Giant cervical goiter in Hashimoto’s thyroiditis: A case report

A giant cervical goiter, defined as a thyroid mass larger than 8 cm in diameter, is usually a nodular or adenomatous goiter. A giant cervical goiter can also be caused by hyperthyroidism (i.e., Hashimoto’s thyroiditis). The surgical indications for patients with Hashimoto’s disease include suspected malignant tumors, persistent symptoms related to the disease, or persistent enlargement of the goiter. We herein describe a woman who developed symptoms of compression from a thyroid tumor, the volume of which was almost the largest reported in the relevant literature to date. The bilateral lobes of the giant thyroid tumor were removed by total en bloc excision. We protected the bilateral recurrent laryngeal nerve and preserved the bilateral upper and lower parathyroid glands in situ. The excised left lobe tumor was 16 × 9 × 5.5 cm, whereas the right lobe tumor was 12 × 8 × 4 cm. The pathological diagnosis was Hashimoto’s thyroiditis. Although surgical excision is difficult, it is still the main treatment modality for giant goiters in patients with Hashimoto’s thyroiditis and can help to reduce the occurrence of complications.     

A textual research on the origin and evolution of the Chinese character Zheng ( 症)

"症"是"證"的俗字,用以代指"證"中有关疾病的义项.欲考察其产生、发展的具体时期,当依据古籍的刊刻年代而非成书年代.元以前刻本中未见"症"字,"症"字诞生的时间下限大约在元末,弘治、正德、嘉靖三朝"症"字始多见于版刻,万历以降"症"字开始大量替代"證",逐渐成为表示"病症"这一义项时的主要用字.其产生、发展、普及与词义分化的需要、文人刻书的风尚、医学丛书的刊行、戏曲小说的繁荣有较为密切的联系.清代至民国"症"仍与"證"混用,而今"症"字表"症状"之义,主要是在西医学影响下,中医学欲昭示自身独特性的结果.     

联合应用取栓术及动脉溶栓治疗158例急性下肢动脉栓塞

[背景]探讨球囊导管取栓术及动脉置管溶栓联合应用治疗下肢动脉栓塞的效果.[病例报告]利用球囊导管给158例急性下肢动脉栓塞患者进行下肢动脉取栓术,术后在动脉内留置导管,持续滴入溶栓药物,连续2～4d.治疗成功者为128例(81.0%),好转为20例(12.7%),有效率为93.7%(148/158);截肢者为7例(4.2%);所有患者术后踝臂指数提高为0.75～0.90,平均为0.83;未见穿刺部位明显血肿及球囊扩张导致夹层形成等并发症发生.[讨论]下肢动脉取栓术及置管溶栓联合应用对下肢动脉栓塞治疗有明显的效果.     

胆石症胆道感染并发心包积脓7例分析

本院26年中胆石症、胆道感染并发心包积脓7例。其中6例死亡,作者指出,凡胆石症并感染的患者出现心肺症状和体征,应警惕本并发症的发生。A型超声和X线检查对诊断有重要帮助。一旦确诊应及时行心包穿刺抽脓或心包造口引流;及时有效地处理胆道原发病灶是预防和减少本并发症的根本措施。     

Arthroscopic Intra‐Articular Repair of the Torn Subscapularis Tendon with Single Anterior Portal,Single Suture Anchor,and X‐Shaped Fixation Technique

Subscapular tendon plays an important role in shoulder joint function. With the advance of magnetic resonance imaging technology and the popularization of arthroscopic shoulder surgery, subscapularis tears have been increasingly detected. However, reduction and fixation of subscapular tendon tears appears to be technically challenging. This study aims to describe an arthroscopic intra‐articular X‐shaped fixation technique: a procedure of subscapularis tendon repair performed with the aid of a suture passer using only a single anterior portal and a single suture anchor. By incorporating the advantages of a single anterior working portal for anchor placement and tear repair, this technique provides an easier way to use suture lasso and make knots in a limited working space, and the whole procedure is minimally invasive with a short learning curve. This technique has been applied in patients with subscapularis tears involving no intraoperative or postoperative complications. Our technology offers a valuable new treatment option for subscapularis tears.     

Effects of Kangdaxin on myocardial fibrosis in heart failure with preserved ejection fraction rats

BackgroundThis study aimed to explore the effects of Kangdaxin oral liquid on myocardial fibrosis in heart failure with preserved ejection fraction (HFpEF) rats.MethodsA total of 30 Sprague Dawley (SD) rats were randomly divided into 3 groups Sham operation group (Sham), HFpEF group (HFpEF), and HFpEF with drug intervention group (HFpEF + I). Rats in HFpEF + I group were given Kangdaxin oral liquid at a dose of 2.7 mL/(kg·d). After modeling or treatment, the value of E/A and E/e'' in each group of rats were measured by echocardiography. The N-terminal pro b-type natriuretic peptide (NT-proBNP) level was determined by enzyme-linked immunosorbent assay (ELISA). Heart weight/body mass index (Hw/W) and left ventricular weight/body mass index (LVw/W) were calculated after the rats were sacrificed; the transforming growth factor-β1 (TGF-β1) protein expression level in cardiac tissue was detected by western blot.ResultsCompared with sham group, the values of diastolic function item (E/A) and mitral annular early diastolic velocity (E/e'') in HFpEF group were significantly decreased, and the level of NT-proBNP was significantly increased (P<0.05). Compared with HFpEF group, the value of E/A and E/e'' in HF + I group were significantly increased, and the level of NT-proBNP was significantly decreased (P<0.05). Compared with sham group, the expression of TGF-β1 protein in heart tissue of HFpEF group were significantly increased (P<0.05). Compared with HFpEF group, the expression of TGF-β1 protein in HFpEF + I group were significantly decreased (P<0.05).ConclusionsKangdaxin oral liquid has protective effect on heart in HFpEF rats, which can reduce the protein expression of TGF-β1 in the heart tissue of HFpEF rats. This may be a possible mechanism to inhibit myocardial fibrosis and improve cardiac diastolic function.     

Classification of hepatic cavernous hemangioma or hepatocellular carcinoma using a convolutional neural network model

BackgroundComputed tomography (CT) is a common imaging technique for diagnosis of liver tumors. However, the intensity similarity on non-contrast CT images is small, making it difficult for radiologists to visually identify hepatic cavernous hemangioma (HCH) and hepatocellular carcinoma (HCC). Recently, convolutional neural networks (CNN) have been widely used in the study of medical image classification because more discriminative image features can be extracted than the human eye. Therefore, this study focused on developing a CNN model for identifying HCH and HCC.MethodsThis study is a retrospective study. A dataset consisting of 774 non-contrast CT images was collected from 50 patients with HCC or HCH, and the ground truth was given by three radiologists based on contrast-enhanced CT. Firstly, the non-contrast CT images dataset were randomly divided into a training set (n=559) and a test set (n=215). Then, we performed preprocessing of the non-contrast CT images using pseudo-color conversion, and the proposed CNN model developed using training set. Finally, the following indicators (accuracy, precision, recall) were used to quantitatively analyze the results.ResultsIn the test set, the proposed CNN model achieved a high classification accuracy of 84.25%, precision of 81.36%, and recall of 82.18%.ConclusionsThe CNN model for identifying HCH and HCC improves the accuracy of diagnosis on non-contrast CT images.     

A cross-sectional study of obstructive sleep apnea in patients with colorectal cancer

BackgroundThe association between colorectal cancer (CRC) and obstructive sleep apnoea (OSA) has been attracting increasing attention. several studies had confirmed that OSA increases the risk of CRC onset. However, the findings of studies on the morbidity of OSA in patients with CRC were unclear. Therefore, this study aimed to investigate the morbidity of OSA in patients with CRC as well as the association between the clinicopathological characteristics of OSA and CRC.MethodsA total of 414 patients with a pathological diagnosis of CRC from 1 January, 2020 to 30 December, 2020 were included in this study. Demographic characteristics, clinical information, and tumor characteristics of participants were collected; sleep was monitored using a wearable oximeter and via sleep quality questionnaire. The oxygen desaturation index (ODI) was used to classify OSA severity so that the diagnostic criteria for OSA were set based on the ODI as 0–5 (normal) and ≥5 (abnormal). After correcting for confounding factors, a logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the factors affecting the tumor lymph node stage (N stage).ResultsA total of 402 patients with CRC were included in this study, including 225 (55.97%) men and 177 (44.03%) women. The mean ODI value of participants was 3.40±8.17. The morbidity of OSA among the patients with CRC having ODI ≥5 was 16.17%. A comparison between the normal and abnormal ODI value groups revealed that the high proportion of abnormal ODI was related to higher N stage (P<0.05). Logistic regression analysis revealed a correlation of ODI values and age to the N stage. Specifically, CRC patients with an abnormal ODI had a higher risk of lymph node metastasis compared to those with normal ODI (OR =1.915, 95% CI: 1.025 to 3.579). Moreover, patients with CRC aged ≥65 years had a higher risk of lymph node metastasis compared to those aged <65 years (OR =2.190, 95% CI: 1.163 to 4.125).ConclusionsCRC patients with abnormal ODI are susceptible to OSA. Additionally, abnormal ODI and age ≥65 years are relevant factors for the N2 stage.     

MiR-21 mediates the radiation resistance of glioblastoma cells by regulating PDCD4 and hMSH2

The purpose of this study was to investigate the molecular mechanism by which miR-21 and its target genes mediate radiation resistance of glioblastoma cells.Real-time PCR was employed to detect miR-21 expression in normal brain tissues,glioblastoma tissues and glioblastoma cell lines (A172,T98G and U87MG).T98G cells were transfected with anti-miR-21 oligonucleotides,or plasmids containing PDCD4 or hMSH2 (PDCD4-pcDNA3 and hMSH2-pcDNA3).The survival curve was obtained to investigate the sensitivity of T98G cells to radiation.Cell apoptosis was measured by using the Caspase-3/7 kit and cell cycle by flow cytometry.Western blotting was performed to detect the expression of hMSH2 and PDCD4 in miR-21-inhibiting T98G cells.The results showed that miR-21 expression in glioblastoma cells and tissues was conversely associated with the radiation sensitivity.Over-expression of miR-21 resulted in radiation resistance,while knockdown of miR-21 led to higher sensitivity of glioblastma cells to radiation.After miR-21 knockdown,the apoptosis of T98G cells was significantly increased and the G2 phase arrest was more significant.In addition,miR-21 knockdown increased the expression of endogenous PDCD4 and hMSH2,which contributed to the apoptosis and G2 arrest of T98G cells.The findings suggested that miR-21 may mediate the resistance of glioblastoma cells against radiation via its target genes PDCD4 and hMSH2.MiR-21 and its target genes may be used as potential molecular targets for clinical radiotherapy sensitization in the future.     

肾移植受者术后焦虑抑郁情况及其对生存质量的影响

目的：探讨肾移植受者术后焦虑抑郁情况并分析其对生存质量的影响。方法：采用 STAI 和 BDI 量表调查87例在我院进行肾移植手术的受者焦虑抑郁情况,采用 SF-36量表调查其生活质量,同时将85例健康体检者作为对照组一并调查。结果：肾移植受者的状态焦虑、特质焦虑评分明显劣于对照组,肾移植受者抑郁发生率高达25.59%。肾焦虑状态得分、抑郁程度、术后生存时间、再就业是影响生存质量的关键因素。结论：肾移植受者存在较为严重的焦虑抑郁等负性情绪,严重影响了其术后生存质量。