Purpose:Thyroid nodules with high-suspicion ultrasound features but benign cytologic findings remain a diagnostic challenge due to potential false-negative fine-needle aspiration (FNA) results. The BRAFV600E mutation, a hallmark of papillary thyroid carcinoma (PTC), may improve malignancy risk stratification. This study prospectively evaluated the diagnostic performance of BRAFV600E mutation testing in ultrasound-high-suspicion thyroid nodules with non-malignant cytology. Methods:A prospective observational study was conducted at the China-Japan Union Hospital of Jilin University between January 2019 and July 2024, enrolling 562 ultrasound-high-suspicion thyroid nodules with non-malignant or indeterminate cytology (Bethesda II-III). Preoperative BRAFV600E analysis was performed using PCR-based methods, and all nodules subsequently underwent surgical excision with definitive histopathology. Associations between mutation status, sonographic patterns, and final diagnoses were assessed through univariate and multivariable logistic regression. Results:Among 562 nodules, 280 (49.8%) harbored the BRAFV600E mutation. Final pathology confirmed 390 PTCs (69.4%) and 172 benign lesions (30.6%). The BRAFV600E mutation was strongly associated with malignancy (66.2% vs. 12.8%, P < 0.001). On multivariable analysis, BRAFV600E positivity independently predicted PTC (OR = 10.36, 95% CI = 6.18-17.35, P < 0.001). The test showed a sensitivity of 66.2%, specificity of 87.2%, positive predictive value of 92.1%, and overall accuracy of 72.6%. Conclusion:BRAFV600E mutation testing is a valuable molecular tool for evaluating high-suspicion thyroid nodules with cytologically benign or indeterminate findings. Its strong predictive value enables earlier identification of papillary thyroid carcinoma (PTC), but results should always be interpreted alongside clinicopathologic and imaging assessments to guide optimal diagnostic decisions. In this highly selected cohort, BRAFV600E testing added diagnostic value beyond high-suspicion ultrasound features, improving the distinction between true malignancy and benign mimics in a population with a 69.4% baseline cancer prevalence.

ObjectiveThis study aimed to evaluate the clinical value of repeat fine-needle aspiration biopsy (rFNAB) for thyroid nodules initially classified as Bethesda Category III, to explore the optimal timing for repeat biopsy, and to optimize the biopsy strategy by integrating ultrasonographic characteristics.MethodsWe retrospectively analyzed the clinical data of 109 patients (114 nodules) who underwent rFNAB at our hospital from December 2020 to December 2025, including 87 females and 22 males. Based on rFNAB results, the nodules were divided into a definitive diagnosis group (93 nodules) and a non-definitive diagnosis group (21 nodules). The definitive diagnosis group was further subdivided into a malignant group (62 nodules, Bethesda V/VI) and a benign group (31 nodules, Bethesda II). We recorded biopsy results, intervals between biopsies, postoperative pathological findings, and ultrasonographic features. Statistical differences between groups were analyzed. Statistical methods included the χ² test, Fisher’s exact test, binary logistic regression analysis, and ROC curve analysis.ResultsAmong the 114 Bethesda Category III nodules, 93 (81.6%) obtained a definitive diagnosis through rFNAB, including 62 malignant (66.7%) and 31 benign (33.3%) nodules; 21 nodules (18.4%) remained non-diagnostic. Forty-seven patients with malignant rFNAB results underwent surgical treatment, including 9 (19.1%) in the <3-month interval group and 38 (80.9%) in the ≥3-month interval group. No significant differences were observed in lymph node metastasis rates or recurrence risk stratification between the two groups. Among the ultrasonographic characteristics of the malignant, benign, and non-diagnostic groups, only calcification type showed a statistically significant difference (P < 0.05). Additionally, ROC curve analysis confirmed the diagnostic efficacy of the TI-RADS score for Bethesda Category III nodules (AUC = 0.746). The maximum Youden index (0.403) was achieved at a cut-off value of 8 points (specificity 83.9%, sensitivity 56.5%).ConclusionRepeat fine-needle aspiration biopsy (rFNAB) significantly improves the diagnostic rate for thyroid nodules initially diagnosed as Bethesda Category III, and the time interval between the two biopsies does not affect diagnostic performance. For the follow-up of nodules with an initial Bethesda Category III FNAB result, rFNAB is recommended when the TI-RADS score is ≥8, especially if suspicious ultrasonographic signs such as new or persistent microcalcifications are present. During the procedure, multi-point sampling should target non-calcified areas at the nodule periphery to improve the accuracy and reliability of rFNAB.

BackgroundPediatric papillary thyroid cancer presents with a more advanced stage of disease than adult PTC; and it is more likely to be aggresive and distant metastases, although the survival rate is high.MethodsA retrospective observational study was performed in children and adults with PTC. Fisher’s exact, chi-square, and rank-sum tests were used to examine the differences. Univariate and multivariate Cox regression analyses were applied to determine the possible risk factors for prognosis. A Kaplan-Meier curve analysis was performed to investigate the relationship between the clinicopathological characteristics and recurrence rate.ResultsThe study involved 156 children and 1,244 adults with PTC. Compared to the group without recurrence, proportions of tumors measuring > 1 cm (48.3% vs. 90.9%) and multifocality (30.3% vs. 63.6%) were higher, N1b stage occurred more frequently (33.8% vs. 100%). However, among adult PTC patients, those with recurrence were older (76.1% vs. 59.4%) than those without recurrence. Risk factors for pediatric PTC recurrence included tumor size and multifocality. However, in adult PTC, the risk factor was LLNM. The newly constructed Stratification.N showed better performance, as illustrated by the fact that patients who were classified into Stratification.N 3 showed an obviously poorer prognosis (P=0.01 and P=0.00062), especially in those aged >14 years (P=0.0052).ConclusionCompared with adult PTC, pediatric PTC showed unique characteristics in terms of clinical pathology and recurrence. Tumor size and multifocality were strong risk factors for pediatric PTC. Accordingly, the novel proposed risk stratification method could effectively predict the recurrence of pediatric PTC.

Objective:To investigate the feasibility and advantages of unilateral primary hyperparathyroidism (PHPT) treated by transthyretal interosseous muscle approach surgery.Methods:Clinical data of 7 patients with unilateral PHPT treated by interstitial sternocleidomastoid muscle approach from Jan. 2021 to Feb. 2022 in the thyroid surgery of China-Japan Union Hospital of Jilin University were retrospectively analyzed, including preoperative blood calcium concentration, operation time, incision length, intraoperative parathyroid hormone (PTH) , blood calcium concentration and PTH value in the first month after surgery, abnormal sensation of the skin in the anterior cervical area, etc. The feasibility and advantages of interstitial sternocleidomastoid muscle approach surgery for unilateral PHPT were analyzed.Results:All 7 patients with unilateral PHPT were operated successfully. The PTH was 17.2-63.3 pg/ml on recheck 1 month after surgery, which were all within the normal range. The time from skin opening to resection of the diseased parathyroid gland was 20-35 min, and the length of the surgical incision was 3-4 cm. all patients were given intravenous and oral calcium therapy after surgery, and the blood calcium and PTH levels were within the normal range at 3-12 months of follow-up; the incision recovered well, and there was no significant sensory and functional abnormalities in the anterior neck area.Conclusion:The treatment of unilateral PHPT through the sternocleidomastoid interosseous approach can ensure the safety and efficacy of the operation while better protecting the sensory and motor functions of the anterior cervical region and improving the aesthetics of the surgical incision.

Background:In recent years, the study of radiomics in thyroid diseases has developed rapidly. This study aimed to establish a preoperative radiomics prediction model for central compartment lymph node metastases (CLNMs) in papillary thyroid microcarcinoma (PTMC) patients using gradient-boosting decision tree (GBDT) model and evaluate the performance of the model. Methods:A total of 274 patients with PTMC admitted for thyroid surgery at China-Japan Union Hospital of Jilin University from January 2020 to July 2022 were retrospectively analyzed. Patients were randomized into training and validation cohorts according to a ratio of 8:2. Radiomics features were extracted from the ultrasound (US) images of PTMC lesions. The open-source software Pyradiomics was used to extract radiomics features, and WEKA software was used to select CLNM-related radiomics features. Clinical risk factors for CLNM were screened by statistical methods. The GBDT model was constructed by combining radiomics features and clinical risk factors, and compared with the diagnostic efficacy of US-reported cervical lymph node status. Shapley Additive exPlanations (SHAP) was applied to visualize and analyze the GBDT model globally and locally. Results:A total of seven radiomics features were significantly correlated with central lymph node status in the training and validation cohorts. The predictors in the GBDT model included the radiomics features, sex, age, and body mass index (BMI). The area under the curve (AUC) values of the GBDT model in the training and validation cohorts were 0.946 [95% confidence interval (CI): 0.920-0.972] and 0.845 (95% CI: 0.714-0.976), respectively, compared with 0.583 (95% CI: 0.508-0.659) and 0.582 (95% CI: 0.430-0.736) for US-reported lymph node status alone. The Delong test showed a significant difference between AUS in the training and validation cohorts (P<0.001, respectively). SHAP visual analysis showed the effect of each parameter on the GBDT model globally and locally. Decision curve analysis demonstrated the clinical utility of the GBDT model. Conclusions:The prediction of CLNM by the GBDT model, based on US radiomics features and clinical factors, can be better than that by using US alone in patients with PTMC. Furthermore, the GBDT model may serve a guidance of clinical decision for patient's treatment strategy.

Lymphatic metastasis is the leading cause responsible for recurrence and progression in papillary thyroid cancer (PTC), where dysregulation of long non-coding RNAs (lncRNAs) has been extensively demonstrated to be implicated. However, the specific lymphatic node metastatsis-related lncRNAs remain not identified in PTC yet. Lymphatic node metastatsis-related lncRNA, MFSD4A-AS1, was explored in the PTC dataset from The Cancer Genome Atlas and our clinical samples. The roles of MFSD4A-AS1 in lymphatic metastasis were investigated in vitro and in vivo. Bioinformatic analysis, luciferase assay and RNA immunoprecipitation assay were performed to identify the potential targets and the underlying pathway of MFSD4A-AS1 in lymphatic metastasis of PTC. MFSD4A-AS1 was specifically upregulated in PTC tissues with lymphatic metastasis. Upregulating MFSD4A-AS1 promoted mesh formation and migration of human umbilical vein endothelial cells and invasion and migration of PTC cells. Importantly and consistently, MFSD4A-AS1 promoted lymphatic metastasis of PTC cells in vivo by inducing the lymphangiogenic formation and enhancing the invasive capability of PTC cells. Mechanistic dissection further revealed that MFSD4A-AS1 functioned as competing endogenous RNA to sequester miR-30c-2-3p, miR-145-3p and miR-139-5p to disrupt the miRNA-mediated inhibition of vascular endothelial growth factors A and C, and further activated transforming growth factor (TGF)-β signaling by sponging miR-30c-2-3p that targeted TGFBR2 and USP15, both of which synergistically promoted lymphangiogenesis and lymphatic metastasis of PTC. Our results unravel novel dual mechanisms by which MFSD4A-AS1 promotes lymphatic metastasis of PTC, which will facilitate the development of anti-lymphatic metastatic therapeutic strategy in PTC.

甲状腺癌作为最常见的内分泌恶性肿瘤,发病率逐年攀升.甲状腺恶性肿瘤已成为我国新发病例数及发病率最多的恶性肿瘤之一.随着甲状腺癌诊断技术的不断提高和广泛应用,国内外指南及专家共识的发布,使得国内对甲状腺癌的诊治也逐渐趋于规范化.但随着时间的推移,甲状腺癌再次手术的问题也逐渐突显.

Background:Differentiated thyroid cancer (DTC) has a high incidence but a generally good prognosis. However, lymph node metastasis is likely to occur. It usually metastasizes from the central group lymph nodes to the deep cervical lymph nodes and less frequently to the sternocleidomastoid-sternohyoid muscle. The lymph nodes between the sternocleidomastoid and sternohyoid muscles (LNSS) is easily overlook. Ignoring the preoperative assessment and dissection of level LNSS, especially in the contralateral neck level LNSS, may lead to incomplete surgery and thus require reoperation. The metastatic relevant factors and pathway for LNSS remains inconclusive require further investigation. There is a lack of reports of contralateral or bilateral cervical level LNSS metastasis in thyroid cancer. We hope to arouse attention to the level LNSS through our two case reports.Case Description:We report two cases of non-ipsilateral LNSS metastases. The patients were diagnosed with thyroid cancer by fine-needle aspiration (FNA), and ultrasound examination showed enlarged lymph nodes at the LNSS level. After surgical treatment and postoperative paraffin pathology, both patients were diagnosed with papillary thyroid carcinoma (PTC) and LNSS-level lymph node metastasis. Case 1 was a 63-year-old woman admitted to our hospital with a 15-day history of an untreated thyroid nodule and preoperative euthyroidism. This patient underwent total thyroidectomy, central and left neck LNSS dissection. Her prognosis was good, and there were no signs of recurrence at her 6-month follow-up appointment; Case 2 was a 24-year-old woman admitted to our hospital for a physical examination of an anterior cervical mass that had been present for 1 year and preoperative euthyroidism. This patient underwent total thyroidectomy, central and bilateral neck LNSS dissection. Her prognosis was good, and there were no signs of recurrence at her 12-month follow-up appointment.Conclusions:The occurrence of contralateral and bilateral simultaneous LNSS metastasis in thyroid cancer is relatively rare. However, in clinical practice, surgeons should focus on the evaluation and clearance of LNSS, especially in patients with cancer foci located in the lower pole, cancer foci invading the anterior cervical band muscle, extensive metastasis in the lateral cervical lymph nodes or stages T3/4 and to reduce postoperative recurrence.

[This corrects the article DOI: 10.1016/j.omtn.2021.02.023.].

Background Thyroid surgery is increasingly demanding in terms of cosmetic neck outcomes and protection of anterior neck function, so we have adopted an alternative sternocleidomastoid intermuscular approach (SMIA) for open/conventional thyroidectomy. The protection of recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN) is the key and difficult point in thyroid surgery. The aim of this study was to testify the feasibility of RLN and EBSLN functional protection during SMIA thyroidectomy with the intraoperative neuromonitoring. Methods A total of 39 patients and 39 RLN and EBSLNs who underwent monitored SMIA thyroidectomy were included. Thyroid gland is revealed and excised anterior to the cervical sheath between the sternal and clavicular heads of the sternocleidomastoid muscle. Standardized intraoperative neuromonitoring (IONM) procedures and postoperative laryngeal examination were performed to audit the SMIA. Following the four-step method, V1, R1, R2, and V2 were monitored and the signal values were recorded. Statistical analysis was used to evaluate the change of IONM amplitude of RLN, combined with the results of laryngoscopy before and after operation to determine the status of RLN. EBSLN injuries were identified from changes in cricothyroid muscle (CTM) twitch and EMG. SMIA video vignette is detailed. Results All RLN and EBSLNs [17 on the left and 22 on the right] were monitored in 39 patients [5 men, 34 women; mean age 34.1±8.7 years; mean body mass index 22.5 (±3.0, 17.0–30.8) kg/m2] undergoing SMIA. For RLN of the affected side, we compared the V2 and V1 (1,236±672 vs. 1,240±428, P=0.973), R2 and R1 (1,676±778 vs. 1,656±765, P=0.849) signals separately, and the results were not statistically different (P>0.05). Comparing the V1 (1,240±428 vs. 1,309±395, P=0.601) signals of the bilateral recurrent laryngeal nerve, there was no statistical difference (P>0.05). CTM twitch and EMG were preserved. Conclusions The SMIA technique appears feasible. RLN and EBSLN are easier to be exposed during thyroid surgery of SMIA, which is beneficial to the neuroprotection during the operation. At the same time, it can protect the anterior cervical function and improve the cosmetic effect after operation.

Background: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer.PTC is slow growing, and prognosis after surgery is excellent.However, PTC is associated with a high incidence of cervical lymph node metastasis, and usually metastasizes from the central lymph nodes to the ipsilateral cervical and mediastinal lymph nodes.Anatomic studies have shown that the thyroid gland and surrounding tissue have an abundant lymphatic network that facilitates tumor dissemination and lymph node metastasis, there may be many ways to connect lymph nodes on both sides of the neck of patients, which needs further research and discussion.Case Description: We report the case of a 45-year-old female who was diagnosed with thyroid cancer of the right lobe and right lateral lymph node metastasis by fine-needle aspiration (FNA).During surgery, 0.2 mL of carbon nanoparticle (CN) suspension was injected into the right lobe of the thyroid gland, which resulted in black staining of a lymph node at the contralateral entrance point to the recurrent laryngeal nerve (LN-epRLN).The black-stained lymph node was resected, and the pathology results revealed lymph node metastasis from thyroid cancer.The left lobe of the thyroid was benign.Conclusions: Retro-tracheal periesophageal lymph node metastasis may be a rare metastatic pathway in thyroid cancer.

Circular RNAs (circRNAs) are a group of non-coding RNAs featured by covalently closed circular structure. CircRNA_0079558 (circ_0079558) is derived from RAPGEF5 gene, and it has been found to be significantly up-regulated in papillary thyroid carcinoma (PTC). However, the role and working mechanism of circ_0079558 in PTC progression have never been illustrated. The levels of circ_0079558 and MET proto-oncogene, receptor tyrosine kinase (MET) were up-regulated in PTC tissues and cell lines, as evidenced by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blot assay. The silencing of circ_0079558 or MET restrained cell proliferation, migration and invasion whereas triggered cell apoptosis in PTC cells, as verified by Cell Counting Kit-8 (CCK8) assay, plate colony formation assay, transwell invasion assay, wound healing assay and flow cytometry. Through using MET specific inhibitor PHA665752, we found that circ_0079558 overexpression enhanced the malignant behaviors of PTC cells through activating MET/AKT pathway. Through dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay, microRNA-26b-5p (miR-26b-5p) was identified to be the intermediary molecular between circ_0079558 and MET, and circ_0079558 knockdown reduced the expression of MET partly through elevating miR-26b-5p in PTC cells. The miR-198/FGFR1 pathway was identified as another signal axis downstream of circ_0079558, and the co-overexpression of FGFR1 and MET largely rescued the proliferation ability of circ_0079558-silenced PTC cells. Through xenograft tumor model, we found that circ_0079558 silencing restrained xenograft tumor growth in vivo. In conclusion, circ_0079558 facilitated the proliferation and motility whereas inhibited the apoptosis of PTC cells largely through mediating miR-26b-5p/MET/AKT signaling.

Abstract Background Fine-needle aspiration cytology (FNAC) is a basic diagnostic tool for thyroid nodules. However, 15–30% of nodules are cytologically indeterminate. Midkine (MK), a pleiotropic growth factor, is often upregulated in patients with cancers. This study aimed to evaluate the role of MK and its ratios in fine-needle aspirates (FNA) for predicting thyroid malignancy. Methods This retrospective study included patients with thyroid nodules who underwent preoperative FNA and/or thyroidectomy between April 2017 and September 2017. MK levels in FNA washout were measured by enzyme-linked immunosorbent assay, and thyroglobulin (TG) and free thyroxine (FT4) levels in FNA washout were measured by chemiluminescent immunometric assays. Results A total of 217 patients with 242 nodules were included in this study. The concentrations of TG, FT4, MK/TG, MK/FT4, and FT4/MK were significantly different between papillary thyroid carcinomas and benign thyroid nodules. Both MK/TG and MK/FT4 ratios were positively correlated with maximum tumor diameter, extrathyroidal extension, and T and N stages. The area under the curve for MK/TG was 0.719 with a cutoff value of 55.57 ng/mg, while the area under the curve for MK/FT4 was 0.677 with a cutoff value of 0.11 μg/pmol. FNAC in combination with MK/FT4 had a higher sensitivity (95% vs. 91%) and accuracy (96% vs. 92%) than FNAC alone for cytologically indeterminate specimens, those of unknown significance, or those suspected of malignancy. Conclusions MK/FT4 and MK/TG may have diagnostic utility for evaluation of papillary thyroid carcinomas, particularly for cytologically indeterminate thyroid nodules.

The principal issue derived from thyroid cancer is its high propensity to metastasize to the lymph node. Aberrant exprssion of long non-coding RNAs have been extensively reported to be significantly correlated with lymphatic metastasis of thyroid cancer. However, the clinical significance and functional role of lncRNA-MAPK8IP1P2 in lymphatic metastasis of thyroid cancer remain unclear. Here, we reported that MAPK8IP1P2 was downregulated in thyroid cancer tissues with lymphatic metastasis. Upregulating MAPK8IP1P2 inhibited, while silencing MAPK8IP1P2 enhanced anoikis resistance in vitro and lymphatic metastasis of thyroid cancer cells in vivo . Mechanistically, MAPK8IP1P2 activated Hippo signaling by sponging miR-146b-3p to disrupt the inhibitory effect of miR-146b-3p on NF2, RASSF1, and RASSF5 expression, which further inhibited anoikis resistance and lymphatic metastasis in thyroid cancer. Importantly, miR-146b-3p mimics reversed the inhibitory effect of MAPK8IP1P2 overexpression on anoikis resistance of thyroid cancer cells. In conclusion, our findings suggest that MAPK8IP1P2 may serve as a potential biomarker to predict lymphatic metastasis in thyroid cancer, or a potential therapeutic target in lymphatic metastatic thyroid cancer.

Background: Hypocalcemia is the most frequent complication after thyroidectomy and central neck dissection (CND). Early intact parathyroid hormone (iPTH) determination has been proposed as an early predictor parathyroid gland state. We aim to describe iPTH kinetics after central compartment lymph node dissection (CLND). Methods: A large prospective observational study was conducted among 840 patients who underwent thyroid cancer surgery between July and December 2016 in China-Japan Union Hospital of Jilin University. Data were obtained from the patient's iPTH evaluation 15 min after CND and serum calcium records during three years of post-operative follow-up. Age, sex, BMI, preoperative PTH, operative and pathologic details were analyzed. Backward stepwise logistic regression analyses were performed to find potential risk factors for predicting iPTH <15 pg/mL. The odds ratio and 95% confidence interval are estimated using the logistic regression coefficients. The prediction model was assessed using the receiver operating characteristic curve. Results: The incidence of permanent hypocalcemia was 0.12%, while, 44.52% of patients were central lymph node metastasis. Multivariate analyses found associations among iPTH <15 pg/mL and several risk factors, especially preop PTH and type of surgery. The risk of iPTH <15 pg/mL, after total thyroidectomy plus CND, is almost 17 times that of lobectomy plus CND (OR =17.648, 95% confidence interval: 10.011-31.110). A model was created using multivariate analysis, which involved surgical procedure, and preop PTH could separate thyroid operation with iPTH <15 pg/mL. The biological index showed an area under the ROC curve of 0.697 and 0.613 separately. Using values below the lowest or above the highest cut-off point, the presence or absence of iPTH <15 pg/mL could possibly be predicted before thyroidectomy and CND. Conclusions: A lobectomy procedure for papillary thyroid carcinoma patients with clinically uninvolved neck lymph nodes (cN0) who have primary tumors (T1 or T2) could accompany prophylactic CND (ipsilateral or bilateral) to provide clearance of disease compared to total thyroidectomy.

目的 探讨神经监测技术在继发性甲状旁腺功能亢进手术中的应用.方法 回顾性分析手术治疗继发性甲状旁腺功能亢进病人59例,术中均应用神经监测技术.结果 术后喉返神经(RLN)损伤暂时性损伤1例(1.6％,1/59),喉镜见左侧声带固定于旁正中位,术后6周双侧声带运动对称、闭合良好.术后无喉上神经及迷走神经损伤症状的病例.在神经监测技术保护下,本组共切除异常甲状旁腺236枚,术中甲状旁腺的位置对RLN损伤没有统计学意义(P＞0.05).异常甲状旁腺平均长径≥2 cm的81枚,其中1例(0.7％)出现RLN损伤;平均长径＜2 cm甲状旁腺134枚,无RLN损伤,异常甲状旁腺大小对RLN损伤没有统计学意义(P＞0.05).手术时间≥1.5 h43例,＜1.5 h 16例,术后一日咽部不适47例,无咽部不适12例,手术时间长短并不是出现RLN损伤的原因,是出现术后出现咽喉部不适的因素(P＜0.05).结论 对继发性甲状旁腺功能亢进病人,术中常规应用神经监测技术对降低喉神经损伤并发症,缩短手术时间有显著应用价值.

手术切除病变的甲状旁腺是原发性甲状旁腺功能亢进(primary hyperparathyroidism,PHPT)的有效治疗方法,低钙血症是术后早期最常见的并发症.本文对原发性甲状旁腺功能亢进病人临床特征及生化指标与术后血钙下降的相关性进行综述.预测并分析PHPT术后血钙下降的程度,为术后制定有效的钙补充策略提供参考,降低术后暂时性或永久性低钙血症发生率.

急性化脓性甲状腺炎（Acute suppurative thyroiditis AST）是甲状腺的非特异性感染性疾病。由于甲状腺有完整的包膜、丰富的血供及淋巴引流、组织中存在大量的碘及生成过氧化氢,因此甲状腺组织本身具有显著的抗感染能力 [1] ,故AST临床少见。AST多见于儿童,甲状腺左叶受累较多,多以发热、颈部肿胀、疼痛就诊,AST进展迅速,未及时治疗的AST可能并发败血症、骨髓炎或化脓性血栓性静脉

目的 探讨超声辅加绘图技术对继发性甲状旁腺功能亢进甲状旁腺术前定位的效果.方法 前瞻性收集2017年6月至2018年6月期间在吉林大学中日联谊医院甲状腺外科行手术治疗的继发性甲状旁腺功能亢进患者20例,术前由术者亲自操作超声检查.前5例(超声组)仅行超声检查,后15例(超声辅加绘图组)采取超声辅加手绘标记技术,记录术前定位与术中甲状旁腺位置的符合率.结果 超声组的超声识别率为77.78％(14/18),病理诊断符合率为100％ (18/18);超声辅加绘图组的超声识别率为93.85％ (61/65),病理诊断符合率为100％ (65/65).2组的超声识别率比较差异有统计学意义(x2=0.850,P＜0.05),超声辅加绘图组的超声识别率较高.超声组患者的手术时间长于超声辅加绘图组(t=0.876,P=O.041).2组患者术后均未出现喉返神经损伤,术后复查喉镜均未出现声带麻痹.结论 对继发性甲状旁腺功能亢进患者,术前超声辅加绘图技术定位甲状旁腺快速而准确,在临床制定手术方案、术中精准切除甲状旁腺及缩短手术时间方面有一定的应用价值.

Recent evidence has revealed that certain microRNAs (miRNAs) are dysregulated in thyroid cancer (TC), which has been associated with the pathogenesis and development of TC. Therefore, improved understanding of the detailed roles of miRNAs that are aberrantly expressed in TC may aid the development of valuable therapeutic methods for the management of patients with this malignancy. In this study, miRNA‑873‑5p (miR‑873) expression in TC tissues and cell lines was detected by reverse‑transcription quantitative polymerase chain reaction (RT‑qPCR). MTT and cell invasion assays were performed to investigate the effects of miR‑873 overexpression on TC cell proliferation and invasion in vitro. Bioinformatics analysis, luciferase reporter assay, RT‑qPCR and western blot analysis were employed to evaluate whether zinc finger E‑box‑binding homeobox 1 (ZEB1) is a direct target of miR‑873 in TC cells. The present study reported that miR‑873 was weakly expressed in human TC tissues and cell lines. Functionally, miR‑873 overexpression suppressed TC cell proliferation and invasion in vitro. Mechanistically, ZEB1 was predicted to be a putative target of miR‑873. In addition, miR‑873 was proposed to directly bind to the 3'‑untranslated region of ZEB1 and decrease its expression in TC cells at the mRNA and protein levels. Furthermore, ZEB1 expression was significantly upregulated in TC tissues and negatively correlated with miR‑873 expression. Furthermore, ZEB1 restoration partially reversed the suppressive effects of miR‑873 overexpression on TC cell proliferation and invasion. These results demonstrated that miR‑873 may serve tumour‑suppressive roles in the progression of TC, and its suppressive effects could be mediated by the inhibition of ZEB1. Therefore, miR‑873 may be a valuable therapeutic target in the management of patients with TC.