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Purpose To assess the feasibility of nuclear score combined with ultrasound features on indeterminate thyroid nodules in fine needle aspiration cytological diagnosis.Methods A consecutive cohort of 119 thyroid fine-needle aspiration(FNA)specimens with indeterminate diagnosis(TBSRTC cate-gory Ⅲ-Ⅴ)and available histopathologic follow-up was evalua-ted.Original sonographic images and cytological slides of each nodule were reviewed by two experienced sonographers and two experienced cytopathologists respectively,and evaluated jointly to obtain consensus.The identification of the optimal cut-off points of simplified nuclear score and ultrasound features score for the diagnosis of malignancy or low-risk neoplasm were evalu-ated using the receiver operating characteristic(ROC)curves and the assessment of the area under the ROC curve(AUC).The specificity,sensitivity,positive predictive value(PPV)and negative predictive value(NPV)of nuclear score and US score were evaluated from crosstabs based on Cut-off points and signif-icance were calculated.The diagnostic accuracy of simplified nuclear score combined with ultrasound features was estimated by Logistic regression and ROC curve analysis.Results Nucle-ar grooves,intra-nuclear inclusions and chromatin clearing were more common in malignancy/low-risk neoplasms(P = 0.001,0.013 and 0.001 respectively).A Cut-off point of≥2 for the simplified nuclear score was sensitive for defining malignancy/low-risk neoplasm,and the sensitivity was 99.1%.Nodule height greater than width,absent halo sign,irregular margin and absent intranodular vascularization were more common in malig-nancy/low-risk neoplasms(P = 0.003,0.007,0.003 and 0.004 respectively).When the Cut-off point was set as≥5,the PPV and specificity for defining malignancy/low-risk neoplasm were 95.9%and 78.6%respectively.ROC curve analysis showed that the diagnostic accuracy of nuclear score combined with US score(0.873,95%CI = 0.777-0.970)was higher than that of nuclear score alone(0.817,95%CI = 0.687-0.948,P =0.092)or US score alone(0.758,95%CI 0.637-0.879,P =0.047).But no significant difference was detec-ted between the combined score and the nuclear score.Conclu-sion The addition of simplified nuclear score and US score to FNA cytology can increase the diagnostic accuracy of cytology in indeterminate categories.
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Objective To survey the prevalence of Hyperuricemia (HUA) in elder population of Changchun city,and to detect the correlation between cardiovascular risk factors and the HUA.Methods 900 residents older than 55 years were selected randomly for this questionnaire survey.Physical and laboratory examinations were performed.Results The HUA prevalence rate elder people in Xixin District of Changchun was 16.0％(144/900),while the rates were 13.7％(50/365),15.2％(47/309) and 20.8％(47/226) (P＜0.05) in the elder group (55-65 years),the aged group (66-75 years),and the advanced aged group (older than 76 years) respectively;there was no statistical significant difference in the prevalences between male and female (x2=0.023 5,P＞0.05).The HUA prevalence rate was significantly different between people who had different level of blood pressure,cholesterol,hypersensitive C-reactive protein (hs-CRP),body mass index (BMI),waisthip ratio (WHR).The level of uric acid (UA),total cholesterol (TC) and hs-CRP was significantly different in people with high uric acid when compared with those of normal patients (P＜0.05).There was positive correlation between UA level and TC,triglyceride (TG) level (r=0.364,P＜0.05;r=0.479,P＜0.05).Conclusion The HUA prevalence rate increases significantly as people getting older.There is positive correlation between the increase of uric acid level and the major cardiovascular risk factor.People with hypertension,hyperlipidemia,overweight and obese have high risk for HUA,so change life style and dietary habits may prevent or reduce the occurrence of HUA.
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Objective To investigate the clinical value of automated breast volume scanner(ABVS) system in detection musculoskeletal system lesions.Methods Totally 49 patients were scanned by Acuson S2000 ABVS system after conventional ultrasound examination.The scanning data of ABVS were stored and automatically reconstructed to obtain coronal and sagittal images.Then the results were analyzed and the occurrence rates of circle sign of different lesions were compared.Results The images of 49 lesions were obtained with ABVS and conventional ultrasound successfully.Statistical difference of the occurrence rate of circle sign was found between benign and malignant lesions (x2 =5.559,P =0.021).However,there was no statistical difference between hemangioma and malignant lesions (x2 =2.098,P =0.156).Meanwhile,a missed lesion in conventional ultrasound examination was found in coronal view by ABVS.Conclusions ABVS system can obtain effective coronal images of musculoskeletal system lesions,which represents a progress.
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<p><b>OBJECTIVE</b>To explore the diagnosis and surgical treatment of patients with periampullary carcinoma and situs inversus totalis.</p><p><b>METHODS</b>The data of a patient with periampullary carcinoma and complete situs inversus totalis, a rare disease treated in our hospital on Mar. 2006, was reported, and relative articles were reviewed.</p><p><b>RESULTS</b>This patient was diagnosed with stage I to II of periampullary carcinoma. Bilirubin was recovered one week postoperatively. Incomplete adhesive ileus at gastroenteral anastomosis appeared 2 weeks after the operation and was healed by nutritional support, acupuncture, endoscopic drainage and enteral nutrition. From 1936 to 2006, 15 malignant tumors with situs viscerum inversus totalis were reported, only 5 periampullary carcinomas with situs viscerum inversus totalis were reported.</p><p><b>CONCLUSIONS</b>Surgical operation should be considered for malignant tumor patients with situs inversus totalis without contraindication. Attention should be paid to the opposite anatomical structure in this kind of situation.</p>