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Objective: a comprehensive analysis of the first application of large doses 131 I cleared differentiated thyroid carcinoma (DTC) patients with postoperative residual thyroid tissue (clear A) the effect of influencing factors, to improve the success rate of clearance A provides a theoretical basis. 2, analysis of large doses 131 I Ching A treatment of early adverse reactions, its treatment safety evaluation. 3, the monitoring of high-dose 131 I disease after treatment wards and local environment γ-ray radiation dose rate levels, the evaluation process of medical activities of the radiation safety, specifically large doses 131 I treated the environmental impact. Method: 1, the first high-dose 131 I cleared the DTC A 46 patients after surgery, according to a clear set of results into successful and not successful teams to serve 131 I dose, age, gender, histological type, surgical procedure, surgical times, the last surgery to clear A pre-treatment time, residual thyroid tissue weight, serum TSH levels, thyroid outside metastases, staging and other factors affecting the univariate analysis, draw meaningful indicators based on multivariate conditional Logistic regression analysis, screening for judging success Ching A meaningful indicators and draw the receiver operating characteristic curve (receiver operator characteristic curve, ROC curves). 2, high-dose 131 I Ching A first before treatment and 1 month after blood, liver function, serum calcium, phosphorus, and parathyroid hormone test results were compared and analyzed radioactive thyroiditis (radiotion thyroiditis, RT), radiation sialadenitis (radiation sialoadenitis, RS) were observed. 3, analysis of the radiation measured with a γ for 17 batches of 24 hours after treatment wards at 1 meter from the patient and the ward environment γ radiation dose rate levels. Results: Univariate analysis showed that patients taking large doses of first 131 I dose, age, gender, histological type, number of operations, before taking thyroid hormone therapy, pathological staging was no significant effect on the impact of the Qing A (P> 0.05), while the surgical approach, the residual thyroid tissue weight, serum TSH levels, the last surgery to first clear A pre-treatment time, outside the thyroid metastases and so is the impact of the first clear armor effect factors (P <0.05); through a multi- factor analysis, a clear success for fitting Logistic regression equation: Y = 3.766-0.947 postoperative residual thyroid weight -3.149 -3.373 distant lymph node metastasis, the equation described postoperative residual thyroid tissue weight, without lymph node metastasis, no distant Division A successful transfer is the clear advantage of increasing the protective factors; postoperative residual thyroid judge cleared A successful weight area under ROC curve was 0.871 ± 0.054 (P = 0.000 <0.001), outside the thyroid metastases was 0.725 ± 0.075 (P = 0.009 <0.01), a clear description of its successful prediction is valid. 2, large doses 131 I Ching A first before treatment and 1 month after treatment in peripheral blood leukocyte count (WBC), red blood cell count (RBC), hemoglobin (Hb), platelet count (PLT) and other indicators of liver function tests in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and other indicators, serum calcium (Ca), phosphorus (P), thyroid next to the gland hormone (PTH) and other indicators showed no statistical significance (p> 0.05): This group consisted of five cases occurred RT, the rate was 10.87%, 1 case of RS. Incidence rate of 2.17%. 3, γ radiometer ward measured at 1 m from the patient radiation dose rate γ levels up to 21.71μSv / h, according to China's \240 day basis, I am in this Section staff daily radiation environment of continuous work 3.8 hours; Our department ward environment aisle maximum dose rate levels 0.58μSv / h, calculated with the method in which the general public daily radiation environment stays 7.17 hours. Conclusion: 1, DTC patients after the first application of large doses 131 I Ching A line treatment, the impact of many factors, postoperative residual thyroid tissue weight, no metastases outside the thyroid is to increase the success of the Qing A protective factors for the proposed treatment of patients A clear line should be implemented wherever possible total thyroidectomy for minimal residual thyroid tissue weight, postoperative early implementation 131 I treatment. 2, large doses 131 I treat safe and reliable treatment for the hematopoietic system, liver function, parathyroid function was less affected, radioactive thyroiditis and a lower incidence of salivary gland inflammation. 3, the implementation of high-dose 131 I treatment, take appropriate protective measures, fully able to ensure nuclear medicine practitioners in ionizing radiation dose permitted range, the ward environment relatively safe levels of ionizing radiation.
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