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Methods:The clinical data of 15 cases of nonfunctioning parathyroid cysts admitted in the recent 16 years were retrospectively analyzed.

对近16年来收治的无功能性甲状旁腺囊肿15例患者的临床资料进行回顾性分析研究。

The Ca level was also significantly decreased after the operations but it only had statistic significances in group Ⅰ. Conclusion Both subtotal parathyroidectomy and total parathyroidectomy with parathyroid tissue transplantation in the forearm have therapeutic effects for renal secondary hyperparathyroidism and the effects had no significant differences in the short term.

对内科治疗无效的肾性继发性甲状旁腺功能亢进患者,甲状旁腺次全切除术及甲状旁腺全切+前臂移植术都是有效的治疗方法,且两种手术方式在术后短期内(术后1天及6个月)的治疗效果无统计学差异。

Application of pancreaticoduodenectomy for potentially malignant endocrinal tumor in pancreatic head, the value of surgical procedure in patient asymptomatic primary hyperparathyroidism or in patient with gastrinoma with MEN-1 , etc.

比较有代表性的包括低危组的分化型甲状腺癌患者是否应作甲状腺全切除、胰头部恶性倾向的内分泌肿瘤是否需作胰头十二指肠切除、无症状甲状旁腺腺瘤患者应手术还是随访观察、合并MEN-1的胃泌素瘤患者是选择手术切除抑或药物控制等等。

Itamin D from the skin and diet is metabolized in the lier to 25-hydroxyitamin D (Figure 1), which is used to determine a patient's itamin D status1,2,3,4; 25-hydroxyitamin D is metabolized in the kidneys by the enzyme 25-hydroxyitamin D-1-hydroxylase (CYP27B1) to its actie form, 1,25-dihydroxyitamin D.1,2,3,4 The renal production of 1,25-dihydroxyitamin D is tightly regulated by plasma parathyroid hormone leels and serum calcium and phosphorus leels.1,2,3,4 Fibroblast growth factor 23, secreted from the bone, causes the sodium–phosphate cotransporter to be internalized by the cells of the kidney and small intestine and also suppresses 1,25-dihydroxyitamin D synthesis.5 The efficiency of the absorption of renal calcium and of intestinal calcium and phosphorus is increased in the presence of 1,25-dihydroxyitamin D (Figure 1).2,3,6 It also induces the expression of the enzyme 25-hydroxyitamin D-24-hydroxylase (CYP24), which catabolizes both 25-hydroxyitamin D and 1,25-dihydroxyitamin D into biologically inactie, water-soluble calcitroic acid.2,3,4

从皮肤和食物来的维生素D在肝中代谢为25-羟基维生素D(图1),被用来决定病人体内维生素D情况的1,2,3,4;25-羟基维生素D在肾中被25-羟基维生素D1羟化酶(CYP27B1)转变为有活性的1,25-二羟基维生素D 。1,2,3,4由肾产生1,25-二羟基维生素D是被血浆甲状旁腺激素和血清钙,磷水平紧密调节。1,2,3,4由骨分泌的成纤维细胞生长因子23使钠磷协同转运蛋白被肾和小肠细胞内化及抑制1,25-二羟维生素D合成。5 在1,25-二羟基维生素D作用下肾和小肠吸收钙及磷的效率增高(图1)。2,3,6 它也包括25-羟四- 24 -羟化酶的表达(CYP24),且将1,25二羟基维生素D和25羟基维生素D异化成无生物活性,水溶性的维生素D3-23羧酸。2,3,4

The recommended leel of serum itamin D is the leel at which the parathyroid leel does not become hyperactie, but we now know that itamin D affects not only the parathyroid gland, but all these other systems in the body, and it appears we need een higher leels to hae a positie effect on these other systems, he said.

骨质疏松症的妇女维生素D推荐摄入量为1200单位/天。&他解释到,&这个标准的制定是在无甲状旁腺功能亢进时的维生素D水平。但是进一步的研究结果显示高剂量的维生素D对于全身的其他器官有着积极的作用。

After thyroid reoperation, 3 cases (2.2%) had recurrent laryngeal nerve injury, 2 cases (1.4%) had partial parathyroid gland injury, 2 cases (1.4%) had superior laryngeal nerve injury, but there were no cases of esophageal injury or postoperative bleeding.

再次手术后新发的喉返神经损伤3例(2.2%),甲状旁腺部分损伤2例(1.4%),喉上神经损伤2例(1.4%);无食管损伤及术后出血。

All patients with secondary osteoporosis caused by all endocrine diseases including Cushing's disease, hyperthyrosis, hyperparathyroidism, capsula glandulae thyroideae or thyroid hypofunction and diabetes, and patients whose bone metabolism was interfered by grave diseases were excluded. Three months before the trial, the patients did not receive any drug that could interfere the bone metabolism or affect endothelin, such as estrogenic hormone, calcitionin, nitrogen monoxidum, glucocorticoid. In addition, the patients suffering from bone fracture within 1 year or grave cardio-cerebrovascular disease, which had intimate correlation with endothelin, liver and kidney disfunction were eliminated.

所有纳入病例均排除以下患有引起继发性骨质疏松症的各种内分泌疾病者(如柯兴氏病、甲状腺功能亢进、甲状旁腺功能亢进、甲状腺囊肿或机能低下、糖尿病等);其他严重疾病干扰骨代谢者;测试前3个月内未使用过雌激素、降钙素、一氧化氮、糖皮质激素等干扰骨代谢或对内皮素有影响作用的药品;测试前1年内无骨折;患有严重心脑血管等与内皮素水平相关密切之疾病及肝肾功能异常者。

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