Analysis on the factors affecting the efficacy of 131Ⅰ remnant ablation in patients after thyroidectomy for differentiated thyroid carcinoma

Objective 131Ⅰ is the most effective treatment for thyroidal remnant ablation after thy-roidectomy in patients with differentiated thyroid carcinoma (DTC). Ways to improve its therapeutic efficacy have been a major clinical concern. This study was designed to assess the efficacy of thyroid ablation by finding out its leading factors. Methods Eighty cases of post-operative DTC patients who had undergone first 131Ⅰ remnant ablation therapy were retrospectively reviewed. The efficacy of the therapy was assessed by a diagnostic 131Ⅰ whole body follow-up scan 3- 6 months later. The ablation therapy was considered to be suc-cessful only if no conceivable radioactivity was detected in the thyroidectomy bed. The χ2 test and multi-vari-ance Binary Logistic regression were used to analyze 9 variances which might affect the therapeutic efficacy, including gender, age (<45 years and ≥45 years), type of pathology (papillary or follicular carcinoma), metastasis, residual thyroid weight (low, median, high), 24 h radioiodine uptake ratio (< 10%, 10%-20%, >20%), thyroglobulin (Tg, negative or positive), thyroid stimulating hormone (TSH, <30 mU/L, 30-60 mU/L, >60 mU/L), and radioiodine dose (<1850 MBq,1850-3700 MBq, >3700 MBq). Results 131Ⅰ remnant ablation therapy was successful in 58 of 80 DTC patients (72.5%). Three variances were found to have affected the therapeutic efficacy: residual thyroid weight, 24 h radioiodine uptake ratio and 131Ⅰ dose. The corresponding intra-groups statistical difference of those 3 variances was significant by χ2 test (χ2 = 8.892, 9.528, 15.085, P = 0.012, 0.009, 0. 001), while the intra-group statistical differences of the remaining variances were insignificant (χ2 =0.486, 0. 051, 0. 322, 0. 010, 0. 006, 2. 575, all P > 0. 05). All 9 variances were analyzed by the multi-variance Binary Logistic regression model through for-ward stepwise. The variance of residual thyroid weight (X1) and 131Ⅰ dose (X2) were finally selected as the 2 key parameters in the formula, P=e(-0.865-0.868X1+1.677X2)/[1-e(-0.865-0.868X1+1.677X2)] , by the Binary Logistic regression analysis (Wald values were 3.752 and9. 130, P=0.049, 0.003). Conclusions The efficacy of 131Ⅰ ablation of thyroidal remnant in post-operative DTC patients was mainly determined by the re-sidual thyroid weight and the therapeutic 131Ⅰ dose. The other 7 factors included in this study were not found to be statistically significant.     

慢性阻塞性肺病营养状态与甲状腺激素相关性研究

目的 为了探讨慢性阻塞性肺病（ＣＯＰＤ）营养状态与甲状激素水平的关系，以进一步阐明ＣＯＰＤ合并营养不良的机制。方法 对５３例ＣＯＰＤ患者进行营养状况评价，同时测定其血清甲状腺素（Ｔ３、Ｔ４）和促甲状腺激素（ＴＳＨ）水平。结果 发现ＣＯＰＤ重度营养不良组Ｔ３、Ｔ４显著下降，Ｔ３与所有营养参数均呈显著相关性（Ｐ〈０．０５或Ｐ〈０．００１），Ｔ４仅与白蛋白有关（Ｐ〈０．０５），而ＴＳＨ与各营养参数均无相     

ECToolbox分析软件评估猪急性心肌梗死模型生物治疗的疗效

目的 用ECToolbox分析软件定性和定量评估猪急性心肌梗死模型生物治疗的疗效.方法 16头急性心肌梗死模型猪,其中10头心肌局部注射血管生成素相关蛋白2重组腺病毒(Ad.ARP2)作为治疗(A)组;另6头注射生理盐水作对照(B)组.注射后第1周和第4周分别进行门控心肌灌注显像,观察其心肌缺血的部位、范围和程度以及用药后血供改善的情况,使用美国Emory大学1.0版ECToolboxTM分析软件对其显像结果进行定性和定量分析以评估其疗效.采用SPSS 10.0软件,同组第1和第4周结果比较行配对t检验,组间比较行t检验.结果 对于治疗组模型猪:(1)目测法分析缺血程度,显示注射后第1周和第4周侧壁缺血分级评分分别为1.99±0.85和1.71±0.85,部分下壁缺血分级评分分别为1.86±0.67和1.65±0.73.(2)心肌放射性计数密度测定法显示第1周和第4周缺血心肌节段的感兴趣区(ROI)和整个左心室心肌的ROI的放射性比值分别为短轴:25.75±7.16和31.57±5.64,垂直长轴:30.55±4.80和36.03±6.27,水平长轴:25.03±2.65和27.42±3.48,各轴第1周和第4周比较差异均有统计学意义(t=3.83,3.71,2.88,P均<0.01).(3)极坐标靶心图示,第1周和第4周相减靶心图所示原缺血部位黑心区域中有部分白色填充,缺血区面积占整个左心室区域面积百分比由(16.58±5.78)%下降至(12.66±4.90)%.(4)门控采集左心室射血分数(LVEF)第1周和第4周分别为(43.99±5.96)%和(61.03±8.74)%.对照组注射后第1周和第4周,上述心肌缺血程度4项指标未改善.结论 ECToolboxTM分析软件定性和定量分析的4种参数对猪急性心肌死梗模型生物治疗的疗效评估有一定价值.     

核素肾动态显像用于儿童先天性输尿管囊肿的诊断和随访

目的分析儿童先天性输尿管囊肿在99mTc-EC肾动态显像(RDI)中的表现,并评价其临床应用价值.方法22例经泌尿系统B超、静脉肾盂造影(IVP)及手术探察确诊为肾积水或肾重复畸形合并输尿管囊肿的患儿,行利尿RDI检查,6例术后复查.分析24 min内经叠加的1帧/2min系列影像,并评估随访结果.结果输尿管囊肿在RDI系列影像中,表现为显像早期膀胱局部放射性分布缺损,后期有或无填充.随访复查病例,患肾功能提高(t=2.94,P＜0.05),2例膀胱影恢复正常.先天性输尿管囊肿RDI、B超、IVP的阳性率均为81.8%.结论先天性输尿管囊肿的RDI表现有合理的生理基础,其明确的特征性影像可为诊断提供较为准确的依据;用于随访时较B超和IVP检查有独特的优势.     

Analysis on the factors affecting the efficacy of 131Ⅰ remnant ablation in patients after thyroidectomy for differentiated thyroid carcinoma

Objective 131Ⅰ is the most effective treatment for thyroidal remnant ablation after thy-roidectomy in patients with differentiated thyroid carcinoma (DTC). Ways to improve its therapeutic efficacy have been a major clinical concern. This study was designed to assess the efficacy of thyroid ablation by finding out its leading factors. Methods Eighty cases of post-operative DTC patients who had undergone first 131Ⅰ remnant ablation therapy were retrospectively reviewed. The efficacy of the therapy was assessed by a diagnostic 131Ⅰ whole body follow-up scan 3- 6 months later. The ablation therapy was considered to be suc-cessful only if no conceivable radioactivity was detected in the thyroidectomy bed. The χ2 test and multi-vari-ance Binary Logistic regression were used to analyze 9 variances which might affect the therapeutic efficacy, including gender, age (<45 years and ≥45 years), type of pathology (papillary or follicular carcinoma), metastasis, residual thyroid weight (low, median, high), 24 h radioiodine uptake ratio (< 10%, 10%-20%, >20%), thyroglobulin (Tg, negative or positive), thyroid stimulating hormone (TSH, <30 mU/L, 30-60 mU/L, >60 mU/L), and radioiodine dose (<1850 MBq,1850-3700 MBq, >3700 MBq). Results 131Ⅰ remnant ablation therapy was successful in 58 of 80 DTC patients (72.5%). Three variances were found to have affected the therapeutic efficacy: residual thyroid weight, 24 h radioiodine uptake ratio and 131Ⅰ dose. The corresponding intra-groups statistical difference of those 3 variances was significant by χ2 test (χ2 = 8.892, 9.528, 15.085, P = 0.012, 0.009, 0. 001), while the intra-group statistical differences of the remaining variances were insignificant (χ2 =0.486, 0. 051, 0. 322, 0. 010, 0. 006, 2. 575, all P > 0. 05). All 9 variances were analyzed by the multi-variance Binary Logistic regression model through for-ward stepwise. The variance of residual thyroid weight (X1) and 131Ⅰ dose (X2) were finally selected as the 2 key parameters in the formula, P=e(-0.865-0.868X1+1.677X2)/[1-e(-0.865-0.868X1+1.677X2)] , by the Binary Logistic regression analysis (Wald values were 3.752 and9. 130, P=0.049, 0.003). Conclusions The efficacy of 131Ⅰ ablation of thyroidal remnant in post-operative DTC patients was mainly determined by the re-sidual thyroid weight and the therapeutic 131Ⅰ dose. The other 7 factors included in this study were not found to be statistically significant.     

INFUSION OF ESSENTIAL AMINO ACIDS FORTIFIED WITH BRANCHED-CHAIN AMINO ACIDS IN NUTRITIONAL TREATMENT OF CHRONIC RENAL FAILURE

Intravenous supplement of essential amino acids (EAA) 12.6 g/d, fortified with branched-chain amino acids, was given to Group A, 5 patients with chronic renal failure (CRF) (mean creatinine clearance rate 6.55±2.49 ml/min) for 14 days on the basis of low protein diet (0.6 g/kg/d) , and Group B, 4 patients with CRF (mean creatinine clearance rate 9.75±3.93 ml/min) for JO days on the basis of low protein diet(0.4g/kg/d). The nitrogen balance, whole body nitrogen flux and rates of protein synthesis and catabolism and amino nitrogen utilization were markedly improved as compared with the pre-treatment levels. With treatment, the levels of some EAA in plasma such as valine, isoleucine, phenylalanine, lysine and methionine were increased, while that of tyrosine was not changed. In 4 of the Group A patients, blood urea nitrogen, creatinine and phosphate were slightly decreased after treatment, while serum calcium level was significontly increased. In 8 patients uremic symptoms were markedly ameliorated and their nutritional status apparently improved.     

慢性阻塞性肺病伴呼吸功能衰竭所致左室功能紊乱的特征

为了提高老年慢性阻塞性肺病（COPD）伴呼吸衰竭（呼衰）所致的左室功能障碍（LVD）的早期诊断率，采用多途径放射性核素心室造影术（MUGA）测定各项临床变量。根据左室间隔区射血分数（LVEFs）＞40％和＜40％分成二组。结果，LVEFs＞40％和＜40％者其LVEFs分别为60±6％和36±7％（P＜0．01）。LVEF＜40％者均是LVEFs＜40％者，其LVEFs值有极显著降低。左室射血分数（LVEF）和LVEFs值之间有一定的相互关系（r＝0．81，P＜0．05）。MUGA的LVEFs＜40％是老年COPD伴呼衰LVD早期诊断的敏感指标。传统标准的临床变量、胸片和肺功能等评价不能鉴别COPD伴发LVD与否。     

第五届全国核医学学术会议纪要

第五届全国核医学学术会议纪要中华医学会、中国核学会核医学学会召开的第五届全国核医学学术会议于１９９７年５月９～１３日在上海举行。会议共收到论文８２７篇，其中会议交流２６２篇，壁报展示１８５篇。下面简要介绍会议交流的主要内容。神经核医学神经核医学交流论...     

抗MPO抗体对自身免疫性间质肾炎模型免疫炎症的抑制作用

抗ＭＰＯ抗体对自身免疫性间质肾炎模型免疫炎症的抑制作用冯江敏吴靖川周希静自身免疫性间质肾炎病理改变中，常有抗中性粒细胞胞浆抗体（ＡＮＣＡ）相关血管炎发生［肾と透析，１９９４，３６∶４］。病理特点为血管壁多形核中性粒细胞浸润及局灶节段性坏死，病变处Ｐ?..