Bone metastases in newly diagnosed patients with thyroid cancer: A large population-based cohort study

Background

Population-based estimates of the incidence and prognosis of bone metastases (BM) stratified by histologic subtype at diagnosis of thyroid cancer are limited.

Methods

Using multivariable logistic and Cox regression analyses, we identified risk factors for BM and investigated the prognostic survival of BM patients between 2010 and 2015 via the Surveillance, Epidemiology, and End Results (SEER) database.

Results

Among 64,083 eligible patients, a total of 347 patients with BM at the time of diagnosis were identified, representing 0.5% of the entire cohort but 32.4% of the subset with metastases. BM incidence was highest (11.6%) in anaplastic thyroid cancer (ATC), which, nevertheless, was highest (61.5%) in follicular thyroid cancer (FTC) among the subset with metastases. The median overall survival among BM patients was 40.0 months, and 1-, 3-, and 5-year survival rates were 65.2%, 51.3%, and 38.7%, respectively. Compared with papillary thyroid cancer (PTC), FTC (aOR, 6.33; 95% CI, 4.72–8.48), medullary thyroid cancer (MTC) (aOR, 6.04, 95% CI, 4.09–8.92), and ATC (aOR, 6.21; 95% CI, 4.20–9.18) significantly increased the risk of developing BM. However, only ATC (aHR, 6.07; 95% CI, 3.83–9.60) was independently associated with worse survival in multivariable analysis. Additionally, patients with BM alone (56.5%) displayed the longest median survival (66.0 months), compared with those complicated with one extraskeletal metastatic site (lung, brain, or liver) (35.2%; 14.0 months) and two or three sites (8.3%; 6.0 months). The former 5-year overall survival rate was 52.6%, which, however, drastically declined to 23.0% in patients with one extraskeletal metastatic site and 9.1% with two or three sites.

Conclusion

Closer bone surveillance should be required for patients with FTC, MTC, and ATC, and extraskeletal metastases at initial diagnosis frequently predict a poorer prognosis.

Development of stable, cold-adapted, temperature-sensitive/conditional lethal chimeric enterovirus A71 and coxsackievirus A16

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A stable EV-A71 virus vector was created to generate chimeric strains expressing capsid protein genes of EV-A71 C5 and CA16.

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Phenotypic and genetic stability of the generated chimeric EV-A71 and CA16 were analyzed.

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The amino acids at the cleavage site between VP1 and 2A is crucial for stability.

miRNA-34c-5p targets Fra-1 to inhibit pulmonary fibrosis induced by silica through p53 and PTEN/PI3K/Akt signaling pathway

Silica dust particles are representative of air pollution and long-term inhalation of silicon-containing dust through the respiratory tract can cause pulmonary fibrosis. Epithelial-mesenchymal transformation (EMT) plays an important role in the development of fibrosis. This process can relax cell-cell adhesion complexes and enhance cell migration and invasion properties of these cells. Dysregulation of microRNA-34c (miR-34c) is highly correlated with organ fibrosis including pulmonary fibrosis. In this study, we found that miR-34c-5p could alleviate the occurrence and development of silica-mediated EMT. Fos-related antigen 1 was identified as a functional target of miR-34c-5p by bioinformatics analysis and the dual luciferase gene reporting assay. Importantly, chemically induced up-regulation of hsa-miR-34c-5p correlated inversely with the expression of Fra-1 and further exploration found that the miR-34c-5p/Fra-1 axis inhibits the activation of the phosphatase and tensin homolog deleted on chromosome 10/phosphatidylinositol-4,5-bisphosphate3-kinase/protein kinase B (PTEN/PI3K/AKT) signaling pathway. In addition, through interaction with PTEN/p53 it inhibits the proliferation and migration of human bronchial epithelial cells stimulated by silica, and promotes cell apoptosis, thereby preventing EMT. This finding provides a promising biomarker for the diagnosis and prognosis of pulmonary fibrosis. Furthermore, overexpression of miR-34c-5p represents a potential therapeutic approach.

Epigallocatechin-3-gallate ameliorates renal endoplasmic reticulum stress-mediated inflammation in type 2 diabetic rats

Epigallocatechin-3-gallate (EGCG), an essential polyphenolic constituent found in tea leaves, possesses various potent biological activities. This research was undertaken to investigate the impact of EGCG against endoplasmic reticulum (ER) stress-mediated inflammation and to clarify the underlying molecular mechanism in type 2 diabetic kidneys. The male rats were randomized into four groups: normal, diabetic, low-dose EGCG, and high-dose EGCG. In type 2 diabetic rats, hyperglycemia and hyperlipidemia noticeably caused renal structural damage and dysfunction and aggravated ER stress. Meanwhile, sustained ER stress activated the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome and then upregulated the contents of inflammatory cytokines in the diabetic kidney. Following supplementation with 40 mg/kg and 80 mg/kg EGCG, hyperglycemia, hyperlipidemia, and renal histopathological alterations and dysfunction were noticeably ameliorated; renal ER stress, NLRP3 inflammasome, and inflammatory response were markedly repressed in the EGCG treatment groups. In summary, the current study highlighted the renoprotective effects of EGCG in type 2 diabetes and its mechanisms are mainly associated with the repression of ER stress-mediated NLRP3 inflammasome overactivation.

Identification of key pathways and genes in the progression of silicosis based on WGCNA

Silicosis, induced by inhaling silica particles in workplaces, is one of the most common occupational diseases. The prognosis of silicosis and its consequent fibrosis is extremely poor due to limited treatment modalities and lack of understanding of the disease mechanisms. In this study, a Wistar rat model for silicosis fibrosis was established by intratracheal instillation of silica (0, 50, 100 and 200 mg/mL, 1 mL) with the evidence of Hematoxylin and Eosin (HE) and Masson staining and the expressions of inflammatory and fibrotic proteins of rats' lung tissues. RNA of lung tissues of rats exposed to 200 mg/mL silica particles and normal saline for 14 d and 28 d was extracted and sequenced to detect differentially expressed genes (DEGs) and to identify silicosis fibrosis-associated modules and hub genes by Weighted gene co-expression network analysis (WGCNA). Predictions of gene functions and signaling pathways were conducted using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. In this study, it has been demonstrated the promising role of the Hippo signaling pathway in silicosis fibrosis, which will be conducive to elucidating the specific mechanism of pulmonary fibrosis induced by silica and to determining molecular initiating event (MIE) and adverse outcome pathway (AOP) of silicosis fibrosis.

Radionuclide 131I-labeled albumin-indocyanine green nanoparticles for synergistic combined radio-photothermal therapy of anaplastic thyroid cancer

Objectives

Anaplastic thyroid cancer (ATC) cells cannot retain the radionuclide iodine 131 (¹³¹I) for treatment due to the inability to uptake iodine. This study investigated the feasibility of combining radionuclides with photothermal agents in the diagnosis and treatment of ATC.

Methods

¹³¹I was labeled on human serum albumin (HSA) by the standard chloramine T method. ¹³¹I-HSA and indocyanine green (ICG) were non-covalently bound by a simple stirring to obtain ¹³¹I-HSA-ICG nanoparticles. Characterizations were performed in vitro. The cytotoxicity and imaging ability were investigated by cell/in vivo experiments. The radio-photothermal therapy efficacy of the nanoparticles was evaluated at the cellular and in vivo levels.

Results

The synthesized nanoparticles had a suitable size (25–45 nm) and objective biosafety. Under the irradiation of near-IR light, the photothermal conversion efficiency of the nanoparticles could reach 24.25%. In vivo fluorescence imaging and single-photon emission CT (SPECT)/CT imaging in small animals confirmed that I-HSA-ICG/¹³¹I-HSA-ICG nanoparticles could stay in tumor tissues for 4–6 days. Compared with other control groups, ¹³¹I-HSA-ICG nanoparticles had the most significant ablation effect on tumor cells under the irradiation of an 808-nm laser.

Conclusions

In summary, ¹³¹I-HSA-ICG nanoparticles could successfully perform dual-modality imaging and treatment of ATC, which provides a new direction for the future treatment of iodine-refractory thyroid cancer.

Effect of Lugol's solution on 131I therapy efficacy in Graves' disease

PURPOSE

Lugol's solution could control thyroid function and suppress ¹³¹I uptake in hyperthyroidism. This study aimed to investigate the appropriate time to withdraw Lugol's solution before ¹³¹I therapy (RIT) in Graves' disease (GD) patients, and how this should influence ¹³¹I uptake and RIT outcome.

METHODS

Two groups (125 cases and 1805 cases) of GD patients received RIT, who were pre-treated with and without Lugol's solution (RI-CI group and RI group). The RI-CI group was further divided into the following sub-groups depending on the duration span between Lugol's solution withdrawal and RIT: sub-group A, 4-7 d (n = 49); sub-group B, 8-14 d (n = 41); and sub-group C, 15-30 d (n = 35). The highest radioactive iodine uptake rate (RAIU_max), effective half-life (T_eff), TRAb, and free triiodothyronine (FT₃) and free thyroxine (FT₄) levels were compared, and therapeutic outcome was evaluated.

RESULTS

There were no significant differences in RAIU_max, TRAb, and T_eff among the four sub-groups (P > 0.05). Both FT₃ and FT₄ levels in sub-groups A and B were lower than those in group RI and sub-group C (P < 0.05). The outcome of non-hyperthyroidism (euthyroidism + hypothyroidism) in groups RI-CI and RI was significantly different at post-RIT month 1 and 3 (P < 0.05). However, intergroup differences at 6 and 12 months were not significant (P > 0.05).

CONCLUSIONS

Withdrawal of Lugol's solution 4-7 or 8-14 d before RIT does not influence ¹³¹I uptake and RIT efficacy in GD. Moreover, in order to avoid a rapid increase in thyroid hormone levels at the same time, Lugol's solution should be withdrawn 4-7 d before RIT.

Event-Based Tracking Consensus for Multiagent Systems With Volatile Control Gain

This work investigates the tracking consensus problem of multiagent systems over directed networks, where the control gains follow certain volatile patterns. Some event-based consensus protocols are formulated so as to reduce the redundant execution of control. By using an extended differential inequality with a time-dependent coefficient, criteria for tracking consensus under time- and state-dependent triggering conditions are constructed, respectively. It is proved that the time average of the control gain, together with the agent dynamics, network topology, and triggering conditions, governs the consensus despite the fluctuation of control gain. The derived theorem can be utilized to ensure consensus with intermittent strategies aiming to lessen the burden in communications, including aperiodic on-off control with periodic perturbation and pulse-modulated on-off control. Unlike existing works, the requirement of a positive lower bound of control ratios is removed and, thus, a wide range of control gain patterns is possible, signifying higher flexibility in intermittent policy design. Finally, numerical examples are provided to further illustrate the theoretical results.

Improvement of two Mn2+ coordination polymers on cognitive function of aged rats after anesthesia

Two Mn²⁺ coordination polymers (CPs) with the scientific terms of {[Mn(TTPA)·(H₂O)₂]·H₂O}_n (1) and {[Mn(TTPA)·(H₂TTPA)]·2DMSO}_n (2) were favorably created on the basis of multidentate linking organic ligand 2,5-bis-(1,2,4-triazol-1-yl)-terephthalic acid (H₂TTPA) in the conditions of solvent-presupposed thermal reaction. To measure the influence of two Mn²⁺ coordination polymers with novel structures, the ELISA assay and real-time RT-PCR assay were conducted in this present research. First of all, the ELISA assay was conducted to measure the content of inflammatory cytokines released into the hippocampal tissue. In addition to this, the relative expression of the TAU protein in the brain was further determined with real-time RT-PCR assay.

Engineering a HEK-293T exosome-based delivery platform for efficient tumor-targeting chemotherapy/internal irradiation combination therapy

Exosomes are nanoscale monolayer membrane vesicles that are actively endogenously secreted by mammalian cells. Currently, multifunctional exosomes with tumor-targeted imaging and therapeutic potential have aroused widespread interest in cancer research. Herein, we developed a multifunctional HEK-293T exosome-based targeted delivery platform by engineering HEK-293T cells to express a well-characterized exosomal membrane protein (Lamp2b) fused to the αv integrin-specific iRGD peptide and tyrosine fragments. This platform was loaded with doxorubicin (Dox) and labeled with radioiodine-131 (¹³¹I) using the chloramine-T method. iRGD exosomes showed highly efficient targeting and Dox delivery to integrin αvβ3-positive anaplastic thyroid carcinoma (ATC) cells as demonstrated by confocal imaging and flow cytometry in vitro and an excellent tumor-targeting capacity confirmed by single-photon emission computed tomography-computed tomography after labeling with ¹³¹I in vivo. In addition, intravenous injection of this vehicle delivered Dox and ¹³¹I specifically to tumor tissues, leading to significant tumor growth inhibition in an 8505C xenograft mouse model, while showing biosafety and no side effects. These as-developed multifunctional exosomes (denoted as Dox@iRGD-Exos-¹³¹I) provide novel insight into the current treatment of ATC and hold great potential for improving therapeutic efficacy against a wide range of integrin αvβ3-overexpressing tumors.

Predictive factors for the efficacy of 131I therapy with formulated dosage calculation on Graves' disease

OBJECTIVE

To analyse predictive factors to ensure the efficacy of iodine-131 (¹³¹I) therapy on Graves' disease (GD).

SUBJECTS AND METHODS

Graves' disease patients from three tertiary medical centers were enrolled. Serological data, thyroid mass estimation, thyroid radioactive iodine uptake, thyroid texture and thyroid murmurs (bruits) were recorded. Iodine-131 treatment was performed by applying a formulated calculation method. After one year of follow-up, GD patients with euthyroidism and hypothyroidism were classified as the cured group, and the other thyroid function status refers to the uncured group. These analyses were performed by using SPSS17.0 software. A P value of less than 0.05 was considered statistically significant.

RESULTS

A total of 970 GD patients, of which 540 patients (55.7%) belonged to the cured group, and 430 patients (44.3%) belonged to the uncured group, participated in the current analyses. Multivariate logistic regression analysis was performed. Moreover, estimated thyroid mass, thyroid murmurs (bruits), prescribed ¹³¹I dosage, FT3 and FT4 have independent prognostic value for ¹³¹I efficacy, and their odds ratios are 1.368, 2.283, 1.326, 1.467 and 1.419, respectively.

CONCLUSION

Graves' disease patients who are undergoing ¹³¹I therapy using the formulated dosage calculation could be influenced by thyroid mass, thyroid murmurs, ¹³¹I dosage and thyroid function.

Industry Distribution Characteristics of Benzene-Induced Leukemia - 7 PLADs, China, 2005-2019

What is already known about this topic?

In the 1980s. benzene-induced leukemia (BIL) mainly occurred in shoemaking and painting industries. Now the industry distribution of benzene-induced leukemia may have changed over time.

What is added by this report?

BlL cases mainly occurred in the manufacturing industry from 2005-2019, especially in private enterprises and small/medium-sized enterprises. The industry with the largest number of new cases of BIL was the general and special equipment manufacturing. The number of leukemia cases in emerging industries such as computer/electronic product manufacturing was found to be increasing.

What are the implications for public health practice?

Strengthening supervision and regulation of manufacturing, especially of small/medium-sized enterprises and emerging manufacturing industry, may be effective in reducing BIL.

Passenger lymphocyte syndrome in renal transplantation: A systematic review of published case reports

BACKGROUND

Passenger lymphocyte syndrome (PLS) is an immune-mediated hemolysis that occurs after ABO-mismatched kidney transplantation. PLS is caused by donor lymphocytes producing antibodies to recipient red blood cells, resulting in hemolysis. The incidence of PLS has been reported to be approximately 20% in patients with ABO-mismatched groups. Nevertheless, there is no comprehensive review of PLS following renal transplantation. In this review, we systematically summarized the data of patients with PLS after renal transplantation to help clinicians diagnose and treat more effectively.

METHODS

A systematic review was conducted using PubMed, Embase, and Web of Science. All relevant data were collected, including age, sex, and clinical and immune parameters.

RESULTS

A total of 91 published cases were identified. The age ranged from 9 to 70 years old and 58.2% were male. Eighty-six cases were only kidney transplantations, one was liver-kidney transplantation, three were pancreas-kidney transplantations, and one was intestinal-kidney transplantation. Of these cases, 27 received kidneys from deceased donors, whereas 40 received kidneys from living donors. Most patients showed immune hemolysis dominated by anaemia, which was significantly improved after symptomatic support treatment, such as blood transfusion and erythropoietin injection.

CONCLUSION

PLS is an immune-mediated disease that can occur in patients with ABO-mismatched renal transplantation, which commonly causes hemolysis, although death or deformities of the graft can also occur in patients with the disorder. Symptomatic supportive treatment is an effective treatment scheme at present, but more effective treatment and prevention schemes still need to be explored.

Evaluating the Therapeutic Efficacy of Radiolabeled BSA@CuS Nanoparticle-induced Radio-photothermal Therapy against Anaplastic Thyroid Cancer

PURPOSE

Bovine serum albumin (BSA) has been employed as a mild biological template in nanoscale particles. Copper sulfide (CuS) has been used for photothermal therapy (PTT) in several studies. In this study, we aimed to synthesize the ¹³¹ I-labeled BSA-modified CuS nanoparticles (¹³¹ I-BSA@CuS), with attributes of both radiotherapy and PTT, as a therapeutic agent against anaplastic thyroid carcinoma (ATC).

METHOD

BSA@CuS nanoparticles were prepared using the solvothermal reaction and then labeled with Na¹³¹ I by the chloramine-T method. The products were characterized and their cytotoxicity was investigated in vitro and in vivo. The therapeutic efficacy of ¹³¹ I-BSA@CuS was evaluated in ARO cell (an ATC cell line) subcutaneous tumors.

RESULTS

The nanoparticles showed good biocompatibility and low toxicity in vitro and in vivo. BSA@CuS rapidly and effectively converted the light energy from an 808 nm laser into thermal energy with a conversion efficiency of 28.07%. SPECT/CT imaging demonstrated that the accumulation of radioactivity peaked within 24 h and resided in the tumors for 5 days post intratumoral injection. In vivo assays indicated that, compared to monotherapy, the synthesized nanoparticles employing both PTT and radiotherapy possess better therapeutic efficacy against tumors.

CONCLUSION

The synthesized nanomaterial showed uniform dispersion, good stability and aqueous solubility, excellent photothermal properties, and long-term retention in ATC. Hence, combined radiotherapy and PTT can significantly inhibit tumor growth compared to monotherapy, and can be applied in clinical settings.

[Interventional effect of asiaticosdide on rats exposed to silica dust]

Objective: To investigate the effect of asiaticoside for fibrosis in lung tissues of rats exposed to silica and to explore its possible mechanism. Methods: 144 SD male rats were randomly divided into control group, model group, positive drug control group, asiaticoside high-dose group, medium-dose group and low-dose group, each group included 24 rats. Rats in the control group were perfused with 1.0 ml of normal saline, and the other groups were given 1.0 ml 50 mg/ml SiO(2) suspension. Gavage of herbal was given from the next day after model establishment, once a day. Rats in the positive drug control group were administration with 30 mg/kg tetrandrine and rats in the low-dose group, medium-dose group and high-dose group were given 20 mg/kg, 40 mg/kg and 60 mg/kg asiaticoside for fibrosis respectively. Rats in the control group and the model group were given 0.9% normal saline. The rats were sacrificed in on the 14th, 28th and 56th day after intragastric administration and collect the lung tissues to detect the content of hydroxyproline, TGF-β(1) and IL-18, observe the pathological changes of the lung tissues by HE and Masson staining and determine the expressions of Col-I, a-SMA, TGF-β in lung tissues by Western Blot. Results: On the 14th day, 28th day and 56th day after model establishment, the lung tissues of rats in the model group showed obvious inflammatory response and accumulation of collagen fibers, and the degree of inflammation and fibrosis increased with time. The intervention of asiaticoside could effectively inhibit the pathological changes of lung tissues. The contents of hydroxyproline, IL-18 and TGF-β1 in lung tissues of model group were higher than those in the control group (P<0.05) , while the level of hydroxyproline, IL-18 and TGF-β1 in asiaticoside groups were significantly decreased, and the difference was statistically signicant (P<0.05) . Compared with the control group, the expression levels of Col-I, TGF-β1and α-SMA in lung tissue of model group were increased (P<0.05) , while the expression level of Col-I, TGF-β1 and α-SMA were decreased after the intervention of asiaticoside, and the difference was statistically signicant (P<0.05) . Conclusion: Asiaticoside can inhibit the increase of Col-I, TGF-β1 and α-SMA content in the SiO(2)-induced lung tissues of rats, reduce the release of TGF-β1 and IL-18 inflammatory factors in lung tissue, and then inhibit the synthesis and deposition of extracellular matrix in rat lung tissue, and improve silicosis fibrosis.

Effects of high-activity radioactive iodine treatment on renal function in patients with differentiated thyroid carcinoma - retrospective study

INTRODUCTION

It is not clear whether high-activity radioactive iodine (¹³¹I) treatment will affect renal function. This study aimed to investigate the effects of high-activity ¹³¹I treatment on the clinical metrics of renal function in patients with differentiated thyroid carcinoma (DTC).

MATERIAL AND METHODS

262 DTC patients with abnormal baseline renal function (group A) and 262 DTC patients with normal baseline renal function (group B) who received 131I therapy were analysed. Each group was further divided into three subgroups based on the cumulative activity of 131I: subgroup 1 if the cumulative activity was less than 11.1 GBq; subgroup 2 if the cumulative activity was between 11.1 GBq and 18.5 GBq; and subgroup 3 if the cumulative activity was more than 18.5 GBq. The clinical metrics of renal function including serum creatinine (SCr), blood urea nitrogen (BUN) and estimated glomerular filtration rate (eGFR) were measured and compared before initial 131I treatment and 5 years later.

RESULT

There was no significant difference of the demographics between the two groups. In group A, SCr and BUN levels were elevated in 186 and 113 patients, respectively, and eGFR was decreased in 108 patients before the initial ¹³¹I therapy. SCr and BUN levels were found to be increased in all subgroups 5 years after the initial ¹³¹I therapy; furthermore, eGFR was found to be decreased in all subgroups after ¹³¹I therapy, and the difference was statistically significant (p < 0.05). A gender bias was not observed in the changing trends of SCr and BUN levels and eGFR. In group B, no significant difference in the mean levels of SCr, BUN, and eGFR was observed in the 3 subgroups (p > 0.05), regardless of gender, before the initial ¹³¹I therapy and 5 years later. A total of 5, 2, and 2 patients presented with abnormal renal function after ¹³¹I treatment in subgroups 1, 2, and 3, respectively. No statistically significant difference was observed in the incidence of renal dysfunction among the 3 subgroups (p = 0.423).

CONCLUSION

Our findings suggest that the nephrotoxicity of high-activity ¹³¹I therapy, regardless of gender, is very low in patients with DTC with normal renal function; however, high-activity ¹³¹I therapy may exacerbate the loss of renal function in those with renal dysfunction.

Predictive Value of Clinical and Pathological Characteristics for Metastatic Radioactive Iodine-Refractory Differentiated Thyroid Carcinoma: A 16-year Retrospective Study

PURPOSE

To assess predictive value of clinical and pathological characteristics for metastatic radioactive iodine-refractory differentiated thyroid carcinoma (RAIR-DTC) in early stage retrospectively.

METHODS

We studied 199 metastatic DTC patients who were divided into two groups (TgAb negative and TgAb positive). The stimulated Tg (Sti-Tg) at the first and second radioiodine therapy (RIT) were defined as Sti-Tg1 and Sti-Tg2, the suppressed Tg (Sup-Tg) were designated as Sup-Tg1 and Sup-Tg2, while the TgAb were defined as TgAb1 and TgAb2, respectively. Univariate analysis and Logistic regression were used to investigate the effects of 13 observed factors to predict RAIR-DTC.

RESULTS

In TgAb negative group, ROC curve analysis showed that cut-off values of age, Sti-Tg2/Sti-Tg1 and Sup-Tg2/Sup-Tg1 to predict RAIR-DTC were 40 years old, 57.0% and 81.0%, respectively. Age, extrathyroid invasion, Sti-Tg2/Sti-Tg1, Sup-Tg2/Sup-Tg1 and BRAF gene mutation were proved to be independent factors predicting RAIR-DTC. In TgAb-positive group, ROC curve analysis showed that cut-off values of age, TgAb1 and TgAb2/TgAb1 to predict RAIR-DTC were 55 years old, 297 IU/ml (14.8 times higher than the upper limit) and 53.6%, respectively.

CONCLUSIONS

For TgAb-negative DTC, age over 40, extraglandular invasion, mutated BRAF gene, Sti-Tg decreased less than 43%, and Sup-Tg decreased less than 19% after the first two courses of RIT were independent predictors for RAIR-DTC. For TgAb-positive DTC, age over 55, extraglandular invasion, mutated BRAF gene, distant metastasis before RIT, TgAb level 14.8 times higher than the upper limit, TgAb dropped less than 46.4% after two courses of RIT were influencing factors.

HSA-MnO2-131I Combined Imaging and Treatment of Anaplastic Thyroid Carcinoma

Purpose Compelling evidence suggests that nanoparticles (NPs) play a crucial role in cancer therapy. NPs templated with human serum albumin (HSA) has good retention in tumors. Manganese dioxide (MnO₂) has been used to enhance the effect of radiotherapy. In this study, synthesized NPs using HSA-MnO₂ labeled ¹³¹I to perform both imaging and therapy for anaplastic thyroid carcinoma (ATC). Method HSA-MnO₂ was synthesized via HSA using a simple biomineralization method, and then labeled with Na¹³¹I by the chloramine T method. The cytotoxicity and biosafety of HSA-MnO₂ were evaluated by the MTT test. The proliferation-inhibiting effect of HSA-MnO₂-¹³¹I was evaluated in papillary thyroid cancer cell lines (K1, BCPAP, and KTC) and anaplastic thyroid carcinoma cell lines (Cal62, THJ16T, and ARO). For further translational application in medicine, we established a model of transplantable subcutaneously tumors in BALB\c-nu mice to assess the anti-tumor effect of HSA-MnO₂-¹³¹I. The imaging effects of NPs were evaluated by MRI and SPECT/CT. Results The MTT test proved that the HSA-MnO₂ had low toxicity. HSA-MnO₂-¹³¹I significantly inhibited the proliferation of PTC and ATC cell lines. In addition, the results unveiled that HSA-MnO₂-¹³¹I exhibited dual-modality MR/SPECT imaging for thyroid cancer visualization. In particular, HSA-MnO₂-¹³¹I had an enhanced T1 signal in MR. Using SPECT/CT, we observed that HSA-MnO₂-¹³¹I had good retention in tumor tissue, which was helpful for the diagnosis and treatment of tumor. In vivo assays indicated that the NPs led to a reduction in radioresistance in the tumor hypoxic microenvironment. Conclusion The nanomaterial had a simple synthesis method, good water solubility and biosafety, and good retention in tumor tissue. Hence, it could be used for SPECT/CT and MR dual mode imaging and therapy with radioiodine of tumor cells. The experimental results provided a feasible solution for combining radiotherapy and dual-model imaging by NPs for cancer diagnosis and treatment.

[Evaluation of papilledema and visual improvement in patients with idiopathic intracranial hypertension after venous sinus stenting]

Objective: To evaluate the improvement of papilledema and visual acuities in patients with idiopathic intracranial hypertension (IIH) after venous sinus stenting. Methods: The clinical data of 8 IIH patients who met the inclusion criteria underwent venous sinus stenting between January 2013 and December 2016 at Department of Neurosurgery, Tianjin Huanhu Hospital were analyzed retrospectively. There were 6 females and 3 males,aged (32.9±14.4)years (range:19 to 57 years).The thickness of the retinal nerve fiber layer (RNFL) was measured by optical coherence tomography. Fundus,visual acuity and visual field examination were performed before and after operation. If pressure gradient ≥10 mmHg(1 mmHg=0.133 kPa) across the venous stenosis was indicated by intraoperative pressure measurement,the patient would be treated with venous sinus stenting. Intracranial pressure was measured by lumbar puncture 3 to 7 days after operation. RNFL thickness and eye examination were detected 6 months after surgery. CT venogram was used to observe the sinus venous conditions. Paired t test was used to compare the data before and after surgery. Results: All the 8 patients underwent venous sinus stenting successfully. The mean pressure gradient across the venous stenosis was reduced from (24±9.2) mmHg to (2.6±2.0) mmHg (t=8.02,P<0.01). Intracranial pressure decreased from preoperative (41.4±12.7) cmH₂O(1 cmH₂O=0.098 kPa) to postoperative (12.9±3.3) cmH₂O (t=7.08, P<0.01). The RNFL thickness decreased from (275.3±68.3)μm to (131.4±31.8)μm(t=5.80,P<0.05) 6 months after surgery and the baseline visual acuity was improved from(M(Q_R))0.24 (0.25) to 0.65 (0.23)(Z=-2.52,P<0.05).Papilledema was significantly improved in 6 patients,and no significant change in 2 patients. CT venogram indicated adjacent stent restenosis in 1 patient. Conclusion: Venous sinus stenting can effectively improve papilledema and visual acuity caused by IIH.

Analytical validation of the LiCA® high-sensitivity human thyroid stimulating hormone assay

BACKGROUND

We aimed to assess the analytical characteristics of a new high-sensitivity human thyroid stimulating hormone (hTSH) assay on a light-initiated chemiluminescent immunoassay system (LiCA Smart) and examine the utility of this assay in the context of profoundly low TSH levels (<0.01 mIU/L).

METHODS

Analytical validations included precision, linearity, reportable range, analytical sensitivity, interference, reagent lot-to-lot and between-instrument variability, and method comparisons. Additionally, a cross-sectional study was performed to evaluate the assay for the detection of profoundly low TSH levels in comparison to those of two other ultrasensitive hTSH assays.

RESULTS

Within-run and within-lab imprecisions (%CV) were < 5% at all concentrations studied. A satisfactory linearity (R = 0.998, change in recovery < 5%) was verified over the entire measuring range. Method comparisons demonstrated a reasonable agreement (R > 0.99, median bias < 5%) between LiCA and Cobas, ADVIA, UniCel or Architect. The limit of quantitation was 0.0019 mIU/L. Comparative measurements of 236 patient samples with profoundly low TSH levels (<0.01 mIU/L) by LiCA, Cobas, and Architect revealed that the detection rate observed with LiCA (67.8%) was significantly higher than that with Cobas (28.0%) or Architect (21.7%). In a further comparative follow-up of patients with overt hyperthyroidism who were receiving treatment, an earlier recovery response of TSH was observed in LiCA.

CONCLUSIONS

The LiCA Smart hTSH is a precise and highly sensitive fourth-generation assay. The assay demonstrated superior detection sensitivity for profoundly low TSH levels and was acceptable for clinical use.