***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: OBJECTIVE To determine the potential role of intraoperative carbon nanoparticles ( CN ) injections for identification and preservation of parathyroid gl and s , thereby reducing the postoperative hypocalcaemia . METHODS 100 patients with thyroid cancer who underwent total thyroidectomy and central compartment node dissection ( CCND ) were r and omly assigned to receive intraoperative injection of ( CN ) or not for identifying and preserving normal parathyroid gl and s. RESULTS There was no significantly difference for preoperative and postoperative parathyroid hormone ( PTH ) levels between the CN and control group ( P>0.05 ) . The levels of albumin-adjusted serum calcium ( AASC ) before surgery and at day 1 and 1 month after surgery did not reach the significant difference between the two groups ( P>0.05 ) . However , the patients in CN group had the higher level of AASC at day 3 after surgery than those in control group ( P=0.044 ) . Transient postoperative hypoparathyroidism occurred in 24 ( 48 % ) patients in CN group and 28 ( 56 % ) in control groups , respectively ( P=0.423 ) . The incidence of transient postoperative hypocalcemia was 20 % ( 10/50 ) in CN group and 24 % ( 12/50 ) in control groups , respectively ( P=0.629 ) . CONCLUSIONS Carbon nanoparticles can make the thyroid gl and and the central lymph node black-stained , but no-stained for parathyroid gl and s. After rapidly identifying parathyroid and distinguishing it from thyroid and lymph nodes by carbon nanoparticles , complete lymph node dissection and preservation of parathyroid gl and s become feasible during total thyroidectomy with neck lymph node dissection . After identification , strict adherence to capsular dissection remains essential for safe preservation in situ of the parathyroid gl and s and their blood supply OBJECTIVES To determine the incidence , risk factors and clinical relevance of incidental parathyroidectomy during thyroidectomy . METHODS A total of 207 consecutive patients with benign and malignant thyroid disorders undergoing unilateral or bilateral thyroidectomy were included prospect ively in the present study . Patients were divided into two groups according to incidental parathyroidectomy . RESULTS Two hundred and ten thyroidectomies were performed . Group A included 26 patients with incidental parathyroidectomy and group B included 181 patients without incidental parathyroidectomy .  The parathyroid tissue in the resected specimens was found in intrathyroid ( 57.7 % ) , extrathyroid ( 23.1 % ) and central node compartment ( 19.2 % ) sites . On multivariate analysis , two factors sustained their significance independently ; reoperation for recurrent goitre ( p=0.001 ) and concomitant central neck dissection ( p=0.001 ) . There was no statistically significant difference regarding the occurrence of postoperative hypocalcemia between the two groups ( p=0.55 ) . CONCLUSION Reoperation for recurrent goitre and concomitant central neck dissection for cancer thyroid may increase the risk of incidental parathyroidectomy . Incidental parathyroidectomy is not associated with symptomatic postoperative hypocalcemia . Most of removed parathyroid gl and s were intrathyroid , so incidental parathyroidectomy may be unavoidable Objective To investigate the hypothesis that injected carbon nanoparticle ( CN ) suspension helps identify parathyroid gl and s ( PGs ) during thyroid cancer surgery , thereby reducing PG injury . Study Design A prospect i ve , r and omized controlled trial . Setting Sun Yet-san Memorial Hospital , Guangzhou , China . Subjects and Methods Thyroid cancer surgeries were performed on 72 consenting patients who were r and omized for conventional surgery ( control group ) or surgery with CN suspension injection ( CN group ) . The primary end point was the prevalence of symptomatic hypocalcemia and serum calcium levels < 1.9 mmol/L. Results From 36 patients diagnosed with thyroid cancer in each group , symptomatic hypocalcemia was found in 10 patients without CN injection and 3 patients with CN suspension injection ( P = .032 ) . In total , 5.6 % of patients in the CN group presented with muscle cramps compared with 22.2 % of the control group ( P = .041 ) , which showed a significant difference . Conclusion Our r and omized study revealed that CN suspension injection was feasible and appeared to be beneficial for patients undergoing thyroid surgery because the incidence of symptomatic hypocalcemia was lower compared with controls . Therefore , this technology and technique should be more widely considered for thyroid cancer therapy . Additional studies with more patients and longer follow-up times will be needed for a thorough evaluation of this methodology Aim To evaluate the efficacy of carbon nanoparticles ( CNs ) in identifying lymph nodes and preserving parathyroids in endoscopic total thyroidectomy ( ETT ) with central neck dissection ( CND ) , and to further explore the role of CNs in recovering postoperative parathyroid function . Method Fifty-five patients with papillary thyroid carcinoma were r and omized to either CN group ( n = 28 ) or control group ( n = 27 ) . The primary outcome measures were pathological results ( e.g. , amount of incidental removed parathyroids and lymph nodes dissected ) and follow-up results [ e.g. , recovery of serum calcium and parathyroid hormone ( PTH ) levels ] . The secondary end-points were the rates of neuromuscular symptoms , in-hospital postoperative hormonal assay , and lymph node metastases . Results A total of 193 lymph nodes in the CN group and 123 lymph nodes in the control group were detected . The mean number of detected lymph nodes was significantly higher in the CN group than in the control group ( P = 0.009 ) . Parathyroids were present in the thyroid or central nodal specimens of five patients , which were all in the control group . The control group had a relatively higher incidence of incidental parathyroidectomy compared to the CN group ( P = 0.023 ) . Compared to the CN group , the incidence of paresthesia was higher in the control group even if not statistically significant . During follow-up , the serum calcium levels were higher in the CN group than in the control group ; however , there was no statistically significant difference . For the serum PTH levels , the CN group recovered rapidly to the preoperative levels , whereas the control group climbed steadily to the normal range . The serum PTH levels in the CN group were apparently higher than in the control group at 1 week and 1 month postoperatively . Conclusion CNs play an important role in protecting parathyroid gl and s , dissecting lymph nodes thoroughly , and promoting rapid recovery of parathyroid in ETT with CND ( ChiCTR-TRC-14005042 OBJECTIVE We applied carbon nanoparticle suspensions to the papillary thyroid carcinoma cases with no clinical regional lymph node metastasis ( cN0 ) to show the lymph flow from primary tumors , and evaluated its value in the lymph node biopsy of cN0 papillary thyroid carcinoma and protection of parathyroid . PATIENTS AND METHODS One hundred and fourteen patients with cN0 papillary thyroid carcinoma were r and omly assigned to experimental and control groups . The experimental group received carbon nanoparticles injection around the primary tumor , while the control group received no injection . Both groups subsequently received st and ard lateral thyroid gl and resection , isthmus resection , subtotal thyroidectomy , or clearance of lymph nodes ( LNs ) of the central compartment . RESULTS A total of 342 LNs of the central compartment were dissected in the experimental group ( 6.00 ± 0.98 per patient ) with 81 LNs confirmed to be positive ( 0.95 ± 0.77 per patient ) , whereas 261 LNs of the same area were dissected in the control group ( 4.58 ± 0.60 per patient ) with 27 confirmed to be positive ( 0.47 ± 0.50 per patient ) . There is a significant difference between experimental and control groups in the average number of LNs dissected per patient ( 6.00 ± 0.98 vs. 4.58 ± 0.60 , p < 0.001 ) but not the positive LNs per patient ( 0.95 ± 0.77 vs. 0.47± 0.50 , p = 0.11 ) . Parathyroid was found in two patients from the experimental group and in seven patients in the control group ( p = 0.29 ) . Three patients in the experimental group and seven patients in the control group had hypocalcemia ( p = 0.21 ) , and four patients in each group had hoarseness ( p = 0.58 ) . CONCLUSIONS Carbon nanoparticle suspensions can be used to stain central lymph nodes of cN0 papillary thyroid carcinoma without staining of parathyroid and leakage , and improve the resection of LNs OBJECTIVE To investigate the clinical application of carbon nanoparticles staining in cervical lymph node dissection on clinical neck lymph nodes the negative ( cN0 period ) thyroid papillary thyroid carcinoma ( PTC ) . METHOD This retrospective analysis comprised 100 papillary thyroid cancer patients who met inclusion criteria , and they were r and omly divided into the nano-carbon group ( 50 cases ) and control group ( 50 cases ) . They underwent lobectomy , subtotal thyroidectomy or total thyroidectomies and were given elective central compartment neck dissection ( CCND ) . The number of detected lymph nodes in each group was summed , and pathological examination was conducted . The number of lymph nodes ( dyedor not dyed ) and the location of metastatic nodes were recorded separately . RESULT In the nano-carbon group the average number of eliminated lymph nodes is significantly more than that of the control group(P<0.05 ) . The metastasis lymph nodes in the nano-carbon group was higher than that in the control group(P<0.01 ) . Among 100 cases , 2 % had temporary vocal cord palsy , and 8 % had temporary hypoparat hyroidism . No case of permanent vocal cord palsy or permanent hypocalcemia was observed . CONCLUSION The dyed lymph nodes can be easily identified and can be used as a guide for lymphnodes dissection in papillary thyroid carcinoma operation OBJECTIVE To discuss the role of carbon nanoparticles in the protection of parathyroid during thyroid carcinoma surgery . METHOD Seventy-two patients with thyroid carcinoma who had initial surgery were r and omly divided into two groups : carbon nanoparticles group and the control group . Emulsion of carbon nanoparticles was injected into the thyroid gl and of carbon nanoparticles group patients . After thirty minutes , the excision of thyroid carcinoma and VI group neck dissection were performed in carbon nanoparticles group patients , the control group directly underwent operation . The black stained tissue in the dissection specimen of carbon nanoparticles group was separated . The number of total lymph node , metastasis lymph node and parathyroid gl and in the tissure black stained or not in two groups were counted respectively . RESULTS There were 312 lymph nodes in the black stained tissue of central compartment dissection specimen of carbon nanoparticles group . No parathyroid gl and was found in the black stained tissue . Fifteen lymph nodes containing four parathyroid gl and s were found in the non black stained tissue in carbon nanoparticles group while there were 202 lymph nodes containing 13 parathyroid gl and s in the control group . There were statistical difference between the amount of lymph node in black stain tissue and the specimen of the control group . Parathyroid gl and s were not stained black , and no parathyroid gl and was found in the black-stained tissue . CONCLUSION The carbon nanoparticles could be used to identify the lymph node and the parathyroid gl and for protecting the parathyroid gl and in thyroid surgery OBJECTIVE To assess the efficiency of carbon nanoparticle in guiding level VI lymphadenectomy and parathyroid preservation in thyroidectomy for carcinoma . METHODS One hundred and nine patients with well differentiated thyroid carcinoma , in whom thyroidectomy and bilateral lymphadenectomy for level VI were carried out at the same time , were prospect ively studied . Fourty-five cases received carbon nanoparticle injecion in thyroid consistitued trial group , while sixty-four underwent conventional surgery  as  control group  . The numbers of total dissected lymph nodes , metastasis lymph nodes , black-stained lymph nodes , detected parathyroids and mistakenly removed parathyroids were counted respectively . The PTH levels were measured at 1 d , 5 d and 30 d after surgery , respectively . Student 's t test and Chi-square analysis were used for analyzing data . RESULTS The number of lymph node found in the trial group in level VI was checked out as ( 9.7 ± 1.7 ) each side , whereas that of the control group was ( 6.7 ± 1.9 ) each side . The discrepancy of two groups was statistical meaningful ( t = 23.14 , P < 0.001 ) . The discrepancy of the rate of lymph node black-stained 90.5 % ( 738/815 ) , incidence of metastasis of the black-stained lymph nodes 45.9 
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Conclusion CNs can improve the extent of neck dissection and protect the parathyroid gl and s during thyroid cancer surgery .
And the number of identified metastatic lymph nodes can be simultaneously increased