Increased surgical technology has led broad acceptance endoscopic thyroidectomy and its application in the treatment of thyroid diseases, including thyroid carcinoma. Although the incidence of complications and mortality of thyroid surgery has been significantly reduced, serious complications still occur from time to time. The purpose of this retrospective study is to identify the factors that influence the complications of endoscopic thyroidectomy.This study was carried out between January 2012 and December 2019, where a total of 630 patients undergoing endoscopic thyroidectomy via the total areola approach were retrospectively evaluated to identify the key influencing factors of complications.The study established that the common complications included recurrent laryngeal nerve injury (3.33%), superior laryngeal nerve injury (2.54%), hypocalcemia (8.57%), and the incidence of complications was acceptable. Both univariate and multivariate analysis showed that thyroid carcinoma (P = 0.041), operation time lasting more than 150 minutes (P = 0.034) and operation before 2017 (P = 0.001) were risk factors of recurrent laryngeal nerve injury. We established that operation after 2017 (P < 0.005) was the only protective factor of superior laryngeal nerve injury. Thyroid carcinoma (P=0.04), operation mode (P=0.001), and surgery before 2017 (P<0.001) are risk factors for parathyroid injury. Among the clinical groups, operation before 2017 was an independent risk factor for all complications.For thyroid specialists, after the early learning curve, with the continuous improvement of endoscopic operation technology, high-definition equipment and more sophisticated operation equipment can be used in clinical practice, which can prevent and reduce the occurrence of complications.
Abstract Reflection electron microscopy (REM) has been applied to image the surface structures of polished natural diamond (001) faces before and after frictional sliding. Friction tracks produced by a diamond stylus sliding at a nominal contact pressure of a few GPa can be clearly seen in REM images of the surface. The contact between the stylus and the surface is shown to be non-uniform. At low nominal contact pressures, ∼3·5 GPa, the surface shows relative dark contrast at the contact areas, which it is suggested is due to structural modification of the top atomic layers. At nominal contact pressures of ∼13 GPa, the surface is damaged on a scale less than the height of polishing lines. At high nominal contact pressures, ∼21 GPa, ‘grooves’ are produced on the surface. This result, and the absence of surface cracking, suggested that plastic deformation is involved in the process of frictional sliding on diamond at high contact pressures.
Seven-nanometer cobalt nanocrystals are synthesized by colloidal chemistry. Gentle annealing induces a direct structural transition from a low crystalline state to the hexagonal close packed (hcp) phase without changing the size, size distribution, and the lauric acid passivating layer. The hcp structured nanocrystals can be easily redispersed in solvent for further application and processing. We found that the magnetization at saturation and the magnetic anisotropy are strongly modified through the annealing process. Monolayer self-assembly of the hcp cobalt nanocrystals is obtained, and due to the dipolar interaction, ferromagnetic behavior close to room temperature has been observed. This work demonstrates a novel approach for obtaining small size hcp structured cobalt magnetic nanocrystals for many technological applications.