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Objective:To explore the differences of renal dynamic imaging parameters between operation group and non-operation group in infants with severe hydronephrosis, so as to accumulate theoretical basis for diuretic renal scintigraphy to help the treatment decision making.Methods:A total of 107 infants (age: 3(2, 6) months; 90 males and 17 females) with severe hydronephrosis, who underwent diuretic renal scintigraphy between March 2018 and October 2021 in Shanxi Children′s Hospital were retrospectively reviewed. All patients were diagnosed with ureteropelvic junction obstruction and divided into operation group ( n=87) and no-operation group ( n=20). The differences of differential renal function (DRF), peak time, half-time and drainage curve between the two groups were compared with the independent-sample t test or χ2 test, and the correlation between the renal function of the affected side and the anteroposterior pelvic diameter (APD) was analyzed with Pearson correlation analysis. Results:The operation group included 17 patients with DRF<40%, 60 patients with DRF between 40%-55%, and 10 patients with DRF>55%(supernormal renal function). The 40%-55% was considered as normal DBF, and the rest were abnormal. Infants with abnormal renal function in the operation group ( n=27) were more than those in the non-operation group ( n=3), but there was no statistical difference ( χ2=2.07, P=0.150). The proportion of obstruction curve in the operation group (85.1%, 74/87) was significantly higher than that in the non-operation group (55.0%, 11/20; χ2=7.24, P=0.007). Compared with the non-operation group, the peak time of affected kidney in the operation group was significantly longer ((22.77±7.52) vs (15.26±10.29) min; t=3.78, P<0.001), as well as the peak time of contralateral kidney ((11.25±8.47) vs (6.65±5.75) min; t=2.30, P=0.023). There was a negative correlation between the DRF of the affected side and the APD ( r=-0.48, P<0.001). Conclusions:The DBF is mostly in the normal range in infants with severe hydronephrosis, and supernormal renal function is common. The previous operation indication (DRF<40%) is not suitable for the infants, and it needs to be analyzed combined with the type of curve and the APD determined by color Doppler ultrasound. The prolongation of contralateral renal peak time may be an important parameter for the surgical evaluation of severe hydronephrosis in infants.
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Objective To investigate the effect of different treatment methods on the survival of patients with stage Ⅳ differentiated thyroid cancer (DTC).Methods From January 2013 to June 2015,90 patients with stage Ⅳ DTC in the Second Hospital of Shanxi Medical University were randomly divided into three groups according to the digital table,A,B and C group,with 30 cases in each group.The patients in A group were treated with surgery combined with 131 I,and the patients in B group were treated with surgery combined with TSH inhibition,and the patients in C group were treated with operation combined with 131I + TSH inhibition.The therapeutic effect,postoperative quality of life score and short-term and long-term survival rate were evaluated.Results After treatment,the levels of Tg in A group [(25.06 ± 3.41)μg/L] and C group [(24.89 ± 3.27)μg/L] were significantly lower than that in B group [(45.46 ± 3.58) μg/L],and the levels of TSH in B group [(0.36 ± 0.26) mU/L] and C group [(0.36 ± 0.18)mU/L] were significantly lower than that in A group [(0.67 ± 0.31)mU/L] (t =3.624,3.337,3.289,3.667,all P ＜0.05).The success rates of nail clearance in A group and C group were 50.00％ (15/30) and 56.67％ (17/30),respectively,which were significantly higher than 33.33％ (10/30) in B group (x2 =3.475,4.967,all P ＜ 0.05).The postoperative quality of life (GQOL[-74) scores among the three groups had statistically significant differences (F =4.354,5.216,4.672,5.197,all P ＜ 0.05).The 1-year (80.00％),2-year (53.33％) and 3-year (33.33％) survival rates in C group were significantly higher than those in A group (43.33％,36.67％,20.00％) and B group (40.00％,33.33％,16.67％) (x2 =5.467,3.661,3.287,all P ＜0.05).Conclusion For patients with stage Ⅳ DTC,the combination of 131I + TSH inhibitory regimen and operation regimen can significantly improve the therapeutic effect,improve the quality of life and prolong the survival time.
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Objective@#To investigate the effect of different treatment methods on the survival of patients with stage IV differentiated thyroid cancer (DTC).@*Methods@#From January 2013 to June 2015, 90 patients with stage IV DTC in the Second Hospital of Shanxi Medical University were randomly divided into three groups according to the digital table, A, B and C group, with 30 cases in each group.The patients in A group were treated with surgery combined with 131I, and the patients in B group were treated with surgery combined with TSH inhibition, and the patients in C group were treated with operation combined with 131I + TSH inhibition.The therapeutic effect, postoperative quality of life score and short-term and long-term survival rate were evaluated.@*Results@#After treatment, the levels of Tg in A group [(25.06±3.41)μg/L] and C group [(24.89±3.27)μg/L] were significantly lower than that in B group [(45.46±3.58)μg/L], and the levels of TSH in B group [(0.36±0.26)mU/L] and C group [(0.36±0.18)mU/L] were significantly lower than that in A group [(0.67±0.31)mU/L] (t=3.624, 3.337, 3.289, 3.667, all P<0.05). The success rates of nail clearance in A group and C group were 50.00%(15/30) and 56.67%(17/30), respectively, which were significantly higher than 33.33% (10/30) in B group (χ2=3.475, 4.967, all P<0.05). The postoperative quality of life (GQOLI-74) scores among the three groups had statistically significant differences (F=4.354, 5.216, 4.672, 5.197, all P<0.05). The 1-year (80.00%), 2-year (53.33%) and 3-year (33.33%) survival rates in C group were significantly higher than those in A group (43.33%, 36.67%, 20.00%) and B group (40.00%, 33.33%, 16.67%) (χ2=5.467, 3.661, 3.287, all P<0.05).@*Conclusion@#For patients with stage IV DTC, the combination of 131I+ TSH inhibitory regimen and operation regimen can significantly improve the therapeutic effect, improve the quality of life and prolong the survival time.
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Objective To explore the correlation between quantitative value of joint bone scan by single photon emission computed tomography (SPECT) and serum bone metabolic markers in patients with active rheumatoid arthritis (RA).Method Clinical data of 60 newly diagnosed RA patients were retrospectively collected in Department of Rheumatology and Immunology from May 2013 to December 2014,including 28 cases with medical history less than 6 months and 32 from 6 months to 2 years.Serum Cterminal telopeptide of type Ⅰ collgen(CTX-Ⅰ)and N-terminal propeptide of type Ⅰ collagen(PINP) were tested by chemiluminesence.SPECT whole body bone and target joint scan before treatment was done.Thirty-nine healthy subjects as control group received ultrasound,electrocardiogram,X-ray,and whole body bone imaging examination.Quantitative values of joint imaging were calculated for the statistical analysis.Result Demographic data between RA group and control group were comparable (P ＞ 0.05),including sample,sex,age and BMI.The joint SPECT value,CTX-Ⅰ and PINP levels were all significantly higher than those of control group (P ＜ 0.01),which were 6.48 ± 1.98 versus 3.73 ± 1.t6;(0.66 ± 0.37) mg/L versus (0.58 ±0.21) mg/L;(46.35 ±28.15) mg/L versus (30.47 ± 13.75) mg/L respectively.Joint SPECT values had positive correlations with serum CTX-Ⅰ levels in all RA patients,as well as PINP in patients with disease duration 6mon-2years.And the according correlation coefficients were 0.513,0.495,0.402 (P ＜ 0.05).But SPECT value had no correlation with CTX-Ⅰ (P =0.081) in patients with disease duration less than 6 mon.The correlation coefficient was 0.336.Conclusion SPECT imaging quantitative values were positively correlated with serum bone metabolic parameters.Thus SPECT imaging alone or combined with bone markers are helpful in diagnosing active RA.
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Objective To compare SPECT/CT fusion imaging and MRI in the diagnosis of benign hip lesions. Methods Twenty-two patients suspected avascular necrosis of femoral head with hip discomfort, pain or action limited were analyzed retrospectively. All patients underwent radionuclide bone scan and MR examination within 5 days, and the diagnosis was proved with clinical follow-up. Results Eighteen necrosis of the femoral head and 4 hip arthritis including 1 patient with ankylosing spondylitis were found in 44 hip joints of 22 patients. MRI detected 17 femoral head necrosis and 4 hip arthritis, while SPECT/CT fusion image found out 18 femoral head necrosis and 4 hip arthritis. There was corresponding relationship in signs of hip lesions between MRI and SPECT/CT fusion imaging. Conclusion SPECT/CT fusion imaging and MRI has no markedly difference in the diagnosis of hip benign lesions, and is complementary to each other. SPECT/CT fusion image can distinguish the hip lesions from the femoral head lesions, and has a higher accuracy of diagnosing hip lesions than whole body bone scanning.
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The changes of Fas.FasL and Bcl-2 expression in thyrocytes of patients with Graves'disease were investigated before and 2 weeks after 131Ⅰ administration. The results showed that 131Ⅰ couhl induce thyrocytes to express the apoptotic protein Fas, FasL and the anti-apoptotic protein Bet-2 in patients with Graves'disease. A statistically significant correlation was found between the dose of 131Ⅰ and the expression levels of Fas and FasL but not Bet-2 ,suggesting that early onset of hypothyroid after 131Ⅰ administration may be due to the increased expression of Fas and FasL in thyrocytes.
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Forty-two hyperthyroid patients with mild hepatic dysfunction were treated with 131I once orally and followed up for 6 months. The changes of hepatic functions (ALT, AST, ALP, A/G) were determined before and after treatment, hepatic function was ameliorated in these patients. The results indicate that 131I-iodine is safe and effective in treating hyperthyroidism with mild hepatic dysfunction.