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Objective To compare the value of multimodal ultrasound and ultrasound-guided fine-needle aspiration biopsy(US-FNAB)for distinguishing benign and malignant thyroid nodules of Chinese thyroid imaging reporting and data system(C-TIRADS)grade 4.Methods Data of 247 thyroid nodules in 201 patients were retrospectively analyzed,including 193 malignant and 54 benign noes.Taken postoperative pathology as the gold standards,the value of multimodal ultrasound,i.e.the combination of conventional ultrasound,shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)and US-FNAB for distinguishing benign and malignant thyroid nodules were compared.Results The sensitivity,specificity,accuracy,misdiagnosis rate and rate of missed diagnosis of conventional ultrasound for diagnosing malignant thyroid nodules was 86.53％,59.26％,80.57％,40.74％and 13.47％,respectively,of SWE was 78.76％,74.07％,77.73％,25.93％and 21.24％,respectively,of CEUS was 90.16％,77.78％,87.45％,22.22％and 9.84％,respectively,while of multimodal ultrasound was 97.93％,88.89％,95.95％,11.11％and 2.07％,respectively,and of US-FNAB was 89.64％,96.30％,91.09％,3.70％and 10.36％,respectively.The sensitivity,specificity and accuracy of multimodal ultrasound for distinguishing benign and malignant thyroid nodules were higher,while the misdiagnosis rate and missed diagnosis rate were lower than those of conventional ultrasound,SWE and CEUS alone.The sensitivity,accuracy and misdiagnosis rate of multimodal ultrasound were higher,while its specificity and missed diagnosis rate were both lower than those of US-FNAB(all P＜0.05).Conclusion For distinguishing benign and malignant thyroid nodules of C-TIRADS grade 4,multimodal ultrasound had higher sensitivity and accuracy but higher misdiagnosis rate,while US-FNAB had higher specificity but also higher missed diagnosis rate.
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Hepatocellular carcinoma (HCC) is a type of tumor with a high incidence rate, a low rate of early diagnosis, and poor prognosis, and its development and progression involve many factors. As an important organelle in cells, mitochondria is the "energy factory" of cells and is one of the main sites for the production of reactive oxygen species in vivo, and it also participates in the regulation of cell apoptosis. There are varying degrees of changes in mitochondrial membrane, oxidation respiratory chain, mitochondrial dynamics, mitochondrial DNA, and mitochondrial calcium homeostasis during the development and progression of HCC, and such changes may affect the progression of HCC. This article systematically elaborates on the association between mitochondria and HCC, so as to provide a new direction for the diagnosis and treatment of HCC.
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Sodium taurocholate cotransporting polypeptide (NTCP) is not only an important transporter for bile acid absorption into the liver, but also a functional receptor for HBV and HDV, and extensive studies have been performed for its structure, function, gene characteristics, and expression and regulation mechanisms. NTCP is also associated with chronic viral hepatitis, nonalcoholic fatty liver disease, liver fibrosis, primary biliary cholangitis, and hepatocellular carcinoma. This article elaborates on the role of NTCP in various hepatobiliary diseases, so as to provide new direction for the diagnosis and treatment of related diseases.
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BACKGROUND:On CT reconstruction of three-dimensional (3D) model, fracture virtual reduction and internal fixation cannot be achieved, and reasonable operation scheme cannot be formulated. Digital design can fuly meet the needs of clinical orthopedics physicians. Standard parts database can provide the possibility to choose the ideal internal fixation. 3D printing makes the reasonable operation scheme accurate in clinical implementation. OBJECTIVE:To discuss the feasibility, accuracy and minimal invasion of internal fixation in treatment of the distal femoral fracture with digital design of standard parts database by 3D printing. METHODS: (1) Nine adult lower extremity specimens were selected to take continuously thin-layer CT scanning. After Dicom images were imported into the mimics software, the model was established. According to the AO classification, they were classified into A1-3, B1-3 and C1-3 types of distal femoral fracture by virtual design. Internal fixation with plate and screw formed standard parts database virtualy. It was printed out the pilot hole of the navigation module design by three-dimensional printing forming technique. Plate and screw were inserted assisted by the module. X-ray and CT scan were taken postoperatively to access the position. (2) 30 patients with distal femoral fracture were subjected to above fixation. The operation time, intraoperative blood loss and postoperative drainage were recorded. Imaging and curative effects were evaluated during folow-up. RESULTS AND CONCLUSION: (1) Nine samples underwent X-ray and CT scan. 3D reconstruction results revealed plate position, screw entry point, nail direction, length and diameter were consistent with presetting data in Mimics software. The navigation models were designed to fit the lateral bony structure of distal femur. There were good fitting degree, good card position and good stability when the navigation was applied. It could guide plant and screw implantation. (2) In 30 cases, the operation time was (104.63±26.12) minutes, intraoperative blood loss was (121.74±11.49) mL, and postoperative drainage volume was (30.29±6.38) mL. Al patients were folowed up. According to Schagzker criterion, the efficiency of 22 cases was excelent, 6 cases good and 2 cases average, and the excelent and good rate was 93%. The parameters of length, diameter, orientation and angle were consistent with that preoperatively. (3) Internal fixation formed by standard parts database assisted by 3D printing navigation model has advantages of high accuracy, short process, lessened blood loss, high safety, less complications, and precise fixation. Digital design of standard parts database via3D printing navigation module is expected to achieve implant navigation and application.