Expert consensus workshop report: Guidelines for thermal ablation of thyroid tumors (2019 edition)

As a treatment option for cancer, thermal ablation has satisfactory effects on many types of solid tumors (such as liver and renal cancers). However, its clinical applications for the treatment of thyroid nodules and metastatic cervical lymph nodes are still under debate both in China and abroad. In 2015, the “Zhejiang Expert consensus on thermal ablation for thyroid benign nodules, microcarcinoma, and metastatic cervical lymph nodes (2015 edition),” was released by the Thyroid Cancer Committee of Zhejiang Anti-Cancer Association, China. To further standardize the application of thermal ablation for thyroid tumors, the Thyroid Tumor Ablation Experts Group of Chinese Medical Doctor Association has organized many seminars and finally produced a consensus to formulate the “Expert consensus workshop report: Guidelines for thermal ablation of thyroid tumors (2019 edition).”

Clinical significance of CTP combined with ABIC score in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure / 中华肝脏病杂志

Objective@#To investigate the risk factors affecting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and establish a new scoring model to predict the short-term prognosis of patients.@*Methods@#This study enrolled 222 patients with HBV-ACLF. According to their clinical outcomes during hospitalization and 90 days after discharge, they were divided into survival and death group. Clinical data were collected to calculate the Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), albumin-bilirubin (ALBI), and age-bilirubin-international normalized ratio-creatinine (ABIC) scores for prognosis. Multivariate logistic regression analysis was used to analyze the independent risk factors affecting 90-day mortality in HBV-ACLF patients. Cox regression model was used to establish a new prediction model. Area under the receiver operating characteristic curve was used to calculate short-term prognostic value of the models. K-M survival curve was used to predict the prognosis of patients.@*Results@#CTP and ABIC scores were independent risk factors for 90-day mortality in HBV-ACLF patients, and the risk of death from liver failure had increased with increase of score. Cox regression model established a new predictive model CTP-ABIC = 0.551 × CTP + 0.297 × ABIC. Area under the receiver operating characteristic curve of all three scoring models (CTP, ABIC and CTP-ABIC) were 0.878, 0.829, 0.927, respectively. CTP-ABIC score was superior to the CTP and ABIC score (P value < 0.001). Patients with CTP-ABIC score ≥9.08 had higher mortality rate than patients with CTP-ABIC score < 9.08, and the difference was statistically significant (P < 0.001).@*Conclusion@#All three scoring systems can predict short-term prognosis in patients with HBV-ACLF, but the accuracy of CTP-ABIC is superior.

Ultrasonographic characteristics of the follicular variant of papillary thyroid cancer in children and adolescents / 中华内分泌外科杂志

Objective To compare the sonographic features as well as clinical histopathological features of follicular variant papillary thyroid carcinoma(FVPTC) and conventional papillary thyroid carcinoma (CPTC) in pediatric patients.Methods From Jan.2006 to Dec.2017,26 FVPTC patients and 82 CPTC patients were enrolled in this study.The clinical histopathological findings and the sonographic features were compared between the two groups.FVPTCs and CPTCs were divided into PTC-like and follicular neoplasm(FN)-like based on sonographic characteristics.Results The mean nodule size of FVPTCs was larger than that of conventional PTCs.Extrathyroid invasion and cervical lymph node metastasis did not have significant difference between CPTC and FVPTC patients(53.8％ vs 62.2％ and 76.9％ vs 82.9％,respectively).Multiple nodules(P=0.000)and distant pulmonary metastases(P=0.024) were more frequent in CPTCs than in FVPTCs(P＜0.05).The rate of an ill-defined margin (P=0.000) and calcification (P=0.003)in terms of sonographic features were lower in FVPTCs than conventional PTCs(P＜0.05).A Ⅴ+Ⅵ diagnosis of PTC on FNAC of FVPTCs was less common than that of conventional PTCs (P=0.014).Multifocality(P=0.000),extrathyroidal invasion (P=0.000),and lymph node metastasis (P=0.000) were significantly different between PTC-like FVPTCs and FN-like FVPTCs.Conclusion FVPTC in children and adolescents shows a relatively larger size,more benign sonographic features,and a lower diagnostic rate of PTC by FNAC compared with conventional PTCs in pediatric patients.

Value of ultrasound-guided fine needle aspiration cytology in the assessment of ovarian neoplasms and retroperitoneal metastatic lymph nodes / 中华医学超声杂志（电子版）

Objective To evaluate the diagnostic value of ultrasound-guided fine needle aspiration cytology(US-FNAC)in the assessment of radiologically detected ovarian neoplasms and retroperitoneal metastatic lymph nodes. Methods FNAC was performed under ultrasound guidance on 126 patients suspected of ovarian neoplasms and retroperitoneal metastatic lymph nodes. Cytologic examination was performed after staining smears with the haematoxylin and eosin method. Clinical data were retrieved from the medical records and all cytological specimens were reviewed. In these cases, the cytologic findings were correlated with histology of the primary tumor and were compared with surgical pathology. Results Satisfactory sampling was obtained in 86.2% of punctures, and cytological diagnosis was made in 85.7% cases. The size of the lymph nodes punctured was less than 20 mm in 93.5% cases, with the sensitivity of 81.6%、86.2%, specificity of 95.8%、100.0%, positive predictive value of 98.3%、100.0%, negative predictive value of 63.9%、33.3%, and accuracy of 85.3%、87.1%. Seven patients presented slight abdominal discomfort, and relieved without clinical treatment. Conclusions The fine needle aspiration technique has excellent positive predictive value and low morbidity. US-FNAC, as the valuable investigation, is not only useful in the diagnosis of ovarian masses and lymph nodes but can also help in choosing appropriate management. From our experience, US-FNAC can be added in follow-up of selected patients in whom the cytological identification of such masses and nodes is significant for the patient′s treatment.

Conventional and Contrast-enhanced Ultrasound Features of Adenoid Cystic Carcinoma in Major Salivary Gland / 中华医学超声杂志（电子版）

Objective To investigate the characterization of adenoid cystic carcinoma (ACC) in major salivary glandby conventional and contrast-enhanced ultrasound (CEUS).Methods The conventional and contrast-enhanced ultrasound images of 17 ACC in major salivary gland with pathological confirmation were retrospectively reviewed.Results 12 (70.6％) cases in 17 were found in submandibular,while 5 cases (29.4％) were in parotid.All the patients complained a mass,52.9％ had cheek pain,and 17.6％ had hadfacial nerve or lingual nerve paralysis;these symptoms had been present from 3 to 240 months (mean duration was 42.9± 62.1 months).14 cases (82.4％) were primary focuses,and 3 cases (17.6％) were recurrences with recurrence time from 36 to 132 months (mean recurrence time was 70.7±43.2 months).All lesions were hypoechoic with irregular shape,and only 17.6％ had a homogeneous echotexture,64.7％ heterogeneous.64.7％ of all tumors were well-defined.On CDFI,blood flow signal hadn't detected in 23.5％ patients,and 64.7％ hadintermediate (+ and + +) grades of vascularity.Only 11.8％ had the highest grade of vascularity (+ + +).The CEUS images of ACC in major salivary showed slow fill-in,centripetal,higher enhancement,inhomogeneous enhancement,poorly defined margins and after enhancing the size unchanged.No enhancement orlow enhancement area were common in the AC.Facial nerve invasion can be seen in all cases,including 3 cases (17.6％) of lingual nerve invasion,4 cases (23.5％) of blood vessel invasion;4 cases (23.5％) of striated muscle infiltration;1 case with mandibular involvement;1 case (5.9％) with cervical lymph node metastasis.94.1％ of ACC in major salivary gland were cribriform patterns,and 5.9％ were solid pattems.Conclusions ACC in major salivary gland are more likely to happen in the submandibular gland,which has especially high tendency of facial nerve invasion and cheek pain.Conventional Ultrasound and CEUS imaging characteristics can be used to differentiate ACC firom other tumors in major salivary gland,which would help clinicians to diagnose.The clinical course is characterized by very late recurrences;consequently,longer following-up with ultrasound is proposed.

Efficacy of vidarabine monophosphate and ribavirin on the treatment of hand-foot-mouth disease / 中国感染控制杂志

Objective To compare the efficacy of vidarabine monophosphate and ribavirin for treating hand-foot-mouth disease (HFMD) in children.Methods 120 children with HFMD and admitted to a hospital from April 2013 to April 2015 were randomly divided into observation group and control group,60 cases in each group,observation group treated with vidarabine monophosphate,control group treated with ribavirin,the therapeutic efficacy between two groups were compared.Results After treatment,the negative conversion rate of intestinal virus EV and EV71,as well as Coxsackie virus A16(CA16) in observation group were 87.0％,85.7％,and 93.1％ respectively,in control group were 64.0％,69.8％,and 78.6％ respectively,difference between two groups was statistically significant (all P＜0.05).The average length of hospital stay in observation group was shorter than control group ([4.5 ± 1.3] days vs [6.2 ± 1.2] days,P＜0).05),symptom(fever,stomatitis,skin rash) control time in observation group were all shorter than control group(all P＜0.05).Whether patients with or without complication,therapeutic effect of the observation group was better than that of control group;myocardial enzyme data,C reactive protein (CRP),and white blood cell(WBC) in observation group were all lower than control group(all P＜0.05).Conclusion Efficacy of vidarabine monophosphate for treating children with HFMD is better than ribavirin,but it needs further study.

Application of contrast-enhanced ultrasound in differential diagnosis of pleomorphic adenoma and carcinoma expleomorphic adenoma / 中华超声影像学杂志

Objective To assess the contrast-enhanced ultrasound (CEUS) characteristics of pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA).Methods A retrospective analyse was made from the contrast-enhanced ultrasonic features of 42 PA and 8 CXPA.The features included tumor size,echotexture,boundary,shape and blood flow richness on conventional US imaging and rise time (RT),time to peak (TP),peak intensity(PI),time from peak to one half(HT),mean transit time (MTT),and area under the curve(AUC) on contrast-enhanced ultrasound.Results All of PA and CXPA were hypoechoic,but there was no difference between them in shape and blood flow richness (P ＞0.05).37.5％ CXPA has hetergeneous echotexture with the presence of anechoic area,but it appeared in only 4.8％ PA(P ＜0.05).The following findings were observed from a perfusion kinetics of CEUS in all of PA and CXPA:slow in,centripetal,heterogeneous enhancement,with no enhancement area.Well-defined margins were presented in 42 PA and in 7 CXPA(P ＜0.05).Their time-intensity curves showed RT,TP,HT and MTT in CXPA group were obviously higher than those in the PA group(P ＜0.05).However there was no statistical difference in PI and AUC between both groups (P ＞ 0.05).Conclusions Conventional US and CEUS perfusion patten provide limited diagnostic information for distinguishing PA from CXPA.CXPA could be diagnosed by ill defined margins,more internal anechoic area and poorly defined margins.But CEUS quantitative analysis can significantly promote the differentiation.

Efficacy of prostaglandin E1 as adjuvant therapy for mild to moderate acute pancreatitis / 临床肝胆病杂志

Objective ToobservetheclinicaleffectandefficacyofprostaglandinE1(PGE1),thedrugformicrocirculationimprovement, inthetreatmentofacutepancreatitis(AP).Methods Atotalof80patientswithmild-to-moderateAPwhowerehospitalizedandtreated in Second Department of Hepatobiliary and Pancreatic Surgery of the First Hospital of Jilin University from May 2014 to January 2015 were enrolled and randomized into two groups.Forty-four patients in control group received the conventional comprehensive therapy for AP,and 36 patients in experiment group received PGE1 in addition to the conventional therapy.The time to disappearance of abdominal symptoms and the time for serum and urine levels of amylase and serum levels of lipase,C-reactive protein (CRP),and procalcitonin (PCT)to re-turn to normal were compared between the two groups.The independent-samples t-test was applied for comparison of continuous data be-tween the two groups,and the chi-square test or Fisher′s exact test was applied for comparison of categorical data between the two groups. Results ThetwogroupshadsignificantdifferencesinthetimeforserumlevelsofamylaseandCRPandpercentageofneutrophilstoreturn to normal and hospital costs (P=0.041,0.030,0.012,and 0.026,respectively).PGE1 quickly relieved abdominal pain and distention, reducedtheserumlevelofamylase,shortenedthelengthofhospitalstay,andreducedhospitalcosts.Conclusion PGE1hasgoodclinical effect and safety in the treatment of AP,and can be applied as an adjuvant drug in the comprehensive therapy for AP.

A methodologic study of quantitative analysis of contrast enhanced ultrasound in liver / 中华超声影像学杂志

Objective To investigate the effects of contrast dose and region of interest (ROI) depth on quantitative analysis of liver by contrast-enhanced ultrasound (CEUS) during clinical application.Methods After bolus injection of contrast agent,the change of quantitative parameters [including echo mean(EM),rise time(RT),peak intensity(PI),mean transit time(MTT),area under the curve(AUC),time from peak to one half(TPH),wash in slope(WIS),time to peak(TTP)] of time-intensity curves were analyzed based on groups from different doses (1.0 ml and 1.6 ml) and different depth (＜30 mm,30-60 mm,and ≥60 mm).Results MTT and TPH were increased with dose increasing from 1.0 ml to 1.6 ml (P＜0.05).With the dose 1.0 ml,TPH,WIS,PI,AUC and MTT showed significant difference when the depth of the ROI changes (P ＜0.05),with the depth increased,TPH,WIS,PI,and AUC all decreases and MTT increases.For all the other parameters,no significant changes were found (P ＞0.05).Conclusions CEUS and its imaging process can directly influence the accuracy of the parameters from the quantitative analysis.Standardization of contrast agent with predefined dose and depth can potentially facilitate future clinical studies in liver CEUS.

Role of early assessment of antiangiogenic treatment in metastatic colorectal cancer using quantitative contrast-enhanced ultrasonography / 中华超声影像学杂志

Objective To investigate the application of contrast-enhanced ultrasonograhy CEUS in the early assessment of antiangiogenic treatment in metastatic colorectal cancer Methods Among 41 colorectal cancer patients with liver metastases enrolled in this study 25 patients received treatment of antiangiogenic treatment bevacizumab combined with chemotherapy BV group and 16 patients received chemotherapy only non-BV group To assess the treatment responses in the liver lesions between and within these two groups CEUS scans were performed before the treatment T0 or??baseline on the day 2 T1 and on the day 7 T2 after the treatment The percentage differences were evaluated according to the CEUS quantitative parameters such as rise time RT peak intensity PI mean transit time MTT area under the curve AUC time from peak to one half TPH wash in slope WIS and time to peak TTP Results On T1 both the RT and MTT increased within the BV group and decrease within the non-BV group when compared with their own baselines the differences were statistically significant P 0 05 Conclusions CEUS can be used to assess the treatment response in liver metastatic patients with colorectal cancer by monitoring the change of the tumor perfusion before and after the treatment.

The value of multipoint and multidirectional ultrasound-guided fine-needle aspiration cytology in preoperative diagnosis of papillary thyroid microcarcinoma / 中华内分泌外科杂志

Objective To investigate the value of multipoint and multidirectional ultrasound-guided fineneedle aspiration cytology (US-FNAC) in preoperative diagnosis of papillary thyroid microcarcinoma (PTMC).Methods From Jan.2012 to Jan.2013,multipoint and multidirectional US-FNAC were performed in 177 patients with 233 nodules suspected as PTMC,and the cytopathological findings were compared with surgical pathological results and clinical follow-up results.Results Of the 233 biopsies,the cytology were classified as malignant for 146 lesions,suspicious for malignancy for 43 lesions,benign for 24 lesions,follicular lesions for 4 lesions and inadequate sample for 16 lesions.After the second multipoint and multidirectional US-FNAC,only 1 case did not have sufficient cells for diagnosis,and the puncture failure rate was 0.43％.Actually there were 189 malignant and 44 benign lesions confirmed by clinical follow-up and pathological results.The sensitivity,specificity,and accuracy of multipoint and multidirectional US-FNAC was 99.5％,81.8％ and 96.1％ respectively.Conclusions Multipoint and multidirectional US-FNAC has definite value in increasing puncture qualified rate and positive diagnosis rate before operation.

Identification of pathogenic microorganism by sequencing 16S rRNA gene / 中南大学学报(医学版)

OBJECTIVE@#To identify 14 bacteria by sequencing the 16S rRNA gene and establish the basis for clinical application in the future.@*METHODS@#DNA samples of the 14 bacteria were extracted. The 16S rRNA genes were amplified by PCR and sequenced with common primers. The sequences of the 16S rRNA genes were aligned by online software Blastn in nucleotide database. The bacteria were identified according to the homology of their 16S rRNA genes.@*RESULTS@#Twelve bacteria were classified to species, the other 2 bacteria were classified to genus.@*CONCLUSION@#16S rRNA gene sequence analysis is useful in identifying pathogenic bacteria.

Primary experience of improving effectiveness of radiorequency ablation for liver tumor by selective portal vein embolization / 中华超声影像学杂志

Objective To explore the feasibility and efficacy of the selective portal vein embolization (SPVE) before radiofrequency ablation(RFA) for liver tumor large than 3 cm.Methods 63 patients with 63 liver tumor (＞3 cm) located in single liver segment completely or mostly underwent RFA.21 patients (21 lesions) were randomly assigned to receive SPVE before ablation (SPVE + RFA group),other 42 patients were treated with RFA only (RFA group).The complications and treat results of two groups were collected and compared.Results SPVE were achieved in 20 of 21 patients,and no critical complication were happened in both group.During a observation period of median 14.2 months,local tumor progression were observed in 17 of 42 patients (40.5％) in RFA group and in 3 of 20 patients (15.0％) in SPVE+ RFA group,there were significant difference between two groups(P =0.043).Conclusions SPVE can safely and effectively improve the efficacy of RFA for the liver tumors which large than 3 cm and located in single liver segment.

Investigation about Knowledge of Stroke in Patients with First Stroke / 中国康复理论与实践

@#ObjectiveTo investigate the knowledge of stroke in patients with first stroke. Methods259 patients with first stroke were investigated with questionnaire. ResultsMost patients knew that hypertension was a risk factor of stroke, early treatment of stroke was important and hemiplegia was the frequent early symptom of stroke. They lacked other knowledge of stroke such as other risk factors, standards of hypertension, and so on. ConclusionIt is important to improve the knowledge of stroke in patients.

Relationship between level of serum erythropoietin and chemotherapy in elderly patients with cancer / 中华老年医学杂志

Objective To study the relationship between serum erythropoietin(Epo)level and chemotherapy-induced hemoglobin(Hb)level in elderly patients with cancer. Methods　One hundred senile patients(aged≥60 years)with cancer and one hundred and seventy non-senile patients(aged＜60 years)with cancer were selected as aged group and control group,respectively.The serum Epo level was detected by enzyme-linked immunosorbent assay(ELISA). Results　(1)The average levels of the serum Epo in aged group and control group were(22.0±15.1)U/L and(30.4±21.8)U/L,respectively(t=1.2988,P＞0.05).A negative correlation was found between the levels of Epo and Hb in elder cancer patients(r=0.3700,P＜0.001).(2)The levels of serum Epo were(14.7±10.6)U/L,(20.2±9.0)U/L and(42.3±24.8)U/L in 55 cases with normal Hb level,22 cases with mild anemia and 23 cases with moderate to severe anemia,respectively(F=11.6886,P＜0.01).(3)The levels of Epo were(20.2±10.8)U/L,(45.2±39.1)U/L and(25.8±15.9)U/L before chemotherapy,after 4 treatment cycles and 2 treatment cycles respectively(F=4.5477,P＜0.01).The levels of Hb were(111.0±20.5)g/L,(96.8±16.6)g/L and(102.1±19.3)g/L before chemotherapy,after 4 treatment cycles and 2 treatment cycles respectively(F=4.0071,P＜0.01).Conelusions　There is no statistical difference in serum Epo level between senile patients with cancer and non-senile patients with cancer.but serum Epo levelis higher in patients with anemia than without anemia.There is a negative correlation between the levels of Epo and Hb.Chemotherapy can decrease the level of Hb and increase the serum 1evel of Epo in part of patients.The changes are correlated with the conditions of patients before chemotherapy and the time of chemotherapy.

Expression of Hox Genes in Murine Brain by Human Cytomegalovirus Infection / 热带医学杂志

Objective To study the effect of of human cytomegalovirus (HCMV) infection on the expressions of Hox genes.Methods Forty eight kunming mice were randomly divided into infection group (n=32) injected with HCMVAD169 and control group (n=16) injected with saline into their brain.After 7,15,30,and 60 days,the cerebral lesions were observed by pathological method.HCMV antigen was detected by immunohistochemical method and HCMV DNA was detected by polymerase chain reaction (PCR). On the basis of developing HCMV mouse model. reverse trancriptase-polymerase chain reaction (RT-PCR) was applied to determine the expressions of Hox gene in the brains of infected mice.The expression of Hox genes were also analysed with Northern-blot by isotope labelled Hox genes oligonucleotide probes. Results A HCMV infection model was developed and extensive pathological damages in brain tissue of infected mice were observed.Meanwhile.the HCMV-LA and HCMV-DNA were also found in brain tissues of HCMV infected mice.The expression level of Hox genes in control and infected mouse brain were determined by RT-PCR and Northern-blot.RT-PCR and Northern-blot showed that mouse brain expressed Hox-A9,Hox-A10,Hox-A11,Hox-A12,and Hox-A13,but they did not express Hox-B13.After HCMV infection,murine brain was induced to express Hox-B13 gene(P＜0.01),and reached the peak at 30 d after infection.Comparing with the control group,the expression of Hox-A9 and Hox-A11 were down-regulated in infected group (P＜0.05);the expression of Hox-A10 and Hox-A13 were significantly higher in infected groups (P＜0.05).Conclusion The results suggest that HCMVAD169 is able to cause mouse CNS infection and induced the abnormal expressions of Hox genes. which provides more information for understanding the mechanism of congenital abnormal due to HCMV infection and a valuable method of clinical prevention and treatment of HCMV infection.

Cloning and expression of human cytomegalovirus UL123 gene exon 2,3 in bacterial two-hybrid bait plasmid / 中国医师杂志

Objective To clone and express HCMV UL123 gene exon 2,3(ie1-exon2,3) in bacterial two-hybrid bait plasmid,and identify its self-activation property.Methods HCMV ie1-exon2,3 carried on pTWIN1/ie1 recombinant was amplified by PCR and cloned into the pBT plasmid,which was transformed into E.coli XL1-Blue MRF' Kan host strain.The positive recombinant was identified by PCR,restriction enzyme digestions and sequencing analysis.The verified plasmid was transformed into bacterial two-hybrid system reporter strain.The soluble fusion protein was analyzed by SDS-PAGE and Western blot.The self activation effect of the recombinant was then tested.Results Bacterial two-hybrid pBT/ie1-exon2,3 bait plasmid was successfully constructed.The corresponding soluble fusion protein rIE1-N_(85)/?C1 was expressed in bacterial two-hybrid system reporter strain,and didn't show self-activation property.Conclusion Bacterial two-hybrid pBT/ie1-exon2,3 bait plasmid without self-activation property was successfully constructed,and it can be used to screen the library of fetal brains.

Expression of HOXB9 Gene in Hela Cells,Mocoy Cells, SP2/0 Cells and U251 Cells / 中国医师杂志

Objective To study the expression of HOXB9 gene in Hela cells,Mocoy cells, SP2/0 cells and U251 cells. Methods The expression of HOXB9 gene was detected by semi-quantitative RT-PCR method. Results Hela cell and U251 cell expressed HOXB9 gene, which SP2/0 cell and Mocoy cell didn't express it. Conclusion The expression of HOXB9 gene was different in different cells.