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Objective To evaluate clinical application of thyroid fine-needle aspiration biopsy (FNAB) and its diagnostic value.Methods FNAB was performed for 782 cases during 2005-2009 at China-Japan Friendship Hospital,Beijing and their clinical pathological data were retrospectively analyzed.Cytopathological diagnoses by FNAB were classified as unsatisfactory,benign,atypical cellular lesions,follicular neoplasm,suspicious malignancy and definite malignancy.Results of thyroid cytological and histological examinations of 76 patients with subsequent thyroidectomies were compared to those with FNAB to evaluate its diagnostic accuracy.Results Of 782 FNAB specimens,74.4 % (582/782) were classified as benign,2.6 % (20/782) as malignant,5.6 % (44/782) as follicular neoplasm,3.2 % (25/782) as atypical cellular lesion,2.9% (23/782) as suspicious malignancy and 11.3 % (88/782) as unsatisfactory.Among 76 patients with thyroidectomies,65.8 % of them (50/76) were histologically diagnosed as benign lesion,28.9 % (22/76) as definite malignancy and only 5.3 % (4/76) as benign follicular adenoma.Agreement between FNAB cytological diagnoses and histologically confirmed diagnoses for benign lesion and malignancy was 16/16 and 16/17,respectively.Conclusion FNAB is a reliable diagnostic method for evaluation of thyroid nodules.
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Objective To explore the clinical characteristics of gestational diabetes mellitus (GDM) and its relevant factors.Methods Using two diagnostic criteria set by World Health Organization and Carpenter/Coustan respectively, clinical data of 945 pregnant women who underwent glucose challenge test (GCT) in the Department of Obstetrics and Gynecology of China-Japan Friendship Hospital in Beijing during the past year were retrospectively analyzed.Results Of 945 pregnant women, 338 (35.8%) had 1 h serum glucose level equal to or greater than 7.8 mmol/L(140 mg/dl).Of these 338 women with positive GCT, 228 underwent 75 g oral glucose tolerance test (OGTT) and 102 (44.7%) of 228 were diagnosed as GDM. Women with GDM diagnosed according to either criteria had older age, higher body mass index(BMI) before pregnancy, more weight gain during the first 15 weeks of gestation, higher fasting blood glucose in early pregnancy and higher proportion of those with history of diabetes in their first-degree relatives than those with negative GCT. OGTT for pregnant women at about 30 weeks of gestation showed that insulin sensitivity decreased significantly in those with GDM compared with that in those with normal glucose tolerance, and the peak of insulin secretion delayed significantly in women with GDM.Logistic regression analysis showed that older age, higher BMI before pregnancy, more weight gain in early pregnancy and higher fasting blood glucose in early pregnancy were all independently associated with increased incidence of GDM.Conclusions Older age, higher BMI before pregnancy,more weight gain in early pregnancy,higher fasting blood glucose in early pregnancy,higher proportion of those with history of diabetes in their first-degree relatives and more severe insulin resistance were found in pregnant women with GDM than in those without GDM. It is suggested that those pregnant women with risk factors of GDM should be screened by fasting blood glucose in early pregnancy in order to be diagnosed and treated earlier.
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Objective To investigate the clinical characteristics of primary thyroid lymphoma(PTL) and its prognostic factors.Methods Clinical and pathological data of 7 cases diagnosed as primary thyroid lymphoma were retrospectively analyzed.Results All of the 7 patients were diagnosed on thyroidectomy and presented with thyroid nodules,of whom 6 cases were middle-aged to elderly women and some had locally oppressive symptoms.Four cases were diagnosed as diffuse large B non-Hodgkin's lymphoma (DLBCL) and 3 were mucosa-associated lymphoid tissue B-cell lymphoma (MALT).Pathological subtype of mucosa-associated lymphoid tissue B-cell lymphomas and younger patients had better prognosis.Conclusion The possibility of PTL must be kept in mind in the differential diagnosis of thyroid nodules in middle-aged to elderly women.Age and pathological subtype are important prognostic factors.
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Objective The aim of this study was to compare the efficacy of insulin aspart(IASP)and human soluble insulin(HSI)among patients with type 2 diabetes mellitus.Methods After completing a 2-week run-in period,42 patients with type 2 diabetes were randomly assigned to treatment with IASP or HSI for 4 weeks in a open-label,randomized,parallel-group study.The postprandial plasma glucose levels and safety profiles were compared.Results After 4 weeks of treatment,the mean change of the 1-hour postprandial plasma glucose level from baseline was significantly greater in IASP group than in HSI group[(2.1?2.0)mmol/L vs(0.9?1.9)mmol/L,P
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Objective To investigate the diagnostic value of fine-needle aspiration(FNA) for thyroid nodules.Methods The cytological and histological results of 74 patients who had undergone FNAs for thyroid nodules,followed by thyroidectomy,were compared to evaluate the accuracy of cytological diagnosis of thyroid FNA and analyze the common causes of missed diagnosis and misdiagnosis in thyroid cytopathology.Results Benign lesions were histologically diagnosed in 48 patients(65%),malignant tumors in 22 cases(30%) and benign tumors in 4 cases(5%).Cytological diagnosis of benign and malignancy was confirmed histolopathologically in 96% and 94%,respectively.Fifteen discrepant cases came mainly from the group of FNA diagnosis of follicular neoplasm,and the discrepancies resulted mainly from cytodiagnostic errors and overlapping cytological features between adenomatoid nodule and follicular neoplasm.Conclusion Despite some limitations,thyroid fine-needle aspiration is a reliable diagnostic method of assessing thyroid nodular disease,especially in differentiation of benign lesion and malignant lesion.