Secondary hyperparathyroidism (SHPT) is a clinical syndrome that is described as the excessive secretion of parathyroid hormone by the parathyroid glands in response to the long-term stimulation of hypocalcemia and hyperphosphatemia resulting from various causes. Some cases, due to ineffective medication or other general treatments, will progress to refractory SHPT, for which favorable results may be achieved by surgery or local interventional procedures. In this paper, the authors explore the efficacy of surgical and local interventional treatment of SHPT and discuss the prospects of application of these methods of treatment.

Objective: To investigate the relationship between Hashimoto’s thyroiditis (HT) and papillary thyroid carcinoma (PTC). Methods: The clinical data of 495 patients who underwent surgical treatment and diagnosed as PTC by postoperative pathological examination from January 2010 to May 2015 were reviewed. The clinicopathologoic characteristics between patients with and without concomitant HT were compared. Results: Among the 495 PTC patients, 108 cases (21.81%) had concomitant HT. Results of univariate analysis showed that in PTC patients with concomitant HT compared with those without HT, female cases were more frequent (90.7% vs. 71.6%), the preoperative levels of thyroid stimulating hormone (4.04 μIU/mL vs. 2.76 μIU/mL) and thyroid peroxidase antibody (TPOAb) (94.31 IU/mL vs. 33.65 IU/mL) were elevated, maximum tumor diameter was shorter (1.10 cm vs. 1.31 cm) and the number of cases with early clinical stage was increased (stage I: 87.1% vs. 76.8%), and all differences had statistical significance (all P<0.05). Logistic regression analysis showed that gender, TSH level, TPOAb level and clinical stage were independent predictors for PTC combined with HT (all P<0.05). Conclusion: PTC patients with concomitant HT present with female predominance, earlier clinical stage, and small size, suggesting that the combined HT may not increase the invasiveness of PTC, and may have a relatively good prognosis. However, the TSH level is increased in patients with concomitant HT, which suggests that HT may be one of the risks for PTC.

Because of variation of the position of the parathyroid glands and their fragile supplying blood vessels, and they are similar to fat granule or lymph nodes, it is easy to accidentally resect them or destroy their blood supply during surgery for thyroid cancer with central neck dissection, leading to postoperative hypoparathyroidism that seriously affects the patient's quality of life. How to identify parathyroid injury and protect the parathyroid function are major problems of concern of thyroid surgeons. Routine parathyroid autotransplant for preventing hypoparathyroidism during central neck dissection is still controversial. Is the use of nano-carbon of significance for avoiding parathyroid injury? Here, the authors address the above issues to provide reference on how to identify parathyroid injury and protect parathyroid function during central neck dissection.