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简介：AbstractObjective:To investigate the risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC).Methods:A retrospective analysis of 209 patients with PTC who underwent primary surgery at the Beijing Friendship Hospital affiliated with Capital Medical University from November 2014 to November 2018 was performed. The patients were divided into the LLNM group and the non-LLNM group. The clinical and pathological characteristics of the patients were analysed. The risk factors for LLNM were analysed by univariate and multivariate analyses.Results:The incidence of LLNM was 13.4% in PTC patients. Univariate analysis showed that the maximum diameter of the primary tumour > 2 cm (P < 0.001), bilateral primary tumour (P= 0.020), extrathyroidal extension (ETE) (P < 0.001), central lymph node metastasis (CLNM) (P < 0.001), and CLNM number ≥ 5 (P < 0.001) were significantly associated with LLNM. Multivariate logistic regression analysis showed that the maximum diameter of the primary tumour > 2 cm, ETE, and CLNM were independent risk factors for LLNM (OR values were 3.880, 5.202, and 4.474, respectively). There were 6 patients with skip lateral cervical lymph node metastasis, accounting for 21% of all LLNM patients.Conclusion:This study revealed several independent risk factors for predicting LLNM in PTC patients, such as the maximum diameter of the primary tumour > 2 cm, ETE and CLNM. Lateral neck dissection may be recommended in PTC patients with those risk factors. Paying attention to the occurrence of skip lateral cervical lymph node metastasis during the clinical diagnosis and treatment processes is necessary.

简介：AbstractBackground:Changes in thyroid hormone levels are commonly recognized characters among the elderly, which were reported to potentially influence incident frailty. Therefore, we examined the cross-sectional associations of thyroid hormones (THs) with frailty as well as the five components characterizing frailty (fatigue, resistance, ambulation, number of illnesses, and loss of weight) among the oldest-old.Methods:Four hundred and eighty-seven community-dwelling oldest-old from a local community in Haidian District, Beijing, participated in our recruitment campaign between April 2019 and May 2020. The primary outcomes were a definitive diagnosis of frailty according to the FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of weight) and a positive score for each frailty subdomain. Demographic information (age, sex, marital status, and educational status), comorbidities, and details on the participants’ lifestyles were recorded. Serum THs including free triiodothyronin (fT3), triiodothyronine (T3), free thyroxine (fT4), and thyroxine (T4) and thyroid stimulating hormone (TSH) levels were also measured at the beginning of our study. Logistic regressions were conducted to screen for potential risk factors for frailty and its subdomains.Results:Among the total 487 subjects at enrollment, 60 (12.23%) of them were diagnosed with subclinical hypothyroidism and 110 (22.59%) of the total population scored positive for frailty. Logistic regression analyses adjusted for all potential confounders, showed that frailty was significantly associated with the serum TSH concentration (odds ratio [OR]: 1.06), fT3 concentration (OR: 0.54), and subclinical hypothyroidism score (OR: 2.18). The association between fT4 and frailty was absent in our observational study. The fT3/fT4 ratio characterizing peripheral hormone conversion was also tested to be correlated with frailty.Conclusion:Subclinical hypothyroidism, higher TSH level, lower fT3 level, and decreased fT3/fT4 ratio were all associated with frailty assessed by the FRAIL scale among the community-dwelling oldest-old, suggesting a relevant role of thyroid function in aging. Future longitudinal studies are warranted to determine the casual relationship between thyroid dysfunction and frailty in the oldest-old.

简介：摘要ObjectiveThis single-center study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on modulation of thyroid hormone levels and cognition in the recovery stage of patients with cognitive dysfunction following stroke.MethodsSeventy post-stroke patients who had cognitive impairment were randomly assigned to either the rTMS group or the control (sham) group. Both groups were administered basic treatment, with the rTMS group receiving rTMS (1 Hz, 90% MT, 1000 pulse/20 min, once a day for 5 days, for a total of 20 times), the stimulation site was the contralateral dorsolateral prefrontal cortex (DLPFC), and the sham group receiving sham stimulation which had the same stimulation parameters and site, except that the coil plane was placed perpendicular to the surface of the scalp. Cognitive function assessment and thyroid function tests were performed before and after 4 weeks of treatment.Resultserum levels of triiodothyronine (T3), free triiodothyronine (FT3), and thyroid stimulating hormone (TSH) showed a positive correlation with Montreal Cognitive Assessment (MoCA) scale score of stroke patients in the recovery phase. The post-treatment change in the scores of MoCA and Modified Barthel Index (MBI) and scores of 3 cognitive domains (visuospatial function, memory, and attention), as well as serum T3, FT3, and TSH levels, were improved more significantly in the rTMS group, and T3 and FT3 levels significantly affected the MoCA scores within the reference range.ConclusionsSerum T3, FT3, and TSH levels of stroke patients in the recovery phase were positively correlated with MoCA score. rTMS increased T3, FT3, and TSH levels and also improved MoCA and MBI of patients in the recovery phase of stroke.