Objective To investigate the diagnostic value of T cell enzyme-linked immunospot (T-SPOT.TB) assay on extrapulmonary tuberculosis patients.Methods Thirty patients suffered from extrapulmonary mycobacterium tuberculosis(MTB) infection and 30 with non-MTB infection were recruited this study.T-SPOT.TB assay was used to detect early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10(CFP-10) specific T cells in blood samples.PPD skin test was also used.Results (1)The positive rate of MTB detected by T-SPOT.TB assay was 91.89％ (34/37),higher than that of un-tuberculosis group (6.67 ％ (2/30)),and the difference was significant (x2 =48.403,P ＜ 0.001).(2) The sensitivity,specificity,positive prospective value and negative prospective value of T-SPOT.TB assay were 91.89％,93.33％,94.44％ and 90.32％ respectively,better than those of PPD skin test (67.57％,56.67％,65.79％,58.62％),and the differences were markedly (x2 =6.773,10.756,9.392,8.031 respectively ; P =0.009,0.001,0.002,0.005 respectively).Meanwhile T-SPOT.TB assay has low agreement with means of PPD skin test(Kappa =0.311,x2 =6.801,P =0.009).Conclusion T-SPOT.TB assay has a higher sensitivity and specificity in the rapid diagnosis of extrapulmonary tuberculosis.Therefore,it is with great value and applicability as a screening test.

Objective:To evaluate the risk and influencing factors of pulmonary embolism in patients with iliac vein compression syndrome (IVCS) and acute iliofemoral vein thrombosis by CT pulmonary angiography combined with CT venography of inferior vena cava.Methods:The data of 166 patients with acute left iliofemoral vein thrombosis diagnosed in the Affiliated Hospital of Jining Medical University from July 2016 to June 2020 were analyzed retrospectively. All patients underwent one-stop CT pulmonary angiography combined with inferior vena cava CT venography. The patients were divided into IVCS group (101 cases) and non-IVCS group (65 cases) according to the presence or absence of IVCS. The general data of the patients, the stenosis rate of left common iliac vein, the presence of inferior vena cava floating thrombosis, the presence of large pelvic collateral veins, the detection of pulmonary embolism and the pulmonary artery obstruction index of the two groups were compared, and multivariate logistic regression and multiple linear regression were used to analyze the influencing factors of the incidence and severity of pulmonary embolism in IVCS group.Results:There were significant differences in the stenosis rate of left common iliac vein [(68±8)% vs (25±14)%, t=-25.300, P<0.001], the incidence of inferior vena cava floating thrombosis [25/101, 31/65, χ2 =9.310, P=0.002], the length of inferior vena cava floating thrombosis [17.2 (10.9, 27.8)mm vs 27.4 (20.1, 55.9) mm, Z=-2.316, P=0.021], the incidence of pulmonary embolism (43/101 vs 41/65, χ2 =6.651, P=0.010) and the pulmonary artery obstruction index [(10.0% (5.0%, 17.5%) vs 22.5% (10.0%, 30.0%), Z=-3.490, P<0.001] between IVCS group and non-IVCS group. In the IVCS group, multiple logistic regression analysis revealed that the stenosis rate of left common iliac vein [β=-1.964, OR(95%CI) 0.140(0.031-0.638), P=0.011] and inferior vena cava floating thrombosis [β=1.212, OR(95%CI) 3.360(1.566-7.209), P=0.002] was independent factors for the occurrence of pulmonary embolism. Multiple linear regression showed that the influence of inferior vena cava floating thrombosis on the pulmonary artery obstruction index was statistically significant (b=0.352, t=2.410, P=0.021). Conclusion:The incidence and severity of pulmonary embolism in patients with IVCS and acute left iliofemoral vein thrombosis are lower than those without IVCS, and the presence or absence of inferior vena cava floating thrombosis is an important factor affecting the severity of pulmonary embolism.

As the elderly population continues to rise, the issue of disease diagnosis and treatment in the elderly population is becoming a hot topic of concern. Differentiated thyroid cancer is the most common endocrine malignancy in the world, and patients with differentiated thyroid cancer in the elderly have a worse clinical prognosis and higher risk of recurrence and metastasis. Moreover, due to the special characteristics and complexity of the elderly population, patients with differentiated thyroid cancer in the advanced age group have special features in terms of morbidity, preoperative diagnosis, treatment options, and postoperative management compared with other populations. This article reviews the current status of diagnosis and treatment of differentiated thyroid cancer in the elderly, taking into account the findings and opinions of domestic and international studies.

Objective:To analyze the risk factors for central lymph node metastasis (CLNM) in patients with papillary thyroid cancer (PTC) aged 55 years and above, and to construct a predictive model with columnar graph.Methods:This retrospective study included 406 PTC patients aged 55 and above, treated at the First Affiliated Hospital of Zhengzhou University from Nov. 2019 to Feb. 2022. Data on demographic characteristics, disease features, and laboratory test results were collected. Univariate and multivariate logistic regression analyses were used to identify risk factors for CLNM and develop a clinical prediction model and nomogram.Results:The study involved 406 patients, divided into a modeling group (285 patients) and a validation group (121 patients). The predictive model identified independent risk factors for CLNM. In the modeling group, the model demonstrated a ROC AUC of 0.769, with 82.6% sensitivity, 63.0% specificity, and 67.7% accuracy. The validation group showed 66.7% sensitivity, 74.5% specificity, and 72.7% accuracy, with an AUC of 0.760. Hosmer-Lemeshow tests indicated good fit in both groups. Decision curve analysis confirmed the model's clinical decision-making value, showing better performance than traditional strategies and good generalizability and reliability.Conclusions:Sex, maximum tumor diameter, bilateral involvement of thyroid lobes, clinically evident cervical lymph nodes, and local invasion are independent predictive factors for CLNM in patients over 55 with papillary thyroid carcinoma (PTC). A clinical risk stratification nomogram model based on these risk factors demonstrates good predictive performance.