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Objective:To explore the value of multi-parametric MRI for thyroid gland in differentiating benign and malignant thyroid nodules.Methods:From December 2018 to May 2020, 78 patients with 91 post-surgically pathologically confirmed thyroid nodules were enrolled in Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. For each patient, the following MRI findings were obtained including the nodules′ location, size, shape, margin, signal intensity, cystic change, degree and pattern of contrast enhancement, involvement of surrounding structure, and ADC values. The time-intensity curve (TIC) were plotted and subtyped based on dynamic contrast enhancement MRI. The MRI findings between the benign and malignant thyroid nodules were compared using Mann-Whitney U test, χ 2 test or Fisher exact test. Multiple logistic regression analysis was used to select independent predictive variables and build a combined model, and the ROC curve was used to evaluate the diagnostic performance of each MRI finding and the combined model. Results:Between the benign and malignant thyroid nodules, the significant differences were found in size, shape, margin, presence of cystic changes, T 1WI signal intensity, ADC value, enhancement homogeneity, TIC subtypes and presence of thyroid capsule involvement ( P<0.05). Multivariate logistic analysis showed that ill-defined margin (OR=77.61), no presence of cystic changes (OR=36.11) and difference between TIC subtypes (OR=83.41) were independent predictive variables, and the area under the ROC curve (AUC) was 0.879, 0.788, and 0.751, respectively. The AUC, sensitivity and specificity of the combined model were 0.977, 0.986, and 0.904, respectively. Conclusions:Thyroid multi-parametric MRI derived findings can be used for the differential diagnosis of benign and malignant nodules. Combined with the independent risk factors with ill-defined margin, no presence of cystic changes, TIC of type plateau or washout, the diagnostic model has a higher diagnostic efficiency.
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Extraskeletal Ewing sarcoma is a rare event, and extraskeletal Ewing sarcoma of the thyroid gland is even rarer. It has non-specific clinical manifestation and difficulty in early diagnosis. The diagnosis mainly depends on histology and immunohistochemistry. It possesses the features of high malignancy, high rate of local recurrence, and distant metastasis. Currently, the aggressive multimodal treatment contains surgery, chemotherapy, and radiotherapy. This study presented a case of extraskeletal Ewing sarcoma arising in the thyroid gland of a 30-year-old woman, who presented with supraclavicular mass and sense of dysphagia obstruction in Department of Otolaryngology, Head and Neck Surgery, Second Xiangya Hospital, Central South University in 2018. Imaging studies demonstrated a cystic-solid mass in inferior of the left leaf of thyroid gland and in the posterior of the trachea and esophagus. The patient underwent localized tumor resection. The pathological diagnosis revealed that it was a small round cell tumor, and the immunohistochemistry results were considered to be extraskeletal Ewing sarcoma. Subsequently, the patient was given chemotherapy and local radiation therapy. There was no evidence of tumor recurrence or metastasis.
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Adult , Female , Humans , Combined Modality Therapy , Immunohistochemistry , Neoplasm Recurrence, Local , Sarcoma, Ewing/therapy , Thyroid GlandABSTRACT
Objective To study the preparation,quality control and clinical efficacy of compound of the nose Kang.Methods The compound of the nose Kang was extrasted through recirculation,qualitative identification and clinical efficacy of borneol,berberine and panax notoginseng in this compound was detected by thin layer chromatography(TLC).Results Preparation process is stable,thin-layer chromatography have obvious spots,clinical effect is significant.Conclusion The compound preparation is reasonable,simple process,quality is stable,effective,and has no side effects.
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Objective To investigate the serum levels of CXC, CC and C chemokines, and to esti-mate the relationship among the three kinds of chemokines as well as that between these chemokines and other Th1 and Th2-related cytokines, in patients with atopic dermatitis (AD). Methods Fifty-one patients with atopic dermatitis, including 35 males and 16 females with an average age of 17 years and disease course of 13.6 years were enrolled into this study together with 34 normal human controls. ELISA was used to measure the serum levels of monokine induced by IFN-γ (Mig), thymus and activation-regulated chemokine (TARC), cutaneous T cell-attracting chemokine (CTACK) and lymphotactin (Ltn) in these subjects. Severity of AD was assessed according to SCORAD. Results The serum levels were 79.6±28.0 ng/L for Mig, 349.9±91.5 ng/L for TARC, 747.4±359.4 ng/L for CTACK and 141.0±68.4 ng/L for Ltn in patients, significantly higher than those in the normal controls (63.8±26.5 ng/L, 219.4±82.1 ng/L, 294.3± 64.9 ng/L, 80.9±54.2 ng/L, P < 0.05, 0.01, 0.01, 0.01 respectively). A significant correlation was observed between the serum level of CTACK and SCORAD score in patients (r = 0.343, P < 0.05). Similarly, the percentage of body surface area (BSA) involved positively correlated with the serum levels of Mig, TARC, CTACK and Ltn. Furthermore, there was a significant correlation between the serum level of Ltn and TARC (r=0.444, P< 0.01) as well as CTACK (r=0.572, P< 0.01), between that of CTACK and TARC (r=0.524, P< 0.01), and between that of TARC and Mig (r=0.313, P< 0.05). Conclusion The CXC, CC and C chemokines might be involved in the pathogenesis of AD. Further more, CTACK level could serve as a good indicator for the severity of AD.
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1000 ml per day had to be cured by operation.
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Objective To evaluate the efficacy and safety of 0.03% tacrolimus ointment for the treatment of atopic dermatitis (AD) in Chinese children. Methods A total of 139 children, 2 to17 years of age, with moderate to severe AD from 5 study centres were enrolled in this multicentre, randomized, double-blind, vehicle-controlled, parallel group study. Treatment with 0.03% tacrolimus ointment or vehicle was applied twice daily to the affected areas for 3 weeks. Visits were scheduled on day 1 (base line, before treatment) and 1, 2, 3 weeks after the treatment. The main therapeutic parameter was the efficacy rate at the end of the treatment. Results The efficacy rates were 84.6% and 29.0% for tacrolimus group and vehicle group, respectively (P
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Objective To explore whether the Kang Kefei and Tian Runmei′s diagnostic criteria (K-T criteria) is suitable for atopic dermatitis(AD). Methods 917 AD patients, whose diagnosis had been made with the Hanifin and Rajka criteria (H-R criteria) previously, were redignosed by K-T criteria. Their atopic history, and clinical fealures were analysed, too. Results 888 out of 917 patients(96.84%) were consistent with K-T criteria.763 patients (83.21%) had personal or family atopic history. The frequency of facial dermatitis was higher in infantile AD group than that in childhood AD group, adolescence AD group, and adult group. Whereas,the frequency of xerosis,ichthyosis,keratosis pilaris and orbital darkening was lower in infantile AD group than those in other groups. Conclusion Atopic history is an important factor in the diagnosisof AD. K-T criteria is practical and of value in the diagnosis of AD.