Objective: The efficacy and safety of percutaneous ultrasound-guided microwave and laser ablation (MWA and LA, respectively), for treating benign thyroid nodules (BTNs), were retrospectively compared.Methods: Patients (n = 318) underwent ablation of 328 BTNs. Confounding bias was reduced by propensity-score matching, and finally the MWA and LA groups each comprised 160 nodules. At baseline (before ablation), 3, 6, and 12 months, and every 6 months thereafter, the following were recorded: nodule volume reduction rate (VRR), neck symptom scores, cosmetic scores, complications, and side effects.Results: The baseline characteristics of the MWA and LA groups were comparable. The volumes of all nodules were less at all follow-ups relative to the baseline, as were the symptom and cosmetic scores at postoperative 6 months and thereafter (P < 0.01). At each follow-up, the overall VRRs of the MWA and LA groups were comparable. However, for nodules ≥13 mL, the VRR associated with LA at ≥6 months was significantly greater than that of MWA. The average ablation time for MWA was less than that of LA (P < 0.01). The overall incidences of major complications, minor complications, and side effects were 1.6, 2.2, and 18.4%, respectively, and there were no significant differences between the MWA and LA groups.Conclusion: Percutaneous ultrasound-guided MWA and LA are both safe and effective for the treatment of BTNs. Each can significantly reduce the nodule volume and improve the neck symptoms and appearance of patients, with a low incidence of adverse side effects. The efficiency of MWA is higher than that of LA. For nodules ≥13 mL, MWA may be preferred, but at 6 months and subsequent follow-ups the reduction in volume was greater in patients receiving LA.
These findings indicate that 3DSTE can distinguish between MIs of different infarct sizes, and may provide an indirect means for the accurate determination of transmural involvement in infarct segments.
Quantitative contrast-enhanced US indicators help discriminate benign from malignant thyroid nodules. The nodule-to-perinodule peak intensity ratio showed the best diagnostic efficiency.
Osteoarthritis is a common chronic and progressively degenerative joint condition. The stem bark of Eucommia ulmoides Oliver (a member of the Eucommiaceae family), which is also known as Du-Zhong, is a traditional Chinese medicine commonly used for the treatment of rheumatoid arthritis. However, the mechanisms underlying the effects of Eucommia in the treatment of arthritis of the knee require further study. The present study investigated the effects of an aqueous extract of Eucommia on the articular cartilage (by Mankin’s grade) and the levels of matrix metalloproteinase-1 (MMP-1), MMP-3 and MMP-13 in the serum and synovial fluid in a rat model of osteoarthritis. The serum levels of MMP-1, -3 and -13 were measured by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) at weeks 1, 2 and 4. The levels of MMP-1, -3 and 13 were significantly decreased in the rats treated with Eucommia compared with those in the control rats (P<0.05). Histopathological examination results indicated a lower Mankin’s grade in the Eucommia group compared with that of the control rats. Therefore, Eucommia was demonstrated to have a cartilage-protecting effect in rats with osteoarthritis, potentially by improving cartilage metabolism, regulating the degradation of the extracellular matrix of the articular cartilage, and inhibiting apoptosis in chondrocytes, thereby slowing down joint degeneration.
Purpose To compare superb microvascular imaging (SMI) with contrast-enhanced ultrasonography (CEUS) for evaluating the ablation of benign thyroid nodules. Methods 225 Patients with 256 benign thyroid nodules underwent conventional ultrasound, color Doppler flow imaging (CDFI), CEUS, and SMI before and after laser ablation. They were routinely followed up at 1, 3, 6, and 12 months. The volume and volume reduction rate of the ablated nodules was calculated. Results On SMI, the complete ablated nodules had no microvascular perfusion, while the incompletely ablated nodules had microvascular perfusion at the edge of the nodule. The percentages of the detected incompletely ablated nodules of SMI (37/256, 14.45%) and CEUS (41/256, 16.02%) were comparable, and both were significantly higher than CDFI (P< 0.001). CEUS was used as the criterion to determine whether the nodules were completely ablated. The sensitivity, specificity, and accuracy of SMI for detecting incompletely ablated nodules were 90.2, 98.2, and 100%, respectively. The volume of ablated nodules, as measured on ultrasound, was greater than that on CEUS or SMI (both P< 0.001), while CEUS and SMI were similar. The average volume reduction rate of nodules at 1, 3, 6, and 12 months was 40.25, 54.98, 76.83, and 95.43%, respectively. Conclusion SMI sensitively detected the capillaries within residual thyroid nodules after laser ablation. The lesion size and detection rate of incompletely ablated nodules via SMI was consistent with that of CEUS. SMI may replace CEUS in certain cases for monitoring the curative effect of laser ablation for benign thyroid nodules.
Abstract. Shenmai injection (SMI) has been widely used as a therapy to treat a number of diseases. However, its anti-osteoarthritic properties have not yet been fully investigated. In the present study, the protective effect of SMI on knee articular cartilage of anterior cruciate ligament transected rabbits and interleukin-1β (IL-1β)-stimulated human chondrocytes was investigated. For the in vivo study, knee osteoarthritis (KOA) was induced in female New Zealand white rabbits by anterior cruciate ligament transection (ACLT) in the knee of right hind limb. Rabbits either underwent sham surgery or ACLT surgery. Out of the rabbits receiving ACLT surgery, half of the rabbits received one 0.3 ml Shenmai intra-articular injection in the knee per week for four weeks, following ACLT surgery. The other rabbits received the same volume of normal saline solution. The cartilage was subsequently collected for histological evaluation. For the in vitro study, cultured human chondrocytes were treated with 10 ng/ml IL-1β in the presence or absence of 5 and 2% (v/v) SMI for 24 h. Nitric oxide (NO) and prostaglandin E2 (PGE2) levels in cell culture supernatant were assessed using a Griess reaction and ELISA respectively.The mRNA expression of cyclooxgenase-2 (COX-2), inducible nitric oxide synthase (iNOS), matrix metalloproteinase (MMP)-1, MMP-13 and tissue inhibitors of metalloproteinase-1 (TIMP-1) in chondrocytes were detected by reverse transcription-quantitative polymerase chain reaction. The results of the current study revealed that treatment with SMI ameliorated cartilage degradation in the ACLT rabbit model, and decreased levels of NO and PGE2. Furthermore, treatment with SMI decreased levels of COX-2, iNOS, MMP-1 and MMP-13 mRNA expression and increased TIMP-1 mRNA expression in IL-1β-stimulated human chondrocytes. These results indicate that SMI suppresses inflammation and ameliorated cartilage degradation, making it a potential and promising therapeutic option to treat KOA.
Background Computer-aided diagnosis (CAD) is used as an aid tool by radiologists on breast lesion diagnosis in ultrasonography. Previous studies demonstrated that CAD can improve the diagnosis performance of radiologists. However, the optimal use of CAD on breast lesions according to size (below or above 2 cm) has not been assessed. Objective The aim of this study was to compare the performance of different radiologists using CAD to detect breast tumors less and more than 2 cm in size. Methods We prospectively enrolled 261 consecutive patients (mean age 43 years; age range 17-70 years), including 398 lesions (148 lesions>2 cm, 79 malignant and 69 benign; 250 lesions≤2 cm, 71 malignant and 179 benign) with breast mass as the prominent symptom. One novice radiologist with 1 year of ultrasonography experience and one experienced radiologist with 5 years of ultrasonography experience were each assigned to read the ultrasonography images without CAD, and then again at a second reading while applying the CAD S-Detect. We then compared the diagnostic performance of the readers in the two readings (without and combined with CAD) with breast imaging. The McNemar test for paired data was used for statistical analysis. Results For the novice reader, the area under the receiver operating characteristic curve (AUC) improved from 0.74 (95% CI 0.67-0.82) from the without-CAD mode to 0.88 (95% CI 0.83-0.93; P<.001) at the combined-CAD mode in lesions≤2 cm. For the experienced reader, the AUC improved from 0.84 (95% CI 0.77-0.90) to 0.90 (95% CI 0.86-0.94; P=.002). In lesions>2 cm, the AUC moderately decreased from 0.81 to 0.80 (novice reader) and from 0.90 to 0.82 (experienced reader). The sensitivity of the novice and experienced reader in lesions≤2 cm improved from 61.97% and 73.23% at the without-CAD mode to 90.14% and 97.18% (both P<.001) at the combined-CAD mode, respectively. Conclusions S-Detect is a feasible diagnostic tool that can improve the sensitivity for both novice and experienced readers, while also improving the negative predictive value and AUC for lesions≤2 cm, demonstrating important application value in the clinical diagnosis of breast cancer. Trial Registration Chinese Clinical Trial Registry ChiCTR1800019649; http://www.chictr.org.cn/showprojen.aspx?proj=33094
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