Impact of nodular size on the predictive values of gray-scale,color-Doppler ultrasound,and sonoelastography for assessment of thyroid nodules

Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant.Methods:A total of 243 consecutive subjects(214 women,29 men) with 329 thyroid nodules were examined by gray-scale,color-Doppler ultrasound,and sonoelastography in this prospective study.All patients underwent surgery and the final diagnosis was obtained from histopathological examination.Results:Three hundred and twenty-nine nodules(208 benign,121 malignant) were divided into small(SNs,5-10 mm,n=137) and large(LNs,>10 mm,n=192) nodules.Microcalcifications were more frequent in malignant LNs than in malignant SNs,but showed no significant difference between benign LNs and SNs.Poorly-circumscribed margins were not significantly different between malignant SNs and LNs,but were less frequent in benign LNs than in benign SNs.Among all nodules,marked intranodular vascularity was more frequent in LNs than in SNs.By comparison,shape ratio of anteroposterior to transverse dimensions(A/T) ≥1 was less frequent in LNs than in SNs.Otherwise,among all nodules,marked hypoechogenicity and elasticity score of 4-6 showed no significant difference between LNs and SNs.Conclusions:The predictive values of microcalcifications,nodular margins,A/T ratio,and marked intranodular vascularity depend on nodule size,but the predictive values of echogenicity and elastography do not.

Research gaps for three main tropical diseases in the People’s Republic of China

This scoping review analyzes the research gaps of three diseases:schistosomiasis japonica,malaria and echinococcosis.Based on available data in the P.R.China,we highlight the gaps between control capacity and prevalence levels,and between diagnostic/drug development and population need for treatment at different stages of the national control programme.After reviewing the literature from 848 original studies and consultations with experts in the field,the gaps were identified as follows.Firstly,the malaria research gaps include(i)deficiency of active testing in the public community and no appropriate technique to evaluate elimination,(ii)lack of sensitive diagnostic tools for asymptomatic patients,(iii)lack of safe drugs for mass administration.Secondly,gaps in research of schistosomiasis include(i)incongruent policy in the implementation of integrated control strategy for schistosomiasis,(ii)lack of effective tools for Oncomelania sp.snail control,(iii)lack of a more sensitive and cheaper diagnostic test for large population samples,(iv)lack of new drugs in addition to praziquantel.Thirdly,gaps in research of echinococcosis include(i)low capacity in field epidemiology studies,(ii)lack of sanitation improvement studies in epidemic areas,(iii)lack of a sensitivity test for early diagnosis,(iv)lack of more effective drugs for short-term treatment.We believe these three diseases can eventually be eliminated in China's Mainland if all the research gaps are abridged in a short period of time.

Synthesis of 2,5-disubstitued benzimidazole using SnCl_2-catalyzed reduction system at room temperature

Stannous chloride dihydrate is used as an efficient catalyst in reductive cyclization of 2-nitro-5- substituted aniline Schiff base leading to stable 2,5-disubstitued benzimidazole derivatives in excellent yields with good purity. It provides a novel method of synthesis of 2,5-disubstitued benzimidazole under reductive system at room temperature.