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Objective:To investigate the predictive value of early thyroid function changes on the efficacy of patients with Graves′ disease (GD) after 131I therapy. Methods:Data of patients with GD (59 males, 214 females; age (37.4±11.4) years) who underwent single therapy of 131I in Tianjin Medical University General Hospital from November 2017 to January 2019 were retrospectively analyzed. Symptoms, signs and laboratory tests (serum free triiodothyronine (FT 3) and serum free thyroxine (FT 4)) of patients were observed to assess the efficacy of 131I treatment. Efficacy was divided into complete remission (CR), partial remission (PR), non-remission (NR) or relapse. The changes of thyroid function (ΔFT 3=FT 3 before treatment-FT 3 after treatment)/FT 3 before treatment×100%; ΔFT 4=FT 4 before treatment-FT 4 after treatment)/FT 4 before treatment×100%) 1 month after 131I therapy in each efficacy group and differences among them were compared by using independent-sample t test, χ2 test, one-way analysis of variance and the least significant difference t test. ROC curves were drawn to analyze the predictive values of early thyroid function changes on the efficacy of 131I treatment for GD. Logistic regression analyses were performed to identify the influencing factors for the efficacy of 131I therapy. Results:CR rate and total effective rate of 273 GD patients after single therapy of 131I were 67.03%(183/273) and 92.67%(253/273), respectively. After 1 month, CR rate of euthyroidism group ( n=95) was significantly higher than that of hyperthyroidism group ( n=178; 81.05%(77/95) vs 59.55%(106/178); χ2=4.60, P=0.032). ΔFT 3 and ΔFT 4 at the first month were statistically significant and decreased sequentially in the CR group ( n=183), PR group ( n=70), NR or relapse groups ( n=20; F values: 15.40, 12.54, both P<0.001). ROC curve analysis showed that patients with ΔFT 3≥73.64% and (or) ΔFT 4≥59.03% had a higher probability of achieving CR, with sensitivities of 84.3% and 86.7%, and specificities of 62.6% and 62.6%, respectively. Logistic regression analysis showed that 24 h radioactive iodine uptake (odds ratio ( OR)=1.095, 95% CI: 1.031-1.139), dose of 131I given per gram of thyroid tissue ( OR=1.562, 95% CI: 1.321-1.694), ΔFT 3 ( OR=1.354, 95% CI: 1.295-1.482), ΔFT 4 ( OR=1.498, 95% CI: 1.384-1.608) were factors affecting the outcome of patients with GD treated with 131I treatment (all P<0.05). Conclusion:Effects of 131I treatment can be predicted based on the change of the thyroid function at the first month after 131I treatment in patients with GD.
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In the past few decades, some studies reported that changing the specific surface properties of titanium implants, such as surface morphology, surface chemistry, surface charge and wettability, improved the bone bonding ability of titanium implants. Based on the existing evidence, this review paper analyzes the methods and characteristics of surface chemical modification of the superhydrophilic implants (Thommen INICELL?) that were listed in China in recent years, and clarifies the process of early osseointegration from the viewpoint of histomorphology, and evaluates its clinical application effects.
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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 correlation between 131I uptake and therapeutic efficacy in metastatic differentiated thyroid carcinoma (DTC). Methods:The clinical data of 138 patients with metastatic DTC (42 males, 96 females, age range: 8-74 years) treated with 131I in nuclear medicine departments of 31 centers all over China were retrospectively analyzed. The lesional 131I uptake was quantitatively analyzed with target-to-nontarget (T/NT) ratio through the regions of interest in metastatic lesions confirmed by either planar or tomographic 131I SPECT/CT imaging. The efficacies of 131I treatment on the metastatic DTC were divided into complete remission (CR), partial remission (PR), stable disease (SD) and progress disease (PD) based on the change of the lesion diameter before and after the treatment. Factors which may affect therapeutic efficacy were assessed by the univariate (Kruskal-Wallis rank sum test, χ2 test and one-way analysis of variance) and binary logistic regression analyses. The receiver operating characteristic (ROC) curve of lesional T/NT ratio to predict the ineffectiveness of 131I therapy was performed. Results:A total of 1 165 efficacies were evaluated. The planar imaging results ( n=653) showed that there was no statistically significant difference of T/NT ratio among CR, PR, SD and PD groups ( χ2=4.15, P>0.05). The tomographic imaging results ( n=512) suggested CR, PR, SD and PD in 7.6%(39/512), 65.8%(337/512), 22.9%(117/512), and 3.7%(19/512) of individuals, respectively, and the T/NT ratio among the four groups was significantly different ( χ2=30.46, P<0.01). The univariate analysis also showed that age, stimulated thyroglobulin(sTg), 131I dose were the factors affecting therapeutic efficacy ( F or χ2 values: 2.561, 7.095 and 8.799, all P<0.05). Furthermore, binary logistic regression analysis revealed that older patients (odds ratio ( OR)=1.034, P=0.022) or patients with lower lesional T/NT ( OR=1.086, P=0.006) had a higher probability of ineffectiveness. The area under ROC curve for T/NT ratio to predict ineffectiveness was 0.726, and the cut-off value was 6.2, with a sensitivity of 78.7%(107/136) and a specificity of 73.1%(275/376). Conclusions:131I therapy is an effective treatment for metastatic DTC. The age at the time of metastatic diagnosis and the lesional T/NT ratio are independent influential factors for ineffectiveness of 131I therapy. When the leisonal T/NT ratio is lower than 6.2, the inefficiency of 131I is higher.
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Objective:To analyze the trends and influencing factors of residual radioactivity in patients with differentiated thyroid carcinoma (DTC) after 131I therapy. Methods:A total of 132 DTC patients (34 males, 98 females; age (42.8±12.8) years) who received 131I therapy from November 2018 to February 2019 in Tianjin Medical University General Hospital were prospectively analyzed. Patients were divided into first treatment (FT) group ( n=88) and repeat treatment (RT; with 131I treatment≥2 times) group ( n=44). In FT group, there were 30 patients received 131I for remnant ablation, 33 patients for adjuvant therapy and 25 patients for therapy. In RT group, there were 18 patients received 131I for remnant ablation and 26 patients for therapy. 131I dosage: 3.70 GBq for remnant ablation therapy, 3.70-5.55 GBq for adjuvant therapy, 5.55-7.40 GBq for therapy. The residual body radioactivity of patients was monitored at 24, 48 and 72 h after the administration of 131I by dynamic radiation whole-body scanner and compared among groups. All clinical data were reviewed to explore the factors associated with the residual radioactivity. Independent-sample t test, χ2 test and logistic regression analysis were used to analyze the data. Results:At 24 h after 131I therapy, the residual radioactivity of patients in FT group were significantly lower than those in RT group ((880.60±396.64) vs (1 022.31±503.94) MBq; t=-2.765, P=0.035). In FT group, the residual radioactivity of patients with 131I adjuvant therapy+ therapy at 24 and 48 h after 131I administration were higher than those with 131I ablation (24 h: (987.16±447.33) vs (766.27±277.87) MBq, 48 h: (233.47±146.52) vs (183.52±90.65) MBq; t values: -2.711 and -2.021, both P<0.05). In RT group, the residual radioactivity of patients with 131I therapy at 24, 48 and 72 h after 131I administration were (1 246.90±531.69), (244.57±131.35) and (90.65±67.37) MBq respectively, which were higher than those with 131I ablation ((715.50±300.07), (149.85±68.82) and (58.46±31.45) MBq; t values: from -3.822 to -2.682, all P<0.05). There were 17.4%(23/132; 10 patients in FT group, 13 patients in RT group) patients with residual radioactivity >400 MBq at 48 h after 131I treatment, and 100% (132/132) patients with residual radioactivity <400 MBq at 72 h after 131I treatment. T staging, N staging, stimulated thyroglobulin level, and 131I dosage were significant factors affecting the residual radioactivity of patients ( t values: from -2.562 to 4.211, χ2 values: 3.988-8.332, all P<0.05), and T staging and 131I dosage were independent factors ( Walds values: 4.253-14.035, all P<0.05). Conclusions:The residual radioactivity of patients at 24 h after 131I treatments is higher than 400 MBq and hospital isolation time should be appropriately controlled. At 72 h after 131I treatment, the residual radioactivity of patients meets the national standard of discharging hospital. The residual radioactivity of patients with more advanced T staging and 131I dosage (>5.55 GBq) may not reach the standard at 48 h after 131I therapy, and the isolation time should be extended to 72 h.
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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 compare the ablation efficacy and therapy response with 1.1 GBq and 3.7 GBq 131I in postoperative patients with low- and intermediate-risk differentiated thyroid carcinoma(DTC).@*Methods@#A total of 190 patients (43 males, 147 females, age: (45.8±11.1)years) were enrolled from July 2016 to July 2017. Among them, 96 patients received 1.1 GBq 131I and 94 were given 3.7 GBq 131I. Diagnostic whole-body scan was performed 6 months after 131I ablation for treatment response evaluation, and the successful rate of 131I ablation was calculated. χ2 test or Fisher′s exact test was used for data analysis. The cut-off value of 99Tcm-pertechnetate uptake for predicting the successful rate of remnant thyroid ablation in 1.1 GBq group was determined by receiver operating characteristic (ROC) curve analysis.@*Results@#The successful ablation rates in 1.1 GBq and 3.7 GBq groups were 79.2%(76/96) and 81.9%(77/94), respectively (χ2=0.229, P>0.05). There was no significant difference in the therapy response between the two groups (χ2=1.371, P>0.05). The successful ablation rate in 3.7 GBq group was higher than that in 1.1 GBq group for patients with stage Ⅲ (5/6 vs 1/7, P=0.029). Moreover, for patients with 5 μg/L<preablative-stimulated thyroglobulin (ps-Tg)≤10 μg/L, the ablation rate in 1.1 GBq group was lower than that in 3.7 GBq group (3/11 vs 10/13, P=0.038). ROC curve analysis showed the cut-off value of 99Tcm-pertechnetate uptake for prediction of the successful ablation rate in 1.1 GBq group was 0.061 5.@*Conclusion@#The low- and intermediate-risk DTC patients with stage Ⅲ disease, 5 μg/L<ps-Tg≤10 μg/L or higher 99Tcm-pertechnetate uptake of remnant thyroid should be given 3.7 GBq other than 1.1 GBq 131I to obtain a better ablation efficacy.
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Objective To investigate the influence of different time discontinuation of compound iodine solution on 131Ⅰ uptake and curative effect of 131Ⅰ therapy in patients with Graves disease (GD).Methods A total of 1 585 patients (415 males,1 170 females;age range:17-62 years) treated with 131Ⅰ therapy for the first time between January 2012 and November 2016 were enrolled in this retrospective study.All patients were divided into preliminary treatment group (n =85) and control group (no iodine solution taking,n =1 500).Preliminary treatment group including 4-7 d discontinuation subgroup (group A,n=35),8-14 d discontinuation subgroup (group B,n=28) and 15-30 d discontinuation subgroup (group C,n=22).The high-est radioactive iodine uptake (RAIU),effective half-life,free triiodothyronine (FT3) and free thyroxine (FT4) levels before 131Ⅰ therapy were compared,and curative effects were evaluated.One-way analysis of variance,Ridit analysis and x2 test were used to analyze the data.Results The highest RAIU in group A,group B,group C and control group was (64.86 ± 13.20) ％,(67.40 ± 9.10) ％,(73.46 ± 4.65) ％ and (74.14±9.87) ％,respectively (F =1.658,P＞ 0.05).No significant difference was found in the effective half-life among 4 groups (F=0.651,P＞0.05).FT3 level in group A and group B ((11.90±4.85) and (15.51±2.95) pmol/L) was significantly lower than that in control group ((23.98±4.98) pmoL/L) and group C ((22.08±2.31) pmol/L;F=13.972,t values:6.57-12.08,all P＜0.05).FT4 level in group A and group B ((25.65±11.95) and (32.33±6.25) pmol/L) was obviously lower than that in control group ((73.65±21.55) pmol/L) and group C ((68.41±13.94) pmo]/L;F=21.238,t values:36.09-48.00,all P＜0.01).The overall curative effect of preliminary treatment group and that of control group were not statistically significant (u=0.397,P＞0.05),and no significant difference was found in the complete remission rates among 4 groups (x2 =1.169,P＞0.05).Conclusions If pretreatment with compound iodine solution is used before 131Ⅰ therapy in GD,it is feasible to carry out 131Ⅰ therapy within 2 weeks after withdrawal.In order to avoid the possibility of severe hyperthyroidism after 131Ⅰ therapy,it is recommended that radioiodine treatment should be carried out after discontinuation for 4-7 d.
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Objective To compare the ablation efficacy and therapy response with 1. 1 GBq and 3. 7 GBq 131I in postoperative patients with low- and intermediate-risk differentiated thyroid carcinoma (DTC). Methods A total of 190 patients (43 males, 147 females, age:(45.8±11.1)years) were enrolled from July 2016 to July 2017. Among them, 96 patients received 1.1 GBq 131I and 94 were given 3.7 GBq 131I. Diagnostic whole-body scan was performed 6 months after 131 I ablation for treatment response evaluation, and the successful rate of 131I ablation was calculated. χ2 test or Fisher's exact test was used for data analysis. The cut-off value of 99 Tcm-pertechnetate uptake for predicting the successful rate of remnant thyroid ablation in 1.1 GBq group was determined by receiver operating characteristic ( ROC) curve analysis. Results The successful ablation rates in 1.1 GBq and 3.7 GBq groups were 79.2％(76/96) and 81.9％(77/94), respec-tively (χ2=0.229, P>0.05). There was no significant difference in the therapy response between the two groups (χ2=1.371, P>0.05) . The successful ablation rate in 3.7 GBq group was higher than that in 1.1 GBq group for patients with stageⅢ(5/6 vs 1/7, P=0.029). Moreover, for patients with 5μg/L<preablative-stimula-ted thyroglobulin (ps-Tg)≤10μg/L, the ablation rate in 1.1 GBq group was lower than that in 3. 7 GBq group ( 3/11 vs 10/13, P=0.038) . ROC curve analysis showed the cut-off value of 99 Tcm-pertechnetate uptake for prediction of the successful ablation rate in 1.1 GBq group was 0. 0615. Conclusion The low- and inter-mediate-risk DTC patients with stageⅢdisease, 5μg/L<ps-Tg≤10μg/L or higher 99 Tcm-pertechnetate up-take of remnant thyroid should be given 3.7 GBq other than 1.1 GBq 131I to obtain a better ablation efficacy.
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Objective@#To compare the clinical outcomes of posterior maxillary implant surgery when using the regular transalveolar approach or with the crestal approach-sinus (CAS-KIT), a device for maxillary sinus membrane elevation by the crestal approach using a special drilling system and hydraulic pressure.@*Methods@#In this retrospective study 887 patients during Jan 2012 to July 2015 in Hangzhou Dental Hospital with underwent either regular transalveolar approach or CAS-KIT approach for maxillary augmentation; whereas 11 patients dropped out for the reason of serious membrane perforations. Totally, 876 patients with 1 204 plants, placed immediately after transalveolar maxillary augmentation, were included in this study. The data analysis was performed by radiological measures to assess the changes in height of maxillary sinus floor after the transalveolar augmentation at different time points. In addition, the complications after surgery, failure rates, osseointegration condition and the performance of rehabilitation were evaluated as well.@*Results@#Five hundred and three patients were experienced with regular transalveolar approach, and 7 patients were drop out for the serious membrane perforations. Thus, 496 patients received 653 implants in this group; the average lifted range in maxillary sinus floor height changes was (4.08±3.45) mm. The complications were minor membrane perforations during procedure in 64 patients, postoperative maxillary sinus infection happening in 2 patients and 13 patients experienced rehabilitation failure. Three hundred and eighty-four patients had CAS-KIT approach with 4 patients dropped out. Three hundred and eighty patients get 551 implants with the mean lifted range of (8.36±4.07) mm in maxillary sinus floor height changes. Minor membrane perforations during procedure occurred in 31 people and 2 got postoperative maxillary sinus infection. The 4 year overall survival rate of 1 204 implants was 97.26%, with four implants fell off after 3 months of rehabilitation and one implant occurred after one year of rehabilitation.@*Conclusions@#The regular transalveolar sinus lift technique is easier and time saving, but the compromised lifting range in maxillary sinus floor height and the comparatively high occurrence of intraoperative membrane perforations should be concerned. Using CAS-KIT could be an alternative method to perform maxillary sinus augmentation with a reduced incidence of complications. There was no statistically difference in implant failure rates and incidence of postoperative maxillary sinus infection between two groups.
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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 radioactivity distribution of 131 I-bovine serum albumin ( BSA )-mesoporous silica nanoparticles ( MSNs )-anti-vascular endothelial growth factor receptor 2 (VEGFR2) in anaplastic thyroid carcinoma (ATC) and to explore its antitumor efficacy in ATC-bearing nude mouse models. Methods 131 I-BSA-MSNs-anti-VEGFR2 and 131 I-BSA-MSNs were constructed. FRO tumor xenografts were established and the SPECT/CT images of tumor-bearing mice were acquired at differ-ent time points after intratumoral injection with 131 I-BSA-MSNs-anti-VEGFR2 ( targeting group) , 131 I-BSA-MSNs ( non-targeting group) , Na131 I ( Na131 I group) and saline ( control group) , respectively. The changes of body mass and tumor volume in each group were recorded. Two-sample t test and log-rank test were used to analyze the data. Results After incubation for 3 h, the fluorescence intensity in targeting group was higher than that in non-targeting group (345.26±16.35 vs 280.61±9.65;t=5.90, P<0.05). After injection for 1-3 weeks, the radioactivity detected by SPECT/CT in targeting group was obviously stronger than that in non-targeting group ( t values:7.060-12.780, all P<0.05) . At the end of the observation, the tumor vol-ume of Na131I group, control group, non-targeting group and targeting group increased to (278.3±19.3)％, (296.6±24.2)％, (198.7±13.2)％ and (103.7±6.2)％ of the original volume, respectively. The body mass of the first 2 groups decreased to (88.6±3.0)％ and (86.2±3.1)％ of the original body mass respec-tively, while that of the latter 2 groups increased to (102.1±3.1)％ and (116.2±3.4)％ of the original body mass respectively. Survival analysis showed that the median survival time in targeting group ( 38 d) was sig-nificantly longer than that in non-targeting group (34 d;χ2=8.05, P<0.05). Conclusion 131I-BSA-MSNs-anti-VEGFR2 can effectively inhibit the tumor growth of ATC and prolong the survival of tumor-bearing nude mice, which gives a good suggestion for the treatment and prognosis evaluation of ATC.
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BACKGROUND:Hard palate mucosa serves as a main donor material in periodontal plastic surgery and its thickness is crucial for the surgical outcomes. OBJECTIVE: To analyze the thickness of hard palate mucosa in Han population, and analyze the consistency between cone-beam CT image analysis and trans-gingival probing method. METHODS: A total of 30 Han volunteers (300 teeth) were recruited, and the thickness of hard palate mucosa was measured using cone-beam CT image analysis or trans-gingival probing method, to analyze their consistency. RESULTS AND CONCLUSION: The two methods showed a higher consistency in the thickness of hard palate mucosa at the cuspid, first and second premolars as well as first and second molars. The thickness of the hard palate mucosa related to the distance from the gingival margin and tooth position, the thickness from the canine region to the second premolar region thickening gradually, and became the thickest at the second molar, and the thinnest at the cuspid. This study for the first time analyzed the thickness of hard palate mucosa in Chinese Han population, and confirmed there is a high consistency between cone-beam CT image analysis and trans-gingival probing method.
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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 Liver dysfunction is a common complication of hyperthyroidism [ mainly Graves’ disease(GD)], that may restrict the choice as well as affect the ultimate outcome of treatment. The purpose of this study was to describe the clinical and biochemical patterns in patients suffering from Graves’ disease and liver dysfunction and to determine influential factors. Methods A total of 1 928 patients received radioactive iodine, 131 I treatment. Before 131 I therapy, 24 h radioactive iodine uptake of thyroid(24 h RAIU), serum free triiodothyronine (FT3 ), free thyroxine( FT4 ), sensitive thyroid-stimulating hormone( sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroglobulin antibody(TgAb), anti-thyroid peroxidase antibody(TPOAb), and serum hepatic function parameters etc were performed. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ2 test, logistic regression, and Pearson bivariate correlation. Results Ages, the course of Graves’ disease, the weight of thyroid, FT4 , TPOAb, and TRAb in Graves’ disease patients complicated with liver dysfunction were higher than those in patients with normal hepatic function, as shown in table 1. The influential factors including age, course of Graves’ disease, heart rate, weight of thyroid, FT4, 24 h RAIU, TgAb, TPOAb, and TRAb. 24 h RAIU were the protecting factors. Age, course of Graves’ disease, heart rate, weight of thyroid, FT4 , TRAb, and TPOAb were the risk factors. Conclusion The risk of liver dysfunction in patients with Graves’ disease was increased in the following cases: age over 45 years, heart rate above 90 bpm, weight of thyroid more than 35 g, course of Graves’ disease longer than 3 years, FT4 greater than 70. 5 pmol/ L, TPOAb above 360 IU/ ml, and TRAb above 15 IU/ L. In these coses 131 I therapy will be recommended.
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Objective To identify clinical features of papillary thyroid microcarcinoma(PTMC) according to patients' age.Methods Seventy-eight patients with PTMC were divided into 2 groups according to age:≥45 years and ＜45 years.The clinical data were retrospectively analyzed.Results The average preoperative thyroglobulin (Tg)level in ＜45 years group was apparently higher than that in ≥45 years group[(138.61 ± 91.87 vs 80.20 ± 85.00) μg/L,P＜0.01].The average tumor size in ＜45 years group was apparently larger than that in ≥45 years group [(0.64 ± 0.24 vs 0.45 ± 0.25) cm,P＜0.01].There were more patients with multiple cancer foci in ＜45 years group than in ≥45 years group (73.53％ vs 45.45％,P＜0.05).And there were more patients with cancer in bilateral lobes in ＜45 years group than that in ≥45 years group(44.12％ vs 18.18％,P＜0.05).There were no significant differences in preoperative thyroid stimulating hormone level,preoperative thyroglobulin antibody (TgAb)level,incidence of capsular invasion of cancer,neck lymph nodes involvement,distant metastasis,and backgrounds of benign thyroid diseases between two groups (all P＞0.05).Conclusion The patients with PTMCs had different clinical features according to age.Hence,clinicians should consider an individualized treatment according to age in order to achieve better therapeutic efficacy.
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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.