Objective:To observe any effect of repeated unilateral high frequency transcranial magnetic stimulation (rTMS) on the swallowing function and functional magnetic resonance images of dysphagic stroke survivors.Methods:Twenty stroke survivors with dysphagia were randomly divided into a treatment group ( n=10) and a control group ( n=10). Both groups received traditional swallowing rehabilitation training, while the treatment group was additionally provided with high frequency rTMS over the cortical area of the suprahyoid muscle group of the healthy contralateral cerebral hemisphere. The stimulation frequency was 5Hz and the stimulation intensity was 80% of the resting movement threshold. During the 20-minute treatment, there was a 20-second interval between each 2-second dose of stimulation. Before and after the treatment, both groups were evaluated using the Eating Assessment Tool-10 (EAT-10), a swallowing functional communication measurement (FCM) and the modified Mann Assessment of Swallowing Ability (MMASA). In addition, functional magnetic resonance imaging was used to observe any changes in the relevant brain regions. Results:After the treatment the average EAT-10, FCM and MMASA scores of both groups were significantly better than those before the treatment, with the treatment group′s averages significantly superior to those of the control group. After the treatment, the activation range of the parietal lobe, the superior parietal lobule, the BA7 region and the BA40 area in the treatment group was significantly larger than before the treatment and larger than the control group′s ranges.Conclusions:Repeated high-frequency transcranial magnetic stimulation of the cortical area of the suprahyoid muscles in the contralateral cerebral hemisphere can improve dysphagia and promote the activation of brain areas related to swallowing after a stroke.

Calcitonin participates in physiological regulation of calcium metabolism, but it might not be the key factor.Multiple immunoassay methods have been developed for serum calcitonin detection.However, significant differences exist among the methods, and the results of immunoassay are affected by many factors.This paper mainly discusses some major advances in experimental researches of calcitonin and the influence factors of immunological measurement.

Objective To evaluate the differences of serum TSH of suspicious subclinical hypothyroidism determined by four automatic biochemical analyzers and the impact on clinical diagnosis and treatment.Methods Taking results of Roche Cobas e601 laboratory test as a reference, 103 serum samples with TSH 2.50-10.00 mU/L(90 with TSH≥4.27 mU/L) and normal FT3, FT4 were selected.Four different automatic biochemical analyzers (Cobas e601, Immulite2000, Centaur XP, I2000) were used to measure TSH of the serum samples at the same time.Wilcoxon signed rank test, Spearman correlation analysis were used for data analysis.Results TSH (M(P25, P75)) measured by 4 methods were 5.20(4.73, 6.40), 2.95(2.59, 3.48), 3.30(2.94, 4.15) and 4.10(3.43, 4.75) mU/L, which varied significantly from one assay to another (z values:-8.78,-8.41,-7.64,-8.09,-8.50, all P<0.05).The correlations between methods were of great differences (rs ranged from 0.45 to 0.92).Significant differences existed in each other for subclinical hypothyroidism diagnosis based on TSH cutoff respectively.Conclusion Results from different automatic immunoassay analyzers in patients with TSH of 2.50-10.00 mU/L varied widely, hence, it is indeterminate to diagnose subclinical hypothyroidism only relies on a single serum TSH test.

Objective To compare the consistence and difference between the assay results of the second generation of Tg (Tg Ⅱ) and the first generation of Tg (Tg Ⅰ) immunoassay,as well as to evaluate the impact of Tg Ⅱ on the clinical management of thyroid diseases.Methods Serum samples of 249 patients (30 with benign thyroid disorders and 219 with DTC;64 males and 185 females,average age 43.0 years)were collected and assayed by Tg Ⅱ and TgⅠ kits simultaneously.The measuring ranges of TgⅠ and TgⅡ were 0.10-1 000.00 μg/L and 0.04-500.00 μg/L,respectively.Data were analyzed by the Wilcoxon rank sum test and Spearman correlation analysis using IBM SPSS 19.0.Results The assay results of TgⅡ and TgⅠ strongly correlated (rs =0.979,P＜0.05).However,the median value of TgⅡ (2.31 (0.06-13.17) μg/L) was lower than that of TgⅠ(3.63(0.41-16.84) μg/L)(z=-13.25,P＜0.001).The difference between Tg Ⅱ and Tg Ⅰ got bigger when TgⅠ value decreased more.TgⅡ values were 11.09％ lower than TgⅠ (5.61(1.07-26.39) μg/L) vs 6.31(2.07-33.93) μg/L;z=-4.78,P＜0.05) in 30 patients with benign thyroid disorders and 37.71％ lower (2.18(0.07-7.47) μ.g/L) vs 3.50(0.39-10.18) μg/L;z=-9.02,P＜0.001) in 108 DTC patients without 131 Ⅰ treatment.But the above changes had no influence on clinical diagnosis and treatment.In the 71 DTC patients post 131Ⅰ treatment with low TSH and normal TgAb,there were 3 cases with TgⅠ＞1.0 μg/L but TgⅡ＜1.0μg/L,and 12 cases with TgⅠ＞0.1 μg/L but TgⅡ＜0.04 μg/L.Conclusions Serum TgⅡand Tg Ⅰ assay results are strongly correlated,though Tg Ⅱ value is slightly lower than Tg Ⅰ value.This difference may have no significant influence on the clinical diagnosis of thyroid diseases.However,TgⅡ may be better to evaluate the curative effect in some DTC patients post 131Ⅰ therapy.

Objective To interpret the major characteristics of literatures cited by 2015 ATA management guidelines for adult patients with thyroid nodules and DTC (2015 version).Methods The titles,datelines of the references,the medical specialties and regional distribution of the journals,and the definition of the scientific evidence rating for relevant references were extracted and analyzed.The data were roughly compared with those of 2009 revised ATA management guidelines for patients with thyroid nodules and DTC (2009 version).Results A total of 1 078 literatures,from 172 journals and 8 books,were cited by 2015 version,with 63 years spacing from 1952 to 2015.Extensive medical specialties were involved.The journals were world-wide distributed but the regional bias was obvious.Compared to the 2009 version,2015version adopted more recent literatures,and used more evidence rating for the recommendations.However,references with high-quality evidence were both less than 50％ in the two versions.Conclusion Huge amount of references with multi-specialties have been cited in 2015 version,however the regional distribution bias is distinctive and references with high-quality evidence are still insufficient.

Objective To analyse clinical application of hepatitis B virus core antibody(HBcAb)detected by using the chemilu-minescence microparticle immunoassay.Methods A total of 1 6 830 specimen with positive HBcAb detected by using the two pairs of semi-hepatitis test from January 2012 to November 2014 were collected,and divided into three groups according to the cut off in-dex(COI)of detection results of HBcAb,including group 1.0-<9.0,group 9.0-<1 1.0 and group COI≥1 1.0,and detection re-sults were statistically analysed.The hepatitis B virus(HBV)DNA test was carried out in specimen with negative hepatitis B surface antigen(HBsAg)and hepatitis B surface antibody (HBsAb)and COI≥1 1.0.Results The detection rate of HBsAg(+)HBsAb(-) (13.84%)was significantly higher than other expression patterns in group ≥1 1.0(P <0.05).There was no statistically significant differences in positive rate among all expression patterns of HBsAg and HBsAb in the group 9.0-<1 1.0(P >0.05).The detec-tion rate of HBsAg(+)HBsAb(-)of group 9.0-<1 1.0 was significantly lower than that of the other two groups(P <0.05).A total of 304 specimen were HBsAg(-)HBsAb(-)and COI≥1 1,among them 64 specimen were HBV DNA postive and the posi-tive rate was 21.0%.Conclusion In the detection of HBcAb,COI≥1 1 and 1.0-<9.0 could be reference indicators for diagnosiing current and past HBV infection respectively,which should be combined with other laboratory indicators of HBV clinical data for comprehensive analysis.

Adenoma ; pathology ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Parathyroid Neoplasms ; pathology ; Spinal Neoplasms ; secondary

The incidence of thyroid cancer is the top ranking among endocrine carcinoma worldwide.Many imaging modalities have been applied in diagnosing,characterization of the biological behaviors and predicting the outcomes of various thyroid carcinoma.Over the years,18F-FDG PET/CT has been largely used to identify undifferentiated thyroid carcinoma cells in thyroid carcinoma patients with or without 131I avid lesion.The purpose of this mini-review was to update the clinical role and positive impact of 18F-FDG PET/CT in various thyroid carcinoma patients.

Objective To investigate the patterns of change in thyroid functional parameters ( serum TSH,FT3, and FT4 ) in patients with papillary thyroid cancer (PTC) before and after the initial 131I treatment for thyroidal remnant ablation. Methods Seventy-four PTC patients, treated with 3.7 GBq 131 I therapy, were divided into two groups, group A with serum TSH＜30 mIU/L and group B with serum TSH ≥30 mIU/L the day before 131I treatment. Five days after the treatment, the patients were re-examined for serum FT3, FT4, and TSH levels.Results In group A (22 cases), 5 days after the 131I ablation treatment, FT4significantly increased by 88% and FT3 by 87%, while TSH decreased by 87% (all P＜0. 05 ), and 45% (10/22)cases manifested the signs of transient thyrotoxicosis. In group B (52 cases)after treatment, individual variance of FT3 and FT4 was obvious,with FT4 decreased by 13% and FT3 decreased by 14% ( both P＜0. 05 ), while TSH slightly increased by an average of 6% ( P＞0.05 ). Conclusion After the initial 131 I ablation therapy for thyroidal remnant, the thyroid hormone levels in some PTC patients significantly increase while in others may slightly decrease in the early stage. The supplementary and suppressive therapy after 131I ablation for PTC patients might be individualized depending on the thyroid hormone determination.

Objective To investigate the application value of free plasma metanephrines metanephrine(MN) and normetanephrine (NM) measured with enzyme immunoassay (EIA), NM in diagnosis of pheochromocytoma. Methods Histologically confirmed pheochromocytomas (n=30) and control patients with hypertension (n=51) were enrolled in the study. Blood tests for free plasma metanephrines(MN and NM) were performed with a commercially available EIA kit and the results were compared with [3] I-metaiedobenzyl guanidine (MIBG) whole body scan findings. Results The whole body scan was positive in all pheochromocytoma patients and negative in 15 control patients with 100% accuracy. The median values in the 2 groups were 59.3 ng/L and 33.7 ng/L (Z=-2. 440, P<0.05) for MN, 652.0 ng/L and 36. 3 ng/L (Z=-6.699, P<0.001) for NM, with 96. 7% (29/30) sensitivity, 86. 3% (44/51)specificity and 90.1% (73/81) accuracy for their combination ( either or both positive). There was no significantly statistical difference when compared with 13I-MIBG whole body scan findings (100. 0% ,P >0. 05). Conclusion The results show that the EIA method may be eligible as an alternative to HPLC for plasma metanephrines determination in the identification of pheochromocytoma.