Objective To study the effectiveness of ultrasonography in thyroidnodule disease detection and malignant/benign lesion differentiation during health check-up.Method Thyroid examination data of Peking Union Medical College Hospital(PUMCH)staff over the last 6 years were retrospectively reviewed.The results of thyroidnodule scanning by using ultrasonography were compared with the findings of physical examinations.Results Among 6348 health check-up receivers from 2006 to 2010,450 were found to have thyroidnodule(detection rate 7.09％).Twenty malignant lesions were confirmed in histological examinations(mean detection rate per year 0.38％).In 2011,1706 thyroid glands were scanned by both physical examination and ultrasonography,and 525 thyroidnodules were identified(detection rate 30.77％).Surgical operations were performed for 22 suspected malignant tumors,and 18 malignant lesions were finally confirmed(detection rate 1.06％).Conclusion Ultrasonography can improve the detection of thyroidnodule.Irregular shape,microcalcification,and rich blood-flow may indicate malignant nodules.

Objective To highlight the role of physician's experience in physical examination for the early diagnosis of breast cancer.Methods Data of physical examination of mammary glands in 1785 female were analyzed and compare with the uhrasonography and mammngraphy results.Results Of the 31 breast cancers confirmed by pathologic examination after operation,2 cases were bilateral breast cancers and 1 was nonpalpable.9 of 41 cases which suspected by inspection were confirmed as breast cancers.The significant difference was found comparing with control group by X2 test (X2=100.5,P＜0.05).The 34 breast cancers were found in 2089 focus in palpation and there were 6 minimal cancers (diameter≤1.0 cm) among them.Some cancers were found in special location with no malignant clinical manifestation.The rate of missed diagnosis of ultrasonography and rnammography is 16.1% and 19.4%,respectively.Conclusions Physical examination plays an important role in the early detection of breast cancer and physician's experience is a major determinant for avoiding misdiagnosis.

Objective:To study the value of ultrasonic shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in transrectal prostate biopsy.Methods:Clinical data of 100 patients who underwent transrectal prostate biopsy in The Affiliated Hospital of Inner Mongolia Medical University from May 2017 to May 2019 were retrospectively analyzed, and they were divided into SWE group (54 cases) and CEUS group (46 cases) according to puncture methods. Swe-assisted transrectal prostate biopsy was performed in the SWE group and CEUS group. The detection of prostate cancer by SWE and CEUS was recorded, and the sensitivity, specificity and accuracy of the two groups were compared with the biopsy results as the gold standard.Results:SWE detected 35 cases of prostate cancer and 19 cases of prostate hyperplasia, and pathologically confirmed 38 cases of prostate cancer and 16 cases of prostate hyperplasia in SWE group, with a total of 451 needles, with an average of (8.35±1.67)needles/case. There were 28 cases of prostate cancer and 18 cases of prostatic hyperplasia detected by CEUS, 36 cases of prostate cancer and 10 cases of prostatic hyperplasia confirmed by pathology in CEUS group, with a total of 462 needles, with an average of (10.04±1.33)needles/case. There was significant difference in puncture times between the two methods ( P<0.05). There were no significant differences in age, body mass index and pathological results between 2 groups (all P>0.05). There were no significant differences in positive detection rate, sensitivity and specificity between the two groups (all P>0.05). The accuracy of SWE group was significantly higher than CEUS group, and the difference was statistically significant ( P<0.05). The Emean and Emax levels in patients with prostate cancer in SWE group were significantly higher than those in patients with prostate hyperplasia ( P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for Emean diagnosis of prostate cancer was 0.752 (95% CI=0.611-0.894, P=0.007), and the optimal cut-off value was 47.005 kPa. Conclusions:Both SWE and CEUS assisted transrectal prostate biopsy can obtain higher positive rates of prostate cancer. SWE assisted transrectal prostate biopsy can provide quantitative basis for predicting prostate cancer and improve diagnostic accuracy.

BACKGROUNDIt is now recognized that Cimicifuga foetida (C. foetida) extract is effective in alleviating menopausal symptoms. But the durations reported were usually short. The aim of this study was to investigate the effects of C. foetida extract therapy and different estrogen and progesterone sequential therapies, on the breasts of early postmenopausal women.

METHODSThis was a prospective randomized trial. Ninety-six early menopausal women were recruited and randomly assigned into three groups treated with different therapies for 2 years. Patients were given C. foetida extract in Group A, estradiol valerate and medroxyprogesterone acetate in Group B, and estradiol valerate and progesterone in Group C. Ultrasonography was used to monitor changes in breast during treatment.

RESULTSIn comparing breast glandular section thickness before and after 1 and 2 years of treatment, no significant difference was observed in Group A (11.97 ± 2.84 mm vs. 12.09 ± 2.58 mm and 12.61 ± 3.73 mm, P > 0.05); in Group B glandular section thickness had increased significantly (10.98 ± 2.34 mm vs. 11.84 ± 2.72 mm and 11.90 ± 3.33 mm, P < 0.05) after treatment, the same as Group C (11.56 ± 3.03 mm vs. 12.5 ± 3.57 mm and 12.22 ± 4.39 mm P < 0.05). In comparing breast duct width before and after 1 and 2 years of treatment, no significant difference was seen in Group A (1.07 ± 0.19 mm vs. 1.02 ± 0.18 mm and 0.98 ± 0.21 mm, P > 0.05); in Group B the duct width had a downward trend after treatment (0.99 ± 0.14 mm vs. 0.96 ± 0.22 mm and 0.90 ± 0.18 mm, P < 0.05), the same as Group C (1.07 ± 0.20 mm vs. 1.02 ± 0.17 mm and 0.91 ± 0.19 mm, P < 0.05). The nodules detected before treatment had disappeared after 1-year of treatment or exhibited no distinct changes in the three groups. However, new breast nodules had appeared after 2 years of treatment: There was one case in Group A, two cases in Group B and four cases in Group C, with breast hyperplasia after the molybdenum target check.

CONCLUSIONSIn early postmenopausal patients, C. foetida extract therapy and estrogen and progesterone therapy at low doses did not increase the incidence of malignant breast tumors.

Adult ; Breast ; drug effects ; Breast Neoplasms ; drug therapy ; Cimicifuga ; chemistry ; Estrogens ; therapeutic use ; Female ; Hormone Replacement Therapy ; Humans ; Male ; Middle Aged ; Plant Extracts ; pharmacology ; Postmenopause ; Progestins ; therapeutic use ; Software

BACKGROUNDThe purpose of this study was to conduct thyroid ultrasound examinations on a large sample of subjects and explore the occurrence, distribution, and characteristics of thyroid nodules and thyroid cancer to provide some information on the epidemic trend of thyroid nodules and cancer.

METHODSThe thyroid ultrasonic examination results of 19 895 healthy physical examinees who visited the Department of Health Management, Peking Union Medical College Hospital from January 2009 to December 2011 were analyzed retrospectively to determine the detection rate and characteristics of thyroid nodules. Fine needle aspiration or surgical resection was suggested to subjects suspected of having thyroid cancer.

RESULTSThe detection rate of thyroid nodules was 42.6% (8 480/19 895), 40.0% (4 661/11 678) in men and 46.5% (3 819/8 217) in women. The detection rate noticeably increased with increasing age. The detection rate of thyroid nodules by palpation was obviously lower than by ultrasonic examination in various age groups. Among those with thyroid nodules, 61.3% were multiple and 38.7% were solitary; multiple nodule was the major type both in men and women. Twenty-nine cases of malignant nodules were solitary, and 30 cases of malignant nodules were multiple. There was no significant difference. The detection rate of thyroid cancer was 0.30% for the entire group of examinees, and 0.15% in men and 0.50% in women. Among all sex and age groups, 30- to 40-year-old women had the highest detection rate (0.76%). The detection rate of thyroid nodules correlated with age, systolic blood pressure, height, and weight. Increasing age and/or higher systolic blood pressure correlated with a higher detection rate, while smaller height and weight also correlated with a higher detection rate with significant differences. However, there were no significant correlations between the detection rate and diastolic blood pressure or body mass index.

CONCLUSIONSThe detection of thyroid cancer increased significantly, especially in women. Thus, precautions needed to be taken. Regular physical examination and timely intervention after detection of malignant nodules are critical to improve the prognosis in thyroid cancer patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; diagnosis ; epidemiology ; Thyroid Nodule ; diagnosis ; epidemiology ; Young Adult