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2.
Sci Rep ; 11(1): 20706, 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34667219

RESUMO

Higher magnetic fields are always favoured in the magnetoplasmadynamic thruster (MPDT) due to its superior control of the plasma profile and acceleration process. This paper introduces the world's first integrated study on the 150 kW level AF-MPDT equipped with a superconductive coil. A completely new way of using superconducting magnet technology to confine plasma with high energy and extremely high temperatures is proposed. Using the PIC method of microscopic particle simulation, the plasma magnetic nozzle effect and performance of the MPDT under different magnetic-field conditions were studied. The integrated experiment used demonstrated that, in conjunction with the superconducting coil, greater homogeneity and a stronger magnetic field not only caused more even cathode ablation and improved its lifespan but also improved the performance of the MPDT (maximum thrust was 4 N at 150 kW, 0.56 T). Maximum thrust efficiency reached 76.6% and the specific impulse reached 5714 s.

3.
J Surg Oncol ; 2021 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-34689328

RESUMO

AIM: Bowel dysfunction after sphincter-preserving proctectomy, also known as low anterior resection syndrome (LARS), has significant impact on survivors of rectal cancer. This study aimed to assess the temporal change of LARS beyond 2 years after proctectomy, which has not been fully studied. METHODS: We longitudinally enrolled consecutive patients who had received total mesorectal excision in a tertiary academic medical center, with preoperative neoadjuvant therapy if indicated. LARS score was longitudinally assessed by two serial follow-ups, with a fixed interval of 18 months. RESULTS: Overall, 107 patients responded for the first follow-up after a median of q20 months, 96 of whom responded for the second follow-up after a median of 38 months. At the first follow-up, 48 patients (44.9%) reported major LARS, compared with 23 (24.0%) at the second follow-up (p < 0.001). Mean LARS score improved from 27.3 to 18.6, mostly from "urgency" (12.2 vs. 6.2, p < 0.001) and "clustering of stools" (9.7 vs. 7.7, p = 0.001). Anastomosis less than 3 cm from the anal verge was independently associated with LARS improvement. CONCLUSION: Bowel dysfunction continues to improve 2 years after total mesorectal excision, with most symptom relief in urgency and stool clustering, especially in patients with lower anastomosis.

4.
Otolaryngol Head Neck Surg ; : 1945998211038318, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34488520

RESUMO

OBJECTIVE: The extent of neck dissection in papillary thyroid carcinoma (PTC) patients with lateral neck metastasis is controversial. This work aims to screen the patients suitable for superselective neck dissections including only levels III-IV. STUDY DESIGN: Prospective observational cohort study. SETTING: The study was conducted in a high-volume tertiary care setting. METHODS: A total of 134 consecutive previously untreated PTC patients with lateral neck metastases and subjected to 154 therapeutic lateral neck dissections (including levels II, III, IV, and VB) between June 2018 and March 2021 were enrolled. Fine-needle aspiration was performed preoperatively at each suspicious neck level. Clinical predictors were analyzed for occult lymph node metastases at levels II and VB. RESULTS: As a result, 44.8% and 5.8% of neck specimens exhibited metastatic lymph nodes at levels II and VB. In addition, univariate and multivariate analyses showed that the primary tumor in the ipsilateral thyroid upper lobe (P = .016, odds ratio = 3.528) and clinically multiple metastatic lymph nodes in level III-IV (P = .005, odds ratio = 6.414) were independent predictive factors for occult level II metastases. All 3 (1.9%) occult metastases at level VB were found in necks with preoperative multiple lymph node metastases. CONCLUSIONS: A superselective lateral neck dissection including levels III to IV may be considered in patients with PTC when the preoperative evaluation identifies a single lymph node metastasis located at levels III to IV and the primary tumor is not in the upper lobe of the ipsilateral thyroid.

5.
Soft Robot ; 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34550801

RESUMO

Continuum robots with redundant degrees of freedom and postactuated devices are suitable for application in aerospace, nuclear facilities, and other narrow and multiobstacle special environments. The development of a snake-inspired continuum robot is presented in this study. The morphological skeleton structure of the snake body is simulated using underactuated continuum joints, which include several rigid-body joints in series. Each rigid-body joint is driven by the traction of a wire rope. Based on the layered-drive principle, angular synchronous motion can be realized in space with multiple rigid-body joints in a single continuous joint, which can considerably reduce the complexity of the inverse kinematics solution, terminal drive box, and control system. The static and dynamic characteristics of the snake-inspired robot are obtained through torque balance and an equivalent transformation. Finally, we demonstrate trajectory planning and load capacity testing in two robot prototypes with arm lengths of 1500 and 2300 mm (including two and four continuous joints, respectively). The rationality of the structure and the correctness of the control of the layered-drive snake-inspired robot are verified.

6.
BMC Surg ; 21(1): 329, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407789

RESUMO

BACKGROUND: Mediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment of thyroid carcinoma with mediastinal lymphadenopathy. MATERIALS AND METHODS: We retrospectively reviewed the clinical pathologic data and short-term outcomes of thyroid cancer patients with suspicious MLNM treated with video mediastinoscopy-assisted mediastinal dissection at our institution from 2017 to 2020. RESULTS: Nineteen patients were included: 14 with medullary thyroid carcinoma and five with papillary thyroid carcinoma. Superior mediastinal nodes were positive in nine (64.3%) patients with medullary thyroid carcinoma and in four (80.0%) patients with papillary carcinoma. No fatal bleeding occurred. There were three cases of temporary recurrent laryngeal nerve (RLN) palsy postoperatively, one of which was bilateral. Four patients had temporary hypocalcemia requiring supplementation, one had a chyle fistula, and one developed wound infection after the procedure. Postoperative serum molecular markers decreased in all patients. One patient died of cancer while the other 18 patients remained disease-free, with a median follow-up of 33 months. CONCLUSION: Video mediastinoscopy-assisted superior mediastinal dissection can be performed relatively safely in patients with suspicious MLNM. This diagnostic and therapeutic approach may help control locoregional recurrences.


Assuntos
Linfadenopatia , Neoplasias da Glândula Tireoide , Dissecação , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Mediastinoscopia , Esvaziamento Cervical , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
7.
Technol Cancer Res Treat ; 20: 15330338211033076, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34338058

RESUMO

PURPOSE: To commission MCsquare (a multi-cores CPU-based dose calculation engine) for pencil beam scanning (PBS) proton therapy, integrate it into RayStation treatment plan system (TPS) to create a dedicated platform for fast independent dose verification. METHOD: A MCsquare-based independent dose verification platform (MC2InRS) was developed to realize automatic dose re-calculation for clinical use, including data preparation, dose calculation, 2D/3D gamma analysis. MCsquare was commissioned based on in-air lateral dose profiles, integrated depth dose, and the absolute dose of different beam energies for Proteus®ONE. MC2InRS was validated with measurement data using various targets and depths in a water phantom. This study also investigated 15 clinical cases to demonstrate the feasibility and effectiveness of MC2InRS platform in clinic practice. RESULTS: Between simulation and measurement, the distal range differences at 80% (R80) and 20% (R20) dose levels for each energy were below 0.05 mm, and 0.1 mm, respectively, and the absolute dose differences were below 0.5%. 29 out of 36 QA planes reached a 100% gamma passing rate (GPR) for 2%/2mm criteria, and a minimum of 98.3% gamma was obtained in water phantom between simulation and measurement. For the 15 clinical cases investigated, the average 2D GPR (2%/2mm) was 95.4%, 99.3% for MCsquare vs. measurement, MCsquare vs. TPS, respectively. The average 3D GPR (2%/2mm) was 98.9%, 95.3% for MCsquare vs. TPS in water, and computed tomography (CT), respectively. CONCLUSION: MC2InRS, a fast, independent dose verification platform, has been developed to perform dose verification with high accuracy and efficiency for Pencil Bream Scanning (PBS). Its potential to be applied in routine clinical practice has also been discussed.

8.
Gland Surg ; 10(7): 2150-2158, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34422586

RESUMO

Background: Intraoperative neuromonitoring (IONM) reduces the risk of recurrent laryngeal nerve (RLN) injury during thyroid surgery. However, the use of neuromuscular blocking agents (NMBAs), which are essential to improve intubation conditions, may hinder the electromyographic response during IONM. The aim of this prospective, double-blind, randomized controlled trial was to explore the optimal dosage of cisatracurium to produce adequate muscle relaxation for tracheal intubation without significantly affecting evoked potentials of IONM during thyroidectomy. Methods: Patients undergoing thyroidectomy with IONM in our institution, with an American Society of Anesthesiologists grade of I-II, aged 18-75 years, and with a body mass index below 32 kg/m2 were enrolled and randomly assigned (by random numbers) to receive 1× (group C1) or 2× (group C2) the effective dose (ED95) of cisatracurium for tracheal intubation. The patients, surgeons, and anesthesiologists in charge were blinded to group assignment. Anesthesia was induced with sufentanil, propofol, and cisatracurium (0.05 mg/kgin group C1, 0.1 mg/kg in group C2). Ease of intubation was evaluated with the intubation condition score (Cooper score) and the intubation difficulty scale (IDS). Amplitudes of evoked potentials during intermittent IONM were compared between groups. The primary outcomes were the Cooper score, the IDS score, and the evoked potentials of IONM. Results: Fifty-three patients were randomized from October 2019 to November 2020, and 52 were analyzed (with 26 patients in each group). The Cooper score was significantly lower in group C1 [median, 8.0 (interquartile range, 7.0-8.3)] than in group C2 [9.0 (9.0-9.0), P<0.001]. The rate of difficult laryngoscopy without external laryngeal pressure was significantly higher in group C1 than in group C2 (61.5% vs. 11.5%, P<0.001). More patients in group C1 required assistance to complete tracheal intubation (16 vs. 4, P=0.001). The IDS score was significantly higher in group C1 [3.0 (0.0-4.0) vs. 1.0 (0.0-1.0), P=0.045]. There were no significant differences between groups in amplitudes of evoked potentials. No serious adverse events were observed. Conclusions: A dose of 2× ED95 of cisatracurium provided better intubation conditions and easier tracheal intubation than 1× ED95, without disturbing IONM. Trial Protocol: Chinese Clinical Trial Registry (No. ChiCTR1900022884).

9.
Laryngoscope Investig Otolaryngol ; 6(3): 570-575, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34195379

RESUMO

Objective: To assess the accuracy of preoperative ultrasound-guided multilevel fine-needle aspiration (FNA) cytology and thyroglobulin (Tg) estimation in mapping metastatic levels in the lateral neck, in patients with papillary thyroid carcinoma (PTC). Methods: Patients with PTC clinically metastasizing to the lateral neck who were initially treated at the Peking University Cancer Hospital from June 2018 to September 2020 were included. FNA was performed preoperatively in each suspicious neck level; cytological examination (FNA-C) and Tg measurement of the needle-washout fluid (FNA-Tg) were combined to determine metastasis. FNA-Tg cutoff value was calculated, and the accuracy of FNA at different levels were evaluated. Results: In total, 111 patients underwent 124 lymph node dissections. The best cutoff value of FNA-Tg for the diagnosis of metastatic level was 1.0 ng/mL. Multilevel FNA showed sensitivity, specificity, positive predictive value, and negative predictive value in predicting single-level metastasis of 100%, 61.0%, 43.9%, and 100%, respectively. In 64 (51.6%) cases, the involved levels diagnosed by FNA were consistent with that diagnosed by postoperative pathology. Conclusion: FNA-Tg improves the diagnostic performance of FNA-C in lateral neck lymph node metastases. However, limited accuracy was obtained for preoperative multilevel FNA in predicting the extent of metastasis in the lateral compartment.

10.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(3): 240-245, 2021 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-34096228

RESUMO

Aiming at the problem of timeliness of CBCT reconstruction, a CBCT fast short scan reconstruction method is proposed. At the same time, the image reconstruction process in which a new attenuation compensation algorithm is applied to improve image quality. When performing FDK three-dimensional reconstruction of a single-frame acquisition image, the Parker-weighted image is calculated in real time, and a new attenuation compensation algorithm is applied in the back projection process to complete the short scan Parker-weighted reconstruction. This method simulates the CBCT synchronous acquisition and reconstruction process by establishing collection and reconstruction threads. Under the premise of satisfying the reconstruction quality, the reconstruction can be completed within 1 to 2 seconds after the patient collection is completed, which achieves the purpose of real-time.


Assuntos
Tomografia Computadorizada de Feixe Cônico Espiral , Algoritmos , Tomografia Computadorizada de Feixe Cônico , Humanos , Processamento de Imagem Assistida por Computador
11.
Onco Targets Ther ; 14: 3083-3094, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34007185

RESUMO

Purpose: Long noncoding RNAs are crucial regulators in thyroid cancer progression. However, the role of lncRNA CCDC26 in thyroid cancer remains unclear. Here, we aimed to explore the effect of CCDC26 on thyroid cancer progression and the underlying mechanism. Materials and Methods: A total of 50 clinical thyroid cancer samples were studied in patients' samples, cultured cells, and nude mice before and after treatment using quantitative reverse transcription-PCR, CCK-8 assays, BrdU incorporation assays, Transwell assays, cell apoptosis analysis, luciferase reporter gene assay, RNA immunoprecipitation, Western blot analysis, and tumorigenicity analysis. Results: CCDC26 expression was elevated in patients' thyroid cancer tissues and thyroid cancer cell lines. CCDC26 depletion remarkably reduced proliferation, invasion, and migration but induced apoptosis of thyroid cancer cells. Mechanically, miR-422a mimic remarkably reduced the luciferase activity of CCDC26 transfected cells but failed to affect cells transfected with CCDC26 containing the mutated miR-422a-binding site. RNA immunoprecipitation (RIP) assays showed that CCDC26 and miR-422a preferentially interacted with Ago2, but not IgG, in the micro-ribonucleoprotein complexes (miRNPs). CCDC26 depletion enhanced miR-422a expression and MiR-422a inhibitor reversed CCDC26 knockdown-induced inhibition of thyroid cancer progression in vitro. CCDC26 upregulated EZH2 and Sirt6 expression by sponging miR-422a in thyroid cancer cells. Tumorigenicity analysis in nude mice revealed that CCDC26 contributed to thyroid tumor growth via miR-422a/EZH2/Sirt6 axis in vivo. Conclusion: CCDC26 promotes thyroid cancer malignant progression via miR-422a/EZH2/Sirt6 axis. This finding provides new insights into the mechanism by which CCDC26 promotes malignant thyroid cancer development, advances our understanding of lncRNAs' association with thyroid cancer, and indicates that CCDC26 and miR-422a may serve as potential targets for thyroid cancer.

12.
Huan Jing Ke Xue ; 42(4): 2003-2015, 2021 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-33742835

RESUMO

In order to evaluate the potential ecological risk of heavy metals in the soil-crop system in the Xiong'an New District, the heavy metal contents and forms in wheat seed and root soil samples are analyzed, and the comprehensive pollution index (IPIN), potential ecological risk index (RI), bio-enrichment coefficient (BFC), risk assessment code (RAC), principal component analysis, and correlation analysis are used to assess the potential ecological risk of heavy metals and analyze their sources. The results indicate that the average content of Cd, Cu, Pb, and Zn in the root soil is significantly higher than the soil background value in Hebei province. The IPIN ranges from 0.2 to 5.18, 94.83% of the soil samples are in the safe and pollution-free grade, and the potential ecological risks of heavy metal are slight and moderate, accounting for 64.66% and 30.17%, respectively. Cd has the greatest potential ecological harm, followed by Hg, Cr, Ni, and Zn. All the heavy metal elements besides Cd in the root soil are dominated by the residual form, which accounts for 60%, and the bioactive form (ion-exchange and water-soluble state) of Cd accounts for 33.43%, indicating relatively high bio-availability. The risk assessment code can be ranked as Cd > Ni > Hg > As > Cu > Cr > Zn > Pb, and the risk of Cd is moderate, while other elements are of low or no risk. The leading potential source of heavy metals is human activity combined with the geological background. The migration and enrichment capability of the wheat seeds is in order from strong to weak of Zn > Cu > Cd > Hg > As > Ni > Pb > Cr, and the biological effective components of As, Cd, Pb, and Zn plays an substantial role in promoting the absorption of heavy metals. The content of heavy metals in the wheat seeds has a negative correlation with the soil pH, and the physical and chemical indices, such as OM and CEC, has bi-directional influence on the biological effective state of the heavy metals.


Assuntos
Metais Pesados , Poluentes do Solo , China , Monitoramento Ambiental , Humanos , Metais Pesados/análise , Medição de Risco , Solo , Poluentes do Solo/análise
13.
Gland Surg ; 10(1): 319-327, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33633988

RESUMO

Background: Distinguishing aggressive pT1 papillary thyroid carcinomas (PTCs) from indolent PTCs before or during surgery is important. To the best of our knowledge, few reports in the literature have examined the value of the cytomorphologic features of PTC as predictors of aggressiveness. Methods: This retrospective study included 226 pT1 PTC patients who underwent preoperative fine-needle aspiration cytology (FNAC) and surgery at Peking University Cancer Hospital between January 2018 and December 2019. Data on the clinical characteristics and pathological results were obtained from the electronic medical record database. All FNAC smears were blindly reviewed by two independent cytopathologists, and the associations between nine cytomorphologic features (lymphocytes, multinucleated giant cells, cellularity, cellular adhesiveness, nuclear size, nuclear pleomorphism, nuclear membrane regularity, intranuclear pseudoinclusions and the amount of cytoplasm) and clinicopathological parameters were statistically analyzed. Results: Univariate analysis showed that cellularity, intranuclear pseudoinclusions, cellular adhesiveness, nuclear size, and nuclear pleomorphism were strong predictors of some clinicopathological parameters such as extracapsular invasion (ECI) and lymph node metastasis (LNM). Multivariate analysis confirmed that cellular adhesiveness was a strong independent predictor of ECI (P=0.001) and LNM (P<0.001), and the amount of cytoplasm can also predict LNM (P=0.024). Conclusions: Cytomorphologic features including cellular adhesiveness and the amount of cytoplasm in preoperative FNAC smears could be a valuable tool for predicting ECI or LNM and may be predictors of aggressiveness in patients with pT1 PTC.

14.
Cancer Med ; 9(22): 8397-8405, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32976686

RESUMO

BACKGROUND: Thyroid nodules are highly prevalent, with fine-needle aspiration (FNA) commonly used as the standard preoperative tool for their diagnosis. However, the method classifies some of the samples as indeterminate, leading to unnecessary surgery. In this study, we evaluated the value of next-generation sequencing (NGS) for cancer diagnosis in indeterminate thyroid nodules. MATERIALS AND METHODS: We performed a prospective, blinded cohort study on 189 patients, with 196 Bethesda III/IV nodules. Specifically, we analyzed DNA mutations and RNA fusions across the FNA samples using NGS, then reviewed follow-up reports from 84 nodules following definitive surgery, to determine the assay performance. RESULTS: Enough DNA and RNA were obtained in 188 nodules, revealing mutations or fusions in 34.6% of them. The most frequently mutated genes were RAS, followed by BRAF V600E. Based on surgical pathology, 39% (33/84) and 4.8% (4/84) of the nodules were malignant and intermediate, respectively. According to the risk stratification criteria, 28 cases were categorized High-Risk group, all of the resected nodules (n = 20) were malignant. Twenty-four thyroid nodules were in the Low-Risk group, 28.6% (4/14) surgically removed nodules were malignant. In the Benign-Like category, 18.0% (9/50) were malignant. Five out of 13 nodules with benign mutations were resected, including SPOP, EZH1, and ZNF148, all of them were benign. If genetic alterations annotated with High-Risk or Low-Risk was considered as positive, and negative if Benign-Like. Multigene testing revealed sensitivity, specificity, positive predictive values (PPV), and negative predictive value (NPV) of 73%, 80%, 71%, and 82%, respectively. In addition, if four intermediate nodules were counted as malignant, the PPV and NPV were 71% and 74%. CONCLUSION: Our results allow for further stratification of Bethesda III/IV thyroid nodules based on the risk of their malignancy. SPOP, EZH1, and ZNF148 mutations may be used as benign markers.


Assuntos
Biomarcadores Tumorais/genética , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Neoplasias da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/genética , Transcriptoma , Adulto , Idoso , Pequim , Biópsia por Agulha Fina , Proteínas de Ligação a DNA/genética , Feminino , Fusão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Estadiamento de Neoplasias , Proteínas Nucleares/genética , Complexo Repressor Polycomb 2/genética , Valor Preditivo dos Testes , Estudos Prospectivos , Proteínas Repressoras/genética , Método Simples-Cego , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia , Fatores de Transcrição/genética , Adulto Jovem
15.
Gland Surg ; 9(3): 711-720, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32775261

RESUMO

Background: Ultrasound-guided fine-needle aspiration (FNA) cytology is a crucial diagnostic technique used to assess thyroid nodules. In the past, ultrasound-guided FNA was performed mainly by radiologists. However, many surgeons are increasingly being trained for this procedure now. In this study, we aimed to compare the adequacy and efficiency of ultrasound-guided FNA performed by newly trained head and neck surgeons with experienced radiologists in a single institution. We also assessed the malignancy rates in nondiagnostic nodules and the differences between benign and malignant nodules. Methods: This is a retrospective study. The data from patients who underwent ultrasound-guided FNA performed by surgeons or radiologists in two consecutive years were collected. Medical records, cytology results, and surgical pathology results were analyzed. Results: During the study period, a total of 2,405 ultrasound-guided FNAs were performed on 2,163 patients. The head and neck surgeons and radiologists performed 1,132 and 1,273 ultrasound-guided FNA procedures, respectively. The nondiagnostic rate was 14.49% for surgeons and 15.40% for radiologists (P=0.533). There were no differences in patient age, gender, nodule size, and other sonographic characteristics between the groups of patients who were treated by radiologists versus surgeons. The median waiting time from biopsy appointment to performing ultrasound-guided FNA was 0 days for head and neck surgeons, and 6 days for radiologists (P<0.001). Of the 40 patients who had a repeat FNA or surgery, 19 (47.50%) had a malignancy. Preoperative information about age, gender, operator, and characteristics of nodules did not predict the outcome of nodules with Bethesda category I. Conclusions: The adequacy of ultrasound-guided FNAs performed by head and neck surgeons is similar to that of skilled radiologists, while surgeons are more efficient than radiologists. Nondiagnostic FNA reports should not be considered benign, and repeat FNA or selective surgical treatment is recommended.

16.
Chin J Cancer Res ; 32(2): 140-148, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32410792

RESUMO

Objective: To evaluate the diagnostic utility of The Bethesda System for Reporting Thyroid Cytology (TBSRTC) at Peking University Cancer Hospital, the incidence of noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), and the impact of reclassification on cytopathological outcomes. Methods: We performed a retrospective study of thyroid fine-needle aspiration (FNA) cases between April 2014 and March 2019. The FNA results were classified according to TBSRTC. Post-surgery histological findings were followed up. Results: A total of 2,781 thyroid FNAs were performed. The incidences of the 6 diagnostic categories (DCs I-VI) were 14.8%, 17.1%, 15.8%, 2.3%, 11.6% and 38.5%, respectively. A total of 1,122 patients (40.3%) had corresponding histological results. NIFTP accounted for 0.4% of papillary thyroid carcinoma (PTC) cases, and there was no significant difference in the risk of malignancy (ROM) for each TBSRTC DC between "NIFTP=carcinoma (Ca)" and "NIFTP≠Ca". When "NIFTP=Ca", the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TBSRTC were 98.0%, 84.0%, 99.4%, 58.3%, and 97.5%, respectively. When "NIFTP≠Ca", the sensitivity, specificity, PPV, NPV and accuracy of the TBSRTC were 98.1%, 81.5%, 99.3%, 61.1%, and 97.5%, respectively. Conclusions: TBSRTC is effective in the preoperative diagnosis of thyroid nodules in Peking University Cancer Hospital. The impact of the reclassification of NIFTP on cytopathological outcomes is limited because of its low incidence, and the revised ROMs are not suitable for Asian patients.

17.
Diagn Pathol ; 15(1): 1, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900180

RESUMO

OBJECTIVE: FNA is a simple, safe, cost-effective and accurate diagnostic tool for the initial screening of patients with thyroid nodules. The aims of this study were to determine the diagnostic utility of FNAC performed in our institution, assess the cytomorphologic features that contribute to diagnostic errors and propose improvement measures. METHODS: A total of 2781 FNACs were included in the study, and 1122 cases were compared with their histological diagnoses. We retrospectively reexamined our discordant (both false-negative and false-positive) cases and performed a systematic review of previous studies on causes of misdiagnoses. RESULTS: When DC V and DC VI were both considered cytologic-positive, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 98.3, 30.9, 94.9, 58.3 and 93.5%, respectively. If DC VI was considered cytologic-positive, the sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC were 98.0, 84.0, 99.4, 58.3, and 97.5% respectively. The main cause of false-negative diagnoses was sampling error (13/15, 86.7%), while interpretation error led to the majority of the false-positive diagnoses (38/47, 80.9%). Overlapping cytological features in adenomatous hyperplasia, thyroiditis and cystic lesions were the major factors contributing to interpretation errors, while the size and number of nodules may have led to false-negative diagnoses because of heterogeneity and unsampled areas. CONCLUSIONS: The sensitivity and PPV of thyroid FNAC in our institution were higher than those in the published data, while the specificity and NPV were lower. Regarding the FNA category DC V, a frozen section analysis during diagnostic lobectomy is necessary. Multiple passes should be performed in various parts of a large nodule or from different nodules to reduce the risk of false-negative findings. Cytopathologists should strengthen their criteria for the identification of adenomatous hyperplasia, thyroiditis and cystic lesions to avoid false-positive diagnoses. NIFTP has little effect on diagnostic accuracy and the distribution of diagnostic errors.


Assuntos
Carcinoma Papilar/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Tireoidite/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Carcinoma Papilar/patologia , Erros de Diagnóstico , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Secções Congeladas , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Tireoidite/patologia , Adulto Jovem
18.
J Colloid Interface Sci ; 555: 403-412, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31398567

RESUMO

Herein a versatile adsorbent has been synthesized by immobilization of ethylenediaminetetraacetic acid (EDTA) into the pores of the Zr-based metal organic framework (UiO-66) through a facile method. The as-prepared EDTA modified UiO-66 (UiO-66-EDTA) was characterized completely to investigate its physical and chemical properties. It shows great chemical stability with octahedral structure and carboxylic groups and amine groups. Through batch experiments, UiO-66-EDTA shows no specificity for the removal of diverse heavy metal ions (three categories: soft acids, hard acids, and borderline acids) because of its both hard and relatively softer chemical characters of functional groups. The maximum removal capacities of UiO-66-EDTA for Eu3+ (hard acids), Hg2+ (soft acids) and Pb2+ (borderline acids) are 195.2, 371.6 and 357.9 mg g-1, respectively. Notably, 11 metal ions removal efficiency reaches over 99% in co-existing system. The results from X-ray photoelectron spectroscopy (XPS) analysis reveal the coordination of Eu3+, Hg2+ and Pb2+ with carboxyl groups (COOH) and tertiary amine groups (CN(C)C) is responsible for their removal by UiO-66-EDTA. Given the fact that UiO-66-EDTA possesses high chemical stability, facile synthesis method, efficient removal performance and superior reusability, it can be applied in treatment of seriously polluted water with multi-pollutants.

19.
PLoS Genet ; 15(5): e1008165, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31091225

RESUMO

Coordinated transcriptional and epigenetic mechanisms that direct development of the later differentiating second heart field (SHF) progenitors remain largely unknown. Here, we show that a novel zebrafish histone deacetylase 1 (hdac1) mutant allele cardiac really gone (crg) has a deficit of ventricular cardiomyocytes (VCs) and smooth muscle within the outflow tract (OFT) due to both cell and non-cell autonomous loss in SHF progenitor proliferation. Cyp26-deficient embryos, which have increased retinoic acid (RA) levels, have similar defects in SHF-derived OFT development. We found that nkx2.5+ progenitors from Hdac1 and Cyp26-deficient embryos have ectopic expression of ripply3, a transcriptional co-repressor of T-box transcription factors that is normally restricted to the posterior pharyngeal endoderm. Furthermore, the ripply3 expression domain is expanded anteriorly into the posterior nkx2.5+ progenitor domain in crg mutants. Importantly, excess ripply3 is sufficient to repress VC development, while genetic depletion of Ripply3 and Tbx1 in crg mutants can partially restore VC number. We find that the epigenetic signature at RA response elements (RAREs) that can associate with Hdac1 and RA receptors (RARs) becomes indicative of transcriptional activation in crg mutants. Our study highlights that transcriptional repression via the epigenetic regulator Hdac1 facilitates OFT development through directly preventing expression of the RA-responsive gene ripply3 within SHF progenitors.


Assuntos
Histona Desacetilase 1/genética , Histona Desacetilase 1/metabolismo , Função Ventricular/genética , Proteínas de Peixe-Zebra/genética , Proteínas de Peixe-Zebra/metabolismo , Animais , Diferenciação Celular/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Coração/fisiologia , Ventrículos do Coração/metabolismo , Miócitos Cardíacos/fisiologia , Organogênese , Proteínas Repressoras/metabolismo , Células-Tronco/metabolismo , Fatores de Transcrição/metabolismo , Tretinoína/metabolismo , Função Ventricular/fisiologia , Peixe-Zebra/genética , Peixe-Zebra/metabolismo
20.
J Med Syst ; 43(7): 194, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31114956

RESUMO

3D/3D image registration in IGRT, which aligns planning Computed Tomography (CT) image set with on board Cone Beam CT (CBCT) image set in a short time with high accuracy, is still a challenge due to its high computational cost and complex anatomical structure of medical image. In order to overcome these difficulties, a new method is proposed which contains a coarse registration and a fine registration. For the coarse registration, a supervised regression convolutional neural networks (CNNs) is used to optimize the spatial variation by minimizing the loss when combine the CT images with the CBCT images. For the fine registration, intensity-based image registration is used to calculate the accurate spatial difference of the input image pairs. A coarse registration can get a rough result with a wide capture range in less than 0.5 s. Sequentially a fine registration can get accurate results in a reasonable short time. RSD-111 T chest phantom was used to test our new method. The set-up error was calculated in less than 10s in time scale, and was reduced to sub-millimeter level in spatial scale. The average residual errors in translation and rotation are within ±0.5 mm and ± 0.2°.


Assuntos
Planejamento da Radioterapia Assistida por Computador , Erros de Configuração em Radioterapia/prevenção & controle , Radioterapia Guiada por Imagem/métodos , Algoritmos , Humanos , Imageamento Tridimensional , Imagens de Fantasmas , Tomografia Computadorizada por Raios X
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