in different levels. ConclusionsThe diagnostic accuracy of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT patients with PTH > 130 pg/mL (especially parathyroid adenoma) were higher than that of CT examination, and it is not associated with the serum CA concentration.
Objective To explore the impact of basic fibroblast growth factor (bFGF) and parathyroid hormone-related protein (PTHrP) on early and late chondrogenic differentiation of rabbit bone marrow mesenchymal stem cells (BMSCs) induced by transforming growth factor β1 (TGF-β1). Methods BMSCs were isolated from 3 healthy Japanese rabbits (2-month-old, weighing 1.6-2.1 kg, male or female), and were clutured to passage 3. The cells were put into pellet culture system and were divided into 5 groups according to different induce conditions: TGF-β1 group (group A), TGF-β1/bFGF group (group B), TGF-β1/21 days bFGF group (group C), TGF-β1/PTHrP group (group D), and TGF-β1/21 days PTHrP group (group E). At the beginning, TGF-β1 (10 ng/mL) was added to all groups, then bFGF and PTHrP (10 ng/mL) were added to groups B and D respectively; bFGF and PTHrP (10 ng/mL) were added to groups C and E at 21 days respectively. The gene expressions of collagen type I (Col I), Col II, Col X, matrix metalloproteinases (MMP)-13, and alkaline phosphatase (ALP) activity were detected once every week for 6 weeks. The 1, 9-dimethylmethylene blue (DMMB) staining was used to observe the extracellular matrix secretion at 6 weeks. Results The expression of Col I in groups C and E showed a significant downward trend after 3 weeks; the expression in group A was significantly higher than that in groups C and E at 4 and 5 weeks (P lt; 0.05), and than that in groups B and D at 3-6 weeks (P lt; 0.05); and significant differences were found between groups B and C at 3 and 4 weeks, and between groups D and E at 3 weeks (P lt; 0.05). After 3 weeks, the expressions of Col II and Col X in groups C and E gradually decreased, and were significantly lower than those in group A at 4-6 weeks (P lt; 0.05). Groups B and D showed no significant difference in the expressions of Col II and Col X at all time points, but there was significant difference when compared with group A (P lt; 0.05). MMP-13 had no obvious expression at all time points in group A; significant differences were found between group B and groups A, C at 3 weeks (P lt; 0.05); and the expression was significantly higher in group D than in groups A and E (P lt; 0.05). ALP activity gradually increased with time in group A; after 4 weeks, ALP activity in groups C and E obviously decreased, and was significantly lower than that in group A (P lt; 0.05); there were significant differences between groups B and C, and between groups D and E at 2 and 3 weeks (P lt; 0.05). DMMB staining showed more cartilage lacuna in group A than in the other groups at 6 weeks. Conclusion bFGF and PTHrP can inhibit early and late chondrogenic differentiation of BMSCs by changing synthesis and decomposition of the cartilage extracellular matrix. The inhibition is not only by suppressing Col X expression, but also possibly by suppressing other chondrogenic protein.
【Abstract】ObjectiveTo investigate the technique of establishing a model of aparathyroid rat which could be used in the study of parathyroid cells transplantation. Methods Parathyroid glands were surgically excised and identified pathologyically. Serum calcium and parathyroid hormone in rats before operation and on day 2，5，10，15 and 30 after operation were measured. Results Parathyroid glands were resected successfully in 8 rats, and the resection rate was 80% (8/10). No obvious changes of serum calcium and parathyroid hormone levels were found before and after operatiion in sham parathyroid gland excision group (Pgt;0.05). However, statistically significant changes of those data were found perioperatively in parathyroid gland excision group (P＜0.01). Conclusion The model of aparathyroid rat can be established successfully after parathyroid glands in rats are excised exactly. Parathyroid allotransplantation could be performed ten days after parathyriodectomy.
Objective To evaluate the diagnostic significance and to analyze reasons of false negative cases forpreoperative ultrasonography， 99Tcm-sestamibi scintigraphy （MIBI scintigraphy）， and CT in primary hyperparathyroidism（PHPT）. Methods Clinical data of 69 patients with PHPT， who underwent operation in Affiliated Shengjing Hospital of China Medical University between Jan. 2003 and Aug. 2012 were retrospectively analyzed. Results There were 76 parathyroid lesions in 69 PHPT patients proved by operation and pathology， including 58 cases of parathyroid adenoma with 60 lesions， 7 cases of parathyroid hyperplasia with 11 lesions， and 4 cases of parathyroid carcinoma with 5 lesions. The sensitivity of ultrasonography， CT， and 99Tcm-MIBI scintigraphy were 81.94% （59/72）， 61.76% （21/34）， and 69.57% （16/23）， the accuracy of 3 kinds of tests were 78.67% （59/75）， 61.76% （21/34）， and 66.67% （16/24）， the positive predictive value were 95.16% （59/62）， 100% （21/21）， and 94.12% （16/17） respectively. There was significant differ-ence only between ultrasonography and CT in sensitivity （P=0.03）， no other significant difference was found （P＞0.05）.Conclusions Ultrasonography is complementary to 99Tcm-MIBI scintigraphy， but CT has little significance in diagnosis of PHPT. Both of ultrasonography and 99Tcm-MIBI scintigraphy should be used before operation routinely to localize parathyroid lesions.
ObjectiveTo explore the value of carbon nanoparticles on surgery for thyroid carcinoma. MethodLiteratures about application of carbon nanoparticles and lymphatic mapping in the thyroid carcinoma were reviewed. ResultsThe carbon nanoparticle was a new lymph tracer with a clear lymphatic mapping and a longer time for dying, which could accurately reflect the status of cervical lymph nodes, trace the sentinel lymph node in the thyroid carcinoma. The parathyroid gland could not be stained black, it was easy to be identified and protected. ConclusionsThe carbon nanoparticle provides an effective help in treatment for thyroid carcinoma. The more extensive and more profound application of lymphatic mapping depends on more clinical study.
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.
Objective To investigate the function and survival of parathyroid tissue transplanted into the rectus of rat by different pre-treatment. Methods Male，adult Wistar rats （seventy）as donors and adult SD rats （thirty-five）as receptors. Model rats were established by resection of parathyroid and randomly divided into five groups （digital random method）：direct transplantation group， high-oxygen culture group， ciclosporin A （CsA） group， 60Co irradiated group， and integrated treatment group. Each receptor received four PTG from two donors and the PTG were transplanted into the rectus of the receptors. Changes in concentration of serum calcium and PTH at different time points before and after parathyroid transplantation in each group recipient rats were observed. Results Serum calcium and PTH could reach or remain normal level after thyroid tissue transplantation in all groups in 1 week after operation， which significantly differed from those of pre-transplanted （P＜0.01）. The survival time among the five groups were different： the duration for keeping serum calcium and PTH at normal level（only 3 week and 4 weeks）in direct transplantation group was shortest than that in high-oxygen culture group （5 weeks and 8 weeks）， CsA group （6 weeks and 8 weeks）， 60Co irradiated group （5 weeks and 7 weeks）, and integrated treatment group （5 weeks and 9 weeks）. Compared with direct transplantation group， the levels of serum calcium and PTH in high-oxygen culture group，CsA group，60Co irradiated group, and integrated treatment group were significantly higher in 4-9 weeks point （P＜0.05， except high-oxygen culture group in 9 weeks and 60Co irradiated group in 8 weeks after operation had no significant difference）. Compared with integrated treatment group， the levels of serum calcium and PTH in high-oxygen culture group，CsA group， and 60Co irradiated group were significantly lower in 7-9 weeks point （P＜0.05）. Conclusions PTG tissues transplanted in rectus can maintain serum calcium level at normal range，and measurement on graft or receptors can prolong the survival period of parathyroid graft. Tissue transplantation of parathyroid after culture may provide a potent way to cure hypothyroidism.