This study aimed to evaluate the efficacy and safety of ultrasound-guided microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT). This study enrolled 46 patients with PHPT from two centers between July 2019 and January 2024. The primary end point was clinical success, defined as the achievement of normal levels of both intact parathyroid hormone (iPTH) and serum calcium at 6 months post-MWA (40/46). Secondary end points were technical success and procedure-related complications, with the former defined as the achievement of complete ablation. The clinical and technical success rate were 87.0% (40/46) and 100.0% (56/56), respectively. Serum iPTH, calcium and phosphorus showed significant improvement within the 6 months post-MWA [iPTH, 156.6 (114.3-241.0) pg/mL vs. 58.3 (49.0-62.4) pg/mL; calcium, 2.70 ± 0.30 mmol/L vs. 2.38 ± 0.11 mmol/L; phosphorus, 0.86 ± 0.19 mmol/L vs. 1.01 ± 0.17 mmol/L, respectively; all, p < 0.01]. The 6-month volume reduction rate (VRR) was 79.0%, and no long-term complications were observed during follow-up. These results suggest that ultrasound-guided MWA is a safe and effective non-surgical alternative for the management of PHPT.

Objective:To identify factors independently associated with quality-of-life (QoL) impairment in Graves' hyperthyroidism (GH) patients and develop a clinically applicable nomogram for outpatient settings. Methods:A total of 402 GH patients were recruited from the outpatient clinic of Endocrinology Department of Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, from January 2024 to June 2025. Participants were surveyed using a general information questionnaire, the Thyroid-specific Patient-Reported Outcome Short-Form (ThyPRO-39), the Pittsburgh Sleep Quality Index (PSQI), the Hamilton Depression Scale (HAMD), and the Hamilton Anxiety Scale (HAMA). Univariate and multivariate analyses identified independent predictors of QoL impairment. A nomogram was developed and validated using the area under the receiver operating characteristic curve (AUC), bootstrap-calibrated plots, and decision curve analysis (DCA). An online dynamic calculator (dynnom) was also developed to facilitate clinical application. Results:Multivariate analysis revealed that thyroid eye disease (TED), goiter, sleep disturbances, anxiety, and depressive symptoms were independent predictors of QoL impairment. The nomogram demonstrated an excellent discriminative ability: AUC was 0.886 in the training group and 0.844 in the validation group. Bootstrap calibration showed good consistency between predicted and observed probabilities. DCA revealed favorable net clinical benefit across a 0.2-0.6 threshold range. The associated online calculator further improved clinical usability. Conclusions:The nomogram integrating TED, goiter, sleep, and emotional factors provides a reliable tool for early identification of GH patients at high risk of QoL impairment in outpatient settings. Future external multicenter validation is needed to improve its generalizability.

ObjectiveTo evaluate the effects of multidisciplinary management in the Diabetes Reversal Clinic on the remission of type 2 diabetes mellitus (T2DM), and explore the predictive factors for remission of diabetes.MethodsThis was a real-world, single-arm observational study. Patients with T2DM who received remission-oriented treatment at the Diabetes Reversal Clinic and followed up regularly for more than 24 weeks were included. The primary outcome was the remission rate of T2DM, and the secondary outcomes were changes in fasting blood glucose (FBG), 2-hour postprandial blood glucose, HbA1c, blood lipids, and body composition. Differences in clinical characteristics between the remission and non-remission groups were analyzed. The multivariate logistic regression analysis was performed to screen predictive factors.ResultsThe remission rate was 29.24% (50/171) after multidisciplinary management in the Diabetes Reversal Clinic. The remission group was younger, had a shorter duration of diabetes, used fewer types of medications at baseline, had a lower FBG and HbA1c, a higher β-cell function index HOMA-β, and a lower triglyceride level. The multivariate logistic regression analysis revealed that age (OR = 0.93, 95% CI: 0.89-0.97, P = 0.002), type of medications at baseline (OR = 0.45, 95% CI: 0.26-0.77, P = 0.004), baseline FBG (OR = 0.64, 95% CI: 0.46-0.89, P = 0.008), and weight loss magnitude (OR = 1.15, 95% CI: 1.01-1.31, P = 0.038) were independent predictors of T2DM remission.ConclusionIn this real-world study, the remission rate of T2DM patients who visited the Diabetes Reversal Clinic for more than 24 weeks was 29.24% (50/171). Younger age, shorter disease duration, fewer baseline medications, lower FBG and HbA1c, higher HOMA-β, lower triglycerides, and greater weight loss were associated with remission of T2DM. Among them, age, baseline medication type, baseline FBG, and weight loss were identified as factors independently associated with remission. However, due to the single-arm observational design, causality cannot be established, and further prospective controlled trials are required to confirm these findings.

Objective:To investigate the efficacy and safety of the early addition of Haizao Yuhu Decoction (HYD) with methimazole (MMI) versus the monotherapy of MMI in treating Graves' disease (GD). Methods:This was a prospective observational study. A total of 198 patients with GD were assigned to either the HYD combined with MMI group or the MMI monotherapy group according to clinical judgment and patient preference. To minimize confounding bias, propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. Primary (thyroid function, MMI dose) and secondary outcomes (general conditions, thyrotrophin receptor antibody [TRAb], thyroid size, peak systolic velocity of the superior thyroid artery [STA-PSV], the Thyroid-related Patient-Reported Outcome 39 [ThyPRO39] scores, traditional Chinese medicine [TCM] syndrome scores, and safety) were measured at 0 (V1), 4 (V2), 8 (V3) and 12 weeks of treatment (V4). Results:Each group consisted of 54 GD patients after a 1:1 PSM. A greater decline in free thyroxine (FT4) (16.67 [7.64, 24.43] pmol/L vs 9.82 [3.49, 19.02] pmol/L, P = 0.018) and free triiodothyronine (FT3) (5.32 [3.10, 10.33] pmol/L vs 3.46 [1.16, 7.63] pmol/L, P = 0.043) was observed at V2 in the combination group than in the MMI group. The cumulative dose of MMI during the 12-week treatment was significantly lower in the combination group than in the MMI group (814.20 [600.00, 1050.00] mg vs 1007.10 [782.10, 1125.00] mg, P = 0.004). The combination group showed more pronounced reductions in the STA-PSV, TCM syndrome scores, and ThyPRO scores (P = 0.032, 0.010, and 0.044, respectively). The cumulative incidence of adverse events in the combination group was significantly lower than that in the MMI group (5.56% [3/54] vs 18.52% [10/54], P = 0.038). Conclusion:The combination of HYD and MMI serves as an effective and safe treatment of GD, accelerating thyroid function recovery, reducing thyroid hormone levels and ATD dosage, alleviating hyperthyroid symptoms, and lowering the risk of adverse events.

ObjectiveThe clinical management of RAS-mutated nodules faces significant challenges. This study aimed to explore the efficacy of microwave ablation (MWA) for the treatment of thyroid nodules ≤ 2 cm with isolated RAS gene mutations.MethodsThis retrospective study was conducted between February 2022 and July 2024. A total of 23 patients with small RAS-mutated thyroid nodules who underwent MWA and completed at least 12 months of follow-up were enrolled. Data on nodule volume, volume reduction rate (VRR), and MWA-related adverse events were collected. Intra-group comparisons were performed using the Friedman rank sum test with post-hoc pairwise comparisons. Factors affecting VRR were analyzed using linear regression. ROC analysis was conducted as an exploratory approach to determined the optimal diameter cut-off for predicting complete regression.ResultsThe cohort included 4 males (17.39%) and 19 females (82.61%), with a mean age of 45.35 ± 14.65 years. The median preoperative maximum diameter and volume were 6.20 (5.30-8.70) mm and 81.16 (46.12-256.56) mm³, respectively. All 23 patients completed ≥ 12 months of follow-up, with 6 patients reaching the 24-month follow-up. After an initial transient enlargement, the nodules showed sustained shrinkage. At the 12-month follow-up, the median VRR was 11.84% (P < 0.001), and the complete regression rate was 13.0%. By 24 months, the median VRR had reached 100%, with 83.33% complete regression (5/6). Nodules < 6 mm had higher regression rates. No local recurrence or distant metastasis occurred during the available follow-up period.ConclusionPreliminary findings suggest that MWA may have favorable short-term efficacy and safety in the treatment of small RAS-mutated thyroid nodules.

BackgroundNTRK fusions are relatively rare in papillary thyroid carcinoma (PTC), and their clinicopathological characteristics, particularly in unselected populations and in comparison with BRAFV600E PTC, have not been systematically elucidated.MethodsIn this retrospective study, we analyzed PTC patients who underwent surgery between October 2022 and May 2025. All patients underwent preoperative fine-needle aspiration biopsy and multigene molecular testing. Ultimately, 38 patients with NTRK-fusion PTC and 1196 patients with BRAFV600E PTC were included. A comprehensive analysis of the clinical, ultrasonographic, and pathological features of NTRK-fusion PTC was conducted, with comparison to BRAFV600E PTC.ResultsAmong the 38 identified NTRK-fusion PTC patients, NTRK3 (81.6%) was the predominant fusion type. Histologically, classical PTC and mixed growth patterns with follicular architecture (34.2% each) were most frequent, followed by the follicular variant (18.4%). NTRK-fusion PTC demonstrated a high rate of lymph node metastasis (LNM) (78.9%). Among preoperative parameters, a tumor diameter >12 mm on ultrasound was associated with increased risk of lateral LNM (OR = 5.00, 95% CI: 1.10-22.82; P = 0.038). Besides, NTRK1-fusion PTCs demonstrated a significantly higher frequency of bilateral lobe involvement compared to NTRK3-fusion PTCs (57.1% vs. 12.9%, P = 0.025). Compared to patients with BRAFV600E PTC, those with isolated NTRK-fusion (n=34) were significantly younger (median age: 35.0 vs 43.0 years), had larger tumors (median diameter: 10.5 vs 7.0 mm), higher rates of LNM (76.5% vs 50.7%), and greater prevalence of co-existing Hashimoto’s thyroiditis (61.8% vs 28.3%) and follicular nodular disease (26.5% vs 10.6%) (all P < 0.01). Cytopathologically, NTRK-fusion PTC demonstrates a higher proportion of atypia of undetermined significance/follicular neoplasm compared to BRAFV600E PTC (41.2% vs. 16.1%). Sonographically, isoechogenicity (20.6% vs. 7.9%), microcalcifications (79.4% vs. 58.0%), and a wider-than-tall shape (91.2% vs. 52.5%) were more frequently observed in the NTRK-fusion group (all P < 0.05).ConclusionsNTRK-fusion defines a distinct PTC molecular subtype characterized by a high burden of LNM and a spectrum of features linked to follicular growth patterns. These findings facilitate the preoperative identification of this tumor subtype and provide a foundation for individualized risk stratification and tailored management strategies.

OBJECTIVE:To evaluate the efficacy and safety of tocilizumab (TCZ) in treating active, moderate-to-severe, glucocorticoid-resistant thyroid eye disease (TED), and to develop a nomogram to predict the response to TCZ treatment. METHODS:This study involving 59 patients with active, moderate-to-severe, glucocorticoid-resistant TED from three medical institutions in China. The primary outcome was the treatment response rate at 12 weeks and 24 weeks, as evaluated by the Clinical Activity Score (CAS). Secondary outcomes included proptosis parameters and the thickness of extraocular muscles measured by orbital magnetic resonance imaging (MRI), diplopia, serum thyroid-stimulating receptor antibody (TRAb) and interleukin-6 (IL-6) levels, and adverse events. Factors influencing the treatment response were identified by multivariate logistic regression, and a nomogram was then created to predict the success or failure of TCZ treatment. RESULTS:An absolute response rate of 59.32% (35/59) was detected at 12 weeks and 73.08% (38/52) at 24 weeks after TCZ treatment. CAS significantly decreased from 4 at baseline to 2 following TCZ treatment (p < .001). Compared to that at baseline, the exophthalmometric value was significantly alleviated in both eyes at 12 weeks of TCZ treatment (right eye 22.08 ± 3.09 mm vs. 20.40 ± 2.77 mm, left eye, 22.09 ± 3.26 mm vs. 20.52 ± 2.59 mm, both p < .001). At 24 weeks, a significant decrease of diplopia grade (by one or more grades) from baseline was seen in 45.95% (17/37) of the affected eyes, and a complete resolution was observed in 9 TED patients (p < .05). No serious adverse events were reported during the study period. The multivariate logistic regression analysis showed that smoking history, baseline CAS, proptosis, and free thyroxine (FT4) levels were risk factors for a poor response to TCZ treatment (p < .05). The receiver operating characteristic (ROC) curve analysis demonstrated that the nomogram, created based on these risk factors, generated an area under the curve (AUC) of 0.801 (95% CI: 0.659-0.943) in the training set and 0.792 (95% CI: 0.558-1) in the validation set. Furthermore, the Hosmer-Lemeshow calibration curve showed that the C-statistic in ROC, Brier score, χ2 value and p value of the nomogram were 0.801, 0.171, 6.125 and 0.633 in the training set, and 0.778, 0.167, 6.353 and 0.608 in the validation set, respectively. CONCLUSION:TCZ treatment appears to inhibit clinical activity and proptosis in patients with active, moderate-to-severe, glucocorticoid-resistant TED, with a high safety profile. A nomogram incorporating smoking history, baseline CAS, proptosis, and FT4 levels can help predict the response to TCZ treatment.

Treatments for secondary and tertiary hyperparathyroidism (SHPT/THPT) remain significant challenges in patients with end-stage renal disease. Thermal ablation (TA) has emerged as a minimally invasive, safe, and effective alternative to surgical resection (SR). However, technical variations and a lack of standardization have limited its widespread adoption. To address these challenges, an international expert panel developed consensus recommendations using a modified Delphi method, integrated with a systematic literature review. As a result, sixteen recommendations were formulated, addressing diagnosis, preoperative preparation, technical procedures, postoperative management, follow-up strategies, efficacy assessment, and complications associated with TA for SHPT/THPT. These recommendations aim to promote standardized treatment protocols, improve procedural safety, and provide evidence-based guidance for clinical practice and future research in ultrasound-guided TA for SHPT/THPT management.

Hashimoto's Thyroiditis (HT), as the primary cause of hypothyroidism worldwide, has shown an increasing prevalence. Although Western medicine can regulate thyroid function, its effect on reducing autoantibodies is limited. Based on the holistic concept and syndrome differentiation and treatment, Traditional Chinese Medicine (TCM) has demonstrated unique advantages in regulating immunity, improving symptoms, and delaying disease progression. By sorting out the etiology, pathogenesis, main treatment methods, and efficacy of HT, this paper aims to explore the progress of TCM in the treatment of HT and provide ideas and methods for clinical practice. However, there is a lack of high-quality clinical evidence for TCM treatment of HT. In the future, high-quality clinical trials are needed to confirm the efficacy, so as to promote new breakthroughs in TCM treatment of HT.

To determine the prevalence of fatty pancreas disease (FPD) diagnosed by transabdominal ultrasound in Chinese elderly aged 65 years and above to explore the correlation between triglyceride glucose index (TyG index) and FPD and its severity, and to evaluate the ability of TyG index to identify FPD and its severity. The study population was derived from the Thyroid Diseases in Older Population: Screening, Surveillance, and Intervention (TOPS) study conducted in the iodine-adapted areas of Jiangsu Province from May to July 2021. A total of 567 participants aged 65 years and above in rural areas were included in the final analysis. TyG index was calculated by the established formula: Ln [TG (mg/dL) × FBG (mg/dL)/2]. FPD and the degree of intra-pancreatic fat deposition (IPFD) were diagnosed by abdominal ultrasound. The logistic regression model was performed to determine the correlation between clinical parameters, including TyG index, and FPD and its severity. The diagnostic power of TyG index was assessed by receiver operating characteristic curve (ROC). Overall, 72.66

OBJECTIVE:To assess the long-term efficacy of ultrasound-guided radiofrequency ablation (RFA) and microwave ablation (MWA) in treating benign thyroid nodules (BTNs) and to establish a nomogram predicting post-ablation regrowth. METHODS:This multi-center retrospective study included 611 patients with 753 BTNs treated by thermal ablation and followed for ≥24 months. Linear regression was used to identify factors affecting volume reduction rate (VRR). Univariate and multivariate Cox regression were performed to determine predictors of regrowth, which were incorporated into a predictive nomogram validated by calibration, concordance index (C-index), ROC, and decision curve analysis (DCA). RESULTS:All BTNs with a median follow-up of 36 months, nodules showed progressive shrinkage, with VRR >75% at 12 months and stabilizing near 90% by 24 months. At 60 months, the median VRR was 88.46%, with no significant difference between MWA and RFA (p > 0.05). Regrowth occurred in 6.51% (49/753) of nodules, and most were successfully retreated. Baseline maximum diameter was the only factor associated with VRR (p = 0.014). Independent predictors of regrowth included age (HR = 0.951, 95% CI: 0.909-0.994), baseline maximum diameter (HR = 1.628, 95% CI: 1.112-2.382), and energy per unit volume (HR = 0.994, 95% CI: 0.991-0.997). The nomogram demonstrated excellent performance (C-index 0.908 training, 0.792 validation), with calibration, ROC, and DCA confirming predictive accuracy and clinical utility. CONCLUSION:RFA and MWA demonstrated durable long-term efficacy and favorable safety profiles in the treatment of BTNs, with approximately 6% of nodules developing regrowth during follow-up. A nanogram is established to predict the regrowth risk.

Ethnopharmacological relevanceThe Sihai Shuyu Formula (SHSY) shows promising potential for treating Graves’ disease (GD), although the therapeutic mechanisms and pharmacological basis of SHSY have not been thoroughly evaluated.ObjectiveThis work is aim to investigate the pharmacological basis and mechanism of SHSY in the treatment of GD by integrating non-targeted serum metabolomics and network pharmacology coupled with molecular docking technology.Materials and methodsGD was induced in mice through injections of Ad-TSH289. Treatments included methimazole, inorganic iodine, and both low and high doses of SHSY administered via gavage. At the end of the treatment period, serum levels of thyroxine (T4) and thyrotropin receptor antibody (TRAb) were measured. Hematoxylin-Eosin (H&E) staining assessed the effects of these pharmacological interventions on thyroid gland tissues. Ultra-High Performance Liquid Chromatography with Quadrupole Time-of-Flight Mass Spectrometry (UPLC-Q-TOF-MS) was used in conjunction with network pharmacology and molecular docking to identify and predict SHSY’s active chemical components and targets. A comprehensive analysis of the multi-level bioinformatic analysis, including protein-protein interactions (PPI) and functional pathways of the targets, was conducted, followed by verification through immunohistochemistry (IHC) to clarify SHSY’s pharmacological basis and action mechanisms in treating GD.ResultsAfter 8 weeks of treatment, SHSY significantly reduced serum T4 and TRAb levels in GD mice and enhanced the morphology of thyroid tissues. Comparative analysis of rat blood samples and SHSY using UPLC-Q-TOF-MS identified 19 blood-entry components, the potential active components of SHSY acting on GD. Further network pharmacological analysis indicated that SHSY targets the PI3K/Akt signaling pathway through components such as PIK3CD, SRC, PIK3CA, HRAS, EGFR, PIK3R1, AKT1, PTPN11, and PIK3CB. Molecular docking confirmed the effective binding of SHSY’s components to these targets. IHC confirmed that the IGF1R/PI3K/Akt signaling pathway is a significant therapeutic target of SHSY, with key substances including Guggulsterone, Betulinic aldehyde, and Forsythoside H.ConclusionsSHSY appears to effectively treat GD through the IGF1R/PI3K/Akt signaling pathway, with Guggulsterone, Betulinic aldehyde, and Forsythoside H as the critical pharmacological components. It may serve as an adjunctive treatment for GD alongside traditional therapies such as antithyroid medications, surgery, and radioiodine therapy.

Background/Objective:To investigate the remission rate and metabolic outcomes under the Diabetes Reversal Clinic with multidisciplinary management. Methods:Patients with type 2 diabetes who visited the Diabetes Reversal Clinic from April 2022 to December 2024 were enrolled. Baseline characteristics and metabolic indicators were recorded. Participants received comprehensive multidisciplinary management including personalized treatment plans, structured lifestyle modification, continuous glucose monitoring, and traditional Chinese medicine as adjunctive therapy. After 6 months, the remission rate, the rate of target glycated hemoglobin A1c < 53 mmol/mol (7.0%), and changes of metabolic indicators in patients were analyzed. Results:Our major results found that, among 171 patients with type 2 diabetes who were followed for more than 6 months, 50 (29.24%) patients achieved remission and 149 (87.13%) patients achieved the target of glycated hemoglobin A1c < 53 mmol/mol (7.0%). At the end of 2022, 2023, and 2024, the annual diabetes remission rate reached 6.12% (6/98), 16.78% (25/149), and 16.24% (19/117), respectively. The multidisciplinary management significantly decreased body mass index, waist circumference, waist-to-height ratio, fasting blood glucose, glycated hemoglobin A1c, and homeostasis model assessment of insulin resistance, while significantly increasing high-density lipoprotein cholesterol (all P < 0.05). Conclusion:A diabetes remission rate of 29.24% and a target rate of 87.13% were obtained after 6 months of multidisciplinary management among patients with type 2 diabetes in the Diabetes Reversal Clinic. Our findings suggest that the multidisciplinary management model employed in the Diabetes Reversal Clinic is superior to conventional management in general outpatient clinics for promoting diabetes remission and metabolic reversal.

Thermal ablation has started to gain acceptance as a therapeutic approach for the management of papillary thyroid cancer (PTC), mainly in the T1 stage (tumor size ≤ 2 cm in greatest dimension and limited to the thyroid). Despite its increasing popularity, a lack of uniformity in the technical details persists, and existing guidelines do not fully align with recent research advancements. To standardize the use of US-guided thermal ablation for T1N0M0 PTC, a panel of experts jointly issued this expert consensus on thermal ablation for PTC. This consensus was developed by experts with specific competence and expertise in this field through rounds of the modified Delphi method. An evidence-based approach incorporating the practical experience of the panelists was adopted. The consensus was developed through extensive discussions, systematic literature review with meta-analysis, and expert evaluations. In this consensus, a total of 27 recommendations are made, addressing the indications and contraindications for thermal ablation for PTC, physician training, preoperative preparation, technical procedures, complications, efficacy assessment, and follow-up strategies. This expert consensus provides up-to-date, high-quality, standardized guidance to harmonize treatment practices, enhance patient outcomes, and potentially shape future research and policy developments in the management of T1N0M0 PTC using US-guided thermal ablation.

Carcinoma showing thymus-like differentiation (CASTLE) is a rare tumor occurring in the thyroid and soft tissues of the neck. Treatments and prognosis for CASTLE significantly differ from those associated with squamous cell carcinoma and anaplastic thyroid carcinoma. To date, fewer than 100 cases have been reported. Given the lack of a standardized treatment protocol and the diagnostic complexity, documenting these cases is essential. A 74-year-old male patient was admitted to the hospital due to hoarseness lasting for 1 month and thyroid nodules for over 2 weeks. The ultrasound revealed a grade 4 nodule in the left thyroid, and the needle biopsy reported the presence of glandular epithelial cells of varying sizes, some arranged in a papillary pattern, and was negative for BRAF mutation. Thyroid surgeons performed a left partial thyroidectomy and a left cervical lymph node biopsy, and the immunohistochemical staining led to a diagnosis of intrathyroid thymus carcinoma. Follow-up on his postoperative recovery shown no signs of local recurrence or distant metastasis during this period. This paper conducts a systematic review of the literature to enhance understanding, diagnosis, treatment, and prognosis of this condition. The goal was to raise clinical awareness and guide appropriate treatment strategies.

Objective: To evaluate the therapeutic effects of microwave ablation (MWA) versus surgery in treating low-risk papillary thyroid microcarcinoma (PTMC) and to assess recurrence-free survival (RFS) in patients with and without the BRAFV600E mutation. Methods: Between August 2016 and September 2022, 158 patients diagnosed with low-risk PTMC treated with MWA and 288 patients who underwent surgical treatment were retrospectively analyzed. All patients were followed-up for over a year. Local tumor progression (LTP), RFS and adverse events associated with both treatments were monitored. Following propensity score matching (PSM), comparisons were made regarding LTP, RFS, complications and treatment variables. Results: Prior to matching, MWA patients were younger than those in the surgery group (38 (30.75, 47) vs 43 (34, 50.75), P = 0.000). Tumors treated with MWA had smaller maximum diameters (5.7 (4.6, 7.0) vs 6.9 (5.8, 8.6), P = 0.000) and volumes (70.7 (35.2, 120.9) vs 122.0 (63.9, 228.8), P = 0.000). After 1:1 PSM, each group contained 141 patients with comparable baseline characteristics. During the follow-up, LTP developed in nine patients: six in the MWA group and three in the surgery group. There were no cases of distant metastasis or cancer-related deaths. Adjusting for age, sex, tumor location and largest diameter, there was no significant association between treatment modality and recurrence (HR = 3.75, 95% CI: 0.94–14.98, P = 0.062). There were no significant differences in RFS between patients with and without the BRAFV600E mutation in both groups (P = 0.45 and 0.74, respectively). Furthermore, the incidence of complications was comparable between treatments. Conclusion: Both MWA and surgical treatment offer similar efficacy and safety profiles for managing low-risk PTMC. MWA may represent a viable alternative to conventional surgical approaches, especially for patients harboring the BRAFV600E mutation.

ObjectiveThis study aims to investigate the correlation between dietary inflammatory index (DII) and mortality resulting from all-cause and cardiovascular diseases (CVD) in adults affected by metabolic syndrome (MetS).MethodsThe focus of this study was to analyze the information of 13,751 adults who had been diagnosed with MetS. DII scores were computed based on a 24-hour dietary intake at the start of the study. By implementing both the Cox regression analysis and restricted cubic spline(RCS) analysis, we examined the correlation between DII score and mortality.ResultsAfter a mean follow-up duration of 114 months, a total of 2,343 individuals (representing 13.45% of the sample) died, with 639 fatalities attributed to CVD. The degrees of dietary inflammation were classified into three groups based on DII scores: low, medium, and high-grade. The mortality rates for each tertile of DII were 11.55%, 13.96%, and 15.05%, respectively. In comparison to participants with T1, the multivariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for participants with T3 were 1.16 (95% CI: 1.01-1.34) regarding mortality caused by any reason, and 1.26 (95% CI: 0.95-1.68) for mortality related to CVD. Through the use of the Kaplan-Meier survival curve and RCS, it was observed that individuals in the high DII tertile had an increased likelihood of death compared to those in the low DII tertile.ConclusionOur findings provide validation of the theory that diets high in inflammatory substances contribute to elevated mortality rates for all causes and CVD-related deaths in individuals diagnosed with MetS.

This multicenter, open-label, randomized controlled trial (RCT) aims to assess the efficacy and safety of levothyroxine monotherapy in lowering the risk of cardiovascular disease (CVD) in untreated older adults with subclinical hypothyroidism (SCH) who are diagnosed according to population-specific TSH reference values. A total of 254 patients with SCH who meet the diagnostic criteria will be recruited, and the baseline clinical data of the patients will be collected. Then, a total of 127 patients will be randomly divided into each of the treatment and control groups, and the treatment group will receive daily levothyroxine doses (Merck Euthyrox® levothyroxine 50 mcg tablet). Specifically, 50 µg of levothyroxine per day will be administered to patients in the treatment group (or 25 µg to patients with a body weight < 50 kg) for at least 48 weeks to maintain thyroid-stimulating hormone (TSH) levels within the normal range. The participants in the control group will be subjected only to thyroid status evaluation, and the results will be recorded. The participants will complete five visits before and after the start of the trial, and differences in the change in carotid intima–media thickness (CIMT), maximum mean change in plaque burden, and changes in lipid profiles, bone mineral densities, and incidences of fatal and nonfatal cardiovascular events between the initial visit and the last follow-up visit will be evaluated via vascular ultrasound. We will explicitly address whether levothyroxine replacement therapy provides cardiovascular benefits for older adults with subclinical hypothyroidism. ClinicalTrials.gov, No. ChiCTR2400092634. Registered on 30 November 2024. Recruitment for this study began on December 1, 2024, and continues until at least until November 30, 2025.

This study aimed to identify the correlation of serum 25(OH)D level with sarcopenia and its components in Chinese elderly aged 65 years and above from rural areas. A total of 368 Chinese elderly aged 65 years and above in rural areas were enrolled. Indicators of muscle mass and strength, including the appendicular skeletal muscle mass (ASM), skeletal muscle index (SMI) and hand grip strength (HGS) were measured. Physical performance was assessed by the Short Physical Performance Battery (SPPB). Serum 25(OH)D levels were measured using the liquid chromatography with tandem mass spectrometry. Correlations of serum 25(OH)D level with sarcopenia and its components in Chinese elderly were identified by the binary logistic regression and linear regression analyses. The median serum 25(OH)D level was 34.80 ng/ml, and significantly higher in men than in women (40.70 ng/ml vs. 27.30 ng/ml). The prevalence of sarcopenia in our cohort was 21.5%, and higher in men than in women (29.4% vs. 10.8%). The serum 25(OH)D level was not correlated with sarcopenia, HGS and SPPB score in either male or female elderly. Positive correlations of age with sarcopenia, low HGS and low SPPB score were observed in male elderly, while significant correlations were not observed in females. Correlation analyses of sarcopenia components revealed that age was negatively correlated with SMI and gait speed in male elderly, but negatively correlated with the gait speed and positively correlated with the time to complete 5 sit-to-stand movements in female elderly. In conclusion, rural Chinese elderly have relatively high vitamin D level and prevalence of sarcopenia. Age but not serum 25(OH)D level is significantly correlated with sarcopenia in vitamin D sufficient male elderly.