ABSTRACT
Objective To evaluate the possible interactions among different impact factors possibly affecting the treatment efficacy of 131I in Graves′ disease (GD). Methods Six hundred and thirty two GD patients that had been treated by 131I, with or without antithyroid drugs (ATD), were included in this study. The impact factors were pre-defined as age (x1), sex (x2), mass of thyroid (x3), course of disease (x4), initial symptom (x5), condition of disease (x6), ATD treatment duration (x7), effective half life time (x8), maximum 131I uptake rate (x9), total dose of 131I (x10), dose of 131I per gram of thyroid (x11), TRAb (x12), TSI (x13), TgAb (x14), and thyroid microsomal antibody(TMAb) level(x15). Interactions among different impact factors were studied by t-test, χ2 test and multi-variant logistic regression. Results Age, mass of thyroid, ATD treatment duration, maximum 131I uptake rate, dose of 131I per gram of thyroid tissue and TSI level were identified as independent impact factors affecting the 131I treatment efficacy on GD (χ2=6.908, t=-4.063, χ2=13.558, t=-2.553, t=4.528, χ2=9.716, all P0.05; F=2.928, 1.992, 2.629, 2.215, all P<0.05), which indicated that the treatment efficacy with co-existing multiple factors was not equal to simple summation of single factors. Conclusions The interactions among multiple factors can cause indi-rect effect on 131I treatment, which might guide the prescription of 131I dosage for GD treatment.
ABSTRACT
<p><b>BACKGROUND</b>(131)I therapy is recognized as the simplest, safest, least expensive, and most effective treatment, and accepted by more and more patients. However its curative effect is influenced by many factors, therefore there are some difficulties for doctors to establish individual treatment strategy. The aims of this study were to determine the incidence of early and late hypothyroidism after (131)I treatment for Graves' disease (GD) and to compare their correlation, to observe and analyze the influential factors and to understand the predictabilities of them.</p><p><b>METHODS</b>Five hundred GD patients (144 males, 356 females; age (41.2 +/- 12.3) years) received (131)I treatment for the first time. The therapeutic procedure was carried out as the following: undergoing (131)I uptake test to obtain maximum of thyroid uptake value and effective half-life (EHL) time; estimating the thyroid's weight by ultrasonography; determination of thyroid hormones and correlative antibodies; pre-therapy physical examination; thyroid imaging; calculating (131)I therapeutic dosage; per os uptake of the determined (131)I dosage; follow-up appraisal of curative effect. The observing parameters included age, gender, thyroid weight, GD duration, condition of onset, state of disease, course of treatment, EHL time, maximum of thyroid uptake value, (131)I dosage and titer of correlative antibodies. We sorted out the data and used both univariate and multivariate analysis to evaluate them statistically.</p><p><b>RESULTS</b>The incidence rates of early and late hypothyroidism were 33.2% and 6.6% respectively after (131)I treatment and approximately 22.2% cases of late hypothyroidism developed from early hypothyroidism. The influential factors of early hypothyroidism included course of GD, the highest thyroid uptake ratio of (131)I, EHL time and thyroid microsome antibody (TMAb), etc. A multivariate analysis on late hypothyroidism showed that female patients, with recurrence after anti-thyroid drug treatment and higher thyroid weight, had lower possibility of late hypothyroidism after (131)I therapy.</p><p><b>CONCLUSIONS</b>The incidence of early hypothyroidism is higher than that of late hypothyroidism. The highest thyroid uptake ratio of (131)I, EHL and TMAb will increase the possibility of early hypothyroidism, while GD course is the protective factor. Higher (131)I dosage, longer EHL and higher TMAb titer will also increase the possibility of late hypothyroidism. The multi-perspective and multi-factor analysis has the benefit to establish individualized treatment strategy.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Graves Disease , Radiotherapy , Hypothyroidism , Epidemiology , Iodine Radioisotopes , Therapeutic Uses , Logistic Models , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of Drynaria fortunei J. Smith naringin (DFSN) on proliferation and differentiation of human periodontal ligament cells (hPDLC).</p><p><b>METHODS</b>Cultured human periodontal ligament cells were treated with DFSN at different concentrations. Cell proliferation was determined by MTT method; cell differentiation was evaluated through the examination of alkaline phosphate (ALP) activities.</p><p><b>RESULTS</b>DFSN in a concentration ranged from 0.01 mu mol/L to 10 mu mol/L showed a promoting effect on proliferation of hPDLC (P< 0.05), and it also promoted ALP activities of hPDLC (P<0.05).</p><p><b>CONCLUSION</b>Drynaria fortunei J. Smith naringin can promotes the proliferation and differentiation of human periodontal ligament cells.</p>