ObjectiveTo analyze the association between the outcome of exophthalmos and the curative effect of hyperthyroidism in Graves disease after 131I therapy.Methods Five hundred and thirty-eight cases of Graves disease accompanied with exophthalmos and hyperthyroidism who received 131I therapy from January 2001 to January 2010 were reviewed retrospectively,and the association between the outcome of exophthalmos and the curative effect of hyperthyroidism was analyzed.ResultsThe effective rate of hyperthyroidism after 131I therapy was 94.8％ (510/538).The effective rate of exophthalmos after 131I therapy was 73.2％(394/538).And the effective rate of hyperthyroidism with exophthalmos was 71.6％ (385/538).The incidence of improvement,inefficiency,exacerbation was 75.5％ (385/510),21.0％ (107/510),3.5％( 18/510) in hyperthyroidism effective patients ( 510 cases ) and 32.1％ ( 9/28 ),50.0％ ( 14/28 ),17.9％ ( 5/28 )in hyperthyroidism ineffective and recrudescence patients(28 cases),there was significant difference between the two patients (P ＜ 0.05 ).The incidences of improvement,inefficiency,exacerbation were 78.1％(281/360),18.9％(68/360),3.1％(11/360) in hyperthyroidism cured patients(360 cases),78.2％(36/46),17.4％ (8/46),4.3％ (2/46) in hypothyroidism patients(46 cases),there was no significant difference between the two (P ＞ 0.05 ).The incidence of improvement,inefficiency,exacerbation was 86.4％ ( 229/265 ),9.8％(26/265 ),3.8％( 10/265 ) in mild exophthalmos after 131I therapy(265 cases),59.9％(106/177),35.6％(63/177),4.5％(8/177) in moderate and severe inactive exophthalmos after 131I therapy( 177 cases),there were significant differences in the inciclence of improvement and inefficiency between the two patients (P＜0.05).For patients with moderate and severe active exophthalmos,glucocorticoids therapy could obtain satisfactory effect.Conclusion131I therapy is an effective method for Graves disease with exophthalmos,and there is a significant association between the outcome of exophthalmos and the curative effect of hyperthyroidism.

The incidence rate of thyroid cancer is increasing very rapidly during the past years.131I treatment for DTC is an effective method.However,DTC refractory to 131I treatment or therapeutic failure is not uncommon.High level expression of nuclear factor-kappa B (NF-λB) in thyroid cancer is closely related with carcinogenesis,progression,anti-apoptosis and therapeutic resistance.NF-κB inhibitor was effective for the treatment of thyroid cancer.Combined NF-κB inhibitor with131I may improve the therapeutic efficacy.

Objective To study the effect of nuclear factor-kappa B (NF-κB) inhibition by small interference RNA (siRNA) on the apoptosis of DTC cells treated by 131 I.Methods DNA binding assay was performed at 24 h after 131I treatment (2 × 104 MBq/L) on KTC-1 cells.The cell survival assay was conducted at 48 h after 131 I treatment.Western blot was used to detect the changes of NF-κB p65 at 6 h after 131I treatment,and the changes of anti-apoptotic factors and apoptotic key factors at 24 h after 131 I treatment.The anti-apoptotic factors included in this study were X chromosome-linked inhibitor of apoptosis (XIAP),cellular inhibitor of apoptosis 1 (cIAP1) and B-cell lymphoma extra large (Bcl-xL),and the apoptotic key factors were caspase 3 and poly-ADP-ribose polymerase (PARP).A total of 4 groups were studied for the detection of p65 and anti-apoptotic factors by Western blot:no oligonucleotide transfection control group (A),no oligonucleotide transfection + 131I group (B),scrambled oligonucleotides transfection + 131I group (C) and p65 siRNA transfection + 131I group (D).Another 6 groups of studies were:oligonucleotide transfection control group (1),scrambled oligonucleotides transfection group (2),p65 siRNA transfection group (3),no oligonueleotide transfection + 131I group (4),scrambled oligonucleotides transfection +131I group (5) and p65 siRNA transfection + 131I group (6).One-way analysis of variance and q test were performed for statistical analysis.Results The results of DNA binding assays for the 6 groups (1,2,3,4,5,6) were (100.00 ± 11.65)％,(96.00 ± 17.98)％,(9.28 ±5.01)％,(322.72 ±50.81)％,(311.36 ±44.81)％ and (36.96 ± 15.66)％,respectively (F =137.74,P ＜0.01).NF-κB functions were strengthened with 131 I treatment (qgrouo 4∶1 =10.90,qroup 5∶2 =11.38,both P ＜ 0.01).However,NF-κB p65 siRNA transfection could inhibit NF-κB functions (qgroup1∶3 =18.25,qgroup4∶6 =13.71,both P ＜0.01).Cell survival rates of the 6 groups were (100.00 ± 11.65)％,(96.32 ± 9.44)％,(70.88 ±7.41)％,(64.16 ±9.50)％,(62.24 ±9.37)％ and (28.64 ±6.74)％ (F=52.76,P＜0.01).There were significant differences between groups 3 and 6,groups 4 and 6 (q =10.76 and 7.79,both P ＜ 0.01).Western blot results showed that the expression of NF-κB p65 in the 4 groups (A,B,C,D) were (56.60 ±7.37)％,(111.07 ± 13.31)％,(113.16± 15.04)％ and (12.46 ±2.74)％,respectively (F=60.17,P ＜ 0.01).The t65 levels increased with 131 I treatment (qgroup B∶A =6.20,qroup c∶ A =5.85,both P ＜0.01); while decreased significantly using NF-κB p65 siRNA transfection (qgroup B:D =-12.57; qgroupC∶D =11.41,both P ＜ 0.01).Western blot results showed that XIAP,cIAP1 and Bcl-xL in the 4 groups were (17.59±1.96)％,(16.45± 1.85)％ and (19.92 ±2.22)％; (98.37± 17.92)％,(109.81 ±19.16)％ and (95.59 ±22.20)％ ; (98.43 ±18.71)％,(98.86± 15.88)％ and (100.99 ±21.70)％ ;(7.00 ± 0.95) ％,(5.86 ± 0.35) ％ and (9.52 ± 0.90) ％,respectively (F =44.22,56.51 and 29.11,all P ＜ 0.01).131 I treatment induced higher expression of all the 3 genes (qgroup B∶ A =7.76,8.40 and 5.88,all P ＜0.01),while NF-κB p65 siRNA transfection,on the contrary,reduced the expression of all the 3 genes (qgroupB:D =8.82,9.40 and 6.71,all P ＜0.01).There were significant differences of p19,p17,p116 and p89 in the 6 groups(F =39.03,48.45,32.56,52.20,all P ＜ 0.01),especially among group 3,4 and 6 (q =3.18-9.98,all P ＜ 0.05).Conclusions 131I could activate NF-κB function and enhance the expressions of anti-apoptotic factors.NF-κB p65 siRNA transfection could effectively suppress this effect and therefore magnify 131I induced apoptosis in DTC cells.

BACKGROUND:Calcium citrate has a better solubility than calcium phosphate, calcium sulfate, and other calcium biomaterials. The synthetic calcium citrate has a good denseness, and stably releases calcium ions at a high efficiency during the degradation. Consequently, it may be more suitable for the fil ing of fracture defects, providing needed calcium ions for early fracture healing.
OBJECTIVE:To prepare calcium citrate biomaterials with a novel formulation based on the natural bio-mineralized oyster shel s and citric acid so as to expect to get a good application in fracture healing repair.
METHODS:Crushing, grinding, and chemical reaction methods were used for refinement. Particle size analyzer, X-ray diffraction, scanning electron microscope, and Fourier transform infrared spectroscopy were adopted for analysis of the size distribution, composition, mineral phases, and micro-morphology. Biological characteristics were evaluated through a simulated body fluid experiment.
RESULTS AND CONCLUSION:Oyster shel powder was reacted with saturated citric acid to produce the calcium citrate material that had uniform crystal structure and compact bonding among crystal bodies, and exhibited a certain mechanical ability. The calcium citrate material had a good crystal structure that was conductive to prolong the degradation time. The calcium citrate released calcium ions slowly, and did not produce dramatic changes in the pH value (7.20-7.46) of the surrounding in the dissolution process. With the gradual degradation of calcium citrate materials, Ca2+concentration in solution increased gradual y and stably, and ultimately achieved an appropriate concentration of 7 mmol/L, suitable for osteoblast proliferation and differentiation. Calcium citrate prepared using natural oyster shel has good biological properties, and exhibits a natural superiority to artificial bone materials.

Objective To investigate the predicative value of midkine (MK) as a cancer biomarker for metastatic lesions in differentiated thyroid cancer (DTC) patients with positive thyroglobulin antibodies (TgAb) before the first 131Ⅰ therapy.Methods MK levels were measured by enzyme-linked immunosorbent assay in 151 recruited DTC patients included in this study according to strict inclusion and exclusion criteria.There were 28 TgAb positive DTC patients with metastases and 123 DTC patients without metastases.The value of pre-131Ⅰ-ablative MK to predict metastasis was assessed by receiver operating characteristic (ROC) curves in these two groups of patients.Results MK levels were significantly higher in TgAb positive DTC patients than those in DTC patients without metastases.MK levels showed good diagnostic value,with an area under the curve of 0.856 (P＜0.001),and a diagnostic accuracy of 83％ at the optimal cut-off value of 550 ng/L.Conclusion Results show that MK can potentially be used as a surrogate biomarker for predicting DTC metastases when thyroglobulin is not suitable due to TgAb positivity.

Objective To study whether Bay 11-7082,a nuclear factor-kappa B (NF-KB) inhibitor,could enhance the treatment efficacy of 131I on DTC in nude mice.Methods Total thyroid ablation nude mice models were prepared by intraperitoneal injection of 37 MBq 131I.The xenografted mice were divided into4 groups (18/group):131I group,Bay 11-7082 group,combination of 131I and Bay 11-7082 group and control group.Drug dosages were given as:intraperitoneal injection of 37 MBqT31I on day 1 in the 7th week in the 131I group; intraperitoneal injection of 10 mg/kg Bay 11-7082 on day 1,2 and 3 in the 7th week in the Bay 11-7082 group; intraperitoneal injection of both 131I and Bay 11-7082 as above-mentioned in the combined treatment group; injection of saline in the control group.The xenografted tumor volume curves were drawn every 7 days.Pertechnetate imaging was performed before thyroid ablation.Post-ablative and post-therapeutic 131I whole body imaging was conducted.On day 7 in the 7th week,6 mice in each group were sacrificed and apoptotic staining was performed on excised xenograft tumors.Apoptosis index was determined as positive cells over total ceils × 100％.One-way analysis of variance and q test were performed for statistical analysis.Results Thyroid and stomach could be visualized on pertechnetate imaging before thyroid ablation.Post-ablative 131I imaging showed increased uptake by the thyroid gland.Post-therapeutic 131I imaging showed increased uptake by the malignant tumor lesions in both the 131I and combined groups.Tumor volume curves showed significant differences in volume changes among different methods of therapy from the end of the 8th week (F =11.91-246.56,all P ＜ 0.01).Combined treatment was more effective than single-therapies (q =3.36-14.99,all P ＜ 0.01).Apoptosis indices for the control group,131I group,Bay 11-7082 group and combined group were (0.28 ±0.15)％,(5.49 ±0.69)％,(6.82 ±0.72)％ and (16.21 ± 1.57) ％,respectively (F =304.40,P ＜ 0.01).Apoptosis index in the combined group was significantly higher than those in each single therapy group (q =15.33 and 13.33,both P ＜ 0.01).Conclusion NF-κB inhibition by Bay 11-7082 could effectively enhance the treatment efficacy of 131I on DTC.

Hyperuricemia and metabolic syndrome were studied in 17 762 subjects of Tianjin Municipality from July 2007 to July 2009. The overall prevalence rate of hyperuricemia was 12. 16% (2160cases) , the rate in males was significantly higher than that in females (15. 71% vs. 6. 51% , P <0. 01).The overall prevalence rate of metabolic syndrome was 25. 56% (4540 cases) , the rate in males was also higher than that in females (28. 17% vs. 21. 40% , P <0. 01). Binary logistic regression analysis disclosed that females with high uric acid were twice likely to suffer from metabolic syndrome than males; and female ≤ 44 years with hyperuricemia had the highest odd ratio for metabolic syndrome.

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.

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.