Hypomelanotic macules are often the first sign of TSC. Genetic testing has a high detection rate in patients with a clinical diagnosis of TSC. Topical sirolimus appears to be both effective and well-tolerated as a treatment of facial angiofibromas in children with TSC. The response typically plateaus after 12 to 24 weeks of treatment.

Background Accurately evaluating the lymph node status preoperatively is critical in determining the appropriate treatment plan for non-small-cell lung cancer (NSCLC) patients. This study aimed to construct a novel nomogram to predict the probability of lymph node metastasis in clinical T1 stage patients based on non-invasive and easily accessible indicators. Methods From October 2019 to June 2022, the data of 84 consecutive cT1 NSCLC patients who had undergone PET/CT examination within 30 days before surgery were retrospectively collected. Univariate and multivariate logistic regression analyses were performed to identify the risk factors of lymph node metastasis. A nomogram based on these predictors was constructed. The area under the receiver operating characteristic (ROC) curve and the calibration curve was used for assessment. Besides, the model was confirmed by bootstrap resampling. Results Four predictors (tumor SUVmax value, lymph node SUVmax value, consolidation tumor ratio and platelet to lymphocyte ratio) were identified and entered into the nomogram. The model indicated certain discrimination, with an area under ROC curve of 0.921(95%CI 0.866–0.977). The calibration curve showed good concordance between the predicted and actual possibility of lymph node metastasis. Conclusions This nomogram was practical and effective in predicting lymph node metastasis for patients with cT1 NSCLC. It could provide treatment recommendations to clinicians.

Objectives Thymectomy plays an important role in the comprehensive treatment of myasthenia gravis (MG). The present study aimed to investigate the risk factors for postoperative myasthenic crisis (POMC) in these patients and then establish a predicting model based on preoperatively available indicators. Methods The clinical records of 177 consecutive patients with MG who received extended thymectomy between January 2018 and September 2022 in our department were retrospectively reviewed. Patients were divided into two groups according to whether they developed POMC and needed ventilation support for more than 24 hours. Univariate and multivariate regression analyses were conducted to identify the independent risk factors of POMC. Then a nomogram was constructed to intuitively show the results. Finally, the calibration curve and bootstrap resampling were used to evaluate its performance. Results POMC occurred in 42 (23.7%) patients. By multivariate analysis, body mass index (BMI) (p = 0.029), Osserman classification (p = 0.015), percentage of predicted forced vital capacity (FVC, pred%) (p = 0.044), percentage of predicted forced expiratory volume in the first second (FEV1, pred%) (p = 0.043) and albumin to globulin ratio (AGR) (p = 0.009) were identified as independent risk factors and entered into the nomogram. The calibration curve showed good concordance between the predicted and actual probability of prolonged ventilation. Conclusions Our model is a valuable tool for predicting POMC in MG patients. For those high-risk patients, appropriate preoperative treatment is necessary to improve the symptoms and greater attention to postoperative complications is needed.