Objective To observe the effect of the first iodine-131 ablation of thyroid remnants in pa-tients with differentiated thyroid cancer (DTC) and discuss factors that may be influential in the treatment. Meth-ods All DTC patients confirmed by pathology received iodine-131 therapy after necessary preparation. Accord-ing different operation procedures, time interval between operation and iodine-131 treatment and dose of iodine - 131, the patients were divided into different groups. Therapy effects were observed in different groups. Results Ablation successful rate was 88.5% in total thyroidectomy group, compared with 44.4% in subtotal thyroidecto-my group. 92.7% ablation rate was seen in the group of I-2 months time interval between operation and iodine - 131 treatment, while in the group of over 1 year time interval, only 50% ablationrate was achieved. Ablation successful rate was 47.6% in the group of low dose of iodine-131 (2.96GBq), compared with 82.8% in the high dose group (4.44GBq). Conclusions Total thyroidectomy and cervical lymph nodes dissection should be recommended for the patients with DTC. The better interval time between operation and iodine-131 ablation thy-roid remnants is 1～2 months. The high dose of iodine-131 shows better result than low dose of iodine-131 treatment.

Objective To evaluate the relationship and screening value of percentage of body fat (BF%) and waist height ratio (WHtR) for hyperlipidemia in physical examination people. Methods A total of 2 668 objects taking physical examination in Henan Province People′s Hospital from September to December 2014 were included in this study. Values of height, body mass index (BMI), waist circumference, body composition and blood lipid level were detected. The receiver oper?ating characteristic curve (ROC) was used to analyze the screening rate of WHtR and BF%on hyperlipidemia with sensitivi?ty, specific and area under the curve (AUC). After stratified by age, waist circumference and BMI, multivariable logistic re?gression analysis was used to investigate the association between hyperlipidemia risk, BF% and WHtR. Results The screening accuracy rate on hyperlipidemia was higher for BF%, AUC was 0.79 in both female and male people. Among wom?en with BMI<18.5 kg/m2 and 18.5~<24 kg/m2, the risk of hyperlipidemia was higher in superfatted group than that of normal group. There was no correlation between WHtR and hyperlipidemia. Among men older than 40 y or with abnormal waist cir?cumference (≥85 cm), the risk of hyperlipidemia was higher in superfatted group than that of normal group, but not associat?ed with WHtR. Conclusion The BF%is a better screening indicator for hyperlipidemia compared with that of WHtR and BMI. Women with BMI<18.5 kg/m2 and 18.5~<24 kg/m2 and men older than 40 y or with waist circumference over 85 cm are suggested to do body composition tests to improve screening accuracy for hyperlipidemia.

Objective To analyze the misdiagnosis reasons of lung lesions detected by 18 F-FDG PET-CT .Methods Twenty-seven cases of misdiagnosed lung lesions were retrospectively analyzed ,including 14 cases of benign lesions misdiagnosed as lung cancer and 13 cases of lung cancer misdiagnosed as benign lesion ,which were analyzed from the aspects of the CT signs ,lesion size , SUVmax value ,SUVmax value at two-phase PET and clinicopathology .Results The CT signs in the false positive group were mainly manifested as clear border ,uniform density and so on ,while which in the false negative group were mainly manifested as lob-ulation sign ,spicule sign ,pleural indentation sign ,and so on .The mean maximum lesion diameter in the false positive group was (3 .23 ± 0 .59)cm ,which in the false negative group was (1 .67 ± 0 .27)cm .The SUVmax mean value in the false positive group was 10 .49 ,which in the false negative group was 5 .49 .The mean increasing rate of the SUVmax by dual-phase PET-CT in the false positive group was 38 .4% ,which in the false negative group was 17 .9% .The clinicopathologic inflammatory lesion was easy to be misdiagnosed as lung cancer ,high differentiated lung cancer and carcinoid were easy to be misdiagnosed as benign lesion .Conclusion Judging the malignant or benign lung lesions should consult in the patient′s clinical data and strengthen the comprehensice appli-cation of CT signs ,lesion size and SUVmax value .

OBJECTIVE:To explore an effective method to formulate management-related strategies for off-lable use of drugs by the evidence-based medicine. METHODS:The process of guideline formulation included seven procedures,i.g. establishment ofguideliesformulation workgroup;investigation and selection of the status quo on off-label drug use;identification of the clinical problems;retrieval and evaluation and comprehensing of evidence;applification of GRADE in evidence quality grading;formation of the recommendations consensus;peer review and result publication. And eventually guidelines were formed based on the steps. This study took off-label use of rheumatoid immunoprotective subjects as a case to explore. RESULTS & CONCLUSIONS:Based on the evidence evaluation system and above 7 steps,the methods and process of guideline formulation on off-label use of rheuma-toid immunoprotective subjects that integrated administration,law,clinical medicine,pharmacy subjects were made .The process of guideline formulation fully reflects multidisciplinary characteristics of the workgroup,the advanced nature of the process,the comprehensiveness of evidence ,the rigor of evidence quality grading,and the normalization of consensus. It provides reference in methodology for establishing a comprehensive evidence-based evaluation and management system of off-label use of drugs for all clinical specialist disease. Therefore,this scientific research results may promote the standardization and legalization of the off-label use of drugs management in China.

Objective To optimize a method for extracting traditional Chinese medicine composition with insomnia,and to prepare the insomnia granules for quality control.Methods The optimal extraction process was screened by orthogonal test using high-performance liquid chromatography with geniposide as the evaluation index.The particle size,bulk density,angle of repose,moisture,solubility,hygroscopicity and loading difference of the insomnia granule were evaluated,and the difference between the trial test and the pilot test were analyzed to comprehensively monitor the quality of the insomnia granule.Results The best extraction process was to add 10 times of water and cooked it three times for 1.5 hours each time.The average yield rate of dry extract of the pilot test and trial test was 22.10％,15.52％,and the average yield of powder was 84.96％ and 93.12％,respectively.The conversion rate from the pilot test to the trial test is 76.97％.Both the trial test and the pilot test particles met the quality requirements of the 2015 edition of the pharmacopoeia.Conclusions The preparation method of the insomnia granules is simple and the quality is uniform.The results of the pilot scale showed that the conversion rate is high,the quality is controllable,and the technical feasibility of industrial production is obtained.

Objective To observe oxygen uptake efficiency plateau (OUEP,i.e.highest (V)O2/(V)E) and carbon dioxide output efficiency (lowest (V)E/(V)CO2) parameter changes during exercise in normal subjects.Methods Five healthy volunteers performed the symptom limited maximal cardiopulmonary exercise test (CPET) at Harbor-UCLA Medical Center.(V)O2/(V) E and (V) E/(V) CO2 were determined by both arterial and central venous catheters.After blood gas analysis of arterial and venous sampling at the last 30 seconds of every exercise stage and every minute of incremental loading,the continuous parameter changes of hemodynamics,pulmonary ventilation were monitored and oxygen uptake ventilatory efficiency ((V)O2/(V)E and (V) E/(V)CO2) was calculated.Results During CPET,as the loading gradually increased,cardiac output,heart rate,mixed venous oxygen saturation,arteriovenous oxygen difference,minute ventilation,minute alveolar ventilation,tidal volume,alveolar ventilation and pulmonary ventilation perfusion ratio increased near-linearly (P ＜0.05-0.01,vs.resting); arterial oxygen concentration maintained at a high level without significant change (P ＞ 0.05) ; stroke volume,respiratory rate,arterial partial pressure of carbon dioxide,arterial blood hydrogen ion concentration and dead space ventilation ratio significantly changed none-linearly (compare resting state P ＜ 0.05-0.01).OUE during exercise increased from 30.9 ± 3.3 at resting state to the highest plateau 46.0 ± 4.7 (P ＜ 0.05 vs.resting state),then,declined gradually after anaerobic threshold (P ＜ 0.05 -0.01,vs.OUEP) and reached 36.6 ±4.4 at peak exercise.The (V)E/(V)CO2 during exercise decreased from the resting state (39.2 ± 6.5) to the minimum value (24.2 ± 2.4) after AT for a few minutes (P ＞ 0.05 vs.earlier stage),then gradually increased after the ventilatory compensation point (P ＜ 0.05 vs.earlier stage) and reached to 25.9 ± 2.7 at peak exercise.Conclusions Cardiac and lung function as well as metabolism change during CPET is synchronous.In the absence of pulmonary limit,appearing before and after anaerobic threshold,OUEP and lowest (V) E/(V) CO2 could be used as reliable parameters representing the circulatory function.

Hypoxia conditioning could increase the survival of transplanted neuronal progenitor cells (NPCs) in rats with cerebral ischemia but could also hinder neuronal differentiation partly by suppressing mitochondrial metabolism. In this work, the mitochondrial metabolism of hypoxia-conditioned NPCs (hcNPCs) was upregulated via the additional administration of resveratrol, an herbal compound, to resolve the limitation of hypoxia conditioning on neuronal differentiation. Resveratrol was first applied during the in vitro neuronal differentiation of hcNPCs and concurrently promoted the differentiation, synaptogenesis, and functional development of neurons derived from hcNPCs and restored the mitochondrial metabolism. Furthermore, this herbal compound was used as an adjuvant during hcNPC transplantation in a photothrombotic stroke rat model. Resveratrol promoted neuronal differentiation and increased the long-term survival of transplanted hcNPCs. 18-fluorine fluorodeoxyglucose positron emission tomography and rotarod test showed that resveratrol and hcNPC transplantation synergistically improved the neurological and metabolic recovery of stroke rats. In conclusion, resveratrol promoted the neuronal differentiation and therapeutic efficiency of hcNPCs in stroke rats via restoring mitochondrial metabolism. This work suggested a novel approach to promote the clinical translation of NPC transplantation therapy.
Animals ; Brain Ischemia/drug therapy* ; Cell Differentiation ; Hypoxia ; Neurons ; Rats ; Resveratrol/pharmacology*