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OBJECTIVE：To investigate the effects of rabepr azole on the pharmacokinetic characteristics of clopidogrel and its active metabolite in healthy volunteers with different CYP2C19 genotypes. METHODS ：Healthy volunteers were selected as subjects，and then randomly divided into extensive metabolizer （EM）group，intermediate metabolizer （IM）group，and poor metabolizer（PM）group with 8 subjects in each group ，according to their CYP2C19 genotypes by random number table. In single-dose，randomized，open，two-cycle-crossover design ，each group was given Clopidogrel bisulfate tablets 300 mg or Clopidogrel bisulfate tablets 300 mg+Rabeprazole sodium enteric-coated tablets 20 mg. UPLC-MS/MS method was adopted to detect the concentration of clopidogrel and its active metabolite derivative （MP-H4）. The pharmacokinetic parameters were calculated and compared by DAS 2.0 software. RESULTS ：There was no statistical significance in clinical data as age ，height， body weight ，liver enzymes and serum creatinine among 3 kinds of metabolism subjects （P＞0.05）. Compared with subjects receiving clopidogrel alone ，cmax and AUC 0－t of clopidogrel of subjects combined with rabeprazole in EM group were increased by 36％ and 27％，while those of MP-H 4 were decreased by 34％ and 28％（P＜0.01）；cmax and AUC 0－t of clopidogrel of subjects combined with rabeprazole in IM group were increased by 19％ and 18％，while those of MP-H 4 were decreased by 19％ and 16％ （P＜0.05 or P＜0.01）；there was no statistical significance in cmax and AUC 0－t of clopidogrel and MP-H 4 in PM group after receiving rabeprazole additionally as well as tmax of clopidogrel and MP-H 4 in all metablism subjects ，compared with clopidogrel alone（P＞0.05）. CONCLUSIONS ：Among CYP2C19 EM and IM subjects ，combined use of rabeprazole can significantly increase the exposure of clopidogrel and decrease the exposure of its active metabolite MP-H 4，but has no significant impact on clopidogrel and its active metabolite in CYP2C19 PM subjects.
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Objective To evaluate the correlation between standardized uptake value (SUV) measured on 18F-FDG PET/CT scan and residual tumor after argon-helium knife cryoablation.Methods The clinical data of 40 patients with hepatic or pulmonary malignant tumors,who were treated with argon-helium knife cryoablation during the period from March 2008 to December 2015 at authors' hospital,were collected.18FFDG PET/CT scan was performed both before and after the treatment,and the SUV values of each patient were calculated.The data were analyzed based on the pathological findings and clinical follow-up results.Results A total of 42 lesions were detected in the 40 patients.After treatment,radionuclide concentration was demonstrated in 38 lesions,and 16 lesions were proved to be the tumor residual by follow-up imaging and pathological examination.In other 22 lesions the radionuclide concentration was due to inflammatory response.The SUV value of the tumor residual was strikingly higher than that of the inflammatory response (6.13±1.21 vs.2.64±0.96,P＜0.05).The group with low SUV value had a lower recurrence rate (P=0.020) and a higher survival rate (P=0.039).The tumor survival rate of the low SUV value group was significantly lower than that of the group with high SUV value (x2=14.994,P=0.000 2).Conclusion 18F-FDG PET/CT imaging has unique value in promptly detecting marginal residual lesion after argon-helium knife cryoablation,which provides useful information for the evaluation of cryoablation effect as well as for the making of further therapeutic plan.
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Objective To analyze clinical results of newborn hearing concurrent genetic screening and to ex-plore the significance of genetic test and potential correlations between the genotype and clinical phenotype.Methods Newborns in Foshan born during May,2012 and September,2013 were recruited.Two-step hearing screening was carried out by using AABR (automated auditory brainstem response).Blood samples were collected with a standard protocol for testing hot-spot mutations of common deafness-susceptibility genes.ResuIts A total of 10 238 newborns,including 9 295 rooming-in infants and 943 NICU infants,received hearing screening and 99.16%of passed the initial screening.The passing rates of rooming-in and NICU infants were significantly different (χ2 =99.1,PG heterozygous mu-tation frequency was 0.80% (82/10 238)and the homozygous mutation frequency was 0.03% (3/10 238);c.2168A>G heterozygous mutation frequency was 0.12% (12/10 238).MTRNR1 1555A>G heteroplasmic mutation fre-quency was 0.04% (4/10 238)while the homoplasmic mutation frequency was 0.18% (18/10 238).1494C>T ho-moplasmic mutation frequency was 0.01% (1/10 238).GJB2 c.235delC and SLC26A4 c.919 -2A>G mutations were found to be the most recurrent mutations in participants,and finally eight infants aged 6 days to 25 months di-agnosed with moderate to very severe sensorineural hearing loss were correlated with these two mutations.ConcIu-sion Genetic screening is a potent strategy to complement the conventional hearing screening since it is helpful for determining high risk individuals and early discovering possible late-onset hearing loss.