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1.
Int J Hyperthermia ; 37(1): 157-167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32024398

RESUMO

Background: Image-guided radiofrequency ablation (RFA) of large solid benign thyroid nodules (BTNs) usually require a high amount of energy. Injection of ethanol into a benign thyroid nodule before RFA can lower the procedural time and patient discomfort.Objective: To investigate the efficacy and safety of ethanol ablation (EA) combined with RFA in the treatment of solid BTNs (>10 ml) and to compare this modified method with RFA treatment alone.Methods: A total of 366 nodules in 366 patients were treated from June 2017 to Mar. 2018, 76 (M:F = 32:44, age 46 ± 14 years) were treated with EA + RFA and 290 (M:F = 99:191, age 49 ± 14 years) were treated with RFA. 44 patients (44 nodules) of each group formed a matched cohort after adjustment with propensity score matching. The average time, energy and power of the RFA procedure were retrospectively compared between the two groups. The postoperative nodule volume reduction ratio (VRR), compressive symptoms, cosmetic concerns, comprehensive satisfaction score, thyroid function and complications were retrospectively compared within and between the two groups after 6 months after treatment.Results: No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. The mean RFA time (454.7 s (interquartile range (IQR), 290.8-589.0 s vs. 796.0 s (IQR, 554.0-976.30 s), p < .001), energy (3.69 ± 1.99 kJ vs. 5.10 ± 2.15 kJ, p = .009) and power (6.17 ± 1.38 W vs. 7.21 ± 1.29 W, p < .001) in the EA + RFA group were significantly lower than those in the RFA group. Mean nodule reduction at 6 months in the EA + RFA group and in the RFA group was 69.81 ± 11.48% vs. 67.43 ± 12.13% (10-30 ml, p = .454) and 62.75 ± 11.41% vs. 59.82 ± 10.53% (>30 ml, p = .456), respectively. The Medium nodules shrunk more than the large nodules (all p < .001), and the pressure symptoms and cosmetic signs significantly improved in the large nodules in both groups (all p < .05). Patients in the EA + RFA group had the highest satisfaction.Conclusions: EA combined with RFA shortened the ablation time of RFA, reduced the total energy and power required and improved patient satisfaction. This modified RFA approach may be considered a low-risk and high-efficacy alternative to treat solid BTNs greater than 10 ml in size.

2.
Int J Hyperthermia ; 37(1): 168-174, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32026736

RESUMO

Purpose: To evaluate the safety and efficacy of ultrasound-guided RFA for the treatment of papillary thyroid microcarcinoma (PTMC).Materials and methods: The data of 204 nodules from 198 PTMC patients who were treated using RFA were retrospectively reviewed in this study. Demographic variables, complication details and CEUS results in different time points were collected. The volumes and volume reduction rate (VRR) of the ablated area under CEUS at different follow-up time points were calculated and compared.Results: All the patients were successfully treated without major complication. Mild complications included cervical discomfort in three cases, postoperative cervical pain in one case, and transient hoarse voice in five cases. The volume of the ablated area in the 1st, 3rd, 6th, 12th, 18th and 24th month postoperatively were 241.7 ± 298.3mm3, 89.8 ± 147.2 mm3, 37.6 ± 87.2 mm3, 13.6 ± 59.8 mm3, 2.4 ± 14.4 mm3, and 0.2 ± 2.0 mm3 respectively, with a statistically significant decrease (F = 138.1, p = .000), and the VRR in those time points were 73.9 ± 13.7%, 90.5 ± 8.2%, 96.1 ± 5.9%, 98.8 ± 3.2%, 99.6 ± 1.9% and 99.8 ± 1.0% respectively, with a statistically significant decrease (F = 695.3, p = .000).Conclusions: US-guided RFA is safe and effective for PTMC, with a good oncological outcome and VRR. Further randomized controlled prospective trials are still needed to compare the value of RFA and surgery.

3.
J Ultrasound Med ; 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32064662

RESUMO

OBJECTIVES: Super-resolution ultrasound (SRUS) has become a tool for in vivo microvascular imaging. Most of the SRUS methods are based on microbubble localization: namely, ultrasound localization microscopy (ULM). The aim of this study was to develop a nonlocalization SRUS method and verify its feasibility in microvascular imaging. METHODS: We introduce a new super-resolution strategy based on the postprocessing of contrast-enhanced ultrasound. The proposed method, which is termed ultrasound diffraction attenuation microscopy (UDAM), uses super-resolution radial fluctuations instead of microbubble localization to overcome acoustic diffraction limits. Biceps of Japanese long-ear white rabbits were adopted to validate its feasibility on muscle vascular imaging, using a clinical accessible ultrasound system at a frame rate of 30 Hz under a single bolus injection of SonoVue (Bracco SpA, Milan, Italy). The super-resolution image was compared with the maximum-intensity projection and ULM. RESULTS: The animal study illustrates that the proposed UDAM can obtain super-resolution microvascular images of rabbits' muscles under a single bolus injection of SonoVue with a 150-second contrast-enhanced ultrasound video. Both ULM and UDAM can achieve a very similar vascular structure with the maximum-intensity projection but much higher spatial resolution. The measurement of 1-dimensional signals shows that UDAM can distinguish the subwavelength structures and substantial reduce the full width at half-maximum of microvessels. CONCLUSIONS: We conclude UDAM provides a noninvasive tool for in vivo super-resolution microvascular imaging.

4.
Thyroid ; 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-31910107

RESUMO

Background: Papillary thyroid microcarcinoma (PTMC) typically carries an excellent prognosis regardless of the treatment option pursued. Radiofrequency ablation (RFA) for thyroid disease has been utilized for benign lesions and in patients who are poor surgical candidates for thyroid cancers with compression symptoms, but the efficacy and limitations of RFA as first-line therapy for PTMC has not been described in adequate detail. The purpose of our study was to investigate RFA versus thyroidectomy in terms of efficacy, oncologic outcomes, quality of life, complications, and costs over a 5-year period of follow-up. Methods: From January 2013 to November 2013, 174 consecutive patients with an isolated, solitary intrathyroidal PTMC were identified in a Chinese teaching hospital. Those with more aggressive or advanced PTMCs were not included. Ninety-four patients elected RFA and 80 patients elected surgery for treatment of these PTMC. Nodules were confirmed to be PTMC without an aggressive histological type by core needle biopsy in the RFA group and by final surgical pathology in the surgery group. The extent of surgery was decided based on patient preferences in consultation with the surgeons. Of all the patients, 58 (72.5%) underwent lobectomy, 22 (27.5%) underwent total thyroidectomy, and 53 (66.3%) underwent lymph node dissection. Pre- and post-treatment variables were compared between the two groups, including demographics, tumor characteristics, treatment, local tumor progression, lymph node metastasis, distant metastasis, local recurrence, complications, and quality-of-life findings. Results: Patient-specific variables were similar between groups, as were oncologic outcomes after 5 years of follow-up. When compared with RFA, surgery took longer, had a longer hospitalization time, and was costlier (all p < 0.001). The surgery group had three complications, with 2 (2.5%) permanent recurrent laryngeal nerve injuries and 1 (1.3%) case of permanent hypoparathyroidism, while none was reported in the RFA group (p = 0.095). The surgery group had a lower post-treatment thyroid-related quality of life. Conclusions: For carefully selected low-risk intrathyroidal PTMC, RFA was not oncologically inferior to open surgery, and it was associated with a higher quality of life and lower overall costs.

5.
Med Sci Monit ; 26: e918452, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31929498

RESUMO

BACKGROUND The diagnosis of thyroid cancer and distinguishing benign from malignant thyroid nodules by junior radiologists can be challenging. This study aimed to develop a computer-aided diagnosis (CAD) system based on the Thyroid Imaging Reporting and Data System (TI-RADS) to distinguish benign from malignant thyroid nodules by analyzing ultrasound images to improve the diagnostic performance of junior radiologists. MATERIAL AND METHODS A modified TI-RADS based on a convolutional neural network (CNN) was used to develop the CAD system. This retrospective study reviewed 789 thyroid nodules from 695 patients and included radiologists with different diagnostic experience. Five study groups included the CAD group, the junior radiologist group, the intermediate-level radiologist group, the senior radiologist group, and the group in which the junior radiologist used the CAD system. The ultrasound findings were reviewed and compared with the histopathology diagnosis. RESULTS The CAD system for the diagnosis of thyroid cancer showed an accuracy of 80.35%, a sensitivity of 80.64%, a specificity of 80.13%, a positive predictive value (PPV) of 76.02%, a negative predictive value (NPV) of 84.12%, and an area under the receiver operating characteristic (ROC) curve (AUC) of 0.87. The accuracy of the junior radiologists in diagnosing thyroid cancer using CAD was similar to that of intermediate-level radiologists (79.21% vs. 77.57%; P=0.427). CONCLUSIONS The use of ultrasound CAD based on the TI-RADS showed potential for distinguishing between benign and malignant thyroid nodules and improved the diagnostic performance of junior radiologists.

6.
Ultrasound Med Biol ; 46(2): 377-392, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31699548

RESUMO

This study was aimed at evaluating the value of multimodality ultrasound techniques in the detection of crushed sciatic nerve and denervated muscle in rabbits. Fifty healthy male New Zealand white rabbits were randomly divided into five groups (n = 10 in each group): four crushed injury groups at 1, 2, 4 and 8 wk post-sciatic nerve crushed injury, and a control group without crush injury. The crushed sciatic nerve and denervated muscle were measured with conventional ultrasound, shear wave elastography and contrast-enhanced ultrasonography, and the results were compared with the histopathological parameters. The inter- and intra-reader reliability of multimodality ultrasound was assessed with intra-class correlation coefficients. Our results revealed that the sciatic nerve thickened at 2 wk post-crushed injury (p < 0.01), but recovered to almost normal thickness at 8 wk post-injury. Stiffness of the crushed nerve gradually increased (p < 0.01), and intraneural blood volume decreased (area under the curve, peak intensity, time to peak, p < 0.01 each) over time. Histopathological evaluation revealed obvious collagen hyperplasia and poor regenerated microvascular and sparse axonal regeneration and remyelination. Compared with that of the control group, the elastic modulus of the denervated muscle significantly increased (p < 0.05), which may be related to the increased intramuscular collagen (p < 0.01) and decreased muscle fiber cross-sectional area (p < 0.01). There were no significant differences in contrast-enhanced ultrasonography parameters (area under the curve, peak intensity, time to peak) of the denervated muscle between the crush injury groups and the control group (p >0.05). All ultrasound results had excellent inter- and intra-reader consistency (intraclass correlation coefficient >0.80). In conclusion, multimodality ultrasound techniques could provide quantitative information on the morphologic changes, mechanical properties and blood perfusion of crushed nerve and denervated muscle, which may be of great importance in clinical practice.

7.
Int Braz J Urol ; 46(1): 92-100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31851465

RESUMO

PURPOSE: To evaluate the role of contrast-enhanced ultrasound (CEUS) in differentiating bland thrombus from tumor thrombus of the inferior vena cava (IVC) in patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: We retrospectively investigated 30 consecutive patients who underwent robot-assisted radical nephrectomy with IVC thrombectomy and had pathologically confirmed RCC. All patients underwent US and CEUS examination. Two offline readers observed and recorded thrombus imaging information and enhancement patterns. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value for bland thrombus were assessed. RESULTS: Of the 30 patients, no adverse events occurred during administration of the contrast agent. Early enhancement of the mass within the IVC lumen on CEUS was na indicator of tumor thrombus. Bland thrombus showed no intraluminal flow on CEUS. There were eight (26.7%) patients with bland thrombus, including three level II, two level III, and three level IV. There were three cases with cephalic bland thrombus and five cases with caudal bland thrombus. Three caudal bland thrombi extended to the iliac vein and underwent surgical IVC interruption. Based on no intraluminal flow, for bland thrombus, CEUS had 87.5% sensitivity, 100% specificity, 96.7% accuracy, 100% positive predictive value and 95.6% negative predictive value. CONCLUSION: Our study demonstrates the potential of CEUS in the differentiation of bland and tumor thrombus of the IVC in patients with RCC. Since CEUS is an effective, inexpensive, and non-invasive method, it could be a reliable tool in the evaluation of IVC thrombus in patients with RCC.


Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Veia Cava Inferior/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Idoso , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/cirurgia , Meios de Contraste , Feminino , Humanos , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Reprodutibilidade dos Testes , Estudos Retrospectivos , Trombectomia/métodos , Carga Tumoral , Veia Cava Inferior/patologia , Veia Cava Inferior/cirurgia , Trombose Venosa/patologia , Trombose Venosa/cirurgia
8.
Cancer Imaging ; 19(1): 79, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791422

RESUMO

BACKGROUND: Vena cava thrombus is one of the main clinical manifestations of locally aggressive renal cell carcinoma (RCC). Inferior vena cava (IVC) wall invasion and presence of bland thrombus could affect the surgical outcome. This study aims to assess the value of contrast-enhanced ultrasound (CEUS) in detecting wall invasion and differentiating bland thrombus from tumor thrombus during robot-assisted IVC thrombectomy for RCC. METHODS: The intraoperative CEUS findings of 60 patients with RCC accompanied by IVC tumor thrombus were retrospectively analyzed. The CEUS features were compared with the intra- and post-operative pathological findings. CEUS in patients with wall invasion showed that the tumor thrombus was enhanced synchronously with the IVC wall, and the continuity of the IVC wall was lost. In contrast, in patients without wall invasion, CEUS showed that the contrast agent could pass between the tumor thrombus and the IVC wall, and the continuity of IVC wall was good. Typically, contrast-enhanced perfusion was seen in tumor thrombus but not in bland thrombus. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were statistically analyzed. RESULTS: The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the typical enhancement mode of CEUS were 93.1, 93.5, 93.3, 93.1, and 93.5% in identifying wall invasion and 100, 96, 96.7, 83.3, and 100% in differentiating bland thrombus from tumor thrombus, respectively. There were excellent inter-observer agreements for identifying IVC wall invasion and differentiating bland thrombus from tumor thrombus with kappa coefficients of 0.90 and 0.97. CONCLUSIONS: The present study indicates that intraoperative CEUS plays an important role in robot-assisted IVC thrombectomy for RCC. It can detect wall invasion and differentiate bland thrombus from tumor thrombus, thus offering real-time information to the operator during surgery.

9.
Medicine (Baltimore) ; 98(50): e18213, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852078

RESUMO

We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 ≤ BMI < 24 (normal-weight), 24 ≤ BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.


Assuntos
Índice de Massa Corporal , Obesidade/complicações , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia/métodos , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/cirurgia
10.
J Chromatogr A ; : 460663, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31732156

RESUMO

An on-line high-performance liquid chromatography-diode-array-detector-electrospray ionization-ion-trap-time-of-flight-mass spectrometry-total antioxidant capacity detection (HPLC-DAD-ESI-IT-TOF-MS-TACD) system was applied for the identification and evaluation of antioxidants in Rosa chinensis Jacq., an edible flower in food industry and a widely used traditional Chinese medicine. With the help of this platform, the HPLC fingerprint, mass fragmentations, and sample activity profiles against 1,1-diphenylpicryl-2-hydrazyl radical (DPPH•) and ferric reducing antioxidant power (FRAP) were recorded after one injection. Using this technique, 80 compounds were separated and identified by their LC/MS behaviors with the assistance of standard compounds. In addition, 11 different Rosa chinensis Jacq. samples were profiled and then quantified for their DPPH• and FRAP activities. Interestingly, a total of 52 compounds showed antioxidative effects against DPPH• and 61 were active against FRAP. The results demonstrated that the on-line system is a powerful technique for antioxidant discovery in Rosa chinensis Jacq. and other food resources.

11.
Tissue Eng Part A ; 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31516089

RESUMO

Finding treatments that accelerate peripheral nerve regeneration, prolongation, and functional recovery remains a challenging task. Platelet-rich plasma (PRP) contains numerous growth factors and active proteins, and low-dose ultrashort waves (USWs) stimulate the formation of nerve-nourishing vessels, which are powerful for nerve regeneration. The goal of this study was to evaluate the synergistic effects of serial ultrasound-guided PRP injections combined with low-dose USWs radiation on peripheral nerve regeneration in a crush injury model. Fifty rabbits were equally and randomly divided into normal control, model, USW, PRP, and PRP+USW groups. The neurological function, electrophysiological recovery, and histological and morphological evaluation of regenerated nerves, as well as a targeted muscle recovery assessment, were performed to investigate the regenerative effect of PRP combined with USW therapy. Our results showed that the PRP+USW group had the better early axonal regeneration and displayed the earliest positive compound muscle action potential among the treatment groups. At postintervention week 12, a histological evaluation showed similar expression of the S-100 protein in the PRP+USW and normal control groups. Moreover, the morphological assessment revealed a significant increase in the myelinated nerve fiber density and diameter and myelin sheath thickness compared with the USW and PRP groups. The morphometry of the target muscles indicated the lowest reduction in the percent volume in the PRP+USW group, and an ultrasound examination of the targeted muscle showed the best improvement in stiffness and perfusion parameters at 12 weeks after crush injury. Thus, serial ultrasound-guided PRP injections combined with low-dose USW radiation exert a synergistic effect on accelerating functional axon recovery and decreasing atrophy of the target muscles in a crush injury model. Impact Statement This research describes that the application of platelet-rich plasma combined with low-dose ultrashort waves treatment exert a synergistic effect on accelerating peripheral nerve regeneration. With the extensive use of platelet-rich plasma and physical factors in regenerative medicine or clinical rehabilitation medicine, our findings may help establish effective strategies for repairing peripheral nerve injury.

12.
Sci Rep ; 9(1): 13457, 2019 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-31530871

RESUMO

As the largest portion of the terrestrial ecosystems, the arid and semi-arid grassland ecosystem is relatively sensitive and vulnerable to nitrogen (N) deposition. Mowing, the main management in Inner Mongolia grassland also has deep direct and indirect effect on N transformation by removing the nutrient from soils. However, the interaction effect of N addition and mowing on N transformation is still unclear, especially in semi-arid grassland. Here, we conducted a field-manipulated experiment to assess N addition (10 g N m-2 y-1) and mowing (in the middle of August) effects on soil net N mineralization rate across 4 growing seasons (2006-2009) in a semi-arid grassland in Inner Mongolia of northern China. We found that N addition with or without mowing led to significant effect on soil ammonification rate and net N mineralization rate, but had no significant effect on nitrification rates. Furthermore, mowing had no significant effect on soil net N mineralization, ammonification and nitrification rates. N addition and Mowing decreased microbial respiration and metabolic quotient, whereas the interaction of N addition and mowing had no significant effect on microbial respiration and metabolic quotient. Our results indicated that the effects of mowing and N addition did not interactively weaken soil net N mineralization rates in a semi-arid grassland of Northern China. Therefore, the anthropic management (i.e. mowing for hay once a year) with N addition may be a sustainable approach for restoration and reconstruction of vegetation in the abandoned grassland  of Northern China.

13.
Acta Cardiol Sin ; 35(4): 369-379, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31371897

RESUMO

Background: Post-dilation with kissing balloon dilation remains controversial in the 1-stent approach, but many technical improvements are possible to refine the final results. This study aimed to evaluate the results of different side-branch (SB) ostial treatments after main vessel stenting, including ostial optimization technique (OOT), simultaneous kissing balloon dilation (KBD) and single balloon dilation (SBD). Methods: Three different ostial side branch treatments (OOT, n = 5; KBD, n = 5; SBD, n = 5) were emulated in a synthetic bifurcated phantom using a second-generation sirolimus-eluting stent (Firebird2TM, Microport, Shanghai, China). Micro-computed tomography (micro-CT) and optical coherence tomography (OCT) were performed to assess morphologies. Results: Compared to the non-OOT procedures (SBD and KBD), OOT was characterized by the sequential dilation of two snuggling balloons, creating a longer valgus struts length (OOT: 2.13 ± 0.30 mm, SBD: 1.23 ± 0.34 mm, KBD: 1.11 ± 0.39 mm, p < 0.01), broader angulation between the main-branch and valgus struts axes (OOT: 42.72 ± 0.91°, SBD: 25.77 ± 7.81°, KBD: 31.78 ± 1.34°, p < 0.01), shorter neocarina length (OOT: 0.28 ± 0.31 mm, SBD: 0.64 ± 0.38 mm, KBD: 1.11 ± 0.37 mm, p < 0.01), larger SB ostial area (OOT: 6.76 ± 0.17 mm2, SBD: 4.78 ± 0.86 mm2, KBD: 5.87 ± 0.89 mm2, p < 0.01), and lower index of stent cell distortion (OOT: 6.67 ± 3.33%, SBD: 10.67 ± 4.23%, KBD: 20.00 ± 5.29%, p < 0.01). In addition, the rate of severe strut malapposition was lower with the OOT procedure compared with the non-OOT procedures (OOT: 2.22 ± 0.48%, SBD: 10.31 ± 0.66%, KBD: 6.74 ± 1.24%, p < 0.01). Conclusions: OOT, consisting of an initial proximal optimizing technique (POT) and sequential snuggling balloon dilation and then re-POT, significantly optimized the results of provisional bifurcation treatment. The physiological and clinical significance of our observations await further clarification.

14.
Cancer Med ; 8(12): 5450-5458, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31359613

RESUMO

BACKGROUND: Chronic lymphocytic thyroiditis (CLT) is an autoimmune disease commonly associated with papillary thyroid carcinoma characterized by a smaller primary tumor size at presentation. The efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) coexisting with CLT is still unknown. METHODS: Sixty patients with unifocal PTMC were enrolled and classified into PTMC and PTMC+CLT groups (n = 30/group). CLT was diagnosed histopathologically. The ablation area exceeded the tumor margins, and was evaluated by US and contrast-enhanced US (CEUS) for residual tumor to prevent recurrence. Three months after ablation, US-guided core-needle biopsy was performed to assess the presence of residual and recurrent cancer. Preoperative and postoperative data on patients and tumors were recorded and analyzed. RESULTS: There were no differences between groups in age, sex, preoperative tumor volume, ablation time, or ablation power (P > 0.05). There was also no significant difference in postoperative ablation zone volume between the groups at the 1-, 3-, 6-, 12-, and 18-month follow-ups (P > 0.05). The volume reduction rate significantly differed between the two groups at month 3 (P = 0.03). The ablation area could not be identified on US and CEUS at 9.8 ± 5.0 and 10.0 ± 4.8 months in the PTMC and PTMC + CLT groups, respectively (P = 0.197). No serious complications occurred during and after ablation. No residual cancer cells were found on biopsy after ablation. CONCLUSIONS: RFA was effective in patients with PTMC+CLT, and its therapeutic efficacy and safety were similar to those in patients with PTMC without CLT.

15.
J Chromatogr A ; 1598: 232-241, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-30981514

RESUMO

Shuxuening injection (SXNI), one of the traditional Chinese medicine injections (TCMI), is widely used for the treatment of cardiovascular diseases in the clinic. However, its allergic reactions have impeded the clinical applications of SXNI, such adverse reactions have not been well understood due to the lack of methods for detecting haptens. In this study, a high-performance liquid chromatography-diode-array detector-multi-stage mass spectrometry-human serum albumin-fluorescence detector (HPLC-DAD-MSn-HSA-FLD) system was established to identify and screen haptens for the first time. Flavones, flavonols and their glycosides in SXNI showed strong HSA binding ability in different degrees. Fifteen of these compounds were used to study the association of HSA binding ability and sensitizability using isothermal titration calorimetry (ITC) and fluorescence techniques, furthermore, RBL-2H3 cell experiments were conducted to verify the results. It was found that ginkgolides showed no sensitizability, while flavones and flavonol aglycones showed stronger sensitizability than their glycosides. The system was proven to be precise, stable and reproducible, which lays a foundation for screening haptens in SXNI and relevant samples.


Assuntos
Química Farmacêutica/métodos , Cromatografia Líquida de Alta Pressão , Medicamentos de Ervas Chinesas/química , Haptenos/análise , Espectrometria de Massas , Albumina Sérica Humana/análise , Química Farmacêutica/instrumentação , Fluorescência , Humanos , Reprodutibilidade dos Testes
16.
BMJ Open ; 9(1): e023334, 2019 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-30782703

RESUMO

OBJECTIVES: This study aims to summarise the features and trends of thyroid carcinoma in the past two decades in China. DESIGN, SETTING AND PARTICIPANTS: Clinical data obtained from 10 798 patients treated by thyroidectomy from 1994 to 2015 at the Department of General Surgery of the People's Liberation Army General Hospital, Beijing, China were retrospectively analysed. OUTCOME MEASURES: Incidence and histopathological features of thyroid cancer were compared and the risk factors for local lymph node metastasis analysed. RESULTS: Our data indicated a significant increase in the detection of thyroid cancer (from 16.8% to 69.8%, p<0.01). Among the 5235 thyroid cancer cases, papillary thyroid carcinoma (PTC) was the most common histotype, accounting for 95.1% of all malignancies over the 22-year period. Among the 4979 PTCs, micro-PTCs (mPTC) with the largest diameter ≤10 mm has gradually become the dominant form, and its percentage in PTCs has increased from 13.3% in the biennial period of 1994-1995 to 51.2% in 2010-2011. Furthermore, the size of the tumour has decreased significantly from 2.3±1.1 cm in 1994 to 1.2±0.9 cm in the largest diameter (p<0.01), while the average age at diagnosis and female dominance remained unchanged during the period. Logistic regression showed that tumour nodules>1 cm and male gender were the main risk factors for local lymph node metastasis (LNM), whereas patients over 45 years had lower risk. CONCLUSIONS: During the 22-year period, an increased detection of thyroid cancer, particularly mPTC, was found while the occurrence of LNM decreased. Our results suggest that the current preoperative diagnosis and risk stratification are adequate, supporting the published guidelines for the diagnosis of thyroid cancer.

17.
Exp Ther Med ; 17(3): 1847-1854, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30783459

RESUMO

Cx43 has been documented to be involved in ischemic preconditioning (IPC). However, the participation of Cx43-formed hemichannels in IPC and the potential underlying mechanisms remain unclear. The present study focused on cardiomyocytes' volume regulation during IPC to investigate the role of hemichannels in the IPC-induced cardioprotection. In the study, mice cardiomyocytes were respectively treated with a hemichannel blocker, octanol or 18a-Glycyrrhizic acid (18a-GA), and a Cx43-silenced lentivirus. They were subsequently cultured in hypotonic solution to simulate ischemic reperfusion (SIR) and systemic ischemic preconditioning (SIP). Cell morphology and volumetric (area) change were detected by inverted microscopy at 30 min following the addition of hypotonic solution. Cardiomyocyte mortality was assessed by trypan blue stain assay. The analyses revealed that regardless of the treatments, hypotonic solution aggravated cell edema: Compared with the initial condition (the moment before the solution addition, 0 min), the volumetric area increased significantly 30 min later (for hypotonic+DMSO, 5,050±1,511 vs. 3,464±723 µm2; for hypotonic+scramble lentiviral vector, 5,517±1,128 vs. 2,331±536 µm2; P<0.05, respectively). Either treatment alleviated the edematous condition when a comparison was made between 30 min after the hypotonic addition and 0 min (for hypotonic+octanol, 2,990±765 vs. 2,821±773 µm2; for hypotonic+18a-GA, 4,817±1,306 vs. 4,762±1,271 µm2; for hypotonic+Cx43-silenced, 3,627±688 vs. 3,419±814 µm2; P>0.05 for all). Notably, results indicated that the SIP group had lower mortality rates compared with its SIR counterpart; the hypotonic+octanol, hypotonic+18a-GA, and hypotonic+Cx43-silenced group showed markedly-declined mortality when compared with their respective control groups (respectively, 35.70±1.02, 30.76±2.20 vs. 53.58±2.14%; 30.89±2.37 vs. 54.12±2.55%; P<0.05 for all). The results suggest that ischemic preconditioning may provide cardioprotection by blocking the opening of the hemichannels and further mediating the volume regulation of cardiomyocytes.

18.
BMC Cancer ; 19(1): 147, 2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30760229

RESUMO

BACKGROUND: The patient satisfaction of symptoms improvement and disease factors that may affect long-term treatment efficacy of radiofrequency ablation (RFA) for non-functioning solid benign thyroid nodules (TNs) over a 2-year follow up study was investigated. METHODS: This retrospective study evaluated 194 non-functioning solid benign TNs of 103 patients. The TNs were categorized as small (≤5 ml), medium (5.1 to 13 ml), intermediate (13.1 to 30 ml) and large (over 30 ml) according to the initial volume of TNs before ablation. Clinical evaluation and contrast-enhanced ultrasound (CEUS) were carried out before ablation and the follow up at 1, 3, 6 months and every 6 months after ablation. All patients were asked to assess the cosmetic score (1-4 scores) and symptom score (0-10 scores) before ablation and every follow up after ablation. RESULTS: All patients underwent RFA without any major complications. The mean treatment sessions were 1.5 ± 0.6. 98 nodules required a single session (98/194, 50.5%), 87 required two sessions (87/194, 44.9%), 9 required three sessions (9/194, 4.6%). The average follow up months were 16.3 ± 5.6 (range, 6-24 months) and no nodule regrew in our study. After RFA treatment, the TNs volume significantly decreased (P < 0.001). The small group of nodules shrunk larger compared to the medium, intermediate and large groups (P < 0.001). Cosmetic signs and pressure symptoms were significantly improved, particularly in the intermediate and large groups (P < 0.05). CONCLUSIONS: RFA is effective for treating non-functioning solid benign TNs and controlling clinical symptoms with a low complication rate during 2 years follow up. The reduction rate was related to the initial volume of nodules. Patients were satisfied with cosmetic signs and pressure symptoms improvement, particularly in the intermediate and large groups. However, multiple RFA treatments should be used in larger nodules to achieve the desired clinical outcomes.


Assuntos
Neoplasias/terapia , Satisfação do Paciente/estatística & dados numéricos , Ablação por Radiofrequência , Nódulo da Glândula Tireoide/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Nódulo da Glândula Tireoide/epidemiologia , Resultado do Tratamento , Adulto Jovem
19.
Sci Rep ; 9(1): 75, 2019 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-30635590

RESUMO

The association between cervical lymph node metastasis (LNM) and ultrasonographic features as well as BRAFV600E mutations in patients with papillary thyroid carcinoma (PTC) remained controversial. This study investigated the association between LNM and ultrasonographic features as well as BRAFV600E mutation in Chinese patients with PTC. A total of 280 patients with PTC in China were included in this study. 108 had cervical lymph node metastasis, while 172 had not. Younger age (<45years) and several ultrasonographic features were significantly associated with cervical LNM (Ps < 0.05). The BRAFV600E mutation was detected in 81.0% of patients with PTC (226/280). The status of BRAFV600E mutation was not associated with cervical LNM. However, Ct values by PCR and intensity of reactions by immunohistochemistry (IHC) for BRAFV600E expression had shown significant difference between group with and without LNM. Furthermore, an increased proportion of LNM was also found with the incremental intensity of IHC for BRAFV600E expression from weak to strong reaction after adjusted potential confounders. Further studies are required to verify this association and explore the intrinsic mechanism.


Assuntos
Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/secundário , Linfonodos/patologia , Mutação de Sentido Incorreto , Proteínas Proto-Oncogênicas B-raf/genética , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/patologia , Adulto , Grupo com Ancestrais do Continente Asiático , China , Feminino , Predisposição Genética para Doença , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/diagnóstico por imagem , Ultrassonografia
20.
Diagn Cytopathol ; 47(3): 187-193, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30499203

RESUMO

BACKGROUND: Thyroid nodules are very common. Ultrasound (US) and fine needle aspiration (FNA) are both integral in cancer screening. This study investigated the concordance between thyroid nodule sizes measured by US and gross pathologic examination and their relationship with malignancy. METHODS: A retrospective design was used to select consecutive patients with proven carcinoma of the thyroid. The number and maximum diameter of nodules, rates and types of malignancy, as well as predictors of malignancy were determined. RESULTS: The 10 944 patients examined had 15 283 thyroid nodules, 44.6% of which were malignant. Of the 4449 nodules sampled by FNA and the 8748 not sampled by FNA, 76.5% and 30.5% were malignant, respectively. The sensitivity, specificity, positive and negative predictive values (NPVs), and overall accuracy of FNA based on final pathology were 97.9%, 96.3%, 98.8%, 93.5%, and 97.5%, respectively. Nodule sizes determined by US were comparable with most nodules having either the same size range (n = 2959, 77.7%) or differing only by one size range (n = 770, 20.5%). CONCLUSIONS: Thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates. Nodule size estimated by US shows relatively good correlation with final pathologic size. However, thyroid nodules should undergo FNA regardless of size. If the FNA is not benign, nodule size should influence therapeutic decision making.


Assuntos
Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Adulto , Idoso , Biópsia por Agulha Fina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia
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