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1.
Altern Ther Health Med ; 29(3): 116-119, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36580670

ABSTRACT

Context: To date, researchers have found that poor mental health was common during the COVID-19 epidemic. Even if they had been relatively resistant to suicidal ideation during the first three waves of the pandemic, university students may experience a delayed impact on their mental health. Objective: The study intended to measure mental health among university students in Wuhu City, China and to identify an effective approach to universities can use to prevent mental-health issues. Design: The research team performed a cross-sectional study. Setting: The study took place at Anhui polytechnic university, Wuhu, China. Participants: Participants were 2371 students at Anhui polytechnic university in Wuhu city, China. Outcome Measures: The research team used the two-item General Health Questionnaire-12 (GHQ-12) to measure participants' mental health. Results: Among the 2371 participants, 1727 had poor mental health (72.84%), including 843 males (48.81%) and 884 females (51.19%). Poor mental health was significantly associated with an urban residential location (P > .01), the female gender (p>0.01), the second school year (P > .01), and the parents' education level of junior high school or below (both P > .01). Conclusions: The current study suggests that poor mental health among university students is common. Being female, from an urban area, and in the second year of school and having parents with an education of junior high school or below had poorer mental health than those who were male, from the countryside, and in the first year of school and who had parents with a higher level of education.


Subject(s)
COVID-19 , Mental Health , Humans , Male , Female , Universities , Cross-Sectional Studies , Surveys and Questionnaires , COVID-19/epidemiology , Students/psychology , Health Status , China/epidemiology
2.
Chin J Integr Med ; 28(4): 330-338, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34826042

ABSTRACT

OBJECTIVE: To investigate whether Lingbao Huxin Pill (LBHX) protects against acute myocardial infarction (AMI) at the infarct border zone (IBZ) of myocardial tissue by regulating apoptosis and inflammation through the sirtuin 1 (SIRT1)-mediated forkhead box protein O1 (FOXO1) and nuclear factor-κ B (NF-κ B) signaling pathways. METHODS: Six-week-old Wistar rats with normal diet were randomized into the sham, the model, Betaloc (0.9 mg/kg daily), LBHX-L (0.45 mg/kg daily), LBHX-M (0.9 mg/kg daily), LBHX-H (1.8 mg/kg daily), and LBHX+EX527 (0.9 mg/kg daily) groups according to the method of random number table, 13 in each group. In this study, left anterior descending coronary artery (LADCA) ligation was performed to induce an AMI model in rats. The myocardial infarction area was examined using a 2,3,5-triphenyltetrazolium chloride solution staining assay. A TdT-mediated dUTP nick-end labeling (TUNEL) assay was conducted to assess cardiomyocyte apoptosis in the IBZ. The histopathology of myocardial tissue at the IBZ was assessed with Heidenhain, Masson and hematoxylineosin (HE) staining assays. The expression levels of tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-1 ß, and intercellular adhesion molecule-1 were measured using enzyme-linked immunosorbent assays (ELISAs). The mRNA expressions of SIRT1 and FOXO1 were detected by real-time qPCR (RT-qPCR). The protein expressions of SIRT1, FOXO1, SOD2, BAX and NF- κ B p65 were detected by Western blot analysis. RESULTS: The ligation of the LADCA successfully induced an AMI model. The LBHX pretreatment reduced the infarct size in the AMI rats (P<0.01). The TUNEL assay revealed that LBHX inhibited cardiomyocyte apoptosis at the IBZ. Further, the histological examination showed that the LBHX pretreatment decreased the ischemic area of myocardial tissue (P<0.05), myocardial interstitial collagen deposition (P<0.05) and inflammation at the IBZ. The ELISA results indicated that LBHX decreased the serum levels of inflammatory cytokines in the AMI rats (P<0.05 or P<0.01). Furthermore, Western blot analysis revealed that the LBHX pretreatment upregulated the protein levels of SIRT1, FOXO1 and SOD2 (P<0.05) and downregulated NF- κ B p65 and BAX expressions (P<0.05). The RT-qPCR results showed that LBHX increased the SIRT1 mRNA and FOXO1 mRNA levels (P<0.05). These protective effects, including inhibiting apoptosis and alleviating inflammation in the IBZ, were partially abolished by EX527, an inhibitor of SIRT1. CONCLUSION: LBHX could protect against AMI by suppressing apoptosis and inflammation in AMI rats and the SIRT1-mediated FOXO1 and NF- κ B signaling pathways were involved in the cardioprotection effect of LBHX.


Subject(s)
Myocardial Infarction , Sirtuin 1 , Animals , Apoptosis , Drugs, Chinese Herbal , Inflammation/drug therapy , Inflammation/metabolism , Myocardial Infarction/pathology , NF-kappa B/metabolism , Nerve Tissue Proteins , Rats , Rats, Wistar , Sirtuin 1/genetics
3.
Biomed J ; 42(1): 59-65, 2019 02.
Article in English | MEDLINE | ID: mdl-30987707

ABSTRACT

BACKGROUND: The macrofollicular variant of papillary thyroid cancer (MFVPTC) is a rare histological variant of papillary thyroid cancer (PTC), with only 71 cases reported through 2014. This study analyzed the clinical, preoperative thyroid ultrasonography (US), and fine needle aspiration cytology (FNAC) features; and therapeutic outcomes of 11 patients with MFVPTC. METHODS: The records of 393 patients with histologically diagnosed follicular variant of papillary thyroid carcinoma (FVPTC), including 11 with MFVPTC, were retrospectively reviewed. Preoperative thyroid US findings, clinical presentation, treatment outcomes, and survival rates were analyzed. RESULT: Mean tumor size was significantly greater in patients with MFVPTC than that in those with FVPTC (4.2 ± 2.1 cm vs. 2.9 ± 1.7 cm; p = 0.016). No patient with MFVPTC had lymph node involvement, but one had a micrometastasis to the lung, which responded well to therapeutic radioiodine. All MFVPTC lesions were isoechoic on US. Eight nodules had calcifications and eight had irregular margins. FNAC showed that these tumors had low cellularity, absence or focal presence of enlarged clear nuclei, and subtle or focal nuclear features of PTC. Cells were, arranged in microfollicular pattern, with abundant colloid background. Multifocal PTCs were detected in the opposite lobe of two patients. All 11 patients with MFVPTC had excellent outcomes. No patient experienced recurrence, and survival rates were high. CONCLUSIONS: Malignant US criteria combined with FNAC features have a low preoperative diagnostic rate for MFVPTC. Surgery is recommended for patients with thyroid nodules larger than 4 cm and those with subtle and focal atypical nuclei in FNAC.


Subject(s)
Carcinoma/pathology , Neoplasm Recurrence, Local/pathology , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/surgery , Adult , Aged , Biopsy, Fine-Needle , Carcinoma/surgery , Female , Humans , Iodine Radioisotopes , Male , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Thyroid Cancer, Papillary/diagnosis , Thyroid Gland/pathology , Thyroid Gland/surgery , Treatment Outcome , Young Adult
4.
Endocr J ; 65(11): 1101-1109, 2018 Nov 29.
Article in English | MEDLINE | ID: mdl-30158361

ABSTRACT

The efficacy of thyroxine suppressive therapy in reducing nodular growth and its effect to bone mineral density (BMD) in postmenopausal women is still debated. This study aimed to evaluate the therapeutic effect of thyroxine and its influence on BMD. Postmenopausal women with nodular or multinodular goiter during 2013-2015 at Chang Gung Memorial Hospital were enrolled and retrospectively traced back to the first date of visit or treatment. Ninety-four eligible patients were enrolled, of whom 45 were thyroxine-treated (LT-4 group) and 49 were treatment-naïve (control group). Data, including volume of nodules, were analyzed retrospectively. BMD was measured in each LT-4 group patient since the year of enrollment. Nodular volumes were reduced in both LT-4 (from 4.89 ± 4.46 to 4.10 ± 4.57 mL, p = 0.033) and control group (3.48 ± 4.36 to 3.09 ± 2.88 mL, p = 0.239) at initial 2-year follow-up. Nodular volume in LT-4 group increased insignificantly (from 4.89 ± 4.46 to 4.91 ± 5.40 mL, p = 0.711) at the end of 7-year follow-up. The best cut-off predictive nodular volume that may have responded to thyroxine is 2.6 mL (AUC, 0.740; sensitivity, 0.750; specificity, 0.733) during first 2 year. Lumbar spine, total hip and femoral neck BMD were not significantly changed during 2 year's thyroxine suppression therapy. In conclusion, thyroxine suppressive therapy in postmenopausal women had significant reduction in nodule volume at initial 2 years of treatment, especially in volume larger than 2.6 mL. Prolonged thyroxine treatment did not benefit nodular size reduction and may affect BMD minimally in postmenopausal women.


Subject(s)
Bone Density/drug effects , Goiter, Nodular/drug therapy , Thyroxine/therapeutic use , Absorptiometry, Photon , Aged , Female , Femur Neck/diagnostic imaging , Femur Neck/drug effects , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/drug effects , Middle Aged , Postmenopause , Retrospective Studies , Thyroxine/pharmacology , Treatment Outcome
5.
J Ultrasound Med ; 37(3): 667-674, 2018 Mar.
Article in English | MEDLINE | ID: mdl-28880405

ABSTRACT

OBJECTIVES: It is difficult to establish a diagnosis of the follicular variant of papillary thyroid carcinoma (PTC) using fine-needle aspiration cytology (FNAC). Preoperative features on ultrasound (US) imaging are different between follicular PTC and classic PTC. This study developed a risk score system to differentiate follicular PTC from classic PTC and to correlate the risk score of follicular PTC with its FNAC categories and pathologic features. METHODS: The US features, FNAC results, and pathologic reports of 156 follicular PTC nodules and 152 classic PTC nodules from 296 patients with PTC along with their clinical characteristics were reviewed retrospectively. A risk score system based on US features was developed by multivariate logistic regression to differentiate classic PTC from follicular PTC nodules. The risk scores were then correlated with the FNAC category and pathologic features of the nodules. RESULTS: The US risk score (5 × echogenicity + 3 × calcifications + 3 × marginal regularity) had an area under the receiver operating characteristic curve of 0.85 and a cutoff value of 8.0, with specificity of 87% and sensitivity of 69% for predicting a classic PTC nodule. The follicular PTC nodules with low Bethesda categorization (I-III) had a median US risk score of 6 (range, 0-11), which was higher than that of nodules with high categorization (IV-VI; median, 3; range, 0-11). CONCLUSIONS: The US risk score may be useful in differentiating classic PTC from follicular PTC and complementary to FNAC in identifying follicular PTC.


Subject(s)
Adenocarcinoma, Follicular/diagnostic imaging , Carcinoma, Papillary/diagnostic imaging , Thyroid Neoplasms/diagnostic imaging , Ultrasonography/methods , Adenocarcinoma, Follicular/pathology , Biopsy, Fine-Needle , Carcinoma, Papillary/pathology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Retrospective Studies , Sensitivity and Specificity , Thyroid Cancer, Papillary , Thyroid Gland/diagnostic imaging , Thyroid Gland/pathology , Thyroid Neoplasms/pathology
6.
Int J Endocrinol ; 2017: 4208178, 2017.
Article in English | MEDLINE | ID: mdl-28642790

ABSTRACT

A retrospective review of 626 patients with multifocal papillary thyroid carcinoma (PTC) including 147 patients (23.5%) with multifocal papillary thyroid microcarcinoma (PTMC) from a total of 2,536 patients with PTC who visited the Chang Gung Medical Center in Linkou, Taiwan, was performed. A comparison of the clinical features between 626 multifocal and 1,910 solitary PTC cases showed that patients in the multifocal PTC group were older and had a smaller mean tumor size, a more advanced tumor-node-metastasis (TNM) stage, and a higher percentage of nonremission status compared to patients in the solitary PTC group. Of the 626 patients with multifocal PTC, the group with larger tumors showed a more advanced TNM stage, a higher percentage of lymph node metastasis and soft tissue invasion, and a higher nonremission rate compared to the multifocal PTMC group. Of the 626 patients with multifocal PTC, 25 patients (4%) died during a mean follow-up period of 7.1 ± 5.3 years. Kaplan-Meier survival curves showed a significantly lower survival rate associated with multifocal PTMC compared to that with solitary PTMC.

7.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 33(5): 422-425, 2017 May 08.
Article in Chinese | MEDLINE | ID: mdl-29926586

ABSTRACT

OBJECTIVE: To investigate the effects of dandelion polysaccharide on IL-6/STAT3 signaling pathway in rats with ulcerative colitis. METHODS: Forty SD rats were randomly divided into four groups (n=10):control group, model group, positive control group and dandelion polysaccharide group. The ulcerative colitis model was established by treated with 2,4,6-trinitrobenzene sulfonic acid (TNBS). The positive control group was treated with mesalazine 10 mg/kg·d and dandelion polysaccharide group was treated with dandelion polysaccharide 10 mg/kg·d. The levels of interleukin -6(IL-6), colonic myeloperoxidase (MPO) and interleukin-6 receptor (sIL-6Rα) were measured after 4 weeks of treatment. The pathological changes of colonic mucosa were observed in rats. The gene expressions of glycoprotein 130 (gp130), transcriptional activator3(STAT3) and IL-6 were detected. RESULTS: Compared with the normal control group, the level of serum IL-6 in the model group was significantly higher than that in the control group (P<0.01). Compared with the model group, the serum levels of IL-6 in the dandelion polysaccharide group and the methacetin group were significantly decreased (P<0.01). Compared with the model group, the MPO positive density of the rats in the dandelion polysaccharide group and the methacetin group was significantly lower than that in the normal group (P<0.01). Compared with the model group, the levels of sIL-6Rα and gp130 in the rats were significantly lower than those in the model group (P<0.01). Compared with the model group, the expressions of STAT3 and IL-6 mRNA in the intestinal tissue of the rats in the dandelion polysaccharide group and the methacetin group were decreased significantly. CONCLUSIONS: Dandelion polysaccharide can decrease the level of IL-6 in rats with ulcerative colitis, regulate the expression of sIL-6Rα and gp130 protein in IL-6/STAT3 pathway, and then down-regulate the expressions of STAT3 and IL-6 mRNA in intestinal tissue of rats, alleviate the colon inflammation state, protect and repair the mucosal tissue. Dandelion polysaccharide plays a role in the treatment of ulcerative colitis.


Subject(s)
Colitis, Ulcerative/drug therapy , Interleukin-6/metabolism , Polysaccharides/pharmacology , STAT3 Transcription Factor/metabolism , Signal Transduction/drug effects , Taraxacum/chemistry , Animals , Colon/drug effects , Colon/pathology , Random Allocation , Rats , Rats, Sprague-Dawley
8.
Chin Med Sci J ; 32(4): 239-247, 2017 Dec 30.
Article in English | MEDLINE | ID: mdl-29301599

ABSTRACT

Objective To study the protective effect of agrimony extracts from different extracting methods on cerebral ischemia-reperfusion injury in rats, in order to optimize the extraction scheme of agrimony. Methods Male rats were randomly assigned into seven groups: 1. Sham-operated group, 2. Untreated MCAO group (MCAO), 3. Petroleum ether extract of Agrimonia pilosa treated MCAO group (PEA), 4. Ethyl acetate extract of Agrimonia pilosa treated MCAO group (EAEA), 5. Ethanol extract of Agrimonia pilosa treated MCAO group (EEA), 6. Water extract of Agrimonia pilosa treated MCAO group (WEA), 7. Nimodipine treated MCAO group (NP). Intragastrical drug administration (i.g) was performed at 0 and 6 hours after MCAO. Neurological function tests were performed after reperfusion for 24 hours, then the brain was removed for the evaluations of the cerebral infarction volume (percentage of total brain volume) by immunohistochemistry, histological changes (hematoxylin-eosin staining), Na+/K+-ATPase, Ca2+-ATPase (modified method of Svoboda and Mosinger), mRNA expression of Tumor suppressor gene (P53) and hot shock protein (HSP70) (quantitative real-time PCR). Results The neurological function of MCAO group had significantly higher scores than the sham group (P<0.01). The WEA group showed a significantly lower neurological score than the MCAO group (P<0.05), indicating the protective effect of WEA on neurological deficits. The mean infarction volumes of WEA (13.5±6.6%, F=4.75, P<0.01), EEA (19.90±6.90%, F=5.23, P<0.01), PEA (20.40±5.30%, F=4.68, P<0.01) and EAEA (22.50±10.50%, F=6.25, P<0.05) group were all significantly smaller than that of MCAO group (29.40±6.50%). HE staining demonstrated that, compared to the treated groups, the infarcted cerebral tissue of MCAO group had more swelling neural cells, lighter stained nucleus, fewer and irregularly distributed neurons. The activity of Na+/K+-ATPase and Ca2+-ATPase reduced in the MCAO group (3.67±0.48 U/mg, 1.28±0.26 U/mg, respectively), and were significantly higher in WEA group (7.56±0.85 U/mg, F=12.65, P=0.010; 3.59±0.22 U/mg, F=8.32, P=0.041, respectively). The MCAO group showed significantly elevated P53 and HSP70 mRNA expressions compared to the sham group (P<0.01, P<0.05). P53 mRNA expressions in Agrimony extracts treated groups were significantly lower than that of the MCAO group (all P<0.01), with the WEA group showing the greatest difference from MCAO group. The HSP70 mRNA level of the treated groups were not significantly different from that of the MCAO group. Conclusions Treatment using water extracts of agrimony can promote the best functional and metabolic recovery for rat model of cerebral ischemia-reperfusion injury, which maybe relate with the upregulation of energy metabolism in nerve cells after MCAO.


Subject(s)
Agrimonia/chemistry , Brain/metabolism , Cerebrovascular Disorders/prevention & control , Neuroprotective Agents/pharmacology , Plant Extracts/pharmacology , Reperfusion Injury/prevention & control , Animals , Brain/pathology , Brain/physiopathology , Cerebrovascular Disorders/metabolism , Cerebrovascular Disorders/pathology , Cerebrovascular Disorders/physiopathology , Gene Expression Regulation/drug effects , Male , Nerve Tissue Proteins/biosynthesis , Neuroprotective Agents/chemistry , Plant Extracts/chemistry , Rats , Rats, Sprague-Dawley , Reperfusion Injury/metabolism , Reperfusion Injury/pathology , Reperfusion Injury/physiopathology
9.
Nan Fang Yi Ke Da Xue Xue Bao ; 36(10): 1305-1311, 2016 Oct 20.
Article in Chinese | MEDLINE | ID: mdl-27777189

ABSTRACT

OBJECTIVE: To investigate the changes in the population and distribution intestinal microflora and their relationship with depression in post-stroke patients. METHODS: Fecal specimens were obtained from 32 patients with post-stroke depression and 30 healthy adults for gene sequencing of 16S RNA V3 region of the intestinal microorganism using Roche/45 high-throughput sequencing platform. RESULTS: The genus and species of intestinal bacteria showed significant differences between the post-stroke patients and health adults. CONCLUSION: Significant changes in the structure of intestinal flora occur in patients with post-stroke depression.


Subject(s)
Depression/microbiology , Gastrointestinal Microbiome , Intestines/microbiology , Stroke/complications , Adult , Case-Control Studies , Depression/complications , High-Throughput Nucleotide Sequencing , Humans , Stroke/psychology
10.
Asian Pac J Cancer Prev ; 12(6): 1577-81, 2011.
Article in English | MEDLINE | ID: mdl-22126502

ABSTRACT

BACKGROUND: The study was to investigate the relationship between diabetes mellitus ( DM), specific cancers, age, and gender. METHODS: This was a retrospective study that examined the frequency of different forms of cancer among male and female patients with or without DM admitted to a single hospital in Taiwan between January 2009 and June 2010. RESULTS: Of 101,002 study patients admitted to the hospital, 15,901 (15.74%) were diagnosed with DM and 16,748 (16.58%) with a malignancy. The frequency of DM differed between males and females (17.5% vs 14.2%; P<0.001), and males had a higher cancer incidence than females (20.2% vs 13.5%; P<0.001). Patients with DM had a greater frequency of cancer diagnosis than non-DM patients (18.1% vs 16.3%, respectively), with pancreatic, liver, uterine, urinary tract, lung, and secondary cancers being more frequent in DM compared with non-DM patients. In contrast, the proportion of patients with thyroid, esophagus, breast, NPC, and other cancers was lower in DM versus non-DM patients. CONCLUSIONS: This study found that DM was associated with the incidence of specific cancers and that males had a higher frequency of cancer than females. The association of DM and cancer depended upon cancer type, gender, and age.


Subject(s)
Diabetes Mellitus/epidemiology , Neoplasms/epidemiology , Adult , Age Factors , Aged , Aged, 80 and over , Diabetes Complications , Female , Hospitalization , Humans , Incidence , Male , Middle Aged , Neoplasms/complications , Retrospective Studies , Risk Factors , Sex Factors , Taiwan/epidemiology , Young Adult
11.
Endocr Pathol ; 22(3): 144-9, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21647844

ABSTRACT

Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are the most common differentiated thyroid cancers. Previous studies report that Hashimoto's thyroiditis (HT) concomitant with PTC is unusual and improves prognosis compared to classical PTC. Few previous studies address FTC concomitant with HT. In this study, we retrospectively analyzed data from one institution and compared clinical presentations and results of treatment of PTC and FTC with and without HT. In addition, studies comparing presentation and long term follow-up prognosis in classical PTC and FTC were conducted. A total of 1,788 PTC patients and 209 FTC patients underwent thyroidectomy with or without lymph node dissection and follow-up at Chang Gung Medical Center in Linkou, Taiwan. All thyroid carcinomas were pathologically classified according to World Health Organization criteria. Histological patterns of PTC were categorized as classical PTC, or PTC with HT. Follicular thyroid carcinoma patients were categorized as FTC or FTC with HT. The dataset contained a total of 1,703 PTC cases categorized as classical PTC, 85 cases of PTC with HT, 201 cases of FTC and eight cases of FTC with HT. Analysis of Classification of Malignant Tumors (TNM) stage revealed a higher percentage of classical PTC in stage IV than HT group (12.03% vs. 4.70%). Mean tumor size of classical PTC was larger than HT group. Although 42.3% of FTC cases presented with distant metastases, no cases of FTC with HT presented with distant metastasis. Cancer-specific mortality was higher in classical PTC group than in PTC with HT. There was 53.2% of FTC without HT assigned recurrent status, and six of them died of thyroid cancer. No cancer mortality or recurrence in HT with FTC. PTC and FTC with HT presented with better clinical stage and better prognosis after same therapeutic modality. In conclusions, both PTC and FTC with HT have less aggressive clinical presentation and better prognosis.


Subject(s)
Hashimoto Disease/epidemiology , Thyroid Neoplasms/epidemiology , Thyroid Neoplasms/pathology , Adenocarcinoma, Follicular , Adult , Carcinoma , Carcinoma, Papillary , Cell Differentiation/physiology , Female , Hashimoto Disease/complications , Humans , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Prevalence , Recurrence , Thyroid Cancer, Papillary , Thyroid Neoplasms/complications , Thyroid Neoplasms/diagnosis , Tumor Burden
12.
Oncology ; 80(1-2): 123-9, 2011.
Article in English | MEDLINE | ID: mdl-21677457

ABSTRACT

OBJECTIVE: The objective of this study was to determine the therapeutic outcome of papillary thyroid cancer (PTC) patients in different risk groups in one institute. METHODS: A total of 1,759 PTC patients were categorized into low- (n = 1,123), intermediate- (n = 75), and high-risk (n = 561) groups according to tumor-node-metastasis (TNM) stage. RESULTS: Of the patients, 15.1% presented with lymph node metastases, and 4.6% presented with distant metastases at the time of thyroid operation. After 8.0 ± 0.1 years of follow-up, 73 (4.2%) patients died of thyroid cancer. Tumor size, local invasion, and lymph node metastases adversely influenced recurrence and survival. Of the patients in the 3 groups, 9 (0.8%), 8 (10.7%), and 56 (10.0%) died of thyroid cancer, respectively. In addition, 88 (7.8%), 14 (18.7%), and 144 (25.8%) patients showed recurrence during the follow-up period. Patients with highly aggressive histological patterns showed increased recurrence and cancer mortality compared with the low-risk group; otherwise, values were not higher than those of the high-risk group. CONCLUSIONS: The cancer-related mortality was nearly 10% in the intermediate- and high-risk groups, and the patients in these groups required aggressive surgical and postoperative adjuvant therapies.


Subject(s)
Neoplasm Recurrence, Local , Thyroid Neoplasms/mortality , Thyroid Neoplasms/pathology , Adult , Aged , Carcinoma , Carcinoma, Papillary , Disease-Free Survival , Female , Follow-Up Studies , Humans , Iodine Radioisotopes/therapeutic use , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Metastasis , Risk Factors , Sex Factors , Survival Rate , Thyroid Cancer, Papillary , Thyroid Neoplasms/radiotherapy , Thyroid Neoplasms/surgery , Thyroidectomy , Tumor Burden
13.
Chang Gung Med J ; 34(1): 23-34, 2011.
Article in English | MEDLINE | ID: mdl-21392471

ABSTRACT

Tumor-node-metastasis (TNM) staging is the most commonly used model for evaluating therapeutic strategies for papillary thyroid cancer (PTC). Additionally, different histopathological patterns and variants of PTC have been reported to influence the prognosis of these patients. We reviewed the clinical presentation, cancer recurrence, and cancer-specific mortality of the most frequent histological patterns, including the follicular variant (FVPTC), insular pattern, tall cell pattern, diffuse sclerosing type, PTC with Hashimoto's thyroiditis, and multicentric PTC. The tall cell variant of PTC is a more aggressive variant than classical PTC and has a poor prognosis. The high expression of Muc 1 and type IV collagenase in these tumors may facilitate stromal degradation and increase the invasive potential. In contrast, approximately 18% of PTC patients have been identified as having FVPTC. FVPTC patients have a better survival rate than those with follicular thyroid cancer, and fewer instances of lymph node or soft tissue invasion than control patients with classical PTC. The diffuse sclerosing variant of PTC predominantly observed in young patients is a rare aggressive tumor that requires intensive treatment. Despite characteristic clinical and histological features that facilitate easy diagnosis, pre-operative fine needle aspiration cytological diagnosis of this variant is often challenging. Different histological variants of PTC with other histological patterns are important for predicting cancer recurrence. In addition to TNM staging, high-risk histological patterns of PTC require more aggressive follow-up examinations and postoperative adjuvant therapies.


Subject(s)
Carcinoma, Papillary/pathology , Thyroid Neoplasms/pathology , Carcinoma, Papillary/mortality , Carcinoma, Papillary/surgery , Carcinoma, Papillary, Follicular/mortality , Carcinoma, Papillary, Follicular/pathology , Carcinoma, Papillary, Follicular/surgery , Humans , Neoplasm Staging , Thyroid Neoplasms/mortality , Thyroid Neoplasms/surgery , Thyroiditis/etiology
14.
J Clin Ultrasound ; 37(9): 487-92, 2009.
Article in English | MEDLINE | ID: mdl-19750546

ABSTRACT

PURPOSE: To correlate sonographic (US) characteristics and results of fine-needle aspiration biopsy (FNAB) of thyroid nodules in autoimmune thyroiditis (AT) with surgical pathological findings. METHOD: Forty AT patients with 40 nodular lesions were analyzed retrospectively. Five sonographic characteristics were recorded for each nodule: diameter, echogenicity, microcalcification, halo sign, and margin. Preoperative sonograms and FNAB results were compared with postoperative histopathological findings. RESULT: Twenty-four of the 40 nodules were malignant, including 20 papillary carcinomas, 3 follicular carcinomas, and 1 medullary carcinoma. Of the 16 benign nodules, 8 were nodular hyperplasia, 6 lymphocytic thyroiditis, and 1 each follicular adenoma and Hürthle cell adenoma. The only US parameter that was significant in malignant vs. benign nodules was the presence of poorly defined margins. Based on preoperative cytology, 22 of the 23 malignant nodules were correctly diagnosed, and 10 of the 14 benign nodules were correctly identified. The positive predictive value was 78.6%, and the negative predictive value was 93.7%. CONCLUSION: No single US parameter can predict thyroid malignancy in patients with AT. A combination of US and FNAB provides the most sensitive and specific approach available preoperatively.


Subject(s)
Biopsy, Fine-Needle , Neoplasms/diagnostic imaging , Neoplasms/surgery , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/surgery , Thyroiditis, Autoimmune/diagnostic imaging , Thyroiditis, Autoimmune/surgery , Adult , Female , Humans , Male , Middle Aged , Ultrasonography
15.
Thyroid ; 15(7): 708-17, 2005 Jul.
Article in English | MEDLINE | ID: mdl-16053388

ABSTRACT

Thyroid nodule is common disorder in endocrine clinics. In Taiwan, thyroid ultrasonography with fine-needle aspiration cytology (FNAC) is the first-line examination procedure. Data in large series on the incidence of thyroid malignancy presenting with thyroid nodules are lacking in this area. To determine the incidence of malignancy in thyroid nodules and compare the results with other populations, this investigation retrospectively reviewed 21,748 subjects who were examined in one medical center from January 1986 to December 1999. All patients underwent thyroid ultrasonography studies using a real-time ultrasonographic machine and a 10-MHz transducer. Fine-needle aspirations were made in the suspected thyroid nodule and stained using the Romanowsky- based method developed by Liu. By the end of 2002, some 3629 patients (16.7%) had thyroid nodules after surgical treatment. This group comprised 3011 women with a mean age of 41.5 +/- 13.9 years, and 618 men with a mean age of 45.7 +/- 14.9 years. Of patients undergoing surgical treatment, 2761 (76.1%) patients were diagnosed with benign nodules, 858 (23.6%) with malignant nodules, and 10 (0.3%) with atypical adenoma (7 follicular and 3 Hürthle cells). The percentages of thyroid malignancy in each age group revealed two peaks in both genders, namely in patients aged 20 to 29 years and in elderly patients (aged over 65 years). The peak age for thyroid malignancy in both genders was 41 to 60 years (male) and 21 to 40 years (female). The highest ratio of malignancy occurred in the elderly group (37.2%) receiving surgical treatment. In young patients (below 19 years) the percentage of malignancy was no greater than for the whole age group (20.2% versus 25.6%). Anaplastic and metastatic cancers affecting the thyroid were the main subjects in the age group. The present results demonstrated a younger distribution for well-differentiated thyroid cancer, particularly papillary thyroid carcinoma, compared to previous studies. This outcome may have resulted from the routine application of ultrasonography with FNAC in assessing the thyroid nodules, possibly helping to achieve more timely detection. The incidence of thyroid malignancy in young patients was no higher than in adults. Early detection of thyroid malignancy may be the main reason for this phenomenon. Male subjects with thyroid nodules displayed a higher incidence of this malignancy than females. Aging subjects with thyroid nodules suffered a higher rate of malignancy and were poorly differentiated. In conclusion, this retrospective large-series study demonstrated that 3.9% (858/21,748 cases) of patients with thyroid nodules showed histopathologically proven malignancy. Thyroid cancer detected by ultrasonography with FNAC occurred an average of 10 years younger than in prior studies.


Subject(s)
Carcinoma, Papillary/diagnostic imaging , Carcinoma, Papillary/epidemiology , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/epidemiology , Thyroid Nodule/diagnostic imaging , Thyroid Nodule/epidemiology , Adenocarcinoma, Follicular/diagnostic imaging , Adenocarcinoma, Follicular/epidemiology , Adenocarcinoma, Follicular/pathology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Biopsy, Fine-Needle , Carcinoma, Medullary/diagnostic imaging , Carcinoma, Medullary/epidemiology , Carcinoma, Medullary/pathology , Carcinoma, Papillary/pathology , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Distribution , Thyroid Neoplasms/pathology , Thyroid Nodule/pathology , Ultrasonography
16.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-525815

ABSTRACT

Objective To evaluate the efficacy and safety of 0.03% tacrolimus ointment for the treatment of atopic dermatitis (AD) in Chinese children. Methods A total of 139 children, 2 to17 years of age, with moderate to severe AD from 5 study centres were enrolled in this multicentre, randomized, double-blind, vehicle-controlled, parallel group study. Treatment with 0.03% tacrolimus ointment or vehicle was applied twice daily to the affected areas for 3 weeks. Visits were scheduled on day 1 (base line, before treatment) and 1, 2, 3 weeks after the treatment. The main therapeutic parameter was the efficacy rate at the end of the treatment. Results The efficacy rates were 84.6% and 29.0% for tacrolimus group and vehicle group, respectively (P

17.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-410948

ABSTRACT

AIM: To study the adverse reactions of hydroxychloroquine (HCQ) in ophthalmology.  METHODS: Thirty-nine patients treated with HCQ for more than six months were performed ophthalmic examinations including some specifie retinal function tests.  RESULTS: There were 3 patients (8%) who presented the visual fields was minified. The visual acuity of one patient was decreased. The cumulative doses of HCQ were more than 100 g in this three patients.  CONCLUSION: The adverse reactions of HCQ in ophthalmology are related with the cumulative doses of HCQ. The expression is that the visual fields and visual acuity are decreased.

18.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-518670

ABSTRACT

Objective To explore whether the Kang Kefei and Tian Runmei′s diagnostic criteria (K-T criteria) is suitable for atopic dermatitis(AD). Methods 917 AD patients, whose diagnosis had been made with the Hanifin and Rajka criteria (H-R criteria) previously, were redignosed by K-T criteria. Their atopic history, and clinical fealures were analysed, too. Results 888 out of 917 patients(96.84%) were consistent with K-T criteria.763 patients (83.21%) had personal or family atopic history. The frequency of facial dermatitis was higher in infantile AD group than that in childhood AD group, adolescence AD group, and adult group. Whereas,the frequency of xerosis,ichthyosis,keratosis pilaris and orbital darkening was lower in infantile AD group than those in other groups. Conclusion Atopic history is an important factor in the diagnosisof AD. K-T criteria is practical and of value in the diagnosis of AD.

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