Postoperative stimulated thyroglobulin level and recurrence risk stratification in differentiated thyroid cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Postoperative preablative stimulated thyroglobulin (ps-Tg) has been evaluated in predicting prognosis and success of ablation regarding differentiated thyroid cancer (DTC); however, its relationship with recurrence risk and radioiodine decision-making remains uncertain, especially in Chinese DTC patients. We aimed to evaluate the association between ps-Tg and recurrence risk stratification in DTC, to provide incremental values for ps-Tg in postoperative assessment and radioiodine management.</p><p><b>METHODS</b>Seven hundred and seven patients with DTC were included; low-risk (L; n = 90), intermediate-risk (I; n = 283), and high-risk (H; n = 334, 117 with distant metastasis [M1]) patients were divided according to recurrence risk stratification. The M1 group was further analyzed regarding evidence of metastasis. Cut-off values of ps-Tg were obtained using receiver operating characteristic analysis.</p><p><b>RESULTS</b>Patients with more advanced disease at initial risk stratification were more likely to have higher ps-Tg levels (I vs. L: P < 0.05; H vs. I: P < 0.001; H vs. L: P < 0.001). The corresponding cut-off value of ps-Tg for distinguishing sensitivity and specificity in each of the two groups was 2.95 ng/ml (I vs. L: 61.5%, 63.3%), 29.5 ng/ml (H vs. I: 41.9%, 92.6%), 47.1 ng/ml (M1 vs. M0 in the H group: 79.5%, 88.9%) and 47.1 ng/ml (M1 vs. M0 in all patients: 79.5%, 93.7%). With the cut-off value at 47.1 ng/ml, ps-Tg was the only factor that could be used to identify distant metastases, and consequently if measured before radioiodine therapy would prevent 10.26% of patients with M1 from undertreatment.</p><p><b>CONCLUSIONS</b>Ps-Tg, as an ongoing reassessment marker, favors differential recurrence risk grading and provides incremental values for radioiodine treatment decision-making.</p>

Relationship between Variation of Pre-ablation Stimulated Thyroglobulin and Distant Metastasis in Patients with Differentiated Thyroid Cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the relationship between the dynamic variation of pre-ablation stimulated thyroglobulin(sTg)and distant metastasis in patietns with differentiated thyroid cancer(DTC).</p><p><b>METHODS</b>DTC patients after total or near total thyroidectomy were divided into two groups as M1 group(n=38)and M0 group(n=130)according to the presence of distant metastases or not. Clinical data including pre-ablation sTg and the corresponding thyrotropin(TSH)values were dynamically measured. The pre-ablation sTg and corresponding TSH collected at the first time were defined as Tg1 and TSH1,while as Tg2 and TSH2 at the last time. χ(2) test was used to compare the variation tendency of sTg between these two groups. Tg1,Tg2,pre-ablation sTg variation(∆Tg),and ∆Tg/∆TSH ratio between M0 and M1 were compared by Mann-Whitney rank-sum test. The receiver operating characteristic(ROC)curves and diagnostic critical point(DCP)were employed to evaluate the predictive values of the above indicators.</p><p><b>RESULTS</b>Both Tg1 and Tg2 of M1 were significantly higher than those of M0(the Mann-Whitney rank-sum test:Tg1 P<0.001,Tg2 P<0.001). The corresponding areas under the ROC curve(AUC)to differentiate the two groups were 0.921 and 0.942,respectively. The cut-off value of Tg2,which was more accurate in predicting distant metastasis,was 24.3 ng/ml with a sensitivity of 92.11% and a specificity of 83.85%. Both ∆Tg and ∆Tg/∆TSH between these two groups were significantly different(the Mann-Whitney rank-sum test:∆Tg P=0.002,∆Tg/∆TSH P<0.001). ∆Tg/∆TSH worked better than Tg2 in predicting distant metastasis with both higher accuracy(87.50%)and higher specificity(86.92%).</p><p><b>CONCLUSIONS</b>Dynamically tracing pre-ablation sTg may improve the accuracy and specificity of distant metastases prediction in DTC patients. ∆Tg/∆TSH,which means the ratio of sTg variation to TSH variation,may be a useful diagnostic marker for predicting distant metastases in DTC.</p>

Time to disappearance of thyroglobulin antibodies and influencing factors in patients with papillary thyroid carcinoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the time to disappearance of thyroglobulin antibodies (TgAb) and its influencing factors in papillary thyroid carcinoma (PTC) patients with positive TgAb after radioiodine ((131)I) ablation.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 64 PTC patients who had undergone a total thyroidectomy and subsequent (131)I therapy. Patients were divided into two groups according to the presence of concurrent Hashimoto thyroiditis (HD). TgAb1 (TgAb levels determined before (131)I therapy) were above the normal thresholds in all patients. The method of survival analysis (including Life tables and Cox Regression analysis) was used to assess the time to disappearance of TgAb and its influencing factors.</p><p><b>RESULTS</b>The median time to disappearance of positive TgAb (9.0 months vs. 10.4 months, P=0.923) showed no significant difference between these two groups. Cox Regression analysis showed that, among the potential influencing factors including TgAb [partial regression coefficient (B)=-0.004, P=0.001], age(B=-0.018, P=0.362), sex (B=0.644, P=0.320) and HD (B=0.341, P=0.372), only TgAb1 was correlated with the TgAb negative conversion time.</p><p><b>CONCLUSIONS</b>TgAb1 has remarked influence on the time to disappearance of positive TgAb in PTC patients. Patients with a higher TgAb need longer time to achieve negative conversion.</p>

Clinical study of the infra-patellar fat pad strain treated by galvanism penetration of traditional Chinese medicine combined with ultrasonic wave and manipulation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects of galvanism penetration of traditional Chinese medicine combined with ultrasonic wave and manipulation in the treatment of strain of the infrapatellar fat pad, to study an effective approach in the treatment of this diseas.</p><p><b>METHODS</b>Eighty patients were divided randomly into treatment group and control group, there were 40 cases in each group. In treatment group 40 cases were treated by galvanism penetration of traditional Chinese medicine, ultrasonic wave and manipulation, included 22 males and 18 females with an average age of (63.15 +/- 8.10) years old and a mean disease course of (6.84 +/- 3.50) years. In control group, 40 cases were treated with ultrasonic wave and manipulation, included 23 males and 17 females with an average age of (62.63 +/- 8.20) years old and the course was (6.59 +/-3.70) years. visual analogue scale (VAS) and the scales for pain with finger press were evaluated before and after treatment in two groups. The clinical effects were researched and analysed statistically.</p><p><b>RESULTS</b>In treatment group,12 patients were in remarkable effects, 17 in good effective, 9 in effective and 2 in ineffective. As well in control group, above data were 8,15, 8 and 9 respectively. There was a significant difference in the rate of general effective between treatment group and control group (P < 0.05). In treatment group, the scales for VAS before and after treatment were (7.92 +/- 2.21) and (2.16 +/- 1.87) and the scales for pain with finger press before and after treatment were (3.01 +/- 0.63) and (0.86 <-- 0.46). As well in control group, above data were (7.71 +/2.65), (3.83 +/- 2.45), (2.98 +/- 0.61) and (1.32 +/- 0.52) respectively. The comparison of the scales for VAS and pain with finger press before and after treatment in two groups had significant difference (P < O.01).</p><p><b>CONCLUSION</b>Ultrasonic wave and manipulation have a good effect in the treatment of stain of the infrapatellar fat pad, when the galvanism penetration of traditional Chinese medicine is applied at the same time, the therapeutic efficiency can be improved significantly. Three therapies are used in treatment at the same, it can improve the therapeutic effect, and it is an easy, economic, practical and effective comprehensive approach.</p>

Effect of platelet CD42a modification by mPEG-SPA with different molecular masses / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect platelet antigen modification by mPEG-SPA with different molecular masses.</p><p><b>METHODS</b>Platelet CD42a was modified by 5 kD and 20 kD mPEG-SPA, respectively, and the fluorescence intensity of CD42a was detect by flow cytometry and the three-dimensional structure of CD42a simulated to analyze the distribution of lysine in CD42a molecule.</p><p><b>RESULTS</b>After platelet CD42a modification by 5 kD and 20 kD mPEG-SPA, the fluorescence intensity of CD42a decreased sharply by 85.54% and 88.65%, respectively, and multiple lysine regions were identified on the surface of CD42a molecule.</p><p><b>CONCLUSION</b>Both 5 kD and 20 kD mPEG-SPA allow useful modification of platelet CD42a, but 20 kD mPEG-SPA is more advantageous than 5 kD mPEG-SPA.</p>