ABSTRACT
Thyroid storm is a syndrome related to acute exacerbation of thyrotoxicosis for which timely diagnosis and treatment are crucial. Importance of antithyroid drug therapy in thyroid storm patients has been emphasised in clinical treatments for a long time. These patients should receive definitive therapy for their underlying hyperthyroidism to avoid recurrence after controlling thyroid storm. However, the curative effect of antithyroid medication is sometimes limited because of rare or serious side effects or failure to control disease progression, resulting in few treatment alternatives. We present a case of an old woman with thyroid storm and antithyroid drug intolerance, which was successfully managed using a combination of plasma exchange and thyroidectomy. It confirms the significant benefits of therapeutic plasma exchange (TPE) when clinical conditions do not allow routine treatment of thyroid storm. This procedure is safe and effective when performed preoperatively as a rescue measure for thyroid storm patients. Key Words: Thyroid storm, Drug intolerance, Plasma exchange, Total Thyroidectomy.
Subject(s)
Antithyroid Agents , Thyroid Crisis , Antithyroid Agents/therapeutic use , Female , Humans , Plasma Exchange , Plasmapheresis , Thyroid Crisis/therapy , ThyroidectomyABSTRACT
OBJECTIVE: To investigate the effects of liraglutide combined with insulin on oxidative stress and expression levels of serum monocyte chemoattractant protein-1 (MCP-1) and nuclear factor-kB (NF-kB) in patients with type 2 diabetes. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: Department of Endocrinology, the Second Hospital Affiliated to Lanzhou University, China, from September 2016 to January 2018. METHODOLOGY: Ninety-two patients with type 2 diabetes were selected as objects of study. They were randomly divided into observation group and control group, with 46 cases in each group. The control group was treated with insulin alone, and the observation group was treated with liraglutide in combination with insulin. The changes of levels of blood glucose, serum MDA, SOD, MCP-1 and NF-kB were compared between the two groups before and after treatment, and the blood glucose target rate after treatment was compared between the two groups. RESULTS: Before treatment, there were no significant differences in fasting blood glucose, 2h postprandial blood glucose, serum MDA, serum SOD, serum MCP-1 and serum NF-kB between the two groups (p=0.885, 0.961, 0.919, 0.990, 0.954 and 0.837, respectively). After treatment, levels of the fasting blood glucose, 2h postprandial blood glucose, serum MDA, serum MCP-1, and serum NF-kB in the observation group were lower than those in the control group (all p<0.001). The serum SOD level and blood glucose target rate were higher in the observation group than those in the control group (p<0.001 and p=0.010, respectively). CONCLUSION: Liraglutide combined with insulin therapy can effectively improve blood glucose levels in type 2 diabetic, reduce oxidative stress status, decrease the expression of serum MCP-1 and NF-kB, and inhibit the internal inflammatory response.
Subject(s)
Chemokine CCL2/blood , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/drug therapy , Insulin/therapeutic use , Liraglutide/therapeutic use , Oxidative Stress/drug effects , Adult , Aged , Blood Glucose/analysis , Blood Glucose/drug effects , China , Diabetes Mellitus, Type 2/diagnosis , Drug Therapy, Combination , Enzyme-Linked Immunosorbent Assay , Female , Hospitals, University , Humans , Hypoglycemic Agents/therapeutic use , Male , Middle Aged , NF-kappa B/blood , Prognosis , Reference Values , Severity of Illness Index , Treatment OutcomeABSTRACT
Polygala tenuifolia root is used as a functional food due to its attractive health benefits. In this study, ultrahigh-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and gas chromatography-mass spectrometry (GC-MS) were utilized to characterize the bioactive compounds in P. tenuifolia root. The UPLC-MS/MS information revealed 36 bioactive compounds, including oligosaccharide esters, polygalasaponins, and polygalaxanthones. GC-MS identified 34 volatile compounds with fatty acids as the main chemicals. The leading compound judged by UPLC-MS/MS was tenuifoliside A, and oleic acid was the leading volatile from GC-MS profiles. All samples tested showed similar bioactive compound compositions, but the level of each compound varied. Principal component analysis revealed the principal bioactive compounds with significant level variations between samples. These principal chemicals could be used for quality judgment of P. tenuifolia root, instead of measuring the levels of all compositional compounds.
