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Objective:To investigate the effects of normal iodized salt diet on urinary iodine concentration and iodine uptake rate in patients with differentiated thyroid cancer (DTC) before 131I treatment. Methods:A prospective study was conducted on patients with DTC (59 male patients and 130 female patients, age (43.7±12.2) years) who received 131I treatment for the first time after total thyroidectomy in the First Affiliated Hospital of Zhengzhou University between January 2021 and April 2022. Patients were divided into normal iodized salt diet group and limited iodized salt diet group according to whether iodized salt diet was administered 4 weeks before 131I treatment. The age, gender, urinary iodine concentration, iodine uptake rate and tumor risk stratification of the two groups were compared by independent-sample t test or χ2 test. In addition, according to the concentration of urinary iodine, patients were divided into group a1 (urinary iodine <200 μg/L) and group a2 (urinary iodine ≥200 μg/L). Logistic regression analysis was used to analyze the factors affecting urinary iodine concentration. Results:The urinary iodine concentration of normal iodized salt diet group was not significantly different from that of non-iodized salt diet group ((140.53±76.66) vs (121.74±74.64) μg/L; t=1.67, P=0.489). The iodine uptake rates at 2 h, 4 h and 24 h in the 2 groups were (3.77±1.06)% vs (3.42±0.97)%, (3.33±1.07)% vs (3.21±1.15)%, (2.90±2.60)% vs (3.23±2.94)%, respectively ( t values: 2.33, 0.68, -0.81, all P>0.05). There were no significant differences in age ( t=0.56, P=0.889), gender ( χ2=1.33, P=0.250) and tumor risk stratification ( χ2=0.14, P=0.709) between the two groups. Logistic regression analysis showed that tumor risk stratification was associated with urinary iodine concentration (odds ratio ( OR)=3.914, 95% CI: 1.505-10.176; P=0.005). Conclusion:Normal iodized salt diet may have no effect on urinary iodine concentration and iodine uptake rate of patients with DTC before 131I treatment.
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Objective:To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with extensive-stage small cell lung cancer (ES-SCLC).Methods:From March 2019 to June 2020, 69 patients (55 males, 14 females, age: 38-87 years) with ES-SCLC who underwent pretreatment 18F-FDG PET/CT in First Affiliated Hospital of Zhengzhou University were retrospectively enrolled. The variables including gender, age, smoking, weight loss, liver metastasis, bone metastasis, malignant effusion, SUV max of the primary tumor, whole-body MTV (wbMTV) and whole-body TLG (wbTLG) (including wbMTV 40%, wbTLG 40%, wbMTV 2.5 and wbTLG 2.5) were analyzed. The predictors of overall survival (OS) were analyzed by using Kaplan-Meier method (log-rank test). Results:Of 69 ES-SCLC patients, 43(62%) died and 26(38%) were still alive by the end of follow-up, with a median survival time of 15.0(95% CI: 11.7-18.3) months. Univariate analysis revealed that age ( χ2=4.53, P=0.033), bone metastasis ( χ2=18.05, P<0.001), liver metastasis ( χ2=27.94, P<0.001), wbMTV 2.5 ( χ2=3.98, P=0.046), and wbTLG 2.5( χ2=5.80, P=0.016) were significant predictors of OS. Conclusion:wbMTV 2.5 and wbTLG 2.5 are assosciated with OS and may provide some reference value for predicting the prognosis of ES-SCLC patients.
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Objective:To explore the relationship between B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation and clinical pathological features in patients with differentiated thyroid cancer (DTC), and to evaluate the value of BRAF V600E mutation in predicting the efficacy and follow-up of 131I treatment in DTC patients with different risk stratification. Methods:From January 2018 to June 2022, 893 DTC patients (205 males, 688 females, age (42.3±11.9) years) treated with 131I after total thyroidectomy in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Patients were divided into BRAF V600E mutation group ( n=729) and wild-type group ( n=164). According to the 2015 American Thyroid Association (ATA) guidelines, patients were divided into low-risk (39 cases), medium-risk (498 cases) and high-risk (356 cases), and the curative effect was divided into excellent response (ER) and non-excellent response (NER). The χ2 test, independent-sample t test and Mann-Whitney U test were used to compare differences between the two groups. Logistic regression analysis was performed to predict the influencing factors of treatment effect in DTC patients with different risk stratification. Results:The differences in age≥45 years, N stage, unilateral or bilateral DTC, multifocus, mode of operation, number and size of metastatic lymph nodes were statistically significant between BRAF V600E mutation group and wild-type group ( χ2 values: 4.45-17.40, t=-4.08, z=-3.08, all P<0.05). In medium- and high-risk stratification, the stimulated thyroglobulin (sTg) levels before and after 131I treatment were slightly higher in the BRAF V600E mutation group, while significantly sharp decreased of sTg and thyroglobulin antibody (TgAb) in wild-type group ( z value: from -9.30 to -2.65, all P<0.05). In medium- and high-risk stratification, 69.0%(60/87) and 64.3%(45/70) of BRAF V600E wild-type patients reached ER after 131I treatment, which were higher than those of mutant patients (57.4%(236/411) and 45.8%(131/286); χ2 values: 3.96, 7.39, P values: 0.046, 0.007). BRAF V600E mutation was the independent predictor affecting the efficacy of 131I treatment in DTC patients with medium- and high-risk stratification (odds ratio ( OR): 0.411 (95% CI: 0.196-0.864), 0.192 (95% CI: 0.096-0.384), P values: 0.019, <0.001). Conclusions:DTC patients with BRAF V600E mutation are related to the high invasiveness, and show poor improvement in biochemical indicators after initial 131I treatment. In addition, BRAF V600E mutation is an important factor in predicting the therapeutic effect of 131I in DTC patients with medium- and high-risk stratification.
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Objective:To explore the classification of the therapeutic effect of patients with high-risk differentiated thyroid carcinoma (DTC) after surgery and 131I treatment, and to analyze the relevant factors that affect the therapeutic effect. Methods:From January 2015 to January 2018, 256 high-risk DTC patients (70 males, 186 females; age (47.6±12.9) years) in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. According to the 2015 American Thyroid Association(ATA)guidelines for therapeutic effect classification standards and the data measured during 6 months postoperative stimulation state, patients were divided into excellent response (ER) group, inderterminate response (IDR) group, biochemical incomplete response (BIR) group and structurally incomplete response (SIR) group, and the latter two groups were further combined into incomplete response (IR) group. χ2 test, Fisher exact test and Kruskal-Wallis rank sum test were used to compare the clinical characteristics among the four groups. The receiver operating characteristic (ROC) curve of the relationship with ER and IR was established. Multivariate logistic regression was used to analyze the independent influencing factors of ER and IR. The subgroups with B-Raf proto-oncogene, serine/threonine kinase (BRAF) V006E results were individually tested with χ2 test of therapeutic efficacy. Results:There were 48.05%(123/256), 20.31%(52/256), 19.53%(50/256) and 12.11%(31/256) of DTC patients in ER, IDR, BIR and SIR groups respectively. The differences in gender ( χ2=11.495, P=0.008), tumor size ( H=21.368, P<0.001), N stage ( χ2=42.012, P<0.001), distant metastasis ( P<0.001) and pre-ablation stimulated thyroglobulin (psTg) level ( H=142.829, P<0.001) were statistically significant among the 4 groups. The cut-off values of psTg for predicting ER and IR were 5.38 μg/L and 15.85 μg/L with the sensitivities of 79.7%(98/123) and 88.9%(72/81), with the specificities of 84.2%(112/133) and 91.4%(160/175) respectively. The cut-off values of tumor size for predicting ER and IR were 1.45 cm and 1.95 cm with the sensitivities of 63.4%(78/123) and 53.1%(43/81), with the specificities of 66.2%(88/133) and 74.3%(130/175) respectively. Multivariate regression analysis showed that female (odds ratio ( OR)=2.305, 95% CI: 1.041-5.104), N0 stage ( OR=2.365, 95% CI: 1.104-5.066), psTg<5.38 μg/L ( OR=17.271, 95% CI: 8.561-34.841) and tumor size <1.5 cm ( OR=2.194, 95% CI: 1.092-4.409) were independent predictors of ER; psTg≥15.85 μg/L ( OR=81.544, 95% CI: 30.561-217.577), N1b stage ( OR=3.617, 95% CI: 1.276-10.253) and tumor size >4.0 cm( OR=47.060, 95% CI: 2.449-904.360) were independent predictors of IR. The BRAF V006E mutation rate of patients in the distant metastasis subgroup of the SIR group was significantly lower than that in ER, IDR, and BIR groups ( χ2 values: 20.852-40.905, all P<0.008). Conclusions:About 48.05% of high-risk patients can achieve ER half a year after the initial treatment and be classified as low-risk again. Female, patients with N0 stage, psTg<5.38 μg/L and tumor size <1.5 cm have better therapeutic effect after initial treatment; patients with N1b stage, psTg≥15.85 μg/L and tumor size >4.0 cm have poor therapeutic effect after initial treatment.
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Objective:To screen the factors that were conducive to prolonging the effective half-life of 131I, and to provide a basis for selecting more suitable patients for the treatment of hyperthyroidism with lithium carbonate assisted radioactive 131I. Methods:Between July 2017 and March 2019, a total of 61 patients (23 males, 38 females, age: 13-73 (37.7±1.9) years) who received lithium carbonate adjuvant therapy before 131I treatment in the First Affiliated Hospital of Zhengzhou University were collected into this prospective study. Clinical parameters (serum free triiodothyronine (FT 3), serum free thyroxine (FT 4), iodine uptake rate (2 h, 12 h, 24 h) and ratio of iodine uptake rate (2 h/24 h, 4 h/24 h) before and after taking lithium carbonate were compared by using paired t test. The factors which were conducive to prolonging the effective half-life of 131I were analyzed by linear and multiple regression analyses. Results:Compared with the pretreatment results, lithium carbonate treatment significantly improved the 24 h iodine uptake rate ((74.82±2.69)% vs (82.38±2.33)%; t=2.674, P=0.010), decreased the ratio of 4 h/24 h iodine uptake rate ((88.96±2.85)% vs (82.12±2.27)%; t=2.644, P=0.010), prolonged the effective half-life of 131I ((123.03±3.09) vs (130.38±2.49) h; t=2.656, P=0.010), and decreased serum FT 3 ((26.46±1.65) vs (21.31±1.42) pmol/L; t=3.421, P=0.001) and serum FT 4 ((56.59±2.12) vs (49.24±2.19) pmol/L; t=3.289, P=0.002). Linear regression analysis showed that 2 h and 4 h iodine uptake rate, the ratios of 2 h/24 h and 4 h/24 h iodine uptake rate, and effective half-life of 131I before lithium carbonate treatment were related to the effective half-life of 131I after lithium carbonate treatment ( b values: from -0.576 to 0.642, all P<0.05). Multiple linear regression analysis showed that the ratio of 4 h/24 h iodine uptake rate was the main factor affecting the effective half-life of 131I after taking lithium carbonate ( b=0.642, 95% CI: 0.453-0.832, P<0.001). Multiple linear regression equation was y=-49.785+ 0.642 x. Lithium carbonate treatment could prolong the effective half-life of 131I if the ratio of 4 h/24 h iodine uptake exceeded 77.55%. Conclusion:The ratio of 4 h/24 h iodine uptake rate is the main factor affecting the change of the effective half-life of 131I after lithium carbonate treatment, and patients with hyperthyroidism whose ratio of 4 h/24 h iodine uptake rate exceeds 77.55% can effectively prolong the effective half-life of 131I after taking lithium carbonate.
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Objective:To explore the clinical value of surgical resection combined with 131Ⅰ therapy in the treatment of differentiated thyroid carcinoma(DTC)in the elderly. Methods:From January 2010 to December 2015, 168 elderly patients with DTC admitted to the general surgery department of our hospital were divided into the combined treatment group(n=97)and the surgery group(n=71). During the same period, 68 young and middle-aged patients with DTC were enrolled as the control group.The combined treatment and control groups were treated with total or subtotal thyroidectomy combined with 131Ⅰ therapy, while the surgery group received surgical resection only.An enzyme-linked immunosorbent assay(ELISA)was used to monitor the thyroglobulin(Tg)level of patients in the three groups before and 1 week after treatment and 1, 3, 6 months after treatment, and adverse reactions and clinical efficacy grading within 6 months after treatment were evaluated.Tumor recurrence and metastasis and patient survival in the three groups were followed up for 5 years. Results:After 1 month of treatment, serum Tg levels showed significant differences between the three groups( F=15.329, P=0.011), and Tg levels were lower in the control group than in the combined treatment and surgery groups[(30.47±6.97) μg/L vs.(47.13±7.34) μg/L, (46.12±6.55) μg/L, t=3.462 and 4.791, P=0.017 and 0.023)]. After 3 and 6 months of treatment, serum Tg levels still had significant differences between the three groups( F=22.641 and 34.182, P=0.000 and 0.000), and Tg levels were lower in the combined treatment and control groups than in the surgery group[(28.27±10.16) μg/L, (41.82±9.83) μg/L vs.(13.17±2.69), t=3.164 and 4.649, P=0.012 and 0.005; (11.16±5.43) μg/L, (28.67±9.19) μg/L vs.(1.45±0.28) μg/L, t=4.251 and 7.283, P=0.009 and 0.000)], and the control group had lower Tg levels than the combined treatment group( t=2.184 and 4.537, P=0.011 and 0.000). After 6 months of treatment, the incidences of myelosuppression(21.6%, 0.0% vs.11.8%, χ2=17.851, P=0.000)and gastrointestinal reaction(37.1%, 11.3% vs.27.9%, χ2=14.070, P=0.001)were higher in the combined treatment group than in the surgery and control groups.The control group had a higher rate of effectiveness than the other two groups(73.5% vs.62.9%, 31.0%, χ2=8.796 and 33.834, P=0.032 and 0.000)and the combined treatment group had a higher effectiveness rate than the surgery group, (62.9% vs.31.0%, χ2=18.825, P=0.000). During the follow-up, the tumor recurrence-free time and the survival time were better in the control group than in the other two groups( Log Rankχ2=30.335 and 20.628, P=0.000 and 0.000). Conclusions:Surgical resection combined with 131Ⅰ therapy can reduce local progression, recurrence and metastasis of DTC, but its clinical effectiveness is worse in elderly patients than in young and middle-aged patients.
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Objective To investigate the efficacy and safety of posterior pedicle screw internal fixation as add-on to transpedicular bone grafting in the treatment of thoracolumbar fractures in elderly patients.Methods The 86 elderly patients with thoracolumbar fracture admitted to our hospital were enrolled in the retrospective study.All patients were divided into a control group(n=40)receiving posterior short-segment pedicle fixation,and a study group(n=46)undergoing transpedicular bone grafting as add-on to posterior short-segment pedicle fixation.The recovery of lumbar function and neurological function were compared between the two groups.Results The Cobb angle of the injured vertebrae was significantly decreased in two groups at one week after operation,and then increased slightly with time-lapse(Ftime =86.34,P<0.05).The whole Cobb angle of injured vertebrae was lower in the study group than in the control group(F =7.68,P<0.05).The Cobb angle reduction of injured vertebrae was more in the study group than in the control group (Ftime× groups =4.19,P <0.05).The height of the anterior and posterior edges of injured vertebrae was significantly increased in two groups at 1 week after operation,and then decreased slightly with time-lapse(Ftime =75.87 and 66.92,P <0.05).The overall level of anterior and posterior edges height of injured vertebrae was higher in the study group than in the control group(Fgroup =9.75 and 6.76,P<0.05).The increased height of anterior and posterior edges of injured vertebrae was higher in the study group than in the control group(Ftime× groups =7.59 and 5.21,P<0.05).The bone fusion rate was higher in the study group than in control group (97.8 % vs.82.5 %,P < 0.05).The failure rate of internal fixation was lower in the study group than in the control group (2.2 % vs.17.5%,x2 =5.96,P < 0.05).The recovery of neurological function was better in the study group than in the control group(Z =2.12,P <0.05).The Oswestry disability index(ODI)in two groups was decreased with time-lapse(Ftime =85.49,P<0.05).The overall ODI level was lower in the study group than in the control group(Fgroup =47.28,P<0.05).The decrement of ODI index was larger in the study group than in the control group(Ftime× groups =8.97,P < 0.05).Conclusions Posterior pedicle screw internal fixation in combination with transpedicular bone grafting are safe and effective in the treatment of thoracolumbar fractures in the elderly,which can improve the stability of vertebral compression,and promote the recovery of neurological function and lumbar function.
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Objective To investigate the effect of multimedia technology on disease management capability in patients with chronic obstructive pulmonary disease (COPD).Methods 77 patients with COPD were randomly divided into control group ( 38 cases ) and observation group ( 39 cases ) .The control group was educated and managed on the basis of authorization education .While the observation group was cooperated with multimedia technology for COPD education and management , on the basis of authorization education .The intervention time lasted for 3 months.And the self -management capacity and quality of life of patients in the two groups were evaluated by utilizing self-management scale and St .George Respiratory Questionnaire ( SGRQ) respectively before intervention and 3 months after intervention .Results There were no statistically significant differences in self -management capacity and SGRQ score in all subjects before intervention (all P>0.05).After 3 months of intervention,the scores of self-management capacity on symptom management , daily life management , emotional management , information management and self -efficacy of the observation group were (30.71 ±6.79)points,(42.10 ±5.92)points,(39.51 ± 5.64) points,(30.92 ±6.08) points and (31.58 ±5.43) points,respectively,which were significantly higher than those in the control group [(27.76 ±4.12) points,(39.31 ±5.11) points,(36.28 ±6.38) points,(28.39 ± 4.70)points and (29.21 ±3.3)points],and the differences were statistically significant (t=-2.299,-2.207,-2.348,-2.037,-2.299,all P<0.05).The SGRQ scores of respiratory symptoms,disease effects and motion limitation of the observation group were (40.87 ±7.27) points,(41.17 ±7.15) points and (40.48 ±5.91) points, respectively,which were significantly lower than those in the control group [( 44.7 ±8.13 ) points, ( 45.21 ± 7.60)points,(43.60 ±5.87)points],and the differences were statistically significant (t=2.199,2.395,2.321,all P<0.05).Conclusion Application of advanced digital equipment and demonstration equipment to the disease education and management of patients with COPD based on patients 'needs provides effective ways and models to patients'health education ,which promotes the establishment of patients'healthy behaviors and the management of their own diseases ,and significantly improves the patients'self-management capacity and quality of life .
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Objective To explore the location value of preoperative SPECT/CT fusion imaging in ectopic gastric mucosa lesions.Methods Twenty-five children with ectopic gastric mucosa were examined with SPECT/CT.Patients who had fixed abnormal uptake lesions in abdomen within 20 min of the dynamic planar imaging underwent SPECT/CT and image fusion at the end of 20 min.The localization results of lesions by SPECT/CT fusion imaging were compared with intraoperative findings.Results Twenty-five patients with positive planar imaging underwent tomography fusion imaging,and then positive findings were noticed in 17 patients,among them 14 patients' intraoperative findings had high consistency with location of lesions of tomography fusion imaging (Kappa =0.746,P < 0.05).Conclusion SPECT/CT fusion imaging can locate ectopic gastric mucosa lesions accurately and has high application value.
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Objective To explore the prognostic value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT in pediatric neuroblastoma (NB).Methods Twenty-seven NB patients (18 males,9 females;average age (4.6±2.4) years) confirmed by pathology from June 2012 to November 2015 were retrospectively included.All patients had detailed clinical and follow up data.They underwent 18F-FDG PET/CT scan before any treatment,and the largest diameter of primary tumors,maximum standardized uptake value (SUVmax) of primary tumor (Tmax),SUVmax of liver (Lmax),Tmax/Lmax ratio,clinical staging,serum ferritin,serum lactate dehydrogenase (LDH) and serum neuron-specific enolase (NSE) were recorded as prognostic factors.Patients were followed up after treatment for 3-32 months (median:24 months).KaplanMeier survival analysis was used to analyze the influence of Tmax and Tmax/Lmax ratio on 2-year progression free survival (PFS).Cox regression analysis was used to comprehensive analyze the influence of various factors on PFS.Results Of the 27 patients,12(44.4%) experienced disease progression during the follow-up period.Univariate analysis showed that N-myc gene amplification,serum LDH,serum NSE,serum ferritin,the largest diameter of primary tumors,Tmax and Tmax/Lmax ratio were significant prognostic factors for 2-year PFS.The multivariate analysis showed that only the Tmax and Tmax/Lmax,ratio were independent prognostic factors for 2-year PFS.Conclusion 18F-FDG PET/CT can provide effective information on the prognostic information for pediatric NB patients.
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Objective To analyze safety,effectiveness and prognosis of thyroidectomy in elderly patients with thyroid carcinoma.Methods A retrospective analysis was conducted in 142 elderly patients undergoing thyroidectomy for thyroid carcinoma in our hospital from October 2010 to March 2012.Clinical data of surgical treatment and postoperative pathogenetic conditions,including the incidence rate of operation complications,the rate of local relapse and distant metastasis,were analyzed.And the influencing factors on prognosis were also analyzed.Results Thyroidectomies for thyroid carcinoma were successfully completed in all patients.There were a total of 13 cases with postoperative complications,yielding a total complication rate of 9.15 %,including an incision infection in 6 patients,hoarseness in 1 patient,and hypocalcemia in 6 patients.During median follow-up of 51 months,there were 12 patients dead,16 patients relapsing,and 6 patients with local and distant metastasis.Univariate analysis showed that age,lymph node metastasis,and clinical stage may affect the prognosis of elderly patients with thyroid cancer.Multivariate Cox Logistical analysis indicated that age,lymph node metastasis,and clinical stage were independent factors associated with the prognosis of elderly patients with thyroid carcinoma.Conclusions Age,lymph node metastasis,and clinical stage are independent factors for prognosis of elderly patients with thyroid carcinoma.
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Objective To evaluate the efficacy and safety of treating liver cancer using 131I-anti-CD147-monoclonal-antibody (131I-anti- CD147-McAb) by transcatheter hepatic arterial infusion (TAI) in a rabbit liver cancer model. Methods Forty-five rabbit models were randomly divided into three groups evenly. Transcatheter hepatic artery infusion under general anesthesia were performed in all three groups. Group A:control group, saline. Group B:pure 131I solution. Group C: 131I-anti-CD147-McAb solution. About 2 ml blood sample was obtained from all rabbits for liver, kidney,and thyroid function at pre-TAI and post-TAI 1 day, 3 days ,7 days, 14 days, 21 days. The rabbits were scanned by single photon emission computed tomographic (SPECT) to monitor radionuclide bio-distribution and tumor size on 1 day, 7 days, 14 days, 21days after procedures in group B and C. On 14 days after procedure, five rabbits were randomly selected to be sacrificed in each group for pathological and immunological investigations. The remaining rabbits continued to be fed, and survival rates were measured. Results The TAI and SPECT-CT/CT procedures were successfully performed in all rabbits. Test results showed that AST and ALT levels tended to increase transiently 1 day after TAI (P 0.05) 7 days after TAI. FT3 and FT4 mean values of rabbits in group B and C continued to decline 7 days after TAI, while thyroid stimulating hormone (TSH) showed corresponding increase (P0.05). SPEC-CT imaging of rabbits shows that most of the radionuclide was gathered in the gastrointestinal tract and thyroid in Group B, however, radionuclide was mainly concentrated in the tumor lesions in Group C. Fourteen days after procedures, radionuclide imaging of all rabbits disappeared in group B and C. The VX2 liver tumors increased rapidly after treatment in group A and B;but the tumors gradually reduced their size in group C. At 14 days after TAI: The proportion of tumor necrosis in group C was significantly greater than that in groups A and B (P<0.05). The microvessel density (MVD) number of residual tumor in group C was less than groups A or B (P<0.05).TUNEL analysis suggested that more apoptosis bodies was displayed in the residual tumor tissue in group C than that in groups A and B, but the expression of MMP-2 and vessel endothelial grouth factor (VEGF) was significantly reduced in group C than group A and group B. Median survival time of the rabbits in groups A, B, C was 22 days, 26 days and 54 days respectively. Survival time of the rabbits in group C was significantly prolonged than other two groups (P<0.01). Conclusions Radioimmunotherapy with 131I-anti-CD147-McAb by TAI can inhibit the growth and metastasis of liver cancer, and prolong the survival of experimental animals. The method is effective and safe in this animal study.
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Objective To evaluate the diagnostic value of neck ultrasonography (NUS) and 18F-FDG PET/CT imaging during the follow-up of DTC patients with elevated serum TgAb but negative serum Tg and 131I-Dx-WBS after thyroidectomy and 131I ablation.Methods From September 2014 to March 2016,41 DTC patients (10 males,31 females,age 16-73 years) with elevated serum TgAb level (>115 kU/L) but negative serum Tg and 131I-Dx-WBS were enrolled in this prospective study.Patients were divided into positive group and negative group,according to the results of NUS.The rates of recurrence or metastasis between the 2 groups were compared.18F-FDG PET/CT imaging was performed and the results were compared with pathological results.x2 test was used to analyze the data.Results The rate of recurrence or metastasis in the NUS positive patients(9/17) was significantly higher than that in the patients with negative NUS results (16.67%,4/24;x2 =6.047,P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value of 18F-FDG PET/CT imaging for diagnosis of recurrence or metastasis were 12/13,78.57% (22/28),12/18 and 95.65% (22/23) respectively.ROC curve analysis showed that the sensitivity and specificity of 18F-FDG PET/CT imaging were 11/13 and 100% (28/28) respectively when the threshold of SUVmax was set at 4.35.The treatment strategy was changed after 18 F-FDG PET/CT imaging in 12 patients,of which 8 underwent surgery and 4 underwent 131I ablation therapy.Conclusion The NUS and 18F-FDG PET/CT imaging have important significance in clinical diagnosis and subsequent treatment of the DTC patients with elevated serum level of TgAb but negative serum Tg and 131I-Dx-WBS.
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Objective To evaluate the sickness impact and the quality of life in patients who received 131 I treatment for Grave's disease with one year of follow-up.Methods 376 patients with Grave's disease(GD) who voluntarily received 131I treatment were recruited.The follow-up archives were established.The Sickness Impact and the Quality of life in patient' s with GD were measured using the Sickness Impact Profile (SIP),Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale(SAS) and Social Disability Screening Schedule (SDSS) and Quality of life scale(QLS,SF-36) before and after treatment with 131I for 6 months and 12 months.Results 57 out of 376 cases were lost.319 cases finished follow-up studies.There was significant difference of SAS,SDS,SDSS,SIP and SF-36 and their agent score among three groups:before and 6months and 12months after 131I treatment in the 319 patients(F=8.561-1080.317,P<0.001).After treatment with 131I,SAS,SDS,SDSS and SIP score were lower(P<0.05),SF-36 total and agent score were higher(P<0.05).There was no significant difference between the score of SAS,SDS,SDSS,SIP total score and it' s agent score of SD-Ⅱ,SR,W,SF-36 agent score of RP,BP,VT,SF at the end of 12 months compared to the score at the end of 6 months(P>0.05).But there was significant difference between the score of SIP agent score of SD-Ⅰ,HM,RP,SF-36 total score and it' s agent score of PF,GH,RE,M H at the end of 12 months compared to the score at the end of 6 months (P<0.05).At the end of 6 months and 12 months after treatment the subjects were divided five groups according to different clinical outcome.Not only at the end of 6 months,but also at the end of 12 months,there was significant difference of SAS,SDS,SDSS,SIP total score,and it' s agent score of SD-Ⅰ,SD-Ⅱ,SR,W,RP,SF-36 total score,and it's agent score PF,RP,BP,GH,VT,SF,RE,MH among the five groups(F6 =6.870-143.790,F12 =13.956-837.184,P<0.001).There was no significant difference of HM among five groups (F6 =1.733,P6 =0.142; F12 =2.015,P12 =0.092).The score of SF-36 and its agent score PF,RP,VT,SF,RE,MH in three subgroup (healthy control,the patient group at end of 6 months and 12 months with normal thyroid function) was significant different,respectively(F=8.320-82.791,P<0.001).There was no significant different for agent score of BP and GH(F=2.990,2.652,P=0.051,0.072).Conclusion Quality of life of patients with GD is decrease.131I treatment can improve it,but socialpsycho function can not be improved satisfactorily.It is necessary for GD patients to pay attention to the quality of life and provide effective mental intervention to improve the recovery completely.
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Objective To measure the width of space in front of the femoral neck at different age of normal children for diagnosis such as hip disease in children as bilateral transient synovitis of the hip. Methods Four hundred and twenty normal children below 14 years old were divided into 14 groups according to their age. Every group contained 30 children. They underwent bilateral ultrasonographic assessment. The width of space in front of the femoral neck was measured and collected. The mean width value in each group was compared mutually by statistical analysis (t test). Results The mean width of space in front of the femoral neck of normal children below 14 years old was 2.0 - 5.9 mm, the range was 1.2 - 7.8 mm. Conclusions The width of space in front of the femoral neck is different at different age of normal children, the mean value below 14 years old