DTC in pediatric and adolescent patients has lower incidence and is generally reported to have better prognosis.However,compared with DTC in adults,it is more aggressive and the recurrence rate is higher.Surgery and adjuvant radioiodine therapy can minimize the risk of recurrence.Total or near total thyroidectomy combined with central compartment lymph node dissection is the preferred surgical procedure for most of these patients.Radioiodine therapy for ablation of thyroidal remnant or residual disease is recommended in order to reduce the risk of tumor recurrence,but there is slight chance of increased risk of a sec ond primary malignancy (SPM).Long-term follow-up is therefore recommended for the pediatrics and adolescents with DTC after treatment.Multi-disciplinary collaborative management is needed to optimize treatment efficacy and to minimize adverse effects.

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.

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.

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.

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.

Galectin-3 and CD44v6 expressions in thyroid tumors were assayed by immunohistochemistry. The results suggest that galectin-3 expression is one of reliable markers of carcinoma and high CD44v6 expression is related to lymph node metastasis of thyroid carcinoma.

Course teaching for international students in many domestic universities is in English.Some practice and experience of the department of nuclear medicine in Tianjin medical university are introduced from the aspects of teaching course,concerning preparations before class,teaching process and teaching techniques,which will give references to nuclear medicine teaching for international students.

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.

Objective:To evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.Methods:It was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.Results:The mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant ( F=119.731, P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation ( F=185.518, P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant ( F=6.568, P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation ( r/ rs=0.672, 0.385, 0.932; P<0.05). There was no correlation between M value and BCVA ( r/ rs=0.503), EZ and ELM integrity ( r/ rs=0.497, 0.472), SRF ( r/ rs=0.416), CME ( r/ rs=0.821) and ERM ( r/ rs=0.632) after operation ( P>0.05). Conclusions:The BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.

Objective To evaluate the safety and feasibility of totally laparoscopic cholecystolithotomy.Methods Patient baseline characteristics of all 34 totally laparoscopic cholecystolithotomy (TLC) were collected in a database.This group was compared with 34 matched patients who underwent the laparoscopic cholecystectomy (LC) in the same period.Retrospectively,intraoperative and postoperative data were added.Results Operatingtime was significantly longer in the TLC group(124.56 min vs 78.50 min,P ＜0.01).The mean hospitalization expenses of operation was significantly higher in the TLC group(10 970.85 yuan vs 8 666.72 yuan,P ＜0.01).Although not significant less patients have the symptoms of postoperative dyspepsia or diarrhea were seen in the TLC group compared with the LC group (2 vs 6,P =0.26).Intraoperative details and postoperative results such as,blood loss,hospital stay,exhaust time,abdominal bleeding,bile leakage,incision infection have no significant difference.One case of gallstone recurrence was detected in TLC group.No stone recurrence was reported in common bile duct in LC group.Conclusions TLC is effective and feasible for chronic calcular cholecystitis and is particularly favorable for thepatients with medical insurance.However,this approach is technically demanding and should be performed by experienced surgon.