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Background The optimal treatment method for papillary thyroid microcarcinoma (PTMC) is lacking consensus. Here we aimed to compare the efficacy and safety of surgery and microwave ablation (MWA) for PTMC. Methods The clinical data of 644 patients with PTMC treated between July 2013 and June 2020 were retrospectively analyzed. A total of 320 and 324 patients underwent MWA and surgery, respectively. We observed lesion changes in the MWA group and compared the recurrence, metastasis, complications, and other health economic indicators between the 2 groups. Results The mean follow-up time was 890.7 ± 532.9 (187.9–2679.0) days in the MWA group and 910.9 ± 568.4 (193.8–2821.5) days in the surgery group. In the MWA group, lesion volume increased significantly after ablation and then gradually decreased. The final lesion volume reduction rate was 90.73% ± 7.94%, and 193 lesions (60.3%) disappeared completely. There were no significant intergroup differences in recurrence or metastasis. The incidence of main complications (temporary hypothyroidism, hypoparathyroidism, and temporary hoarseness) was significantly lower in the MWA group than in the surgery group (p

Purpose To explore the clinical outcomes and safety of ultrasound-guided microwave ablation (MWA) for treating thyroid benign solid nodules during a three-year follow-up. Methods A total of 53 patients with thyroid benign solid nodules with the largest diameter exceeding 2 cm were treated with US-guided MWA between January 2015 and December 2017. Nodule volume, the cosmetic score, and the symptom scores were evaluated before ablation and 1, 2, and 3 years after the operation. The characteristics of MWA and complications were also evaluated. Results The thyroid nodule volume at each time point after ablation was significantly smaller than that before ablation (p

Background To compare the short-term clinical outcomes of ultrasound-guided microwave ablation (MWA) and parathyroidectomy (PTX) for severe secondary hyperparathyroidism(SHPT). Methods In a prospective multi-center study, we compared the outcomes of MWA and PTX for severe SHPT. The outcome measures were case rate of successful treatment, improvement of clinical symptoms, incidence of complications, and differences in treatment parameters and costs between the two groups. Results A total of 167 eligible patients were included in the study, of which 79 underwent MWA and 88 underwent PTX. There was no significant difference in rate of successful treatment between the MWA and PTX groups (χ2=2.299, p = 0.125). However, the MWA group showed significantly lower range of intact parathyroid hormone (iPTH) decrease than the PTX group (t=−2.352, p = 0.023). Postoperative clinical symptoms improved in both groups, with no significant difference between the two groups (p > 0.05). Postoperative hypocalcemia was significantly more common in the PTX group (p 0.05). The cost of MWA was significantly less than PTX (p = 0.000). Conclusions Both MWA and PTX are effective and safe for severe secondary hyperparathyroidism. PTX is more thorough and traumatic, while MWA is minimally invasive and postoperative iPTH is more consistent with the Kidney Disease: Improving Global Outcomes (KDIGO) recommendation.

BACKGROUND Staging diagnosis of liver fibrosis is a prerequisite for timely diagnosis and therapy in patients with chronic hepatitis B. In recent years, ultrasound elastography has become an important method for clinical noninvasive assessment of liver fibrosis stage, but its diagnostic value for early liver fibrosis still needs to be further improved. In this study, the texture analysis was carried out on the basis of two dimensional shear wave elastography (2D-SWE), and the feasibility of 2D-SWE plus texture analysis in the diagnosis of early liver fibrosis was discussed. AIM To assess the diagnostic value of 2D-SWE combined with textural analysis in liver fibrosis staging. METHODS This study recruited 46 patients with chronic hepatitis B. Patients underwent 2D-SWE and texture analysis; Young's modulus values and textural patterns were obtained, respectively. Textural pattern was analyzed with regard to contrast, correlation, angular second moment (ASM), and homogeneity. Pathological results of biopsy specimens were the gold standard; comparison and assessment of the diagnosis efficiency were conducted for 2D-SWE, texture analysis and their combination. RESULTS 2D-SWE displayed diagnosis efficiency in early fibrosis, significant fibrosis, severe fibrosis, and early cirrhosis (AUC > 0.7, P < 0.05) with respective AUC values of 0.823 (0.678-0.921), 0.808 (0.662-0.911), 0.920 (0.798-0.980), and 0.855 (0.716-0.943). Contrast and homogeneity displayed independent diagnosis efficiency in liver fibrosis stage (AUC > 0.7, P < 0.05), whereas correlation and ASM showed limited values. AUC of contrast and homogeneity were respectively 0.906 (0.779-0.973), 0.835 (0.693-0.930), 0.807 (0.660-0.910) and 0.925 (0.805-0.983), 0.789 (0.639-0.897), 0.736 (0.582-0.858), 0.705 (0.549-0.883) and 0.798 (0.650-0.904) in four liver fibrosis stages, which exhibited equivalence to 2D-SWE in diagnostic efficiency (P > 0.05). Combined diagnosis (PRE) displayed diagnostic efficiency (AUC > 0.7, P < 0.01) for all fibrosis stages with respective AUC of 0.952 (0.841-0.994), 0.896 (0.766-0.967), 0.978 (0.881-0.999), 0.947 (0.835-0.992). The combined diagnosis showed higher diagnosis efficiency over 2D-SWE in early liver fibrosis (P < 0.05), whereas no significant differences were observed in other comparisons (P > 0.05). CONCLUSION Texture analysis was capable of diagnosing liver fibrosis stage, combined diagnosis had obvious advantages in early liver fibrosis, liver fibrosis stage might be related to the hepatic tissue hardness distribution.

Objective Percutaneous ethanol injection (PEI) and microwave ablation (MWA) are both important methods used in treating benign thyroid nodules. This study aimed to investigate the efficacy and safety of a modified PEI method combined with MWA for the treatment of symptomatic, predominantly cystic and benign thyroid nodules. Materials and methods This study included 201 patients who underwent treatment in our department between April 2015 and August 2018. Predominantly cystic thyroid nodules were treated by the modified PEI procedure, which included short-term boiling ethanol ablation (STBEA) and was combined with MWA. Complications, the volume reduction ratio (VRR), symptoms and cosmetic scores were recorded at 1, 3, 6 and 12 months after treatment and every 6 months thereafter. Results No major complications were observed during or after the treatment. Ten patients (4.8%) experienced temporary voice change, which resolved within 3 months. Of 200 (97.6%) out of 205 nodules showed significant volume reduction at the final follow-up. Recurrence occurred for only 5 (2.4%) nodules. The mean thyroid nodule volume decreased from 17.40 ± 3.21 mL at baseline to 1.17 ± 0.37 mL at 12 months. The greatest VRR was observed within the first 3 months after treatment. Conclusions The modified PEI method combined with MWA is safe and effective for the treatment of predominantly cystic benign thyroid nodules and provides a shorter operating time and lower recurrence rate than traditional treatments.

Objectives Artificial intelligence (AI) has been an important addition to medicine. We aimed to explore the use of deep learning (DL) to distinguish benign from malignant lesions with breast ultrasound (BUS). Methods The DL model was trained with BUS nodule data using a standard protocol (1271 malignant nodules, 1053 benign nodules, and 2144 images of the contralateral normal breast). The model was tested with 692 images of 256 breast nodules. We used the accuracy, precision, recall, harmonic mean of recall and precision, and mean average precision as the indices to assess the DL model. We used 100 BUS images to evaluate differences in diagnostic accuracy among the AI system, experts (>25 years of experience), and physicians with varying levels of experience. A receiver operating characteristic curve was generated to evaluate the accuracy for distinguishing between benign and malignant breast nodules. Results The DL model showed 73.3% sensitivity and 94.9% specificity for the diagnosis of benign versus malignant breast nodules (area under the curve, 0.943). No significant difference in diagnostic ability was found between the AI system and the expert group (P = .951), although the physicians with lower levels of experience showed significant differences from the AI and expert groups (P = .01 and .03, respectively). Conclusions Deep learning could distinguish between benign and malignant breast nodules with BUS. On BUS images, DL achieved diagnostic accuracy equivalent to that of expert physicians.

Triple-negative breast cancer shows worse outcome compared with other subtypes of breast cancer. The discovery of dysregulated microRNAs and their roles in the progression of triple-negative breast cancer provide novel strategies for the treatment of patients with triple-negative breast cancer. In this study, we identified the significant reduction of miR-133 in triple-negative breast cancer tissues and cell lines. Ectopic overexpression of miR-133 suppressed the proliferation, colony formation, and upregulated the apoptosis of triple-negative breast cancer cells. Mechanism study revealed that the YES Proto-Oncogene 1 was a target of miR-133. miR-133 bound the 3′-untranslated region of YES Proto-Oncogene 1 and decreased the level of YES Proto-Oncogene 1 in triple-negative breast cancer cells. Consistent with miR-133 downregulation, YES1 was significantly increased in triple-negative breast cancer, which was inversely correlated with the level of miR-133. Restoration of YES Proto-Oncogene 1 attenuated the inhibitory effects of miR-133 on the proliferation and colony formation of triple-negative breast cancer cells. Consistent with the decreased expression of YES Proto-Oncogene 1, overexpression of miR-133 suppressed the phosphorylation of YAP1 in triple-negative breast cancer cells. Our results provided novel evidence for the role of miR-133/YES1 axis in the development of triple-negative breast cancer, which indicated miR-133 might be a potential therapeutic strategy for triple-negative breast cancer.

Background: Although papillary thyroid microcarcinoma (PTMC) has a high incidence and excellent clinical outcome, debate continues as to the therapeutic approach that would be most appropriate after confirming the diagnosis. Methods: We retrospectively analyzed the medical records of 311 patients with T1aN0M0 PTMC between January 2013 and September 2018. In all, 168 underwent microwave ablation (MWA), and 143 underwent surgery. MWA was performed using extensive ablation with hydrodissection. The surgery comprised thyroid lobectomy (TL) with unilateral central lymph node dissection (CND). We examined clinical outcomes during mean follow-up periods of 824 ± 452 days for the TL group and 753 ± 520 days for the MWA group. Results: Postprocedural follow-up revealed that, in the MWA group, the tumors had completely disappeared in 34 patients, and the remainder were reduced to necrotic or carbonized tissue. The incidence of transient hypoparathyroidism was significantly lower in the MWA group than in the TL group (p

Background: Papillary thyroid microcarcinoma (PTMC) has high incidence and low disease-specific mortality. However, active surveillance is not accepted by most patients owing to high physical or ps...

The aim of this article was to determine the efficacy and safety of the combined use of ethanol and microwave (MWA) to thyroid cysts and explore the differences of various cysts.A total of 136 patients and 142 thyroid cystic nodules and predominantly cystic nodules received combination therapy of ethanol and MWA between January 2016 and December 2019 in BeiJing Friendship Hospital. They were divided into different groups according to the size, and the characteristics of fluid aspirated. We compared the Initial size, treatment procedure, postoperative complications, and follow-up results to analyze the characteristics of different groups.The combination treatments reduced the size of cysts by more than 93% with less complications at the end of follow-up. The treatment duration was longest in the colloid cysts (difference from the clear-fluid group, p 0.01), the absolute volume of the clear-fluid group at the end of follow-up was the smallest (difference from the other two groups: P 0.01).There were the similar mean volume reduction rate (VRR) between the large cysts and the small cysts (p0.05).The combination treatments were applicable to all types of cysts. Understanding the characteristics of different cystic nodules and adopting different methods are helpful for us to carry out the minimally invasive treatment of cysts better.

The issue on how to effectively control Internet malicious worms has been drawn significant attention owing to enormous threats to the Internet. Due to the rapid spreading of malicious worms, it is necessary to explore the integrated measures to automatically mitigate the propagation on the Internet. In this paper, a novel worm propagation model is established, which combines both impulsive quarantine and benign worm implementation. Then, sufficient conditions for the global stability of worm-free periodic solution and the permanence of the benign worm are obtained. Finally, the effects of quarantine strategy are assessed and some feasible strategies that can constrain the propagation of malicious worm are provided by numerical simulation.

Benign thyroid nodules occur commonly but only require treatment when symptomatic. Surgical treatment, once routine, has been replaced by newer technologies, such as microwave ablation (MWA). The aim of this study was to assess the efficacy, tolerability and cost of MWA compared to surgery to treat benign thyroid nodules.After obtaining ethical approval and informed consent, a prospective trial was conducted with 52 patients who had symptomatic benign thyroid nodules. Patients were randomly assigned to receive MWA or surgical treatment. The volume reduction ratio (VRR), thyroid function, complications, HRQoL, costs and some parameters were compared.MWA reduced mean nodule volume by 72.3% at 3 months, 84.5% at 6 months and 92.4% at 12 months as effective as surgery in inactivating nodules, and thyroid dysfunction did not occur during 12-month follow-up for those receiving MWA. Although both MWA and surgery were safe, patients undergoing MWA had fewer cases of complications and rarely reported pain. The MWA group was superior to the surgery group in length of stay, postoperative scar length and the operation time. Compared to patients who underwent surgery, those who underwent MWA had better general health and mental health scores at 6 months and 12 months. The mean total cost of the MWA group was lower than that of the surgery group.MWA can significantly reduce nodule volume and nodule-related symptoms with more rapid recovery, more pleasing esthetic outcomes, less physiologic disruption and less expense compared to the surgery.

AIM: To explore the feasibility of non-invasive quantitative estimation of portal venous pressure by contrast-enhanced ultrasound (CEUS) in a canine model. METHODS: Liver fibrosis was established in adult canines (Beagles; n = 14) by subcutaneous injection of carbon tetrachloride (CCl4). CEUS parameters, including the area under the time-intensity curve and intensity at portal/arterial phases (Qp/Qa and Ip/Ia, respectively), were used to quantitatively assess the blood flow ratio of the portal vein/hepatic artery at multiple time points. The free portal venous pressures (FPP) were measured by a multi-channel baroreceptor using a percutaneous approach at baseline and 8, 16, and 24 wk after CCl4 injections in each canine. Liver biopsies were obtained at the end of 8, 16, and 24 wk from each animal, and the stage of the fibrosis was assessed according to the Metavir scoring system. A Pearson correlation test was performed to compare the FPP with Qp/Qa and Ip/Ia. RESULTS: Pathologic examination of 42 biopsies from the 14 canines at weeks 8, 16, and 24 revealed that liver fibrosis was induced by CCl4 and represented various stages of liver fibrosis, including F0 (n = 3), F1 (n = 12), F2 (n = 14), F3 (n = 11), and F4 (n = 2). There were significant differences in the measurements of Qp/Qa (19.85 ± 3.30 vs 10.43 ± 1.21, 9.63 ± 1.03, and 8.77 ± 0.96) and Ip/Ia (1.77 ± 0.37 vs 1.03 ± 0.12, 0.83 ± 0.10, and 0.69 ± 0.13) between control and canine fibrosis at 8, 16, and 24 wk, respectively (all P < 0.001). There were statistically significant negative correlations between FPP and Qp/Qa (r = -0.707, P < 0.001), and between FPP and Ip/Ia (r = -0.759, P < 0.001) in the canine fibrosis model. Prediction of elevated FPP based on Qp/Qa and Ip/Ia was highly sensitive, as assessed by the area under the receiver operating curve (0.866 and 0.895, respectively). CONCLUSION: CEUS is a potential method to accurately, but non-invasively, estimate portal venous pressure through measurement of Qp/Qa and Ip/Ia parameters.

Microwave ablation (MWA) is an effective technique for the treatment of benign thyroid nodules. The aim of this study was to investigate whether it is necessary to study changes in variables other than the volume reduction between follow-up intervals. This study also introduced the index R (SA total of 236 complex benign thyroid nodules in 230 patients who underwent MWA in our department from October 2013 to February 2017 were included. The DAll of the thyroid nodules underwent a significant decrease in size after MWA. The mean decrease in the volume of the thyroid nodules was from 17.40 ± 22.52 mL to 1.31 ± 2.71 mL, with a mean percent decrease of 0.90 ± 0.15% after 12 months. Index R increased over time from 2.55 ± 1.08 to 8.10 ± 5.01, which increased the effectiveness of shape parameterisation between the follow-up periods after the three-month time point, regardless of the initial volume size. For the nodules with a baseline DLong-term follow-up emphasises changes in the shape and spatial structure of complex benign thyroid nodules, rather than size variations, after effective MWA. Index R, which is the surface area to volume ratio, can also reflect the shape change to some degree.

This paper describes a PU learning (Positive and Unlabeled learning) based system for potential URL attack detection. Previous machine learning based solutions for this task mainly formalize it as a supervised learning problem. However, in some scenarios, the data obtained always contains only a handful of known attack URLs, along with a large number of unlabeled instances, making the supervised learning paradigms infeasible. In this work, we formalize this setting as a PU learning problem, and solve it by combining two different strategies (two-stage strategy and cost-sensitive strategy). Experimental results show that the developed system can effectively find potential URL attacks. This system can either be deployed as an assistance for existing system or be employed to help cyber-security engineers to effectively discover potential attack mode so that they can improve the existing system with significantly less efforts.

The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients’ clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

To compare the adequacy of 23-, 25-, and 27-gauge needles in the fine-needle aspiration biopsy of thyroid nodules to develop guidelines for the collection of better specimens for cytologic diagnosis.This randomized prospective study included 156 consecutively enrolled patients with 156 nodules. Each nodule was aspirated with a needle of each size. The obtained specimens were analyzed independently by 2 cytopathologists, and adequacy rates were calculated.In our investigation, there were no statistically significant differences among the adequacy rates achieved with 23-, 25-, and 27-gauge needles (88.5%, 90.4%, and 89.7%, respectively; P .05). The adequacy rates achieved with all 3 needle sizes in hyperechoic nodules were higher than those in hypoechoic samples (P .05). Finally, no differences in adequacy for the different needle sizes were observed according to nodule size (P .05).We conclude that fine-needle aspiration biopsy with a 27-gauge needle can aspirate an adequate specimen for cytopathologic diagnosis of thyroid nodules. The likelihood that inadequate materials will be obtained from hypoechoic nodules is higher than that for hyperechoic nodules.

In this paper, we propose a novel high resolution remote sensing image change detection algorithm based on image fusion and fuzzy clustering models. The original images are fused based on the Wavelet to get the comprehensive differencing map which reserves enough variation characteristics as well as reducing the noise. The idea of modifying traditional clustering algorithms will enhance the final result of the change map. This method is able to achieve the higher detection accuracy based on the revised fuzzy clustering algorithm and could obtain better differencing map with integration of image fusion. Experiments on real images point out the effectiveness and feasibility of the proposed methodology compared with other state-of-the-art ones visually and numerically.

Rationale: Among patients with post-transplant lymphoproliferative disorder (PTLD), there is a high incidence of immunosuppressed transplant recipients. It is necessary to make an early diagnosis to increase the likelihood of a good prognosis. Patient concerns: We report a case of a 54-year-old female patient who developed PTLD after liver and kidney transplantation. Diagnoses: We aimed to analyze the standard diagnosis and follow-up of PTLD with imaging. Radiologists need to be familiar with all imaging modalities when dealing with PTLD, including ultrasonography, computed tomography, magnetic resonance imaging, positron-emission tomography/computed tomography. Interventions: The initial treatment included both reduction of immunosuppression and rituximab. Then the treatment strategy changed to rituximab and chemotherapy. Finally, the treatment strategy combined glucocorticoid therapy. Outcomes: The patient was in a stable condition at the 3-month follow-up. Lessons: Systematic evaluation of the various imaging modalities, treatment options, and prognoses of PTLD in renal allografts suggested that in cases with a poor prognosis, the proper imaging modalities provide essential information with regard to the determination of the appropriate treatment.

Background:Real-time elastography (RTE) and shear wave elastography (SWE) are noninvasive and easily available imaging techniques that measure the tissue strain, and it has been reported that the sensitivity and the specificity of elastography were better in differentiating between benign an

The related theories of Web and Web mining in semantic are concluded and analyzed in this paper. The description on RDF resource is analyzed on the semantic step, and the clustering method for RDFMS data clustering based on Semantic distance is proposed, with the detailed description for the algorithm and examples. With the discussion on the data mining techniques for semantic Web mining, the design on inductive logic programming is proposed for the data mining techniques that are suitable to the semantic Web. Additionally, how to apply to the description of the algorithm is given through the specific examples to verify the feasibility for the data mining in the semantic Web environment.

A 3.3V 8Gb NAND flash memory with a synchronous double-data-rate (DDR) interface is designed and fabricated using 3M 50nm technology to meet the requirements of the markets. This paper achieves a NAND flash program throughput of 100 MB/s with quad-plane operation, which is 5x previously reported. I/O read/write throughput of 200MB/s is achieved using a newly developed DDR interface and data path. The chip features a dual interface, supporting both the newly developed synchronous DDR interface as well as the standard, asynchronous NAND flash interface.