1.Simulation analysis of the protective performance of barium sulfate mortar against positron nuclide γ-rays
Zhiqiang XU ; Huaixin NI ; Jiwu GENG ; Lichun LI ; Zaoqin ZHANG ; Shibiao SU ; Meixia WANG ; Ming LIU
Chinese Journal of Radiological Health 2025;34(2):209-213
Objective To obtain the protective performance parameters of barium sulfate mortar against positron nuclide γ-rays, provide reference data for precise shielding calculations, and guide the design, evaluation, and construction of radiation shielding. Methods The FLUKA program was used to build a model for simulating the dose equivalent rate variation around points of interest under the irradiation of the most commonly used positron nuclide 18F with changes in the thicknesses of lead and barium sulfate mortar. The transmission curves of lead and barium sulfate mortar were fitted, and the half-value layer (HVL) and lead equivalence of barium sulfate mortar were calculated based on the fitted curves. Results The ambient dose equivalent rate coefficient of positron nuclide 18F was 1.339 4×10−1 μSv·m2/MBq·h and the HVL for lead was 4.037 mm, with deviations of 0.043% and 1.53% compared to the values provided in the AAPM Report No. 108, respectively. The HVLs for γ-rays produced by 18F, using barium sulfate mortar with apparent densities of 4.20, 4.00, and 3.90 g/cm3 mixed with 35.2-grade cement in a 4∶1 mass ratio, were 2.914, 2.969, and 3.079 cm, respectively. The lead equivalences were
2.The role of CD8+ regulatory T cell in the pathogenesis of rheumatoid arthritis.
Lichun BAI ; Hongbin LI ; Jing WANG
Chinese Journal of Cellular and Molecular Immunology 2025;41(9):851-857
Rheumatoid arthritis (RA) is an autoimmune disease characterized by complex pathogenesis, with its development closely linked to immune dysregulation. Regulatory T cells (Tregs), as specialized immunomodulatory cells, play a pivotal role in negatively regulating immune responses and maintaining autoimmune tolerance. In recent years, extensive research has focused on the relationship between Tregs and RA pathogenesis, with the functional role of CD8+ Tregs as a critical area of investigation. This review summarizes the alterations in CD8+ Tregs during RA progression and their potential mechanisms of action. By elucidating the diversity of CD8+ Treg subsets and their intricate roles in modulating immune responses, this analysis provides novel insights and therapeutic strategies for RA diagnosis and treatment.
Arthritis, Rheumatoid/pathology*
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Humans
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T-Lymphocytes, Regulatory/immunology*
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CD8-Positive T-Lymphocytes/immunology*
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Animals
3.Schistosoma japonicum cystatin has protective effects against "two-hit" sepsis in mice by regulating the inflammatory microenvironment.
Wenjuan DUO ; Yixiang WANG ; Jiaxing WANG ; Xinlong XU ; Linxian LI ; Dongchen YANG ; Qili SHEN ; Lichun YANG ; Xiaojing LIU ; Qiwang JING ; Liang CHU ; Xiaodi YANG
Journal of Southern Medical University 2025;45(1):110-117
OBJECTIVES:
To evaluate the protective effect of Schistosoma japonicum cystatin (rSj-Cystatin) in a mouse mode of "two-hit" sepsis.
METHODS:
Sixty male C57BL/6 mice randomized equally into sham-operated group, protein group, "two-hit" modeling group, and protein intervention group. In the former two groups, the mice received an intraperitoneal injection of 100 μL PBS followed by exposure of the cecum and then by intraperitoneal injection of 100 μL PBS or 25 μg rSj-Cystatin 30 min later; In the latter two groups, 100 μL PBS containing LPS (5 mg/kg) was injected intraperitoneally 24 h before cecal ligation and puncture (CLP), and 100 μL PBS or 25 μg rSj-Cystatin were injected 30 min after CLP. At 12 h after rSj-Cystatin treatment, 6 mice from each group were sacrificed for detection of TNF-α, IL-6, IL-10, TGF-β, iNOS and Arg-1 in the serum, spleen, liver, lung and kidney tissues using ELISA, for examinations of liver, lung and kidney pathologies with HE staining, and for analysis of CD3+CD4+CD25+Foxp3+ T cell percentage in the spleen using flow cytometry. The remaining mice were observed for general condition and 72-h survival.
RESULTS:
The 72-h survival rates in the 4 groups were 100%, 100%, 0% and 20%, respectively, showing significant differences between the latter two groups. The mouse models of "two-hit" sepsis exhibited obvious tissue pathologies and significant elevations of TNF-α and IL-6 in both the serum and tissue homogenate, which were significantly ameliorated by rSj-Cystatin treatment. Treatment with rSj-Cystatin also increased IL-10 and TGF-β levels and spleen CD3+CD4+CD25+Foxp3+ T cell percentage. The septic mouse models also showed increased iNOS levels in all the detected tissues and a decreased Arg-1 level in the kidney, and these changes were obviously improved by rSj-Cystatin treatment.
CONCLUSIONS
rSj-Cystatin has a protective effect against "two-hit" sepsis in mice by regulating the inflammatory microenvironment.
Animals
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Mice
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Sepsis/drug therapy*
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Male
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Schistosoma japonicum/chemistry*
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Mice, Inbred C57BL
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Cystatins/therapeutic use*
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Interleukin-10/metabolism*
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Interleukin-6/blood*
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Tumor Necrosis Factor-alpha/blood*
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Disease Models, Animal
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Transforming Growth Factor beta/metabolism*
4.Patent Analysis of Galla Chinensis Based on Incopat Patent Database
Chenyu WANG ; Chiqing CHEN ; Jie XIANG ; Zhiwei CHEN ; Lei XU ; Junjie HU ; Lichun YE ; Zhaohua SHI
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(6):1505-1514
Wubeizi(Galla Chinensis)is a commonly used traditional Chinese medicine in modern clinical practice,which is widely used to treat hemorrhoids,bleeding,mouth ulcers and other diseases.Based on the incopat patent database,the global Galla Chinensis sub-patent search in the past 20 years was conducted,and a total of 8123 related patents were retrieved;Using the basic chart analysis method,the pattern analysis of Galla Chinensis sub-patents was carried out from the aspects of application trend,patent value,technical field,legal status,etc.The analysis results show that the development of Galla Chinensis is in the rapid development stage,Galla Chinensis has in-depth research in the treatment of hemorrhoids,oral ulcers,bleeding,Chinese herbal medicine,Chinese patent medicine and cosmetics are the hot spot of research and development at present,China and South Korea are the main distribution countries of Galla Chinensis patents.The number of Chinese Galla Chinensis patents is large,but the patent quality,value and patent level of the world have a certain gap.In view of the current development trend of Galla Chinensis,there is still a large amount of patent application space in this field.Chinese Galla Chinensis patent applicants can combine their own advantages,development trend and short board to formulate scientific development strategy,thus improving the core competitiveness of Galla Chinensis industry fundamentally.
5.Quantitative analysis of foot kinematics in patients with early Parkinson′s disease under dual task
Haohao WANG ; Xiaofan XUE ; Dongtao LIU ; Zhou LONG ; Cheng WANG ; Lichun ZHOU
Chinese Journal of Neurology 2024;57(3):255-265
Objective:To investigate the gait characteristics of patients with early Parkinson′s disease (PD) under cognitive dual task, and to provide sensitive kinematic indicators for the early diagnosis, timely treatment and reasonable rehabilitation of PD.Methods:A total of 62 outpatients and inpatients with early non-tremor Parkinson′s disease in Shijingshan Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University from September 2021 to August 2023 were selected as experimental group (PD group), and 62 healthy controls with comparable age composition ratio were selected as control group. The baseline data, Montreal Cognitive Assessment Scale scores, and the gait assessment scores of the motor part of the Unified Parkinson′s Disease Rating Scale were compared between the 2 groups. The wearable gait analysis device was used to collect the gait parameters of the 2 groups of subjects under single task and dual task, and the foot kinematic characteristics of the patients with early PD were quantified. Independent sample t test and Mann-Whitney U test were used to analyze the gait parameters of the 2 groups. The statistically significant variables were included in Logistic regression analysis to explore the association between gait parameters and PD. Finally, the diagnostic value of the variables was estimated by receiver operating characteristic (ROC) curve analysis. Results:Gait spatio-temporal parameters (per gait cycle): (1) The gait speed of the PD group was slower than that of the control group [(1.01±0.12) m/s vs (1.22±0.18) m/s, t=-7.526] during single task walking. The bipedal support time in the PD group was significantly longer than that in the control group [(0.29±0.05) s vs (0.22±0.06) s, t=6.659]. The differences were both statistically significant (both P<0.001). (2) During dual-task walking, PD patients showed slower gait speed [(0.88±0.11) m/s vs (1.19±0.16) m/s, t=-12.158, P<0.001]. The bipedal support time in the PD group was longer than that in the control group [(0.36±0.05) s vs (0.22±0.05) s, t=12.828, P<0.001]. PD patients had shorter stride length [(109.20±6.21) cm vs (112.77±5.87) cm, t=-3.203, P=0.010]. Stride frequency in the PD group was higher than that in the control group [(114.45±7.10) steps/min vs (110.87±7.16) steps/min, t=2.724, P=0.020]. The single leg support time was longer than that of the control group [(0.49±0.12) s vs (0.45±0.06) s, t=2.643, P=0.020] , and the differences were statistically significant. Gait kinematics parameters: (1) During single task walking, the maximum angle of foot movement in the sagittal plane in the PD group was smaller than that in the control group (17.19°±2.37° vs 19.71°±2.92°, t=-4.691, P<0.001). The minimum angle of movement in the sagittal plane was smaller than that in the control group (-67.08°±4.63° vs -70.10°±3.94°, t=0.395, P=0.001). The minimum horizontal angle of the foot during exercise in the PD group was lower than that in the control group (9.08°±4.02° vs 11.80°±3.60°, t=-3.461, P<0.001). The minimum angle of the foot coronal plane in the PD group was smaller than that in the control group (-10.55°±2.87° vs -12.04°±2.31°, t=2.831, P=0.030; the negative sign only represents the movement direction). The touch angle of the foot in the PD group was significantly lower than that in the control group (11.14°±2.78° vs 12.78°±3.57°, t=-2.779, P=0.030). (2) During dual-task walking, the maximum sagittal angle (15.44°±2.54° vs 18.99°±2.71°, t=-6.673, P<0.05), the minimum angle of sagittal plane (-65.68°±4.73° vs -70.02°±4.04°, t=-4.747, P<0.001; the negative sign only represents the direction of movement), the minimum coronal movement angle (-11.15°± 2.99° vs -13.18°±2.50°, t=3.642, P=0.020), the touch angle (11.01°±3.10° vs 12.83°±4.01°, t=-2.438, P=0.010), the minimum horizontal angle (8.83°±4.04° vs 11.83°±3.63°, t=-3.776, P<0.001), and the change of the angle from the ground (-65.00°±3.54° vs -67.06°±3.61°, t=3.133, P<0.001) in the PD group were all smaller than that in the control group. The differences were all statistically significant. Logistic regression analysis showed that step frequency was positively correlated with PD ( OR=1.124,95% CI 1.040-1.201, P=0.001), minimum angle of coronal plane was positively correlated with PD ( OR=1.501, 95% CI 1.040-2.151, P=0.030). Stride length was negatively correlated with PD ( OR=0.902, 95% CI 0.830-0.978, P=0.010). ROC curve was used to evaluate the diagnostic value of step frequency, stride length and minimum angle of coronal plane. For step frequency, when the maximum Youden index was 0.880, the best cut-off value to distinguish the PD group from the control group was 115.000, the sensitivity was 0.577, the specificity was 0.710, and the area under the curve was 0.656. For the minimum coronal angle, when the maximum Youden index was 0.251, the best cut-off value was -12.575, the sensitivity was 0.728, the specificity was 0.531, and the area under the curve was 0.670. For stride length, when the maximum Youden index was 0, the best cut-off value was 100.91, the sensitivity was 0.950, the specificity was 0.050, and the area under the curve was 0.300. Conclusions:Some gait parameters such as step frequency and minimum angle of coronal plane can be used as kinematic markers to reflect the gait characteristics of early PD, which may be helpful in tracking and evaluating the gait disorder characteristics of early PD patients and predicting the risk of PD. Some gait parameters of PD patients are significantly different from those of healthy people during cognitive-motor dual-task walking.
6.Epidemiological investigation of iron deficiency among preschool children in 10 provinces, autonomous regions, or municipalities in China
Lei WANG ; Jie SHAO ; Wenhong DONG ; Shuangshuang ZHENG ; Bingquan ZHU ; Qiang SHU ; Wei CHEN ; Lichun FAN ; Jin SUN ; Yue GAO ; Youfang HU ; Nianrong WANG ; Zhaohui WANG ; Tingting NIU ; Yan LUO ; Ju GAO ; Meiling TONG ; Yan HU ; Wei XIANG ; Zhengyan ZHAO ; Meng MAO ; Fan JIANG
Chinese Journal of Pediatrics 2024;62(5):416-422
Objective:To understand the current status of anemia, iron deficiency, and iron-deficiency anemia among preschool children in China.Methods:A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces, autonomous regions, or municipalities (East: Jiangsu, Zhejiang, Shandong, and Hainan; Central: Henan; West: Chongqing, Shaanxi, Guizhou, and Xinjiang; Northeast: Liaoning). From May 2022 to April 2023, a total of 21 470 children, including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years, were surveyed. They were divided into 3 age groups: infants (0.5 to<1.0 year), toddlers (1.0 to<3.0 years), and preschoolers (3.0 to<7.0 years). Basic information such as sex and date of birth of the children was collected, and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement. The prevalence rates of anemia, iron deficiency, and iron-deficiency anemia were analyzed, and the prevalence rate differences were compared among different ages, sex, urban and rural areas, and regions using the chi-square test.Results:A total of 21 460 valid responses were collected, including 10 780 boys (50.2%). The number of infants, toddlers, and preschoolers were 2 645 (12.3%), 6 244 (29.1%), and 12 571 (58.6%), respectively. The hemoglobin level was (126.7±14.8) g/L, and the serum ferritin level was 32.3 (18.5, 50.1) μg/L. The overall rates of anemia, iron deficiency, and iron-deficiency anemia were 10.4% (2 230/21 460), 28.3% (6 070/21 460), and 3.9% (845/21 460), respectively. The prevalence rate of anemia was higher for boys than for girls (10.9% (1 173/10 780) vs. 9.9% (1 057/10 680), χ2=5.58, P=0.018), with statistically significant differences in the rates for infants, toddlers and preschoolers (18.0% (475/2 645), 10.6% (662/6 244), and 8.7% (1 093/12 571), respectively, χ2=201.81, P<0.01), and the rate was significantly higher for children in rural than that in urban area (11.8% (1 516/12 883) vs. 8.3% (714/8 577), χ2=65.54, P<0.01), with statistically significant differences in the rates by region ( χ2=126.60, P<0.01), with the highest rate of 15.8% (343/2 173) for children in Central region, and the lowest rate of 5.3% (108/2 053) in Northeastern region. The prevalence rates of iron deficiency were 33.8% (895/2 645), 32.2% (2 011/6 244), and 25.2% (3 164/12 571) in infants, toddlers, and preschoolers, respectively, and 30.0% (3 229/10 780) in boys vs. 26.6% (2 841/10 680) in girls, 21.7% (1 913/8 821), 40.0% (870/2 173), 27.1% (2 283/8 413), 48.9% (1 004/2 053) in Eastern, Central, Western, and Northeastern regions, respectively, and each between-group showed a significant statistical difference ( χ2=147.71, 29.73, 773.02, all P<0.01). The prevalence rate of iron-deficiency anemia showed a significant statistical difference between urban and rural areas, 2.9% (251/8 577) vs. 4.6% (594/12 883) ( χ2=38.62, P<0.01), while the difference in iron deficiency prevalence was not significant ( χ2=0.51, P=0.476). Conclusions:There has been a notable improvement in iron deficiency and iron-deficiency anemia among preschool children in China, but the situation remains concerning. Particular attention should be paid to the prevention and control of iron deficiency and iron-deficiency anemia, especially among infants and children in the Central, Western, and Northeastern regions of China.
7.Analysis of the relationship between serum lncRNA ANRIL and miR-423-5p and airway inflammation and remodeling in children with bronchial asthma and their predictive value
Luqiang ZHANG ; Liya WANG ; Lichun FAN
International Journal of Laboratory Medicine 2024;45(3):308-313
Objective To analyze the relationship between serum long chain non coding ribonucleic acid(ln-cRNA)ANRIL,microRNA(miR)-423-5p and airway inflammation and remodeling in children with bronchial asthma and its predictive value.Methods A total of 98 children with bronchial asthma treated in Haikou Ma-ternal and Child Health Hospital from June 2020 to December 2022 were selected.46 children with acute at-tack were selected as the attack group and 52 children with clinical remission were selected as the remission group.Another 50 children who were healthy during physical examination in the same period were selected as the health group.The relative expression levels of serum lncRNA ANRIL and miR-423-5p were detected by real-time fluorescence quantitative polymerase chain reaction.The serum inflammatory factor indicators[in-terleukin-13(IL-13),transforming growth factor-β1(TGF-β1),vascular endothelial growth factor(VEGF)]were detected by enzyme-linked immunosorbent assay.Airway remodeling indicators[bronchial thickness(T/D),pipe wall area/total cross-sectional area of gas pipeline(WA)]and lung function indicators[first second forced expiratory volume(FEV1),peak expiratory flow(PEF),maximum mid expiratory flow(MMEF)]were measured.The correlation between expression of serum lncRNA ANRIL,miR-423-5p and airway inflam-mation and remodeling indicators were analyzed by the Pearson method.The predictive value of serum ln-cRNA ANRIL and miR-423-5p in the diagnosis of bronchial asthma was analyzed by receiver operating charac-teristic(ROC)curve.Results The relative expression level of serum lncRNA ANRIL in remission and attack groups was higher than that in healthy group,and the relative expression level of serum miR-423-5p was lower than that in healthy group,with statistical significance(P<0.05).The relative expression level of serum ln-cRNA ANRIL in the attack group was higher than that in the remission group,and the relative expression lev-el of serum miR-423-5p was lower than that in the remission group,with statistical significance(P<0.05).The levels of serum VEGF,IL-13 and TGF-β1 in attack and remission groups were higher than those in healthy group,and the difference was statistically significant(P<0.05).The levels of serum VEGF,IL-13 and TGF-β1 in attack group were higher than those in remission group,and the difference was statistically sig-nificant(P<0.05).The levels of T/D and WA in the remission and attack groups were higher than those in the healthy group,and the levels of FEV,,PEF and MMEF were lower than those in the healthy group,with statistical significance(P<0.05).The levels of T/D and WA in the attack group were higher than those in the remission group,and the levels of FEV1,PEF and MMEF were lower than those in the remission group,with statistical significance(P<0.05).The results of Pearson correlation analysis showed that serum ln-cRNA ANRIL expression was positively correlated with airway inflammation and remodeling indicators,and negatively correlated with lung function indicators(P<0.05).The expression of miR-423-5p was negatively correlated with airway inflammation and remodeling indexes,and positively correlated with lung function inde-xes(P<0.05).ROC curve analysis showed that the area under the curve of lncRNA ANRIL and miR-423-5p alone and combined detection were 0.772,0.707 and 0.865 respectively,the predictive value of combined de-tection in diagnosing bronchial asthma was higher.Conclusion The relative expression level of serum lncRNA ANRIL increase in children with bronchial asthma,and miR-423-5p decrease,which promote airway inflamma-tion,remodeling,lung function decrease,and which has high diagnostic efficacy for children with bronchial asthma.
8.Mental Health Status and Its Influencing Factors Among Elderly Hypertension Patients from Rural Areas of Chuxiong and Honghe Prefecture in Yunnan
Qichuan HU ; Hechuan ZHANG ; Lichun JIANG ; Yajing ZHANG ; Fujing FENG ; Ximeng ZHAO ; Yunxian WANG
Journal of Kunming Medical University 2024;45(3):92-98
Objective To investigate the mental health status and its influencing factors among elderly hypertensive patients from Rural Areas of Chuxiong and Honghe Prefecture in Yunnan.Methods Multi-stage random sampling method was adopted to select elderly hypertensive patients from rural Yi ethnic areas in Yunnan.Questionnaires were used to collect their basic information and mental health status.Multivariate logistic regression was performed to explore the influencing factors of mental health among the elderly hypertensives.Results 21.82%(209/958)of elderly people with hypertension have poor mental health status in Chuxiong and Honghe Prefecture,Yunnan.Age of 80-89 years(OR = 2.395,P<0.05)and over 90 years(OR = 3.293,P<0.05),as well as physical disability(OR = 2.037,P<0.05),were risk factors for poor mental health.Compared with those who rated their economic situation as very difficult,rating as somewhat difficult(OR = 0.490,P<0.05),moderate(OR = 0.632,P<0.05)and relatively affluent(OR = 0.344,P<0.05),having a spouse(OR = 0.655,P<0.05),received full concern from the offspring(OR = 0.411,P<0.05)and maintain good relationships with offspring(OR = 0.339,P<0.05)were protective factors.Conclusions The mental health status of elderly people with hypertension is relatively poor in rural areas of Chuxiong and Honghe Prefecture in Yunnan Province.Special attention should be paid to the mental health of older and physically disabled elderly hypertensives.Economic and mental support from children was crucially important in improving the mental health of elderly hypertensive patients in rural areas of Chuxiong and Honghe Prefecture in Yunnan Province.
9.Diagnosis and treatment of prostate mucosa adenocarcinoma under multidisciplinary diagnosis and treatment mode: 2 cases report and literature review
Peng WU ; Fuli WANG ; Jing ZHANG ; Jing REN ; Zhiyong QUAN ; Wanni XU ; Lichun WEI ; Weijun QIN
Journal of Modern Urology 2024;29(2):154-157
【Objective】 To explore the clinicopathological characteristics and comprehensive treatment strategies of prostate mucosa adenocarcinoma under multidisciplinary diagnosis and treatment (MDT) mode. 【Methods】 Data of two patients with typical prostate mucosa adenocarcinoma treated in our hospital during Sep.2020 and Apr.2023 were retrospectively analyzed. 【Results】 In case 1, the clinical manifestation was macroscopic hematuria; multiparametric magnetic resonance imaging (mpMRI) indicated solid prostatic nodules, clinical stage T4N1Mx; initial prostate specific antigen (PSA) was 1.2 ng/mL; 6868Ga-prostate specific membrane antigen PET/CT (68Ga-PSMA PET/CT) suggested abnormal uptake of nuclear lesions in the prostate (SUV4.2-5.3); biopsy results indicated invasive mucinous adenocarcinoma.After prostate and pelvic field radiotherapy + androgen deprivation therapy (ADT) + antihypertensive treatment, lesions were significantly reduced, and hematuria symptoms were relieved.In case 2, the clinical manifestation was dysuria; initial PSA was 91.78 ng/mL; mpMRI suggested invasion of prostate mass into the bladder and clinical stage of T4N1M1b; 68Ga-PSMA PET/CT indicated prostate and pelvic lymph nodes, and multiple bone lesions showed increased nuclide uptake; biopsy results indicated prostate adenocarcinoma with mucinous adenocarcinoma.Initial endocrine treatment was performed.After 3 months, PSA was reduced to 0.083 ng/mL, and imaging showed the tumor was significantly reduced.Robotic-assisted laparoscopic tumor prostatectomy with extended pelvic lymph node dissection was performed, and endocrine adjuvant therapy was continued after surgery. 【Conclusion】 Prostate mucosa adenocarcinoma has different clinicopathological characteristics and prognosis from conventional acinar adenocarcinoma, and the whole-process management under MDT mode is of great value in the diagnosis and treatment of this disease.
10.Chinese thyroid imaging reporting and data system(C-TIRADS)combined with intranodular and perinodular stiffness for distinguishing benign and malignant thyroid nodules
Yaping HE ; Xiangliu OUYANG ; Lichun ZHENG ; Yongli XIA ; Zechao HAN ; Qingwen WANG
Chinese Journal of Medical Imaging Technology 2024;40(1):37-41
Objective To explore the value of Chinese thyroid imaging reporting and data system(C-TIRADS)combined with intranodular and perinodular stiffness for distinguishing benign and malignant thyroid nodules.Methods Data of routine ultrasound and ultrasonic shear wave elastography(SWE)in 117 patients with thyroid nodules confirmed by fine needle aspiration cytology(FNAC)and/or surgical pathology were retrospectively analyzed.The nodules were classified according to C-TIRADS and SWE parameters of nodules and surrounding 2 mm glands measured with SWE technique,including Young's modulus of thyroid nodules(E)and perinodular glandular(Eshell)(the maximum[Emax/Eshellmax],the mean[Emean/Eshellmean]and the minimum[Emin/Eshellmin]as well as standard deviation[ESD/EshellSD]values).Then receiver operating characteristic(ROC)curve was drawn,and area under the curve(AUC)was calculated to assess the efficacy of C-TIRADS,SWE and the combination for differentiating benign and malignant thyroid nodules.Results Totally 117 thyroid nodules of 117 patients were enrolled,including 50 benign and 67 malignant ones.SWE parameters of malignant thyroid nodules were higher than those of benign ones(all P<0.001).AUC of C-TIRADS for differentiating benign and malignant thyroid nodules was 0.736,with sensitivity of 79.10%,specificity of 68.00%and accuracy of 74.36%.AUC of Emax,Emean,Emin and ESD was 0.816,0.752,0.664 and 0.705,respectively,of Emax was the highest.AUC of Eshellmax,Eshellmean,Eshellmin and EshellSD was 0.834,0.804,0.693 and 0.697,respectively,of Eshellmax was the highest,which was not statistically difference with that of Emax(Z=1.044,P=0.297).AUC of C-TIRADS+Emax and C-TIRADS+Eshellmax was 0.835 and 0.843,respectively,being not significantly different(Z=0.574,P=0.566)but higher than that of C-TIRADS(AUC=0.736,Z=2.510,2.230,both P<0.05),with diagnostic specificity and accuracy both higher than those of C-TIRADS(all P<0.05).Conclusion C-TIRADS combined with intranodular and perinodular stiffness could be used to effectively distinguish benign and malignant thyroid nodules,which might improve diagnostic efficiency of C-TIRDAS.

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