Development of an Ultrasonic Nomogram for Preoperative Prediction of Castleman Disease Pathological Type

An ultrasonic nomogram was developed for preoperative prediction of Castleman disease(CD)pathological type(hyaline vascular(HV)or plasma cell(PC)variant)to improve the understanding and diagnostic accuracy of ultrasound for this disease.Fifty cases of CD confirmed by pathology were gathered from January 2012 to October 2018 from three hospitals.A grayscale ultrasound image of each patient was collected and processed.First,the region of interest of each gray ultrasound image was manually segmented using a process that was guided and calibrated by radiologists who have been engaged in imaging diagnosis for more than 5 years.In addition,the clinical characteristics and other ultrasonic features extracted from the color Doppler and spectral Doppler ultrasound images were also selected.Second,the chi-square test was used to select and reduce features.Third,a naïve Bayesian model was used as a classifier.Last,clinical cases with gray ultrasound image datasets from the hospital were used to test the performance of our proposed method.Among these patients,31 patients(18 patients with HV and 13 patients with PC)were used to build a training set for the predictive model and 19(11 patients with HV and 8 patients with PC)were used for the test set.From the set,584 high-throughput and quantitative image features,such as mass shape size,intensity,texture characteristics,and wavelet characteristics,were extracted,and then 152 images features were selected.Comparing the radiomics classification results with the pathological results,the accuracy rate,sensitivity,and specificity were 84.2%,90.1%,and 87.5%,respectively.The experimental results show that radiomics was valuable for the differentiation of CD pathological type.

Epidemiological characteristics of thyroid nodules and risk factors for malignant nodules： a retrospective study from 6 304 surgical cases

Background The prevalence of thyroid nodules （TN） is increasing rapidly.This study analyzed the epidemiological and clinical characteristics of TN in surgically treated patients and identified the risk factors for malignant nodules （MN） to provide more understanding of the differential diagnosis of TN.Methods A total of 6 304 TN cases who underwent thyroid surgery were included in this retrospective study.The clinical data were collected to evaluate the clinical and epidemiological characteristics and related risk factors for MN.The nature of TN （benign nodules （BN） or MN）,medical records,laboratory data,and imaging data were analyzed.The risk factors for MN were screened using Spearman＇s rank correlation analysis and nonconditional binary Logistic regression analysis.Results The number of surgically treated TN cases increased yearly.A total of 34.33％ of cases were MN and 65.67％ were BN.Up to 56.74％ of these cases underwent unnecessary surgery.Among the MN cases,papillary thyroid carcinoma accounted for 94％,in which 46.71％ coexisted with benign thyroid disease and 32.28％ with multiple foci.Single-related factor analysis showed that age,employment,disease duration,history of breast nodules and/or hypertension,the levels of serum thyroid-stimulating hormone （TSH）,thyroglobulin antibody （TgAb）,and thyroid peroxidase antibody （TPoAb）,and ultrasound features of TN were related to MN.Stepwise nonconditional binary Logistic regression analysis showed that 13 factors may be the independent risk factors for MN,including ＜40 years old,previous history of breast nodules and/or hypertension,disease duration ＜1 month,employment,hypoechoic nodule,irregular nodules,nodule calcification,solid echo nodule,fuzzy boundary,rich blood flow within nodules,abnormal lymph nodes around the neck,nodule diameter ＜1 cm,and abnormally high TgAb.Conclusions Our results demonstrate a rapid increase in surgically treated TN cases and ratio of MN and indicate unnecessary surgeries in some cases.This study also suggest that age,duration of thyroid disease,history of breast disease and/or hypertension,the levels of serum TSH,TgAb,and TPoAb,and ultrasound features of TN are related to MN,and some of these factors may be the risk factors for MN.

Chemerin and apelin are positively correlated with inflammation in obese type 2 diabetic patients

Background As two novel adipocytokines, chemerin and apelin play a key role in the pathological process of insulin resistance （IR）, glucose metabolism and obesity, researchers have found that the levels of chemerin and apelin changed significantly in type 2 diabetic patients with obesity, however, the underlying mechanism involved remains unclear. The aim of this study was to investigate whether chemerin and apelin play an important role in the pathophysiologic proceeding of diabetes. Methods This study enrolled 81 newly diagnosed obese type 2 diabetes mellitus （T2DM） patients （T2DM group, n=81）. All the patients were randomly assigned to DM1 group treated with metformin （n=41） and DM2 group treated with pioglitazone （n=40）. After hypoglycemic agents treatment, patients under better blood glucose control were chosen to be given antioxidant treatment. Another 79 subjects without T2DM were recruited as normal control group （NC group）, including 40 subjects （NC1 group） with normal body mass index （BMI） and 39 obese subjects （NC2 group）. Levels of chemerin, apelin, BMI, tumor necrosis factor-α（TNF-α）, homeostasis model assessment of IR （HOMA-IR） and 8-isoprotaglandim F2α（8-iso-PGF2α） were examined at baseline and post-treatment. The relationship between chemerin, apelin and BMI, TNF-α, HOMA-IR, 8-iso-PGF2α was analyzed. Results The baseline levels of chemerin, apelin, TNF-α, HOMA-IR and 8-iso-PGF2α in T2DM group were significantly higher than normal control group （P 〈0.001）. All indices mentioned above were significantly decreased after treatment （P 〈0.05）. In T2DM patients treated with pioglitazone, indices mentioned above except for HOMA-IR, were decreased significantly compared with patients treated with mefformin （P〈0.05）. After antioxidant treatment using lipoic acid, levels of chemerin, apelin, TNF-α and 8-iso-PGF2α were further significantly decreased （P 〈0.05）. Correlation analysis showed that the levels of chemerin and apelin correlated positively with BMI, TNF-α, HOMA-IR and 8-iso-PGF2α before and after treatment with hypoglycemic agents （P〈0.01）. The levels of chemerin and apelin also had positive correlation with TNF-a and 8-iso-PGF2α after antioxidant treatment （P〈0.05）. Conclusions The levels of chemerin and apelin in obese T2DM patients are closely related to IR. The increased levels may be a result of compensatory response to IR, and also may be the causative factor of IR. The levels of chemerin and apelin correlate closely with oxidative stress and inflammation. The two adipokines may be inflammatory factors playing important roles in the initiation and development of obese T2DM. Chemerin and apelin are related to the pathophysiology of IR, oxidative stress and inflammation.