Using a CT-based scale to evaluate disease extension and the resectability of locally advanced thyroid cancer.

OBJECTIVES: To establish a computed tomography (CT)-based scale to evaluate the resectability of locally advanced thyroid cancer. METHODS: This twin-centre retrospective study included 95 locally advanced thyroid cancer patients from the 1st centre as the training cohort and 31 patients from the 2nd centre as the testing cohort, who were categorised into the resectable and unresectable groups. Three radiologists scored the CT scans of each patient by evaluating the extension to the recurrent laryngeal nerve (RLN), trachea, oesophagus, artery, vein, soft tissue, and larynx. A 14-score scale (including all comprised structures) and a 12-score scale (excluding larynx) were developed. Receiver-operating characteristic (ROC) analysis was used to evaluate the performance of the scales. Stratified fivefold cross-validation and external verification were used to validate the scale. RESULTS: In the training cohort, compromised RLN (p < 0.001), trachea (p = 0.001), oesophagus (p = 0.002), artery (p < 0.001), vein (p = 0.005), and soft tissue (p < 0.001) were predictors for unresectability, while compromised larynx (p = 0.283) was not. The 12-score scale (AUC = 0.882, 95%CI: 0.812-0.952) was not inferior to the 14-score scale (AUC = 0.891, 95%CI: 0.823-0.960). In subgroup analysis, the AUCs of the 12-score scale were 0.826 for treatment-naïve patients and 0.976 for patients with prior surgery. The 12-score scale was further validated with a fivefold cross-validation analysis, with an overall accuracy of 78.9-89.4%. Finally, external validation using the testing cohort showed an AUC of 0.875. CONCLUSIONS: The researchers built a CT-based 12-score scale to evaluate the resectability of locally advanced thyroid cancer. Validation with a larger sample size is required to confirm the efficacy of the scale. CLINICAL RELEVANCE STATEMENT: This 12-score CT scale would help clinicians evaluate the resectability of locally advanced thyroid cancer. KEY POINTS: • The researchers built a 12-score CT scale (including recurrent laryngeal nerve, trachea, oesophagus, artery, vein, and soft tissue) to evaluate the resectability of locally advanced thyroid cancer. • This scale has the potential to help clinicians make treatment plans for locally advanced thyroid cancer.

[Clinical observation on cake-separated mild-warm moxibustion for treatment of knee osteoarthritis].

OBJECTIVE: To observe clinical therapeutic effect of monkshood cake-separated mild-warm moxibustion at Zusanli (ST 36) and Xiyan (EX-LE 5) on knee osteoarthritis. METHODS: The patients of monkshood cake-separated mild-warm moxibustion group were treated with monkshood cake-separated mild-warm moxibustion at Dubi (ST 35), Zusanli (ST 36) and Neixiyan (EX-LE 4) on the affected side, and the medication group with oral administration of Xianling Gubao Capsules. After treatment for 4 weeks, VAS and index of severity of osteoarthritis (ISOA scale) were used for assessment of clinical therapeutic effect. RESULTS: After treatment, the arthralgia and the index of severity significantly improved in the two groups (P < 0.01), and the analgesic effect and improvement of ISOA in the monkshood cake-separated mild-warm moxibustion group were better than those in the medication group (P < 0.05). The basic clinical cured rate was 80.0% and the effect-producing time was (10.91 +/- 4.17) days in the monkshood cake-separated mild-warm moxibustion group, and 53.3% and (12.28 +/- 4.60) days in the medication group, respectively, with a significant difference between the two groups (P < 0.05). CONCLUSION: Therapeutic effect of monkshood cake-separated mild-warm moxibustion on knee osteoarthritis is better than that of oral administration of Xianling Gubao Capsules.

[Clinical observation on treatment of rheumatoid arthritis with cake-separated mild moxibustion combined with Western medicine].

OBJECTIVE: To observe the effect-increasing action of cake-separated mild moxibustion on rheumatoid arthritis (RA), and to probe a new method for RA. METHODS: Sixty cases were randomly divided into 2 groups. The control group (n=30) were treated with oral administration of methotrexate (MTX) as basic treatment, and non-steroid anti-inflammatory agents (NSAIDs) according to conditions of the patient. The treatment group (n=30) were treated with the same treatment as the control group, and Fuzi case-separated moxibustion at Guanyuan (CV 4) and Zusanli (ST 36) was added. They were treated for 3 months. RESULTS: After treatment of 3 months, the total effective rate was 83.3% in the treatment group, which was higher than 60.0% in the control group (P < 0.05); there were significant differences before and after treatment in all indexes in the two groups (P < 0.05 or P < 0.01); the ratio of the patients who completely withdrew NSAIDs in the treatment group was significantly higher than that in the control group (P < 0.05); the rate of adverse reaction in the treatment group was significantly lower than that in the control group (P < 0.05). CONCLUSION: Fuzi cake-separated mild moxibustion can increase clinical therapeutic effect on RA and reduce dosage of NSAIDs.