To explore the geochemical characteristics and genesis of the elements in ferromanganese nodules from the Northwest Pacific,this study analyses the mineral composition,elemental content,occurrence phase and genetic me...To explore the geochemical characteristics and genesis of the elements in ferromanganese nodules from the Northwest Pacific,this study analyses the mineral composition,elemental content,occurrence phase and genetic mechanisms of samples by X-ray diffraction(XRD),inductively coupled plasma-optical emission spectrometry(ICP-OES),inductively coupled plasma-mass spectrometry(ICP-MS)and phase analysis methods.The results show that ferromanganese nodules are mainly hydrogenetic,and Mn/Fe content ratio ranges from 0.95 to 2.05.The major minerals are vernadite(δ-MnO_(2))and amorphous ferric oxyhydroxide(FeOOH),and the secondary minerals include todorokite,birnessite,quartz and plagioclase.Ferromanganese nodules contain high contents of Co(0.24%-0.42%),Cu(0.23%-0.73%),Ni(0.33%-0.86%)and rare earth elements(REEs,1192-1990μg/g),which have positive Ce and negative Y anomalies but no Eu anomaly.A cluster analysis suggests that the elements in ferromanganese nodules can be divided into three groups:hydrogenetic components,including Fe,Ti,Zr,P,Pb,Co,Ba,Sr,V and REEs;diagenetic components,including Mn,Ni,Mg,Zn and Cu;and detrital components,including Al,Na,K and Ca.According to chemical leaching,ferromanganese nodules can be divided into four phases:Na,Ca,Mg and Sr are mainly enriched in the carbonate phase;Mn,Co,Ni and Ba are mainly enriched in the Mn-oxide phase;Fe,P,Ti,Cu,Pb,V,Zn,Zr and REEs are mainly enriched in the Fe-oxide phase;and Al and K are mainly enriched in the residual phase.A combination of the two different methods reveal selective enrichment of metal elements from seawater by ferromanganese nodules,featuring multisource mineralization.Moreover,through ion exchange and adsorption,approximately 71.2%of REEs are enriched in the Fe-oxide phase,15.4%in the Mn-oxide phase and 12.4%in the residual phase,while REE contents in the carbonate phase are relatively low.In addition,under the oxic conditions of seawater,the oxidation of soluble Ce^(3+)to insoluble CeO_(2)together with Fe-Mn minerals results in Ce enrichment in ferromanganese nodules.This study provides a reference for the metallogenesis of ferromanganese nodules from the Northwest Pacific.展开更多
Thyroid nodules are common,with a prevalence of approximately 70%on thyroid ultrasonography;approximately 5%of these nodules are malignant.Distingui-shing malignant and benign thyroid nodules is critical for clinical ...Thyroid nodules are common,with a prevalence of approximately 70%on thyroid ultrasonography;approximately 5%of these nodules are malignant.Distingui-shing malignant and benign thyroid nodules is critical for clinical management.Clinicians can judiciously select patients for fine-needle aspiration,understand the cytology results and subsequent follow-up,and determine surveillance stra-tegies for non-operated nodules.The challenge in selecting thyroid nodules for fine-needle aspiration is to avoid the diagnosis of small,clinically insignificant cancers without missing more severe diseases.The molecular characteristics of thyroid nodules are critical for their diagnosis and treatment.However,iden-tifying these characteristics is costly and challenging because of unexpected technical difficulties.An imaging association model based on molecular features will bridge the essential link between molecular characteristics and the computed tomography radiomics,then improve diagnostic efficiency,reducing invasive examinations.展开更多
BACKGROUND Accurate preoperative differentiation of benign and malignant thyroid nodules is critical for optimal patient management.However,conventional imaging modalities present inherent diagnostic limitations.AIM T...BACKGROUND Accurate preoperative differentiation of benign and malignant thyroid nodules is critical for optimal patient management.However,conventional imaging modalities present inherent diagnostic limitations.AIM To develop a non-contrast computed tomography-based machine learning model integrating radiomics and clinical features for preoperative thyroid nodule classification.METHODS This multicenter retrospective study enrolled 272 patients with thyroid nodules(376 thyroid lobes)from center A(May 2021-April 2024),using histopathological findings as the reference standard.The dataset was stratified into a training cohort(264 lobes)and an internal validation cohort(112 lobes).Additional prospective temporal(97 lobes,May-August 2024,center A)and external multicenter(81 lobes,center B)test cohorts were incorporated to enhance generalizability.Thyroid lobes were segmented along the isthmus midline,with segmentation reliability confirmed by an intraclass correlation coefficient(≥0.80).Radiomics feature extraction was performed using Pearson correlation analysis followed by least absolute shrinkage and selection operator regression with 10-fold cross-validation.Seven machine learning algorithms were systematically evaluated,with model performance quantified through the area under the receiver operating characteristic curve(AUC),Brier score,decision curve analysis,and DeLong test for comparison with radiologists interpretations.Model interpretability was elucidated using SHapley Additive exPlanations(SHAP).RESULTS The extreme gradient boosting model demonstrated robust diagnostic performance across all datasets,achieving AUCs of 0.899[95%confidence interval(CI):0.845-0.932]in the training cohort,0.803(95%CI:0.715-0.890)in internal validation,0.855(95%CI:0.775-0.935)in temporal testing,and 0.802(95%CI:0.664-0.939)in external testing.These results were significantly superior to radiologists assessments(AUCs:0.596,0.529,0.558,and 0.538,respectively;P<0.001 by DeLong test).SHAP analysis identified radiomic score,age,tumor size stratification,calcification status,and cystic components as key predictive features.The model exhibited excellent calibration(Brier scores:0.125-0.144)and provided significant clinical net benefit at decision thresholds exceeding 20%,as evidenced by decision curve analysis.CONCLUSION The non-contrast computed tomography-based radiomics-clinical fusion model enables robust preoperative thyroid nodule classification,with SHAP-driven interpretability enhancing its clinical applicability for personalized decision-making.展开更多
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
Polymetallic nodules,hereinafter referred to as PN,enriched with Co,Ni,Mn,and Cu,are likely to be commercially mined in the near future.These metals in PN are potential strategic alternatives for the world’s energy t...Polymetallic nodules,hereinafter referred to as PN,enriched with Co,Ni,Mn,and Cu,are likely to be commercially mined in the near future.These metals in PN are potential strategic alternatives for the world’s energy transition.Therefore,intensive studies are necessary on the spatial distribution patterns of PN in the deep sea.In this study,the distribution probabilities of PN in the Pacific,Indian and Atlantic oceans were estimated based on binary logistic regression of PN occurrence with ore-controlling factors including water depth(WD),marine sediment thickness(SedTh),Calcium carbonate(CaCO_(3))concentrations in surface sediments,primary productivity(PP),near bottom current velocities(BC).Furthermore,the distribution probability of PN was constrained by seafloor ages and PN sites,and subsequently,the prospects for nodules in the Pacific,Indian and Atlantic oceans were obtained.The results indicate that the low-latitude Pacific region(30°N-30°S),particularly the Clarion-Clipperton Zone and the Penrhyn Basin,is the most promising area for PN exploration.展开更多
Objective:To explore the effectiveness of multi-modal teaching based on an online case library in the education of gene methylation combined with spiral computed tomography(CT)screening for pulmonary ground-glass opac...Objective:To explore the effectiveness of multi-modal teaching based on an online case library in the education of gene methylation combined with spiral computed tomography(CT)screening for pulmonary ground-glass opacity(GGO)nodules.Methods:From October 2023 to April 2024,66 medical imaging students were selected and randomly divided into a control group and an observation group,each with 33 students.The control group received traditional lecture-based teaching,while the observation group was taught using a multi-modal teaching approach based on an online case library.Performance on assessments and teaching quality were analyzed between the two groups.Results:The observation group achieved higher scores in theoretical and practical knowledge compared to the control group(P<0.05).Additionally,the teaching quality scores were significantly higher in the observation group(P<0.05).Conclusion:Implementing multi-modal teaching based on an online case library for pulmonary GGO nodule screening with gene methylation combined with spiral CT can enhance students’knowledge acquisition,improve teaching quality,and have significant clinical application value.展开更多
OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical ...OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.展开更多
Objective:To investigate the application of experience-based and Magnetic Resonance Imaging(MRI)radiomics in differentiating benign and malignant pulmonary nodules and masses.Methods:Sixty patients with pulmonary nodu...Objective:To investigate the application of experience-based and Magnetic Resonance Imaging(MRI)radiomics in differentiating benign and malignant pulmonary nodules and masses.Methods:Sixty patients with pulmonary nodules or masses admitted from April 2024 to April 2025 were selected as study subjects.Surgical pathology was used as the gold standard to explore the differential diagnostic value of experience-based and MRI radiomics.Results:Twenty one MRI radiomic features were selected for screening,with 14 features removed and 7 remaining for normality testing.Using surgical pathology as the gold standard,among the 60 patients,36 were benign and 24 were malignant,with detection rates of 60.00%and 40.00%,respectively.The detection rates of lobulation,vascular convergence sign,and GGO components in benign pulmonary nodules/masses were lower than those in malignant ones(P<0.05).The radiomics formula was Radscore=Intercept+Weight(Feature)×Feature,with the calculated formula being Radscore=0.16-0.32×Sphericity+0.11×Mass.The AUC of the UTE Rad-score model was 0.672,which was lower than the AUC of the UTE nomogram(0.789)and the combined model(0.832)(P<0.05).Conclusion:Experience-based and MRI radiomics can play a significant role in differentiating benign and malignant pulmonary nodules and masses,with the combined model demonstrating more prominent diagnostic value.展开更多
Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially...Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially leading to false positives or missed detections.To solve these problems,the YOLOv8 network is enhanced by adding deformable convolution and atrous spatial pyramid pooling(ASPP),along with the integration of a coordinate attention(CA)mechanism.This allows the network to focus on small targets while expanding the receptive field without losing resolution.At the same time,context information on the target is gathered and feature expression is enhanced by attention modules in different directions.It effectively improves the positioning accuracy and achieves good results on the LUNA16 dataset.Compared with other detection algorithms,it improves the accuracy of pulmonary nodule detection to a certain extent.展开更多
With the development of the multicellular nodules in the leaves of Hypericum per plastids increased both in number and volume, and some plastids degenerated and were surrounded by dark tubular elements and vesicles. S...With the development of the multicellular nodules in the leaves of Hypericum per plastids increased both in number and volume, and some plastids degenerated and were surrounded by dark tubular elements and vesicles. Some vesicles fused with vacuoles and secreted substances into vacuoles. There are many multivesicles, multimembrane structures and osmiophilic droplets in vacuoles of nodule cells. Meanwhile, dictyosome secreted vesicles into the vacuoles. However, there is a large central vacuole completely filled with secretory materials (hypericin) in matured multicellular nodules. This suggests that the osmiophilic droplets may be a precursor of hypericin originated from the degenerated plastids. There were abundant endoplasmic reticulums and dictyosomes between the plastids and osmiophilic droplets, suggesting that they may be involved in the synthesis and/or transport of the precursor of hypericin.展开更多
Accurate classification of pulmonary nodules is critical for early diagnosis of lung cancer. However, non-invasive and accurate diagnosis of benign and malignant pulmonary nodules faces great challenges. In this study...Accurate classification of pulmonary nodules is critical for early diagnosis of lung cancer. However, non-invasive and accurate diagnosis of benign and malignant pulmonary nodules faces great challenges. In this study, we develop a nano zero-valent iron(nZVI)-assisted laser desorption/ionization mass spectrometry(LDI MS) platform, which enables ultra-high-throughput acquisition of abundant metabolic fingerprint information of serum in negative ion mode. We further recruit a large-scale multicenter prospective cohort and collect 1099 serum samples from participants with benign and malignant nodules. The accurate machine learning models are built and validated based on n ZVI-assisted LDI MS metabolomics to achieve efficient classification of benign and malignant nodules. Using our established stacking ensemble learning model, the AUC of the ROC curve for benign and malignant lung nodule classification can be as high as 0.9, and the sensitivity can reach 85.5%, which is significantly better than existing clinical models. This work provides an integrated workflow from detection technology to diagnostic models for biomarkerbased pulmonary nodule diagnosis, which would be widely used in rapid and large-scale screening of pulmonary nodules.展开更多
BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has ass...BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has assessed the relationship between TN and adenomatous colonic polyps.AIM To assess the association between adenomatous colonic polyps,thyroid-stimulating hormone,and TN.METHODS We searched PubMed,MEDLINE,Cochrane Library,EBSCO,and the first 100 articles in Google for articles published in English from inception until April 2025.We included prospective cohorts,retrospective studies,case-control studies,and cross-sectional studies.The keywords thyroid nodules,adenomatous colon polyps,thyroid volume,metabolic syndrome,insulin resistance,and thyroid malignancy were used.RESULTS Out of 237 articles,25 full texts were reviewed,and 5 full texts were included in the final meta-analysis.No relationship was found between TN,colonic polyps,and thyroid-stimulating hormone levels[odd ratio(OR):1.78,95%confidence interval(CI):0.55-5.74,P=0.33].Colonic polyps were more common among patients with TN when addressing heterogeneity(OR:0.42,95%CI:0.30-0.52,P<0.001 and OR:0.08,95%CI:0.70-0.86,P=0.85).CONCLUSION TN were similar among patients with and without adenomatous colonic polyps.However,TN was more common among colon polyps when addressing the heterogeneity.Thyroid-stimulating hormone was not different between those with and without TN.Age,sex,adiposity,and smoking effects might explain the higher rate observed by the included studies.Further studies controlling for the same are needed.展开更多
Objective:To explore a simple method for improving the diagnostic accuracy of malignant lung nodules based on imaging features of lung nodules.Methods:A retrospective analysis was conducted on the imaging data of 114 ...Objective:To explore a simple method for improving the diagnostic accuracy of malignant lung nodules based on imaging features of lung nodules.Methods:A retrospective analysis was conducted on the imaging data of 114 patients who underwent lung nodule surgery in the Thoracic Surgery Department of the First People’s Hospital of Huzhou from June to September 2024.Imaging features of lung nodules were summarized and trained using a BP neural network.Results:Training with the BP neural network increased the diagnostic accuracy for distinguishing between benign and malignant lung nodules based on imaging features from 84.2%(manual assessment)to 94.1%.Conclusion:Training with the BP neural network significantly improves the diagnostic accuracy of lung nodule malignancy based solely on imaging features.展开更多
This study aims to compare the clinical value of a general large language model(DeepSeek GPT)and a disease-specific optimized model(BAIMGPT)in pulmonary nodule consultation and management.Through a multicenter real-wo...This study aims to compare the clinical value of a general large language model(DeepSeek GPT)and a disease-specific optimized model(BAIMGPT)in pulmonary nodule consultation and management.Through a multicenter real-world study,1,000 patients with pulmonary nodules from 12 hospitals will be recruited for a randomized self-controlled trial evaluating the performance of the two models across eight dimensions:convenience,friendliness,sense of security,accuracy in question comprehension,response professionalism,voice interaction,visual empowerment,and demand level.The core methodologies include dual user evaluation,third-party blinded review,and endpoint assessment.The study was expected to validate BAIMGPT’s advantages in improving screening awareness,personalized management,and physician-patient trust,providing evidence-based support for AI-powered early lung cancer screening.The protocol has passed ethical review,with anonymized data processing ensuring both innovation and safety.展开更多
Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,trea...Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,treated from June 2023 to May 2024,were included.All patients underwent pathological examination and CT scans,with pathological results serving as the gold standard.The diagnostic performance of CT alone and CT combined with the artificial intelligence-assisted diagnostic system was analyzed,and differences in CT imaging features and evaluation results of benign and malignant pulmonary nodules were compared.Results:The sensitivity,specificity,and accuracy of CT combined with the artificial intelligence-assisted diagnostic system were significantly higher than those of CT alone(P<0.05).Moreover,the false-positive and false-negative rates were significantly lower for the combined approach compared to CT alone(P<0.05).Conclusion:The artificial intelligence-assisted diagnostic system effectively identifies malignant features in pulmonary nodules,providing valuable clinical reference data and enhancing diagnostic accuracy and efficiency.展开更多
Aimed at the issues of high feature dimensionality,excessive data redundancy,and low recognition accuracy of using single classifiers on ground-glass lung nodule recognition,a recognition method was proposed based on ...Aimed at the issues of high feature dimensionality,excessive data redundancy,and low recognition accuracy of using single classifiers on ground-glass lung nodule recognition,a recognition method was proposed based on CatBoost feature selection and Stacking ensemble learning.First,the method uses a feature selection algorithm to filter important features and remove features with less impact,achieving the effect of data dimensionality reduction.Second,random forests classifier,decision trees,K-nearest neighbor classifier,and light gradient boosting machine were used as base classifiers,and support vector machine was used as meta classifier to fuse and construct the ensemble learning model.This measure increases the accuracy of the classification model while maintaining the diversity of the base classifiers.The experimental results show that the recognition accuracy of the proposed method reaches 94.375%.Compared to the random forest algorithm with the best performance among single classifiers,the accuracy of the proposed method is increased by 1.875%.Compared to the recent deep learning methods(ResNet+GBM+Attention and MVCSNet)on ground-glass pulmonary nodule recognition,the proposed method’s performance is also better or comparative.Experiments show that the proposed model can effectively select features and make recognition on ground-glass pulmonary nodules.展开更多
Granulomatosis with polyangiitis(GPA)poses significant therapeutic challenges due to its susceptibility to concurrent infections and frequent relapses.Professor SHI Zaixiang proposed the therapeutic theory of lifting ...Granulomatosis with polyangiitis(GPA)poses significant therapeutic challenges due to its susceptibility to concurrent infections and frequent relapses.Professor SHI Zaixiang proposed the therapeutic theory of lifting depression and removing blood stasis,resolving phlegm and dispelling nodulation for GPA management.He identified the core pathogenesis as“Qi collapse with collateral obstruction and phlegm-stasis intermingling”,establishing the treatment principle of comprehensive intervention through ascending ancestral Qi,activating blood circulation,and resolving phlegm-stasis nodules.In clinical practice,Professor SHI emphasizes maintaining immune homeostasis with herbal medicine to enhance efficiency,while dynamically balancing Qi,blood,Yin,and Yang.Notably,he highlights the critical role of emotional factors in autoimmune disease progression.A representative case was provided to elucidate his clinical reasoning in GPA treatment.展开更多
Pharmaceuticals and personal care products(PPCPs)have been considered as potential contributors to thyroid nodule(TN)and abnormal thyroid homeostasis,but epidemiological evidence is scarce.A total of 1261 individuals ...Pharmaceuticals and personal care products(PPCPs)have been considered as potential contributors to thyroid nodule(TN)and abnormal thyroid homeostasis,but epidemiological evidence is scarce.A total of 1261 individuals comprised of 367 TN patients and 895 controls were recruited from Sichuan,China.The urinary concentrations of fourteen PPCPs were measured.Five thyroid hormones(THs)in serum were determined as indicators of thyroid homeostasis,including thyroid-stimulating hormone,triiodothyronine(T3),thyroxine(T4),free-T3 and free-T4.Serum levels of thyroglobulin antibody(TGAb)and thyroperoxidase antibody(TPOAb)were quantified to identify individual thyroid antibody(TA)statuses.TN patients exhibited higher propyl-paraben(PrP)(median:1.30μg/g Cr)level than controls(0.64μg/g Cr).PrP were significantly associated with TN risk with ORs of 1.060(95%CI:1.002,1.122).The relationship of methyl-paraben with TN risk was nonlinear(p=0.049).PPCP exposurewas significantwith TN risk only in females and TA positive(TPOAb or TGAb)groups,indicating that PPCP susceptibility to TN differs by sex and TA status.Linear regression models showed ethyl-paraben was significantly negatively associated with T4(β:-0.005,95%CI:-0.011,-0.002)and T3(β:-0.007,95%CI:-0.015,-0.002),and positively associated with TPOAb(β:0.059,95%CI:0.000,0.119),suggesting that certain PPCP exposure could affect thyroid homeostasis and autoimmunity.The effects of PPCP exposure on TH and TA levels presented sex-specific.Our findings suggest that PPCP exposure increases TN risk and affects thyroid homeostasis,exhibiting sex and antibody status dependence.展开更多
BACKGROUND Minute Pulmonary Meningothelial-like Nodules(MPMNs)are rare benign pulmonary nodules,which are more common in elderly women and have a higher detection rate in lung tissues of patients with lung malignant d...BACKGROUND Minute Pulmonary Meningothelial-like Nodules(MPMNs)are rare benign pulmonary nodules,which are more common in elderly women and have a higher detection rate in lung tissues of patients with lung malignant diseases.Its origin is not yet clear.At present,there are few reports on the diagnostic methods such as imaging and pathological manifestations of MPMNs.This article reports a 70-year-old female patient with pulmonary adenocarcinoma combined with MPMNs and reviews of the relevant literature.CASE SUMMARY A 70-year-old women was admitted to our institution with feeling sour in her back and occasional cough for more than 2 mo.Computerized electronic scanning scan and 3D reconstruction images in our institution showed there were multiple ground-glass nodules in both of her two lungs.The biggest one was in the apicoposterior segment of left upper lobe,about 2.5 mm×9 mm in size.We performed thoracoscopic resection of the left upper lung apicoposterior segment of the patient,and the final pathological report was minimally invasive adenocarcinoma.Re-examination of high resolution computed tomography 21 mo after surgery showed multiple ground-glass nodules in both lungs,and a new groundglass nodule was found in the superior segment of the right lower lobe.We took pathological biopsy of the right upper lung and right lower lung nodules for the patient under thoracoscopy.The histomorphology of the right lower lobe nodule showed multiple lesions in the lung tissue,and the small foci in the alveolar septum were distributed in mild form of the aggregation of short spindle cells.The immunohistochemistry showed that the lesion was epithelial membrane antigen(EMA)(+),somatostatin receptor 2a(SSTR2a)(+),S-100(-),chromogranin A(-),Syn(-),cytokeratin(-)and HMB-45(-).The final diagnosis was minimally invasive adenocarcinoma,accompanied by MPMNs.We recommend that patients continue to receive treatment after surgery and to do regular follow-up observations.CONCLUSION The imaging manifestations of MPMNs are atypical,histomorphology and immunohistochemistry can assist in its diagnosis.This article reviews the relevant literature of MPMNs immunohistochemistry and shows that MPMNs are positive for EMA,SSTR2a,and progesterone receptor.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 index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery.展开更多
基金The Fund of Laoshan Laboratory under contract No.LSKJ202203602the National key R&D Program of China under contract No.2022YFC2803600the Taishan Scholarship from Shandong Province.
文摘To explore the geochemical characteristics and genesis of the elements in ferromanganese nodules from the Northwest Pacific,this study analyses the mineral composition,elemental content,occurrence phase and genetic mechanisms of samples by X-ray diffraction(XRD),inductively coupled plasma-optical emission spectrometry(ICP-OES),inductively coupled plasma-mass spectrometry(ICP-MS)and phase analysis methods.The results show that ferromanganese nodules are mainly hydrogenetic,and Mn/Fe content ratio ranges from 0.95 to 2.05.The major minerals are vernadite(δ-MnO_(2))and amorphous ferric oxyhydroxide(FeOOH),and the secondary minerals include todorokite,birnessite,quartz and plagioclase.Ferromanganese nodules contain high contents of Co(0.24%-0.42%),Cu(0.23%-0.73%),Ni(0.33%-0.86%)and rare earth elements(REEs,1192-1990μg/g),which have positive Ce and negative Y anomalies but no Eu anomaly.A cluster analysis suggests that the elements in ferromanganese nodules can be divided into three groups:hydrogenetic components,including Fe,Ti,Zr,P,Pb,Co,Ba,Sr,V and REEs;diagenetic components,including Mn,Ni,Mg,Zn and Cu;and detrital components,including Al,Na,K and Ca.According to chemical leaching,ferromanganese nodules can be divided into four phases:Na,Ca,Mg and Sr are mainly enriched in the carbonate phase;Mn,Co,Ni and Ba are mainly enriched in the Mn-oxide phase;Fe,P,Ti,Cu,Pb,V,Zn,Zr and REEs are mainly enriched in the Fe-oxide phase;and Al and K are mainly enriched in the residual phase.A combination of the two different methods reveal selective enrichment of metal elements from seawater by ferromanganese nodules,featuring multisource mineralization.Moreover,through ion exchange and adsorption,approximately 71.2%of REEs are enriched in the Fe-oxide phase,15.4%in the Mn-oxide phase and 12.4%in the residual phase,while REE contents in the carbonate phase are relatively low.In addition,under the oxic conditions of seawater,the oxidation of soluble Ce^(3+)to insoluble CeO_(2)together with Fe-Mn minerals results in Ce enrichment in ferromanganese nodules.This study provides a reference for the metallogenesis of ferromanganese nodules from the Northwest Pacific.
文摘Thyroid nodules are common,with a prevalence of approximately 70%on thyroid ultrasonography;approximately 5%of these nodules are malignant.Distingui-shing malignant and benign thyroid nodules is critical for clinical management.Clinicians can judiciously select patients for fine-needle aspiration,understand the cytology results and subsequent follow-up,and determine surveillance stra-tegies for non-operated nodules.The challenge in selecting thyroid nodules for fine-needle aspiration is to avoid the diagnosis of small,clinically insignificant cancers without missing more severe diseases.The molecular characteristics of thyroid nodules are critical for their diagnosis and treatment.However,iden-tifying these characteristics is costly and challenging because of unexpected technical difficulties.An imaging association model based on molecular features will bridge the essential link between molecular characteristics and the computed tomography radiomics,then improve diagnostic efficiency,reducing invasive examinations.
基金Supported by the Science and Technology Development Fund of Nanjing Medical University,No.NMUB20230037the Youth Scientific Research Nurturing Fund of Jiangbei Campus of Zhongda Hospital Affiliated with Southeast University,No.JB2024Q01.
文摘BACKGROUND Accurate preoperative differentiation of benign and malignant thyroid nodules is critical for optimal patient management.However,conventional imaging modalities present inherent diagnostic limitations.AIM To develop a non-contrast computed tomography-based machine learning model integrating radiomics and clinical features for preoperative thyroid nodule classification.METHODS This multicenter retrospective study enrolled 272 patients with thyroid nodules(376 thyroid lobes)from center A(May 2021-April 2024),using histopathological findings as the reference standard.The dataset was stratified into a training cohort(264 lobes)and an internal validation cohort(112 lobes).Additional prospective temporal(97 lobes,May-August 2024,center A)and external multicenter(81 lobes,center B)test cohorts were incorporated to enhance generalizability.Thyroid lobes were segmented along the isthmus midline,with segmentation reliability confirmed by an intraclass correlation coefficient(≥0.80).Radiomics feature extraction was performed using Pearson correlation analysis followed by least absolute shrinkage and selection operator regression with 10-fold cross-validation.Seven machine learning algorithms were systematically evaluated,with model performance quantified through the area under the receiver operating characteristic curve(AUC),Brier score,decision curve analysis,and DeLong test for comparison with radiologists interpretations.Model interpretability was elucidated using SHapley Additive exPlanations(SHAP).RESULTS The extreme gradient boosting model demonstrated robust diagnostic performance across all datasets,achieving AUCs of 0.899[95%confidence interval(CI):0.845-0.932]in the training cohort,0.803(95%CI:0.715-0.890)in internal validation,0.855(95%CI:0.775-0.935)in temporal testing,and 0.802(95%CI:0.664-0.939)in external testing.These results were significantly superior to radiologists assessments(AUCs:0.596,0.529,0.558,and 0.538,respectively;P<0.001 by DeLong test).SHAP analysis identified radiomic score,age,tumor size stratification,calcification status,and cystic components as key predictive features.The model exhibited excellent calibration(Brier scores:0.125-0.144)and provided significant clinical net benefit at decision thresholds exceeding 20%,as evidenced by decision curve analysis.CONCLUSION The non-contrast computed tomography-based radiomics-clinical fusion model enables robust preoperative thyroid nodule classification,with SHAP-driven interpretability enhancing its clinical applicability for personalized decision-making.
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.
基金The Marine Science and Technology Fund of Shandong Province for Laoshan Laboratory under contract No.LSKJ202203600-2the China Ocean Mineral Resources Research and Development Association(COMRA)project under contract No.DY135-N2-1-04.
文摘Polymetallic nodules,hereinafter referred to as PN,enriched with Co,Ni,Mn,and Cu,are likely to be commercially mined in the near future.These metals in PN are potential strategic alternatives for the world’s energy transition.Therefore,intensive studies are necessary on the spatial distribution patterns of PN in the deep sea.In this study,the distribution probabilities of PN in the Pacific,Indian and Atlantic oceans were estimated based on binary logistic regression of PN occurrence with ore-controlling factors including water depth(WD),marine sediment thickness(SedTh),Calcium carbonate(CaCO_(3))concentrations in surface sediments,primary productivity(PP),near bottom current velocities(BC).Furthermore,the distribution probability of PN was constrained by seafloor ages and PN sites,and subsequently,the prospects for nodules in the Pacific,Indian and Atlantic oceans were obtained.The results indicate that the low-latitude Pacific region(30°N-30°S),particularly the Clarion-Clipperton Zone and the Penrhyn Basin,is the most promising area for PN exploration.
基金supported by the Autonomous Region Industry-Education Integration Project“Application of DNA Methylation Combined with Spiral CT in the Screening of Pulmonary Ground-Glass Nodules and AI Recognition Systems in Teaching Practice”(Project No.2023210016)the“Open Project of the State Key Laboratory of High Incidence Diseases in Central Asia”(Project No.SKL-HIDCA-2021-28).
文摘Objective:To explore the effectiveness of multi-modal teaching based on an online case library in the education of gene methylation combined with spiral computed tomography(CT)screening for pulmonary ground-glass opacity(GGO)nodules.Methods:From October 2023 to April 2024,66 medical imaging students were selected and randomly divided into a control group and an observation group,each with 33 students.The control group received traditional lecture-based teaching,while the observation group was taught using a multi-modal teaching approach based on an online case library.Performance on assessments and teaching quality were analyzed between the two groups.Results:The observation group achieved higher scores in theoretical and practical knowledge compared to the control group(P<0.05).Additionally,the teaching quality scores were significantly higher in the observation group(P<0.05).Conclusion:Implementing multi-modal teaching based on an online case library for pulmonary GGO nodule screening with gene methylation combined with spiral CT can enhance students’knowledge acquisition,improve teaching quality,and have significant clinical application value.
基金Beijing Natural Science Foundation:Research on the Mechanism of Chaiqi Decoction in Improving Vascular Endothelial Injury in Metabolic Syndrome by Regulating Pyroptosis via miR-21(No.7212181)。
文摘OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.
文摘Objective:To investigate the application of experience-based and Magnetic Resonance Imaging(MRI)radiomics in differentiating benign and malignant pulmonary nodules and masses.Methods:Sixty patients with pulmonary nodules or masses admitted from April 2024 to April 2025 were selected as study subjects.Surgical pathology was used as the gold standard to explore the differential diagnostic value of experience-based and MRI radiomics.Results:Twenty one MRI radiomic features were selected for screening,with 14 features removed and 7 remaining for normality testing.Using surgical pathology as the gold standard,among the 60 patients,36 were benign and 24 were malignant,with detection rates of 60.00%and 40.00%,respectively.The detection rates of lobulation,vascular convergence sign,and GGO components in benign pulmonary nodules/masses were lower than those in malignant ones(P<0.05).The radiomics formula was Radscore=Intercept+Weight(Feature)×Feature,with the calculated formula being Radscore=0.16-0.32×Sphericity+0.11×Mass.The AUC of the UTE Rad-score model was 0.672,which was lower than the AUC of the UTE nomogram(0.789)and the combined model(0.832)(P<0.05).Conclusion:Experience-based and MRI radiomics can play a significant role in differentiating benign and malignant pulmonary nodules and masses,with the combined model demonstrating more prominent diagnostic value.
文摘Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially leading to false positives or missed detections.To solve these problems,the YOLOv8 network is enhanced by adding deformable convolution and atrous spatial pyramid pooling(ASPP),along with the integration of a coordinate attention(CA)mechanism.This allows the network to focus on small targets while expanding the receptive field without losing resolution.At the same time,context information on the target is gathered and feature expression is enhanced by attention modules in different directions.It effectively improves the positioning accuracy and achieves good results on the LUNA16 dataset.Compared with other detection algorithms,it improves the accuracy of pulmonary nodule detection to a certain extent.
文摘With the development of the multicellular nodules in the leaves of Hypericum per plastids increased both in number and volume, and some plastids degenerated and were surrounded by dark tubular elements and vesicles. Some vesicles fused with vacuoles and secreted substances into vacuoles. There are many multivesicles, multimembrane structures and osmiophilic droplets in vacuoles of nodule cells. Meanwhile, dictyosome secreted vesicles into the vacuoles. However, there is a large central vacuole completely filled with secretory materials (hypericin) in matured multicellular nodules. This suggests that the osmiophilic droplets may be a precursor of hypericin originated from the degenerated plastids. There were abundant endoplasmic reticulums and dictyosomes between the plastids and osmiophilic droplets, suggesting that they may be involved in the synthesis and/or transport of the precursor of hypericin.
基金financially supported by the Fundamental Research Funds for the Central Universities (No. WHU 2042024kf0009)National Key Research and Development Program of China (No. 2021YFC2700700)the National Natural Science Foundation of China (Nos. 22074111, 22004093)。
文摘Accurate classification of pulmonary nodules is critical for early diagnosis of lung cancer. However, non-invasive and accurate diagnosis of benign and malignant pulmonary nodules faces great challenges. In this study, we develop a nano zero-valent iron(nZVI)-assisted laser desorption/ionization mass spectrometry(LDI MS) platform, which enables ultra-high-throughput acquisition of abundant metabolic fingerprint information of serum in negative ion mode. We further recruit a large-scale multicenter prospective cohort and collect 1099 serum samples from participants with benign and malignant nodules. The accurate machine learning models are built and validated based on n ZVI-assisted LDI MS metabolomics to achieve efficient classification of benign and malignant nodules. Using our established stacking ensemble learning model, the AUC of the ROC curve for benign and malignant lung nodule classification can be as high as 0.9, and the sensitivity can reach 85.5%, which is significantly better than existing clinical models. This work provides an integrated workflow from detection technology to diagnostic models for biomarkerbased pulmonary nodule diagnosis, which would be widely used in rapid and large-scale screening of pulmonary nodules.
文摘BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has assessed the relationship between TN and adenomatous colonic polyps.AIM To assess the association between adenomatous colonic polyps,thyroid-stimulating hormone,and TN.METHODS We searched PubMed,MEDLINE,Cochrane Library,EBSCO,and the first 100 articles in Google for articles published in English from inception until April 2025.We included prospective cohorts,retrospective studies,case-control studies,and cross-sectional studies.The keywords thyroid nodules,adenomatous colon polyps,thyroid volume,metabolic syndrome,insulin resistance,and thyroid malignancy were used.RESULTS Out of 237 articles,25 full texts were reviewed,and 5 full texts were included in the final meta-analysis.No relationship was found between TN,colonic polyps,and thyroid-stimulating hormone levels[odd ratio(OR):1.78,95%confidence interval(CI):0.55-5.74,P=0.33].Colonic polyps were more common among patients with TN when addressing heterogeneity(OR:0.42,95%CI:0.30-0.52,P<0.001 and OR:0.08,95%CI:0.70-0.86,P=0.85).CONCLUSION TN were similar among patients with and without adenomatous colonic polyps.However,TN was more common among colon polyps when addressing the heterogeneity.Thyroid-stimulating hormone was not different between those with and without TN.Age,sex,adiposity,and smoking effects might explain the higher rate observed by the included studies.Further studies controlling for the same are needed.
基金Zhejiang Medical and Health Technology Project(Project No.2020PY072)。
文摘Objective:To explore a simple method for improving the diagnostic accuracy of malignant lung nodules based on imaging features of lung nodules.Methods:A retrospective analysis was conducted on the imaging data of 114 patients who underwent lung nodule surgery in the Thoracic Surgery Department of the First People’s Hospital of Huzhou from June to September 2024.Imaging features of lung nodules were summarized and trained using a BP neural network.Results:Training with the BP neural network increased the diagnostic accuracy for distinguishing between benign and malignant lung nodules based on imaging features from 84.2%(manual assessment)to 94.1%.Conclusion:Training with the BP neural network significantly improves the diagnostic accuracy of lung nodule malignancy based solely on imaging features.
文摘This study aims to compare the clinical value of a general large language model(DeepSeek GPT)and a disease-specific optimized model(BAIMGPT)in pulmonary nodule consultation and management.Through a multicenter real-world study,1,000 patients with pulmonary nodules from 12 hospitals will be recruited for a randomized self-controlled trial evaluating the performance of the two models across eight dimensions:convenience,friendliness,sense of security,accuracy in question comprehension,response professionalism,voice interaction,visual empowerment,and demand level.The core methodologies include dual user evaluation,third-party blinded review,and endpoint assessment.The study was expected to validate BAIMGPT’s advantages in improving screening awareness,personalized management,and physician-patient trust,providing evidence-based support for AI-powered early lung cancer screening.The protocol has passed ethical review,with anonymized data processing ensuring both innovation and safety.
基金supported by Chengdu University of Traditional Chinese Medicine“Xinglin Scholars”Subject Talent Scientific Research Enhancement Plan(No.YYZX2022056).
文摘Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,treated from June 2023 to May 2024,were included.All patients underwent pathological examination and CT scans,with pathological results serving as the gold standard.The diagnostic performance of CT alone and CT combined with the artificial intelligence-assisted diagnostic system was analyzed,and differences in CT imaging features and evaluation results of benign and malignant pulmonary nodules were compared.Results:The sensitivity,specificity,and accuracy of CT combined with the artificial intelligence-assisted diagnostic system were significantly higher than those of CT alone(P<0.05).Moreover,the false-positive and false-negative rates were significantly lower for the combined approach compared to CT alone(P<0.05).Conclusion:The artificial intelligence-assisted diagnostic system effectively identifies malignant features in pulmonary nodules,providing valuable clinical reference data and enhancing diagnostic accuracy and efficiency.
基金the National Natural Science Foundation of China(No.62271466)the Natural Science Foundation of Beijing(No.4202025)+1 种基金the Tianjin IoT Technology Enterprise Key Laboratory Research Project(No.VTJ-OT20230209-2)the Guizhou Provincial Sci-Tech Project(No.ZK[2022]-012)。
文摘Aimed at the issues of high feature dimensionality,excessive data redundancy,and low recognition accuracy of using single classifiers on ground-glass lung nodule recognition,a recognition method was proposed based on CatBoost feature selection and Stacking ensemble learning.First,the method uses a feature selection algorithm to filter important features and remove features with less impact,achieving the effect of data dimensionality reduction.Second,random forests classifier,decision trees,K-nearest neighbor classifier,and light gradient boosting machine were used as base classifiers,and support vector machine was used as meta classifier to fuse and construct the ensemble learning model.This measure increases the accuracy of the classification model while maintaining the diversity of the base classifiers.The experimental results show that the recognition accuracy of the proposed method reaches 94.375%.Compared to the random forest algorithm with the best performance among single classifiers,the accuracy of the proposed method is increased by 1.875%.Compared to the recent deep learning methods(ResNet+GBM+Attention and MVCSNet)on ground-glass pulmonary nodule recognition,the proposed method’s performance is also better or comparative.Experiments show that the proposed model can effectively select features and make recognition on ground-glass pulmonary nodules.
基金supported by the Seventh Batch of National Academic Experience Inheritance Project for Senior TCM Experts from the National Administration of Traditional Chinese Medicine(No.GZYRJS[2022]76)the Sixth Batch of Beijing Municipal Academic Experience Inheritance Project for TCM Experts from Beijing Administration of Traditional Chinese Medicine(No.JZYKZ[2019]139).
文摘Granulomatosis with polyangiitis(GPA)poses significant therapeutic challenges due to its susceptibility to concurrent infections and frequent relapses.Professor SHI Zaixiang proposed the therapeutic theory of lifting depression and removing blood stasis,resolving phlegm and dispelling nodulation for GPA management.He identified the core pathogenesis as“Qi collapse with collateral obstruction and phlegm-stasis intermingling”,establishing the treatment principle of comprehensive intervention through ascending ancestral Qi,activating blood circulation,and resolving phlegm-stasis nodules.In clinical practice,Professor SHI emphasizes maintaining immune homeostasis with herbal medicine to enhance efficiency,while dynamically balancing Qi,blood,Yin,and Yang.Notably,he highlights the critical role of emotional factors in autoimmune disease progression.A representative case was provided to elucidate his clinical reasoning in GPA treatment.
基金supported by the National Natural Science Foundation of China(Nos.21976046 and 42177412)the Ministry of Education of China(No.B17025).
文摘Pharmaceuticals and personal care products(PPCPs)have been considered as potential contributors to thyroid nodule(TN)and abnormal thyroid homeostasis,but epidemiological evidence is scarce.A total of 1261 individuals comprised of 367 TN patients and 895 controls were recruited from Sichuan,China.The urinary concentrations of fourteen PPCPs were measured.Five thyroid hormones(THs)in serum were determined as indicators of thyroid homeostasis,including thyroid-stimulating hormone,triiodothyronine(T3),thyroxine(T4),free-T3 and free-T4.Serum levels of thyroglobulin antibody(TGAb)and thyroperoxidase antibody(TPOAb)were quantified to identify individual thyroid antibody(TA)statuses.TN patients exhibited higher propyl-paraben(PrP)(median:1.30μg/g Cr)level than controls(0.64μg/g Cr).PrP were significantly associated with TN risk with ORs of 1.060(95%CI:1.002,1.122).The relationship of methyl-paraben with TN risk was nonlinear(p=0.049).PPCP exposurewas significantwith TN risk only in females and TA positive(TPOAb or TGAb)groups,indicating that PPCP susceptibility to TN differs by sex and TA status.Linear regression models showed ethyl-paraben was significantly negatively associated with T4(β:-0.005,95%CI:-0.011,-0.002)and T3(β:-0.007,95%CI:-0.015,-0.002),and positively associated with TPOAb(β:0.059,95%CI:0.000,0.119),suggesting that certain PPCP exposure could affect thyroid homeostasis and autoimmunity.The effects of PPCP exposure on TH and TA levels presented sex-specific.Our findings suggest that PPCP exposure increases TN risk and affects thyroid homeostasis,exhibiting sex and antibody status dependence.
基金the National Natural Science Foundation of China,No.81972829.
文摘BACKGROUND Minute Pulmonary Meningothelial-like Nodules(MPMNs)are rare benign pulmonary nodules,which are more common in elderly women and have a higher detection rate in lung tissues of patients with lung malignant diseases.Its origin is not yet clear.At present,there are few reports on the diagnostic methods such as imaging and pathological manifestations of MPMNs.This article reports a 70-year-old female patient with pulmonary adenocarcinoma combined with MPMNs and reviews of the relevant literature.CASE SUMMARY A 70-year-old women was admitted to our institution with feeling sour in her back and occasional cough for more than 2 mo.Computerized electronic scanning scan and 3D reconstruction images in our institution showed there were multiple ground-glass nodules in both of her two lungs.The biggest one was in the apicoposterior segment of left upper lobe,about 2.5 mm×9 mm in size.We performed thoracoscopic resection of the left upper lung apicoposterior segment of the patient,and the final pathological report was minimally invasive adenocarcinoma.Re-examination of high resolution computed tomography 21 mo after surgery showed multiple ground-glass nodules in both lungs,and a new groundglass nodule was found in the superior segment of the right lower lobe.We took pathological biopsy of the right upper lung and right lower lung nodules for the patient under thoracoscopy.The histomorphology of the right lower lobe nodule showed multiple lesions in the lung tissue,and the small foci in the alveolar septum were distributed in mild form of the aggregation of short spindle cells.The immunohistochemistry showed that the lesion was epithelial membrane antigen(EMA)(+),somatostatin receptor 2a(SSTR2a)(+),S-100(-),chromogranin A(-),Syn(-),cytokeratin(-)and HMB-45(-).The final diagnosis was minimally invasive adenocarcinoma,accompanied by MPMNs.We recommend that patients continue to receive treatment after surgery and to do regular follow-up observations.CONCLUSION The imaging manifestations of MPMNs are atypical,histomorphology and immunohistochemistry can assist in its diagnosis.This article reviews the relevant literature of MPMNs immunohistochemistry and shows that MPMNs are positive for EMA,SSTR2a,and progesterone receptor.
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 index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery.
