［Abstract］　Secondary hyperparathyroidism(SHPT) is a common complication in patients with chronic kidney disease(CKD), and parathyroidectomy(PTX) is one of the most important methods for the treatment of SHPT. The use rate of PTX is low in China, and the indications for PTX adopt the international guidelines and are considered to be a high-risk surgical treatment. This article mainly reviews intact parathyroid hormone(iPTH)>800 pg/ml as the cut-off value for indication and surgical risk of PTX. The therapeutic value of whether lower iPTH cut-off value(<800 pg/ml) for PTX and performed in the early stage of CKD instead of ESRD is applicable and brings better benefits for patients and lower surgical risks to be affirmed by prospective randomized controlled study in China. Only in this way can we develop surgical indications suitable for patients with SHPT in China. Constructing multidisciplinary team(MDT) helps to improve the safety of clinical and research of surgical treatment for SHPT.]]> 2019/4/1 16:03:53 CHENG Ruo-chuan, SU Yan-jun 5true ［Abstract］　Secondary hyperparathyroidism(SHPT) has become one of the common complications of chronic kidney disease(CKD), but surgical treatment for SHPT is still in the state of the coexistence of several operation methods, and there is no unified standard for surgical indications and the choice of different operation methods. Multidisciplinary treatment for the parathyroid disease has been adopted by specialists and is worthy of further promotion. Future efforts need to be made to reduce operative complications, decrease recurrence rate, establish a perioperative evaluation pattern, perfect the assessment of calcium metabolism and establish a postoperative follow-up system. This article reviews the history, status quo and goal for surgical treatment of SHPT.]]> 2019/4/1 16:03:53 ZHENG Xun, CHEN Bao-jie, SU An-ping, et al. 4true ［Abstract］　This article summarizes the experience in the diagnosis and treatment of primary hyperparathyroidism(PHPT). PHPT is the most common cause of hypercalcemia. In countries where biochemical screening is routine, such as Europe and North America areas, asymptomatic PHPT is diagnosed as a common disease. Blood calcium and PTH should be a screen method for the patients suspected of having PHPT. Preoperation precise localization is helpful for the resection of pathological lesions. Ultrasound and ^99mTc-MIBI SPECT have been the most common approaches to pre-operative localization. The use of intraoperative PTH measurements has given assurance about the likelihood of cure after removal of the single or multiply involved parathyroid tissues. PHPT should be recommended to those who meet any one of the criteria for surgery: hypercalcemia consistently >1 mg/dl above normal; fracture; renal stones; Z-score<-2.5 at any site; and age <50 years. In the patients who do not meet any criteria for surgery, a conservative approach with appropriate monitoring is acceptable.]]> 2019/4/1 16:03:53 WANG Hong-cheng, CHEN Jiong 3true ［Abstract］　Objective　To compare the clinical efficacy of total parathyroidectomy(TPTX) and total parathyroidectomy with auto-transplantation (TPTX+AT) on uremic secondary hyperparathyroidism(SHPT). Methods　A retrospective analysis was performed on 200 uremic SHPT patients from three hospitals who underwent parathyroidectomy during June 2014 and June 2017. The TPTX group(n=97) underwent TPTX and the TPTX+AT group(n=103) underwent TPTX+AT. Intact parathyroid hormone(iPTH), calcium and phosphorus in serum were collected before operation and at the first day, first week, third month and the first year after operation. Clinical symptoms, postoperative complications and palindromia were observed. Results　All the patients were operated smoothly, and their symptoms such as bone pain, skin itching, myasthenia and restless leg syndrome were significantly alleviated after operation. The levels of iPTH, calcium and phosphorus in the two groups decreased significantly at the first day, first week, third month and the first year after operation compared with those before operation(P<0.05). The differences of iPTH, serumal calcium and phosphorus levels were not statistically significant between the two groups at different time points after operation(P>0.05). There were no significant differences in the decreased levels of iPTH, serumal calcium and phosphorus between the two groups after operation(P>0.05). During a follow-up of 1 year, the recurrence rate of the TPTX group［ 3.09%(3/97)］ was lower than that of the TPTX+AT group［3.88%(4/103)］, but the difference was not statistically significant(P>0.05). There were no obvious adverse reactions in both groups, such as severe intolerable hypocalcemia, low transport osteopathy and so on. Conclusion　Both of the operative methods are effective in treatment of uremic SHPT. The adverse reactions and recurrence rates are low. The selection of the operative methods should follow the principle of individualization, patients′ requirements and the willingness of kidney transplantation.]]> 2019/4/1 0:00:00 LIAO Dan, LIU Tian-qi, ZHU Mao-guang 2true ［Abstract］　Objective　To explore the application of nano carbon parathyroid negative imaging in operation on patients with chronic kidney disease(CKD) secondary hyperparathyroidism(SHPT). Methods　Forty SHPT patients were randomly divided into two groups. The treatment group(n=20) was injected with carbon nanoparticles in the thyroid gland to find parathyroid glands, and underwent parathyroidectomy(PTX) and autologous forearm transplantation. The control group(n=20) underwent PTX and autologous forearm transplantation. Results　The thyroids and lymph nodes were quickly dyed black after injection of carbon nanoparticles suspensions, while the targeted parathyroids were not colored. The intraoperative fields were clear and parathyroids were rapidly stripped and dissected. The average time of operation in the treatment group(60.28±10.50)min was significantly shorter than that in the control group(120.35±13.50)min (P<0.01). The average hospitalization time of the treatment group(7.21±2.20)days was significantly shorter than that of the control group(10.25±3.15)days (P<0.01). The ostalgia and pruritus symptoms disappeared after operation in the two groups,and the postoperative blood iPTH decreased significantly after surgery, but there were no significant differences between the two groups(P>0.05). Conclusion　The carbon nanoparticles suspension injection has significant positioning value in the PTX of SHPT patients, which can shorten the operation time, reduce the trauma, and shorten the time of hospitalization.]]> 2019/4/1 16:03:53 LIAO Dan, ZHANG Meng-die, ZHENG Hou-pu, et al. 1true