The Asian Thyroid Working Group, from 2017 to 2023

The Asian Thyroid Working Group was founded in 2017 at the 12th Asia Oceania Thyroid Association (AOTA) Congress in Busan, Korea. This group activity aims to characterize Asian thyroid nodule practice and establish strict diagnostic criteria for thyroid carcinomas, a reporting system for thyroid fine needle aspiration cytology without the aid of gene panel tests, and new clinical guidelines appropriate to conservative Asian thyroid nodule practice based on scientific evidence obtained from Asian patient cohorts. Asian thyroid nodule practice is usually designed for patient-centered clinical practice, which is based on the Hippocratic Oath, “First do not harm patients,” and an oriental filial piety “Do not harm one’s own body because it is a precious gift from parents,” which is remote from defensive medical practice in the West where physicians, including pathologists, suffer from severe malpractice climate. Furthermore, Asian practice emphasizes the importance of resource management in navigating the overdiagnosis of low-risk thyroid carcinomas. This article summarizes the Asian Thyroid Working Group activities in the past 7 years, from 2017 to 2023, highlighting the diversity of thyroid nodule practice between Asia and the West and the background reasons why Asian clinicians and pathologists modified Western systems significantly.

A systematic evaluation of the efficacy differences of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of DME / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To systematically review the difference between the efficacy of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of diabetic macular edema(DME).<p>METHODS:Retrieved from PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, CQVIP, and CECDB databases, randomized controlled trials(RCT)and retrospective clinical control trials(CCT)about the difference between the efficacy of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of diabetic macular edema were collected. The search time was from the establishment of the library until August 2019. Meta-analysis was performed by using RevMan 5.3/Stata 14.0 software after screening the literature, extracting the data, and evaluating the quality of the literature by two researchers.<p>RESULTS: A total of 7 studies, 6 RCTs and 1 CCT involving 401 patients and 545 eyes were included. The results of Meta-analysis showed that the best corrected visual acuity(BCVA)measured values in the 577nm subthreshold micropulse diode laser group were higher than the conventional laser group \〖95% <i>CI</i>(0.02, 0.08), <i>P</i>=0.002\〗. The macular retinal thicken measured values in the 577nm subthreshold micropulse diode laser group was significantly lower the conventional laser group \〖95% <i>CI</i>(-26.96 to -10.88), <i>P</i><0.00001\〗. The mean sensitivity within macular 10° examination measured values in the 577nm subthreshold micropulse diode laser group was significantly higher than that conventional laser group \〖95% <i>CI</i>(1.56 to 2.39), <i>P</i><0.00001\〗.<p>CONCLUSION: 577nm subthreshold micropulse diode laser can not only better improve the visual function of patients with DME, but also have a higher safety in treatment. 577nm subthreshold micropulse diode laser has good research value for the treatment of DME, it's worthy of application and promotion in clinical practice.

A systematic evaluation of the efficacy differences of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of DME / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To systematically review the difference between the efficacy of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of diabetic macular edema(DME).<p>METHODS:Retrieved from PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, CQVIP, and CECDB databases, randomized controlled trials(RCT)and retrospective clinical control trials(CCT)about the difference between the efficacy of 577nm subthreshold micropulse diode laser and conventional laser in the treatment of diabetic macular edema were collected. The search time was from the establishment of the library until August 2019. Meta-analysis was performed by using RevMan 5.3/Stata 14.0 software after screening the literature, extracting the data, and evaluating the quality of the literature by two researchers.<p>RESULTS: A total of 7 studies, 6 RCTs and 1 CCT involving 401 patients and 545 eyes were included. The results of Meta-analysis showed that the best corrected visual acuity(BCVA)measured values in the 577nm subthreshold micropulse diode laser group were higher than the conventional laser group \〖95% <i>CI</i>(0.02, 0.08), <i>P</i>=0.002\〗. The macular retinal thicken measured values in the 577nm subthreshold micropulse diode laser group was significantly lower the conventional laser group \〖95% <i>CI</i>(-26.96 to -10.88), <i>P</i><0.00001\〗. The mean sensitivity within macular 10° examination measured values in the 577nm subthreshold micropulse diode laser group was significantly higher than that conventional laser group \〖95% <i>CI</i>(1.56 to 2.39), <i>P</i><0.00001\〗.<p>CONCLUSION: 577nm subthreshold micropulse diode laser can not only better improve the visual function of patients with DME, but also have a higher safety in treatment. 577nm subthreshold micropulse diode laser has good research value for the treatment of DME, it's worthy of application and promotion in clinical practice.

Thyroid fine-needle aspiration cytology in Taiwan: a nationwide survey and literature update

In Taiwan, thyroid fine-needle aspiration cytology is easily accessible and reliable for evaluating thyroid nodules. The sonographic pattern plays a major role and is the deciding factor for aspiration. We conducted a nationwide survey in 2017 and it revealed that 31% of laboratories had adopted The Bethesda System for Reporting Thyroid Cytopathology. There was a relatively high unsatisfactory rate (24.04%) and low rates of indeterminate diagnoses, including atypia of undetermined significance/follicular lesions of undetermined significance: 4.87%, and follicular neoplasm/suspicious for a follicular neoplasm: 0.35%. Moreover, the risks of malignancy in benign, atypia of undetermined significance, and suspicious for a follicular neoplasm were relatively high. These may reflect strict diagnostic criteria for indeterminate categories and better patient selection for surgery. Improvements in specimen sampling and continuing education programs are crucial. Newly-developed thyroid cytology technologies, such as immunocytochemistry, molecular testing, and computerized cytomorphometry, may further facilitate cytology diagnoses.

Thyroid Fine-Needle Aspiration in Taiwan: The History and Current Practice

In Taiwan, thyroid cancer is the most common endocrine gland malignancy and the incidence of thyroid cancer has increased four-fold in the past two decades. Fine-needle aspiration is an accurate and cost-effective method of evaluating thyroid nodules and has been the gold-standard diagnostic tool for thyroid tumors in Taiwan since the 1980s. This article reviews the history, current practice, reporting systems, training, and quality assurance for thyroid fine-needle aspiration cytology in Taiwan.

Combined hepatectomy in radical resection for hilar cholangiocarinoma / 中国医师杂志

Objective To evaluate the value of combined hepatectomy in radical resection for hilar cholangiocarinoma. Methods The clinical data and follow-up data of 67 patients of resection for hilar cholangiocarinoma in Henan Tumor Hospital from June 2005 to october 2008 were retrospectively analyzed. Results According to intraoperative exploration situation and bismuth types, tumor resection was combined performed with hepatectomy (n＝38)or non-hepatectomy (n＝29). The rate of R0 resection was 55.3% in hepatectomy group(n＝21) and 34.5% in non-hepatectomy group(n＝10), and the difference was significant（P＝0.024）. The incidence of complications were 39.5% in hepatectomy group(n＝15) and 13.4% in non-hepatectomy group(n＝4), and one patient with liver and kidney failure died in hospital. The 1, 3, 5 years of survival rate were 89.3%,53.6% and 32.1% respectively in R0 group (n＝31) and 69.7%,30% and 10% respectively in R1～R2 group(n＝36), there were significant differences in the postoperative survival rate between both groups（P＝0.018). The 1, 3, 5 years of survival rate were 81.8%,48.5% and 24.2% in hepatectomy group and 75%,32% and 16% in non-hepatectomy group respectively, and the differences were significant（P＝0.037). Conclusions Aggressive resection including combined hepatectomy for hilar cholangiocarcinoma can play an important role for curative effect and long term survival rate.