Value of ultrasound shear wave elasticity imaging in diagnosis of Hashimoto's thyroiditis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the correlation between Young's modulus of the thyroid tissue measured by in shear wave elastography (SWE) and the clinical manifestations of Hashimoto's thyroiditis in different stages.</p><p><b>METHODS</b>A total of 104 patients with the clinical diagnosis of Hashimoto's thyroiditis were enrolled in this study, including 26 with hyperthyroidism, 29 with normal thyroid function, 27 with subclinical hypothyroidism, 22 with clinical hypothyroidism, with 50 healthy volunteers serving as the healthy control group. All the subjects underwent SWE to obtain the Young's modulus value of the thyroid tissue. Univariate analysis of variance was used to compare the Young's modulus among the groups, and Pearson correlation analysis was used to analyze the correlation between the Young's modulus of the thyroid tissue and serum levels of thyroid microsomal antibody (TMAb) and thyroid globulin antibody (TGAb).</p><p><b>RESULTS</b>In the 4 groups of patients, the Young's modulus increased significantly in the order of hyperthyroidism group, normal thyroid function group, subclinical hypothyroidism group and clinical hypothyroidism group (F=60.983, P<0.01). The Young's modulus was significantly lower in hyperthyroidism group than in the other 3 groups (P<0.05), and was significantly lower in normal thyroid function group than in subclinical hypothyroidism group and clinical hypothyroidism group (P<0.05).</p><p><b>CONCLUSION</b>The Young's modulus of the thyroid tissue measured by shear wave elastography is related with the clinical manifestations of Hashimoto's thyroiditis in different stages, but the relevance needs to be further confirmed by multi-center, randomized, controlled studies involving a larger sample size.</p>

Exploration of standardized vascular ultrasound training in China / 中华医学超声杂志（电子版）

Objective To explore standardized continuing vascular ultrasound training in China.Methods Data of current ultrasound practitioner education levels in the secondary and tertiary hospitals were collected.Under the direction of the Chinese Ultrasound Doctor Association (CUDA),Vascular Ultrasound Guidelines were introduced.The CUDA Steering Committee for Standardized Vascular Ultrasound Training and Vascular Ultrasound Training Centers were established.Results The questionnaires were received from 182 ultrasound departments of 57 secondary hospitals and 125 tertiary hospitals.The proportion of ultrasound practitioners who obtained a university degree was significantly higher in the ultrasound departments of tertiary hospitals than that in the secondary hospitals (75.18% vs 52.63%).The proportion of ultrasound practitioners who only received short-term ultrasound training and did not have tertiary education was significantly higher in the ultrasound departments of secondary hospitals than that in the tertiary hospitals (8.31% vs 1.03%).The directors of ultrasound departments in both secondary and tertiary hospitals believed that ultrasound practitioners should at least have a university diploma and preferably have a university degree.The CUDA and the American Registry for Diagnostic Medical Sonography (ARDMS) co-hosted two standardized vascular ultrasound training seminars and the first Registered Physician in Vascular Interpretation (RPVI) credential examination in Beijing.A well-known vascular ultrasound reference book,Introduction to Vascular Ultrasound was translated from English into Chinese and published in September 2008.The CUDA Vascular Ultrasound Guidelines were drafted by 12 vascular ultrasound experts from China,U.S.and Australia,which were widely discussed and passed by the CUDA Standing Committee.The guidelines have been published in the Chinese Journal of Ultrasonography and on the website of CUDA (www.cuda.org.cn).The CUDA has signed a publishing contract with a medical press to publish the guideline booklet.The CUDA Steering Committee for the Standardized Vascular Ultrasound Training was established which includes 24 domestic and foreign experts.The CUDA Standardized Vascular Ultrasound Training Centers were awarded to 12 hospitals,which were selected,trained and assessed by the CUDA from 35 candidates.Each center is expected to undertake one to two standardized vascular ultrasound training courses each year.Conclusion Continuing education of vascular ultrasound introduced by CUDA has been accepted positively by a portion of Chinese doctors with ultrasound major.

Effect of obstructive sleep apnea hypopnea syndrome on arterial stiffness / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on brachial-ankle pulse wave velocity (b-aPWV) in untreated diagnosed patients.</p><p><b>METHODS</b>This study involved 24 consecutive male patients with newly diagnosed untreated OSAHS (aged 39.13±8.31 years) and 22 normal male individuals (aged 39.59±10.86 years) matched for age and body mass index. Carotid and extremities ultrasound were performed in all the subjects, and none of them had atherosclerosis, arterial calcification, or aneurysm. No subject had a history of hypertension, coronary heart disease or stroke. All the subjects underwent arterial stiffness evaluation by means of b-aPWV measurements.</p><p><b>RESULTS</b>The b-aPWV in OSAHS patients was significantly higher than that in normal subjects (1346.86±123.48 vs 1237.91±84.46, P<0.01), and the rate of positive b-aPWV in OSAHS patients was significantly higher (13/24 vs 1/22, P<0.01).</p><p><b>CONCLUSION</b>The value and positive rate of b-aPWV in OSAHS patients are higher than those in normal people, suggesting increased arterial stiffness in OSAHS patients.</p>

Influence of microwave ablation and surgical resection of small primary hepatocellular carcinoma on hematogenous dissemination of tumor cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the influence of percutaneous microwave ablation (PMA) and surgical resection for patients with small primary hepatocellular carcinoma (PHC) on dissemination of tumor cells in peripheral blood determined by AFP mRNA.</p><p><b>METHODS</b>Forty patients with small PHC (The maximal diameter < or = 5 cm) confirmed histologically were included in this study. All the patients had single tumor nodule only without metastasis. Of the 40 patients, 19 were treated by PMA and 21 by surgical resection. Blood samples were collected and tested immediately before treatment, 30 min after the mass ablated/resected, 1 d and 7 d later by RTD-Nested-RT-PCR for AFP mRNA. The CD3, CD4, CD8 and CD4/CD8 in blood, and hepatic function were tested at the same time points as well.</p><p><b>RESULTS</b>After treatment, ALT and AST in peripheral blood increased in both groups, but more intensely in the surgical group. The CD3, CD4 and CD4/CD8 in peripheral blood decreased at 30 min, 1 day and 7 days after surgical resection, and the lowest value was at 30 min after surgery. The immune function was kept at the same level as pre-treatment in the PMA group. AFP mRNA copies in blood could be detected in 27 of 40 patients (67.5%) in two groups before treatment, and the copy number was increased after treatment. There was no significant difference between the two groups. The patients were followed up for 1 - 16 months. AFP mRNA copies in blood could be detected persistently in the 4 patients with extrahepatic metastasis or liver recurrence.</p><p><b>CONCLUSION</b>Surgical resection and microwave ablation may cause PHC cells dissemination into the blood circulation in patients with small PHC, and there was no difference between the two treatment groups. The cellular immune function in peripheral blood is decreased after surgical resection, but is maintained at the same level as pre-treatment in the PMA group. The impairment of liver function is less severe after PMA treatment than surgical resection. PMA may provide certain value for clinical management of small hepatocellular carcinoma.</p>