Assessing the relative effectiveness of various ultrasound-guided ablation techniques for treating benign thyroid nodules: A systematic review and network meta-analysis.

BACKGROUND: Benign thyroid nodules (BTNs) represent a prevalent clinical challenge globally, with various ultrasound-guided ablation techniques developed for their management. Despite the availability of these methods, a comprehensive evaluation to identify the most effective technique remains absent. This study endeavors to bridge this knowledge gap through a network meta-analysis (NMA), aiming to enhance the understanding of the comparative effectiveness of different ultrasound-guided ablation methods in treating BTNs. METHODS: We comprehensively searched PubMed, Embase, Cochrane, Web of Science, Ovid, SCOPUS, and ProQuest for studies involving 16 ablation methods, control groups, and head-to-head trials. NMA was utilized to evaluate methods based on the percentage change in nodule volume, symptom score, and cosmetic score. This study is registered in INPLASY (registration number 202260061). RESULTS: Among 35 eligible studies involving 5655 patients, NMA indicated that RFA2 (radiofrequency ablation, 2 sessions) exhibited the best outcomes at 6 months for percentage change in BTN volume (SUCRA value 74.6), closely followed by RFA (SUCRA value 73.7). At 12 months, RFA was identified as the most effective (SUCRA value 81.3). Subgroup analysis showed RFA2 as the most effective for solid nodule volume reduction at 6 months (SUCRA value 75.6), and polidocanol ablation for cystic nodules (SUCRA value 66.5). CONCLUSION: Various ablation methods are effective in treating BTNs, with RFA showing notable advantages. RFA with 2 sessions is particularly optimal for solid BTNs, while polidocanol ablation stands out for cystic nodules.

Prognostic Value of Lymph Node Parameters in Elderly Patients With Stage III Serous Ovarian Cancer Based on Competing Risk Model.

OBJECTIVES: Competing risk models were used in this study. The purpose of this study was to assess the predictive usefulness of lymph node characteristics in elderly patients with stage III serous ovarian cancer. METHODS: We conducted a retrospective analysis on 148,598 patients from 2010 to 2016 using the surveillance, epidemiology, and end results database. Lymph node characteristics were collected and examined, including the number of lymph nodes retrieved the number of lymph nodes examined (ELN) and the number of positive lymph nodes (PN). Using competing risk models, we evaluated the connection between these variables and overall survival (OS) and disease-specific survival (DSS). RESULTS: This study included a total of 3457 ovarian cancer patients. Multivariate analysis using the COX proportional hazards model found that ELN>22 was an independent predictive factor for both OS (hazard ratio [HR] [95% CI]=0.688 [0.553 to 0.856], P <0.05) and DSS (HR [95% CI]=0.65 [0.512 to 0.826], P <0.001), PN>8 was identified as a significant risk factor for both OS (HR [95% CI]=0.908 [0.688 to 1.199], P =0.497) and DSS (HR [95% CI]=0.926 [0.684 to 1.254], P =0.62). Subsequently, using the competing risk model, ELN>22 was found to be an independent protective factor for DSS (HR [95% CI]=0.738 [0.574 to 0.949], P =0.018), while PN>8 was identified as a risk factor for DSS (HR [95% CI]=0.999 [0.731 to 1.366], P =1). CONCLUSIONS: Our findings demonstrate the robustness of the competing risk model to evaluate the results of the COX proportional hazards model analysis.

Ultrasound-guided microwave ablation for benign thyroid nodules results in earlier and faster nodule shrinkage in patients with Hashimoto's thyroiditis than in those with normal thyroid function.

Objectives: Given that the histological features of the thyroid parenchyma in patients with Hashimoto's thyroiditis (HT) differ from those of the normal thyroid gland, HT may affect the effectiveness of ultrasound-guided microwave ablation (MWA) for benign thyroid nodules (BTNs). The present study aimed to compare the effectiveness of MWA for the treatment of BTNs in patients with both BTNs and HT and those with BTNs and normal thyroid function, based on changes in the volume reduction ratio (VRR) of the BTNs. Methods: Patients who had achieved a VRR ≥50% after MWA for BTN (July 2020-June 2021), followed up for 12 months, and their data were retrospectively analyzed. Results: A total of 213 nodules were identified in 185 patients, including 167 in the "BTN" group and 46 in the "BTN + HT" group. A comparison of the fitting curves for VRR-follow-up time revealed that the VRR increased with time after MWA, although the relationship was nonlinear. Piece-wise linear regression model analysis of the threshold effect of VRR and follow-up time in the two groups indicated that the inflection point of the "BTN" group occurred at 2.1 months: VRR increased fastest within 2.1 months of MWA (rate of change: 32.9% per month; P < 0.001), following which the rate of change was slower and maintained at 1.0% per month (P = 0.006). In the "BTN + HT" group, the inflection point occurred 1.5 months after MWA, with the most significant increase occurring in this period (rate of change: 41.5% per month; P < 0.001), followed by a rate of 2.8% per month (P < 0.001) after 1.5 months. Conclusions: The relationship between VRR and follow-up time for ultrasound-guided MWA for BTN is nonlinear and exhibits a threshold effect. The current results indicated that the VRR in both groups increased before and after the inflection point, although the rate of change was greater before than after the inflection point. The inflection point occurs earlier in patients with BTN + HT than in those with BTN yet normal thyroid function, and this difference may be related to the "oven effect" involved in the development of HT.

Effect of Roy's Adaptation, Model-based, Perioperative Nursing Service on Patients: A Clinical Observational Study.

Context: Surgery for early-stage lung carcinoma (LC) is invasive and most patients will experience psychological disorders, such as depression and anxiety. Accumulating evidence has shown that a nursing intervention can exert significant improvements in clinical efficacy for perioperative patients. Objective: The study intended to investigate the clinical value during the perioperative period of a nursing service based on Roy's Adaptation Model (RAM), for patients undergoing radical resection for early-stage LC, to provide accurate guidance and reference for a future clinical nursing intervention for LC patients. Design: The research team designed a retrospective analysis, controlled study. Setting: The study took place at Jiangsu Cancer Hospital in Nanjing, Jiangsu, China. Participants: Participants were 69 patients with early-stage LC who had been admitted to the hospital between March 2018 and March 2020. Intervention: The research team assigned participants to an intervention or a control group, with 42 participants in the intervention group receiving RAM nursing during hospitalization, and 27 participants in the control group receiving routine nursing care. Outcome Measures: The study measured the alterations in pulmonary function (PF) pre- and postoperatively and assessed the incidence of complications postintervention. At baseline and postintervention, the research team also assessed participants' psychological states using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) and their pain levels using a visual analogue scale (VAS). Postintervention, participants competed a nursing satisfaction survey. At baseline and postintervention, the participants completed the Karnofsky Performance Status (KPS) scale for functional status, the Self-Perceived Burden Scale in Cancer Patients (SPBS-CP), the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the WHO-QOL-BREF questionnaire. Results: Postoperatively, the PF indexes had decreased significantly for both groups, but the intervention group's value were significantly higher postoperatively than those in the control group (P < .05). No differences existed in the incidence of adverse reactions between the groups (P > .05). The intervention group had significantly lower SAS and SDS scores, pain scores, and SPBS-CP scores than the control group postintervention but had significantly higher KPS scores (all P < .05). The intervention group significantly higher nursing satisfaction, sleep quality, and quality of life than the control group did (P < .05). Conclusions: RAM nursing can significantly protect the PF of patients with early-stage LC who are undergoing a radical resection and can effectively improve patients' psychological states, sleep quality, and nursing satisfaction, which makes it worthy of clinical reference and popularization.

Profiling of exosomal microRNAs expression in umbilical cord blood from normal and preeclampsia patients.

BACKGROUND: Epidemiological and experimental studies suggest that preeclampsia has a negative impact on maternity and offspring health. Previous studies report that dysregulation in utero-environment increases risk for elderly disease such as cardiovascular disease. However, the underlying mechanisms remain elusive. Specific microRNAs (miRNAs) are packaged in exosomes may regulate microvascular dysfunction in offspring of mothers with preeclampsia. The present study aimed to identify the differential expression profiles of microRNAs in the serum exosomes between patients with preeclampsia and normal pregnancies. METHODS: A comprehensive miRNA sequence-based approach was performed to compare exosomes carry miRNAs (Exo-miRNAs) expression levels in umbilical serum between normal and preeclampsia patients. Exosomes were isolated using the ExoQuick precipitation kit. Serum exosomes were then viewed under electron microscopy, and their characteristics determined by western blotting and nanoparticle-tracking analysis. Illumina platform was used to perform sequencing. Bioinformatics analysis was used to explore differentially expressed Exo-miRNAs in umbilical serum. RESULTS: Based on sequence similarity, 1733 known miRNAs were retrieved. Furthermore, 157 mature miRNAs in serum exosomes were significantly differential expressed between PE and those control groups (P<0.05, log2|FC| > 1). Out, of the 157 miRNAs, 96 were upregulated miRNAs whereas 61 miRNAs were downregulated. The 157 differentially expressed miRNAs targeted 51,424 differentially expressed genes. Functional analysis through KEGG pathway and Gene Ontology results uncovered that target genes of miRNAs with differential expression were significantly linked to several pathways and biological processes. CONCLUSION: The findings of this study showed differential expression of umbilical serum Exo-miRNAs in normal compared with PE patients, implying that these Exo-miRNAs may associate with microvascular dysfunction in offspring of mothers with preeclampsia.

iTRAQ-based quantitative proteomic analysis of thoracic aortas from adult rats born to preeclamptic dams.

BACKGROUND: Preeclampsia and gestational hypertension can cause vascular function impairment in offspring. In our previous work, we described the protein expression profiles of umbilical artery tissues from patients with preeclampsia. METHODS: To gain insights into the mechanisms of vascular dysfunction in adult rats born to preeclamptic dams, we analyzed thoracic aorta tissues by using iTRAQ isobaric tags and 2D nano LC-MS/MS. RESULTS: By using the iTRAQ method, we analyzed 1825 proteins, of which 106 showed significantly different expression in the thoracic aortic. Ingenuity pathway analysis (IPA) showed that the majority of differentially expressed proteins (DEPs) were associated with cardiovascular function. Further analysis indicated that glucose-6-phosphate dehydrogenase (G6PD), which is inhibited by miR-423-5p and activated by TP53, had the strongest effect on cardiovascular function. The expression of G6PD was upregulated in thoracic aorta tissues, as confirmed by Western blotting. The expression of two other vascular function-related proteins, cysteine- and glycine-rich protein 2 (CSRP2) and tubulin alpha-4 A (TUBA4A), was upregulated, as demonstrated by mass spectrometry (MS). CONCLUSIONS: Although the results require further functional validation, these data provide novel findings related to vascular function impairment in the adult offspring of preeclamptic mothers.