Objective This study was designed to evaluate the prevalence of thyroid nodules（TNs） and its relationship with urine iodine concentrations（UICs） after the regional rapid economic growth and lifestyle changes. Meth...Objective This study was designed to evaluate the prevalence of thyroid nodules（TNs） and its relationship with urine iodine concentrations（UICs） after the regional rapid economic growth and lifestyle changes. Methods A cross-sectional survey was conducted in the general population aged 15-69 years. A questionnaire regarding general and personal characteristics and relevant information was administered. Ultrasonography of the thyroid was performed, and serum triiodothyronine（T3）, tetraiodothyronine（T4）, serum thyroid stimulating hormone（TSH）, free triiodothyronine（FT3）, free tetraiodothyronine（FT4）, thyroglobulin antibody（Tg Ab）, thyroid peroxidase antibody（TPOAb）, and TSH receptor antibody（TRAb） levels were measured for each individual subject. Results The prevalence rates of TNs in the whole population, females and males were 27.76%, 34.04%, and 21.60%, respectively. The prevalence of multiple nodules increased with age, whereas the prevalence peaks differed between males and females. The median UICs in the whole population and females with non-TNs were higher than those of subjects with TNs（P=0.0035, P=0.0068）. The median UICs in subjects with a single TN were higher than those in subjects with multiple TNs（P=0.0164, P=0.0127）. The result showed a U-shaped curve relationship between UIC and prevalence of TNs. The prevalence of TNs was the lowest when the UIC was 140-400 μg/L. Conclusion The prevalence of TNs was nearly 30% and increased with age. The relationship between UIC and prevalence of TNs is U-shaped, with an increase in risk when the UIC was 〈140 μg/L and 〉400 μg/L. Very low or high UIC levels need attention and correction.展开更多
Xanthogranulomatous cholecystitis(XGC) is an uncommon variant of chronic cholecystitis characterized by xanthogranulomatous inflammation of the gallbladder. Intramural accumulation of lipid-laden macrophages and acute...Xanthogranulomatous cholecystitis(XGC) is an uncommon variant of chronic cholecystitis characterized by xanthogranulomatous inflammation of the gallbladder. Intramural accumulation of lipid-laden macrophages and acute and chronic inflammatory cells is the hallmark of the disease. The xanthogranulomatous inflammation of the gallbladder can be very severe and can spill over to the neighbouring structures like liver, bowel and stomach resulting in dense adhesions, perforation, abscess formation, fistulous communication with adjacent bowel. Striking gallbladder wall thickening and dense local adhesions can be easily mistaken for carcinoma of the gallbladder, both intraoperatively as well as on preoperative imaging. Besides, cases of concomitant gallbladder carcinoma complicating XGC have also been reported in literature. So, we have done a review of the imaging features of XGC in order to better understand the entity as well as to increase the diagnostic yield of the disease summarizing the characteristic imaging findings and associations of XGC. Among other findings, presence of intramural hypodense nodules is considered diagnostic of this entity. However, in some cases, an imaging diagnosis of XGC is virtually impossible. Fine needle aspiration cytology might be handy in such patients. A preoperative counselling should include possibility of differential diagnosis of gallbladder cancer in not so characteristic cases.展开更多
Objective： To compare the enhancement features of dysplastic nodnles with a focus of hepatocellular carcinoma （DN-HCC） versus HCC and regenerative nodules （RN） in cirrhotic patients. Methods： One hundred and nin...Objective： To compare the enhancement features of dysplastic nodnles with a focus of hepatocellular carcinoma （DN-HCC） versus HCC and regenerative nodules （RN） in cirrhotic patients. Methods： One hundred and ninety-three cirrhotic patients were enrolled in this study; they had 215 focal liver lesions, 1.0-3.5 cm in size, which were examined using contrast-enhanced ultrasound （CEUS） with SonoVue and diagnosed as HCC, RN or DN-HCC by biopsy. Samples were obtained using 18-gauge needles in the different enhanced areas. The enhancement features of DN-HCC, HCC and RN were evaluated. Results： There were 86 HCC lesions, 102 RN lesions, and 27 DN-HCC lesions diagnosed by biopsy. Of 86 HCC lesions, 87.2% （75/86） showed complete enhancement during the arterial phase, and 12.8% （11/86） had inhomogeneous enhancement, with no enhancement in the central area during the arterial phase; 100% （86/86） exhibited washout during the late phase. Of 102 RN lesions, 95.1% （97/102） had delayed or simultaneous enhancement during the arterial phase, and 4.9% （5/102） displayed slight enhancement during the arterial phase; 26.5% （27/102） exhibited washout and 73.5% （75/102） exhibited no washout during the late phase. In 27 DN-HCC lesions, only part of the lesions enhanced during the arterial phase and washed out during the late phase; the other areas had delayed or simultaneous enhancement during the arterial phase, and 29.6% （8/27） exhibited slight washout in the late phase. In 86 HCCs, the pathological feature was HCC in the enhanced area of 75 lesions, hepatocellular fatty degeneration in the slightly enhanced area of 7 lesions, and hepatocellular necrosis in the unenhanced area and HCC in the enhanced area of 4 lesions. In 102 RNs, the pathological diagnosis was hepatocyte proliferation with or without fatty degeneration. In 27 DN-HCCs, the pathological feature was HCC in the enhanced area and hepatocye regeneration in the unenhanced area. Conclusions： CEUS is useful for the diagnosis o展开更多
Viral-mediated gene transfer of thymidine kinase ofherpes simplex virus (HSV-tk) has been used to confercytotoxic sensitivity to ganciclovir (GCV) in a variety oftnmor cells. HSV-tk converts GCV into a phosphorylatedc...Viral-mediated gene transfer of thymidine kinase ofherpes simplex virus (HSV-tk) has been used to confercytotoxic sensitivity to ganciclovir (GCV) in a variety oftnmor cells. HSV-tk converts GCV into a phosphorylatedcompound which is toxic for dividing cells by blockingDNA synthesis. Our previous study has shown展开更多
Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic...Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP inde展开更多
基金supported by Shanghai Municipal health Bureau(number 20134332)the research grants of the Shanghai Municipal Bureau of Health(number 20134053)+3 种基金Health Fields Specific Research Grant(201202012)the Major Project of Shanghai Municipal Science and Technology Commission(11DJ1400202)the four grants from Key Discipline of Shanghai Public Health-Food and Nutrition Sciences(12GWZX0702)Shanghai Rising-Star Program(15YF1411100)
文摘Objective This study was designed to evaluate the prevalence of thyroid nodules（TNs） and its relationship with urine iodine concentrations（UICs） after the regional rapid economic growth and lifestyle changes. Methods A cross-sectional survey was conducted in the general population aged 15-69 years. A questionnaire regarding general and personal characteristics and relevant information was administered. Ultrasonography of the thyroid was performed, and serum triiodothyronine（T3）, tetraiodothyronine（T4）, serum thyroid stimulating hormone（TSH）, free triiodothyronine（FT3）, free tetraiodothyronine（FT4）, thyroglobulin antibody（Tg Ab）, thyroid peroxidase antibody（TPOAb）, and TSH receptor antibody（TRAb） levels were measured for each individual subject. Results The prevalence rates of TNs in the whole population, females and males were 27.76%, 34.04%, and 21.60%, respectively. The prevalence of multiple nodules increased with age, whereas the prevalence peaks differed between males and females. The median UICs in the whole population and females with non-TNs were higher than those of subjects with TNs（P=0.0035, P=0.0068）. The median UICs in subjects with a single TN were higher than those in subjects with multiple TNs（P=0.0164, P=0.0127）. The result showed a U-shaped curve relationship between UIC and prevalence of TNs. The prevalence of TNs was the lowest when the UIC was 140-400 μg/L. Conclusion The prevalence of TNs was nearly 30% and increased with age. The relationship between UIC and prevalence of TNs is U-shaped, with an increase in risk when the UIC was 〈140 μg/L and 〉400 μg/L. Very low or high UIC levels need attention and correction.
文摘Xanthogranulomatous cholecystitis(XGC) is an uncommon variant of chronic cholecystitis characterized by xanthogranulomatous inflammation of the gallbladder. Intramural accumulation of lipid-laden macrophages and acute and chronic inflammatory cells is the hallmark of the disease. The xanthogranulomatous inflammation of the gallbladder can be very severe and can spill over to the neighbouring structures like liver, bowel and stomach resulting in dense adhesions, perforation, abscess formation, fistulous communication with adjacent bowel. Striking gallbladder wall thickening and dense local adhesions can be easily mistaken for carcinoma of the gallbladder, both intraoperatively as well as on preoperative imaging. Besides, cases of concomitant gallbladder carcinoma complicating XGC have also been reported in literature. So, we have done a review of the imaging features of XGC in order to better understand the entity as well as to increase the diagnostic yield of the disease summarizing the characteristic imaging findings and associations of XGC. Among other findings, presence of intramural hypodense nodules is considered diagnostic of this entity. However, in some cases, an imaging diagnosis of XGC is virtually impossible. Fine needle aspiration cytology might be handy in such patients. A preoperative counselling should include possibility of differential diagnosis of gallbladder cancer in not so characteristic cases.
基金supported by the National Natural Science Foundation of China (No. 81471768)Training Program of the Health Research Plan of the Capital Citizens of Beijing Municipal Science & Technology Commission (No. Z111107067311026)
文摘Objective： To compare the enhancement features of dysplastic nodnles with a focus of hepatocellular carcinoma （DN-HCC） versus HCC and regenerative nodules （RN） in cirrhotic patients. Methods： One hundred and ninety-three cirrhotic patients were enrolled in this study; they had 215 focal liver lesions, 1.0-3.5 cm in size, which were examined using contrast-enhanced ultrasound （CEUS） with SonoVue and diagnosed as HCC, RN or DN-HCC by biopsy. Samples were obtained using 18-gauge needles in the different enhanced areas. The enhancement features of DN-HCC, HCC and RN were evaluated. Results： There were 86 HCC lesions, 102 RN lesions, and 27 DN-HCC lesions diagnosed by biopsy. Of 86 HCC lesions, 87.2% （75/86） showed complete enhancement during the arterial phase, and 12.8% （11/86） had inhomogeneous enhancement, with no enhancement in the central area during the arterial phase; 100% （86/86） exhibited washout during the late phase. Of 102 RN lesions, 95.1% （97/102） had delayed or simultaneous enhancement during the arterial phase, and 4.9% （5/102） displayed slight enhancement during the arterial phase; 26.5% （27/102） exhibited washout and 73.5% （75/102） exhibited no washout during the late phase. In 27 DN-HCC lesions, only part of the lesions enhanced during the arterial phase and washed out during the late phase; the other areas had delayed or simultaneous enhancement during the arterial phase, and 29.6% （8/27） exhibited slight washout in the late phase. In 86 HCCs, the pathological feature was HCC in the enhanced area of 75 lesions, hepatocellular fatty degeneration in the slightly enhanced area of 7 lesions, and hepatocellular necrosis in the unenhanced area and HCC in the enhanced area of 4 lesions. In 102 RNs, the pathological diagnosis was hepatocyte proliferation with or without fatty degeneration. In 27 DN-HCCs, the pathological feature was HCC in the enhanced area and hepatocye regeneration in the unenhanced area. Conclusions： CEUS is useful for the diagnosis o
文摘Viral-mediated gene transfer of thymidine kinase ofherpes simplex virus (HSV-tk) has been used to confercytotoxic sensitivity to ganciclovir (GCV) in a variety oftnmor cells. HSV-tk converts GCV into a phosphorylatedcompound which is toxic for dividing cells by blockingDNA synthesis. Our previous study has shown
文摘Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP inde
