Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

BACKGROUND Cervical lymph node metastasis in papillary thyroid carcinoma(PTC) affects the treatment and prognosis of patients. Ultrasound is a common imaging method for detecting cervical lymph nodes in PTC patients; however, it is not accurate in determining lymph node metastasis.AIM To evaluate the value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in PTC.METHODS A total of 94 patients with PTC were recruited. According to pathological results,lymph nodes were divided into two groups: metastatic group(n = 50) and reactive group(n = 63). The routine ultrasound findings, contrast-enhanced ultrasound and elastography data were recorded and compared. Logistic regression was used to generate predictive probability distributions for the diagnosis of lymph node metastasis with different indicators. Receiver operating characteristic curve analysis was used to test the efficacy of contrast-enhanced ultrasound combined with elastography based on routine ultrasound in evaluating PTC cervical lymph node metastasis.RESULTS The ratio of long diameter/short diameter(L/S) ≤ 2, irregular marginal morphology, missing lymphatic portal, peripheral or mixed blood flow distribution, peak intensity(PI), non-uniform contrast distribution and elasticity score in the metastatic group were significantly higher than those in the reactive group(P < 0.05). L/S ratio, missing lymphatic portal, PI and elasticity score had a significant influence on the occurrence of PTC cervical lymph node metastasis(P< 0.05). Furthermore, the area under the curve(AUC) for lymph node metastasis diagnosed using the combination of PI ratio, elasticity score, missing lymphatic portal and LS was 0.936, which was significantly higher than the AUC for PI ratio alone. The difference was statistically significant(P < 0.05). The fitting equation for the combined diagnosis was logit(P) =-12.341 + 1.482 × L/S ratio + 3.529 ×missing lymphatic portal + 0.392 × PI + 3.288 × elasticity score.CONCLUSION Based on the gray-scale ultrasound, the combination of contrast-enhanced ultrasound and elastography can accurately assess PTC cervical lymph node metastasis.

Mothers’experiences of neonatal intensive care:A systematic review and implications for clinical practice

BACKGROUND Preterm birth is on the rise worldwide.Neonatal intensive care units(NICUs)have enabled many critically ill newborns to survive.When a premature baby is admitted to the NICU,the mother–infant relationship may be interrupted,affecting the mother's mental health.AIM To examine the maternal emotions associated with having a child in the NICU and provide suggestions for clinical practice.METHODS MEDLINE,CINAHL,PsychARTICLES,and PsychINFO were searched for relevant articles between 2005 to 2019,and six qualitative articles were chosen that explored the experiences of mothers who had a preterm infant in the NICU.The thematic analysis method was used to identify the most common themes.RESULTS Four main themes of the experience of mothers who had a preterm infant in the NICU were identified:Negative emotional impacts on the mother,support,barriers to parenting,and establishment of a loving relationship.CONCLUSION NICU environment is not conducive to mother-child bonding,but we stipulate steps that health care professionals can take to reduce the negative emotional toll on mothers of NICU babies.

Experiences of Chinese nurses studying for master’s degree in the UK: a qualitative study

Objective:To explore experiences of Chinese nurses who study for Master of Science in Professional Practice(health care)in the United Kingdom.Methods:A qualitative approach was applied,consisting of semi-structured telephone interviews(n=8).The Colaizzi seven-step framework analysis method was used to extract themes.Results:The themes that emerged are as follows:(1)gains from studying overseas,(2)difficulties during studying,and(3)impacts of learning experience on work.The gains for nurses studying overseas include the improvement of scientific research capabilities,reconstruction of critical thinking,and development of reflection ability.Difficulties while studying mainly include language barrier,strict assessment,and boring life.Conclusions:The education of nursing postgraduate attaches impor tance to the cultivation of thinking.Nurses are very interested in nursing research including qualitative and quantitative methods.Nurses encountered language barriers in their study and life even though they knew a cer tain level of English.

Modulation of antiviral cytokine production and lung protection against influenza virus by the glycosides from Ligustrum purpurascens

Ligustrum purpurascens has been used as a traditional herb for over 2,000 years in China.This study was design to investigate the modulation of antiviral cytokines and reduction in lung inflammation of virus-infected mice by the glycosides isolated from Ligustrum purpurascens.Methods:Ligustrum purpurascens glycosides(LPG)were isolated from the leaves of Ligustrum purpurascens.Proliferation of spleen lymphocytes were investigated after LPG treatment.The in vitro and in vivo cytokine modulation of LPG was studied.Furthermore,the anti-inflammatory and antiviral activities of LPG,with the potential to reduce inflammatory lung disorders,were investigated by influenza A virus infected mice.Results:LPG could significantly promote the proliferation,and also could stimulate the production of IFN-γby spleen lymphocytes in a dose-dependent manner.IFN-γexpression level was increased significantly compared to the control and presented a dose-dependent manner in vitro.Furthermore,LPG inhibit the expression of TNF-αand IL-10,which return to normal level in the cyclophosphamide-induced mice model in vivo.Besides,the histopathological analysis indicated LPG reduced acute lung injury in mice infected with influenza virus.Conclusion:This study suggested that LPG could increase the exression of IFN-γ,immunoregulation and decrease lung inflammation of virus-infected mice.

Association between glioblastoma cell-derived vessels and poor prognosis of the patients

Background:Vessels with different microcirculation patterns are required for glioblastoma(GBM)growth.However,details of the microcirculation patterns in GBM remain unclear.Here,we examined the microcirculation patterns of GBM and analyzed their roles in patient prognosis together with two well-known GMB prognosis factors(O^(6)-methylguanine DNA methyltransferase[MGMT]promoter methylation status and isocitrate dehydrogenase[IDH]mutations).Methods:Eighty GBM clinical specimens were collected from patients diagnosed between January 2000 and December 2012.The microcirculation patterns,including endothelium-dependent vessels(EDVs),extracellular matrix-dependent vessels(ECMDVs),GBM cell-derived vessels(GDVs),and mosaic vessels(MVs),were evaluated by immunohistochemistry(IHC)and immunofluorescence(IF)staining in both GBM clinical specimens and xenograft tissues.Vascular density assessments and three-dimensional reconstruction were performed.MGMT promoter methylation status was determined by methylation-specific PCR,and IDH1/2 mutations were detected by Sanger sequencing.The relationship between the microcirculation patterns and patient prognosis was analyzed by Kaplan-Meier method.Results:All 4 microcirculation patterns were observed in both GBM clinical specimens and xenograft tissues.EDVs were detected in all tissue samples,while the other three patterns were observed in a small number of tissue samples(ECMDVs in 27.5%,GDVs in 43.8%,and MVs in 52.5%tissue samples).GDV-positive patients had a median survival of 9.56 months versus 13.60 months for GDV-negative patients(P=0.015).In MGMT promoter-methylated cohort,GDV-positive patients had a median survival of 6.76 months versus 14.23 months for GDV-negative patients(P=0.022).Conclusion:GDVs might be a negative predictor for the survival of GBM patients,even in those with MGMT promoter methylation.