Purpose Lymph node metastasis (LNM) is a vital prognosis factor in patients with papillary thyroid microcarcinoma (PTMC). The study tried to identify clinicopathological factors for LNM of PTMC. Methods The clinicopathological data of 1031 patients with PTMC were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with cervical lymph node metastasis. ROC analysis was used to determine the ideal critical points of the sum of the maximum diameter of multifocal in a unilateral lobe. Results The probability of LNM, central lymph node metastasis (CLNM) and lateral lymph node metastasis(LLNM)of PTMC patients were 35.6, 33.7 and 5.6%, respectively. In addition, 1.9% PTMC had LLNM only. Male, age ≤ 40 years, tumor largest diameter ≥ 5 mm, multifocal, non-uniform echoic distribution, the sum of the maximum diameter of multifocal in a unilateral lobe ≥ 8.5 mm, tumors in the lower pole location were prone to CLNM. Ultrasound mix-echo, the sum of the maximum diameter of the multifocal ≥ 10.75 mm, tumors in the upper pole location were extremely prone to LLNM. T3 were prone to LLNM or skip LLNM. Conclusions According to the clinicopathological characteristics of PTMC, the cervical lymph nodes should be correctly evaluated to guide the surgical treatment.

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Objective: To characterize electroencephalogram (EEG) power in different frequency bands during rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep in patients with obstructive sleep apnea (OSA).Methods: Retrospective data on 151 patients were collected and divided into three groups: primary snoring group (AHI < 5/h), mild-moderate OSA group (6 ≤ AHI < 30/h), and severe OSA group (AHI ≥ 30/h). EEG recordings in the frontal, central, and occipital regions were extracted from both REM and NREM sleep, to compute the normalized spectral power densities in the delta, theta, alpha, sigma, beta, and gamma frequency bands, using Fast Fourier Transform. Correlations between the computed EEG power and PSG parameters were analyzed.Results: In NREM sleep, elevated normalized power spectral density (PSD) in the delta band was observed in the severe OSA group compared to the other two groups. In contrast, the PSD of the other frequency bands showed a corresponding decrease in the severe OSA group. In REM sleep, similar changes were observed in the frontal region. Delta band PSD was positively correlated with Apnea Hypopnea Index (AHI) (r = 0.33), longest time of apnea, oxygen desaturation index (ODI) (r = 0.34), percent sleep time below 90% SaO2 (T90%) (r = 0.30), Arousal Index (ArI) (r = 0.29), and negatively correlated with N3%, minimum oxygen saturation (minSaO2).Conclusion: Our findings provide neurophysiological evidence for pathological cortical activation during REM/NREM sleep, which may be associated with the arousals and cognitive impairments in OSA. The technique of power spectral analysis could prove a potentially useful tool in complementing traditional PSG parameters in assessing disease burden to guide therapeutic decisions.

AimsTo examine drug use behavior of clients attending Methadone Maintenance Treatment (MMT) programs and its relationship with the clients’ social network characteristics.DesignCross-sectional study.SettingFour MMT clinics in Kunming, Yunnan province, China.Participants324 consecutive MMT clients.MeasurementsA structured, self-completed questionnaire on background characteristics and existing social network. Current drug use was assessed by urine test for opiate metabolites.AnalysisThe association between client's social network characteristics and their own current drug use behavior is analysed using multiple logistic regression adjusting for socio-demographic characteristics. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) are obtained to give the strength of the associations.FindingsMMT clients were more likely to concurrently use heroin while attending MMT if their social network had any of the following characteristics: more than half of the members were older than them (AOR = 1.03, 95% CI = 1.00,1.06), any member had a high level of influence on them (AOR = 6.47, 95% CI = 2.86,14.65) and any member joined them in using drugs (AOR = 1.94, 95% CI = 1.04,3.63). Having a social network member who could provide emotional support (AOR = 0.11, 95% CI = 0.03,0.35), having a spouse and/or child in their social network (AOR = 0.44, 95% CI = 0.24,0.81) and having a social network member with a high level of closeness (AOR = 0.28, 95% CI = 0.09,0.90) were associated with a decreased odds of heroin use.ConclusionSocial networks who could provide MMT clients with emotional support and a close relationship were significant factors for reducing the risk of concurrent drug use among clients attending MMT clinics in Kunming, China. Behavioral interventions should address the role of family and social network members in providing support to these clients.

Higher dosage of methadone is recommended as a way to improve treatment adherence.