Resumo Introdução O tratamento do microcarcinoma papilífero de tireoide permanece controverso. A metástase em linfonodos centrais é comum e é uma consideração importante na seleção da estratégia de tratamento. Objetivo Investigar os fatores de risco clínico-patológicos e as características ultrassonográficas de nódulos tireoidianos para metástase em linfonodos centrais em microcarcinoma papilífero de tireoide. Método Foram analisados retrospectivamente os dados de 599 pacientes com microcarcinoma papilífero de tireoide submetidos à cirurgia de 2005 a 2017 em uma única instituição. Análises univariadas e multivariadas foram usadas para identificar os fatores clínico-patológicos e as características ultrassonográficas pré-operatórias das metástases em linfonodos centrais. Uma análise de curva ROC (receiver-operating characteristic) foi feita para identificar a eficácia das características ultrassonográficas na previsão dessas metástases. Um nomograma baseado nos fatores de risco foi estabelecido para prever a metástase em linfonodos centrais. Resultados A incidência de metástase em linfonodos centrais foi de 22,4%. As análises univariadas e multivariadas sugeriram que sexo, idade, multifocalidade, invasão extratireoidiana e metástase em linfonodos laterais eram fatores de risco independentes para a metástase em linfonodos centrais. As análises univariadas e multivariadas revelaram que o formato nodular, a margem e a calcificação estavam independentemente associadas à metástase em linfonodos centrais. A análise da curva ROC mostrou que a combinação do formato, margem e calcificação apresentou excelente precisão na previsão dessas metástases. O nomograma foi desenvolvido com base nos fatores de risco identificados para predizer a metástase em linfonodos centrais e a análise do gráfico de calibração indicou o bom desempenho e a utilidade clínica do nomograma. Conclusões Em pacientes com microcarcinoma papilífero de tireoide, metástase em linfonodos centrais está associado ao sexo masculino, menor idade ( < 45 anos), invasão extratireoidiana, multifocalidade e presença de metástase em linfonodos laterais. As características ultrassonográficas, como formato irregular, margem mal definida e calcificação, podem melhorar a eficácia da previsão de metástase em linfonodos centrais. Cirurgiões e radiologistas devem ficar mais atentos aos pacientes que apresentam esses fatores de risco. O nomograma pode ajudar a orientar a tomada de decisão cirúrgica para o microcarcinoma papilífero de tireoide.

Abstract Introduction The treatment of papillary thyroid microcarcinoma remains controversial. Central lymph node metastasis is common in papillary thyroid microcarcinoma and it is an important consideration in treatment strategy selection. Objective The aim of this study was to investigate clinicopathologic risk factors and thyroid nodule sonographic characteristics for central lymph node metastasis in papillary thyroid microcarcinoma. Methods We retrospectively reviewed the data of 599 papillary thyroid microcarcinoma patients who underwent surgery from 2005 to 2017 at a single institution. Univariate and multivariate analyses were used to identify the clinicopathologic factors and preoperative sonographic features of central lymph node metastasis. A receiver-operating characteristic, ROC curve analysis, was performed to identify the efficacy of ultrasonographic features in predicting central lymph node metastasis. A nomogram based on the risk factors was established to predict central lymph node metastasis. Results The incidence of central lymph node metastasis was 22.4%. The univariate and multivariate analyses suggested that gender, age, multifocality, extrathyroidal invasion, and lateral lymph node metastasis were independent risk factors for central lymph node metastasis. The univariate and multivariate analyses revealed that nodular shape, margin, and calcification were independently associated with central lymph node metastasis. The ROC curve analysis revealed that the combination of shape, margin and calcification had excellent accuracy in predicting central lymph node metastasis. The nomogram was developed based on the identified risk factors for predicting central lymph node metastasis, and the calibration plot analysis indicated the good performance and clinical utility of the nomogram. Conclusions Central lymph node metastasis is associated with male gender, younger age (<5 years), extrathyroidal invasion, multifocality and lateral lymph node metastasis in papillary thyroid microcarcinoma patients. The ultrasongraphic features, such as irregular shape, ill-defined margin and calcification, may improve the efficacy of predicting central lymph node metastasis. Surgeons and radiologists should pay close attention to the patients who have these risk factors. The nomogram may help guide surgical decision making in papillary thyroid microcarcinoma.

This study aimed to investigate the clinical characteristics, prognosis, and factors for survival of patients who underwent early-start peritoneal dialysis (PD) within 24 h after catheter insertion three years after PD. This study was conducted from January 1, 2013 to December 31, 2017. All adult patients who were diagnosed with end-stage renal disease (ESRD) and underwent PD for the first time within 24 h after catheter insertion in our hospital were included. All patients with PD were followed-up until they withdrew from PD, switching to hemodialysis, were transferred to other medical centers, underwent renal transplantation, died or were lost to follow-up, or continued to undergo dialysis until the end of the study period. The follow-up observation lasted three years. The number of eligible patients was 110, and switching to hemodialysis and death were the main reasons for patients to withdraw from PD. The 1-, 2-, and 3-year technical survival rates of patients were 89.1, 79.1, and 79.1% respectively, while the 1-, 2- and 3-year survival rates were 90, 81.8, and 81.8%, respectively. The Charlson comorbidity index, age, hemoglobin, serum albumin, diabetic nephropathy, chronic glomerulonephritis, and hypertensive renal damage were independent risk factors that affected the prognosis of PD patients. Under the condition of ensuring the quality of the PD catheter insertion, early-start PD within 24 h after catheter insertion is a safe treatment approach for ESRD patients.

Abstract Concentrated growth factor (CGF) is an autogenuous product that contains highly concentrated number of platelets and can be derived from venous blood by selective centrifugation. It has been speculated that local growth factors in human platelets (insulinlike growth factor, IGF; transforming growth factor, TGF-b; platelet derived growth factor, PDGF) would enhance healing of grafts and also counteract resorption. The osteogensis effect of CGF and acellular dermal matrix (ADM) for alveolar cleft defects was evaluated in this study. Twenty alveolar cleft patients were divided randomly into two groups. One group underwent guided bone regeneration (GBR) using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting combined with CGF (CGF group). Cone beam computed tomography (CBCT) images were obtained at 1 week and 6 months following the procedure. Using Mimics 17.0 software, the bone resorption rate and bone density improvement rate were calculated and compared between the two groups. Although not significant between ADM and CGF in bone resorption rate, the bone density improvement in cases with CGF(61.62 ± 4.728%) was much better than in cases with ADM (27.05 ± 5.607%) (p = 0.0002). Thus, CGF could be recommended to patients with alveolar cleft as a better choice.

Sugarcane brown rust disease caused by Puccinia melanocephala is one of the important fungal diseases affecting sugarcane yield around the world. Cultivar resistance is the most appropriate control method for this disease. In this study, 62 introgression lines chosen from the crossing Saccharum officinarum L. cv. Ludashi x Erianthus rockii Yunnan 95-19 were evaluated for brown rust resistance using artificial inoculation. More than 30% of the introgression lines were identified as resistant. Clones Yunye 09-609, Yunye 09-618, Yunye 09-622, Yunye 09-636, Yunye 09-637, Yunye 09-645, Yunye 09-647 and Yunye 09-652 were shown to have high levels of resistance. The resistant lines identified in this study could be used as sources of brown rust resistance in sugarcane breeding programs.