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Objective To evaluate the relationship between thyroid nodules combined with Hashimoto's thyroiditis(HT) and the risk of thyroid cancer.Methods This retrospective study included 1212 patients undergoing thyroidectomy in the Second Hospital of Tianjin Medical University from Jan.2010 to Jul.2017.The incidence of thyroid cancer in those thyroid nodules with and without HT based on the postoperative pathological results was compared.Results Among 843 patients of thyroid benign nodules,15.3％ cases were complicated with HT.Of all the patients with malignant tumors,365 cases were PTC,accounting for 96.5％ of all malignant tumors,and among whom,10.8％ were complicated with HT.Of the 169 cases of thyroid nodules combined with HT,23.7％ patients had PTC.For patients with thyroid nodules without HT,30.3％ had PTC.The difference had no statistical significance (x2=3.08,P＞0.05).Conclusion Thyroid nodules complicated with HT doesn't increase the incidence of thyroid cancer.
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Objective To evaluate the clinical efficacy and prognostic factors of limited-stage small cell lung cancer ( LS-SCLC) treated with 125 I radioactive seed implantation guided by CT combined with systemic chemotherapy. Methods A total of 128 limited-stage small cell lung cancer patients were treated with 125 I radioactive seed implantation combined with chemotherapy from Jun 2008 to Jun 2012 in Tianjin Medical University Second Hospital. Theχ2 test was used to analyze the influencing factors of short-term efficacy. Survival rate was calculated by Kaplan-Meier method, single factor analysis was performed by Log-rank, and multivariate analysis was performed by Cox proportional hazard model. Results Totally 128 patients finished the treatment. The overall response rate was 86.7％ ( 111/128 ) after 6 months of treatment. The 1-, 2-and 3-year overall survival rate was 77.9％, 39.8％and 28.0％, respectively, and the median survival time was 21.0 months. The univariate analysis showed that the following factors were main prognostic factors:age, performance status ( PS) , hemoglobin≥120 g/L before treatment, smoking index, the maximum diameter of tumor, neuron-specific enolase before treatment, subscribe for prophylactic cranial irradiation ( PCI) , number of chemotherapy cycle, chemotherapy response, prescribed dose ( PD ) , postoperation dose covering 100％ volume ( D100 ) , remedial model. multivariate analysis revealed that age, PS, hemoglobin≥120 g/L before treatment and PD, the maximum diameter of tumor, number of chemotherapy cycle, chemotherapy response, and remedial model were the independent prognostic factors for survival. 29 patients of 128 suffered from aerothorax and the incidence rate of aerothorax was 27.7％. Totally 16 patients occurred hemoptysis and theincidence rate was 12.5％. Conclusions 125 I radioactive seed implantation therapy showed good effecacy in the treatment of LS-SCLC. Age, PS, hemoglobin≥120 g/L before treatment, the maximum diameter of tumor, number of chemotherapy cycle, chemotherapy response, and remedial model might be the main prognostic factors for LS-SCLC patients.
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Background It is determined that the patients with thyroid-associated ophthalmopathy (TAO) often occur dry-eye related symptoms due to increasing tear evaporation caused by exophthalmos.However,more than half of thyroid dysfunction patients without TAO appear ocular surface inflammation.It is very important for us to understand the association of thyroid dysfunction patients without TAO with ocular damage.Objective This study was to observe the ocular surface changes in thyroid dysfunction patients without TAO.Methods A prospective cohort study was performed.Thirty-one patients who were initially diagnosed as thyroid dysfunction without TAO were included in the Second Hospital of Tianjin Medical University from January 2015 to May 2016 as the thyroid dysfunction group,and 16 helthy subjects were simutenniously selected as the control group under the informed consent of all the individuals.The peripheral blood was collected to detect the thyroid function-related indexes.Then the patients with thyroid dysfunction were divided into thyroid stimulating hormone (TSH) reduced group (18 patients) versus TSH elevated group (13 patients) and thyrotrophin receptor antibody (TRAb)+ group (20 patients) versus TRAb-group (11 patients).Exophthalmos degree,Schirmer I test (S I t),tear film break-up time (BUT),fluorescent integral,ocular surface disease index (OSDI) and corneal inflammation index were examined and intergrouply compared.The correlations of thyroid function indexes with ocular surface examination results were analyzed.Results There were no significant differences in exophthalmos degree and S I t values between thyroid dysfunction group and control group (t =0.037,P =0.971;t =0.815,P =0.419).The BUT values were (7.74 ± 1.45) seconds and (10.56± 1.40) seconds,fluorescent integral scores were 5.00 (1.50) and 2.50 (2.38),OSDI scores were 45.58 ± 9.23 and 19.47 ± 6.25,and corneal inflammation index scores were 0.11 (0.22) and 0.00 (0.06) in the thyroid dysfunction group and the control group,respectively,showing significant differences between the two groups (all at P＜0.01).There were not significant differences in exophthalmos degree,S I t,BUT and corneal inflammation index scores between the TSH elevated group and TSH reduced group (t =0.473,P =0.640;t =0.650,P=0.521;t=1.634,P=0.l13;Z=0.270,P=0.787).The fluorescent integral scores were 4.00 (2.00) and 5.00 (1.00),and OSDI scores were 40.08±9.91 and 47.11±9.75 in the TSH elevated group and TSH reduced group,repectively,with statistically significant differences between these two groups (all at P＜0.01).The exophthalmos degrees,S I t,BUT and corneal inflammation index scores were not considerably different between TRAb-group and TRAb+ group (all at P＞0.05);and significant differences were seen in fluorescent integral scores (4.00[1.50] vs.5.50 [1.50]) and OSDI scores ([39.18±6.25] vs.[46.78±8.76]).Corneal inflammation index scores were positive correlated with serum TSH (R2 =0.520,P =0.000),and fluorescent integral scores,OSDI scores and corneal inflammation index scores were positive correlated with serum TRAb (R2 =0.587,P =0.000;R2 =0.329,P =0.024;R2 =0.400,P=0.005).Conclusions Thyroid dysfunction patients without TAO have ocular surface dysfunction,which probably is associated with abnormal serum TSH and TRAb.
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Background and purpose:Although FDG tumor imaging has been applied in clinic widely, dual-phase imaging can provide much more information about the FDG uptaking of pulmonary lesions. The purpose of the study was to evaluate the usefulness of dual-phase18F-FDG coincidence detection SPECT/CT imaging in the differential diagnosis of the pulmonary lesions.Methods:There were 28 patients with pulmonary lesions which were detected by CT. All the patients undertook the SPECT/CT imaging at 2 time-phases respectively: early imaging at 40-60 min and delayed imaging at 2-3 h after the intravenous injection of FDG. Data processing: calculating the radio of T and N in early and delayed imaging respectively; T: The radioactive count of the lesions; N: The radioactive count of the normal tissue; and the change rate:ΔT/N. ROC was used to ifnd out the threshold of T1/N1, T2/N2及ΔT/N in the differential diagnosis between benign and malignant lesions. AUC was used to evaluate the diagnosis value of the dual-phase and single-phase imaging.Results:The threshold of T1/N1 in early imaging was 2.65, whereas AUC was 0.767. The sensitivity, speciifcity and accuracy were 83.3%, 30% and 64.3%, respectively. The threshold of T2/N2 in delayed imaging was 3.14, whereas AUC was 0.847. The sensitivity, speciifcity and accuracy were 94.4%, 60.0% and 82.1%, respectively. The threshold ofΔT/N in delayed imaging was 16.9%, whereas AUC is 0.950. The sensitivity, speciifcity and accuracy were 88.5%, 71.4% and 86.2%, respectively.Conclusion:Dual-phase18F-FDG coincidence detection SPECT/CT imaging has much higher accuracy and speciifcity. However it still has false positivity, and should be analyzed with CT and clinical history.
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Objective To explore the clinical value of the thin-section CT scanning in all the steps of non-small cell lung cancer (NSCLC) therapy through 125I seed implantation. Methods In the 137 patients who were diagnosed with non-small cell cancer (NSCLC), the preoperative targets were delineated by CT scan, and the implantation plan was accom-plished according to treatment planning system (TPS); Intraoperative 125I seeds were implanted under the guidance of CT, then their positions were confirmed and corrected by CT scan layer-by-layer in real time;Post implantation dosimetry was validated also under the help of CT scan. If necessary, distribution and number of seeds should be adjusted to conform dose distribution under the principle of effectivity and micro-invasion;Follow-up and periodic evaluation should also be accom-plished by CT scan. Results Dose-volume histograms (DVHs) showed that the dose in line with the targets meet the re-quirement of prescription dose while the surrounding organs at risk were within the scope of their tolerance dose. Among 137 patients, implanted seeds number was the same with seeds number of TPS plan in 129 patients, and the coincidence rate was 94%. CT scan showed the local control efficient rate was 91.9%after 6 months. The 1-year and 2-year survival rates were 91.2%and 50.4%respectively. No serious operation-led complication was found during treatment. Conclusion The thin-section CT could be applied in all key steps of 125I seed implantation in NSCLC therapy, especially it is clinical significant and irreplaceable in quality assurance and control of seed implantation therapy.
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Objective:To improve the therapeutic gain ratio from 125I seed implants by investigating the QA/QC strategies used in brachytherapy treatment of lung cancer. Methods:A total of 287 lung cancer and pulmonary metastases cases were studied. Among which, 184 are male and 103 are female with a mean age of 61.9 years. The NOA-NSCLC subgroup and pulmonary metastases were targeted on conventional CT positioning. Considering that COA-NSCL subgroup on the tumor target area is difficult to determine with CT, the coincidence circuit SPECT was used to assist in positioning. A dose-volume histogram was constructed to evaluate the quality of the TPS and optimization. Corrections on real-time positioning are necessary when using an image-guided implantation. The C-LC should be aligned with the FFB for CT-guided percutaneous puncture implantation. After implantation, dosimetry verification was con-ducted. Results:The NOA-NSCLC subgroup, comprising the risk organs such as heart, lung, and spinal column, received an average dose of 137, which was significantly lower than that of normal tissue dose tolerance. The NOA-NSCLC subgroup and lung metastases have matched peripheral dosages of 92.1 and 106.2 Gy with local-control efficiency rates of 91.97% (126/137) and 96.0% (48/50), 1-year survival rates of 91.24%and 83.4%(42/50), and 2-year survival rates of 50.36%(69/137) and 52.3%(26/50), respectively. The 35 COA-NSCL subgroup and 65 lung cancer group have local control efficiency rates of 91.43%(32/35) and 92.3%(60/65) and 1-year survival rates of 88.57%(31/35) and 80.30%(53/66), respectively. Conclusion:Proper radiation dosimetry as a QA/QC strategy was found to improve particle-implantation therapy gain and greatly reduce the risks of radiation pneumonia and pulmonary fibrosis.
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Objective To observe the characteristic changes in cardiac function and to raise diagnostic accuracy and sensibility.Methods 39 silent myocardial ischemia and 58 angina and 46 age-matched healthy subjects and 62 obsolete myocardial infarction underwent myocardial tomography imaging and gated ventricular imaging.Covariance analysis was used to compare difference between SPECT imaging and parameters of function.The age was tested as covariate factor,then SNK-Q test and multiple comparison were carried on.Results The silent myocardial ischemia and angina showed reversible radioactive defect or fixed defect.Most of myocardial SMI showed single peak exempt TPFR.EF,PFR and PER showed remarkably statistical difference (P<0.01).The multiple comparison of PFR and PER was increased according by OMI,AN,SMI and negative control group (P<0.05).Conclusions The myocardial damage and PFR,PER in SMI is lower than that in AN group,which have no remarkably influence on the parameters of diastolic and retractile function in left ventricular.
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Objective To evaluate the early detection of diabetic cystopathy(DCP)with the technology of noninvasive urodynamics.Methods 70 patients with type 2 diabetes mellitus(DM)and 30 normal control subjects were checked with the technology of noninvasive urodynamics.Based on their disease course of less or mole than 5 years.the DM patients were divided into two groups.Maximal flow rate,average flow rate,the volume leading to first bladder sensation and residual urine volume were measured by using noninvasive urodynamic technology.Results Among the 70 DM patients,34 were detected to have bladder residual urine,so the DCP detection rate was 48.6%.In the patients with DCP,the average residual urine volume Was 7-139 ml(30.1±27.1)ml,while there was no residual urine in the normal control group.As compared with the normal control group,maximal flow rate and average flow rate were decreased in all the patients with DM and those with DCP(P＜0.01).After follow up of the disease,the patients with a course of more than five years of disease control had even lower maximal flow rate and average flow rate.Conclusion Maximal flow rate decrease and bladder residual urine detected with the technology of noninvasive urodynamics may be widely used in early detection and early diagnosis of DCP.
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After treatment for 3 months in the patients with impaired glucose tolerance (IGT), plasma glucose, insulin and homeostasis model assessment for insulin resistance (HOMA-IR) were decreased both in rosiglitazone therapy group and in the group treated with rosiglitazone combined with body weight control.Those parameters in the latter group were decreased more significantly than those in the former.Rosiglitazone ameliorates the insulin resistance in patients with IGT, which is further improved when combined with body weight control.
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Objective To evaluate the clinical diagnosis value of 99mTc-single photon emission computed tomography(SPECT)brain blood perfusion imaging in intractable paroxysmal epilepsy and analyse the imaging character.Methods Two hundred and thirty-eight intractable paroxysmal epilepsy patients performed99mTc-SPECT,MRI,CT,and electroencephalogram(EEG).The results of examinations were ana lyzed and compared.Results The positive rate of epileptic focus in brain SPECT blood perfusion imaging in the generalized tonic-clonic seizure,absence seizure,partial seizure and complex partial seizure were 85.7%,95.7%,89.8%and 90.9%,the positive rate were much higher than those in other methods(P＜0.01).The 23 patients with SPECT focus were carried on a-γ-knife treatment with follow-up for more than one year,and the efficient rate was 78.26%.Conclusions The detection sentivity of SPECT is distinctively higher than that in others.SPECT has an important clinical value to define target region of the stereotaxic radio surgery.
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ObjectiveTo analyze therapeutic efficiency of 125 iodine brachytherapy seeds implantation guided by flexible fiber-optic bronchoscopy(FFB)image in terminal central non-small cell lung carcinoma (NSCLC).MethodsUnder therapy planning system (TPS) and guided by flexible fiber-optic bronchoscopy image,125 iodine seeds were implanted in 66 Confirmed terrainal cases with NSCLC and its posology Was validated and rechecked regularly.Remlts Complete remission (CR) was observed in 15 cases and partial remission (PR) in 36 cases during the first-year follow-up,with an overall efficiency rate (CR+PR) of 77.3 percent and one-year survival of 80.3 percent.Complete remission (CR) was observed in seven cases,partial remission (PR) in 22 cases,stable condition (SC) in three cases.and no progression was found during the second-year follow-up,respectively,with an overall efficiency rate (CR+PR) of 90.6 percent and two-year survival of 43.8 percent No radioactive damage were observed in the early and late stages of therapy.ConclusionsTherapy with radioactive 125 iodine seeds implantation guided by flexible fiber-optic bronchoscopy image could relieve airway obstruction effectively in terminal lung cancer and control progression of bronchiogenic carcinoma.
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Objective To detect the changes of renal hemodynamics, radionuclide renal dynamic imagings were performed in patients with type 2 diabetes millitus (DM) in different stage. Methods Fifty seven patients with type 2 DM were divided into 3 groups according to the value of urinary albumin excretion rate (UAER). (1)GroupDM1:UAER200 ?g/min, 20 cases. 99m Tc DTPA and 99m Tc EC renal dynamic imagings were performed in the type 2 DM patients of 3 groups and 20 normal controls (NC). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and renogramweregainedsimultaneously.Results GFR and ERPF were significantly increased in group DM1 than those in NC (P