Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan ...Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan Hospital of Wuhan University (January 2022 to January 2024) analysed thyroid tumor characteristics using B-mode ultrasound, colour Doppler imaging, and CEUS post-RFA. Thyroid hormone levels were also assessed before RFA and at 1, 3, and 6 months after the procedure. Results: The study involved 72 patients with benign thyroid nodules, comprising 13 males and 59 females, with a mean age of 45.8 ± 12.1 years. Complete inactivation was achieved in 70.8% of nodules, while 29.2% showed partial inactivation. Nodules with complete inactivation exhibited more calcification (p = 0.040), whereas those with partial inactivation demonstrated higher vascularity (p Conclusion: In conclusion, this study found that therapeutic RFA effectively achieves high rates of complete inactivation in benign thyroid nodules, with the degree of inactivation mainly influenced by nodule vascularity and calcifications.展开更多
BACKGROUND Hydrodissection is a widely used technique during radiofrequency ablation(RFA)for benign thyroid nodules.Although it could effectively avoid thermal injury to the surrounding critical structures and achieve...BACKGROUND Hydrodissection is a widely used technique during radiofrequency ablation(RFA)for benign thyroid nodules.Although it could effectively avoid thermal injury to the surrounding critical structures and achieve complete treatment,routine operation of the remaining needle could cause perithyroidal hemorrhage.In this report,we present 2 cases of perithyroidal hemorrhage during RFA caused by a hydrodissection needle,which have not been reported before.CASE SUMMARY A 21-year-old female and a 45-year-old male were admitted for RFA for benign thyroid nodules.Considering that their nodules were adjacent to the recurrent laryngeal nerve,the needle used for hydrodissection was placed and remained between the dorsal capsule of the lateral lobe and the recurrent laryngeal nerve.During the procedure,active bleeding near the needle appeared on ultrasonography(US).Although moderate pressure was quickly applied to the neck for several minutes,contrast-enhanced US(CEUS)still showed an active hemorrhage.A radiofrequency electrode was placed at the bleeding point under the guidance of CEUS to stop the bleeding,and the procedure was finally confirmed to be successful by CEUS,without other complications.CONCLUSION Hydrodissection during RFA of benign thyroid nodules was associated with a risk of perithyroidal hemorrhage.The timely recognition of this acute hemorrhage could help in the timely control of the bleeding,and CEUS-guided ablation of the bleeding point could be useful.展开更多
Objective: to explore the effect of using quality nursing concept during peritreatment of patients with benign thyroid disease. Methods: the study was conducted from October 2019 to October 2020, and the study subject...Objective: to explore the effect of using quality nursing concept during peritreatment of patients with benign thyroid disease. Methods: the study was conducted from October 2019 to October 2020, and the study subjects selected patients with benign thyroid disease and required thoracectomy. The total number of study cases was 60.Before the formal study, with the consent of the study subjects and their family members, the above 60 study subjects were randomly divided into the two research groups, among which the routine care group was called the control group, and the quality care group during perisurgery was known as the observation group. Comparative analysis of the effects of the two groups under different modes of care was conducted. Results: the time of surgery, intraoperative bleeding, incision flow and hospital time in the perioperative care with quality care were better than the control group, and the difference between groups was large, and the obtained P-value was lower than 0.05.Patients in the observation group had higher quality of life scores in all dimensions after intervention compared with the control group, and showed large differences between groups, and the obtained P-value was lower than 0.05.The comparison of pain scores at admission was quite different, and the P-value was higher than 0.05. After perinatal care, both patients were lower, but the observation group was significantly lower than the control group, and the difference was large, and the P-value was lower than 0.05.The observation group had more satisfaction with the care services they had received than in the control group, and the comparison between the groups varied greatly, and the obtained P-value was lower than 0.05.Conclusion: in the implementation of thoracoscopic resection of benign thyroid disease patients with perioperative nursing reference high quality nursing concept is of important significance, can not only to ensure the smooth operation, optimize the surgical index, but also can enhance the prognostic effect, promote patient recovery speed, is worth actively quoted in clinical practice.展开更多
Objective: to explore the treatment of benign thyroid tumors. Methods: the patients in our hospital were selected to compare the therapeutic effects of modified Miccoli operation through isthmus approach and upper lat...Objective: to explore the treatment of benign thyroid tumors. Methods: the patients in our hospital were selected to compare the therapeutic effects of modified Miccoli operation through isthmus approach and upper lateral approach. Results: the patients in the observation group had better drainage volume, operation time, thyroid function, and fewer complications (P < 0.05). There was little difference in hospitalization time and thyroid function before treatment between the two groups (P > 0.05). Conclusion: the upper isthmus approach modified Miccoli operation can improve the therapeutic effect and has high safety in patients with benign thyroid tumor.展开更多
Objective: to compare the clinical value of endoscopic assisted small cervical incision surgery and traditional thyroid surgery in the treatment of thyroid benign tumors. Methods: a total of 100 patients who were admi...Objective: to compare the clinical value of endoscopic assisted small cervical incision surgery and traditional thyroid surgery in the treatment of thyroid benign tumors. Methods: a total of 100 patients who were admitted to our hospital from January 2017 to March 2020 were randomly divided into observation group (endoscopic assisted small incision surgery in the neck) and control group (traditional thyroid surgery), 50 cases in each group. Results: in the observation group, the satisfaction rate of incision scar (94%) was high, and the complication rate (8%) was low (P < 0.05). In addition, the scores of VAS, VRS and PPI after operation in the observation group were all lower (P < 0.05). Conclusion: endoscopic-assisted cervical small incision surgery for benign thyroid tumors is more effective.展开更多
Subcutaneous implantation of benign thyroid tissue is a rare complication of thyroid surgery. Here the authors report two cases of subcutaneous implantation of benign thyroid tissue following conventional thyroid surg...Subcutaneous implantation of benign thyroid tissue is a rare complication of thyroid surgery. Here the authors report two cases of subcutaneous implantation of benign thyroid tissue following conventional thyroid surgery. The diagnosis and differential diagnosis of cervical subcutaneous thyroid tissue implantation, and their clinical pathological characteristics are retrospectively investigated. The mechanism of the implantation process is analyzed. The management of patient with cervical subcutaneous soft tissue implantation is also discussed.展开更多
Objective: to analyze the diagnostic value of ultrasonography in benign and malignant thyroid lesions. Methods: retrospective analysis was performed on 70 patients with pathologically confirmed thyroid lesions admitte...Objective: to analyze the diagnostic value of ultrasonography in benign and malignant thyroid lesions. Methods: retrospective analysis was performed on 70 patients with pathologically confirmed thyroid lesions admitted to our hospital from March 2019 to March 2020. According to the benign and malignant lesions, they were divided into benign group (n = 38) and malignant group (n = 32). Ultrasound examination was performed on all patients, and ultrasound signs, blood flow signals and hemodynamic indexes of patients in both groups were observed. Results: the ultrasonographic signs of malignant group were as follows: very low echo, blurred boundary and irregular lesion. Benign group: usually hyperechoic, its boundary is clear, the lesion is regular. The incidence of grade III blood signals in the malignant group was higher than that in the benign group and the incidence of grade I signals in the benign group was higher than that in the malignant group. Meanwhile, the peak systolic and end-diastolic blood flow velocity in the malignant group were also higher than that in the benign group, respectively, with statistical significance (P < 0.05). Conclusion: ultrasound has a good application effect in the diagnosis of benign and malignant thyroid lesions, and its ratio of blood flow signal level and hemodynamic indexes are significantly different, which is worth popularizing.展开更多
Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapie...Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapies. Methods A systematic search of literature from the PubMed database was conducted for identifying eligible studies on implantation of thyroid hyperplastic or neoplastic cells after endoscopic thyroid surgery. Results Overall, 5 reported cases on patients suffering from endoscopic thyroid surgery with implantation of thyroid hyperplastic or neoplastic cells were included in the systematic review. Conclusions Unskilled surgeons, rough intraoperative surgical treatment, scarification or rupture of tumor, contamination of instruments, chimney effect, aerosolization of tumor cells may be associated with the implantation after endoscopic thyroidectomy. To minimize the risk of such complication, we should be more meticulous and strict the endoscopic surgery indications.展开更多
Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this stu...Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.展开更多
文摘Objective: To assess the predictors of successful inactivation of benign thyroid nodules using radiofrequency ablation (RFA) and the hormonal responses thereafter. Methods: A retrospective study conducted at Zhongnan Hospital of Wuhan University (January 2022 to January 2024) analysed thyroid tumor characteristics using B-mode ultrasound, colour Doppler imaging, and CEUS post-RFA. Thyroid hormone levels were also assessed before RFA and at 1, 3, and 6 months after the procedure. Results: The study involved 72 patients with benign thyroid nodules, comprising 13 males and 59 females, with a mean age of 45.8 ± 12.1 years. Complete inactivation was achieved in 70.8% of nodules, while 29.2% showed partial inactivation. Nodules with complete inactivation exhibited more calcification (p = 0.040), whereas those with partial inactivation demonstrated higher vascularity (p Conclusion: In conclusion, this study found that therapeutic RFA effectively achieves high rates of complete inactivation in benign thyroid nodules, with the degree of inactivation mainly influenced by nodule vascularity and calcifications.
文摘BACKGROUND Hydrodissection is a widely used technique during radiofrequency ablation(RFA)for benign thyroid nodules.Although it could effectively avoid thermal injury to the surrounding critical structures and achieve complete treatment,routine operation of the remaining needle could cause perithyroidal hemorrhage.In this report,we present 2 cases of perithyroidal hemorrhage during RFA caused by a hydrodissection needle,which have not been reported before.CASE SUMMARY A 21-year-old female and a 45-year-old male were admitted for RFA for benign thyroid nodules.Considering that their nodules were adjacent to the recurrent laryngeal nerve,the needle used for hydrodissection was placed and remained between the dorsal capsule of the lateral lobe and the recurrent laryngeal nerve.During the procedure,active bleeding near the needle appeared on ultrasonography(US).Although moderate pressure was quickly applied to the neck for several minutes,contrast-enhanced US(CEUS)still showed an active hemorrhage.A radiofrequency electrode was placed at the bleeding point under the guidance of CEUS to stop the bleeding,and the procedure was finally confirmed to be successful by CEUS,without other complications.CONCLUSION Hydrodissection during RFA of benign thyroid nodules was associated with a risk of perithyroidal hemorrhage.The timely recognition of this acute hemorrhage could help in the timely control of the bleeding,and CEUS-guided ablation of the bleeding point could be useful.
文摘Objective: to explore the effect of using quality nursing concept during peritreatment of patients with benign thyroid disease. Methods: the study was conducted from October 2019 to October 2020, and the study subjects selected patients with benign thyroid disease and required thoracectomy. The total number of study cases was 60.Before the formal study, with the consent of the study subjects and their family members, the above 60 study subjects were randomly divided into the two research groups, among which the routine care group was called the control group, and the quality care group during perisurgery was known as the observation group. Comparative analysis of the effects of the two groups under different modes of care was conducted. Results: the time of surgery, intraoperative bleeding, incision flow and hospital time in the perioperative care with quality care were better than the control group, and the difference between groups was large, and the obtained P-value was lower than 0.05.Patients in the observation group had higher quality of life scores in all dimensions after intervention compared with the control group, and showed large differences between groups, and the obtained P-value was lower than 0.05.The comparison of pain scores at admission was quite different, and the P-value was higher than 0.05. After perinatal care, both patients were lower, but the observation group was significantly lower than the control group, and the difference was large, and the P-value was lower than 0.05.The observation group had more satisfaction with the care services they had received than in the control group, and the comparison between the groups varied greatly, and the obtained P-value was lower than 0.05.Conclusion: in the implementation of thoracoscopic resection of benign thyroid disease patients with perioperative nursing reference high quality nursing concept is of important significance, can not only to ensure the smooth operation, optimize the surgical index, but also can enhance the prognostic effect, promote patient recovery speed, is worth actively quoted in clinical practice.
文摘Objective: to explore the treatment of benign thyroid tumors. Methods: the patients in our hospital were selected to compare the therapeutic effects of modified Miccoli operation through isthmus approach and upper lateral approach. Results: the patients in the observation group had better drainage volume, operation time, thyroid function, and fewer complications (P < 0.05). There was little difference in hospitalization time and thyroid function before treatment between the two groups (P > 0.05). Conclusion: the upper isthmus approach modified Miccoli operation can improve the therapeutic effect and has high safety in patients with benign thyroid tumor.
文摘Objective: to compare the clinical value of endoscopic assisted small cervical incision surgery and traditional thyroid surgery in the treatment of thyroid benign tumors. Methods: a total of 100 patients who were admitted to our hospital from January 2017 to March 2020 were randomly divided into observation group (endoscopic assisted small incision surgery in the neck) and control group (traditional thyroid surgery), 50 cases in each group. Results: in the observation group, the satisfaction rate of incision scar (94%) was high, and the complication rate (8%) was low (P < 0.05). In addition, the scores of VAS, VRS and PPI after operation in the observation group were all lower (P < 0.05). Conclusion: endoscopic-assisted cervical small incision surgery for benign thyroid tumors is more effective.
文摘Subcutaneous implantation of benign thyroid tissue is a rare complication of thyroid surgery. Here the authors report two cases of subcutaneous implantation of benign thyroid tissue following conventional thyroid surgery. The diagnosis and differential diagnosis of cervical subcutaneous thyroid tissue implantation, and their clinical pathological characteristics are retrospectively investigated. The mechanism of the implantation process is analyzed. The management of patient with cervical subcutaneous soft tissue implantation is also discussed.
文摘Objective: to analyze the diagnostic value of ultrasonography in benign and malignant thyroid lesions. Methods: retrospective analysis was performed on 70 patients with pathologically confirmed thyroid lesions admitted to our hospital from March 2019 to March 2020. According to the benign and malignant lesions, they were divided into benign group (n = 38) and malignant group (n = 32). Ultrasound examination was performed on all patients, and ultrasound signs, blood flow signals and hemodynamic indexes of patients in both groups were observed. Results: the ultrasonographic signs of malignant group were as follows: very low echo, blurred boundary and irregular lesion. Benign group: usually hyperechoic, its boundary is clear, the lesion is regular. The incidence of grade III blood signals in the malignant group was higher than that in the benign group and the incidence of grade I signals in the benign group was higher than that in the malignant group. Meanwhile, the peak systolic and end-diastolic blood flow velocity in the malignant group were also higher than that in the benign group, respectively, with statistical significance (P < 0.05). Conclusion: ultrasound has a good application effect in the diagnosis of benign and malignant thyroid lesions, and its ratio of blood flow signal level and hemodynamic indexes are significantly different, which is worth popularizing.
文摘Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapies. Methods A systematic search of literature from the PubMed database was conducted for identifying eligible studies on implantation of thyroid hyperplastic or neoplastic cells after endoscopic thyroid surgery. Results Overall, 5 reported cases on patients suffering from endoscopic thyroid surgery with implantation of thyroid hyperplastic or neoplastic cells were included in the systematic review. Conclusions Unskilled surgeons, rough intraoperative surgical treatment, scarification or rupture of tumor, contamination of instruments, chimney effect, aerosolization of tumor cells may be associated with the implantation after endoscopic thyroidectomy. To minimize the risk of such complication, we should be more meticulous and strict the endoscopic surgery indications.
基金supported by the National Natural Science Foundation of China(81772850 and 82273300)。
文摘Emerging evidence suggests that microbial dysbiosis plays vital roles in many human cancers.However,knowledge of whether the microbial community in thyroid tumor is related to tumorigenesis remains elusive.In this study,we aimed to explore the microbial community in thyroid tissues and its contribution to papillary thyroid cancer(PTC).In parallel,we performed microbial profiling and transcriptome sequencing in the tumor and adjacent normal tissues of a large cohort of 340 PTC and benign thyroid nodule(BTN)patients.Distinct microbial signatures were identified in PTC,BTN,and their adjacent nontumor tissues.Intra-thyroid tissue bacteria were verified by means of bacteria staining,fluorescence in situ hybridization,and immunoelectron microscopy.We found that 17 bacterial taxa were differentially abundant in PTC compared with BTN,which included enrichment in PTC of the pathobionts Rhodococcus,Neisseria,Streptococcus,Halomonas,and Devosia,and depletion of the beneficial bacteria Amycolatopsis.These differentially abundant bacteria could differentiate PTC tumor tissues(PTC-T)from BTN tissues(BTN-T)with an area under the curve(AUC)of 81.66%.Microbial network analysis showed increased correlation strengths among the bacterial taxa in PTC-T in comparison with BTN-T.Immunefunction-corresponding bacteria(i.e.,Erwinia,Bacillus,and Acinetobacter)were found to be enriched in PTC with Hashimoto’s thyroiditis.Moreover,our integrative analysis revealed that the PTC-enriched bacteria had a positive association with key PTC-oncogenic pathway-related genes,including BRAF,KRAS,IRAK4,CTNNB1,PIK3CA,MAP3K7,and EGFR.In conclusion,our results suggest that intratumor bacteria dysbiosis is associated with the thyroid tumorigenesis and oncogenic signaling pathways of PTC.
