Diagnostic value of 2017 ACR Thyroid Imaging Reporting and Data System (TI-RADS) combined with fine needle aspiration biopsy in thyroid nodules.

OBJECTIVE: To evaluate diagnostic value of Thyroid Imaging Reporting and Data System published by American College of Radiology (ACR TI-RADS) in 2017, ultrasound-guided fine-needle aspiration (US-FNA), and the combination of both methods in differentiation between benign and malignant thyroid nodules. METHODS: The data of US-FNA and ACR TI-RADS are collected from 159 patients underwent thyroid surgery in our hospital, which include a total of 178 thyroid nodules. A Bethesda System for Reporting Thyroid Cytopathology category of ≥IV and an ACR TI-RADS category ≥4 are regarded as diagnosis standards for malignancy in US-FNA and ACR TI-RADS, respectively. The pathological results after surgery are considered as the gold standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the ACR TI-RADS, US-FNA and the combination of both methods for the differential diagnosis of thyroid nodules are calculated, respectively. RESULTS: The sensitivity, specificity and accuracy of ACR TI-RADS are 85.4%, 37.5%and 72.5%, respectively. The sensitivity, specificity and accuracy of US-FNA are 70.0%, 100%and 78.1%, respectively. After combining these two methods, the sensitivity, specificity and accuracy increase to 99.23%, 37.50%and 82.58%, respectively. The sensitivity of ACR TI-RADS is higher than that of US-FAN, and the sensitivity of combining these two methods is also higher than that of using ACR TI-RADS and US-FNA alone. CONCLUSION: The established ACR TI-RADS can help in selecting the target during nodule puncture, while the combination of ACR TI-RADS and US-FAN can further improve diagnostic ability for detecting malignant thyroid nodules.

Comparison of different methods of intestinal obstruction in a rat model.

AIM: To investigate different methods of creating incomplete intestinal obstruction in a rat model and to compare their electrophysiologic, morphologic and histologic characteristics. METHODS: Rat ileum was partially obstructed by the respective application of: braided silk (penetrated the mesentery and surrounded intestine); half ligation (penetrated directly and ligated 1/2 cross-section of the intestine); wide pipe (6 mm in width, surrounded the intestine); narrow pipe (2 mm in width, surrounded the intestine). A control was also included (no obstruction). Various behavioral and electrophysiologic variables, as well as morphologic and immunohistochemical observations were recorded by blinded investigators at different time points (12, 24, 48, 72 h), including daily general condition, ileal wet weight and circumference, macromorphous and micromorphous intestine, bowel movement capability in vivo and in vitro, slow wave and neural electrical activity, and the number of c-Kit positive interstitial cells of Cajal (ICC). RESULTS: Despite being of a similar general condition, these methods resulted in different levels of obstruction in each group compared with the control at different time points (12, 24, 48, 72 h). However, these fields of the wide pipe rat showed significantly differences when compared with the other three obstructed groups at 12 to 72 h, including macroscopic and histological presentation, intestinal transit ratio and contractility, circumference and wet weight, amplitude and frequency of nerve electrical discharge and slow wave, and ICC numbers (all P < 0.01). CONCLUSION: The wide pipe rat method is significantly more reliable and stable than the other methods of obstruction, demonstrating that use of the wide pipe method can be a useful model of incomplete intestinal obstruction.

[Study on regulatory effect of Bushen Antai Recipe on levels of estrogen and progesterone in blastocyst implantation dysfunction mice].

OBJECTIVE: To investigate the effect and explore the mechanism of Bushen Antai Recipe (BAR) on pregnancy rate and number of implantation site in blastocyst implantation dysfunction (BID) mice induced by indomethacin. METHODS: Pregnant mice were divided into 3 groups randomly: the normal group, the model group and the BAR group. Tap water was given orally to the rats in the normal and model groups, and BAR to the rats in the BAR group from the first day of pregnancy for 5 or 8 days; on the 3rd and 4th day dissolvent was injected subcutaneously twice per day in the normal group, while indomethacin (4.33 mg/kg) was injected subcutaneously twice per day in the other two groups to establish implantation dysfunction model; serum estrogen (E) and progesterone (P4) levels were detected on the 5th and 8th day; the pregnancy rate and number of implanted site was observed and the receptors of E and P4 in endometrium of uterus were examined by immunohistochemistry on the 8th day. RESULTS: The pregnancy rate and number of implanted site was 27.3% and 5.3 +/- 0.7 respectively in the model group, significantly lower than those in the normal group (90.9%, 13.3 +/- 2.8), and the BAR group (72.7%, 10.7 +/- 2.2, P < 0.05). Serum E level was higher in the BAR group than that in the model group on the 5th and 8th day, and even higher than that in the normal group on the 8th day; serum P4 level was lower in the model and BAR groups than that in the normal group on the 5th day (P < 0.01), but higher in the BAR group than that in the model group on the 8th day. Immunohistochemical observation showed that expressions of E and P4 receptor increased remarkably in the BAR group than those in the model group. CONCLUSION: BAR increases the pregnancy rate and number of implanted site of indomethacrne induced BID mice through regulating E and P4 levels and enhancing the expressions of their receptors in the endometrium.