ObjectiveTo evaluate liver reserve function in patients with hepatitis B cirrhosis using indocyanine green (ICG) clearance test, and to investigate the correlation of ICG clearance test with Child-Turcotte-Pugh (CTP) class and the Model for End-Stage Liver Disease (MELD) score in evaluating liver function. MethodsA total of 127 patients with hepatitis B cirrhosis who were hospitalized in The First Affiliated Hospital of Fujian Medical University from January 2012 to January 2015 were enrolled. ICG clearance test was performed for all the patients, and the ICG plasma clearance (K value), effective liver blood flow (EHBF), and ICG retention at 15 minutes (ICG R15) were calculated. CTP class and MELD score were also determined. An analysis of variance was used for comparison between groups, the least significant difference t-test was used for comparison between any two groups, Spearman rank correlation was performed for correlation analysis, and the area under the receiver operating characteristic (ROC) curve was used to compare liver reserve function. ResultsAmong all the patients with hepatitis B cirrhosis, 63 had CTP class A, 45 had CTP class B, and 19 had CTP class C hepatitis B cirrhosis. With the increasing CTP class, ICG R15 gradually increased, while EHBF and K value gradually decreased (F=14696，9126 and 4094，P=0001,0003 and 0005). In the evaluation of liver function, ICG R15 was positively correlated with MELD score and CTP class (r=0.525 and 0.838, both P＜0.01) and was negatively correlated with EHBF and K value (r=-0.703 and -0.901, both P＜0.01). The area under the ROC curve was 0.85 for ICG R15 and 065 for MELD score. ConclusionICG test can accurately and dynamically reflect liver reserve function, and ICG R15 can evaluate liver reserve function better than CTP class and MELD score.

Objective:To investigate the risk factors of recurrence after surgical resection of differentiated thyroid carcinoma combined with iodine-131 and TSH（Thyroid stimulating hormone） inhibition therapy. Methods:From January 2015 to April 2020, the clinical data of patients with structural recurrence and without recurrence were retrospectively collected after surgical treatment combined with iodine-131 and TSH inhibition therapy in the First Medical Center of PLA General Hospital. The general conditions of the two groups of patients were analyzed and the measurement data in line with the normal distribution was used for comparison between groups. For measurement data with non-normal distribution, the rank sum test was used for inter-group comparison. The Chi-square test was used for comparison between the counting data groups. Univariate and multivariate regression analyses were used to determine the risk factors associated with relapse. Results:The median follow-up period was 43 months（range 18-81 months） and 100 patients（10.5%） relapsed among the 955 patients. Univariate analysis showed that tumor size, tumor multiple, the number of lymph node metastases>5 in the central region of the neck, and the number of lymph node metastases>5 in the lateral region were significantly correlated with post-treatment recurrence（P<0.001, P=0.018, P<0.001, P<0.001）. Multivariate analysis showed that tumor size（adjusted odds ratio OR: 1.496, 95%CI: 1.226-1.826, P<0.001）, tumor frequency（adjusted odds ratio OR: 1.927, 95%CI: 1.003-3.701, P=0.049）, the number of lymph node metastases in the central neck region>5（adjusted odds ratio OR: 2.630, 95%CI: 1.509-4.584, P=0.001） and the number of lymph node metastases in the lateral neck region>5（adjusted odds ratio OR: 3.074, 95%CI: 1.649-5.730, P=0.001） was associated with tumor recurrence. Conclusion:The study showed that tumor size, tumor multiple, the number of lymph node metastases in the central region of the neck>5 and the number of lymph node metastases in the side of the neck >5 are independent risk factors for recurrence of differentiated thyroid cancer after surgical resection combined with iodine-131 and TSH inhibition therapy.
Humans ; Thyroid Cancer, Papillary/surgery* ; Lymphatic Metastasis/pathology* ; Retrospective Studies ; Neck Dissection ; Thyroidectomy/adverse effects* ; Neoplasm Recurrence, Local/pathology* ; Thyroid Neoplasms/surgery* ; Risk Factors ; Adenocarcinoma ; Thyrotropin ; Lymph Nodes/pathology*