Polymer-based cascaded waveguide Bragg grating for blood glucose sensing.

Waveguide Bragg grating (WBG) blood glucose sensing, as a biological sensing technology with broad application prospects, plays an important role in the fields of health management and medical treatment. In this work, a polymer-based cascaded WBG is applied to glucose detection. We investigated photonic devices with two different grating structures cascaded-a crossed grating and a bilateral grating-and analyzed the effects of the crossed grating period, bilateral grating period, and number of grating periods on the sensing performance of the glucose sensor. Finally, the spectral reflectance characteristics, response time, and sensing specificity of the cascaded WBG were evaluated. The experimental results showed that the glucose sensor has a sensitivity of 175 nm/RIU in a glucose concentration range of 0-2 mg/ml and has the advantages of high integration, a narrow bandwidth, and low cost.

The function and mechanism of PSMD14 in promoting progression and resistance to anlotinib in osteosarcoma.

BACKGROUND: Osteosarcoma is a rare bone malignancy that frequently affects adolescents and poses formidable obstacles in its advanced stages. Studies revealed that PSMD14 may be a viable osteosarcoma treatment target. However, PSMD14's function and mechanism in osteosarcoma remain unknown. This study aimed to examine the function and mechanism of PSMD14 in the biological behavior of osteosarcoma and its role in anlotinib resistance. METHODS: Western blotting, qRT-PCR, and immunohistochemistry (IHC) studies were used to examine PSMD14 levels. The role of PSMD14 in the malignant phenotype of osteosarcoma and its molecular pathway was explored by a series of studies, including Western blotting, cell amplification assay, transwell assay, and tumor growth. Furthermore, a series of in vitro investigations were done to determine the effect of PSMD14 on anlotinib-resistant osteosarcoma cell lines. RESULTS: PSMD14 expression was elevated in osteosarcoma tissues compared to normal tissues. Overexpression of PSMD14 was associated with osteosarcoma patients' pathological grade and clinical stage, and PSMD14 was an independent poor prognostic factor. PSMD14 knockdown inhibits in vitro cell proliferation, migration, invasion, and in vivo tumor growth. PSMD14 knockdown has the potential to downregulate the PI3K/Akt/mTOR pathway, which was regarded as one of the key mechanisms promoting tumor growth. PSMD14 was likewise overexpressed in anlotinib-resistant OS cell lines, and its knockdown not only reduced the proliferation, migration, and invasion of subline cells and triggered cell apoptosis. Importantly, combination therapy with anlotinib enhanced these effects. CONCLUSIONS: PSMD14 is substantially expressed in osteosarcoma and may be an independent risk factor associated with poor prognosis. It can promote tumor progression and anlotinib resistance in osteosarcoma and may promote osteosarcoma progression by modulating PI3K/AKT/mTOR signaling pathway.

Inhibitory effects of longan seed extract on polycyclic aromatic hydrocarbons formation and muscle oxidation in baked mutton kebabs.

Longan seeds, rich in phenolic compounds with antioxidant properties, are an underestimated by-product of longan processing. Polycyclic aromatic hydrocarbons (PAHs), which are carcinogenic and mutagenic, are produced during the cooking of meat products at high temperatures. The effects of different concentrations of longan seed extract (LSE, 0.2, 0.6, 1.0 mg/mL) on the formation of PAHs and muscle oxidation in mutton kebabs were investigated. Mutton kebabs were baked at 150, 200, 250 °C for 20 min, respectively, and the contents of PAHs, the degree of lipid and protein oxidation were evaluated. The results showed that LSE exhibited positive effects in inhibiting total PAHs formation (range from 14.9 to 48.8 %), decreasing the thiobarbituric acid reactive substances (TBARS) values (range from 17.1 to 39.1 %), reducing carbonyl content (range from 22.0 to 51.2 %) and increasing sulfhydryl content (range from 18.6 to 51.8 %). This study provided a guidance and potential solution for reducing the content of PAHs and muscle oxidation levels in baked meat.

Fabrication and characterization of polymer optical waveguide Bragg grating for pulse signal sensing.

Polymer materials have the advantages of a low Young's modulus and low-cost preparation process. In this paper, a polymer-based optical waveguide pressure sensor based on a Bragg structure is proposed. The change in the Bragg wavelength in the output spectrum of the waveguide Bragg grating (WBG) is used to linearly characterize the change in pressure acting on the device. The polymer-based WBG was developed through a polymer film preparation process, and the experimental results show that the output signal of the device has a sensitivity of 1.275 nm/kPa with a measurement range of 0-12 kPa and an accuracy of 1 kPa. The experimental results indicate that the device already perfectly responds to a pulse signal. It has significant potential application value in medical diagnostics and health testing, such as blood pressure monitoring, sleep quality monitoring, and tactile sensing.

Microring structure for flexible polymer waveguide-based optical pressure sensing.

Flexible pressure sensors provide a promising platform for artificial smart skins, and photonic devices provide a new technique to fabricate pressure sensors. Here, we present a flexible waveguide-based optical pressure sensor based on a microring structure. The waveguide-based optical pressure sensor is based on a five-cascade microring array structure with a size of 1500 µm × 500 µm and uses the change in output power to linearly characterize the change in pressure acting on the device. The results show that the device has a sensing range of 0-60 kPa with a sensitivity of 23.14 µW/kPa, as well as the ability to detect pulse signals, swallowing, hand gestures, etc. The waveguide-based pressure sensors offer the advantages of good output linearity, high integration density and easy-to-build arrays.

FCOS-LSC: A Novel Model for Green Fruit Detection in a Complex Orchard Environment.

To better address the difficulties in designing green fruit recognition techniques in machine vision systems, a new fruit detection model is proposed. This model is an optimization of the FCOS (full convolution one-stage object detection) algorithm, incorporating LSC (level scales, spaces, channels) attention blocks in the network structure, and named FCOS-LSC. The method achieves efficient recognition and localization of green fruit images affected by overlapping occlusions, lighting conditions, and capture angles. Specifically, the improved feature extraction network ResNet50 with added deformable convolution is used to fully extract green fruit feature information. The feature pyramid network (FPN) is employed to fully fuse low-level detail information and high-level semantic information in a cross-connected and top-down connected way. Next, the attention mechanisms are added to each of the 3 dimensions of scale, space (including the height and width of the feature map), and channel of the generated multiscale feature map to improve the feature perception capability of the network. Finally, the classification and regression subnetworks of the model are applied to predict the fruit category and bounding box. In the classification branch, a new positive and negative sample selection strategy is applied to better distinguish supervised signals by designing weights in the loss function to achieve more accurate fruit detection. The proposed FCOS-LSC model has 38.65M parameters, 38.72G floating point operations, and mean average precision of 63.0% and 75.2% for detecting green apples and green persimmons, respectively. In summary, FCOS-LSC outperforms the state-of-the-art models in terms of precision and complexity to meet the accurate and efficient requirements of green fruit recognition using intelligent agricultural equipment. Correspondingly, FCOS-LSC can be used to improve the robustness and generalization of the green fruit detection models.

[Evaluation of Extrathyroidal Extension of Papillary Thyroid Microcarcinoma With Three-Dimensional Tomographic Ultrasound Imaging].

Objective To evaluate extrathyroidal extension (ETE) in papillary thyroid microcarcinoma (PTMC) with three-dimensional tomographic ultrasound imaging (3D-TUI). Methods A total of 97 thyroid nodules of 79 patients with PTMC treated in PUMC Hospital from February 2016 to January 2018 were included in this study.Two ultrasound experts performed independent blinded assessment of the relationship between thyroid nodules and thyroid capsule by two-dimensional ultrasound (2D-US) and 3D-TUI.The results of 2D-US and 3D-TUI in evaluating ETE were compared with intraoperative findings and postoperative histological and pathological results. Results Among the 97 nodules,54 (55.7%) nodules had ETE.The diagnostic sensitivity (68.5% vs.37.0%;χ2=10.737,P=0.002),accuracy (74.5% vs.56.7%;χ2=6.686,P=0.015),and area under the receiver operating characteristic curve[0.761 (95%CI=0.677-0.845) vs.0.592 (95%CI=0.504-0.680);Z=3.500,P<0.001] of 3D-TUI were higher than those of 2D-US.However,3D-TUI and 2D-US showed no significant difference in the specificity (84.1% vs.81.4%;χ2=0.081,P=0.776),negative predictive value (67.9% vs.50.7%;χ2=3.645,P=0.066),or positive predictive value (84.1% vs.71.4%;χ2=1.663,P=0.240). Conclusion Compared with 2D-US,3D-TUI demonstrates increased diagnostic efficiency for ETE of PTMC.

Numerical study on the wall-impinging diesel spray soot generation and oxidation in the cylinder under cold-start conditions of a diesel engine.

The combustion of wall-impinging diesel spray of heavy-duty diesel engines deteriorates combustion quality under cold-start conditions, making it difficult to control soot emissions. To investigate the causes of soot increase in the combustion of wall-impinging spray at low temperature and low speed starting conditions, the effect of the starting fuel mass on the soot formation and oxidation process was analyzed using a multidimensional computational fluid dynamics (CFD) model. The results show that the diesel spray is guided by the piston wall and the limited space, the spray impinged on the wall and the vapor-phase fuel flowed in the spray interaction zone. Thus, the soot mainly accumulates in the spray interaction zone, the region near the cylinder head and the bowl wall in the combustion chamber bowl. The soot from the vapor of deposited fuel film in the piston bowl wall and near wall region accumulates continuously in the after combustion stage, becoming the main source of soot emissions at the time of exhaust valve opening (EVO). Increasing the mass of starting fuel raises the mass of the rich mixture and wall-impinging fuel, which enhances the mismatch between fuel and air, resulting in higher soot generation, while soot is more difficult to be completely oxidized by OH radicals, and ultimately soot emissions increase significantly. It can be deduced that the engine-optimized injection strategy may mitigate the increase in soot emissions at high start-up fuel injection conditions.

Evaluation of Appendicular Muscle Mass in Sarcopenia in Older Adults Using Ultrasonography: A Systematic Review and Meta-Analysis.

BACKGROUND: The measurement of appendicular muscle mass is essential for the diagnosis of sarcopenia. Ultrasonography is an accurate and convenient method used to evaluate muscle mass. OBJECTIVE: The aim of the study was to evaluate the diagnostic value of ultrasonography for appendicular muscle mass in sarcopenia in older adults and find out proper ultrasound parameters. METHODS: Medline, Embase, Cochrane, and Web of Science databases were searched for relevant articles. Published studies on the validity and/or reliability of ultrasonography for quantifying muscle mass of the limbs in sarcopenia in the older population were included. A systematic review was conducted based on specific muscles and reference methods. A meta-analysis was conducted to assess the validity and reliability of the ultrasonography. RESULTS: Forty articles were included in this review. There were nine, nine, nine, and four studies included in the qualitative synthesis for a diagnostic test, correlation coefficient, intra-class reliability, and inter-class reliability, respectively. The diagnostic value of rectus femoris (RF) or gastrocnemius (GM) thickness on ultrasonography for sarcopenia or low muscle mass was moderate (the area under summary receiver operating characteristic curve [SROC] = 0.76, 95% confidence interval [CI]: 0.72-0.79, SROC = 0.80, 95% CI: 0.76-0.83, respectively). The pooled correlation between muscle mass on dual-energy X-ray (DXA) or bioelectrical impedance analysis (BIA) and muscle thickness (MT) on ultrasound was moderate (r = 0.56, 95% CI: 0.49-0.62). There was a low-to-moderate correlation between muscle mass on DXA or BIA and cross-sectional area (CSA) on ultrasound (r = 0.267-0.584). The correlation was high to very high between muscle mass from DXA and the ultrasound-predicted formula (r = 0.85-0.963). The CSA from ultrasound had a high or very high correlation with that from computed tomography or magnetic resonance imaging (r = 0.826, intra (inter)-correlation coefficient [ICC] = 0.998-0.999). The respective meta-analyses showed good inter-rater and intra-rater reliabilities (ICC > 0.9). CONCLUSION: Ultrasonography is a reliable and valid diagnostic method for the quantitative assessment of appendicular muscle mass in sarcopenia in older people. The thickness and CSA of the RF or GM seem to be proper ultrasound parameters to predict muscle mass in sarcopenia. Multicenter studies with large samples and the application of new ultrasonic techniques will be the future research directions.

Experimental study on combustion and emission characteristics of diesel engine with high supercharged condition.

The effect of diesel engine continuous strengthening on combustion and emission remains to be clarified. This study tested combustion and emission processes at different intake pressures on a single-cylinder diesel engine. The results show that the combustion of diesel engine after continuous strengthening is concentrated in diffusion and post-combustion periods, the overall heat release slows down, and the power increment decreases gradually. When the intake pressure increases to 0.25 MPa, the premixed heat release peak almost disappears, while the value of diffusion combustion period increases significantly. Meanwhile, the gravity center of combustion moves backward and the cumulative heat release rate decreases. The power increases by 95% as the intake pressure increases from 0.15 MPa to 0.25 MPa, but only 44% as it further increases to 0.36 MPa. Meanwhile, the exhaust temperature increases after high supercharging. The above effects are more prominent at high excess air coefficient and low speed. Moreover, with the decrease of excess air coefficient, the proportion of heat release in the post-combustion stage to the whole combustion increases and the power increment is limited. However, the thermal efficiency decreases approximately linearly and the fuel consumption rate increases sharply. In addition, as the excess air coefficient decreases, the exhaust temperature increases, PM increases and NOx decreases. The above effects are more pronounced at higher boost ratio.

Parathyroid disorder and concomitant thyroid cancer in patients with multiple endocrine neoplasia type 1: A retrospective cohort study.

ABSTRACT: This study aimed to determine the rates and characteristics of parathyroid disorder and thyroid cancer in patients with multiple endocrine neoplasia type 1 vs sporadic primary hyperparathyroidism (SPHP) undergoing parathyroidectomy.Patients with multiple endocrine neoplasia type 1-associated primary hyperparathyroidism (MPHP) or SPHP who underwent initial or reoperative parathyroid exploration from 1999 to 2019 were identified via a clinical database. The data for MPHP patients (n = 15) were compared to those of a selected 2:1 age- and sex-matched SPHP cohort (n = 30) who all underwent thyroidectomy for concurrent thyroid nodules.Compared with that of the SPHP group, the parathyroid hormone level of the MPHP group was much higher (470.67 ±â€Š490.74 pg/mL vs 217.77 ±â€Š165.60 pg/mL, P = .001). Multiglandular parathyroid disease (6/15 [40%] vs 3/30 [10%], P = .026) and more hyperplasia (7/15 [46.7%] vs 5/30 [16.7%], P = .039) were found in the MPHP group, and more parathyroid lesions presented as a round shape (long/short meridian < 2) by ultrasound (16/20 [80%] vs 8/31 [25.8%], P < .001). Regarding thyroid nodules, there was no difference in the rate of histologic thyroid cancer, but more thyroid cancer was found in the last 5 years among the MPHP cases (5/9 [55.6%] vs 3/18 [16.7%], P = .052).Multiglandular parathyroid disease and hyperplasia were more frequent in the MPHP cohort than in the SPHP cohort, and the parathyroid lesions usually presented with a round shape on ultrasonography. More concurrent thyroid cancer was found in MPHP than SPHP patients over the previous 5 years.

Development and validation of a nomogram based on stromal score to predict progression-free survival of patients with papillary thyroid carcinoma.

BACKGROUND: Growing evidence has proved that stromal cells, as the critical component of tumor microenvironment (TME), are closely associated with tumor's progression. However, the model based on stromal score to predict progression-free survival (PFS) in papillary thyroid carcinoma (PTC) has not been developed. The study aimed at exploring the relation between stromal score and prognosis, then establishing a nomogram to predict PFS of patients with PTC. METHOD: We obtained the stromal score and clinicopathological characteristics of PTC patients from The Cancer Genome Atlas (TCGA) database. Cox regression analysis assisted in selecting prognosis-related factors. A stromal score-based nomogram was built and verified in the training and validation cohorts, respectively. The calibration curve, concordance index (C-index), decision curve analysis (DCA) as well as receiver operating characteristic (ROC) curve assisted in measuring the performance exhibited by the nomogram. RESULTS: We divided 381 PTC patients into the training cohort (n = 269) and the validation cohort (n = 112) randomly. Compared with patients who had a low stromal score, patients with a high stromal score appeared with significantly better PFS [Hazard ratio (HR) and 95% confidence interval (CI): 0.294, 0.130-0.664]. The C-index of the PFS nomogram was 0.764 (0.662-0.866) in the training cohort and 0.717 (0.603-0.831) in the validation cohort. The calibration curves for PFS prediction in the nomogram were remarkably consistent with the actual observation. DCA indicated superior performance of the nomogram to predict PFS than the American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) staging system. The ROC curves showed the favorable sensitivity and specificity of the novel nomogram. CONCLUSION: High stromal score was significantly associated with improved PFS in patients with PTC. The nomogram based on the stromal score and clinicopathological patterns yielded a reliable performance to predict the prognosis of PTC.

Establishment of an Ultrasound Malignancy Risk Stratification Model for Thyroid Nodules Larger Than 4 cm.

BACKGROUND: The incidence and mortality of thyroid cancer, including thyroid nodules > 4 cm, have been increasing in recent years. The current evaluation methods are based mostly on studies of patients with thyroid nodules < 4 cm. The aim of the current study was to establish a risk stratification model to predict risk of malignancy in thyroid nodules > 4 cm. METHODS: A total of 279 thyroid nodules > 4 cm in 267 patients were retrospectively analyzed. Nodules were randomly assigned to a training dataset (n = 140) and a validation dataset (n = 139). Multivariable logistic regression analysis was applied to establish a nomogram. The risk stratification of thyroid nodules > 4 cm was established according to the nomogram. The diagnostic performance of the model was evaluated and compared with the American College Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS), Kwak TI-RADS and 2015 ATA guidelines using the area under the receiver operating characteristic curve (AUC). RESULTS: The analysis included 279 nodules (267 patients, 50.6 ± 13.2 years): 229 were benign and 50 were malignant. Multivariate regression revealed microcalcification, solid mass, ill-defined border and hypoechogenicity as independent risk factors. Based on the four factors, a risk stratified clinical model was developed for evaluating nodules > 4 cm, which includes three categories: high risk (risk value = 0.8-0.9, with more than 3 factors), intermediate risk (risk value = 0.3-0.7, with 2 factors or microcalcification) and low risk (risk value = 0.1-0.2, with 1 factor except microcalcification). In the validation dataset, the malignancy rate of thyroid nodules > 4 cm that were classified as high risk was 88.9%; as intermediate risk, 35.7%; and as low risk, 6.9%. The new model showed greater AUC than ACR TI-RADS (0.897 vs. 0.855, p = 0.040), but similar sensitivity (61.9% vs. 57.1%, p = 0.480) and specificity (91.5% vs. 93.2%, p = 0.680). CONCLUSION: Microcalcification, solid mass, ill-defined border and hypoechogenicity on ultrasound may be signs of malignancy in thyroid nodules > 4 cm. A risk stratification model for nodules > 4 cm may show better diagnostic performance than ACR TI-RADS, which may lead to better preoperative decision-making.

Exploring the diagnostic value of photoacoustic imaging for breast cancer: the identification of regional photoacoustic signal differences of breast tumors.

We examined 14 benign and 26 malignant breast nodules by a handheld dual-modal PA/US imaging system and analyzed the data using the quantitative and semi-quantitative method. The PA signal spatial density and PA scores of different regions of the benign and malignant nodules were compared, and the diagnostic performances of two diagnostic methods based on PA parameters were evaluated. For both quantitative and semi-quantitative results, significant differences in the distributions of PA signals in different regions of benign and malignant breast lesions were identified. The PA parameters showed good performance in diagnosing breast cancer, indicating the potential of PAI in clinical utilization.

Construction and Validation of a Nomogram Based on the Log Odds of Positive Lymph Nodes to Predict the Prognosis of Medullary Thyroid Carcinoma After Surgery.

BACKGROUND: This study aimed to explore the prognostic impact that the log odds of positive lymph nodes (LODDS) has on medullary thyroid cancer (MTC) and to develop a nomogram incorporating LODDS to predict the cancer-specific survival (CSS) of MTC. METHODS: Data from 1110 MTC patients after total thyroidectomy were collected from the Surveillance, Epidemiology, and End Results (SEER) database and divided into training and validation cohorts. The prognostic efficiency of N status from the American Joint Committee on Cancer (AJCC) staging system, the number of positive lymph nodes (PLNN), and LODDS were compared using the Harrell concordance index (C-index), the Akaike information criterion (AIC), and area under the receiver operating characteristic (ROC) curve (AUC). A multivariate Cox analysis was performed to determine the independent prognostic factors, and a nomogram based on LODDS was constructed. The nomogram's performance was assessed with the C-index, AUC, calibration curves, and decision curve analysis (DCA). RESULTS: Among the three lymph node (LN) staging systems, LODDS showed the highest accuracy in predicting CSS for MTC. In the training cohort, the C-index of the LODDS-based nomogram was 0.895. The AUCs were 0.949, 0.917, 0.925, and 0.901 for predicting 1-, 3-, 5- and 10-year CSS, respectively. The calibration plots and DCA showed the superior clinical applicability of the nomogram. These results were verified in the validation cohort. CONCLUSIONS: As an independent prognostic factor for MTC, LODDS demonstrated superior prognostic efficiency over N status and PLNN. This LODDS-based nomogram yielded better performance than the AJCC tumor-node-metastasis (TNM) staging system in predicting CSS after surgery for MTC.

Differentiation of Thyroid Nodules Difficult to Diagnose With Contrast-Enhanced Ultrasonography and Real-Time Elastography.

According to the 2015 American Thyroid Association (ATA), referred risk stratification and thyroid nodules with intermediate- and low-suspicion patterns are difficult to diagnose. The objective of this study is to evaluate the diagnostic performance of contrast-enhanced ultrasonography (CEUS) and elastosonography (ES) for the differentiation of these thyroid nodules. From November 2011 to June 2016, a total of 163 thyroid nodules with intermediate- and low-suspicion patterns in 150 consecutive patients at our hospital were studied before surgery. With surgical pathology as the standard, the diagnostic value of CEUS and ES was analyzed. There were 29 (17.8%) malignant lesions and 134 (82.2%) benign lesions. The enhancement patterns of CEUS, the echogenicity, and the elastography were significantly different between malignant and benign lesions (P < 0.05). Heterogenous enhancement was more common in malignant nodules, and the sensitivity, specificity, positive predictive value, negative predictive value, and odds ratio were 51.7, 88.1, 48.4, 89.4, and 10.1%, respectively. The diagnostic accuracy of CEUS was better than the conventional ultrasound [area under the curve (AUC), 0.729 vs. 0.616, P = 0.021]. The enhancement patterns of CEUS were helpful in the differential diagnosis of thyroid nodules with intermediate and low suspicion.

Blood-Rich Enhancement in Ultrasonography Predicts Worse Prognosis in Patients With Papillary Thyroid Cancer.

Contrast-enhanced ultrasound (CEUS) can be used to evaluate microcirculation in cancers, which in turn is associated with the biologic features and ultimately patient prognosis. We conducted a retrospective analysis to examine potential association between CEUS parameters and prognosis in patients with papillary thyroid cancer (PTC). The analysis included 306 patients who underwent CEUS prior to thyroidectomy at our center during a period from 2012 to 2019. Subjects with excellent response (ER) were compared to the non-ER group (including indeterminate response, biochemical incomplete response and structural incomplete response). During the median follow-up of 34 months, ER was observed in 195 (63.7%) subjects. The remaining 111 (36.3%) patients developed non-ER events, with distant metastasis in five (1.6%) cases. In a multivariate COX regression, non-ER event was associated with the male sex (OR = 1.83, 95%CI: 1.21-2.76) and blood-rich enhancement in CEUS (OR = 1.69, 95%CI: 1.04-2.75). Based on this finding, we developed a predictive model: high risk for developing non-ER events was defined as having both risk factors; low risk was defined as having none or only one risk. In receiver operating characteristic (ROC) analysis, the area under the curve was 0.59 (95%CI: 0.52-0.66). The sensitivity and specificity were 17.1 and 95.4%, respectively. The positive and negative predictive values were 67.9 and 66.9%, respectively. In conclusion, blood-rich enhancement in CEUS is associated with non-ER events after thyroidectomy in patients with PTC.

Ultrasound characteristics of cervical lesions in patients with radioiodine refractory differentiated thyroid cancer: A strobe-compliant article.

Radioiodine refractory (RAIR) is the major cause of thyroid cancer-related death. In order to avoid needless Radioiodine (RAI) therapy, recognizing the RAIR cases in time is important for the patients to obtain more time for the effective therapy.Evaluate the ultrasound features of cervical metastatic lymph node in patients with RAIR differentiated thyroid cancer (DTC).Seventeen adult patients with histologically confirmed locally advanced or metastatic RAIR-DTC were prospectively enrolled. The ultrasound (US) characteristics of cervical lesions in patients with the RAIR-DTC were compared with cervical lymph node metastasis from 59 non RAIR-DTC cases.Among the 17 patients, cervical lymph node metastasis was found in 15 patients (88.3%). The cervical lesions of RAIR-DTC (mean size, 2.0 cm) were larger than that in non RAIR-DTC group (mean size, 1.30 cm). More multiple lesions and more lesions with visible flow were found in the RAIR Group, while fewer hyperechogenic punctuations were found in RAIR group (P < .05). The distant metastasis rates showed that RAIR-DTC led to a poorer prognosis than those of patients in the non RAIR Group (P < .01).Ultrasound can help distinguish metastasized cervical lymph nodes of RAIR-DTC patients from non RAIR-DTC patients. For RAIR-DTC patients, a long-term US evaluation should be performed.

Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules.

PURPOSE: To compare the value of Thyroid Imaging Reporting and Data Systems proposed by Kwak (KWAK-TIRADS) and ACR (ACR TI-RADS) and 2015 American Thyroid Association (ATA) guidelines in the diagnosis of surgically resected thyroid nodules. METHODS: From January 2015 to December 2015, 2544 thyroid nodules in 1758 patients who underwent thyroidectomy at our center were included. The KWAK-TIRADS category, ACR TI-RADS and ultrasound (US) pattern based on ATA guidelines were assigned to each thyroid nodule. Nodules were divided into groups according to their maximal diameter further. RESULTS: Of all the nodules, 863 (33.9%) were benign, whereas 1681 (66.1%) were malignant. The malignancy percentage of ACR TI-RADS category 1, 2, 3, 4, and 5 were 0%, 1.3%, 9.1%, 52.5%, and 88.8%, respectively. KWAK-TIRADS and ATA guidelines showed a better diagnostic efficiency than ACR TI-RADS (P < 0.01). ACR TI-RADS demonstrated a higher specificity (79.7%, P < 0.05), whereas the ATA US pattern had a higher sensitivity (95.5%, P < 0.01). The TIRADS (KWAK-TIRADS and ACR TI-RADS) category and ATA guidelines performed better in differentiating nodules >1 cm. KWAK-TIRADS showed better diagnostic efficiency than the other methods in differentiating nodules >1 cm (AUC: 0.92, P < 0.01). CONCLUSIONS: KWAK-TIRADS and ATA guidelines provide a better diagnostic efficiency than ACR TI-RADS. The TIRADS (KWAK-TIRADS and ACR TI-RADS) category and ATA guidelines perform better in differentiating nodules >1 cm than nodules ≤1 cm. KWAK-TIRADS perform better in differentiating nodules >1 cm than other methods.

Ultrasonographic Multimodality Diagnostic Model of Thyroid Nodules.

The aim of this study was to identify independent risk factors for thyroid cancer, establish an ultrasonographic multimodality diagnostic model for thyroid nodules, and explore the diagnostic value of the model. From November 2011 to February 2015, 307 patients with a total of 367 thyroid nodules underwent conventional ultrasound, contrast-enhanced ultrasound (CEUS), and ultrasound elastography examinations before surgery. A binary logistic regression analysis was performed to identify independent risk factors for thyroid cancer and to establish a multimodality diagnostic model for thyroid nodules. The diagnostic performance of conventional ultrasound, CEUS, ultrasound elastography, and the multimodality diagnostic model was assessed and compared. The following seven independent risk factors were included in the logistic regression models: age, irregular shape, hypoechoic pattern, marked hypoechoic pattern, irregular blood flow distribution, heterogeneous enhancement, and an elastic score of 3/4. The multimodality diagnostic model had a diagnostic accuracy of 86.9%, with a sensitivity of 93.5% and a specificity of 77.3%. The multimodality diagnostic model improved the diagnostic accuracy compared with that of conventional ultrasound, CEUS, and ultrasound elastography. Independent risk factors for thyroid cancer included age, irregular shape, hypoechoic pattern, marked hypoechoic pattern, irregular blood flow distribution, heterogeneous enhancement, and an elastic score of 3/4. The multimodality diagnostic model was demonstrated to be effective in the diagnosis of thyroid nodules.