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Objective To explore the diagnostic value of thyroglobulin measurement with fine‐needle aspiration ( FNA‐Tg ) in detecting papillary thyroid carcinoma ( PTC ) metastatic lymph nodes ,and analyze the impact of different factors on the diagnostic accuracy of FNA‐Tg . Methods One hundred and fifty‐four lymph nodes from 138 patients w ho underwent total thyroidectomy and cervical lymphadenectomy were enrolled . Ultrasonography ,fine needle aspiration cytology ( FNAC) and FNA‐Tg results were acquired in all patients . T he diagnostic value of FNAC ,FNA‐Tg and the combination of the two methods were compared in suspicious PTC metastatic lymph nodes . T he influence of lymph nodes size ,lymph nodes cystic change and serum thyroglobulin antibody( TgAb) on the accuracy of FNAC and FNA‐Tg were analyzed . Results T he sensitivities of FNAC ,FNA‐Tg ,and the combination of the two methods in the diagnosis were 79 .5% , 95 .5% and 97 .7% ,respectively . T he specificities were 100% ,93 .9% and 100% ,respectively . T he size and cystic change of lymph nodes had effects on the accuracy of FNAC( P ＜0 .05) ,w hile they had no effect on the accuracy of FNA‐Tg ( P ＝0 .42 ,0 .67 ) . T he serum TgAb level had no influence on the accuracy of FNAC and FNA‐Tg ( P ＝ 0 .88 ,0 .34 ) . Conclusions FNA‐Tg is sensitive to metastatic lymph nodes in PTC w hich not affected by the lymph nodes size ,the lymph nodes cystic change and serum TgAb level . Application of FNA‐Tg with FNAC can improve the sensitivity of diagnosis ,w hich is important in the diagnosis of PTC metastatic lymph nodes .
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Objective To investigate the application value of shear wave elastography (SWE) combined with superb micro-vascular imaging (SMI) in differentiating malignant and benign thyroid masses.Methods Seventy-eight patients diagnosed by ultrasound and verified with postoperative pathological analysis were enrolled.Conventional two-dimensional ultrasound was applied to observe the masses.SWE was performed to evaluate the elasticity and the Young's modulus (AveT1) value acquired.ROC curve was drawn to calculate the sensibility and specificity using the cut-off value of AveT1.SMI was applied to define Adler's grading standard according to the degree of blood supply.The sensitivity,specificity and accuracy of SWE and SWE combined with SMI in differentiating malignant and benign thyroid masses were analyzed.Results ①According to pathological analysis,there were 42 benign and 44 malignant masses;②The AveT1 value between malignant and benign groups were all significantly different (P ＜0.01).41.4 kPa was used as the best cut-off value of AveT1.The area under the ROC curve were 0.83 with sensitivity 86.9％ and specificity 88.1％;③There were more masses with the Alder class Ⅱ-Ⅲ in malignant group than those in benign group,and the difference was statistically significant (P ＜0.01);④Quantified with SWE or SWE combined with SMI,the sensitivity were 86.9％ and 91.3％,specificity were 88.1％ and 92.8％,and accuracy were 87.5％ and 94.1 ％,respectively,and the difference was statistically significant (P ＜ 0.01).Conclusions SWE combined with SMI represents an excellent application value in differentiating malignant and benign thyroid masses,which could improve the sensitivity,specificity and accuracy of the diagnosis for thyroid masses using ultrasound.
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Objective To investigate whether two-dimension speckle tracking imaging(2D-STI) and ICAM-1-targeted myocardial contrast echocardiography could detect the acute cellular rejection of heart transplantation at the early stage.Methods The abdominal heterotopic heart transplantation model was successfully established using Wistar and SD rats.Forty-eight rats were divided into allografts (ALLO) group (n =24) and isografts(ISO) group (n =24).Echocardiography,2D-STI and ICAM-1 targeted myocardial contrast echocardiography were performed at 1,3,5 day after transplantation respectively.After ultrasound imaging,transplanted hearts were harvested for Hematoxylin-eosin staining and immunofluorescence histochemistry to evaluate acute cellular rejection and ICAM-1 expression.Results There were obvious difference between ALLO group and ISO group in echocardiographic parameters at 5 days after transplantation surgery (all P ＜0.05).Compared with those in ISO group,global circumferential strain and strain rate (GCS,GCSr),and circumferential strain of endo-myocardium (CSendo) decreased in ALLO group at day 3 post-transplantation (all P＜0.05).Compared with those in ISO group,all strain parameters in ALLO decreased significantly at postoperative day 5 (all P＜ 0.05).Myocardial contrast echocardiography using ICAM-1-targeted microbubbles showed that the video intensity in ALLO group was significant higher than that in ISO group at postoperative day 3 and day 5 (all P＜0.05).Conclusions 2D-STI and myocardial contrast echocardiography using ICAM-1-targeted microbubbles are sensitive and useful for detecting heart transplant acute rejection at the early stage.
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The medical education of China and the United States was compared by analyzing the differences about educational system, teaching mode and teaching content in this paper. Standard-ization of the Chinese medical education system, improving clinical practice, teaching students by initi-ating questions and advanced medical education technology were recommended in China. This paper will inspirit and provide experience for the innovation of Chinese medical education.