Background It is determined that the patients with thyroid-associated ophthalmopathy (TAO) often occur dry-eye related symptoms due to increasing tear evaporation caused by exophthalmos.However,more than half of thyroid dysfunction patients without TAO appear ocular surface inflammation.It is very important for us to understand the association of thyroid dysfunction patients without TAO with ocular damage.Objective This study was to observe the ocular surface changes in thyroid dysfunction patients without TAO.Methods A prospective cohort study was performed.Thirty-one patients who were initially diagnosed as thyroid dysfunction without TAO were included in the Second Hospital of Tianjin Medical University from January 2015 to May 2016 as the thyroid dysfunction group,and 16 helthy subjects were simutenniously selected as the control group under the informed consent of all the individuals.The peripheral blood was collected to detect the thyroid function-related indexes.Then the patients with thyroid dysfunction were divided into thyroid stimulating hormone (TSH) reduced group (18 patients) versus TSH elevated group (13 patients) and thyrotrophin receptor antibody (TRAb)+ group (20 patients) versus TRAb-group (11 patients).Exophthalmos degree,Schirmer I test (S I t),tear film break-up time (BUT),fluorescent integral,ocular surface disease index (OSDI) and corneal inflammation index were examined and intergrouply compared.The correlations of thyroid function indexes with ocular surface examination results were analyzed.Results There were no significant differences in exophthalmos degree and S I t values between thyroid dysfunction group and control group (t =0.037,P =0.971;t =0.815,P =0.419).The BUT values were (7.74 ± 1.45) seconds and (10.56± 1.40) seconds,fluorescent integral scores were 5.00 (1.50) and 2.50 (2.38),OSDI scores were 45.58 ± 9.23 and 19.47 ± 6.25,and corneal inflammation index scores were 0.11 (0.22) and 0.00 (0.06) in the thyroid dysfunction group and the control group,respectively,showing significant differences between the two groups (all at P＜0.01).There were not significant differences in exophthalmos degree,S I t,BUT and corneal inflammation index scores between the TSH elevated group and TSH reduced group (t =0.473,P =0.640;t =0.650,P=0.521;t=1.634,P=0.l13;Z=0.270,P=0.787).The fluorescent integral scores were 4.00 (2.00) and 5.00 (1.00),and OSDI scores were 40.08±9.91 and 47.11±9.75 in the TSH elevated group and TSH reduced group,repectively,with statistically significant differences between these two groups (all at P＜0.01).The exophthalmos degrees,S I t,BUT and corneal inflammation index scores were not considerably different between TRAb-group and TRAb+ group (all at P＞0.05);and significant differences were seen in fluorescent integral scores (4.00[1.50] vs.5.50 [1.50]) and OSDI scores ([39.18±6.25] vs.[46.78±8.76]).Corneal inflammation index scores were positive correlated with serum TSH (R2 =0.520,P =0.000),and fluorescent integral scores,OSDI scores and corneal inflammation index scores were positive correlated with serum TRAb (R2 =0.587,P =0.000;R2 =0.329,P =0.024;R2 =0.400,P=0.005).Conclusions Thyroid dysfunction patients without TAO have ocular surface dysfunction,which probably is associated with abnormal serum TSH and TRAb.

Objective To detect the changes of renal hemodynamics, radionuclide renal dynamic imagings were performed in patients with type 2 diabetes millitus (DM) in different stage. Methods Fifty seven patients with type 2 DM were divided into 3 groups according to the value of urinary albumin excretion rate (UAER). (1)GroupDM1:UAER200 ?g/min, 20 cases. 99m Tc DTPA and 99m Tc EC renal dynamic imagings were performed in the type 2 DM patients of 3 groups and 20 normal controls (NC). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and renogramweregainedsimultaneously.Results GFR and ERPF were significantly increased in group DM1 than those in NC (P

Background and purpose:Although FDG tumor imaging has been applied in clinic widely, dual-phase imaging can provide much more information about the FDG uptaking of pulmonary lesions. The purpose of the study was to evaluate the usefulness of dual-phase18F-FDG coincidence detection SPECT/CT imaging in the differential diagnosis of the pulmonary lesions.Methods:There were 28 patients with pulmonary lesions which were detected by CT. All the patients undertook the SPECT/CT imaging at 2 time-phases respectively: early imaging at 40-60 min and delayed imaging at 2-3 h after the intravenous injection of FDG. Data processing: calculating the radio of T and N in early and delayed imaging respectively; T: The radioactive count of the lesions; N: The radioactive count of the normal tissue; and the change rate:ΔT/N. ROC was used to ifnd out the threshold of T1/N1, T2/N2及ΔT/N in the differential diagnosis between benign and malignant lesions. AUC was used to evaluate the diagnosis value of the dual-phase and single-phase imaging.Results:The threshold of T1/N1 in early imaging was 2.65, whereas AUC was 0.767. The sensitivity, speciifcity and accuracy were 83.3%, 30% and 64.3%, respectively. The threshold of T2/N2 in delayed imaging was 3.14, whereas AUC was 0.847. The sensitivity, speciifcity and accuracy were 94.4%, 60.0% and 82.1%, respectively. The threshold ofΔT/N in delayed imaging was 16.9%, whereas AUC is 0.950. The sensitivity, speciifcity and accuracy were 88.5%, 71.4% and 86.2%, respectively.Conclusion:Dual-phase18F-FDG coincidence detection SPECT/CT imaging has much higher accuracy and speciifcity. However it still has false positivity, and should be analyzed with CT and clinical history.

BACKGROUND: Animal experimental studies have confirmed that cell transplantation, neurotrophic factor infusion or transplantation as well as other methods can alter the local environment of injured spinal cord and promote its partial function recovery.OBJECTIVE: This study aimed to assess the clinical efficacy of olfactory ensheathing cell transplantation for the treatment of the sequel of myelitis, and to explore whether it would promote the recovery of the spinal cord function.DESIGN: A non-randomized self-control study.SETTING: Ward of Second Department of Surgery of Taian Disabled Soldiers Hospital of Shandong Province.PARTICIPANTS: Thirty-two patients with obsolete myelitis, who come from all over China and suffered from disease for 0.5 to 7 years, admitted to our hospital between June 2004 and July 2007 were recruited in this study. The involved patients, including 21 males and 11 females, were aged 5-48 years. Their neurological functions were not obviously improved after various conventional treatments and limb function exercise. Meanwhile, various sensorimotors and autonomic nerve functional impairments were left. Among the patients, 18 suffered from acute viral myelitis, 8 from acute purulent myelitis and 6 from tuberculous myelitis. After onset, they were all given large doses of radiosonde,dexamethasone, anti-inflammatory and immunomodulatory drugs and various neurotrophic drugs. Twenty-six patients presented complete injury and six patients incomplete injury. Informed consent of treatment was obtained from each patient. The therapeutic protocol was approved by the Ethics Committee of the hospital. Embryonic olfactory bulbs were harvested from aborted embryo, which was donated voluntarily by the patients or their relatives.METHODS: Cells were isolated from embryonic olfactory bulbs, cultured and purified for 7 to 14 days, and finally they were digested into single-cell suspension. Under the surgical miscroscope, the cells were transplanted onto the regions which were above or below the spinal cord injury site. Two weeks to 2 months postoperatively, neurological function of spinal cord was assessed by using the American Spinal Injury Association (ASIA) Scoring Standard formulated in 2000, and was compared to pre-operation function.MAIN OUTCOME MEASURES: ①Sensory function change. ②Motor function change.RESULTS: Half a year to 2 years after olfactory ensheathing cell transplantation, the sensory and motor functions of 32 patients were all obviously improved (motor function: 55.72±10.50 vs. 51.53±13.41; light touch:69.53±11.68 vs.63.06±15.98; pain sense: 69.50±12.20 vs. 64.03±15.0, all P ＜ 0.01 ).CONCLUSION: Olfactory ensheathing cell transplantation can help to promote the neurological function recovery of patients with the sequel of myelitis. However, its long-term curative effect needs to be further investigated.

Objective To evaluate the early detection of diabetic cystopathy(DCP)with the technology of noninvasive urodynamics.Methods 70 patients with type 2 diabetes mellitus(DM)and 30 normal control subjects were checked with the technology of noninvasive urodynamics.Based on their disease course of less or mole than 5 years.the DM patients were divided into two groups.Maximal flow rate,average flow rate,the volume leading to first bladder sensation and residual urine volume were measured by using noninvasive urodynamic technology.Results Among the 70 DM patients,34 were detected to have bladder residual urine,so the DCP detection rate was 48.6%.In the patients with DCP,the average residual urine volume Was 7-139 ml(30.1±27.1)ml,while there was no residual urine in the normal control group.As compared with the normal control group,maximal flow rate and average flow rate were decreased in all the patients with DM and those with DCP(P＜0.01).After follow up of the disease,the patients with a course of more than five years of disease control had even lower maximal flow rate and average flow rate.Conclusion Maximal flow rate decrease and bladder residual urine detected with the technology of noninvasive urodynamics may be widely used in early detection and early diagnosis of DCP.

Objective To observe the characteristic changes in cardiac function and to raise diagnostic accuracy and sensibility.Methods 39 silent myocardial ischemia and 58 angina and 46 age-matched healthy subjects and 62 obsolete myocardial infarction underwent myocardial tomography imaging and gated ventricular imaging.Covariance analysis was used to compare difference between SPECT imaging and parameters of function.The age was tested as covariate factor,then SNK-Q test and multiple comparison were carried on.Results The silent myocardial ischemia and angina showed reversible radioactive defect or fixed defect.Most of myocardial SMI showed single peak exempt TPFR.EF,PFR and PER showed remarkably statistical difference (P<0.01).The multiple comparison of PFR and PER was increased according by OMI,AN,SMI and negative control group (P<0.05).Conclusions The myocardial damage and PFR,PER in SMI is lower than that in AN group,which have no remarkably influence on the parameters of diastolic and retractile function in left ventricular.

Objective To explore the clinical value of the thin-section CT scanning in all the steps of non-small cell lung cancer (NSCLC) therapy through 125I seed implantation. Methods In the 137 patients who were diagnosed with non-small cell cancer (NSCLC), the preoperative targets were delineated by CT scan, and the implantation plan was accom-plished according to treatment planning system (TPS); Intraoperative 125I seeds were implanted under the guidance of CT, then their positions were confirmed and corrected by CT scan layer-by-layer in real time;Post implantation dosimetry was validated also under the help of CT scan. If necessary, distribution and number of seeds should be adjusted to conform dose distribution under the principle of effectivity and micro-invasion;Follow-up and periodic evaluation should also be accom-plished by CT scan. Results Dose-volume histograms (DVHs) showed that the dose in line with the targets meet the re-quirement of prescription dose while the surrounding organs at risk were within the scope of their tolerance dose. Among 137 patients, implanted seeds number was the same with seeds number of TPS plan in 129 patients, and the coincidence rate was 94%. CT scan showed the local control efficient rate was 91.9%after 6 months. The 1-year and 2-year survival rates were 91.2%and 50.4%respectively. No serious operation-led complication was found during treatment. Conclusion The thin-section CT could be applied in all key steps of 125I seed implantation in NSCLC therapy, especially it is clinical significant and irreplaceable in quality assurance and control of seed implantation therapy.

BACKGROUND: Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord.OBJECTIVE: To probe into the effect and safety of transplantation of olfactory ensheathing cells on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN: Self-control experiment.SETTING: Wards of the Department of Surgery, Taian Rongjun Hospital of Shandong Province.PARTICIPANTS: Totally 48 patients admitted for obsolete spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years.METHODS: ①Cell culture: Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and puri fied for 1 to 2 weeks, and finally made into single cell suspension. ②Operation and cell transplantation: Under general anesthesia, the purified single cell suspension (about 0.05-0.20 mL) of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 mm in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function: Injury Scoring Standard made by American Spinal Injury Association (ASIA) was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or followed up through telephone at postoperative 3 weeks to 1 year.MAIN OUTCOME MEASURES: Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients.RESULTS: ①All the 48 patients had improvement in spinal function, and continued improved tendency was found in the observation and follow-up through telephone at postoperative 3 weeks to 1 year. ②Scoring by ASIA for sensory function was higher after operation than before operation (touch sensation: 56.9, 51.2, P ＜ 0.01; pain sensation: 55.2, 48.3, P ＜ 0.01). Sensory function was improved obviously at the lower shift of sensory level,generally more than 2 segments. ③Scoring by ASIA for motor function was higher after operation than before operation (44.8, 40.7, P ＜ 0.01), but the improvement was slow. ④Scoring by ASIA for automatic nervous system was higher after operation than before operation (18.0, 14.5, P ＜ 0.01); diaphoresis, increased enterokinesia and other automatic nervous system improved earliest.CONCLUSION: Transplantation of olfactory ensheathing cells promotes the spinal and neurofunctional recovery of patients with malignant spinal injury, and the therapeutic method is safe.

ObjectiveTo analyze therapeutic efficiency of 125 iodine brachytherapy seeds implantation guided by flexible fiber-optic bronchoscopy(FFB)image in terminal central non-small cell lung carcinoma (NSCLC).MethodsUnder therapy planning system (TPS) and guided by flexible fiber-optic bronchoscopy image,125 iodine seeds were implanted in 66 Confirmed terrainal cases with NSCLC and its posology Was validated and rechecked regularly.Remlts Complete remission (CR) was observed in 15 cases and partial remission (PR) in 36 cases during the first-year follow-up,with an overall efficiency rate (CR+PR) of 77.3 percent and one-year survival of 80.3 percent.Complete remission (CR) was observed in seven cases,partial remission (PR) in 22 cases,stable condition (SC) in three cases.and no progression was found during the second-year follow-up,respectively,with an overall efficiency rate (CR+PR) of 90.6 percent and two-year survival of 43.8 percent No radioactive damage were observed in the early and late stages of therapy.ConclusionsTherapy with radioactive 125 iodine seeds implantation guided by flexible fiber-optic bronchoscopy image could relieve airway obstruction effectively in terminal lung cancer and control progression of bronchiogenic carcinoma.

Objective To evaluate the clinical diagnosis value of 99mTc-single photon emission computed tomography(SPECT)brain blood perfusion imaging in intractable paroxysmal epilepsy and analyse the imaging character.Methods Two hundred and thirty-eight intractable paroxysmal epilepsy patients performed99mTc-SPECT,MRI,CT,and electroencephalogram(EEG).The results of examinations were ana lyzed and compared.Results The positive rate of epileptic focus in brain SPECT blood perfusion imaging in the generalized tonic-clonic seizure,absence seizure,partial seizure and complex partial seizure were 85.7%,95.7%,89.8%and 90.9%,the positive rate were much higher than those in other methods(P＜0.01).The 23 patients with SPECT focus were carried on a-γ-knife treatment with follow-up for more than one year,and the efficient rate was 78.26%.Conclusions The detection sentivity of SPECT is distinctively higher than that in others.SPECT has an important clinical value to define target region of the stereotaxic radio surgery.