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Objective To compare therapeutic effects of lithium carbonate administration (LCA) given in 2 methods and combined with 131I treatment in patients with incipient Graves disease (IGD) accompanied by leukopenia.Methods From January 2014 to January 2016,192 IGD patients with leukopenia were enrolled in this retrospective study,including 49 males,143 females (average age:(39.65 ± 12.18) years).All patients did not receive antithyroid drugs (ATD) therapy and were divided into 3 groups by random number table method:group A(131I treatment plus LCA given at the same time for 2 weeks;n=65),group B (LCA given at a week before and after 131I treatment;n=67),control group (only treated with 131I;n=60).Cure rate (3 and 6 months after treatment),WBC (2 weeks,1,3 and 6 months after treatment) and adverse reaction rate (ADR;within 2 weeks after treatment) of 3 groups were analyzed before and after treatment.One-way analysis of variance,the least significant difference t test,x2 test were used.Results Compared with control group,group A and group B showed higher cure rates (3 months after treatment:87.7％ (57/ 65),88.1％(59/67),70.0％(42/60);6 months:89.2％(58/65),89.6％(60/67),71.7％(43/60);x2 values:9.05,9.58,both P＜0.05),higher increasing rates of WBC (3 months after treatment:(38.9± 5.1)％,(39.8±6.3)％,(20.2±3.3)％;F=19.87,t values:12.15,11.56,all P＜0.01),lower ADR (3.1％(2/65),14.9％ (10/67),30.0％(18/60);x2=17.19,P＜0.05).The ADR of group A was lower than that of group B (x2=4.26,P＜0.05).Conclusion For IGD patients with leukopenia and normal kidney function,the treatment of LCA combined with 131I at the same time for 2 weeks is safe and effective,and patients have less ADR.
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Objective To investigate the protective effect of standard dose prednisone(starting dose about 0.4 mg/kg bw) combined with glutamine(2 g/d) for Graves' ophthalmopathy(GO) after 131I treatment.Methods The prospective randomized controlled trial was performed and included 116 consecutive patients with mild-to-moderate GO or no active GO after 131I treatment,but with high risk factors.The experimental group(59 cases) started to take oral prednisone(0.44 ± 0.13)mg/kg at 2 d atter theatment,meanwhile replenishing glutamine,and prednisone was gradually decreased by 5mg per 2 weeks and stopped until 2 months;the control group(57 cases) received the initial dose prednisone(0.43± 0.14)mg/kg without replenishing glutamine,and the rest was same as the experimental group.The GO change and prednisone adverse reactions in 2,4,6 months after treatment were evalua ted in the two groups.Results The baseline characteristics had no significant difference between the two groups.In comparison of the experimental group and control group after 6-month treatment,the CAS score was (2.8 ± 0.8 vs.3.5 ± 0.9),exophthalmos degree was (19.6±8.1)mm vs.(21.7±3.0)mm,eyelid width was (11.3±2.9)mm vs.(13.8±3.1)mm,the improvement degree in the experimental group except for degree was superior to the control group (P＜0.01).No new onset GO or deterioation oc curred in the two groups;the experimental group had 42 cases(71.2 ％) of GO improvement and 17 cases(28.8 ％) of stability,while the control group had 39 cases(68.4％) of GO improvement and 18 cases(31.6％) of stability,and the curative effects had no sttis-tical difference between the two groups(P＞0.05).The side effects in the control group were more than those in the experimental group(63.1％ vs.30.5％,P＜0.05).the body mass increase was more obvious [(3.8±1.8) kg vs.(1.4±1.2)kg,P＜0.01],and SBP and DBP in the two groups were slightly increased[(10±4)mm Hg vs.(9±5)mm Hg P＞0.05].Conclusion Using the initial dose of oral prednisone(about 0.4 mg/kg) for 2 months and simultaneously replenishing glutamine (2 g/d)can effectively improve mild-moderate GO,and effectively reduce the adverse reactions of GC.However it is needed to extend the follow-up time to assess whether it can truly prevent the deterioration of GO,and to conduct a further study for the role of glutamine.
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Objective To prepare 99Tcm-B2-S22-AFA (99Tcm-TP1623)and investigate its biodistribution and kinetic imaging in healthy animals.Methods TP-1623 was synthesized and labeled indirectly by 99Tcm using stannous chloride as the reductive agent.The labeling rate was determined with chromatography using Whatman 3MM filter paper and by calculating the specific activity.The biodistribution of 99Tcm-TP1623 was tested at 1,5,10,30,60,120 min after intravenous injection into mice.According to the SPECT images and the time response of the radioactivity in the region of interest (ROI),the dynamic distribution of 99Tcm-TP1623 was assayed.Results The radiolabeling rate of 99Tcm-TP1623 was (96.4-± 0.1) ％ and the specific activity was (24.35 ± 0.06) TBq/mmol.After being conserved at room temperature for 4 h,the radiochemical purity of 99Tcm-TP1623 was (95.03 ± 0.97) ％.The oil-water distribution coefficient was-(2.51 ± 0.15).The bio-distribution test showed that the radioactivity in mice blood disappeared very fast over time by a quick excretion through renal.Meanwhile,the radioactivities in the heart,lung,liver,muscle and bone of mice decreased gradually along time and after 60 min they approached to the lowest levels.The radioactivity in brain always kept at a low level,but the radioactivity in intestinal increased slowly.For rabbits,the SPECT images showed that the radioactivity in blood disappeared quickly and the radioactivities were eliminated through kidneys.Meanwhile there were excretion images in gallbladder and intestinal,but no obvious nuclide accumulation in thyroids and stomach,and low radioactivity in brain as well.Conclusions 99Tcm-TP1623 is easy to prepare and has a high radiolabeling efficiency and good stability in vivo and in vitro,and it has excellent dynamic characteristics in normal animals.
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Objective To investigate the clinical efficacy and safety of 90Sr-90Y applicator combined with topical timolol maleate for infantile superficial hemangiomas.Methods A total of 59 infants with hemangiomas were randomly divided into a study group (n=33; ≤3 months,15 cases;＞3 months,18 cases) and a control group (n=26; ≤3 months,10 cases; ＞3 months,16 cases).The study group was treated with 90Sr-90Y applicator combined with timolol maleate solution (0.5％) and the control group was treated with the same dose of 90Sr-90Y applicator combined with saline.Treatment effectiveness was compared between the two groups,and x2 test was used for statistical analysis.Adverse reaction was observed and recorded.Results The effective rate was 18/18,and the cure rates were 14/15 (≤ 3 months) and 16/18 (＞3 months) in the study group.The effective rates were 8/10 (≤3 months) and 11/16 (＞3 months),and the cure rates were 6/10 (≤3 months) and 9/16 (＞3 months) in the control group.Both the effective rate and cure rate of the study group were significantly higher than those of control group (x2 =22.22 and 30.29,≤3 months; x2 =36.69 and 27.31,＞3 months; all P＜0.01).Significant adverse reaction was not found in both groups.Conclusion 90Sr-90Y applicator combined with 0.5％ solution of topical timolol maleate has a very high effective and cure rate for infantile superficial hemangiomas,without significant adverse reaction observed.
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Objective To evaluate the accuracy of 99mTcO4- gastrointestinal imaging in the diagnosis of Meckel’s diverticulum in children. Methods The clinical data of 99mTcO4-imaging, surgery and pathological results of 95 children with gastrointestinal bleeding were retrospectively analyzed. Results Forty-four cases of 95 patients had positive ifnding of 99mTcO4-ectopic gastric mucous membrane imaging, and positive rate was 46.3%. In the positve cases 52.3%cases (23/44) were diagnosed of intestinal heterotopic gastric mucosa, 47.7%cases (21/44) were suspected of intestinal heterotopic gastric mucosa. The sex ratio (males to females) was 7.8:1. Thirty-seven positive cases underwent operation;among them, 35 cases were found to have Meckel’s diverticulum and 1 case had duplication of the digestive tract;Diverticulum lesion was not found in 1 case. The samples of 35 cases diagnosed surgically of Meckel’s diverticulum were examined by pathologic histology. All 35 cases were conifrmed as Meckel’s diverticulum and ectopic gastric mucosa epithelium, including 2 cases with ulcer formation, 1 case with small patches of pancreatic tissue, 1 case with ileocecal junction of suppurative enteritis and 1 case with chronic appendicitis. Conclusions 99mTcO4-radionuclide imaging technique is of high value for the non-invasive diagnosis of children’s Meckel’s diverticulum.
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The target therapeutic agents of HER-2 extracellular ligand-binding domain have become the core of breast cancer research. A small peptide molecule and an anti-HER2 extracellular domain monoclonal antibody conjugated with protein toxins, radioisotopes, and chemotherapeutic drugs (immunoconjugate) can improve efficacy and reduce systemic toxicity. Vaccines based on HER-2 extracellular region should protect patients from HER-2-overexpressing breast cancer growth. In this review, studies on targeted-block therapies of the HER-2 extracellular ligand-binding domain in breast cancer were discussed to provide references for clinical applications.