Factors influencing the efficacy of residual thyroid clearance with 131I for the first time after surgery in patients with differentiated thyroid cancer / 中国医师杂志

Objective:To explore the influencing factors of residual thyroid clearance with 131I after surgery in patients with differentiated thyroid cancer (DTC). Methods:A retrospective analysis was conducted on the clinical data of 100 DTC patients admitted to the Hunan Provincial People′s Hospital from January 2018 to February 2021 who underwent 131I treatment for the first time. The success rates of first thyroidectomy using different doses of 131I, different pathological types, and different treatment times were compared, and logistic regression analysis was conducted to investigate the influencing factors of the efficacy of first postoperative 131I thyroidectomy in DTC patients. Results:A total of 54 patients successfully cleared residual thyroid, 46 patients failed to clear residual thyroid, and the success rate of clearing residual thyroid was 54%. The success rates of first clearance of residual thyroid in patients with 131I doses of 80 mCi, 90 mCi, and 100 mCi were 37.50%(12/32), 52.78%(19/36), and 71.88%(23/32), respectively, with statistically significant differences among the groups ( P<0.05); The success rates of first removal of residual thyroid in patients with follicular carcinoma, mixed papillary follicular carcinoma, and papillary carcinoma were 65.71%(23/35), 39.13%(9/23), and 52.38%(22/42), respectively. There was no statistically significant difference between the groups ( P>0.05); The success rates of first removal of residual thyroid in the group1 of patients (treatment time<3 months), the group2 of patients (treatment time 3-12 months), and the group3 of patients (treatment time>12 months) were 68.09%(32/47), 44.44%(16/36), and 35.30%(6/17), respectively. There was no statistically significant difference between the groups ( P>0.05); There was no statistically significant difference in the success rate of clearing residual thyroid in DTC patients of different genders, ages, pathological stages, and thyroid stimulating hormone (TSH) levels (all P>0.05); The difference in the success rate of clearing residual thyroid in DTC patients with different metastatic conditions and stimulating thyroid globulin (sTg) was statistically significant (all P<0.05); sTg, postoperative lymph node metastasis, and postoperative distant metastasis were independent risk factors for the efficacy of residual thyroid clearance in DTC patients for the first time after surgery (all P<0.05). Conclusions:The influencing factors for the efficacy of the first 131I in removing residual thyroid include differences in 131I dosage, presence or absence of metastatic lesions during treatment, Tg levels, etc. Reducing Tg levels is an important factor in improving remission rate, and controlling lymph nodes and distant metastasis is a key factor for the successful efficacy of the first 131I in removing residual thyroid.

Validated analytical study of the effect of Lycopene on the pharmacokinetics of Paracetamol and Chlorzoxazone in rats

Lycopene was reported to influence some cytochrome P450 enzymes activity. The present study investigates the effect of lycopene on the pharmacokinetics of paracetamol and chlorzoxazone. Lycopene (20 mg/kg) was intra-peritoneally administered to two groups of rats for eight consecutive days and two other groups were given vehicle. On the eighth day, chlorzoxazone and paracetamol were separately intravenously administered to a lycopene group and a control group. Blood samples were collected at different time intervals, treated and analyzed using HPLC. The HPLC method used for paracetamol analysis was based on isocratic elution using a mobile phase consisting of water: methanol, (77:23 v/v) at a flow rate 1 mL min−1, Kromasil C18 column, and UV detection at 254 nm using caffeine as internal standard. About chlorzoxazone, separation was carried out using water: acetonitrile (60: 40, v/v) as the mobile phase at a flow rate 1 mL min−1, Inertsil ODS-3 C18 column, UV detection at 283 nm and esomeprazole as internal standard. Statistical analysis of the pharmacokinetic data using student t test showed a significant increase in AUC 0-t , AUC 0-Inf and t1/2 of paracetamol (P<0.05) and of chlorzoxazone (P<0.05) in the groups pretreated with lycopene (20 mg/kg), significant increase in the volume of distribution of paracetamol (P < 0.05), but no significant difference in that of chlorzoxazone. In other words, paracetamol and chlorzoxazone showed significant decrease (P < 0.05), respectively. These results demonstrate that treatment of rats with Lycopene (20mg/kg, ip) has a significant effect on the metabolic clearance and the pharmacokinetics of both drugs

Association between Helicobacter pylori infection and creatinine clearance rate in elderly hypertensive patients / 中华老年医学杂志

Objectives To reveal the association between Helicobacter pylori infection and creatinine clearance rate in elderly patients with hypertension.Methods A total of 600 elderly hypertensive patients with different degrees of renal impairment and helicobacter pylori(HP)infection were randomly selected from Department of Health Care,General Hospital of Tianjin Medical University from 2010 to 2015.Serum creatinine concentration detection was conducted and creatinine clearance rate was calculated.Patients were divided into HP infection group(n =254)and non-HP-infection group (n =346).The multiple logistic regression analysis showed the correlation between Helicobacter pylori infection and decreased creatinine clearance rate.Results Creatinine clearance rate was significantly lower in HP-infection group[(61.1 ± 12.7)ml/min] than in non-HP-infection group[(78.5 ± 11.9) ml/min,P =0.014].Multifactorial logistic analysis revealed that Helieobacter pylori infection was significantly associated with decreased creatinine clearance rate(OR=3.5 18,95 ％ CI:1.105～4.918,P =0.011).Conclusions Helicobacter pylori infection is significantly related with decreased creatinine clearance rate in elderly patients with hypertension.

MR Tracer Diffusion in Cerebral Interstitial Fluid of Elderly SD Rats / 中国医学影像学杂志

Purpose With the progression of brain tissue aging, the transport and drainage characteristics of metabolites and secretory products for neurons in extracellular space occurs irreversible change. This paper aims to investigate and quantify MR tracer diffusion characteristics in cerebral interstitial fluid of elderly SD rats. Materials and Methods MR contrast agent Gd-DTPA was injected into the caudate nucleus of two groups of rats including 8 in experimental group (15-17 month old) and 15 in control group (7-10 month old). MR scan was performed at 0.25 h, 0.5 h, 1 h, 2 h, 3 h and 4 h to observe the dynamic distribution in the caudate and measure the diffusion and clearance rate. Results There was no statistically significant difference in diffusion rate and D* between control group with (3.32±0.70)×10-4 mm2/s and experimental group with (3.25±0.46)×10-4 mm2/s (t=1.739, P>0.05). The clearance rate k' was significantly different between control group (0.62±0.12)×10-4/s and experimental group (0.29±0.08)×10-4/s (t=11.602, P<0.05). Conclusion The degeneration of aging brain tissue changes the composition of extracellular space resulting in decreased speed of ISF clearance. This may cause accumulation of metabolites which eventually triggers a variety of age-related diseases.

Incremento da depuração renal em pacientes gravemente enfermos: incidência, fatores associados e efeitos no tratamento com vancomicina / Augmented renal clearance in critically ill patients: incidence, associated factors and effects on vancomycin treatment

Objetivo: Foi descrito um incremento da depuração renal em alguns grupos de pacientes gravemente enfermos, o qual pode induzir à eliminação de concentrações de fármacos por filtração glomerular aquém do ideal, principalmente no caso de antibióticos. Sua ocorrência e os fatores determinantes têm sido pouco estudados. Nossos objetivos foram determinar a incidência e os fatores associados ao incremento da depuração renal, bem como seus efeitos nas concentrações e na posologia de vancomicina em uma série de pacientes em unidade de terapia intensiva. Métodos: Estudamos, de forma prospectiva, 363 pacientes admitidos durante 1 ano em uma unidade de terapia intensiva clínico-cirúrgica. Foram excluídos pacientes que tivessem nível de creatinina sérica >1,3mg/dL. A depuração de creatinina foi calculada a partir da coleta de urina de 24 horas. Os pacientes foram agrupados segundo a presença de incremento da depuração renal (depuração de creatinina >120mL/min/1,73m2), e os possíveis fatores de risco foram analisados por meio de análise bivariada e logística. Em pacientes tratados com vancomicina, foram registradas a posologia e as concentrações plasmáticas. Resultados: O incremento da depuração renal esteve presente em 103 pacientes (28%), os quais eram mais jovens (48±15 versus 65±17 anos; p<0,0001), tinham mais frequentemente admissões obstétricas (16 versus 7%; p=0,0006) e por trauma (10 versus 3%; p=0,016), e menos comorbidades. Os únicos determinantes independentes para o desenvolvimento de incremento da depuração renal foram idade (OR=0,95; IC95%=0,93-0,96; p<0,0001;) e ausência de diabetes (OR 0,34; IC95% 0,12-0,92; p=0,03). Doze dos 46 pacientes que receberam vancomicina tinham ...

Objective: An augmented renal clearance has been described in some groups of critically ill patients, and it might induce sub-optimal concentrations of drugs eliminated by glomerular filtration, mainly antibiotics. Studies on its occurrence and determinants are lacking. Our goals were to determine the incidence and associated factors of augmented renal clearance and the effects on vancomycin concentrations and dosing in a series of intensive care unit patients. Methods: We prospectively studied 363 patients admitted during 1 year to a clinical-surgical intensive care unit. Patients with serum creatinine >1.3mg/dL were excluded. Creatinine clearance was calculated from a 24-hour urine collection. Patients were grouped according to the presence of augmented renal clearance (creatinine clearance >120mL/min/1.73m2), and possible risk factors were analyzed with bivariate and logistic regression analysis. In patients treated with vancomycin, dosage and plasma concentrations were registered. Results: Augmented renal clearance was present in 103 patients (28%); they were younger (48±15 versus 65±17 years, p<0.0001), had more frequent obstetric (16 versus 7%, p=0.0006) and trauma admissions (10 versus 3%, p=0.016) and fewer comorbidities. The only independent determinants for the development of augmented renal clearance were age (OR 0.95; p<0.0001; 95%CI 0.93-0.96) and absence of diabetes (OR 0.34; p=0.03; 95%CI 0.12-0.92). Twelve of the 46 patients who received vancomycin had augmented renal clearance and despite higher doses, had lower concentrations. Conclusions: In this cohort of critically ill patients, augmented renal clearance was a common finding. Age and absence of diabetes were the only independent determinants. Therefore, younger and previously healthy patients might require larger vancomycin dosing. .

The levels of serum lactate, lactate clearance rate and transaminase in septic rats and their relationship with liver damage / 中国医师杂志

Objective To explore the serum lactic acid,transaminase and their relationship with liver pathological damage in sepsis rats,whether a correlation exists between serum lactate clearance rate and transaminase in sepsis rats,and whether they can be used as indicators for the prediction and evaluation of septic rats liver injury.Methods A total of 150 clean Sprague-Dawley (SD) rats was divided into normal group (n =50),sham operated group (n =50),and the cecal ligation and puncture (CLP) (n =50).Ten rats were killed after successful surgery at the 6th,12th,24th,48th,and 72nd hour in CLP group,respectively.At each time point,10 normal rats and 10 sham-operated rats were taken as a control in the corresponding time point.The liver tissue was obtained for pathological analysis.The levels of lactate and liver transaminase were detected and the lactate clearance rate was calculated.The levels of lactate and transaminase at each time point were statistically compared.The correlation analysis was performed among serum lactate,transaminase,and liver damage pathological changes.Results The rat hepatocytes in CLP group begin to appear at the 6th hour,and the damage was gradually enhanced at the 12th,24th,and 48th,and up to the worst damage at the 48th time point.The levels of lactate and alanine aminotransferase (ALT)in CLP group at the 12th and 24th hour were significantly elevated compared with the normal and sham operation groups (P ＜0.05); The level of aspartate aminotransferase (AST) in CLP group at the 6th,12th,24th,48th,and 72nd hour was significantly elevated compared with the normal and sham operation groups (P ＜ 0.05).A positive correlation was found between the levels of ALT and lactate (r =0.766,P ＜0.05),and a negative correlation was found between lactate clearance rate and ALT (r =-0.712,P ＜0.05).Conclusions In septic rats,both lactate and lactate clearance rate were correlated with ALT,and they were correlated with liver pathological damage.The level of lactate,lactate clearance rate,and ALT could be used as the key indicators to predict liver damage in septic rats.

Correlation between blood lipids and creatinine clearance in the elderly patients with coronary heart disease / 中华老年医学杂志

Objective To explore the relationship between blood lipids and creatinine clearance (Ccr)in aged patients with coronary heart disease(CHD).Methods According to coronary artery angiography(CAG)and Ccr,784 subjects aged 65 years and over were divided into groups and Their lipid levels were compared.Results With increasing lesion of coronary branches,the level of Ccr was obviously decreased(F=5.35,P＜0.01).The level of apolipoprotein A1(ApoA1)was reduced and apolipoprotein B(ApoB)enhanced in renal function of moderate-severe injury(CCr＜0.83 ml ·s-1 · 1.73m-2)(F=5.31,F=4.91,both P＜0.01).The level of ApoA1 was decreased(F=3.52,P＜0.05)and Apo B increased(F=5.65,P＜0.01)in male renal function of moderate-severe injury.The levels of ApoA1 decreased(F=5.79,P＜0.01),ApoB increased(F=4.56,P＜0.05)and high density lipoprotein-cholesterol reduced(F=3.39,P＜0.05)in CHD with renal group of moderatesevere injury.Multi-logistic regression analysis showed that Ccr,HDL-C,ApoA1 and ApoB were influencing factors of CHD.Conclusions Abnormal blood lipid and renal dysfunction are risk factors of CHD,dyslipidemia may induce renal dysfunction.It is important to control lipids and improve other organ functions in the aged patients with CHD.

Clinical value of serial blood lactic acid monitoring in prognostic prediction for ICU patients / 中华全科医师杂志

al blood lactic acid monitoring is simple, easy and practical to use in predicting prognosis of ICU patients sensitively.

A Study of Insulin Resistance and its Clinico-Metabolic Correlates by Modified Harano's Method in Euglycemic Cirrhotics

To study insulin resistance and its clinico metabolic correlates in 20 euglycemic cirrhotics by Modified Harano's method. 20 euglycemic cirrhotics (18 male and 2 female; 14 alcoholic & 6 post hepatitis B) and equal number of age, sex and BMI matched healthy controls of mean ± SD age 37.1±8.35 v/s 36.5±7.48 years and BMI 18.4±1.83 v/s 18.5±1.77 kg/m2 were enrolled. All subjects underwent 75 gram oral glucose tolerance test (OGTT) in a fasting state. Samples for glucose (0,30,60, 90 & 120 min) and insulin ( 0 & 120 min) were withdrawn. Assessment of insulin resistance was carried out by Insulin suppression test (Modified Harano's method) i.e. simultaneous infusion of glucose as 20% dextrose @ 6 mg/kg/min and plain human insulin @ 50 mU/kg/hr. Steady state plasma glucose (SSPG) and steady state plasma insulin (SSSI) of 120-150 min of infusion were determined. Metabolic clearance rate for glucose (MCR) calculated as rate of glucose infusion/SSPG and insulin clearance rate (ICR) as rate of insulin infusion/SSSI. Lower the MCR and ICR, higher is the state of IR. Correlations of MCR and ICR with various clinical and metabolic variables were then studied. The result of present study suggests that cirrhosis is an insulin resistant state with low clearance rates for glucose and insulin, significant higher levels of glucose and insulin in postprandial state and markedly low levels of lipids. The state of insulin resistance is independent of severity of hepatic decompensation as classified by Child-Pugh's classification, etiology, nutritional status, clinical state, liver function tests and serum lipids.

Comparison of single plasma sample methods and prediction of dual plasma sample method in measurement of 99mTc-Diethylene Triamine Pentaacetic Acid plasma clearance / 北京大学学报(医学版)

Objective:To find an applicable condition of the single-plasma-sample method (SPSM) to measure the glomerular filtration(GFR) with 99m Tc-Diethylene Triamine Pentaacetic Acid ( 99m Tc- DTPA) , and predict the value of 99m Tc-DTPA plasma clearance by dual plasma sample method (DPSM ) from that by SPSM.Methods:Three hundred and thirty five patients with chronic kidney disease (CKD) were selected (192 males and 143 females). The average age was 51.91?14.76 years. The GFR was determined simultaneously by 2 methods: (1) SPSM (sGFR); (2) DPSM (tGFR), using DPSM as reference standard, sGFR calculated from the different SPSM was compared with tGFR. An equation was developed to predict tGFR from sGFR. GFR estimated by abbreviated Modification of Diet in Renal Disease (MDRD) equation (aGFR) was evaluated as the criterion in selection of DPSM and SPSM. The condition that DPSM could be substituted by SPSM in GFR measurement was given. Results: When tGFR ≥ 30 mL/ (min?1.73 m2), all of the sGFR were significantly correlated with tGFR. Among them, Watson modified Christensen and Groth’s equation at sample time=240 min tended to be the most accurate (r=0.977, RMSE=10.91), and tGFR could be predicted from sGFR using the equation: Predicted tGFR mL/(min?1.73 m2)=7.755 4+0.789 3?sGFR+0.002 4 ?sGFR2 (n=297, r2= 0.959 1 , P