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Objective To investigate the value of ultrasound and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of mass-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). Methods A retrospective analysis was performed for the clinical data, ultrasound findings, and CEUS findings of 11 patients with mass-type AIP who were diagnosed in Tangshan Workers' Hospital from January 2015 to December 2020, and their characteristic manifestations were analyzed and compared with the data of 23 patients with PDCA. The chi-square test was used for comparison of categorical data between two groups. Results For the 11 patients with mass-type AIP, CEUS had a diagnostic accuracy of 63.64%, and all of these patients had hypoechoic single lesions; the patients with clear boundaries, regular morphology, pancreatic duct dilatation or cutoff, and blood flow signal accounted for 54.55%, 63.64%, 18.18%, and 36.36%, respectively, while in the PDCA group, such patients accounted for 30.43%, 34.78%, 78.26%, and 21.74%, respectively, and there was a significant difference in the presence or absence of pancreatic duct dilatation or cutoff between the two groups( χ 2 =11.089, P 0.05). For the 11 patients with mass-type AIP, CEUS showed that 7 patients (63.64%) had hyperenhancement and 4 (36.36%) had iso-enhancement in the arterial phase, and 5 patients (45.45%) had hyperenhancement in the arterial phase and 6 (54.55%) had iso-enhancement in the venous phase; for the 23 patients with PDCA, 22 (95.65%) had hypoenhancement of lesions in both arterial and venous phases, and there were significant differences in the enhancement pattern in arterial and venous phases between the two groups ( χ 2 =30.345 and 30.084, both P < 0.05). Conclusion The enhancement pattern of CEUS and the presence or absence of pancreatic duct dilatation or cutoff have a relatively high value in the differential diagnosis of mass-type AIP and PDCA.
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Objective To investigate the efficacy of thyroid ablation with low dose (1 110 MBq) 131 I for non-distant metastases differentiated thyroid carcinoma (DTC) and its probable influence factors.Methods A total of 183 DTC patients (48 males,135 females,average age:(39.75±10.14) years) treated by thyroid ablation with 1 110 MBq 131I from January 2015 to December 2016 were respectively observed.All patients underwent diagnostic whole body scan (Dx-WBS) and the stimulated thyroglobulin (sTg) was measured 6-9 months after thyroid ablation.According to the results,patients were divided into successful ablation group (G1) and unsuccessful group (G2).Clinical and pathological characteristics of 2 groups were compared by two-sample t test,Mann-Whitney u test andx2 test.Logistic regression was used to identify the influence factors for efficacy of 131I ablation,and the cutoff value was determined by receiver operating characteristic (ROC) curve analysis.Results There were 156 patients in G1 and 27 patients in G2.The successful ablation rate was 85.25％(156/183).Comparing with patients in G2,patients in G1 showed higher thyroid stimulating hormone (TSH) before ablation and lower sTg.The TSH level was 137.94(124.21,150.00) and 74.91(55.57,98.18) mU/L respectively (u=6.458,P＜0.05),and sTg was 1.80(0.69,5.20) and 22.30(4.49,32.20) μg/L respectively (u=-6.174,P＜0.05).Logistic regression showed that TSH,sTg and T stage before ablation were independent predictors for efficacy of 131I ablation (odds ratios:0.357-0.944).The optimal cutoff values of TSH and sTg identified by ROC curve analysis were 122.98 mU/L and 13.78 μg/L.Conclusions Low-dose 131I is effective enough for ablation treatment in non-distant metastases DTC patients with low T stage and low sTg(＜ 13.78 μg/L).High TSH (＞ 122.98 mU/L) before ablation may facilitate the efficacy of 131I ablation.
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Objective To compare the diagnostic value of shear wave elastography and 18F-FDG PET/CT imaging in diagnosis of thyroid microcarcinoma.Methods Shear wave elastography and 18F-FDG PET/CT data of patients with thyroid nodules confirmed by pathology were analyzed retrospectively.The sensitivity,specificity,accuracy,positive and negative predictive value of the two methods in diagnosis of malignant thyroid micronodules were compared.Results In all of the 48 micronodules,37 were malignant,11 were benign.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of shear wave elastography and 18F-FDG PET/CT were 91.89％ (34/37),81.82％ (9/11),89.58％ (43/48),94.44％ (34/36),75.00％ (9/12) and 29.73％ (11/37),72.73％ (8/11),39.58％ (19/48),78.57％ (11/ 14),23.53％ (8/34),respectively.The sensitivity,accuracy and negative predictive value between the two methods had statistical difference (all P＜0.05),and the specificity and positive predictive value between the two methods had no statistical difference (both P＞0.05).Conclusion Compared to 18F FDG PET/CT imaging,the diagnositic value of shear wave elastography in diagnosis of thyroid microcarcinoma has obvious advantages.
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Objective:To explore influence of standardized secondary prevention on prognostic outcome of patients with coronary heart disease (CHD).Methods:A total of 128 CHD patients were randomly and equally divided into secondary prevention group and routine treatment group.Routine treatment group received routine CHD therapy during hospitalization,received routine discharge guidance,and they were followed up once/six months.Secondary prevention group were served by specific physicians and received secondary prevention intervention,and they were followed up once/month after discharge.CHD patients received questionnaire to know their knowledge about CHD risk factors and compliance taking secondary prevention drugs after discharge.Risk factor control and recurrence rate of CHD etc.were assessed.Results:Compared with routine treatment group,after one-year follow up,there were significant rise in awareness rate of risk factors (34.38% vs.78.18%);control of risk factors (blood pres-sure,blood lipids,smoking,diet and exercise etc.)and administration rate of secondary prevention drugs after dis-charge (18.75% vs.87.50%),and significant reductions in clinic events [heart failures (18.75% vs.4.69%),an-gina pectoris (28.13% vs.6.25%),rehospitalization (21.89% vs.3.13%)and myocardial infarction (15.63% vs. 4.69%)]in secondary prevention group,P <0.05 or <0.01. Conclusion:Standardized secondary prevention is ef-fective in patients with coronary heart disease,which is worth clinic extending.
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Objective:To investigate the expression and clinical significance of wild-type p53-induced phosphatase 1 (Wip1) in thyroid carcinoma and biological effect of siRNA-targeting Wip1 on the thyroid carcinoma cell line. Methods:Immunohistochemistry and reverse transcription polymerase chain reaction (RT-PCR) were performed to detect the expression of Wip1 in 73 specimens of thy-roid carcinoma tissues and normal thyroid tissues (5 cm away from the margin of thyroid carcinoma), respectively. Wip1 siRNA was transiently transfected into the papillary thyroid carcinoma cell by using a liposome-mediated method and then detected by RT-PCR and Western blot. Methyl thiazolyl tetrazolium (MTT) assay and flow cytometry (FCM) were also conducted to observe cell proliferation, cell apoptosis, and cell cycle. Results:The positive rates of Wip1 protein were 80.8%in thyroid carcinoma tissues and 9.6%in the nor-mal tissues (χ2=47.036, P0.05). However, significant correla-tions among Wip1 expression, lymph node metastasis, clinical stages and tumor differentiation (P<0.05) were observed. RT-PCR and Western blot results showed that K1 cell-transfected Wip1 siRNA exhibited a relatively lower expression than normal cells (t=17.039, t=14.637, P<0.05). MTT assay results showed that the K1 cells transfected with Wip1 siRNA showed a lower survival fraction, higher cell apoptosis, higher percentage of G0/G1 phases, and lower cell concentration in G2/M and S phases (P<0.05). Conclusion:Wip1 pro-tein and mRNA were increased in thyroid carcinoma and are correlated with lymph node metastasis, clinical stages and tumor differenti-ation. Wip1 may be involved in proliferation, apoptosis, and cycle of thyroid cancer cells.
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Objective To evaluate the clinical value of 131 I in the treatment of senile hyperthyroid heart disease .Methods 95 ca-ses of elderly hyperthyroid heart disease were orally treated by 131 I .The thyroid function was detected before 131 I therapy and in 3 months ,6 months and 1 year after treatment .The gated blood pool imaging was performed before treatment and in 1 year after treatment for evaluating the therapeutic effect .Results The cure rate was 97 .89% for hyperthyroidism ,100 .00% for paroxysmal atrial fibrillation and 84 .00% for persistent atrial fibrillation .FT3 ,FT4 and TSH levels had statistical difference between before treatment and in 3 ,6 ,12 months after treatment (P<0 .05) .The left ventricular systolic and diastolic function parameters had sta-tistical differences between before treatment and in 1 year after treatment (P< 0 .05) .The left ventricular systolic and diastolic function was improved significantly .Conclusion Selecting radioactive 131 I for treating elderly hyperthyroid heart disease is the key to improve hyperthyroid heart disease ,can effectively control the FT3 ,FT4 and TSH levels and improve the heart function .