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Objective:To analyze the short-term effect of targeted drugs on quality of life in patients with radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC).Methods:From February 2020 to April 2022, 19 RAIR-DTC patients (10 males, 9 females; age (54.5±14.5) years) who received targeted drugs therapy (sorafenib, lenvatinib or anlotinib) in Tianjin Medical University General Hospital were prospectively enrolled. The thyroglobulin (Tg) levels prior and 1, 3, 6 months post the targeted treatment, and the adverse events were measured and recorded. Response evaluation criteria in solid tumors (RECIST) 1.1 version was used to evaluate the treatment response. The quality of life based on five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) was monitored prior and 3 months post the targeted treatment, and the prevalence rates of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression were analyzed, and the scores of health assessment were assessed. Paired t test, Kruskal-Wallis rank sum test and χ2 test were used to analyze data. Results:The prevalence rates of mobility (8/19), self-care (6/19), usual activities (10/19), pain/discomfort (10/19), and anxiety/depression (12/19) in 3 months post treatment were higher than those prior treatment (1/19, 1/19, 1/19, 2/19, 2/19; χ2 values: 4.38-11.31, all P<0.05). The score of health assessment prior treatment was (84.37±6.25), which was higher than that at 3 months post treatment (71.63±9.14; t=5.02, P=0.001). After targeted treatment, 10 patients were with skin toxicity, 8 patients were with hypertension, 8 patients were with weight loss, 7 patients were with diarrhea, 6 patients were with fatigue, 5 patients were with hepatic dysfunction, 2 patients were with proteinuria, 2 patients were with muscle pain and 1 patient was with oral ulcer. Of 19 patients, 17 insisted on continuing treatment, and the other two stopped treatment. The Tg levels at 1, 3 and 6 months post treatment were 56.26(44.60, 210.50), 53.36(41.25, 203.07) and 54.35(34.71, 223.52) mg/L, respectively, which were lower than the level prior treatment with no significant difference (110.16(49.63, 294.50) mg/L; H=2.42, P=0.490). After 3 months of targeted treatment, the progression-free survival (PFS) rate was 16/17, including 7 patients with partial response (PR), 9 patients with stable disease (SD), and 1 patient with progression of disease (PD). After 6 months of targeted treatment, the PFS rate was 10/17, including 5 patients with PR, 5 patients with SD, and 7 patients with PD. Conclusion:After 3-6 months of targeted treatment, the tumor markers of most patients are decreased with metastases improved, but the adverse events of targeted drugs have a great impact on quality of life in patients with RAIR-DTC.
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ObjectiveTo investigate the effect of entecavir (ETV) antiviral therapy on the prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) receiving transcatheter arterial chemoembolization (TACE). MethodsA total of 170 HCC patients who received TACE for the first time in Liver Cancer Center of Nanfang Hospital from January 2011 to March 2018 were enrolled, among whom 114 patients were treated with ETV (ETV treatment group) and 56 patients did not receive antiviral therapy (control group). Baseline demographic data, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), albumin (Alb), platelet count (PLT), Child-Pugh class, HBeAg and HBV DNA levels, alpha-fetoprotein, and BCLC stage were recorded before treatment, and the changes in HBV DNA level, ALT, AST, TBil, Alb, and Child-Pugh class were observed at weeks 4-8 after treatment; long-term survival was also observed after treatment. Short- and long-term clinical benefits (overall survival) were observed for all patients. The t-test or the Wilcoxon signed-rank test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Multivariate logistic regression analyses were performed for related clinical indices before treatment to identify the risk factors for HBV reactivation. The Kaplan-Meier method was used to analyze the survival curves of overall survival, and the log-rank test was used for comparison of survival curves. ResultsThere was no significant difference in the incidence rate of HBV reactivation between the ETV treatment group and the control group (15.79% vs 16.07%, χ2=0.002，P=0.962). The univariate analysis showed that PLT was a risk factor for HBV reactivation (Z=-2.183,P=0.029), and the multivariate analysis showed that HBV DNA level was an independent risk factor for HBV reactivation (hazard ratio =1.000, 95% confidence interval: 1.000-1.000, P=0.015). The 1-, 3-, and 5-year survival rates were 56.20%, 30.30%, and 13.20%, respectively, in the ETV treatment group and 60.60%, 27.20%, and 16.30%, respectively, in the control group. There was no significant difference in overall survival rate between the two groups (χ2=0.049,P=0.755). ConclusionAntiviral therapy can reduce the incidence rate of HBV reactivation after TACE in patients with HBV-related HCC.
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Objective:To explore the impact of urinary iodine concentration (UIC) on response to 131I treatment in differentiated thyroid cancer (DTC) patients with different risk stratifications. Methods:A total of 181 patients with DTC (75 males, 106 females, age: (44.1±12.5) years), who received the first 131I treatment in Tianjin Medical University General Hospital between January 2018 and February 2019, were retrospectively analyzed. Patients were divided into low- to intermediate-risk and high-risk groups. The treatment response was categorized into excellent response (ER) and non-excellent response (non-ER). Factors being evaluated including age, sex, preablative stimulated thyroglobulin (ps-Tg), UIC, etc. Mann-Whitney U test, χ2 test and logistic regression analysis were used for data analysis. Results:The UIC and ps-Tg in the low- to intermediate-risk group ( n=113) was 111.60(55.80, 204.65) μg/L and 2.08(0.63, 4.91) μg/L, respectively. Compared with the ER subgroup ( n=86), non-ER subgroup ( n=27) had higher UIC and ps-Tg level ( z values: -2.585, -4.511, both P<0.05). In the high-risk group ( n=68), UIC was 115.40(61.23, 167.28) μg/L and ps-Tg was 16.65(4.52, 43.45) μg/L. Compared with the ER subgroup ( n=20), non-ER subgroup ( n=48) had higher ps-Tg level ( z=-4.677, P<0.01), while the UIC was not significantly different between ER and non-ER subgroups ( z=-0.013, P>0.05). The multivariate logistic analysis indicated the ps-Tg level was the significant variable for non-ER in low- to intermediate-risk group (odds ratio( OR)=6.157(95% CI: 1.046-36.227); OR=22.965(95% CI: 3.591-146.857), both P<0.05) and high-risk group ( OR=9.696 (95% CI: 1.379-68.169), P<0.05); a high UIC could be an indicator of non-ER only in the low- to intermediate-risk group ( OR=3.715(95% CI: 1.201-11.488), P<0.05). Conclusions:The non-ER is associated with UIC in the low- to intermediate-risk group; however, UIC does not affect the non-ER in the high-risk group. Higher ps-Tg level is associated with non-ER in patients with low- to intermediate-risk and high-risk DTC.
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Objective:To investigate the prognostic factors of differentiated thyroid cancer (DTC) patients with positive thyroglobulin antibody (TgAb) and varying ages after operation and 131I treatment. To explore the value of TgAb level and its change in the prognosis of DTC patients. Methods:Clinical data of 131 TgAb positive DTC patients were retrospectively analyzed. According to age, they were divided into young group(age<55 years, n=95) and elder group (age≥55 years, n=36). According to response, it was divided into excellent response group (110 cases) and non-excellent response group (21 cases). χ2 test and t test were used to compare the clinicopathological features between excellent response group and non-excellent response group. By logistic regression analysis, the independent risk factors affecting the prognosis of patients were analyzed. The receiver operating characteristic curve was used to determine the TgAb value of persistent or recurrent DTC, and the Kaplan-Meier regression curve was used to analyze the time of TgAb becoming negative. P<0.05 was statistically significant. Results:In young patients, the higher serum TgAb level before 131I treatment and the lateral lymph node metastasis were the independent influencing factors of poor prognosis [ OR=0.89(95% CI 0.83-0.95), OR=0.15(95% CI 0.05-0.52); both P<0.05]. In elder group, extraglandular invasion and higher serum TgAb before 131I treatment were associated with poorer prognosis [ OR=0.05(95% CI 0-0.83), OR=0.91(95% CI 0.76-1.13); P<0.05]. The serum TgAb thresholds for predicting DTC persistence/recurrence were 315.5 IU/mL(246.0 IU/mL in the young group and 516.5 IU/mL in the elder group). The mean time TgAb sera turned negative was (26.37±2.22) months [(23.28±2.37) months for young group and (32.64±4.07) months for elder group]. The TgAb decreased >50% in one year of the patients who had a lower probability of disease persistence/recurrence than the group without ( P<0.05). Conclusions:The high level of serum TgAb before 131I treatment and lateral lymph node metastasis were independent factors of poor prognosis in young patients, while in elder patients, extraglandular tumor invasion and the high level of serum TgAb before 131I treatment were independent factors of poor prognosis. The rate of TgAb change one year after treatment may be used as an early marker for predicting the disease status of TgAb positive patients.
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Objective:To investigate the clinical features of patients with recurrent or metastatic differentiated thyroid carcinoma(DTC)after 131I therapy. Methods:From December 2000 to December 2017, a total of 40 patients[14 males amd 26 females, median age 48(29-60)years] with recurrent or metastatic DTC after 131I therapy in Tianjin Medical University General Hospital were reviewed. We analyzed the clinical pathological features of the patients receiving the initial 131I ablation to screen the relevant factors affecting the time of recurrence or metastasis, the dynamic serological changes, imaging characteristics and the iodine uptake in the lesion at diagnosis. Chi- square test, Mann- Whitney U test and Kaplan- Meier analysis were used to compare the differences between the two groups. Results:The time of recurrence or metastasis of DTC after 131I therapy was not statistically different in the patient′s age, gender, multifocal cancer, lymph node metastasis, the interval between the initial 131I therapy and the operation, stimulated thyroglobulin(Tg)levels before the initial ablation and last 131I therapy, and times of 131I therapy( P > 0.05), but associated with the T-stage of in-situ tumor, soft tissue metastasis and initial therapeutic dose of 131I. Patients with the T4-stage of in-situ tumor( P=0.033), soft tissue metastasis( P=0.008)and tumor initial dose≤3.7 GBq( P=0.002)were more prone to early recurrence or metastasis. From termination of 131I therapy to the diagnosis of tumor recurrence or metastasis, Tg [Tg antibodys(TgAb)negative] and TgAb(TgAb positive)showed a gradually increasing trend. Recurrent or metastatic lesions were mostly located in the cervical lymph nodes, and most of them were multiple. Among the 40 patients with recurrent or metastatic DTC, only 3 patients had iodine-avid lesions. Conclusion:The T-stage of in-situ tumor, soft tissue metastasis and initial therapeutic dose of radioiodine are important factors affecting the time of recurrence or metastasis after 131I therapy in DTC patients. Most of the recurrent or metastatic lesions don′t ever concentrate radioiodine, so it′s difficult to benefit from continued 131I therapy.
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Objective To analyze the stimulated thyroglobulin (sTg) level and variation tendency before and after 131I therapy in papillary thyroid carcinoma (PTC),and evaluate the predictive value of sTg for the efficacy of 131I therapy.Methods From January 2013 to September 2016,a total of 178 PTC patients (53 males,125 females;average age (44.1±11.4) years) without distant metastases who received 131I treatment in Tianjin Medical University General Hospital were reviewed.The patients were divided into two groups:group 1 (n=23) with residual thyroid detected by 131I whole body scan (WBS) and group 2 (n=155) without residual thyroid.Both thyroid stimulating hormone (TSH) and sTg were measured and defined as TSH1,sTg1 before 131I therapy,and TSH2,sTg2 after 131I therapy.Data of the two groups were compared with two-sample t test,x2 test and Mann-Whitney u test.The receiver operating characteristic (ROC) curve and diagnostic critical point (DCP) were used to evaluate the predictive value of sTg in radioiodine ablation efficacy.Results There were no significant differences in age (t=1.007),gender (x2 =1.419),tumor diameter (u=1 385),multifocal cancer (x2 =0.371),extrathyroidal extension (x2 =0.020) or lymph node metastasis (x2=0.391,all P＞0.05) between group 1 and group 2.The levels of sTg1 and sTg2 of group 1 were 6.3(2.0,16.9) and 1.7(0.8,4.2) μg/L,which were higher than those of group 2 (2.7(0.6,6.4) and 0.3(0.2,1.3) μg/L;u=1 118.5,817.0,both P＜0.01).△sTg and △sTg/△TSH showed no statistical differences between the two groups (u =1 359.5,1 195.0,both P＞0.05).The area under ROC curve,DCP,sensitivity,specificity,positive predictive value,and negative predictive value of sTg1 were 0.686,4.435 μg/L,60.9％(14/23),67.7％(105/155),21.9％ (14/64) and 92.1％(105/144),respectively.Meanwhile,the parameters of sTg2 were 0.771,0.460 μg/L,91.3％ (21/23),58.1％ (90/ 155),24.4％(21/86) and 97.8％(90/92),respectively.Conclusions The level of sTg could be used to predict the efficacy of 131I therapy in PTC patients.Preablative sTg1 (＜4.435 μg/L) or postablative sTg2 (＜ 0.460 μg/L) holds high negative predictive value in identifying the efficacy of single 131I therapy.
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Objective To investigate the correlation between external dose equivalent rate (EDER)and residual radioactivity in DTC patients after 131I therapy.Methods A total of 70 DTC patients (15 males,55 females;average age (45.7±12.8) years) who received 131I therapy from January 2015 to May 2015 were reviewed.Patients were divided into remnant ablation group (Group 1,43 patients) and the group of therapy for persistent disease (Group 2,27 patients).The determination of dose equivalent rate at 1,2 and 3 m from the patients was performed at 1,6,18,24,30,42,48,54,66 and 72 h after the administration of 131 I.Simultaneously,the residual radioactivity was estimated through collecting their urine and monitoring the excretion of radioactivity.The correlation between EDER and residual radioactivity was analyzed.Results The functions of standard EDER (μSv · h-1 · MBq-1) at 1 m from the patients of Group 1 and Group 2 were H=0.044 77e-0.063 8t +0.015 04e-0.396t.and H=0.039 71e-0.0629t +0.014 12e-0.325t,respectively.And the functions of residual radioactivity (MBq) of the two groups were A =A0(0.84e-0.061 7t+ 0.16e-0.158 4t)and A =Ao(0.69e-0.087 7t+ 0.31e-0.047 3t),respectively.There was a positive correlation between EDER and residual radioactivity in DTC patients after the administration of 131I (r=0.95,P＜0.001).The fitting function of the dose equivalent rate at 1 m from the patients was H(μSv/h)=0.048A (MBq).Conclusions The residual radioactivity in DTC patients after 131 I therapy can be estimated by determining the EDER.The dose equivalent rate at 1 m from the patients of lower than 19.2 μSv/h can be used as the limitation of radiation isolation.
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Objective To analyze the efficacy of 131I therapy for Graves' disease,and to investigate the incidences of complete remission and hypothyroidism after single or multiple treatments.Methods Altogether 2 125 patients with Graves' disease (614 males,1 511 females) aged (39.8 ± 10.2) years received 131I treatment.The diagnostic and therapeutic procedures were carried out as follows:physical examination,determination of thyroid hormones and antibodies,undergoing 131I uptake test to obtain maximum of thyroid uptake value and effective half-life time,ultrasonography,thyroid imaging,calculating 131I therapeutic dosage,131I treatment,follow-up appraisal of curative effect.The data were analyzed by x2 test,optimal scale regression,logistic regression and discriminant analysis.Results The rates of complete remission,hypothyroidism,partial response,and invalid in the 2 125 cases more than half a year after 131I therapy were 54.3 ％,21.3 ％,20.3 ％,and 4.1％ respectively.In all patients the rate of clinical cure (including complete remission and hypothyroidism) and rate of effectiveness were 75.6％ and 95.9％ respectively.The rate of recovery and incidence of hypothyroidism in patients who accepted single 131I treatment were 52.4％ and 21.2％ respectively,while in patients who accepted twice or multiple 131I therapy the respective figures became 66.2％ and 21.8％ accordingly.The influential factors in the effectiveness of 131I treatment included age,thyroid weight,TSH receptor antibody (TRAb),and dose of 131 I per gram of thyroid.Conclusions Patients who did not achieve clinical cure for over 6 months after first 131 I treatment,may receive another131 I therapy to further improve the remission rate.Age,thyroid weight,TRAb etc,contribute to the efficacy of 131I therapy for Graves' disease.The multi-perspective and multi-factor analysis would have the benefit to establish individualized treatment strategy.
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Objective To investigate the efficacy and influential factors of 131I treatment for lung metastases from DTC.Methods Fifty patients (18 males,32 females;age (40.8±13.2) years) with lung metastases from DTC who underwent 131I treatment from October 2007 to December 2012 were retrospectively analyzed.The efficacy of 131 I treatment was assessed using 131I imaging and determination of serum Tg level after 6 months.The possible factors affecting efficacy included patients' age,gender,operation method,pathological classification,the diagnostic time of pulmonary metastasis,serum Tg level at diagnosis,131I uptake pattern,characteristics of other imaging modalities,cervical lymph node metastases and extrapulmonary distant metastases (assign 1 for metastases,0 for no metastases).Univariate and multivariate analyses (Student t test,Fisher exact test and logistic regression) were performed to investigate the factors.Results The rates of complete remission,partial response and invalid of 131I treatment were 20％ (10/50),74％ (37/50) and 26％ (13/50) respectively.Univariate analysis showed that age(t =2.019,P＜0.05),gender (P =0.032),serum Tg level at diagnosis (t =2.646,P＜ 0.05),findings of other imaging modalities (P =0.039),and extrapulmonary distant metastases(P=0.023) were the factors influencing outcome of 131I treatment.Multivariate logistic regression analysis showed that the influential factors included age,serum Tg levels and extrapulmonary distant metastases.The regression equation was as follows:logit P =2.127-0.056× age-0.163×Tg level-1.280×extrapulmonary distant metastasis (x2=10.484,P＜0.001).Aged patients,a significant increase of Tg level and extrapulmonary distant metastases indicated a poor prognosis.Conclusions 131I treatment is an effective method for lung metastases from DTC.The patients with younger age,lower Tg levels,no other distant metastases had good response to 131I treatment.
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Objective Midkine ( MK ) and nuclear factor-kappa B ( NF-kB ) play pivotal roles in tumorigenesis, which are considered as promising cancer biomarkers. The efficacy of MK and NF-kB as markers for diagnosis and prediction of synchronous metastasis in papillary thyroid cancer ( PTC ) was the aim of present investigation. Methods Seventy six cases of PTC and seventy cases of multi-nodular goiter ( MNG ) were retrieved. The PTC group was further divided into subgroup 1 (16 cases with synchronous metastasis) and subgroup 2 (60 cases without metastases). A retrospective review of clinical information, radiological examinations,131 I treatments and post-131 I-therapy scans were done. Immunohistochemistry of MK, NF-kB p65, and Ki-67 was performed on paraffin-embedded specimens and results were quantified. Diagnostic values of the parameters were conducted by receiver operating characteristic (ROC) curves. Diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were determined. Protein levels of MK and NF-kB p65 were then confirmed by Western blot. Results Immunoreactivities of MK and NF-kB p65, and positive percentage of Ki-67 were significantly higher in PTC group than in MNG group (all P<0. 01). ROC showed good differential diagnostic capabilities of all three parameters with diagnostic accuracies of 82. 192% , 80. 137% , and 84. 091%respectively. Moreover, all three parameters were significantly higher in subgroup 1 than those in subgroup 2 (all P<0. 01). ROC showed good predicting efficacies in synchronous metastasis of all three parameters with diagnostic accuracies of 82. 895% , 80. 263% , and 76. 316% respectively. By one-way analysis of variance, Western blot showed that MK and NF-kB p65 protein levels in lesions from subgroup 1 were significantly higher than those from subgroup 2, both were significantly higher than those in MNG lesions ( P<0. 01). Conclusion MK and NF-kB immunohistochemistry can potentially be used for differential diagnosis between PTC and MNG, and for prediction of synchronous metastases.
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<p><b>OBJECTIVE</b>To observe the clinical characteristics and short-term survival of patients with splenomegaly and acute-on-chronic liver failure related to chronic HBV infection.</p><p><b>METHODS</b>Electronic medical records of patients with acute-on-chronic liver failure were collected to analyze the clinical parameters and 4-week survival of patients with or without splenomegaly.</p><p><b>RESULTS</b>Of the 149 patients enrolled, the overall 28-day mortality rate was 48.3%, which was lower in patients with enlarged spleen than those without (34.2% vs 54.1%, P=0.034). Compared with patients without splenomegaly, patients with splenomegaly had lower platelet counts (P=0.001), lower ALT levels (P=0.005) and lower PT-INR (P=0.010). Although the occurrence of hepatic encephalopathy was comparable between patients with or without splenomegaly, severe conditions were more frequent in those without splenomegaly. Hepatic encephalopathy grades, serum creatinine levels, neutrophil percentages over 70%, PT-INR and splenomegaly were independent factors associated with the 28-day survival, and this novel model was superior to model of end-stage of liver disease in predicting the 4-week survival (P=0.017).</p><p><b>CONCLUSION</b>Patients with splenomegaly that evolves into acute-on-chronic liver failure have unique clinical characteristics and further clinical observations are warranted.</p>
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Humans , Acute-On-Chronic Liver Failure , Mortality , Chronic Disease , Hepatic Encephalopathy , Splenomegaly , MortalityABSTRACT
Objective To study the effect of nuclear factor-kappa B (NF-κB) inhibition by small interference RNA (siRNA) on the apoptosis of DTC cells treated by 131 I.Methods DNA binding assay was performed at 24 h after 131I treatment (2 × 104 MBq/L) on KTC-1 cells.The cell survival assay was conducted at 48 h after 131 I treatment.Western blot was used to detect the changes of NF-κB p65 at 6 h after 131I treatment,and the changes of anti-apoptotic factors and apoptotic key factors at 24 h after 131 I treatment.The anti-apoptotic factors included in this study were X chromosome-linked inhibitor of apoptosis (XIAP),cellular inhibitor of apoptosis 1 (cIAP1) and B-cell lymphoma extra large (Bcl-xL),and the apoptotic key factors were caspase 3 and poly-ADP-ribose polymerase (PARP).A total of 4 groups were studied for the detection of p65 and anti-apoptotic factors by Western blot:no oligonucleotide transfection control group (A),no oligonucleotide transfection + 131I group (B),scrambled oligonucleotides transfection + 131I group (C) and p65 siRNA transfection + 131I group (D).Another 6 groups of studies were:oligonucleotide transfection control group (1),scrambled oligonucleotides transfection group (2),p65 siRNA transfection group (3),no oligonueleotide transfection + 131I group (4),scrambled oligonucleotides transfection +131I group (5) and p65 siRNA transfection + 131I group (6).One-way analysis of variance and q test were performed for statistical analysis.Results The results of DNA binding assays for the 6 groups (1,2,3,4,5,6) were (100.00 ± 11.65)％,(96.00 ± 17.98)％,(9.28 ±5.01)％,(322.72 ±50.81)％,(311.36 ±44.81)％ and (36.96 ± 15.66)％,respectively (F =137.74,P ＜0.01).NF-κB functions were strengthened with 131 I treatment (qgrouo 4∶1 =10.90,qroup 5∶2 =11.38,both P ＜ 0.01).However,NF-κB p65 siRNA transfection could inhibit NF-κB functions (qgroup1∶3 =18.25,qgroup4∶6 =13.71,both P ＜0.01).Cell survival rates of the 6 groups were (100.00 ± 11.65)％,(96.32 ± 9.44)％,(70.88 ±7.41)％,(64.16 ±9.50)％,(62.24 ±9.37)％ and (28.64 ±6.74)％ (F=52.76,P＜0.01).There were significant differences between groups 3 and 6,groups 4 and 6 (q =10.76 and 7.79,both P ＜ 0.01).Western blot results showed that the expression of NF-κB p65 in the 4 groups (A,B,C,D) were (56.60 ±7.37)％,(111.07 ± 13.31)％,(113.16± 15.04)％ and (12.46 ±2.74)％,respectively (F=60.17,P ＜ 0.01).The t65 levels increased with 131 I treatment (qgroup B∶A =6.20,qroup c∶ A =5.85,both P ＜0.01); while decreased significantly using NF-κB p65 siRNA transfection (qgroup B:D =-12.57; qgroupC∶D =11.41,both P ＜ 0.01).Western blot results showed that XIAP,cIAP1 and Bcl-xL in the 4 groups were (17.59±1.96)％,(16.45± 1.85)％ and (19.92 ±2.22)％; (98.37± 17.92)％,(109.81 ±19.16)％ and (95.59 ±22.20)％ ; (98.43 ±18.71)％,(98.86± 15.88)％ and (100.99 ±21.70)％ ;(7.00 ± 0.95) ％,(5.86 ± 0.35) ％ and (9.52 ± 0.90) ％,respectively (F =44.22,56.51 and 29.11,all P ＜ 0.01).131 I treatment induced higher expression of all the 3 genes (qgroup B∶ A =7.76,8.40 and 5.88,all P ＜0.01),while NF-κB p65 siRNA transfection,on the contrary,reduced the expression of all the 3 genes (qgroupB:D =8.82,9.40 and 6.71,all P ＜0.01).There were significant differences of p19,p17,p116 and p89 in the 6 groups(F =39.03,48.45,32.56,52.20,all P ＜ 0.01),especially among group 3,4 and 6 (q =3.18-9.98,all P ＜ 0.05).Conclusions 131I could activate NF-κB function and enhance the expressions of anti-apoptotic factors.NF-κB p65 siRNA transfection could effectively suppress this effect and therefore magnify 131I induced apoptosis in DTC cells.
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Objective: According to the medical system reform’s requirement of “strengthening supervision, increasing the public health investment, reforming the compensation mechanism of public hospital, establishing public hospital performance evaluation and incentive system”, public hospitals should continue to reform its management system optimization, performance appraisal is the core content of hospital internal reform performance appraisal method, which is an important guarantee for the results of hospital performance evaluation. Methods: The study on the assessment methods of hospital performance, use “public hospital”, “performance” and“performance evaluation” as the keywords to search the Chinese HowNet and Wanfang database retrieval and 142 articles; by reading the whole passage and the method of stratified sampling, the common performance appraisal method are used to collect and collate, eventually the assessment method of hospital performance of 32 Chinese literature references are included in the study. Results:Summarize the evaluation methods of hospital performance application condition advantages, disadvantages and present situation, and establish a set of performance evaluation methods with the management of public hospitals more perfect, scientific and detailed theoretical basis. Conclusion: In the process of the medical system reform, according to the characteristics of hospitals, to choose suitable and effective performance appraisal methods to help the performance management in hospital, and receive more economic benefits while maximize social benefits.