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LESSONS Anti-neutrophil cytoplasmic antibody-associated glomerulonephritis and IgG4-associated tubulointerstitial nephritis with C3glomerulonephritis rarely occur simultaneously. Laboratory analysis and pathology are both needed to ensure diagnostic accuracy. However, in this case, the three diseases overlapped to such a large extent that achieving a definitive diagnosis was particularly challenging. Timely and accurate diagnosis is crucial for selecting the best treatment course and optimizing patient outcome.BACKGROUND The pathogenesis of cervical spondylotic is degenerative changes of the cervical intervertebral disc, or bone hyperplasia of the posterior and hook joints, and instability of the joints of the cervical vertebrae. It causes the nerve roots to be stimulated and oppressed. The clinical manifestations are the sensation, movement, and reflex disorder of the cervical spinal nerve roots that are stimulated and oppressed, especially the numbness and pain of the neck, shoulders, upper limbs, and fingers. In this systematic review, we aimed to evaluate the efficacy and safety of acupuncture and chiropractic in the treatment of cervical spondylotic. METHODS AND ANALYSIS We will search for PubMed, Cochrane Library, AMED, Embase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to September 2019. Sodium 2-(1H-indol-3-yl)acetate compound library chemical We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the RevMan 5.3 and Stata 13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of cervical spondylotic. ETHICS AND DISSEMINATION This systematic review will evaluate the efficacy and safety of acupuncture and chiropractic for cervical spondylotic. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process trial.BACKGROUND Though studies have shown association between C-reactive protein (CRP) level and the risk of ovarian cancer (OC), there have been some inconsistencies. The current metaanalysis was conducted to study the relationship between CRP and OC. PATIENTS AND METHODS Three electronic databases of PubMed, Embase, and Cochrane Library were searched for prospective studies of OC from inception till May 2018. Relative risk (RR) was summarized using random-effects model, and the results of sensitivity, subgroup analyses, and publication biases were also calculated. RESULTS A total of 13 cohorts involving 1,852 OC patients were included for the final meta-analysis. The summary RRs indicated that high CRP was associated with an increased risk of all invasive OC (RR1.36; 95% confidence interval [CI]1.03-1.80; P = .032), while moderate CRP showed no significant impact on the risk of all invasive OC compared with low CRP (RR1.17; 95% CI0.97-1.41; P = .107). High (RR 1.42; 95% CI 0.85-2.37; P = .183) or moderate (RR 1.29; 95% CI 0.94-1.77; P = .119) CRP levels showed little or no effect on serous OC. Similarly, no significant differences for the comparisons of high versus low (RR 1.82; 95% CI 0.27-12.42; P = .540) or moderate versus low (RR 0.72; 95% CI 0.31-1.69; P = .455) CRP levels for the risk of mucinous OC were observed. Moreover, high (RR 0.58; 95% CI 0.13-2.54; P = .471) or moderate (RR 0.81; 95% CI 0.44-1.47; P = .484) CRP levels were not associated with the risk of endometrioid OC compared with low CRP levels. CONCLUSION High CRP levels were associated with increased risk of invasive OC. The risk of other OC types with CRP levels showed no association.RATIONALE Chyle fistula is a rare but troublesome complication of neck dissection. Topical application of Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) injection has been reported as a novel, viable, and effective approach in the treatment of chyle fistula following neck dissection. However, there have been no reports regarding the treatment of chyle fistula using ultrasound (US)-guided percutaneous injection of PA-MSHA. PATIENT CONCERNS We describe 2 patients with thyroid cancer who developed chyle fistula following neck dissection, which remained unresolved despite the use of conservative treatment. DIAGNOSES Both the patients were diagnosed with chyle fistula by laboratory testing, which showed that drainage fluid triglyceride concentration was >100 mg/dL. INTERVENTIONS When conservative treatment failed, a 2 mL undiluted PA-MSHA preparation was percutaneously injected at the effusion site of the left supraclavicular area under US guidance with aseptic technique. Concomitantly, the drainage tube was clamped for at least 30 minutes. OUTCOMES Chyle fistula in both patients were successfully resolved with this technique within 2 or 4 days, without notable side effects. LESSONS US-guided percutaneous injection of PA-MSHA is a simple and effective method to treat chyle fistula following neck dissection, which may serve as a useful addition to the medical treatment for cervical chyle fistula.RATIONALE Schwannomas involving the thyroid gland are very rare and only a few cases have been reported in the literature. However, previous reports did not distinguish between thyroid bed schwannomas and intrathyroidal schwannomas. Here, we report a thyroid bed schwannoma mimicking a malignant thyroid nodule and review the literature on thyroid bed schwannomas. PATIENT CONCERNS A 33-year-old woman presented at our hospital with mild neck swelling. DIAGNOSIS Thyroid ultrasound revealed a well-defined, oval-shaped, markedly hypoechoic solid nodule with echogenic foci suggesting macro- and microcalcifications in the left thyroid gland. The lesion was considered a "highly suspicious" intrathyroidal nodule, based on the guidelines for the assessment of thyroid nodules. Fine needle aspiration was performed twice, but the cytological results were nondiagnostic. INTERVENTIONS Left thyroidectomy was performed, and schwannoma of the thyroid bed was confirmed on histopathologic analysis. OUTCOMES The patient was in a stable condition after surgery, and the thyroid function test results were within the normal range.
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