Evaluation of accuracy of pathological diagnosis based on thyroid core needle biopsy / 北京大学学报(医学版)

OBJECTIVE@#To explore the protocol for diagnosing thyroid nodules based on core needle biopsy (CNB) and study the biomarkers' application in distinguishing indeterminate samples.@*METHODS@#Patients with thyroid nodules treated at Peking University First Hospital from 2015 to 2020 were reviewed. In the study, 598 cases with CNB and matched resected specimens were retrieved. According to "diagnostic categories of thyroid CNB" proposed by the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group, the CNB samples were diagnosed as follows: Ⅰ, unsatisfactory; Ⅱ, benign; Ⅲ, indeterminate; Ⅳ, follicular neoplasm; Ⅴ, suspicious for malignancy; and Ⅵ, malignant. The samples of CNB Ⅲ were stained by immunohistochemistry (IHC) using antibodies against CK19, Galectin-3, HBME-1, and CD56, and detected by next-generation sequencing (NGS) using an OncoAim® thyroid cancer multigene assay kit (Singlera Genomics) that detected 26 genes. Taking the resected specimens' classification as the gold standard, the predictive value of CNB for determining the malignancy of thyroid nodules and the biomarkers for distinguishing the samples of CNB Ⅲ was calculated.@*RESULTS@#The study included 598 patients, of which none were CNB Ⅰ, 40 cases were CNB Ⅱ, 40 cases were CNB Ⅲ, 32 cases were CNB Ⅳ, 35 cases were CNB Ⅴ, and 451 cases were CNB Ⅵ. The predictive value of CNB Ⅳ for determining follicular neoplasm was sensitivity (Sen) 100.00% and specificity (Sep) 100.00%, CNB Ⅴ-Ⅵ for determining malignancy was Sen 94.55% and Sep 100.00%, CNB Ⅱ for determining benign lesions was Sen 75.00% and Sep 99.80%. The predictive value of biomarkers for determining malignancy in cases of CNB Ⅲ was Sen 96.30% and Sep 92.31% by NGS, and Sen 81.48% and Sep 92.30% by IHC.@*CONCLUSION@#The Korean "diagnostic categories of thyroid CNB", which considers the histological specificity of CNB samples and the habits of clinicians, have strong operability, high diagnosis rate, and high clinical value. Under this framework, the cases of CNB Ⅵ should be treated with surgical operation, the cases of CNB Ⅴ-Ⅵ are recommended to be treated as malignant neoplasms, and the major cases of CNB Ⅱ could be followed up without worrisome except the one considered malignant by ultrasound. The value of biomarkers in distinguishing the cases of CNB Ⅲ is significant.

Impact of Cerebral Blood Perfusion and Cognitive Function of Carotid Artery Stenting Combined with Medical Therapy for Patients with Severe Internal Carotid Stenosis / 中山大学学报(医学科学版)

[objective]To study effect of cerebral blood perfusion and cognitive function of carotid artery stenting com-bined with medical therapy for patients with severe internal carotid stenosis.[Methods]124 patients with severe internal ca-rotid stenosis from June 2014 to June 2016 were divided into observed group and the treatment group,The treatment group given pure medical therapy,observation group given carotid artery stenting combined with medical therapy.One year follow-upr,cerebral blood flow perfusion,cognitive function,adverse events were compared between two groups.[Result]The ob-servation group rTTP,rMTT,rCBV,rCBF were significantly lower than treatment group(P<0.05,P<0.01);MMSE,MoCA score were significantly higher than treatment group(P<0.05);Vascular Occlusion,vascular restenosis,cerebral ischemic stroke,transient cerebral ischemia were significantly lower than treatment group(1.61% vs 11.29%,4.84% vs 19.35%, 1.61% vs 14.52%,4.84% vs 17.74,P<0.05).[Conclusion]Carotid artery stenting combined with medical therapy help to improve cerebral blood flow perfusion in patients with severe internal carotid stenosi,improve cognitive function,and pre-vent adverse events.

Analysis of mitochondrial DNA D-loop region mutation and its significance in human oncocytoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the mutation in mitochondrial DNA displacement-loop (mtDNA D-loop) region in oncocytoma and its relationship with tumorigenesis and tumor development.</p><p><b>METHODS</b>The mtDNA D-Loop region of 20 thyroid or renal oncocytomas and the adjacent normal tissues were amplified by PCR, and then sequenced. Five human fetal renal tissues were collected as matched controls.</p><p><b>RESULTS</b>Among the 20 oncocytomas, 21 mutations which focused on hypervariable region I (HVI) were found in 7 tumor tissues and 1 normal tissue with the mutation rates of 35% and 5%, respectively. At the same time, 191 polymorphisms were found in the 20 cases.</p><p><b>CONCLUSION</b>mtDNA D-loop region, especially HV I, is the mutational hotspot of oncocytomas, which may be closely related with mtDNA duplicating rate and the function of mitochondria.</p>

Biomechanical research in treating unstable Pilon fracture with anatomic plate of distal tibia / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the mechanical characteristics of new anatomic plate of distal tibia from view of biomechanics.</p><p><b>METHODS</b>Twelve fresh adult moist ankle specimens were randomly divided into four block groups (every group had 3 specimens), 3 tibial specimens as a normal control (normal group N), 9 specimens were resulted in unstable distal tibial Pilon fracture. Using steel plate fixation with a new anatomic distal tibial plate (group A), reconstruction plate (group B), clover plate (group C). Group B and group C as control group to test the remote axial compressive strength, remote axial stiffness, reversing biomechanical properties, contacted characteristics of the tibial astragaloid articular surface.</p><p><b>RESULTS</b>The remote axial compressive strength, remote axial stiffness, reversing biomechanical properties, contacted characteristics of tibial astragaloid articular surface the in distal tibial Pilon fracture instability of group A were near normal group N (P>0.05). Group A was best than group B and C (P<0.05).</p><p><b>CONCLUSION</b>The new anatomic plate of distal tibia was relatively strong, which can reach effective and stable fixation for unstable distal tibial Pilon fracture.</p>

CT and MRI Study of Brain Lesions in Carbon Monoxide Intoxication / 实用放射学杂志

Objective To evaluate CT and MRI features of brain lesions in CO poisoning and to compare the ability of detecting rate of lesions by CT and MRI.Methods CT and MRI appearances in 52 cases with CO poisoning were analysed and compared.Results Necroses and degenerations of globus pallidus in 9 cases,cerebral white matter demyelination in 3 cases and brain atrophy in 3 cases were showed by CT.The detecting rate was 28.8% by CT while,necroses and degeneration of glodus pallidus were observed in 24 cases and white matter change in 7 cases were observed by MRI,the detecting rate was 59.6% which was higher than that of CT (?