1.Clinical value of serum TgAb and TPOAb in diagnosis and treatment of papillary thyroid microcarcinoma
Wenzhen DENG ; Cheng CHEN ; Bing LING ; Li ZHAO ; Li ZHENG ; Xianqun ZHOU ; Qian LIANG ; Jixiu YI
Chongqing Medicine 2024;53(5):727-732,737
Objective To investigate the clinical value of thyroid globulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)in the diagnosis and treatment of papillary thyroid microcarcinoma(PTMC).Methods A total of 346 patients with thyroid nodules who underwent surgical treatment in the hospital from August 2012 to October 2021 were selected as the research objects.According to the postoperative pathologi-cal results,the patients were divided into the benign nodule group,PTMC group and non-micro papillary thy-roid carcinoma(PTC)group.The general data of the patients and thyroid function indexes[free triiodothyro-nine(FT3),free tetraiodothyronine(FT4),thyroid stimulating hormone(TSH),TgAb and TPOAb]before and after operation were collected,the tumor recurrence or lymph node metastasis after operation were ob-served,and the relationship between serum TgAb and TPOAb and the risk and prognosis of PTMC was ana-lyzed.Results The positivity rate of TgAb in the PTMC and non-micro PTC groups was significantly higher than that in the benign nodule group(P<0.05).The TPOAb positivity rate was not significantly different among the three groups(P>0.05).Only the TSH level in the PTMC group was higher than that in the non-micro PTC group(P<0.05).Multivariate logistic analysis showed that younger age,higher TSH and positive TgAb were independent risk factors for PTMC and non-micro PTC(P<0.05).However,the risk of PTC didn't increase with increasing TgAb titres.The positivity rate of TgAb in the PTMC and non-micro PTC groups didn't change significantly within one month after operation,but decreased in one year after operation(P<0.05).The TPOAb positivity rate decreased after operation,but the difference was not statistically sig-nificant(P>0.05).In the PTMC group,four cases had tumor recurrence or lymph node metastasis,and the TgAb level increased by 88.4%,49.5%,5.7%and 84.0%respectively when the tumor recurred or metasta-sized.Among them,the TPOAb level increased by 51.6%,30.0%and 2.9%respectively in three cases and decreased by 53.9%in one case.In the PTMC group,there were 11 patients with cervical lymph node enlarge-ment,and there was no statistical difference in TgAb and TPOAb levels when the condition changed(P>0.05).Conclusion TgAb is a risk factor for PTMC,and can be followed up regularly during the diagnosis and treatment of PTMC.The specificity of TPOAb is not as good as that of TgAb,and appropriate follow-up can be chosen during the course of the disease.
2.Study on quality standard of Yi medicine Gynura japonica and quality evaluation of medicinal materials from different producing areas
EQIXIAOLI ; Jixiu SHEN ; Jiang LUO ; DIJIUCIGA ; Yuan LIU ; Zhengming YANG ; Ying LI
China Pharmacy 2023;34(3):309-314
OBJECTIVE To improve the quality standard of Yi medicine Gynura japonica, and to evaluate its quality. METHODS Using 15 batches of G. japonica from different producing areas as samples, the contents of water, total ash, acid- insoluble ash and water-soluble extract were determined according to the method stated in part Ⅳ of Chinese Pharmacopoeia (2020 edition). The contents of total alkaloid (calculated by senecionine) was determined by UV spectrophotometry. The contents of senecionine and seneciphylline were determined by HPLC. Using above 7 indexes as evaluation indexes, cluster heat map analysis, principal component analysis (PCA) and entropy weight approximation ideal ranking (TOPSIS) were used to evaluate the quality of medicinal material comprehensively. RESULTS Among 15 batches of G. japonica, the moisture contents were 8.88%-12.60%, the total ash contents were 4.43%-11.02%, the acid-insoluble ash contents were 0.56%-3.45%, the water-soluble extract contents were 21.71%-53.91%, the total alkaloid contents (calculated by senecionine) were 0.15%-0.39%, and the contents of senecionine and seneciphylline were 0.01% -0.05% and 0.01%-0.06% respectively. According to the results of various indicators, it was preliminarily proposed that the water content in the sample of G. japonica should not exceed 13.00%, the total ash content should not exceed 11.50%, the acid-insoluble ash content should not exceed 3.70%, the water-soluble extract should not be less than 20.70%, the total alkaloid content should not be less than 0.15%, the contents of senecionine and seneciphylline should not be less than 0.01% both. The results of cluster heat map analysis showed that the 15 batches of samples could be divided into four categories; the results of PCA and TOPSIS showed that the samples with high-quality ranking were jsq-2, jsq-5, jsq-6 and jsq-10, and the samples with low-quality ranking were jsq-4, jsq-13 and jsq-14. CONCLUSIONS In this study, the quantitative analysis method of total alkaloids (calculated by senecionine), senecionine and seneciphylline in G. japonica is established, and the limits of each index are preliminarily determined. Among 15 batches of samples, the qualities of medicinal material collected from Linza Village of Ganluo County of Liangshan Yi Autonomous Prefecture, Machangping Village of Luojishan Town of Puge County of Liangshan Yi Autonomous Prefecture and other places are better.