石墨烯热疗对良性甲状腺结节的疗效
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摘要
目的:探讨石墨烯热疗对良性甲状腺结节的影响。方法:选取良性甲状腺结节患者97例,随机分为对照组(47例和治疗组(50例),对照组不接受任何干预措施,治疗组接受4个疗程共120 d的石墨烯护颈带治疗。超声测量两组患者治疗前后甲状腺结节最大直径、最大横截面面积,并采用直接化学发光法检测治疗前后两组患者甲状腺功能(FT3、FT4和促甲状腺激素)。结果:对照组治疗前后甲状腺结节最大直径、最大横截面面积无明显变化(P>0.05);经过治疗后,治疗组甲状腺结节最大直径减小(0.17±0.13)cm(P<0.05),最大横截面面积减小(0.41±0.45)cm2(P<0.05)。两组患者治疗前后甲状腺功能无明显变化(P>0.05)。结论:石墨烯热疗可缩小良性甲状腺结节的最大直径和最大横截面面积,对甲状腺功能无明显影响,具有良好的临床应用前景。
Objective To explore the responses of benign thyroid nodules to graphene thermal therapy. Methods A total of 97 patients with benign thyroid nodules were enrolled in this study and then randomly divided into control group(n=47) and treatment group(n=50). Control group did not receive any intervention measure, while treatment group received 4 courses(120 days) of graphene neck protection bandage treatment. The maximum diameter and maximum cross-sectional area of the thyroid nodules before and after treatment in both groups were measured with ultrasound. Thyroid functions(FT3, FT4 and thyroid stimulating hormone) in both groups before and after treatment were detected by direct chemiluminescence.Results The maximum diameter and maximum cross-sectional area of the thyroid nodules before and after treatment showed no obvious changes in control group(P>0.05). However, the maximum diameter and maximum cross-sectional area of the thyroid nodules in treatment group were reduced by(0.17±0.13) cm and(0.41±0.45) cm2, respectively(P<0.05). The hyroid functions remained stable in both groups before and after treatment(P>0.05). Conclusion Graphene thermal therapy which can reduce the maximum diameter and maximum cross-sectional area of benign thyroid nodules and has no significant effects on the thyroid functions is worthy of clinical application.
Objective To explore the responses of benign thyroid nodules to graphene thermal therapy. Methods A total of 97 patients with benign thyroid nodules were enrolled in this study and then randomly divided into control group(n=47) and treatment group(n=50). Control group did not receive any intervention measure, while treatment group received 4 courses(120 days) of graphene neck protection bandage treatment. The maximum diameter and maximum cross-sectional area of the thyroid nodules before and after treatment in both groups were measured with ultrasound. Thyroid functions(FT3, FT4 and thyroid stimulating hormone) in both groups before and after treatment were detected by direct chemiluminescence.Results The maximum diameter and maximum cross-sectional area of the thyroid nodules before and after treatment showed no obvious changes in control group(P>0.05). However, the maximum diameter and maximum cross-sectional area of the thyroid nodules in treatment group were reduced by(0.17±0.13) cm and(0.41±0.45) cm2, respectively(P<0.05). The hyroid functions remained stable in both groups before and after treatment(P>0.05). Conclusion Graphene thermal therapy which can reduce the maximum diameter and maximum cross-sectional area of benign thyroid nodules and has no significant effects on the thyroid functions is worthy of clinical application.
引文
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[8] KIM H, LEE D, KIM J, et al. Photothermally triggered cytosolic drug delivery via endosome disruption using a functionalized reduced graphene oxide[J]. ACS Nano, 2013, 7(8):6735-6746.
[9] BIONDI B, COOPER D S. The clinical significance of subclinical thyroid dysfunction[J]. Endocr Rev, 2008, 29(1):76-131.
[10]AKHAVAN O, GHADERI E, ABOUEI E, et al. Accelerated differentiation of neural stem cells into neurons on ginseng-reduced graphene oxide sheets[J]. Carbon, 2014, 66:395-406.
[11]VISWANATHAN S, NARAYANAN T N, ARAN K, et al.Grapheneprotein field effect biosensors:glucose sensing[J]. Mater Today, 2015, 18(9):513-522.
[12]HE J L, ZHU X D, QI Z N, et al. Killing dental pathogens using antibacterial graphene oxide[J]. ACS Appl Mater Interfaces, 2015, 7(9):5605-5611.
[13]FAN Z J, LIU B, WANG J Q, et al. A novel wound dressing based on Ag/graphene polymer hydrogel:effectively kill bacteria and accelerate wound healing[J]. Adv Funct Mater, 2014, 24(25):3933-3943.
[14]LI J, WANG G, ZHU H, et al. Antibacterial activity of large-area monolayer graphene film manipulated by charge transfer[J]. Sci Rep,2014, 4(3):4359.
[15]AKHAVAN O, GHADERI E, ESFANDIAR A. Wrapping bacteria by graphene nanosheets for isolation from environment, reactivation by sonication, and inactivation by near-infrared irradiation[J]. J Phys Chem B, 2011, 115(19):6279-6288.
[16]PHAM V T, TRUONG V K, QUINN M D, et al. Graphene induces formation of pores that kill spherical and rod-shaped bacteria[J]. ACS Nano, 2015, 9(8):8458-8467.
[17]胡希丽,田明伟,朱士凤,等.基于石墨烯整理的远红外发射棉织物[J].成都纺织高等专科学校学报, 2016, 33(2):11-14.HU X L, TIAN M W, ZHU S F, et al. Far infrared emitting cotton fabric based on graphene finishing[J]. Journal of Chengdu Textile College, 2016, 33(2):11-14.
[18]曲丽君,田明伟,迟淑丽,等.部分石墨烯复合纤维与制品的研发[J].纺织学报, 2016, 37(10):170-177.QU L J, TIAN M W, CHI S L, et al. Research and development of some graphene composite fibers and products[J]. Journal of Textile Research, 2016, 37(10):170-177.
[19]SAHU A, CHOI W I, LEE J H, et al. Graphene oxide mediated delivery of methylene blue for combined photodynamic and photothermal therapy[J]. Biomaterials, 2013, 34(26):6239-6248.
[20]DEMBERELDORJ U, CHOI S Y, GANBOLD E O, et al. Gold nanorod-assembled pegylated graphene-oxide nanocomposites for photothermal cancer therapy[J]. Photochem Photobiol, 2014, 90(3):659-666.
[21]YANG K, HU L L, MA X X, et al. Multimodal imaging guided photothermal therapy using functionalized graphene nanosheets anchored with magnetic nanoparticles[J]. Adv Mater, 2012, 24(14):1868-1872.
[22]中日医学科技交流协会热疗专业委员会,中华医学会放疗分会热疗专业委员会.中国肿瘤热疗临床应用指南(2017.V1.1)[J].中华放射肿瘤学杂志, 2017, 26(4):369-375.Sino Japan Science and Technology Association, Chinese Medical Association Radiotherapy Branch Thermotherapy Specialized Committe. Chinese application guide of clinical application of tumor hyperthermia(2017.V1.1)[J]. Chinese Journal of Radiation Oncology,2017, 26(4):369-375.
[23]吕晓宁,李鸣皋.远红外线生物学效应及其在组织修复中的临床应用[J].中国组织工程研究与临床康复, 2009, 13(46):9147-9150.LüX N, LI M G. Biological effects and clinical application of farinfrared rays in tissue repair[J]. Journal of Clinical Rehabilitative Tissue Engineering Research, 2009, 13(46):9147-9150.
[24]膝艳杰,赵慧.中远红外线对荷瘤鼠S-180肝脏MDA, SOD和GSHPx的影响[J].黑龙江医药科学, 1999, 22(6):8-9.XI Y J, ZHAO H. Effects of fat and middle infra-red ray on MAD,SOD and GSH-Px in the S-180 tumor rat[J]. Heilongjiang Medicine and Pharmacy, 1999, 22(6):8-9.
[2]徐小炮,姜涌斌,刘梅,等.健康体检人群甲状腺结节患病情况及相关因素分析[J].中华保健医学杂志, 2018, 20(3):210-212.XU X B, JIANG C B, LIU M, et al. Analysis of the prevalence and relevant factors of thyroid nodules among physical examination population[J]. Chinese Journal of Health Care and Medicine, 2018,20(3):210-212.
[3]霍立双,刘丰雨,高琛,等.我国大陆地区甲状腺结节患病率Meta分析[J].河北医科大学学报, 2017, 38(2):138-141.HUO L S, LIU F Y, GAO C, et al. Prevalence of thyroid nodules in mainland China:a Meta-analysis[J]. Journal of Hebei Medical University, 2017, 38(2):138-141.
[4]郭奕瑞,刘颖,张莉.健康体检人群甲状腺结节患病率及相关因素分析[J].现代防医学, 2016, 43(22):4063-4065.GUO Y R, LIU Y, ZHANG L. Analysis of the prevalence and relevant factors of thyroid nodule among the population undergoing routine physical examinations[J]. Modern Preventive Medicine, 2016, 43(22):4063-4065.
[5]林旋,郎江明,魏爱生,等.健康体检人群甲状腺结节发病危险因素的病例对照研究[J].广东医学, 2018, 39(4):604-607.LIN X, LANG J M, WEI A S, et al. Study of case control on risk factors of thyroid nodules among physical examination population[J]. Guangdong Medical Journal, 2018, 39(4):604-607.
[6] BRYAN R, HAUGEN, ERIK K, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer:what is new and what has changed?[J]. Arch Intern Med, 2016, 156(19):2165.
[7]中华医学会内分泌学分会,中华医学会外科学分会内分泌学组,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南[J].中华核医学与分子影像杂志, 2013, 33(2):96-115.Society of Endocrinology of Chinese Medical Association,Endocrinology Group of Surgical Branch of Chinese Medical Association, Head and Neck Oncology Committee of Chinese AntiCancer Association, et al. Guidelines for the diagnosis and treatment of thyroid nodules and differentiated thyroid carcinoma[J]. Chinese Journal of Nuclear Medicine and Molecular Imaging, 2013, 33(2):96-115.
[8] KIM H, LEE D, KIM J, et al. Photothermally triggered cytosolic drug delivery via endosome disruption using a functionalized reduced graphene oxide[J]. ACS Nano, 2013, 7(8):6735-6746.
[9] BIONDI B, COOPER D S. The clinical significance of subclinical thyroid dysfunction[J]. Endocr Rev, 2008, 29(1):76-131.
[10]AKHAVAN O, GHADERI E, ABOUEI E, et al. Accelerated differentiation of neural stem cells into neurons on ginseng-reduced graphene oxide sheets[J]. Carbon, 2014, 66:395-406.
[11]VISWANATHAN S, NARAYANAN T N, ARAN K, et al.Grapheneprotein field effect biosensors:glucose sensing[J]. Mater Today, 2015, 18(9):513-522.
[12]HE J L, ZHU X D, QI Z N, et al. Killing dental pathogens using antibacterial graphene oxide[J]. ACS Appl Mater Interfaces, 2015, 7(9):5605-5611.
[13]FAN Z J, LIU B, WANG J Q, et al. A novel wound dressing based on Ag/graphene polymer hydrogel:effectively kill bacteria and accelerate wound healing[J]. Adv Funct Mater, 2014, 24(25):3933-3943.
[14]LI J, WANG G, ZHU H, et al. Antibacterial activity of large-area monolayer graphene film manipulated by charge transfer[J]. Sci Rep,2014, 4(3):4359.
[15]AKHAVAN O, GHADERI E, ESFANDIAR A. Wrapping bacteria by graphene nanosheets for isolation from environment, reactivation by sonication, and inactivation by near-infrared irradiation[J]. J Phys Chem B, 2011, 115(19):6279-6288.
[16]PHAM V T, TRUONG V K, QUINN M D, et al. Graphene induces formation of pores that kill spherical and rod-shaped bacteria[J]. ACS Nano, 2015, 9(8):8458-8467.
[17]胡希丽,田明伟,朱士凤,等.基于石墨烯整理的远红外发射棉织物[J].成都纺织高等专科学校学报, 2016, 33(2):11-14.HU X L, TIAN M W, ZHU S F, et al. Far infrared emitting cotton fabric based on graphene finishing[J]. Journal of Chengdu Textile College, 2016, 33(2):11-14.
[18]曲丽君,田明伟,迟淑丽,等.部分石墨烯复合纤维与制品的研发[J].纺织学报, 2016, 37(10):170-177.QU L J, TIAN M W, CHI S L, et al. Research and development of some graphene composite fibers and products[J]. Journal of Textile Research, 2016, 37(10):170-177.
[19]SAHU A, CHOI W I, LEE J H, et al. Graphene oxide mediated delivery of methylene blue for combined photodynamic and photothermal therapy[J]. Biomaterials, 2013, 34(26):6239-6248.
[20]DEMBERELDORJ U, CHOI S Y, GANBOLD E O, et al. Gold nanorod-assembled pegylated graphene-oxide nanocomposites for photothermal cancer therapy[J]. Photochem Photobiol, 2014, 90(3):659-666.
[21]YANG K, HU L L, MA X X, et al. Multimodal imaging guided photothermal therapy using functionalized graphene nanosheets anchored with magnetic nanoparticles[J]. Adv Mater, 2012, 24(14):1868-1872.
[22]中日医学科技交流协会热疗专业委员会,中华医学会放疗分会热疗专业委员会.中国肿瘤热疗临床应用指南(2017.V1.1)[J].中华放射肿瘤学杂志, 2017, 26(4):369-375.Sino Japan Science and Technology Association, Chinese Medical Association Radiotherapy Branch Thermotherapy Specialized Committe. Chinese application guide of clinical application of tumor hyperthermia(2017.V1.1)[J]. Chinese Journal of Radiation Oncology,2017, 26(4):369-375.
[23]吕晓宁,李鸣皋.远红外线生物学效应及其在组织修复中的临床应用[J].中国组织工程研究与临床康复, 2009, 13(46):9147-9150.LüX N, LI M G. Biological effects and clinical application of farinfrared rays in tissue repair[J]. Journal of Clinical Rehabilitative Tissue Engineering Research, 2009, 13(46):9147-9150.
[24]膝艳杰,赵慧.中远红外线对荷瘤鼠S-180肝脏MDA, SOD和GSHPx的影响[J].黑龙江医药科学, 1999, 22(6):8-9.XI Y J, ZHAO H. Effects of fat and middle infra-red ray on MAD,SOD and GSH-Px in the S-180 tumor rat[J]. Heilongjiang Medicine and Pharmacy, 1999, 22(6):8-9.