Tuberculosis remains a significant global public health threat.Early diagnosis and effective treatment are crucial to combat this disease.Yet,traditional diagnostic methods for tuberculosis face limitations due to their low sensitivity,extended detection periods,and dependence on sputum samples.Molecular diagnostic techniques,while offering higher sensitivity,still primarily rely on sputum samples,thereby impeding significant advancements in tuberculosis diagnosis.In clinical settings,there exists a pressing demand for diagnostic approaches that are not solely reliant on sputum samples.In recent years,extracellular vesicles(EVs),as emerging biomarkers,have demonstrated substantial potential in various diseases,including tumors and infectious diseases.A multitude of studies indicate that EVs also exhibit potential in the field of tuberculosis.This review provides an in-depth analysis of the biological characteristics of EVs and their role in the pathogenesis of tuberculosis.It systematically summarizes the progress and significance of EV-based biomarkers in tuberculosis diagnosis,treatment monitoring,and disease mechanism exploration,while addressing the challenges and future prospects in this field.The aim is to offer valuable insights and up-to-date research findings to researchers and clinicians engaged in tuberculosis-related studies.

Thermal ablation (TA) is a widely applied minimally invasive treatment for benign thyroid nodules and low-risk papillary thyroid microcarcinoma. Compared to conventional surgery, TA offers advantages such as minimal trauma, rapid recovery, and no scarring. However, this procedure may lead to various complications, including intraoperative pain, nerve injury, hemorrhage, tracheal injury, skin burns, vasovagal reactions, nodule rupture, and thyroid dysfunction. Although TA demonstrates excellent safety and efficacy, further standardization of procedural protocols is necessary to minimize the incidence of complications.

Objective:To evaluate the predictive role of ultrasound, genetic testing, and clinical features in the malignancy risk of Bethesda Ⅲ thyroid nodules, and to explore strategies for optimizing treatment decisions.Methods:This retrospective study included 227 Bethesda Ⅲ thyroid nodules from patients who underwent surgical treatment at the Thyroid Surgery Department of Nanjing Drum Tower Hospital between Jan. 2020 and Dec. 2023. All patients underwent ultrasound evaluation and fine-needle aspiration. For nodules diagnosed as ultrasound, genetic testing, and clinical features were analyzed using univariate and multivariate regression to assess their association with malignancy.Results:Among the 227 nodules, 214 were malignant, resulting in a malignancy rate of 94.2%. The malignancy rate of thyroid nodules was 94.2%. In univariate analysis, age ( P=0.016), BRAF V600E gene mutation ( P<0.001), nodule size ( P=0.002), and TIRADS ( P<0.001) were significantly associated with malignancy in Bethesda Ⅲ thyroid nodules. Multivariate analysis confirmed that age ( OR=0.939, P=0.049) and BRAF V600E gene mutation ( OR=24.641, P<0.001) were significantly associated with thyroid nodule nature and served as independent predictive factors for malignancy. Conclusions:Genetic testing is an important method for predicting the malignancy of Bethesda Ⅲ thyroid nodules, and ultrasound also has high clinical value in assessing the malignancy risk of nodules. While some clinical features are highly correlated with nodule characteristics, they may not be practical in clinical application. For nodules classified as TIRADS 3 through ultrasound evaluation and negative for BRAF mutations, continued observation may be considered, whereas TIRADS 5 nodules or nodules with BRAF mutations should be prioritized for surgical treatment.

Thermal ablation (TA) is a widely applied minimally invasive treatment for benign thyroid nodules and low-risk papillary thyroid microcarcinoma. Compared to conventional surgery, TA offers advantages such as minimal trauma, rapid recovery, and no scarring. However, this procedure may lead to various complications, including intraoperative pain, nerve injury, hemorrhage, tracheal injury, skin burns, vasovagal reactions, nodule rupture, and thyroid dysfunction. Although TA demonstrates excellent safety and efficacy, further standardization of procedural protocols is necessary to minimize the incidence of complications.

Objective:To evaluate the predictive role of ultrasound, genetic testing, and clinical features in the malignancy risk of Bethesda Ⅲ thyroid nodules, and to explore strategies for optimizing treatment decisions.Methods:This retrospective study included 227 Bethesda Ⅲ thyroid nodules from patients who underwent surgical treatment at the Thyroid Surgery Department of Nanjing Drum Tower Hospital between Jan. 2020 and Dec. 2023. All patients underwent ultrasound evaluation and fine-needle aspiration. For nodules diagnosed as ultrasound, genetic testing, and clinical features were analyzed using univariate and multivariate regression to assess their association with malignancy.Results:Among the 227 nodules, 214 were malignant, resulting in a malignancy rate of 94.2%. The malignancy rate of thyroid nodules was 94.2%. In univariate analysis, age ( P=0.016), BRAF V600E gene mutation ( P<0.001), nodule size ( P=0.002), and TIRADS ( P<0.001) were significantly associated with malignancy in Bethesda Ⅲ thyroid nodules. Multivariate analysis confirmed that age ( OR=0.939, P=0.049) and BRAF V600E gene mutation ( OR=24.641, P<0.001) were significantly associated with thyroid nodule nature and served as independent predictive factors for malignancy. Conclusions:Genetic testing is an important method for predicting the malignancy of Bethesda Ⅲ thyroid nodules, and ultrasound also has high clinical value in assessing the malignancy risk of nodules. While some clinical features are highly correlated with nodule characteristics, they may not be practical in clinical application. For nodules classified as TIRADS 3 through ultrasound evaluation and negative for BRAF mutations, continued observation may be considered, whereas TIRADS 5 nodules or nodules with BRAF mutations should be prioritized for surgical treatment.

Tuberculosis remains a significant global public health threat.Early diagnosis and effective treatment are crucial to combat this disease.Yet,traditional diagnostic methods for tuberculosis face limitations due to their low sensitivity,extended detection periods,and dependence on sputum samples.Molecular diagnostic techniques,while offering higher sensitivity,still primarily rely on sputum samples,thereby impeding significant advancements in tuberculosis diagnosis.In clinical settings,there exists a pressing demand for diagnostic approaches that are not solely reliant on sputum samples.In recent years,extracellular vesicles(EVs),as emerging biomarkers,have demonstrated substantial potential in various diseases,including tumors and infectious diseases.A multitude of studies indicate that EVs also exhibit potential in the field of tuberculosis.This review provides an in-depth analysis of the biological characteristics of EVs and their role in the pathogenesis of tuberculosis.It systematically summarizes the progress and significance of EV-based biomarkers in tuberculosis diagnosis,treatment monitoring,and disease mechanism exploration,while addressing the challenges and future prospects in this field.The aim is to offer valuable insights and up-to-date research findings to researchers and clinicians engaged in tuberculosis-related studies.

Objective To evaluate the application value of simultaneous amplification and testing for Myco-bacterium tuberculosis(SAT-TB)in evaluating the curative effect of initial treatment of smear-positive pul-monary tuberculosis patients.Methods A total of 62 newly treated smear positive pulmonary tuberculosis pa-tients from June 2022 to June 2023 in Guangzhou Panyu District Chronic Disease Control Station were selected as the study objects,and the curative effect was evaluated by liquid-based sandwich cup method,Roche culture method and SAT-TB detection method.All patients received the standard anti-tuberculosis treatment regimen of 2HRZE/4HR standard regimen,and sputum samples were detected by liquid-based sandwich cup method,Roche culture method,and SAT-TB detection method at the 2nd,4th,and 8th week of treatment,respectively.Results Among 62 patients,54 cases were positive and 8 cases were negative using Roche culture method,47 cases were positive and 15 cases were negative using SAT-TB detection method.60 cases were positive and 2 cases were negative by Mycobacterium tuberculosis(MTB)-DNA test.The positive rates of the three methods were 87.10％(54/62),75.81％(47/62)and 96.77％(60/62),respectively.Taking Roche culture method re-sults as the standard,the sensitivity of SAT-TB detection method and MTB-DNA was 97.87％(46/47)and 90.00％(54/60),and the specificity was 46.67％(7/15)and 100.00％(2/2),respectively.There were signifi-cant differences between Roche culture method and SAT-TB detection method and MTB-DNA test(x2=20.070,P＜0.05,x2=13.985,P＜0.05),the difference between the results of SAT-TB detection method and MTB-DNA test was also statistically significant(x2=8.365,P＜0.05).The negative conversion rates of MTB in sputum samples were 69.35％(43/62),29.03％(18/62)and 41.94％(26/62)at the 2nd,4 th,and 8 th weeks,respectively.77.42％(48/62),59.68％(37/62),58.06％(36/62),82.26％(51/62),79.03％(49/62),75.81％(47/62).There were significant differences in the negative conversion rates of MTB in sputum sam-ples between SAT-TB and liquid-based sandwich cup method at the 2nd and 4th weeks(x2=8.365,P＜0.05,x2=4.465,P＜0.05),while there was no significant difference between the results of Roche culture method at the 2nd,4th and 8th weeks(x2=1.726,P＞0.05,x2=0.000,P＞0.05,x2=0.046,P＞0.05).Conclusion The use of SAT-TB detection method in clinical practice to evaluate the efficacy of smear positive pulmonary tuberculo-sis patients could accurately and quickly assess the negative conversion rate and treatment effect of patients,and provide a reliable basis for guiding clinical treatment.It could be considered as an effective auxiliary diag-nosis and evaluation method of curative effect,worthy of promotion and practical application.