Identification of Rhizobia Isolated from Nodules of Mexican Commercial Soybean Varieties

Rhizobia, crucial for nitrogen fixation in leguminous plants, play a vital role in soybean cultivation. This study, conducted in Mexico, a major soybean importer, aimed to identify bacteria from nodules of five soybean varieties in high-production regions. Multilocus sequence analysis (MLSA) was employed for enhanced species resolution. The study identified six Bradyrhizobium species: Bradyrhizobium japonicum USDA 110, Bradyrhizobium japonicum USDA 6, Bradyrhizobium elkanii USDA 76, Bradyrhizobium neotropicale, Bradyrhizobium lablabi, and Bradyrhizobium icense. Bradyrhizobium japonicum USDA 110 predominated in the soils, displaying symbiotic preference for the Huasteca 400 variety. However, phylogenetic analysis didn't reveal a clear association between strains, soil, and soybean variety. This research sheds light on the diversity of rhizobia in Mexican soybean cultivation, contributing to the understanding of symbiotic relationships in soybean production systems.

Pathological diagnosis and immunohistochemical analysis of giant retrosternal goiter in the elderly: A case report

BACKGROUND Elderly giant retrosternal thyroid goiter is a rare yet significant medical condition,often presenting clinical symptoms that can be confused with other diseases,posing diagnostic and therapeutic challenges.This study aims to delve into the characteristics and potential mechanisms of this ailment through pathological diagnosis and immunohistochemical analysis,providing clinicians with more precise diagnostic and treatment strategies.A 77-year-old male,was admitted to hospital with the chief complaint of finding a goiter in the semilunar month during physical examination,accompanied by dyspnea.Locally protruding into the superior mediastinum,the adjacent structure was compressed,the trachea was compressed to the right,and the local lumen was slightly narrowed.The patient was diagnosed with giant retrosternal goiter.Considering dyspnea caused by trachea compression,our department planned to perform giant retrosternal thyroidectomy.Immunohistochemical results:Tg(+),TTF-1(+),Calcitonin(CT)(I),Ki-67(+,about 20%),CD34(-).Retrosternal goiter means that more than 50%of the volume of the thyroid gland is below the upper margin of the sternum.As retrosternal goiter disease is a relatively rare disease,once the disease is diagnosed,it should be timely surgical treatment,and the treatment is more difficult,the need for professional medical team for comprehensive treatment.CONCLUSION The imaging manifestations of giant retrosternal goiter are atypical,histomorphology and immunohistochemistry can assist in its diagnosis.This article reviews the relevant literature of giant retrosternal goiter immunohisto-chemistry and shows that giant retrosternal goiter is positive for Tg,TTF-1,and Ki-67.

Lithium carbonate-induced giant goiter and subclinical hyperthyroidism in a patient with schizophrenia:A case report and review of literature

BACKGROUND Lithium carbonate is used to manage various mood disorders,but it can cause thyroid abnormalities,including goiter,hypothyroidism,and hyperthyroidism.In rare cases,it can lead to giant goiter and subclinical hyperthyroidism,which may require surgical intervention in severe cases.CASE SUMMARY This case represents a rare development of giant goiter and subclinical hyperthyroidism in a schizophrenia patient who was subjected to prolonged lithium carbonate treatment.The enlarged thyroid gland caused pressure on the airway and recurrent laryngeal nerve,which led to respiratory distress,hoarseness,and dysphagia.The immediate danger of suffocation required urgent surgical intervention.In this report,we describe the case of a 41-year-old Chinese woman.This sheds light on the etiology and challenges associated with managing a giant goiter.The patient underwent a subtotal thyroidectomy to relieve airway compression and facilitate airway expansion.Prior to the procedure,the patient was given iodine to prepare.Concurrently,changes were made to the psychiatric medication regimen.Following surgery,the patient's respiratory function and vocal cord functionality improved significantly,and her mental state remained stable.CONCLUSION It is essential to monitor thyroid function,test thyroid antibody levels,and perform thyroid ultrasounds consistently in all patients undergoing long-term lithium carbonate treatment.This vigilance helps prevent severe and potentially life-threatening thyroid enlargement.

Pathological and Clinical Correlation European Union-Thyroid Imaging Reporting and Data System (EU-TIRADS) Classification of Thyroid Nodules in Two University Hospitals in Cotonou

Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these countries testify to the effectiveness of this tool for the management of nodular thyroid pathology. However, in Benin, the contribution of this classification has not yet been evaluated. It is therefore to overcome this inadequacy that we undertook this study. Objective: Participate in improving the diagnostic and therapeutic management of thyroid nodules at the CNHU HKM in Cotonou and at the CHUZ in Suru-Léré. Methods: This is a cross-sectional study with retrospective data collection spread over a period of 3 years 5 months, from January 2019 to May 2022 and carried out jointly in the Endocrinology Metabolism Nutrition and ORL-CCF departments of the CNHU HKM of Cotonou and in the ORL-CCF department of the CHUZ of Suru-Léré. The study population consisted of patients who consulted the University Clinic of Endocrinology Metabolism Nutrition, the University Clinic of ORL-CCF of the CNHU-HKM and the University Clinic of ORL-CCF of the CHUZ of Suru-Léré for thyroid nodule and who have had surgery. The study data was collected from patients hospitalization records using a survey form. Results: On ultrasound, according to the EU-TIRADS classification, 56.8% of nodules presented a low risk of malignancy (EU-TIRADS 3) compared to respectively 19.8%;23% and 2.5% of nodules with zero (EU-TIRADS 2), intermediate (EU-TIRADS 4) and high (EU-TIRADS 5) risk of malignancy. Regarding the performance of this classification, it is sensitive in 37.5% of cases and has a specificity of 78.5% with a PPV (Positive Predictive Value) and a NPV (Negative Predictive Value) respectively of 6.6 % and 91.6%. Furthermore, the bivariate correlations revealed that the size of the nodule was significantly associated with the malignancy of the nodule (p = 0.014) and the calculated value of the Yule’s Q coefficient (0.375) reflects a moderate intensity of the connection between the EU-TIRADS and histology. Conclusion: the EU-TIRADS classification, due to its excellent NPV, is of great interest for the management of thyroid nodules at the CNHU-HKM of Cotonou and at the CHUZ of Suru-Léré. In view of this, particular emphasis must be placed on its regular and rigorous use.

Advancements in Medication Rule for Pulmonary Nodules: A Review of Current Research Progress

This paper reviewed the literature on medication rule of pulmonary nodules in recent years. It is found that contemporary doctors pay more attention to regulating Qi, clearing heat and detoxifying, eliminating phlegm, dissolving phlegm and dissipating masses. They use mild drugs, cold and warm treatments in parallel, combining the tastes of pungent, bitterness, and sweetness at the same time. The treatment focuses on the five viscera with emphasis on the lung meridian while also considering the spleen and stomach functions as well as soothing liver stagnation. This information aims to provide some reference for clinical treatment of pulmonary nodules.

Tongue image feature correlation analysis in benign lung nodules and lung cancer

Objective To analyze the differences in the correlation of tongue image indicators among patients with benign lung nodules and lung cancer.Methods From July 1;2020 to March 31;2022;clinical information of lung cancer patients and benign lung nodules patients was collected at the Oncology Department of Longhua Hos-pital Affiliated to Shanghai University of Traditional Chinese Medicine and the Physical Ex-amination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chi-nese Medicine;respectively.We obtained tongue images from patients with benign lung nod-ules and lung cancer using the TFDA-1 digital tongue diagnosis instrument;and analyzed these images with the TDAS V2.0 software.The extracted indicators included color space pa-rameters in the Lab system for both the tongue body(TB)and tongue coating(TC)(TB/TC-L;TB/TC-a;and TB/TC-b);textural parameters[TB/TC-contrast(CON);TB/TC-angular second moment(ASM);TB/TC-entropy(ENT);and TB/TC-MEAN];as well as TC parameters(perAll and perPart).The bivariate correlation of TB and TC features was analyzed using Pearson’s or Spearman’s correlation analysis;and the overall correlation was analyzed using canonical correlation analysis(CCA).Results Samples from 307 patients with benign lung nodules and 276 lung cancer patients were included after excluding outliers and extreme values.Simple correlation analysis indi-cated that the correlation of TB-L with TC-L;TB-b with TC-b;and TB-b with perAll in lung cancer group was higher than that in benign nodules group.Moreover;the correlation of TB-a with TC-a;TB-a with perAll;and the texture parameters of the TB(TB-CON;TB-ASM;TB-ENT;and TB-MEAN)with the texture parameters of the TC(TC-CON;TC-ASM;TC-ENT;and TC-MEAN)in benign nodules group was higher than lung cancer group.CCA further demon-strated a strong correlation between the TB and TC parameters in lung cancer group;with the first and second pairs of typical variables in benign nodules and lung cancer groups indicat-ing correlation coefficients of 0.918 and 0.817(P<0.05);and 0.940 and 0.822(P<0.05);re-spectively.Conclusion Benign lung nodules and lung cancer patients exhibited differences in correla-tion in the L;a;and b values of the TB and TC;as well as the perAll value of the TC;and the texture parameters(TB/TC-CON;TB/TC-ASM;TB/TC-ENT;and TB/TC-MEAN)between the TB and TC.Additionally;there were differences in the overall correlation of the TB and TC be-tween the two groups.Objective tongue diagnosis indicators can effectively assist in the diag-nosis of benign lung nodules and lung cancer;thereby providing a scientific basis for the ear-ly detection;diagnosis;and treatment of lung cancer.

Systemic lupus erythematosus in a 15-year-old female with multiple splenic nodules:A case report

BACKGROUND Systemic lupus erythematosus(SLE)is a chronic inflammatory disease primarily affecting young females.SLE can invade any organ,and various forms of splenic invasion have been reported.Manifestations include splenomegaly and splenic infarction,rupture,and calcification.The study encountered a rare case of splenic involvement,with nodules of various sizes without calcifications or ruptures.CASE SUMMARY A 15-year-old girl presented with arthralgia,weight loss,fever,increased levels of inflammatory markers,and positive antinuclear antibody test results.The patient was diagnosed with SLE.She was asymptomatic while taking steroids and hydroxychloroquine.Ten months after discharge,the patient developed a fever and abdominal pain.Lupus enteritis was suspected,and abdominopelvic computed tomography(AP-CT)was performed.There were no specific findings in the gastrointestinal tract,but multiple splenic nodules were observed.Infection or hemangioma was considered;however,no specific radiological findings were observed.A biopsy of the spleen was performed to determine the possibility of malignancy.The histological findings of the spleen included extensive periarteriolar necrosis with hematoxylin bodies and numerous karyorrhectic debris.Based on the biopsy results,the patient was diagnosed with an SLE flare-up and was maintained on high-dose steroids and immunosuppressants.CONCLUSION As disease activity increased,multiple nodules in the spleen that were previously unseen were observed using AP-CT and histologically confirmed.Spleen invasion by SLE can appear in multiple nodular forms and patterns.Therefore,physicians should consider these findings when differentiating these nodules from infections and malignancies.

A Survey of Lung Nodules Detection and Classification from CT Scan Images

In the contemporary era,the death rate is increasing due to lung cancer.However,technology is continuously enhancing the quality of well-being.To improve the survival rate,radiologists rely on Computed Tomography(CT)scans for early detection and diagnosis of lung nodules.This paper presented a detailed,systematic review of several identification and categorization techniques for lung nodules.The analysis of the report explored the challenges,advancements,and future opinions in computer-aided diagnosis CAD systems for detecting and classifying lung nodules employing the deep learning(DL)algorithm.The findings also highlighted the usefulness of DL networks,especially convolutional neural networks(CNNs)in elevating sensitivity,accuracy,and specificity as well as overcoming false positives in the initial stages of lung cancer detection.This paper further presented the integral nodule classification stage,which stressed the importance of differentiating between benign and malignant nodules for initial cancer diagnosis.Moreover,the findings presented a comprehensive analysis of multiple techniques and studies for nodule classification,highlighting the evolution of methodologies from conventional machine learning(ML)classifiers to transfer learning and integrated CNNs.Interestingly,while accepting the strides formed by CAD systems,the review addressed persistent challenges.

Phase II Clinical Study of Three-Dimensional Printed Coplanar Template Combined with CT-Guided Percutaneous Core Needle Biopsy of Pulmonary Nodules in Elderly Patients

Background: As the population age structure gradually ages, more and more elderly people were found to have pulmonary nodules during physical examinations. Most elderly people had underlying diseases such as heart, lung, brain and blood vessels and cannot tolerate surgery. Computed tomography (CT)-guided percutaneous core needle biopsy (CNB) was the first choice for pathological diagnosis and subsequent targeted drugs, immune drugs or ablation treatment. CT-guided percutaneous CNB requires clinicians with rich CNB experience to ensure high CNB accuracy, but it was easy to cause complications such as pneumothorax and hemorrhage. Three-dimensional (3D) printing coplanar template (PCT) combined with CT-guided percutaneous pulmonary CNB biopsy has been used in clinical practice, but there was no prospective, randomized controlled study. Methods: Elderly patients with lung nodules admitted to the Department of Oncology of our hospital from January 2019 to January 2023 were selected. A total of 225 elderly patients were screened, and 30 patients were included after screening. They were randomly divided into experimental group (Group A: 30 cases) and control group (Group B: 30 cases). Group A was given 3D-PCT combined with CT-guided percutaneous pulmonary CNB biopsy, Group B underwent CT-guided percutaneous pulmonary CNB. The primary outcome measure of this study was the accuracy of diagnostic CNB, and the secondary outcome measures were CNB time, number of CNB needles, number of pathological tissues and complications. Results: The diagnostic accuracy of group A and group B was 96.67% and 76.67%, respectively (P = 0.026). There were statistical differences between group A and group B in average CNB time (P = 0.001), number of CNB (1 vs more than 1, P = 0.029), and pathological tissue obtained by CNB (3 vs 1, P = 0.040). There was no statistical difference in the incidence of pneumothorax and hemorrhage between the two groups (P > 0.05). Conclusions: 3D-PCT combined with CT-guided percutaneous CNB can improve the puncture accuracy of elderly patients, shorten the puncture time, reduce the number of punctures, and increase the amount of puncture pathological tissue, without increasing pneumothorax and hemorrhage complications. We look forward to verifying this in a phase III randomized controlled clinical study. .

Ultrasound in Ti-Rads Classification of Thyroid Nodules at the Marie Curie Medical Clinic

Introduction: A thyroid nodule is a localized hypertrophy within the thyroid parenchyma. The aim of our study was to study the benefit of ultrasound in the Ti-rads classification of thyroid nodules. Methodology: This was a prospective study with a descriptive aim, with prospective collection, which took place over a period of 17 months at the “Marie Curie” medical clinic. The ultrasound machine used was a Voluson E8 from 2011 and the examinations were carried out by two radiologists and two experienced sonographers. The parameters studied were sociodemographic data;clinical data and ultrasound aspects of the Ti-rads classification in the management of nodules. Results: We collected 235 patients out of 738 patients referred to the service for a cervical ultrasound, i.e. a frequency of 31.84% of cases. There was a female predominance with 95.7% of cases and a sex ratio of 0.04. The average age of our patients was 50 years. We found on cervical ultrasound: Isthmo-lobar glandular hyperplasia in 99 patients, i.e. a frequency of 42.1%. The Ti-rads 3 classification was the most represented in 69.4% of cases. The benignity criterion represented 85.6% of cases in our patients and the malignancy criterion represented 14.4% of cases. Conclusion: The precise description of a thyroid nodule provided by ultrasound (Ti-rads) is essential in the management of nodules.

Hyperparathyroidism presented as multiple pulmonary nodules in hemodialysis patient status post parathyroidectomy:A case report

BACKGROUND Primary hyperparathyroidism is typically caused by a single parathyroid adenoma.Ectopic parathyroid adenomas occur as well,with cases involving various sites,including the mediastinum,presenting in varying frequencies.Secondary hyperparathyroidism develops in the context of chronic kidney disease,primarily due to vitamin D deficiency,hypocalcemia,and hyperphosphatemia.It is frequently diagnosed in patients undergoing dialysis.This article presents a rare case of hyperparathyroidism involving multiple hyperplastic parathyroid glands with pulmonary seeding in a 50-year-old female patient undergoing hemodialysis(HD).CASE SUMMARY The patient had a history of parathyroidectomy 10 years prior but developed recurrent hyperparathyroidism with symptoms of pruritus and cough with sputum during a period of routine dialysis.Radiographic imaging revealed multiple nodules in both lungs,with the largest measuring approximately 1.35 cm.Surgical histopathology confirmed the presence of hyperplastic parathyroid glands within the pulmonary tissue.After tumor resection surgery via videoassisted thoracic surgery with wedge resection,the patient was discharged in stable condition and in follow-up her symptoms showed improvement.CONCLUSION This article describes hyperparathyroidism presenting as pulmonary nodules in a patient undergoing postparathyroidectomy HD,highlighting diagnostic challenges and a positive outcome from tumor resection surgery.

Role of inflammatory markers in the evaluation of indeterminate pulmonary nodules:a review

The global mortality rate of lung cancer surpasses that of any other type of cancer,establishing it as the foremost cause of cancer-related deaths worldwide.The objectives of lung nodule assessment are to expedite the diagnosis and treatment of patients with malignant nodules while minimizing unnecessary diagnostic procedures for those with benign nodules.The systemic inflammatory response is closely linked to tumorigenesis.Serum levels of inflammatory markers and their derived parameters markers including neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),monocyte-to-albumin ratio(MAR),platelet-to-lymphocyte ratio(PLR)and systemic immune‐inflammation index(SII),closely associated with lung cancer.The objective of this article is to comprehensively evaluate the differentiation between benign and malignant pulmonary nodules in terms of inflammatory response indicators,aim at provide practical recommendations for the clinical diagnosis,treatment,and management of pulmonary nodules.

Analysis of the Prevalence Characteristics of Lung Nodules and Their Influencing Factors in The Health Check-Up Population

Objective: To study the prevalence characteristics of pulmonary nodules and their influencing factors in the health check-up population. Methods: A total of 500 cases of health checkups were selected for the data study to analyze the detection and prevalence characteristics of pulmonary nodules. The influencing factors between the pulmonary nodules group and the no pulmonary nodules group were analyzed. Results: A total of 209 cases were detected, of which there were more males than females, and for female patients, the detection rate increased with age (P < 0.05). The distribution of gender, age, smoking, respiratory symptoms, and exposure to kitchen fumes between the two groups was compared (P < 0.05). The multifactorial analysis concluded that risk factors include, respiratory symptoms, older age, exposure to kitchen fumes, and smoking. In addition, patients who exercised more had a lower risk of developing lung nodules. Conclusion: The detection rate of pulmonary nodules was high in the health check-up population and the influencing factors analyzed involved the presence of respiratory symptoms, older age, kitchen fume exposure, and smoking, while the positive influencing factor was increased exercise.

Treatment of 198 Cases of Thyroid Nodules with Sanying Capsule Combined with Xiaoying Patch

[Objectives]To observe the clinical efficacy of Sanying capsule combined with Xiaoying Patch in treating thyroid nodule(TN).[Methods]Two groups were treated similarly,with 200 cases in the control group undergoing basic treatment for 12 weeks and 198 cases in the observation group receiving Sanying capsule combined with Xiaoying patches for the same duration.The clinical symptoms,number of nodules,diameter of the largest nodule,and maximum reduction of nodules were observed before and after treatment.A control analysis was performed,and the underlying mechanisms were explored.[Results]The primary symptoms of the observation group exhibited a more favorable improvement than those of the control group.Additionally,the number of nodules decreased,the diameter of the largest nodule decreased,and the maximum reduction of nodules decreased in both groups following treatment.However,the observation group demonstrated a more pronounced improvement than the control group(P<0.05).[Conclusions]The combination of Sanying capsule and Xiaoying patch has been demonstrated to be an effective treatment for TN,with a high degree of reliability in terms of safety.

Primary pulmonary meningioma and minute pulmonary meningothelial-like nodules: Rare pulmonary nodular lesions requiring more awareness in clinical practice

In this editorial,we comment on an article by Ruan et al published in a recent issue of the World Journal of Clinical Case.Pulmonary meningothelial proliferative lesions,including primary pulmonary meningiomas,minute pulmonary meningothelial-like nodules,and metastatic pulmonary meningiomas are rare pulmonary lesions.These lesions are difficult to differentiate from lung cancers based on clinical and imaging manifestations.Herein,we briefly introduce the clinical,imaging,and pathological characteristics of these lesions and discuss their pathogenesis to strengthen the current understanding of pulmonary meningothelial proliferative lesions in clinical diagnosis and therapy.

Pathological diagnosis and immunohistochemical analysis of minute pulmonary meningothelial-like nodules:A case report

BACKGROUND Minute Pulmonary Meningothelial-like Nodules(MPMNs)are rare benign pulmonary nodules,which are more common in elderly women and have a higher detection rate in lung tissues of patients with lung malignant diseases.Its origin is not yet clear.At present,there are few reports on the diagnostic methods such as imaging and pathological manifestations of MPMNs.This article reports a 70-year-old female patient with pulmonary adenocarcinoma combined with MPMNs and reviews of the relevant literature.CASE SUMMARY A 70-year-old women was admitted to our institution with feeling sour in her back and occasional cough for more than 2 mo.Computerized electronic scanning scan and 3D reconstruction images in our institution showed there were multiple ground-glass nodules in both of her two lungs.The biggest one was in the apicoposterior segment of left upper lobe,about 2.5 mm×9 mm in size.We performed thoracoscopic resection of the left upper lung apicoposterior segment of the patient,and the final pathological report was minimally invasive adenocarcinoma.Re-examination of high resolution computed tomography 21 mo after surgery showed multiple ground-glass nodules in both lungs,and a new groundglass nodule was found in the superior segment of the right lower lobe.We took pathological biopsy of the right upper lung and right lower lung nodules for the patient under thoracoscopy.The histomorphology of the right lower lobe nodule showed multiple lesions in the lung tissue,and the small foci in the alveolar septum were distributed in mild form of the aggregation of short spindle cells.The immunohistochemistry showed that the lesion was epithelial membrane antigen(EMA)(+),somatostatin receptor 2a(SSTR2a)(+),S-100(-),chromogranin A(-),Syn(-),cytokeratin(-)and HMB-45(-).The final diagnosis was minimally invasive adenocarcinoma,accompanied by MPMNs.We recommend that patients continue to receive treatment after surgery and to do regular follow-up observations.CONCLUSION The imaging manifestations of MPMNs are atypical,histomorphology and immunohistochemistry can assist in its diagnosis.This article reviews the relevant literature of MPMNs immunohistochemistry and shows that MPMNs are positive for EMA,SSTR2a,and progesterone receptor.

Increased Prevalence of Thyroid Nodules Across Nearly 10 Years in Shanghai,China

Objective This study aimed to determine whether the prevalence of thyroid nodules(TNs)increased due to modern lifestyles or other factors,despite the advances in screening and diagnostic tools.Methods This study included 3474 pairs of participants,who were matched by gender and age(±3 years)from two cross-sectional sampling surveys:(1)the program on the iodine nutritional status and related health status of residents in Shanghai in 2009;(2)the thyroid disease screening program for adults in Shanghai between 2017 and 2018.The prevalence of TNs and thyroid diseases in 2009 and 2017–2018 were compared,and the potential risk factors of TNs were detected.Results The prevalence of TNs in 2009 was 28.9%:22.5%in males and 34.5%in females.In 2017,this increased to 43.8%:37.9%in males and 49.1%in females.The prevalence of TNs significantly increased from 2009 to 2017(odds ratio,1.486;95%confidence interval,1.238–1.786).In addition,female gender,thyroid disease history,and age were the main risk factors for TNs after adjusting for confounders in the logistic regression across the time period.Conclusion The prevalence of TNs significantly increased across nearly 10 years in Shanghai.

Clinical and Pathological Research Status of Multiple Pulmonary Nodules

With the changes in disease spectrum and the popularization of screening of low-dose spiral CT (CT) in the chest, more and more pulmonary nodules have been detected, most of which are bipulmonary multiple nodules. The existence of multiple pulmonary nodules means that it may be a pathological state of benign and malignant co-existence. The origin and evolution of pulmonary nodules in different histopathological states have a great impact on the choice of treatment methods. In recent years, the rise of immunotherapy has brought a breakthrough in the treatment of refractory lung cancer. However, some patients are still ineffective in immunotherapy, which may be related to the immune microenvironment where nodules are proportioned in different components in different pathological states. This review article mainly predicts the development process of nodules by analyzing the origin of multiple pulmonary nodules and the immune microenvironment of nodules in different pathological conditions, so as to provide guidance for clinical treatment.

Low cervical incision combined with video-assisted thoracoscopy for resection of a goiter extending to the posterior mediastinum:A case report and literature review

Approximately 25%of goiters extend to the substernal area,and most of them can be removed through a cervical incision.Goiters that extend into the posterior mediastinum are very rare,and resection usually requires thoracotomy.In recent years,there have been several reports of resection of substernal goiters by minimally invasive surgery.Here,we present a 75-year-old female with a giant substernal goiter who successfully underwent resection of the goiter extending to the posterior mediastinum using low cervical incision combined with video-assisted thoracoscopy.

Advances in the Intervention of Prunella Spica Capsules on Postoperative Recurrence of Nodular Goiter

As important drugs for the treatment of nodular goiter(NG),Prunella Spica preparations are widely used clinically,and have a significant effect on NG.Various active ingredients in the preparations intervene in the formation of NG by inhibiting the proliferation of thyroid follicular cells,promoting cell apoptosis,regulating immunity,improving the microcirculation of thyroid tissue and other mechanisms,and can reduce the postoperative recurrence of NG.