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Deep neck abscesses are dangerous. Artificial dermis combined with seal negative pressure drainage is a new technique for treating refractory wounds. To compare the efficacy of vacuum sealing drainage (VSD) with that of traditional incision drainage approaches for treating deep neck multiple spaces infections. This retrospective analysis includes patient data from our hospital collected from January 2010 to March 2020. A total of 20 cases were identified. Based on the treatment methods, the patients were divided into the VSD group and the traditional group. Inflammation indicators (white blood count, WBC), duration of antibiotic use, hospitalization time, doctors’ workload (frequency of dressing changes) and treatment cost were analyzed and compared between the two groups. Of the 20 patients, 11 patients underwent treatment with VSD, while the other 9 underwent traditional treatment. All patients were cured after treatment. Compared with the traditional group, the VSD group had a slower decline in the inflammation index, shorter duration of antibiotic use, shorter hospital stay, and lower doctor workloads (P .05). VSD technology can markedly improve the therapeutic effect of deep neck multiple spaces infection. This treatment method can be used to rapidly control infections and is valuable in the clinic (P > .05).

Rationale The Nuss procedure has become a major alternative operation for patients with pectus excavatum (PE). Patient concerns We report a case of 27-year-old man with PE who developed thoracic outlet syndrome (TOS) after the Nuss procedure. The patient showed clinical symptoms of brachial plexus compression. Diagnoses Further evaluation demonstrated a narrowed space between the first rib and the anterior scalene muscle and compressing the brachial plexus and vessels. Interventions Nerve nourishing medicine and rehabilitation exercising were taken to restore the muscle strength. Outcomes Several months later, the clinical symptoms disappeared. Lessons Medicine and rehabilitation exercising may benefit the functional recovery of impaired nerve in TOS in the early stage of TOS.

This study aimed to analyze the imaging findings of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and chest thin-layer high-resolution computed tomography (HRCT), correlate the maximum standardized uptake value (SUVmax), and the pathological type of benign or malignant pulmonary nodules (PNs), and assess the diagnostic accuracy in differentiating malignant from benign PNs. A retrospective review of 18F-FDG PET/CT scans from 88 patients with PNs confirmed by pathology or clinical follow-up were included. They both accepted PET/CT and HRCT scan conventional. The final results were determined by a combination of PET/CT and HRCT. Independent samples t test was used for statistical analysis. Receiver operating curves (ROC) were generated and the optimal threshold of SUVmax was determined. The sensitivity, specificity, and accuracy of HRCT, PET/CT, and PET/CT combined with HRCT in the diagnosis of PNs were 83.3%, 70%, 77.3%; 91.7%, 62.5%, 78.4%; and 95.8%, 75%, 86.4%, respectively. The SUVmax of malignant nodules was significantly higher than that of benign nodules, and the difference was statistically significant (t = –5.668, P 3.635 as the best threshold, and the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT in diagnosis of PNs were 83.3%, 62.5%, 79.2%, 71.7%, and 71.4%, respectively. PET/CT combined with HRCT should be advocated to improve the sensitivity, specificity, and accuracy of PET/CT in diagnosis of PNs.

Rationale: 18F-fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) has an important role in the diagnosis of various malignancies. However, F-18 FDG can also exhibit intense accumulation in tissues in inflammatory conditions such as active tuberculosis (TB) and sarcoidosis. Patient concerns: We report a case of a 52-year-old female with irritable cough. CT showed a lung mass with multiple bilateral lung nodules, and sarcoidosis was suspected. F-18 FDG PET/CT was undertaken for the diagnosis and showed intense uptake of FDG in the mass in the lower lobe of the right lung, multiple lymph nodes, liver, and spleen. The maximum standardized uptake value of F-18 FDG was 43.58. This pattern of involvement most likely represents lymphomatous involvement. Diagnoses: Histopathology suggested tubercular involvement. Intervention and outcomes: The patient received anti-TB treatment and recovered. Lessons: Abovementioned extent and distribution of F-18 FDG in tubercular lesion is relatively rare, thus, one must be observant and aware with regards to TB being a strong mimic of lymphoma in endemic regions.

The aim of this study was to evaluate the effects of the first radioactive iodine (131I) therapy on functions of salivary glands in patients with differentiated thyroid carcinoma (DTC). There were 36 consented patients with DTC enrolled in this study, who received 3.7 GBq (100mCi) 131I for ablation after total thyroidectomy. Salivary gland function was assessed using salivary gland scintigraphy in two phases, one 4 hours before and the other 6 months after 131I therapy (both under thyrotropin stimulation condition). Quantitative parameters including uptake fraction (UF), uptake index (UI), excretion fraction (EF), and excretion ratio (ER) were measured and compared. Blood parameters were also compared. Associations between sex and outcome of the first 131I therapy as well as individual salivary gland function were measured. Wilcoxon Signed Rank Sum test and χ2 test were used for statistical analysis. When compared between pre-ablation and post-ablation, UF of bilateral parotid and submandibular glands were significantly increased (all P

Mean platelet volume (MPV) and platelet distribution width (PDW) are morphometric indices of size distribution and variability of platelet. We aimed to explore the associations between MPV or PDW and thyroid function in a large Chinese cohort. This was a cross-sectional study with a recruitment of 13,622 self-reported healthy Chinese (8424 males, 5198 females). Clinical data of the participants comprised of anthropometric measurements, hepatic function, renal function, serum levels of lipid, glucose, C-reactive protein, erythrocyte sedimentation rate, platelet, MPV, PDW, and thyroid hormones. Database was sorted by sex, and the associations between MPV or PDW and thyroid function were analyzed by quartiles of MPV or PDW. Levels of MPV and PDW were compared in different thyroid function subgroups by 1-way analysis of variance and independent sample's t test. Receiver-operating characteristic (ROC) curve was adopted to determine diagnostic values of MPV and PDW for thyroid dysfunction. Crude and adjusted odds ratios of MPV and PDW for thyroid dysfunction with 95% confidence intervals were analyzed by binary logistic regression models. MPV, PDW, and thyroid stimulation hormone were significantly higher in females than in males. Females showed significantly higher incidence of hypothyroidism and hyperthyroidism than males. However, there were no significant differences of MPV and PDW among different thyroid function subgroups in both sexes, and no obvious correlations were revealed between MPV or PDW and thyroid function. From ROC analysis, we demonstrated no diagnostic values of MPV and PDW for thyroid dysfunction. From binary logistic regression models, no risks of different MPV and PDW quartiles were identified for thyroid dysfunction in both sexes. We could not show any association between MPV or PDW and thyroid function. Prospective studies with better defined risk groups should be performed in the future for further verification and validation.

Radioactive iodine (RAI) is considered to be related with hematologic changes. This study aimed to evaluate influence of the first RAI ablation on peripheral complete blood count (CBC) in patients with differentiated thyroid cancer (DTC). Data of CBC at baseline and 6 months after RAI were obtained in 385 patients with DTC with approximately 3700 MBq 131I (ranging 2220–7585 MBq). Further comparison was done in 196 patients with 1-month postablation data available. Routine blood examinations were performed to determine impact of RAI on white blood cell (WBC), red blood cell (RBC), hemoglobin, platelet, neutrophil, lymphocyte, and monocyte in both sexes. Continuous variables were compared by paired t tests and independent samples t test, and categorical variables were compared by chi-square analysis. Data with repeated measurements were analyzed by analysis of variance. The first RAI after thyroidectomy was associated with mild, yet significant declines in WBC, platelet, and lymphocyte, which persisted for 6 months. One month after RAI, significant declines were found in all CBC, including RBC and hemoglobin (all P

The relationship between thyroid-stimulating hormone (TSH) and hyperlipidemia is still a topic of debate. We aimed to explore the impact of gender and age on the association between serum TSH and lipid profile in a large cohort of Chinese. This cross-sectional study enrolled 13,915 participants (8565 male, 5350 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and other serum parameters were collected. The associations between TSH and hyperlipidemia of males and females were analyzed separately after dividing TSH and age into subgroups. Odds ratio for hyperlipidemia was calculated by binary logistic regression models. Young males had significantly higher prevalence of hypercholesterolemia, hypertriglyceridemia, and high serum low-density lipoprotein-cholesterol than females, yet after menopause, females had higher prevalence than males. TSH was positively associated with hyperlipidemia independent of thyroid hormones. Males showed more reduced risks of hyperlipidemia in low TSH concentrations, while females demonstrated more enhanced risks of hyperlipidemia in high TSH concentrations. For instance, if TSH was lower than 0.3 μIU/mL, the risks of developing hypercholesterolemia and hypertriglyceridemia in males were only 0.198 (P 0.05), respectively. If TSH was higher than 4.0 μIU/mL, women displayed significantly higher risks of developing hypertriglyceridemia than the reference TSH risks (P

The relationship between thyroid dysfunction and metabolic syndrome (MS) is complex. We aimed to explore the impact of gender and age on their association in a large Chinese cohort. This cross-sectional study enrolled 13,855 participants (8532 male, 5323 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and serum metabolic parameters were collected. The associations between thyroid function and MS of both genders were analyzed separately after dividing thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and age into subgroups. MS risks were calculated by binary logistic regression models. Young males had significantly higher MS prevalence than females, yet after menopause, females had higher prevalence than males. Females had higher incidence of thyroid dysfunction than males. By using TSH quartiles as the categorical variables and the lowest quartile as reference, significantly increased MS risk was demonstrated in quartile 4 for males, yet quartiles 3 and 4 for females. By using FT3 quartiles as the categorical variables, significantly increased MS risk was demonstrated in quartile 2 to 4 for females only. By using age subgroups as the categorical variables, significantly increased MS risk was shown in both genders, with females (4.408–58.455) higher than males (2.588–4.943). Gender and age had substantial influence on thyroid function and MS. Females with high TSH and high FT3 had higher MS risks than males. Aging was a risk for MS, especially for females. Urgent need is necessary to initiate interventional programs.

To assess the efficacy of radioiodine therapy (RIT) and investigate the prognostic factors for patients with pulmonary metastasis secondary to differentiated thyroid carcinoma (DTC) through a retrospective study. A total of 80 patients with radioactive iodine-131 (131I)-avid pulmonary metastasis from DTC treated with 131I from 2007 to 2014 at our institution entered the study. Treatment response was mainly measured by two parameters: serum thyroglobulin (Tg) levels and post-therapeutic 131I whole-body scan (WBS). Treatment variables were assessed for statistical significance using the univariate and multivariate analyses. A receiver-operating characteristic (ROC) curve was also plotted to verify the accuracy of predictors. Of these 80 patients, the overall effective rate was 72.5% (58/80), the rates for complete response (CR), partial response (PR), and no response (NR) were 20.0%, 52.5%, and 27.5%, respectively. Univariate analysis showed that gender, pulmonary nodule size, absence or presence of extrapulmonary distant metastases, age, and Tg level at diagnosis were significantly associated with 131I therapy efficacy. Binary logistic regression analysis revealed that older patients (odds ratio [OR]:1.481, 95% confidence interval [CI]: 1.457–2.091, P = .020), subjects with higher Tg levels at diagnosis (OR: 1.046, 95% CI: 1.016–1.119, P = .014), and those with extrapulmonary distant metastases (OR: 1.185, 95%CI: 1.025–1.463, P = .020) had a higher probability of poor prognosis. The optimal cutoffs for age and Tg level to predict 131I therapy efficacy for DTC with lung metastases were 46 years old and 55.50 ng/mL, respectively, based on ROC analysis. This study indicated that most DTC patients with pulmonary metastases can obtain partial or complete remission after RIT, while older patients with higher Tg levels at diagnosis and extrapulmonary distant metastases more likely show poor prognosis.

Hepatic dysfunction is often observed in patients with Graves’ hyperthyroidism. The aims of this study were to investigate the risk factors for hepatic dysfunction and to analyze the efficacy of 131I (radioactive iodine-131) treatment. In total, 2385 patients with Graves’ hyperthyroidism (478 males, 1907 females; age 42.8 ± 13.5 years) were involved in our study. Of these, 1552 cases with hepatic dysfunction received 131I treatment. All clinical data were retrospectively reviewed to explore the risk factors associated with hepatic dysfunction using logistic regression analysis. Furthermore, we observed thyroid and liver function indices for the 1552 subjects at 3, 6 and 12 months after 131I treatment, in order to evaluate efficacy. Overall, 65% patients were affected by hepatic dysfunction. The most common abnormality was elevated alkaline phosphatase (ALP), of which the prevalence was 52.3%. The percentages of hepatocellular injury type, bile stasis, and mixed type were 45.8%, 32.4%, and 21.8%, respectively. Both univariate and multivariate analyses demonstrated that age, duration of Graves hyperthyroidism, free triiodothyronine (FT3)level, and thyrotrophin receptor antibody (TRAb) concentration were the most significant risk factors predicting hepatic dysfunction. Additionally, the patients with mild hepatic dysfunction, or hepatocellular injury type were more likely to attain normal liver function after 131I treatment. Furthermore, after 131I treatment, liver function was more likely to return to normal in the cured group of patients compared with the uncured group. Older patients and cases with a longer history of Graves’ hyperthyroidism, higher FT3 or TRAb concentration were more likely to be associated with hepatic dysfunction, and the prognosis of hepatic dysfunction was closely associated with the outcomes of Graves’ hyperthyroidism after 131I treatment.

Leukocyte, erythrocyte or platelet and metabolic syndrome (MS) are closely correlated, and there exist gender differences. We aimed to explore the associations between the hematological parameters and MS in different genders of Chinese. This cross-sectional study included 32,900 participants (20,733 males, 12,167 females) who were enrolled in a health examination. Clinical data including anthropometric measurements and serum parameters were collected. The associations between hematological parameters and MS of both genders were analyzed separately. Odds ratio (OR) of MS was calculated by binary logistic regression models. All hematological parameters were related to MS. With leukocyte and erythrocyte counts rising, the risks of developing MS increased in both genders, which was more obvious in women. For instance, in model 3, the ORs of MS in leukocyte quartiles in females were from 1.333 to 2.045 (P