Treatment of differentiated thyroid carcinoma (DTC) with ~(131)Ⅰ can greatly improve prognosis of patients. However, the administered activity of ~(131)Ⅰ is still a subject for discussion. Different methods for determining the administered activity of ~(131)Ⅰ were reviewed in this article.

Objective To summarize the method of forearm skin flap with dorsal interosseous artery placed by turning the proximal end of the flap to the distal side of the wound to repair skin and soft tissue defect of palm and thumb of hand,and put forward the key points of operation.Methods From 2008 to 2013,the forearm skin flap with interosseous dorsal artery to repair skin and soft tissue defect of palm and the part between thumb and index finger in 20 cases.Dorsal interosseous artery in the forearm is passing through between superficial and deep layers of extensor muscles and sends out 5-13 cutaneous branches to dorsal antebrachium skin.The large skin flap has good blood supply with high survival rate.Results All flaps survived,and good results were achieved in all 20 cases.Conclusion The flap preserved two main arteries from upper limb with good blood supply,and the amount of blood supply of the flap depended on the size of flap,and the wound of donor site can be directly sutured up or covered with free skin graft,thus minimizing the alteration of appearance and function of donor area.

Objective Comparing the diagnostic values for the malignant obstruction diseases of biliary tract between endoscopic retrograde cholangiopancreatography(ERCP)and MR cholangiopancreatography (MRCP). Methods Parallel analysis for the ERCP and MRCP data of 142 malignancies confirmed by surgery and/or ERCP among 383 biliary tract patients was retrospectively carried out. Results MRCP and ERCP were performed with exploration of 137 cases,showing the total conformity of 96.4%; together with localization conformities of 92.3% and 87.3%,qualitative conformities of 78.5% and 89.8% respectively. Conclusions In diagnosing the malignant obstructing disease of biliary tract,MRCP has the advantages in convenience,safety and low false negative,but with higher false positive than ERCP; however,if combined with ERCP can get higher positive conformity.(J Intervent Radiol,2007,16: 673-675)

Objective To measure the shear wave velocity (SWV) of normal adult testis using virtual touch tissue imaging quantification(VTIQ), and to analyze the main impact factors of testicular stiffness and the value of VTIQ in evaluation of testicular spermatogenesis. Methods Totally 200 normal adult male volunteers were recruited and underwent routine testicular ultrasonography for the measurement of bilateral testicular volume. VTIQ technique was used to measure SWV of the upper, middle and lower poles of the bilateral testis. The differences of SWV in bilateral testis and testis of different age groups were compared. The correlation of SWV with age, testicular volume and sperm motility and density was analyzed. Results SWV of both the left and right lateral testis of 200 normal adult males were (1.23±0.18)m/s, and no statistically significant difference was found (t=-0.376, P=0.710). There were significant differences of SWV among the 21-30 years old group, 31-40 years old group, 41-50 years old and 51-60 years old group (all P<0.001). Testicular SWV was positively correlated with age (r=0.454, P<0.001) and negatively correlated with testicular volume, sperm motility and density (r=-0.649, -0.668, -0.675, all P<0.001). Conclusion VTIQ technique can quantitatively measure testicular tissue hardness, which may be used to initially evaluate testicular spermatogenesis.

Objective To investigate the biokinetics of 131 I and its absorbed dose in patients with metastatic DTC. Methods Forty?one patients with metastatic DTC who were referred to 131 I therapy were prospectively recruited from September 2009 to September 2011. Scintigraphic images were serially acquired after the ingestion of 131I (3.70-9.25 GBq) to assess the biokinetics. CT was used to measure the masses of the DTC lesions. Calculation of absorbed doses to DTC lesions was based on the Medical Internal Radiation Dosimetry formula of the Society of Nuclear Medicine and Molecular Imaging. Kruskal?Wallis rank sum test was used to compare the differences of absorbed dose among different tumor deposits. Results In total, 59 io?dine?avid metastatic lesions (35 in cervical lymph node, 17 in lung and 7 in bone) in 41 patients were evalu?ated and the mean absorbed dose of DTC lesions was (10.4±6.5) Gy/GBq, with range of 0.1 to 136.2 Gy/GBq. The median absorbed dose was 11.3 Gy/GBq for lymph node metastase, 10.1 Gy/GBq for lung metastases and 9.6 Gy/GBq for bone metastases. There were no statistically significant differences in absorbed doses a?mong the metastases of lymph node, lung and bone ( Z=0.907, P>0.05) . Conclusion A wide inter?lesion variation of absorbed dose to metastatic DTC is observed.

BACKGROUND: Free radicals are produced during ischemia, which can strengthen activity of lipid peroxidation; induce lesion of cell and cellular barrier, result in necrosis or apoptosis of neurons; and aggravate edema of ischemic cerebral tissue.OBJECTIVE: To observe the effects of polydatin (PD) on free radicals, lipid peroxidation, water contents and pathological morphology of brain tissue in rats with focal cerebral ischemia so as to explore its protective mechanisms.DESIGN: A randomized controlled trial.SETTING: Intensive Care Unit, Second Affiliated Hospital, Chongqing University of Medical Sciences; Pediatric Research Institute, Children's Hospital Chongqing University of Medical Sciences.MATERIALS: The experiment was carried out at the Pediatrics Medicine Institute of Chongqing Medical University from October 2001 to July 2002.Totally 48 healthy adult male Wistar rats were divided into 3 groups randomly,with 16 in each group. Group Ⅰ was sham-operated group: rats were anaesthetized, the right common carotid arteries were separated instead of being occluded. Group Ⅱ was ischemia group: to establish the right middle cerebral artery occlusion model of rats. Group Ⅲ was PD pretreatment group: polydatin (6 g/L, 12 mg/kg) were intravenously administrated 30 minutes before the onset of ischemia. Saline substituted for PD, besides, were intravenously administrated with the same way and dosage on Group Ⅰ, Group Ⅱ and Group Ⅲ.The rats were decapitated and the brains were immediately removed after cerebral ischemia 2 hours. In each group, 8 rats were chosen to be determined water contents of brain tissue, the other 8 rats were chosen to be determined levels of lipid peroxidation and free radicals in brain tissue.METHODS: According to the formula which was: wet weight-dry weight/wet weight×100%, water content of cerebral tissue was assayed. Superior liquid was taken to assay MDA with spectrophotometer thiobarbituric acid method (TBA) method, SOD activity assayed by xanthiue oxidase enzyme method, the activities of GSH-Px, CAT and NOS determined by colorimetry,the amount of protein determined by the method of Lowry. All the procedures were carried out strictly according to the instruction.malonaldehyde (MDA) and activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and nitric oxide synthase chemia, contents of SOD, GSH-Px and CAT in cerebral tissue of PD group were obviously higher than those of ichemia model group [(226.43±8.69),(193.37±11.14) NU/mg; (244.38±12.34), (211.71±16.50) μkat/g; (59.85±9.67),water in cerebral tissue of PD group were obviously lower than those of ichemia model group [(6.38±0.54), (8.63±0.78) μmol/g; (78.72±0.43)%,tivity in ischemic tissue but the results were similar to that in ischemia model group [(12.00±1.00), (12.84±1.17) μkat/g, P ＞ 0.05] in brain tissue.ed that PD alleviated the ischemia edema of cerebral ischemia.CONCLUSION: PD can alleviate the reaction of lipid overoxidation, improve the activities of antioxidant-enxymes, reduce ischemia brain edema,protect the function of cell member, bring down the damage to ischemia neurons. It shows that PD has significant cerebral protective role on focal ischemia brain damage.

Objective To determine the activities of 131I for treating differentiated thyroid carcinoma with diffuse pulmonary metastases ( DTC-DPM ) from the perspective of internal radiation dosimetry.Methods According to Medical Internal Radiation Dosimetry (MIRD) schema, the activity constraint,from which the whole bdy retention at 48 h should not exceed 2.96 GBq (2.96 GBq rule), was converted to dose-rate constraint(DRC) to lungs at 48 h ( DRCLU ·48 h ) in 131I therapy for DTC-DPM. Based on the assumption of DRCLU·48 h at 48 h in lung, the fractions of whole body activities ( F48 ), the effective half times of 131I in lungs ( TLL ) and the remainder of body ( TRB ) were 0.6-0.9, 20- 120 h, and 10- 20 h, respectively. The maximum safe activities of 131I for different human phantoms from the Organ Level Internal Dose Assessment (OLINDA) software were calculated. Results According to MIRD schema and 2.96 GBq rule, DRCLU ·48 h should not exceed 46.4 mGy/h in 131I therapy for DTC-DPM. Depending on varying F48 h,TLL and TRB, the maximum safe activities of 131I were 6.77-81.36, 5.29-56.20, 5.08-55.19 and 3.87-40. 52 GBq for the male adult, female adult, 15-year-old, and 10-year-old patients with DTC-DPM, respec tively. Conclusion Dosimetry-guided 131I therapy for DTC-DPM considers adequately the differences of 131I kinetics in individual patients and can adjust administered activities of 131I on the precondition of avoiding radiological pneumonitis and pulmonary fibrosis.

The mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) and phoshoinositide-3-kinase/protein kinase B (PI3K/Akt) signaling pathways play a major role in regulating cell growth, proliferation and apoptosis, via transmission of cell signals to cell nucleus. The genes, coding the MAPK/ERK and PI3K/Akt signaling cascade proteins, are significantly mutated in thyroid cancer. Genetic alternations contribute to aberrant activations and interaction of MAPK/ERK and PI3K/Akt signaling pathways in consequence of malignant follicular cell transformation and progression. This review focuses mainly on the role of genetic alterations in coding MAPK/ERK and PI3K/Akt signaling pathway proteins in generation, progression and diagnosis of thyroid cancer. Moreover, it additionally points out a therapeutic potential in restoring iodine avidity of thyroid cancer cells for radionuclide targeted treatment, by synergistically inhibiting activity of signaling pathways.
Extracellular Signal-Regulated MAP Kinases ; genetics ; metabolism ; Humans ; MAP Kinase Signaling System ; genetics ; Mitogen-Activated Protein Kinases ; genetics ; metabolism ; Mutation ; Phosphatidylinositol 3-Kinases ; genetics ; metabolism ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Signal Transduction ; genetics ; physiology ; Thyroid Neoplasms ; genetics ; physiopathology ; therapy

Objective To investigate the effect of nCPAP as pre-emptive ventilatory support strategy in severe bronchiolitis. Methods A retrospective analysis was made on cases with nCPAP as pre-emptive ventilatory support strategy for severe bronchiolitis in PICU of our hospital from August 2012 to September 2014. Results Seventy-nine children received nCPAP therapy in our PICU. Overall, nCPAP was successful performed in 69 children, 10 patients required intubations. PaO2 and PaO2/FiO2 in patients received intubations were lower than those in patients received only nCPAP before treatment (P < 0.05). There were significant improvements in PaCO2, PaO2, PaO2/FiO2, respiratory rate and heart rate in the patients received only nCPAP at 12 hours and 24 hours post-treatment (P < 0.05). For the 69 patients with hypercapnia received only nCPAP, PaCO2 was significantly reduced at 2 hours, 12 hours and 24 hours post-treatment (P < 0.01). Conclusion Clinically, nCPAP could improve the oxygenation and hypercapnia of patients with severe bronchiolitis. However, these patients, who suffered from severe bronchiolitis with minor PaO2 or PaO2/FiO2, appeared to require intubation as soon as possible.

Objective To investigate the relationship between the absorbed dose to the thyroid remnant and the outcome of m I ablation in patients after operation for DTC.Methods Seventy-two patients (14 males,58 females; age range:16-67 years,average age:(41±16) years) with DTC,prepared for thyroid remnant ablation,were prospectively recruited from September 2009 to September 2011.Scintigraphic images of the head and neck were serially acquired after oral administration of 3.7 GBq of 131I to assess the biokinetics of this tracer in thyroid remnant.Ultrasound was used to measure the mass of the thyroid remnant.Calculation of absorbed dose to thyroid remnant was based on the Medical Internal Radiation Dosimetry formula of the Society of Nuclear Medicine.The outcome of 131 I ablation was evaluated on the basis of stimulated Tg measurements and neck ultrasound at 6-9 months after ablation.Patients with stimulated Tg levels less than 1 μg/L and with no detectable thyroid tissue on neck ultrasound were considered successful ablation of thyroid remnant.Two-sample t test was used to analyze the data.Results The 131I uptake ratios at 24 h were 0.9％-6.3％ in 72 patients and the effective half-lives of 131I were 12.0-146.4 h.The thyroid remnant masses were 1.0-6.9 g; absorbed doses were 23-2 197 Gy,and absorbed dose rates at 24 h were 0.5-8.1 Gy/h.No significant difference was observed in absorbed doses to thyroid remnants in 43 patients having successful ablation and 29 patients having unsuccessful ablation ((363± 148) Gy vs (341± 167) Gy,t =15.097,P＞0.05).However,the absorbed dose-rates of thyroid remnants at 24 h were significantly higher in patients with successful ablation than those in patients with unsuccessful ablation ((3.7±2.1) Gy/h vs (2.9±1.6) Gy/h,t=7.908,P＜0.05).Conclusion A successful ablation is strongly dependent on the absorbed dose-rate of thyroid remnant.