【Abstract】Objective To investigate the safety and clinical significance of total thyroidectomy performed for benign thyroid disease. Methods Eighty-eight patients with benign thyroid disease were treated with total thyroidectomy. The postoperative complications were analyzed. Results With primary total thyroidectomy, the incidences of transient hypocalcemia and transient recurrent laryngeal nerve paralysis were 2.5% and 1.2% respectively. The incidences after reoperation were 28.6%（P＜0.05）and 28.6%（P＜0.01）respectively. No patients had permanent hypoparathyroidism and permanent recurrent laryngeal nerve injury. Conclusion Total thyroidectomy can be performed safely. It can avoid reoperation for the recurrence caused by the remainder thyroid.
Objective To review all published evidence about thyroid disease based on Meta-analysis. Methods We thoroughly searched the MEDLINE and Cochrane Library combined with Meta-analysis and thyroid disease as key words. Results Total 22 articles were obtained but only 14 papers reached our aim. Conclusion These studies ranged from etiology of thyroid cancer, levothyroxine treatment, to Graves’ disease and have provided excellent evidences about some clinical questions. But there still are a lot of questions need us study further.
ObjectiveTo summarize the clinical and genetic characteristics of parathyroid disease associated with CDC73 gene mutation.MethodsThe related literatures on CDC73 gene mutation and parathyroid diseases were collected and reviewed.ResultsCDC73 gene is a tumor suppressor gene which encodes parafibromin protein. CDC73 gene mutation may lead to the decrease or absence of expression of parafibromin protein. CDC73 gene mutation was directly associated with hyperthyroid-jaw tumor syndrome and 15% to 20% patients were associated with parathyroid carcinoma. Their first-degree relatives may also carry CDC73 gene mutation. Partial sporadic parathyroid carcinoma was associated with CDC73 mutation.ConclusionsCDC73 gene mutation is associated with various kinds of parathyroid diseases. Detection of CDC73 gene sequences and immunohistochemical analysis of parafibromin protein may be applied in the diagnosis and improve the prognosis of parathyroid diseases.
Objective To summarize the advanced researchs of autoimmune thyroid disease(ATD) complicated with differentiated thyroid cancer (DTC). Methods The related literatures about concurrent ATD and DTC were consulted and reviewed. Results Hashimoto diseas (HD) complicated with DTC at home and abroad were reported more and more, whether merging with HD or other ATD disease could affect the prognosis of papillary thyroid cancer (PTC) was a controversial topic. HD and DTC (mainly PTC) had some same epidemiological and molecular features. Conclusion Better understanding of clinical pathology and characteristic of DTC concurrent with ATD can provide some new insights to immunotherapy for DTC.
Objective To compare the economic effectiveness of universal screening, high-risk population screening, and no screening strategies for thyroid disease prevention and control among pregnant women in China through cost-effectiveness analysis, providing evidence-based support for optimizing health policy decisions on prenatal thyroid disease screening. Methods Based on the characteristics of thyroid disorders during pregnancy, a combined decision tree and Markov model was developed to conduct a lifetime cost-effectiveness analysis across three strategies: no screening, high-risk population screening, and universal screening. Sensitivity analyses were performed on key parameters. Results Base-case analysis demonstrated that universal screening was the most cost-effective strategy when the World Health Organization (WHO)-recommended payment threshold of 1×gross domestic product (GDP) per capita was used, with an incremental cost-effectiveness ratio (ICER) of 20636.18 yuan per quality-adjusted life year (QALY) compared to no screening, followed by high-risk population screening (ICER=21071.71 yuan/QALY). The results of the sensitivity analysis showed a strong stability of the model. Conclusions Of the 3 screening programs for thyroid disease in pregnancy, universal screening is the most cost-effective when the WHO-recommended payment threshold of 1×GDP per capita is used.
ObjectiveTo summarize the advancement of transoral endoscopic thyroidectomy vestibular approach (TOETVA).MethodThe relevant literatures about comparative study btween TEOTVA and other thyroidectomy were retrospectively analyzed and summarized.ResultsCompared with the conventional open thyroidectomy or other endoscopic thyroidectomy, even though TOETVA requires a longer operative time, it provides similar surgical outcomes and no scar on the body.ConclusionTOETVA is a safe and effective procedure with excellent cosmetic results for patients with thyroid disease.
Objective To summarize the relationship between IgG4 and IgG4 related thyroid diseases. Methods Domestic and international publications involving the pathological features of IgG4-related thyroid diseases and relationship with IgG4 were retrieved and reviewed. Results IgG4-related disease was a newly recognized class of chronic and systemic lymphocytes disease， which may be solitary or involving multiple body organs， as well as thyroid. The expression of IgG4 was found in leisons of Hashimoto thyroiditis， Riedel thyroiditis， and papillary thyroid carcinoma. Conclusions IgG4-related thyroid disease is a new concept of thyroiditis. The knowledge of this new disease will provide appropriate treatment for patients with thyroiditis.
ObjectiveTo summarize and analyze the possible association between thyroid diseases and alopecia areata. MethodThe literatures on the relationship between thyroid disease and alopecia areata in recent years were searched and reviewed. ResultsAmong individuals with alopecia areata, the risk of thyroid disease was heightened. They were more susceptible to autoimmune thyroid conditions, often accompanied by thyroid function abnormalities. Moreover, alopecia areata patients face an increased risk of thyroid cancer. However, in patients with thyroid disease, the change of the incidence of alopecia areata was not completely clear. The risk of alopecia areata was increased in patients with autoimmune thyroid disease, and abnormal thyroid function may be one of the potential reasons for the persistence of alopecia areata. ConclusionsAutoimmune thyroid disease and alopecia areata may have a common disease basis. Patients with alopecia areata are at greater risk of autoimmune thyroid disease and thyroid dysfunction. The increased risk of alopecia areata in patients with autoimmune thyroid disease may be related to abnormal thyroid function.
Objective To reveal the relationship between the iodine nutrition and the change of spectrum of thyroiddiseases by analyzing the change of spectrum of thyroid diseases in different iodine environments before and after the implementation of universal salt iodization （USI）. Methods To compare the urinary iodine concentration between the normal people （1 000 cases） and the patients with thyroid diseases （5 998 cases） by surgical operations who were from 4 cities of Guangxi Zhuang Autonomous Region， covering the iodine deficient areas and the iodine rich areas. Results After the USI was put into practice， the proportions of nodular goiter decreased， but the proportions of toxic nodular goiter， thyroid papillary carcinoma， and Hashimoto thyroiditis were higher than those before USI （P＜0.05）. The urinaryiodine concentrations of nodular goiter， Graves disease， toxic nodular goiter， thyroid papillary carcinoma， and Hashimotothyroiditis were higher than those before the measure was taken （P＜0.05）. The urinary iodine concentration of patients with thyroid was higher than that of normal people （P＜0.05）， and the urinary iodine concentration of patients with thyroidand normal people was higher than those before the USI （P＜0.05）. Conclusions The change of spectrum of thyroid diseases in Guangxi Zhuang Autonomous Region is obvious within 10 years after USI had been taken. The excessive intake of iodine may be one of the dangerous factors leading to toxic nodular goiter， thyroid papillary carcinoma， and Hashimoto thyroiditis.
In response to the “Healthy China 2030” strategy, the General Surgery Quality Control Center of Sichuan Province and the Thyroid Surgery Innovation and Transformation Branch of Sichuan Medical Science and Technology Innovation Association, jointly established 18 quality control (QC) nodes. This framework integrates evidence from many major domestic and international guidelines/consensus and regional clinical QC practices in Western China. The system encompasses three core dimensions: diagnostic logic accuracy (e.g., TQC-01 for targeted screening to avoid over diagnosis by specifying high-risk ultrasonography indications); evidence-based treatment hierarchy (e.g., TQC-06/TQC-08 standardizing staging protocols for surgical indications); treatment outcome optimization (e.g., TQC-17 for long-term quality-of-life tracking). A four-phase closed-loop management structure is implemented. Screening intervention: imaging restricted to high-risk populations. Standardized diagnosis: initial nodule evaluation with serological testing (TQC-02) and pathological verification (TQC-04). Treatment protocolization: stratified execution of surgery/ablation indications (TQC-10). Dynamic prognosis monitoring: 10-year survival tracking post-differentiated thyroid cancer surgery (TQC-17) and multidimensional ablation efficacy assessment (TQC-16). Under the collaborative governance of regional leading institutions, this framework has demonstrated significant impact: reduction of low-value care (e.g., avoidance of non-indicated biopsy for suspicious lesion <1 cm), elimination of critical process omissions (including mandatory TNM staging compliance), and advancement toward regional healthcare quality homogenization. These contributions establish a replicable paradigm for enhancing China’s national thyroid disease clinical quality ecosystem.