Dawn of Advanced Thyroid Cancer Therapy: Targeted Therapy and Immunotherapy / 肿瘤防治研究

In recent years, the incidence of thyroid cancer has increased significantly. Most of the cases are differentiated thyroid cancer, which is characterized by a good prognosis. However, 15% of patients still have persistent or recurrent disease after initial treatment, and those with locally advanced or metastatic cancer are not cured with established treatments and at risk of death. The treatment of advanced thyroid cancer is still controversial at home and abroad, but it tends to targeted therapy and immunotherapy. With the in-depth understanding of the molecular pathogenesis of thyroid cancer, a variety of new targeted therapies have been approved for advanced thyroid cancer. The 2021 guidelines of the Chinese Society of Clinical Oncology (CSCO) and the 2022 guidelines of the European Society of Oncology (ESMO) regard targeted therapy as a level I recommendation for the treatment of advanced thyroid cancer. This article reviews the new progress in clinical treatment of advanced thyroid carcinoma.

Diagnostic value of rapid parathyroid hormone combined with 99Tc m-MIBI SPECT dual-phase imaging in suspected parathyroid tumor / 中华内分泌外科杂志

Objective:To investigate the diagnostic efficacy of 99Tc m-MIBI SPECT dual-phase imaging combined with rapid parathyroid hormone detection in thyroid cancer with suspected parathyroid mass. Methods:Data of 76 cases of thyroid cancer with suspected cervical parathyroid gland tumors receiving colorectal ultrasonography or CT examination in Thyroid Surgery Department of the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. Blood samples were taken before surgery to detect parathyroid hormone. Parathyroid hormone was quickly detected after clamping the tumor blood vessels during surgery. Based on the postoperative pathological results, the sensitivity, specificity, accuracy and consistency of various diagnostic methods were evaluated. The ROC curve was drawn by measuring the value of the parathyroid gland concentration after reduction of the tumor blood vessels by clamping the tumor.Results:The sensitivity and accuracy of the 99Tc m-MIBI SPECT dual-phase imaging combined with the rapid detection of parathyroid hormone in diagnosis of suspected parathyroid tumors were (96.5%, 93.4%) better than the 99Tc m-MIBI SPECT dual-phase imaging methods (77.6%, 78.9%) and intraoperative rapid detection methods (86.2%, 82.8%) , and had a high consistency with the results of pathological examination, Kappa value of 0.81. The combined detection rate of suspected parathyroid tumors was significantly higher than that of 99Tc m-MIBI SPECT dual-phase imaging and rapid intraoperative detection, but there was no significant difference between 99Tc m-MIBI SPECT dual-phase imaging and intraoperative rapid detection. The area under the ROC curve of the reduction ratio a value after clamping the blood vessels of the tumor was 0.774, and the standard error was 0.073. The difference was statistically significant ( P<0.001,95% CI:0.631-0.918) . According to the results obtained by the ROC, the index (sensitivity + specificity-1) was plotted on the ordinate and a was the abscissa. The maximum value of the Jordan index was 0.584. The a value corresponding to this point was 0.52. 0.52 is the DCP value. The corresponding sensitivity, specificity, accuracy was 86.2%,72.2%,and 82.9%. Conclusion:99Tc m-MIBI SPECT dual-phase imaging combined with rapid parathyroid hormone detection during surgery has good diagnostic value for thyroid cancer with suspected parathyroid mass, and is completely consistent with pathological diagnosis.

Clinical analysis of thyroid carcinoma in 110 children and adolescents / 中华实用儿科临床杂志

Objective To study the clinical and pathologic factors for prognosis of children and adolescents with thyroid carcinoma.Methods Clinicopathological data of 110 children and adolescents with thyroid carcinoma at the Affiliated Tumor Hospital of Zhengzhou University from January 1984 to March 2008 were collected and reviewed in this study.Univariate analysis was performed by using Log－rank test to determine predictors of survival,and multiva-riable analysis was performed by a Cox regression model.Results The overall 5－ year and 10 －year survival rates were 95.5%,88.2%,respectively.Gender and histopathologic typing were not related to prognosis.The 5 －year and 10－year survival rates in group ≤12 years old were 91.7% and 81.3%,and those in group ＞12 years old were 98. 4% and 93.5%,respectively.The 5－year and 10－year survival rates in stage T1 and T2 were 100.0%,in stage T3 were 100.0% and 66.7%,respectively,and those in stage T4 were 58.3% and 0.The 5－year and 10－year sur-vival rates in N0 group and N1a group were 100.0%,and those in N1b group were 93.4% and 82.9%,respectively. For patients without the distant metastasis group,the 5－year and and 10－year survival rates were all 96.9%,which were significantly higher than those in the distant metastasis group(84.6%,23.1%).The 5－year and 10－year sur-vival rates in groupⅠwere all 97.8%,those in groupⅡwere 84.6% and 23.1%,respectively,and those in groupⅣwere all 75. 0%.The 5－year and 10－year survival rates in the solitary lesions group were 98.7%,in the multiple le-sions group were 88.2% and 64.7%,respectively.For differentiated thyroid carcinoma,the 5－year and 10－year sur-vival rates in low,and medium risk groups were all 100.0%and those in high risk group were 83.3% and 50.0%,re-spectively.There was a significant relationship between survival and age group,T stage,N stage,M stage,TNM stage, the number of lesions,and risk stratification(all P＜0.05).The Cox regression analysis showed that T stage and M stage were the independent prognostic factors.Conclusions The primary tumor and distant metastatic are important factors affecting the prognosis of children and adolescents.Earlier diagnosis for primary tumor and aggressive manage-ments for metastatic lesions are critical to the survival rate of children and adolescents with thyroid carcinoma.

Clinical analysis of 24 cases of carotid body tumor / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the clinical diagnosis and preoperative management of carotid body tumor.</p><p><b>METHODS</b>A total of 24 cases with carotid body tumors underwent surgery from 2003 to 2013 were reviewed. The clinical and imaging features, treatment and prognosis were retrospectively evaluated. Five of the 24 patients were males and 19 were females. Twenty-three cases were benign and one case was malignant. Seven of the 24 patients had bilateral tumors.</p><p><b>RESULTS</b>Nineteen of twenty-four patients underwent digital subtraction angiography (DSA) and temporary balloon occlusion (TBO) test, and one case of them was positive in the test. Twenty-three benign case were treated with operation. The malignant one treat with biopsy. Three cases underwent resection of tumors with both the internal and external carotid arteries without carotid reconstruction, and none of the three patients died or presented with hemiplegia after operation. Twenty-three benign cases were followed up for 6-122 months, the median was 75 months. The malignant patient died 6 months after operation.</p><p><b>CONCLUSION</b>TBO and DSA are reliable and practical methods to determine the safety of carotid ligation and can be used as routine preoperative examinations.</p>

Clinical observation of intra-operative PTH assay in hyperparathyroidism due to parathyroid tumors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical manifestations and diagnostic method of hyperparathyroidism due to parathyroid tumors and to evaluate the intra-operative detection of parathyroid hormone in surgical treatment.@*METHOD@#Thirty-seven cases with functional parathyroid tumors from January 2003 to October 2012 were retrospectively analyzed. The clinical manifestation, examination and operation method, changes of parathyroid hormone before and after operation were collected.@*RESULT@#All cases were definitely diagnosed before operation. The sensitivity and the positively predictive values of neck ultrasonography were 86.5% and 97.6% respectively, and the same data of Tc-99m-MIBI was 97.2% and 100.0%. The PTH levels declined by 84.9% ten minutes after tumor resecting compared with the level before operation. The serum calcium and PTH returned to normal levels and symptomatic relief occurred after operation.@*CONCLUSION@#Recurrent bone disease, long-term urinary calculus and obscure gastrointestinal symptoms were common symptoms of hyperparathyroidism due to parathyroid tumors. The neck ultrasonography and Tc-99m-MIBI were suitable for location of parathyroid tumors. Surgical operation was an effective treatment for parathyroid tumor. Intra-operative PTH assay would be able to ensure the radical excision and the operative safety for functional parathyroid tumors.

Effects of smoking and glonoine on intracellular Ca~(2+) in vascular smooth muscle cell in rabbits with atherosclerosis / 中国药理学通报

Aim To study the effects of smoking and glonoine on intracellular free Ca2+ concentration([Ca2+]i) in vascular smooth muscle cell in rabbits with atherosclerosis,and to explore the effects of smoking on atherosclerosis and biologic action of glonoine.Methods An atherosclerosis in rabbits was produced.The vascular smooth muscle cells were isolated.The cells were loaded by Fluo-3/AM.[Ca2+]i in vascular smooth muscle cell was measured by flow cytometer(FCM).The spatial distribution and the dynamic changes of [Ca2+]i in single vascular smooth muscle cells were determined by laser scanning confocal microscopy(LSCM).Results Atherosclerosis plaques in arteriae aorta were observed and the degrees were different in various groups.[Ca2+]i in vascular smooth muscle cells in rabbits with atherosclerosis markedly increased[(48.45?5.31) vs that in saline control(38.09?2.57),P

Prevention and management of chylous fistula after neck dissection / 肿瘤研究与临床

Objective To explore the occurrence and prevention and the principle of management of chylous fistula after neck dissection. Methods Retrospective research on 1750 cases of neck dissection in Henan Tumor Hospital from January 1983 to January 2005. There were 48 cases chylous fistula and 1 case chylothorax. The incidence was 2.8 %. 5 cases on the right, 44 cases on the left. 18 cases had completed radiotherapy or chemotherapy before operation. Conservative methods and surgical methods were used in the treatment. Low fat food was supplied to the patients with chylous fistula. The conservative methods was local pressure, the surgical methods was applied while maximal production of chylous exceeding 500 ml a day. Results All the patients were cured finally. The conservative method was 12.6(5~34) days, the surgical method 7.5(3~10)day. Conclusion The key to prevent chylous fistula was to band the rupture of thoracis or lymphatic duct during operation. The conservative methods could be used in patients with slight and middle chylous, when the chylous exceed 500 ml a day or the conservative methods was unavailable, the surgical methods was appropriate, it could shorten the time of tube draw.

Studies on the Analgesic and Antiinflammatory Effects of Japanese Pagoda(Sophora japonica)in Mice and Rats / 中草药

Aqueous extract of Huaibaipi (Sophorae japonica)was shown to possess analgesic and antiinflammatory effects. It reduced rat paw edema,mice ear-swelling,and mice inflammatory peritoneal exudatinn induced by histamine, xylene,and acetic acid. It also prolong the tail-twisting time in rats stimulated by potassium ion permeation,and lengthened the leg-licking time in mice provoked by hotplate. Prolong administration can increase the weights of thymus and spleen in mice.

Protective effects of Danshenhonghua Injection on experimental cerebral ischemia in rats / 中成药

AIM: To study the protetive effects of Danshenhonghua Injection (Radix Salviae Miltiorrhizae,Stigma Croci,etc) on acute cerebral ischemia in rats. METHODS : The model of acute incomplete cerebral ischemia was built by ligaturing bilateral carotid arteries. Cerebral index,cerebral water content ,capillary permeability of brain,and the change of cerebral morphology in rats were observed. RESULTS : The cerebral index,cerebral water content,capillary permeability of brain decreased remarkably with 7.2,14.4mg?kg -1 of Danshenhonghua Injection,and the injury of brain tissue was also abated by Danshenhonghua Injection significantly. CONCLUSION : Danshenhonghua Injection has the protetive effects on acute cerebral ischemia.

Effect of Ficus Carica Polysaccharide on Tumor-bearing Mice / 中成药

Objective: To observe effects of Ficus carica polysaccharide (FCPS) on tumor bearing mice. Methods: The model of S 180 bearing mice and EAC bearing mice were established, tumor cells were inoculated under the skin of right armpit or in abdominal cavity in mice after FCPS being administered orally for ten days, to calculate inhibitive rate of tumor and survial time of mice. Results: FCPS could significantly prevent the growth of tumor, there were no effects on survival time of mice.Conclusion: FCPS had a good antineoplastic effect. It is worth further study.