Objective To study the effect of temporary in vitro preservation of parathyroid on the activity of cells in the process of parathyroid auto-transplantation and function of postoperative in order to improve the survival rate of transplantation.Methods (1)Experimental rabbits for the study were randomly divided into three groups:group A,group B,group C,with 8 rabbits in each group.Then we remove the bilateral inferior parathyroid,in group A,the parathyroid glands were immediately formaldehyde-fixed;in group B and group C,the parathyroid glands were placed in normal saline in 4 ℃ and in room temperature (22-24 ℃) for 30 minutes respectively and then fixed;HE staining was performed on the left parathyroid glands to observe the morphology of the cells;Electron microscopic examination of the right parathyroid glands were performed to observe the ultrastructural changes of the cells.(2)Experimental rabbits were randomly divided into three groups:group D group E and group F,with 8 rabbits in each group,after total thyroidectomy,the double inferior parathyroid glands were took out,in group D,the parathyroid glands were immediately transplanted in bilateral anterior cervical muscles;in group E and group F,the parathyroid glands were placed in normal saline 4 ℃ and in room temperature (22-24 ℃) for 30 minutes respectively and then transplanted.All animals were monitored of serum calcium and PTH on preoperative 1 d and postoperative 1 d,3 d,5 d,7 d;the parathyroid was took out for HE staining to observed survival of parathyroid tissue and pathology damage when 7d after operation.Results (1) The normal parathyroid gland is mainly dominated by the chief cells,the nucleus of the chief cell was round and centered under electron microscope;there were no significant change in the morphology of parathyroid cells,and the mitoehondria of the cells were slightly swollen under 4 ℃;but the parathyroid gland cells were slightly swollen and partially vacuole degeneration,the morphology of the nucleus was irregular,and the mitochondria were extremely swollen and deformed,and the ridge was broken under room temperature.(2)three groups of rabbits after transplantation of parathyroid,serum calcium and PTH decreased significantly,and increased gradually,there was significant difference on the 7th day after the operaion between the two groups (P＜0.05);(3)in group D,the normal parathyroid cells densely distributed in the anterior cervical muscle tissue;in group E,A large number of parathyroid cells survived in muscle tissue,with some vacuolated;in group F,only part of healthy parathyroid ceils scattered in the muscle.Conclusion Parathyroid should be preserved in 4 ℃ normal saline during the operation,and the transplant should be completed in 30 minutes as far as possible.%目的 研究甲状腺术中甲状旁腺自体移植过程中体外临时保存对其细胞活性和移植后功能的影响,以提高甲状旁腺自体移植的成活率.方法 (1)以实验家兔为研究对象,分为A、B、C3组,每组8只.取出双侧下甲状旁腺,A组立即后续处理;B、C组分别置于4℃、室温(22～24℃)生理盐水中30 min.左侧甲状旁腺统一行HE染色,观察细胞形态;右侧甲状旁腺统一行透射电子显微镜检查,观察细胞超微结构变化.(2)实验家兔分为D、E、F3组,每组8只,行双侧甲状腺全切除术后,取出双下甲状旁腺,D组立即移植(双侧颈前肌内,下同);E、F组分别置于4℃、室温(22～24℃)生理盐水中30 min后移植;3组动物于术前1d,术后1、3、5、7d抽血监测血钙、血PTH水平,并于第7天处死动物,切取移植的甲状旁腺组织行HE染色,高倍镜下观察甲状旁腺组织面积及病理损害.结果 正常甲状旁腺以主细胞为主,电镜下主细胞核圆、居中;4℃保存后甲状旁腺细胞形态未见明显变化,主细胞线粒体轻度肿胀;室温保存后甲状旁腺细胞稍肿胀,部分空泡变性,电镜下细胞核形态不规则,线粒体极度肿胀变形、嵴断裂、减少.动物双下甲状旁腺移植术后,血钙、血PTH均明显下降,之后逐渐上升;术后7d两组间差异均有统计学意义(P＜0.05);术后7dD组:正常甲状旁腺细胞密集分布于颈前肌肉组织中;E组部分空泡变性;F组:只有部分健存甲状旁腺细胞散在分布于肌肉中.结论 离体甲状旁腺应保存在4℃生理盐水中,并尽可能在30 min内完成自体移植.
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