Diagnostic value of traditional Chinese medical dialectical classification in hashimoto's thyroiditis complicated with suspicious nodules

Objective:To explore the diagnostic value of traditional Chinese medical(TCM)dialectical classification in Hashimoto's thyroiditis complicated with suspicious nodules.Methods:The clinical data of patients with Hashimoto's thyroiditis complicated with thyroid nodules in the Department of Breast and thyroid surgery of Weifang Hospital of traditional Chinese Medicine from January 2018 to December 2019 were collected.The patients were examined by 2 or more experienced TCM doctors,and the four diagnostic data were obtained,and then the relevant syndrome types of the patients were judged according to the data.According to the color Doppler ultrasonographic features of thyroid nodules,the patients who met the indication of fine needle aspiration biopsy of thyroid nodules were selected and underwent fine needle aspiration biopsy of thyroid nodules before operation.To analyze the clinical diagnostic value of that the ultrasonic mode used in this study and thyroid cytopathology Bethesda report system combine dialectical classification of traditional Chinese medicine in Hashimoto's thyroiditis complicated with suspected thyroid nodules.Result:A total of 89 patients with Hashimoto's thyroiditis complicated with thyroid nodules were collected.according to the ultrasonic mode,the difference between different modes was statistically significant(P<0.05).The mode of color ultrasound is also related to the dialectical classification of traditional Chinese medicine.The patients with high malignant risk score are mainly qi depression and phlegm stagnation,phlegm and blood stasis,while those with low score are exuberant liver fire and heart liver yin deficiency.According to the study of different The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC)classification,the dialectical classification of patients with higher TBSRTC classification was more inclined to qi depression and phlegm stagnation,phlegm and blood stasis,and there was significant difference between different classification(P<0.05).Conclusion:Qi depression and phlegm obstruction,phlegm and blood stasis have high ultrasound malignant risk score and high TBSRTC classification grade in patients with Hashimoto's thyroiditis complicated with suspected thyroid nodules,which has important clinical diagnostic value.

Expression profiling-based clustering of healthy subjects recapitulates classifications defined by clinical observation in Chinese medicine

Differences between healthy subjects and associated disease risks are of substantial interest in clinical medicine. Based on clinical presentations, Traditional Chinese Medicine （TCM） classifies healthy people into nine constitutions： Balanced, Qi, Yang or Yin deficiency, Phlegm-dampness, Damp-heat, Blood stasis, Qi stagnation, and Inherited special constitutions. In particular, Yang and Yin deficiency constitutions exhibit cold and heat aversion, respectively. However, the intrinsic molecular characteristics of unbal- anced phenotypes remain unclear. To determine whether gene expression-based clustering can reca- pitulate TCM-based classification, peripheral blood mononudear cells （PBMCs） were collected from Chinese Han individuals with Yang/Yin deficiency （n = 12 each） and Balanced （n = 8） constitutions, and global gene expression profiles were determined using the Affymetrix HC-UI33A Plus 2.0 array. Notably, we found that gene expression-based classifications reflected distinct TCM-based subtypes. Consistent with the clinical observation that subjects with Yang deficiency tend toward obesity, series-clustering analysis detected several key lipid metabolic genes （diacylglycerol acyltransferase （DGAT2）, acyl-CoA synthetase （ACSL1）, and ATP-hinding cassette subfamily A member 1 （ABCAI）） to be down- and up- regulated in Yin and Yang deficiency constitutions, respectively. Our findings suggest that Yin]Yang deficiency and Balanced constitutions are unique entities in their mRNA expression profiles. Moreover, the distinct physical and clinical characteristics of each unbalanced constitution can be explained, in part, by specific gene expression signatures.