Accurately distinguishing the benign thyroid nodules (BTNs) and malignant thyroid nodules (MTNs) is crucial for treatment planning and prognosis. This study aims to explore the clinical value of artificial intelligence ultrasound-assisted diagnostic system (AI-UADS) in diagnosing the BTNs and MTNs. In this retrospective case-control study, a total of 161 TNs from 91 patients confirmed by surgical pathology were included. All nodules underwent ultrasound examinations and were evaluated by both senior ultrasonographers and AI-UADS, independently. Using surgical pathology as the gold standard, the diagnostic performance of the 2 methods was analyzed using receiver operating characteristic curves (including classify the nodules based on size, location, capsule relationships, and presence or absence of Hashimoto thyroiditis [HT]). The area under the curve, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of AI-UADS in the differential diagnosis of BTNs and MTNs were 0.933, 93.2%, 92.4%, 94.2%, 95.5%, and 90.3%, respectively, all of which were higher than ultrasonographers (0.821, 82.0%, 81.5%, 82.6%, 86.2%, and 77.0%, respectively) (all P < .05). Specifically, the accuracy in diagnosing nodules with a maximum diameter ≤10 mm (94.0% vs 80.7%) and in the left lobe (92.5% vs 81.3%); the accuracy, sensitivity, specificity, positive predictive value and negative predictive value in diagnosing nodules with far from the capsule ([93.8% vs 79.5%], [92.5% vs 75.5%], [94.9% vs 83.1%], [94.2% vs 80.0%], [93.3% vs 79.0%]) and without HT ([94.0% vs 82.7%], [93.2% vs 82.4%], [94.9% vs 83.1%], [95.8% vs 85.9%], [91.8% vs 79.0%]) of AI-UADS were higher than ultrasonographers (all P < .05). The AI-UADS demonstrates good diagnostic performance in differentiating BTNs and MTNs, and can serve as an effective auxiliary tool for ultrasonographers. It shows particular advantages in diagnosing nodules with a maximum diameter ≤10 mm, located in the left lobe, far from the capsule, and in patients without HT.

New-onset refractory status epilepticus (NORSE) is a life-threatening neurological condition that emerges abruptly in individuals without a prior history of epilepsy and is characterised by seizures that are refractory to standard antiseizure medications. NORSE is associated with high mortality and long-term neurological deficits, and autoimmune encephalitis (AIE) represents a major identifiable cause of NORSE. Growing evidence implicates immune-mediated mechanisms as central drivers of NORSE; however, existing studies have focused predominantly on innate immune dysregulation, including cytokine-driven neuroinflammation and microglial activation, whilst the role of adaptive immune mechanisms in AIE-mediated NORSE remains relatively underexplored. This review synthesises current evidence linking adaptive immune responses in NORSE pathogenesis, with particular emphasis on B and T lymphocytes in shaping neuroinflammation. B cell-mediated response is implicated in NORSE cases associated with AIE where autoantibodies such as anti-N-methyl-D-aspartate receptor (NMDAR) disrupt neuronal signalling and contribute to seizure generation. Beyond humoral immunity, T-cell subsets, for instance, cytotoxic T cells, contribute to neuronal damage through recognition of neuronal intracellular antigens. Emerging immunomodulatory therapies targeting adaptive immune components are also discussed, including monoclonal antibody therapies and innovative approaches inspired by conventional chimeric antigen receptor (CAR) T-cell technology. A deeper understanding of the complex interplay between innate and adaptive immune responses is essential to elucidate disease mechanisms and guide future development of more precise mechanism-based therapeutic strategies for NORSE.

Normothermic machine perfusion (NMP) is increasingly used for liver transplantation, but its effect on post-transplantation acute kidney injury (AKI), especially in recipients with renal dysfunction, remains unclear. We evaluated whether NMP was associated with lower early renal injury after deceased donor liver transplantation compared with static cold storage (SCS), including recipients with pre-existing AKI or chronic kidney disease (CKD).

This retrospective study aimed to investigate the predictive value of conventional ultrasonographic features combined with clinical factors for capsular invasion in patients with papillary thyroid carcinoma (PTC) with concurrent Hashimoto's thyroiditis (HT). A total of 262 patients with pathologically confirmed PTC and concurrent HT who underwent surgery at our institution from January 2018 to June 2024 were included as the training cohort. Patients were divided into capsular invasion and non-capsular invasion groups according to postoperative pathological findings. Clinical characteristics, conventional ultrasonographic features, and preoperative serum thyroid-stimulating hormone (TSH) levels were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of capsular invasion, and a nomogram model was constructed based on the selected variables. The predictive performance of the model was evaluated using receiver operating characteristic curves, calibration curves, decision curve analysis, and clinical impact curves. Univariate analysis showed that age, tumor diameter, postoperative lymph node metastasis, lesion margin, and blood flow signal were significantly associated with capsular invasion. Multivariate logistic regression analysis further identified age ≥55 years, larger tumor diameter, ill-defined lesion margin, and abundant blood flow signal as independent predictors of capsular invasion. The combined nomogram model achieved an area under the curve of 0.706 in the training cohort and 0.804 in the external validation cohort, showing better predictive performance than any single factor alone. Calibration curves, decision curve analysis, and clinical impact curves suggested acceptable model calibration and potential clinical utility. These findings indicate that a nomogram incorporating age, tumor diameter, lesion margin, and blood flow signal may provide a practical preoperative tool for estimating the risk of capsular invasion in patients with PTC and HT.

Euthyroid autoimmune thyroiditis (Hashimoto's disease) has been shown to negatively affect female sexual health; however, this adverse impact appears to be mitigated by vitamin D therapy. Emerging research suggests that vitamin E may reduce susceptibility to autoimmune thyroiditis and that supplementation could contribute to improved sexual health outcomes. The present study aimed to investigate whether vitamin E status influences the effects of exogenous vitamin D on female sexual function and depressive symptoms in individuals with this condition. This pilot study included three cohorts of young women with Hashimoto's disease, matched for age, thyroid antibody titers, and 25-hydroxyvitamin D levels, all exhibiting normal TSH and free thyroid hormone concentrations. The cohorts differed in vitamin E intake: below the recommended daily allowance (group 1), adequate intake (group 2), and high intake (exceeding 400 IU daily; group 3). All participants received vitamin D at a daily dose of 100 µg for six months. Serum hormone levels, thyroid antibody titers, and calculated indices of thyroid homeostasis were evaluated at enrollment and at the conclusion of the study. Female sexual function and depressive symptoms were also evaluated at both time points using validated instruments: the Female Sexual Function Index (FSFI) and the Beck Depression Inventory-II (BDI-II). At enrollment, group 2 scored higher than the other cohorts in the sexual desire and arousal domains. Vitamin D supplementation increased serum 25-hydroxyvitamin D in all groups. The decrease in antibody titers was most pronounced in group 2, and only in this group did vitamin D enhance thyroid secretory capacity and increase testosterone levels. In group 2, treatment led to improvements across all FSFI domains and the total score. In group 1, positive effects were limited to the lubrication and lack of pain/discomfort domains, whereas group 3 showed no changes in sexual function. Improvements in female sexual function correlated with vitamin E intake, reductions in antibody titers, and increases in testosterone levels. Significant improvements in depressive symptoms, as measured by the BDI-II, were observed exclusively in group 2. Adequate vitamin E intake is essential to achieve the full effects of vitamin D on female sexual function and mood in young euthyroid patients with Hashimoto's disease.

Background/Objectives: Ultra-high-magnification endoscopy (Endocyto) visualizes microscopic mucosal structures and has been proposed as a tool for assessing mucosal inflammation. We previously developed an endocytoscopic classification system (EC-A to EC-D) for grading the severity of inflammation. In this study, we investigated the relationship between endocytoscopic classification and microRNA (miRNA) expression in 36 patients with ulcerative colitis (UC). Methods: This cross-sectional study was conducted in two phases at two institutions. In the first phase, microarray analysis was performed on biopsy samples from patients with UC and healthy controls enrolled at Nagasaki University Hospital. In the second phase, 36 patients with UC who underwent total colonoscopy via Endocyto at Tottori University Hospital were included, and selected miRNAs were analyzed via quantitative polymerase chain reaction. Results: Differentially expressed miRNAs were identified, and four (miR-141-5p, miR-192-5p, miR-194-5p, and miR-215-5p) were downregulated in inflammatory areas. Notably, miR-192-5p expression was markedly lower in the EC-B and EC-C+D groups than in the EC-A group. Furthermore, expression of CXC motif ligand 2 (CXCL2), a pro-inflammatory chemokine, was upregulated in inflammatory tissues and negatively correlated with miR-192-5p expression. Conclusions: These results indicate that reduced miR-192-5p expression is inversely associated with CXCL2 expression and that, among the miRNAs examined, miR-192-5p downregulation most consistently corresponded to the endocytoscopic classification. Our findings suggest that Endocyto may serve as a real-time, in vivo adjunct for a histology-like assessment of mucosal inflammation; its clinical utility requires prospective validation.

Robotic thyroid surgery (RTS) has gained popularity due to its minimal invasiveness and improved cosmetic outcomes. However, complications like hypoparathyroidism, bleeding, and infection can occur before surgeons' learning curve completion. The purpose of present research is to develop and validate a predictive model for complications in RTS prior to their learning curve completion. We retrospectively analyzed data from 236 cases accepted RTS at our institution from Jan 2020 to Dec 2022. The data of included cases were classified into training set (n = 165) and validation set (n = 71). Data on clinical characteristics, surgical details, and postoperative outcomes were collected. Several regression analysis models were applied to identify independent factors of complications. A nomogram was constructed and validated using the training and validation sets. The overall complication rate was 29.24% (69/236 patients). Multivariate analysis identified BMI (odds ratio [OR] = 3.52, 95% Confidence Interval [CI]: 1.179-11.05), Hashimoto's thyroiditis (OR = 1.69, 95% CI: 1.44-2.05) and tumor size (OR = 2.37, 95% CI: 1.10-5.18) as independent predictors of complications. Based on these predictors, nomogram was constructed. The C-index was 0.8574 (95% CI: 0.762-0.9529) in validation set, indicating good predictive accuracy. This study proposed and validated a nomogram model to predict complications in RTS prior to their learning curve completion. This model can assist clinicians in preoperative counseling and decision-making to minimize surgical risks.

Autoimmune thyroid diseases (AITDs), including Hashimoto's thyroiditis (HT) and Graves' disease (GD), affect approximately 2-5% of the global population. They are the most common organ-specific autoimmune disorders worldwide. Growing epidemiological and immunological evidence indicates that AITDs frequently coexist with immune-mediated dermatological diseases. These include atopic dermatitis (AD), psoriasis, alopecia areata (AA), vitiligo, and chronic spontaneous urticaria (CSU). Targeted immunotherapies have become central to the treatment of many immune-mediated skin diseases. Although these therapies are designed to act on specific immune pathways, they may also exert broader systemic immunomodulatory effects. However, thyroid function and thyroid autoantibodies are not routinely assessed in patients with immune-mediated dermatological conditions. This is also true for some patients with known or suspected AITDs. In this narrative review, we summarize the immunological overlap between cutaneous inflammation and autoimmune thyroid disease. We also discuss thyroid-related evidence for IL-4Rα inhibitors, IL-17 inhibitors, JAK inhibitors, IL-12/23 inhibitors, and immune checkpoint inhibitors (ICIs). Current evidence suggests that ICIs have the strongest established association with thyroid dysfunction. In contrast, the thyroid-related effects of dupilumab and ustekinumab are supported mainly by rare case reports. IL-17 inhibitors and selective IL-23p19 inhibitors may theoretically attenuate thyroid inflammatory pathways. However, this possibility has not yet been confirmed in clinical studies. Based on the available evidence, we propose a risk-stratified approach to thyroid surveillance across targeted immunotherapies. Routine thyroid monitoring is most strongly supported for ICIs. For patients at increased thyroid risk, selective assessment of thyroid function and thyroid autoantibodies may also be considered during treatment with dupilumab or ustekinumab. For oral JAK inhibitors, monitoring may be particularly relevant before treatment, during therapy, and after discontinuation because of the potential for immune rebound. Prospective studies are needed to define which patient subgroups would benefit most from thyroid surveillance during targeted immunotherapy.