Purpose: To investigate the association between lymph node (N) stage and clinical outcome in thyroid cancer patients with initial distant metastasis. Methods: A total of 3,198 cases (1,435 males and 1,763 females) between 2004 and 2015 with initial distant metastasis were obtained from the surveillance, epidemiology, and end results (SEER) database. Patients with a median follow up time of 13 months and a median age of 66 years were analyzed. A total of 1,407 cases had detailed information regarding the four most common metastatic organs after the year 2010. Kaplan-Meier (KM) analyses, log-rank tests, Cox regression, and logistic regression analyses were used.
Purpose: To investigate the risk-stratifying utility of tumor size and a threshold for further stratification on cancer-specific mortality of thyroid cancer (TC) patients in stage IVB. Methods: One thousand three hundred and forty-five patients (620 males and 725 females) with initial distant metastasis over 55 years between 2004 and 2016 from Surveillance, Epidemiology, and End Results databases were investigated, with a median follow-up time of 23 months [interquartile range (IQR), 5-56 months] and a median age of 70 years (IQR, 63-77 years). TC-specific mortality rates were calculated under different classifications. Cox regressions were used to calculate hazard ratios (HRs) and Kaplan-Meier Analyses were conducted to investigate TC-specific survivals. Results: In the whole cohort, patients with tumors >4 cm had the highest TC-specific mortality (67.9%, 330/486), followed by tumor size >1 cm but ≤4 cm (43.08%, 190/441), and tumor size ≤1 cm (32.69%, 34/104). Kaplan-Meier curves showed the increased tumor size was associated with a statistically significant decrease in TC-specific survival (P < 0.001). Papillary thyroid cancer (PTC) patients with tumors >4 cm had significantly higher hazard ratios (HRs) of 2.84 (1.72-4.70) and 3.11 (1.84-5.26) after adjusting age, gender, race, and radiation treatment, compared with patients with tumors ≤1 cm (P < 0.001). The TC-specific mortalities and survivals were further investigated among more detailed subgroups divided by different tumor size, and a threshold of 3 cm could be observed (P < 0.005) for risk stratification. Conclusions: Mortality risk increased with tumor size in PTC patients in stage IVB. Our findings demonstrated the possibility of further stratification in IVB stage in current TNM staging system. Patients with tumor size over 3 cm had an excessively high risk of PTC-specific mortality, which may justify the necessity of more aggressive treatment for them.
The results of mechanical property tests on early-age concrete reinforced with industrial-grade carbon nanotubes (CNTs) are reported. The objective of the study was to validate the effectiveness of CNTs and establish the development of concrete properties with CNT dosage and concrete age. Ultrasonication, ultraviolet–visible spectrophotometry and scanning electron microscopy were employed to inspect or improve the dispersion quality. The test programme considered four CNT dosages and seven concrete ages, with three replicates. The results indicated that industrial-grade CNTs can lead to increases in cubic compressive strength, tensile splitting strength, prismatic compressive strength and ultimate strain of concrete (up to 34·2, 11·1, 19·4 and 8·3%, respectively) comparable to those obtained with the use of fine nanotube particles; no significant influence was found for the other tested concrete properties. The results of this study also indicated that increases in strengths and strain were most significant during the first 7 d, the period when concrete is most prone to cracking due to shrinkage and hydration heat. This implies that industrial-grade CNTs may have a great potential in reducing early-age concrete cracking with much less health risk and lower testing requirements compared with the use of fine nanotube powders.
Background. Intralymphatic immunotherapy (ILIT) is short-course administration of allergen-specific immunotherapy (AIT). This study is aimed at assessing the clinical efficacy and safety of ILIT in patients with allergic rhinitis (AR). Methods. MEDLINE, PUBMED, and Cochrane Library were used to conduct electronic searches for clinical trials comparing ILIT and placebo in patients with AR. The final search took place on August 24, 2022. Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. The outcomes included combined symptom and medication scores (CSMS), visual analog scale (VAS), allergic rhinoconjunctivitis quality of life (RQLQ), Skin-prick test (SPT), and adverse events (AEs). Data were synthesized as mean difference (MD)/standard mean difference (SMD) or risk difference (RD) and 95% confidence interval (CI). Results. Thirteen studies (454 participants) were included in this study. The ILIT group had better clinical improvement on the CSMS (random effects model, SMD-0.85, 95% CI [-1.58, -0.11], P = 0.02 ) and RQLQ (fixed-effects model, MD-0.42, 95% CI [0.69, 0.15], P = 0.003 ) than the placebo group. The booster injection was beneficial for CSMS ( P < 0.0001 ), and the 4-week injection interval was superior to the 2-week injection period for improving VAS ( P < 0.0001 ). Local swelling or erythema was the main AE following injection (random effects model, RD 0.16, 95% CI [0.05, 0.27], P = 0.005 ). Discussion. For individuals with AR, ILIT is safe and effective. ILIT alleviates clinical symptoms and reduces pharmaceutical consumption without causing severe AEs. However, the validity of this study is compromised by the substantial heterogeneity and risk of bias in the included researches. RegistrationCRD42022355329.
Purpose: To investigate the metabolic improvements in obese patients with different serum triglyceride (TG) levels after laparoscopic sleeve gastrectomy (LSG). Methods: 118 severely obese patients [body mass index (BMI)>35kg/m2] underwent LSG with complete information of follow-up for 3 and 6 months were analyzed. Patients were divided into two groups based on their different baseline serum levels of TG. Results: The metabolic parameters (BMI, NC, WC, HC, WHR, blood pressure, liver function, blood glucose, blood lipids, insulin resistance, HbA1c, and UA) of the normal and higher TG groups were significantly improved after surgery. Patients with normal TG had better improvement in BMI and WC compared with higher TG patients in both 3 and 6 months. After adjustment for age and gender, ΔWC positively correlated with ΔBMI (r=0.446, P<0.001), creatinine level (ΔCr, r=0.365, P=0.005) in the normal group in 3 months follow-up. In 6 months after LSG, ΔWC positively correlated with ΔBMI (r=0.657, P<0.001) and ΔCr (r=0.442, P=0.009) while ΔWC negatively correlated with the change in eGFR level (ΔeGFR, r=-0.374, P=0.009) in the normal group. In addition, multivariate linear regression analysis showed that decreased ΔWC levels significantly correlated with ΔBMI (β=1.333, R2 =0.259, P<0.001) and ΔCr (β=0.336, R2 =0.160, P=0.005) both in 3 months and 6 months after LSG. Conclusion: LSG can effectively improve metabolic disorders. Moreover, there were differences in weight loss between the normal and high TG groups after LSG, indicating that the baseline TG level can be used to predict short-term weight loss after LSG. Disclosure G. Li: None. Y. Huang: None. J. Zhang: None. X. Wang: None. C. Qian: None. X. Cheng: None. S. Qu: None. Funding National Key Research and Development Program of China (2018YFC1314100); National Natural Science Foundation of China (81970677); Shanghai Pujiang Program (2019PJD040); Shanghai Committee of Science and Technology (18411951803, 17DZ1910603)
AimsTo investigate the predictive value of baseline serum triglyceride (TG) levels for improvements of metabolism after laparoscopic sleeve gastrectomy (LSG).Methods112 obese patients [body mass index (BMI) ≥ 35 kg/m2] underwent LSG and with complete information of anthropometric and metabolic parameters were divided into normal TG group (group A) and high TG group (group B), while group A had TG levels ≤ 1.7 mmol/L, and group B had TG levels > 1.7 mmol/L. The post-operative changes (Δ) in metabolic parameters between the two groups were compared.ResultsIn the whole cohort, the metabolic parameters were significantly improved at 6 months after LSG. BMI and waist circumference (WC) decreased significantly in the two groups. The ΔBMI among group A and group B were 11.42±3.23 vs 9.13±2.77 kg/m2 (p<0.001), respectively. ΔBMI was positively correlated with ΔWC (r=0.696, p<0.001), Δfasting insulin level (r=0.440, p=0.002), Δfasting serum C peptide level (r=0.453, p=0.002), and Δhomeostasis model assessment insulin resistance index (r=0.418, p=0.004) in group A. Compared with group B, group A had a significantly higher odds ratio (OR) of 2.83 (95% confidence interval [CI]1.25–6.38, p=0.012)and 2.73 (95% CI 1.11–6.72, p=0.029) for ΔBMI and ΔWC after adjustment for age and gender, respectively.ConclusionsObese patients with baseline TG levels under 1.7 mmol/L had greater loss of weight at six months follow-up later LSG. This finding suggests that baseline TG level may have a predictive value for weight loss, at least in the short-term follow-up.
Purpose: To investigate the serum levels of uric acid (UA) in obese acanthosis nigricans (AN) patients with different thyroid hormones (THs) levels within the normal range. Methods: We investigated 834 obese patients (385 females and 449 males) with euthyroid function in the department of endocrinology of shanghai 10th people’s hospital from 2011 to 2019 with the median age of 29 years (interquartile range 22-36 years) for this study. 343 patients were diagnosed of AN. The cut-offs for thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were 2mIU/L, 16mIU/L and 5mIU/L, respectively. Results: In male obese patients, AN patients with high TSH and FT4 had higher levels of UA compared to those with high TSH and low FT4 (523.20±120.98 vs. 477.56±86.92umol/L, P=0.036) and showed a correlation with fasting C-peptide (FCP) (r=0.330, P=0.029). The TSH, FT3, and FT4 alone did not showed any predictive value in male patients. In female patients, high FT3 was associated with higher levels of UA (388.47±100.95 vs. 366.33±82.40umol/L, P=0.019). However, the predictive value of FT3 in female was obtained only in low TSH subgroup (low TSH+ high FT3 vs. low TSH+ low FT3, P=0.033) not in high TSH patients. The levels of fasting insulin, 2h-insulin, FCP, 2h C-peptide, total cholesterol, triglyceride and testosterone were in correlation with higher UA levels in female obese patients with low TSH and high FT3(all P<0.05). Conclusion: The metabolic characteristics of UA are found to differ in obese patients with euthyroid function, in which AN plays an important role for male obese patients with high TSH and high FT4. But in the case of female, a combination of THs instead of AN showed it’s unique in UA metabolism. Disclosure J. Zhang: None. G. Li: None. X. Cheng: None. X. Wang: None. M. Jayachandran: None. Y. Huang: None. S. Qu: None. Funding National Key Research and Development Program of China (2018YFC1314100); National Natural Science Foundation of China (81970677); Shanghai Pujiang Program (2019PJD040); Effect of ApoC3 High Expression on Islet Cells and Related Molecular Mechanism (03.05.18.002)
Purpose: To present thyroid hormones (THs) cutoff values to assess the association of THs and glucose metabolism in obese patients with euthyroid function. Methods: This study investigated 445 obese patients (235 females and 210 males) with euthyroid function received treatment in the department of endocrinology of shanghai 10th people’s hospital from 2011 to 2019, with the median age of 29 years (interquartile range 22-35 years). The cut-offs for thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were 2mIU/L, 16mIU/L, and 5mIU/L, respectively. Results: Fasting blood glucose (FBG) and 2h-glucose (BG120) were significantly higher in low FT3 (P<0.05) and high FT4 patients (P<0.05). In patients with TSH under 2mIU/L, a low FT3 group was robustly associated with higher FBG and BG120 levels (P<0.05). In patients with TSH under 1.5mIU/L, additional association with lower fasting and 2h-insulin (P<0.05) could be found. FT3 had no predictive value in high TSH patients. In patients TSH over 1.5 or 2mIU/L, a high FT4 group was robustly associated with higher FBG and BG120 levels (P<0.05). FT4 had no predictive value in low TSH patients. Patients with TSH over 2mIU/L, high FT4 group had a crude odds ratio of 2.65(95% Confidence interval 1.40-5.03, P=0.003) for FBG compared with low FT4 and remained significant after adjustments for age, gender and body mass index. Similar results could be obtained in patients with TSH over 1.5mIU/L. Conclusions: A combination of TSH and FT4/FT3 instead of only one thyroid hormone indicator had predictive value of glucose metabolism in obese patients with euthyroid function. Disclosure J. Zhang: None. G. Li: None. X. Cheng: None. X. Wang: None. M. Jayachandran: None. Y. Huang: None. S. Qu: None. Funding National Key Research and Development Program of China (2018YFC1314100); National Natural Science Foundation of China (81970677); Shanghai Pujiang Program (2019PJD040); Effect of ApoC3 High Expression on Islet Cells and Related Molecular Mechanism (03.05.18.002)
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