Goiter in the Qing Dynasty.

Empress Dowager Cixi, the supreme ruler of China's Qing Dynasty, along with Imperial Concubine Jin, may have suffered from goiter. Our suspicions were aroused by two interesting historical photographs. Herein, we provide a medical interpretation of these historical images in an attempt to present the cases of these two historical figures.

Evaluation of progression-free survival as a surrogate endpoint for overall survival in locally advanced or metastatic differentiated thyroid cancer: a systematic review.

PURPOSE: Patients with locally advanced or metastatic differentiated thyroid cancer (DTC) have a variable prognosis, and the development of more effective treatment strategies is an important research topic. Overall survival (OS) is the gold standard for research endpoints in randomized controlled trials (RCTs), but observing an OS benefit requires the inclusion of a large number of patients and a long follow-up period. In this study, we aimed to investigate whether progression-free survival (PFS) could be used as a surrogate endpoint for OS in locally advanced or metastatic DTC clinical trials. MATERIALS AND METHODS: We conducted a search in the PubMed and EMBASE databases to include all RCTs of locally advanced or metastatic DTC and extracted survival data. A weighted linear regression analysis was performed to explore the correlation between PFS benefit and OS benefit by taking the logarithm of the hazard ratios (HRs) of PFS and OS for each trial with a base of 10 and weighted by the number of patients in each RCT. RESULTS: Seven RCTs, including 1410 patients, were included. At the trial level, PFS benefit was weakly correlated with OS benefit (R2 = 0.210, 95% CI: 0.000-0.811) and did not meet the statistical criteria for the surrogate endpoint. CONCLUSION: This study does not support PFS as a surrogate endpoint for OS in locally advanced or metastatic DTC clinical trials. TRIAL REGISTRATION: PROSPERO Identifier: CRD42022334898.

High-density lipoprotein cholesterol and carcinogenesis.

High-density lipoprotein cholesterol (HDLC) has been recognized to be associated with atherosclerosis. In the past few years many studies have found that HDLC is also related to tumor development and progression. Despite some opposing views, a large number of studies support a negative association between HDLC and tumor incidence. Measuring serum HDLC concentrations may facilitate assessment of the prognosis of cancer patients and provide a biomarker for tumors. However, there is a lack of molecular mechanism studies on the link between HDLC and tumors. In this review we discuss the impact of HDLC on the incidence and prognosis of cancer in different systems, as well as prospects for the prediction and treatment of cancer in the future.

Is TikTok a high-quality source of information on thyroid cancer?

PURPOSE: Increased Internet users tend to use online video platforms as a source of medical information. There are many thyroid cancer-related videos on TikTok, the most popular short-video application in China. However, quality evaluation of these videos remains absent. The aim of this study is to evaluate the quality of thyroid cancer-related videos on TikTok. METHODS: A search was performed on TikTok with the keyword "thyroid cancer". The top 100 videos in the search results were selected. Characteristics of videos including video length, duration on TikTok, thumbs up, thumbs up/day, comments, comments/day, favorites, favorites/day, reposts, and reposts/day were collected. The Patient Education Materials Assessment Tool (PEMAT), modified DISCERN (mDISCERN), Video Information and Quality Index (VIQI), and Global Quality Score (GQS) were applied to assess the quality of videos. RESULTS: Among the 100 videos in this study, most were uploaded by surgical physicians (n = 50), and the most common topic was anatomy/basic facts (n = 21). The mean scores of the PEMAT, PEMAT-U, and PEMAT-A were 71.18 ± 16.56, 82.23 ± 15.00, and 44.00 ± 37.57, respectively. Among the five questions of the mDISCERN tool, 71, 90, 82, 9, and 28 videos were evaluated as "yes", respectively. The mean scores of mDISCERN, VIQI, and GQS were 2.80 ± 1.03, 14.87 ± 2.27, and 3.72 ± 1.00, respectively. The characteristics and quality of videos are significantly different based on the uploader and content. CONCLUSIONS: The quality of thyroid cancer information on TikTok is unsatisfactory. There is a need for high-quality thyroid cancer-related information on short-video platforms for patient education.

Laparoscopic excision for intrapelvic schwannoma of the sciatic nerve: A case report.

Schwannoma is a benign tumor of the nerve sheath originating from Schwann cells. The tumor rarely occurs in the sciatic nerve. The patient in the present case report was a 58-year-old woman presenting with pain in the right hip and leg, as well as numbness of the right lower limb. Magnetic resonance imaging revealed a solid tumor of 2.9 cm in diameter in the right pelvic space. The mass was considered to be a neurogenic tumor originating from the right sciatic nerve. Total laparoscopic surgery was performed to safely separate the tumor from the surrounding tissues, with preservation of the right sciatic nerve. The pathological result suggested a schwannoma. The patient recovered well with a transient numbness in the right heel. The laparoscopic approach used for this intrapelvic schwannoma of the sciatic nerve was safe and feasible, with the advantages of a magnified surgical field and small skin incision. However, the specific surgical approach should be based on the detailed condition of each patient and the experience of the surgeon with regard to laparoscopic surgery on benign presacral tumors and rectal tumors.

Copy number variations: A novel molecular marker for papillary thyroid cancer.

Background: We aimed to screen tumor-associated functional genes on a large scale through copy number variation (CNV) analysis of papillary thyroid cancer (PTC). Methods: We analyzed 74 tissue samples from 41 patients with thyroid nodules. The samples were subjected to whole-genome resequencing and then analyzed by the 'WISECONDOR' method. Potential chromosome CNV regions were identified between the different sample groups. Results: Of the 74 samples from 41 patients, 28 were PTC tissue samples, 29 were para-carcinoma tissue samples, 13 were benign tumor tissue samples and 4 were para-benign tumor tissue samples. According to our findings, PTC can be identified by CNVs at the corresponding positions on chromosomes 5, 7, 8, 10, and 17. For carcinoma tissue, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and area under the curve (AUC) of the test method were 100%, 66.7%, 87.5%, 100.0%, 90.0% and 0.83 (95% confidence interval [CI], 0.67-1.00) and for para-carcinoma tissue, these values were 96.6%, 75.0%, 96.6%, 75.0%, 93.9% and 0.86 (95% CI, 0.60-1.00). Conclusion: CNV analysis assays involving high-volume sequencing analysis can increase the identification of PTC, potentially avoiding errors caused by position deflection in sampling.

Nomograms Based on Serum N-glycome for Diagnosis of Papillary Thyroid Microcarcinoma and Prediction of Lymph Node Metastasis.

Non-invasive biomarkers for the diagnosis and prognosis of papillary thyroid microcarcinoma (PTMC) are still urgently needed. We aimed to characterize the N-glycome of PTMC, and establish nomograms for the diagnosis of PTMC and the prediction of lymph node metastasis (LNM). N-glycome of PTMC (LNM vs. non-LNM, capsular invasion (CI) vs. non-CI (NCI)) and matched healthy controls (HC) were quantitatively analyzed based on mass spectrometry. N-glycan traits associated with PTMC/LNM were used to create binomial logistic regression models and were visualized as nomograms. We found serum N-glycome differed between PTMC and HC in high-mannose, complexity, fucosylation, and bisection, of which, four N-glycan traits (TM, CA1, CA4, and A2Fa) were significantly associated with PTMC. The nomogram based on four traits achieved good performance for the identification of PTMC. Two N-glycan traits (CA4 and A2F0S0G) showed strong associations with LNM. The nomogram based on two traits showed relatively good performance in predicting LNM. We also found differences between CI and NCI in several N-glycan traits, which were not the same as that associated with LNM. This study reported serum N-glycosylation signatures of PTMC for the first time. Nomograms constructed from aberrant glycans could be useful tools for PTMC diagnosis and stratification.

Mental Health in Postoperative Thyroid Patients During the COVID-19 Pandemic.

Background: Little is known about mental health in patients after thyroid surgery during the peak of the COVID-19 pandemic in China. This study aimed to assess the mental health of postoperative thyroid patients and to explore potential factors associated with psychological symptoms. Methods: In this study, we surveyed 241 patients who underwent thyroid surgery at Peking Union Medical College Hospital. Insomnia, anxiety, depression, and posttraumatic stress symptoms (PTSS) were measured using the Insomnia Severity Index (ISI), Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire (PHQ-9), and Impact of Event Scale-Revised (IES-R), respectively. Results: A significant proportion of postoperative patients reported experiencing insomnia, anxiety, depression, and PTSS. Patients that were older, single/divorced/widowed, and less educated; had lower income and poor general health; had undergone surgery within the past six months; had disrupted follow-up, and; searched social media for COVID-19-related information were associated with worse mental health. Conclusions: During the COVID-19 pandemic, postoperative thyroid patients tended to develop mental health problems and have less psychological support, emphasizing the importance of patient education and psychological interventions.

Serum Linkage-Specific Sialylation Changes Are Potential Biomarkers for Monitoring and Predicting the Recurrence of Papillary Thyroid Cancer Following Thyroidectomy.

Background: Although papillary thyroid cancer (PTC) could remain indolent, the recurrence rates after thyroidectomy are approximately 20%. There are currently no accurate serum biomarkers that can monitor and predict recurrence of PTC after thyroidectomy. This study aimed to explore novel serum biomarkers that are relevant to the monitoring and prediction of recurrence in PTC using N-glycomics. Methods: A high-throughput quantitative strategy based on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to obtain serum protein N-glycomes of well-differentiated PTC, postoperative surveillance (PS), postoperative recurrence (PR), and matched healthy controls (HC) including linkage-specific sialylation information. Results: Serum N-glycan traits were found to differ among PTC, PS, PR, and HC. The differentially expressed N-glycan traits consisting of sixteen directly detected glycan traits and seven derived glycan traits indicated the response to surgical resection therapy and the potential for monitoring the PTC. Two glycan traits representing the levels of linkage-specific sialylation (H4N3F1L1 and H4N6F1E1) which were down-regulated in PS and up-regulated in PR showed high potential as biomarkers for predicting the recurrence after thyroidectomy. Conclusions: To the best of our knowledge, this study provides comprehensive evaluations of the serum N-glycomic changes in patients with PS or PR for the first time. Several candidate serum N-glycan biomarkers including the linkage-specific sialylation have been determined, some of which have potential in the prediction of recurrence in PTC, and others of which can help to explore and monitor the response to initial surgical resection therapy. The findings enhanced the comprehension of PTC.

Anxiety and quality of life among papillary thyroid cancer patients awaiting final pathology results after surgery.

PURPOSE: There is a lack of research on short-term mental health and health-related quality of life (HRQoL) in thyroid cancer patients. This study aimed to assess the short-term anxiety level and HRQoL of patients during the early postoperative period while awaiting pathology results, and to explore the important factors associated with state anxiety. METHODS: In this single-center cross-sectional study, 349 patients with papillary thyroid cancer were included. Anxiety and HRQoL were measured using the State-Trait Anxiety Inventory (STAI) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30), respectively. RESULTS: In general, papillary thyroid cancer patients reported good quality of life with a mean global quality of life score of 75.69 ± 20.66 (on a scale of 0-100, where 100 means the best). There was no significant difference in HRQoL between the two groups, except regarding social functioning (p = 0.027). The anxiety levels of the two groups were similar; however, the state anxiety score (42.17 ± 12.52) was significantly higher than the trait anxiety score (40.69 ± 11.18) among patients in the non-FNA group (p = 0.023). Dyspnea, insomnia, QL, and trait anxiety were independent factors that affected state anxiety. CONCLUSION: Patients with papillary thyroid cancer had good postoperative HRQoL and a significantly higher than usual level of state anxiety while awaiting pathology results. Symptoms of dyspnea and insomnia, global quality of life, and trait anxiety are important factors associated with state anxiety. Preoperative FNA results may moderate the change in anxiety level. These findings may help clinicians provide psychological support.