Purpose: Our study aims to compare ultrasound (US)-guided percutaneous microwave ablation (PMWA) and conventional thyroidectomy in benign thyroid nodules (BTN) treatment. Materials and methods: From December 2015 to December 2017, a total of 280 patients with at least one benign thyroid nodule were studied retrospectively, including 156 patients treated with US-guided PMWA and 124 patients treated with conventional thyroidectomy. Propensity score matching was performed to decrease the confounding bias due to retrospective assignment and to balance the pre-operation data of the two groups. A total of 106 pairs (1:1) was created. The operation time, intraoperative blood loss, postoperative hospitalization time, serum levels of interleukin (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) 12 h after operation and postoperative complications incidence rate were compared between the two groups. The volume reduction ratio was calculated in the US-guided PMWA group at 1, 3, 6 and 12 months after treatment. Registration number: ChiCTR1800015531. Results: Significant differences were found between the two groups in levels of CRP, IL-6, and TNF-α after the operation； there were significant differences between the two groups in intraoperative blood loss, operation time, postoperative hospitalization time and postoperative complications rate. The volume reduction ratio at 1, 3, 6 and 12 months after treatment was 15.2%, 47.6%, 67.2% and 79.6%, respectively. Conclusions: Our study demonstrated that US-guided PMWA is characterized by a definite therapeutic success rate, good cosmetic effect, slight injury and rapid recovery. US-guided PMWA is an effective technique for benign thyroid nodules treatment．

Background: Large benign thyroid nodules often lead to cosmetic problems and compression on trachea. Thermal ablation is an effective method for benign thyroid nodules treatment. Among all the thermal ablation techniques, microwave and radiofrequency are frequently used energy sources. However, treatment outcomes of the two ablation types have not been compared in detail. Therefore, we conducted this study aiming for comparing the safety and efficacy of the two ablation techniques in benign thyroid nodules treatment.Methods: Information was retrospectively collected from patients with benign thyroid nodules, who received radiofrequency ablation or microwave ablation between January 1, 2018, and December 31, 2019, in a main hospital in South China. Patients were divided into microwave ablation group and radiofrequency ablation group according to the techniques applied. A propensity score matching was performed to balance the baseline indexes between the two groups. We also recorded and analyzed the operative variables including operative duration, intraoperative blood loss, hospitalization time, and overall costs. Postoperative quality of life, volume reduction rates, and complication rates were routinely evaluated during the follow-up by asking patients to fulfil questionnaires at the 1^st, 3^rd, 6^th, 12^th, and 18^th postoperative month.Results: A total of 943 patients receiving microwave ablation or radiofrequency ablation in the years of 2018 and 2019 met our inclusion criteria. After 1:1 propensity score matching, 289 pairs of patients were matched. There was no significant difference between the two groups in operative duration, intraoperative blood loss, hospitalization time, overall cost, quality of life scores, complication rates or volume reduction rates.Conclusion: There was no significant difference between microwave and radiofrequency ablation in terms of safety and efficacy. Both of the two techniques` are ideal therapeutic methods in benign thyroid nodules treatment.Registration number: ChiCTR2000034764.

We aimed to assess the therapeutic effect of reimplantation of biliary metal stents by percutaneous transhepatic cholangial drainage (PTCD) in patients with recurrent malignant obstructive jaundice (MOJ). Furthermore, we explored the prognostic value of inflammation-based markers in these patients.We reviewed 33 cases of recurrent MOJ after implantation of biliary metal stents by PTCD, all of which underwent reimplantation of stents under digital subtraction angiography guidance. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin were compared between before and after reimplantation (1 week, 1 month, and 3 months postoperatively). Preoperative clinical data were collected to calculate the inflammation-based markers, including systemic immune-inflammation index (SII, neutrophil × platelets/ lymphocyte), platelets-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR). The primary outcome was overall survival (OS), which was estimated by the Kaplan-Meier method and Cox regression analysis.The levels of ALT, AST, total bilirubin, and direct bilirubin significantly reduced after the reimplantation operation. During a median follow-up time of 10 months, 18 (54.5%) patients died. Gender, albumin, SII, PLR, NLR, and MLR were found to be associated with OS by the log-rank test and univariate analysis. Multivariate Cox analysis identified elevated levels of SII and PLR as significant factors for predicting poor OS.Reimplantation is clinically feasible in patients with recurrent MOJ after implantation of biliary metal stents. SII and PLR are independent, useful inflammation-based prognostic models for predicting outcomes in these patients.