The thyroid, an endocrine gland located at the base of the neck, produces thyroid hormones (triiodothyronine (T3) and thyroxine (T4)). The production of these hormones is possible by iodine and other nutrients such as...The thyroid, an endocrine gland located at the base of the neck, produces thyroid hormones (triiodothyronine (T3) and thyroxine (T4)). The production of these hormones is possible by iodine and other nutrients such as selenium and certain vitamins. To assess the thyroid disturbances in the mountain population of Benin, a survey was conducted in Natitingou, a mountain town located in the department of Atacora, in the northwest of Benin, on a sample of thirty (30) adults (15 men and 15 women), most of whom are educated. The results of the questionnaire revealed that 43% of the surveyed population acknowledged having knowledge on the mentioned subject and have dietary habits based on the consumption of seafood, and also legumes (20%). The examination of the serum results of the dosage of T3, T4 and TSH hormones revealed cases of thyroid disturbances in the region (36.32% in men and 44.98% in women). The analysis of a comparative table including the “VEDALAB Easy Reader+” and five (05) other readers, presents the performance, reading techniques, principles, advantages and disadvantages of each device. Pending further studies, some recommendations were made at the end of this study to the academic authorities regarding probable cases of dysthyroidism for which additional examinations are required and an awareness for the improvement of dietary habits.展开更多
目的探讨基于MRI征象与影像组学诊断进展期胃癌T3和T4a分期效能的对比分析。方法选取于同济大学附属东方医院庐江分院行MRI检查,经病理结果证实,共计纳入208例胃癌患者,其中T3期96例,T4a期112例。首先应用传统影像学征象判断进展期胃癌...目的探讨基于MRI征象与影像组学诊断进展期胃癌T3和T4a分期效能的对比分析。方法选取于同济大学附属东方医院庐江分院行MRI检查,经病理结果证实,共计纳入208例胃癌患者,其中T3期96例,T4a期112例。首先应用传统影像学征象判断进展期胃癌侵犯浆膜层等征象,比较多序列MRI征象在病理证实T3和T4a期胃癌中表现的差异性;其次按7:3的比例随机分为训练组(n=145)和验证组(n=63),分别从常规T2非抑脂序列及高比值DWI序列(b=1000 s/mm^(2))图像中提取影像组学特征,构建影像组学联合模型;然后分别绘制基于传统MRI征象与影像组学联合模型工作特征(receiver operating characteristic,ROC)曲线,并计算ROC曲线下面积(area under the curve,AUC)、特异度及灵敏度,量化两种诊断方式对胃癌T3和T4a分期的诊断效能。结果传统多序列MRI征象诊断AUC:0.929(95%CI:0.887~0.970),特异度0.912,灵敏度0.916;MRI影像组学联合模型训练组诊断AUC:0.975(95%CI:0.974~0.976),特异度0.946,灵敏度0.956,验证组诊断AUC:0.971(95%CI:0.965~0.974),特异度0.946,灵敏度0.943,均具有统计学意义(P<0.05)。结论基于MRI影像组学模型诊断T3和T4a分期效能高于传统MRI征象,值得临床工作中进一步推广使用。展开更多
BACKGROUND Both phases of euthyroid sick syndrome(ESS)are associated with worse prognosis in septic shock patients.Although there are still no indications for supplementation therapy,there is no evidence that both pha...BACKGROUND Both phases of euthyroid sick syndrome(ESS)are associated with worse prognosis in septic shock patients.Although there are still no indications for supplementation therapy,there is no evidence that both phases(initial and prolonged)are adaptive or that only prolonged is maladaptive and requires supplementation.AIM To analyze clinical,hemodynamic and laboratory differences in two groups of septic shock patients with ESS.METHODS A total of 47 septic shock patients with ESS were divided according to values of their thyroid hormones into low T3 and low T3T4 groups.The analysis included demographic data,mortality scores,intensive care unit stay,mechanical ventilation length and 28-day survival and laboratory with hemodynamics.RESULTS The Simplified Acute Physiology Score II score(P=0.029),dobutamine(P=0.003)and epinephrine requirement(P=0.000)and the incidence of renal failure and multiple organ failure(MOF)(P=0.000)were significantly higher for the low T3T4.Hypoalbuminemia(P=0.047),neutrophilia(P=0.038),lymphopenia(P=0.013)and lactatemia(P=0.013)were more pronounced on T2 for the low T3T4 group compared to the low T3 group.Diastolic blood pressure at T0(P=0.017)and T1(P=0.007),as well as mean arterial pressure at T0(P=0.037)and T2(P=0.033)was higher for the low T3 group.CONCLUSION The low T3T4 population is associated with higher frequency of renal insufficiency and MOF,with worse laboratory and hemodynamic parameters.These findings suggest potentially maladaptive changes in the chronic phase of septic shock.展开更多
AIM To provide evidence regarding the postoperative treatment of patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer, for which guidelines have not been established. METHODS Patients who had undergone curative resect...AIM To provide evidence regarding the postoperative treatment of patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer, for which guidelines have not been established. METHODS Patients who had undergone curative resection between 1996 and 2014 with a pathological stage of T4 b N1-3 M0/Tx N3 b M0 for gastric cancer were retrospectively analyzed; staging was based on the 7 th edition of the American Joint Committee on Cancer staging system. The clinicopathological characteristics, administration of adjuvant chemotherapy, and patterns of recurrence were studied. Univariate and multivariate analyses of prognostic factors were conducted. The chemotherapeutic agents mainly included fluorouropyrimidine, platinum and taxanes, used as monotherapy, doublet, or triplet regimens. Patterns of first recurrence were categorized as locoregional recurrence, peritoneal dissemination, or distant metastasis.RESULTS The 5-year overall survival(OS) of the whole group(n = 176) was 16.8%, and the median OS was 25.7 mo(95%CI: 20.9-30.5). Lymphovascular invasion and a node positive rate(NPR) ≥ 0.8 were associated with a poor prognosis(P = 0.01 and P = 0.048, respectively). One hundred forty-seven(83.5%) of the 176 patients eventually experienced recurrence; the most common pattern of the first recurrence was distant metastasis. The prognosis was best for patients with locoregional recurrence and worst for those with peritoneal dissemination. Twelve(6.8%) of the 176 patients did not receive adjuvant chemotherapy, while 164(93.2%) patients received adjuvant chemotherapy. Combined chemotherapy, including doublet and triplet regimens, was associated with a better prognosis than monotherapy, with no significant difference in 5-year OS(17.5% vs 0%, P = 0.613). The triplet regimen showed no significant survival benefit compared with the doublet regimen for 5-year OS(18.5% vs 17.4%, P = 0.661). Thirty-nine(22.1%) patients received adjuvant chemotherapy for longer than six months; the median OS in patients who received adjuvant chemotherapy for longer than six months was 40.2 mo(95%CI: 30.6-48.2), significantly longer than the 21.6 mo(95%CI: 19.1-24.0) in patients who received adjuvant chemotherapy for less than six months(P = 0.001).CONCLUSION Patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer showed a poor prognosis and a high risk of distant metastasis. Adjuvant chemotherapy for longer than six months improved outcomes for them.展开更多
文摘The thyroid, an endocrine gland located at the base of the neck, produces thyroid hormones (triiodothyronine (T3) and thyroxine (T4)). The production of these hormones is possible by iodine and other nutrients such as selenium and certain vitamins. To assess the thyroid disturbances in the mountain population of Benin, a survey was conducted in Natitingou, a mountain town located in the department of Atacora, in the northwest of Benin, on a sample of thirty (30) adults (15 men and 15 women), most of whom are educated. The results of the questionnaire revealed that 43% of the surveyed population acknowledged having knowledge on the mentioned subject and have dietary habits based on the consumption of seafood, and also legumes (20%). The examination of the serum results of the dosage of T3, T4 and TSH hormones revealed cases of thyroid disturbances in the region (36.32% in men and 44.98% in women). The analysis of a comparative table including the “VEDALAB Easy Reader+” and five (05) other readers, presents the performance, reading techniques, principles, advantages and disadvantages of each device. Pending further studies, some recommendations were made at the end of this study to the academic authorities regarding probable cases of dysthyroidism for which additional examinations are required and an awareness for the improvement of dietary habits.
文摘目的探讨基于MRI征象与影像组学诊断进展期胃癌T3和T4a分期效能的对比分析。方法选取于同济大学附属东方医院庐江分院行MRI检查,经病理结果证实,共计纳入208例胃癌患者,其中T3期96例,T4a期112例。首先应用传统影像学征象判断进展期胃癌侵犯浆膜层等征象,比较多序列MRI征象在病理证实T3和T4a期胃癌中表现的差异性;其次按7:3的比例随机分为训练组(n=145)和验证组(n=63),分别从常规T2非抑脂序列及高比值DWI序列(b=1000 s/mm^(2))图像中提取影像组学特征,构建影像组学联合模型;然后分别绘制基于传统MRI征象与影像组学联合模型工作特征(receiver operating characteristic,ROC)曲线,并计算ROC曲线下面积(area under the curve,AUC)、特异度及灵敏度,量化两种诊断方式对胃癌T3和T4a分期的诊断效能。结果传统多序列MRI征象诊断AUC:0.929(95%CI:0.887~0.970),特异度0.912,灵敏度0.916;MRI影像组学联合模型训练组诊断AUC:0.975(95%CI:0.974~0.976),特异度0.946,灵敏度0.956,验证组诊断AUC:0.971(95%CI:0.965~0.974),特异度0.946,灵敏度0.943,均具有统计学意义(P<0.05)。结论基于MRI影像组学模型诊断T3和T4a分期效能高于传统MRI征象,值得临床工作中进一步推广使用。
基金approved by the Institutional Review Board(IRB)of Cantonal Hospital Zenica,and the protocols used in the study were approved by the Ethical Committee of Cantonal Hospital Zenica(00-03-35-38-14/22).
文摘BACKGROUND Both phases of euthyroid sick syndrome(ESS)are associated with worse prognosis in septic shock patients.Although there are still no indications for supplementation therapy,there is no evidence that both phases(initial and prolonged)are adaptive or that only prolonged is maladaptive and requires supplementation.AIM To analyze clinical,hemodynamic and laboratory differences in two groups of septic shock patients with ESS.METHODS A total of 47 septic shock patients with ESS were divided according to values of their thyroid hormones into low T3 and low T3T4 groups.The analysis included demographic data,mortality scores,intensive care unit stay,mechanical ventilation length and 28-day survival and laboratory with hemodynamics.RESULTS The Simplified Acute Physiology Score II score(P=0.029),dobutamine(P=0.003)and epinephrine requirement(P=0.000)and the incidence of renal failure and multiple organ failure(MOF)(P=0.000)were significantly higher for the low T3T4.Hypoalbuminemia(P=0.047),neutrophilia(P=0.038),lymphopenia(P=0.013)and lactatemia(P=0.013)were more pronounced on T2 for the low T3T4 group compared to the low T3 group.Diastolic blood pressure at T0(P=0.017)and T1(P=0.007),as well as mean arterial pressure at T0(P=0.037)and T2(P=0.033)was higher for the low T3 group.CONCLUSION The low T3T4 population is associated with higher frequency of renal insufficiency and MOF,with worse laboratory and hemodynamic parameters.These findings suggest potentially maladaptive changes in the chronic phase of septic shock.
文摘AIM To provide evidence regarding the postoperative treatment of patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer, for which guidelines have not been established. METHODS Patients who had undergone curative resection between 1996 and 2014 with a pathological stage of T4 b N1-3 M0/Tx N3 b M0 for gastric cancer were retrospectively analyzed; staging was based on the 7 th edition of the American Joint Committee on Cancer staging system. The clinicopathological characteristics, administration of adjuvant chemotherapy, and patterns of recurrence were studied. Univariate and multivariate analyses of prognostic factors were conducted. The chemotherapeutic agents mainly included fluorouropyrimidine, platinum and taxanes, used as monotherapy, doublet, or triplet regimens. Patterns of first recurrence were categorized as locoregional recurrence, peritoneal dissemination, or distant metastasis.RESULTS The 5-year overall survival(OS) of the whole group(n = 176) was 16.8%, and the median OS was 25.7 mo(95%CI: 20.9-30.5). Lymphovascular invasion and a node positive rate(NPR) ≥ 0.8 were associated with a poor prognosis(P = 0.01 and P = 0.048, respectively). One hundred forty-seven(83.5%) of the 176 patients eventually experienced recurrence; the most common pattern of the first recurrence was distant metastasis. The prognosis was best for patients with locoregional recurrence and worst for those with peritoneal dissemination. Twelve(6.8%) of the 176 patients did not receive adjuvant chemotherapy, while 164(93.2%) patients received adjuvant chemotherapy. Combined chemotherapy, including doublet and triplet regimens, was associated with a better prognosis than monotherapy, with no significant difference in 5-year OS(17.5% vs 0%, P = 0.613). The triplet regimen showed no significant survival benefit compared with the doublet regimen for 5-year OS(18.5% vs 17.4%, P = 0.661). Thirty-nine(22.1%) patients received adjuvant chemotherapy for longer than six months; the median OS in patients who received adjuvant chemotherapy for longer than six months was 40.2 mo(95%CI: 30.6-48.2), significantly longer than the 21.6 mo(95%CI: 19.1-24.0) in patients who received adjuvant chemotherapy for less than six months(P = 0.001).CONCLUSION Patients with T4 b N1-3 M0/Tx N3 b M0 gastric cancer showed a poor prognosis and a high risk of distant metastasis. Adjuvant chemotherapy for longer than six months improved outcomes for them.
