Traditional Chinese Medicine Intervenes in Atherosclerosis by Regulating TLR/NLRP3 Pathway via TRPV1/TRPA1 / 中国实验方剂学杂志

Atherosclerosis is a chronic inflammatory disease caused by lipid accumulation and vascular endothelial dysfunction. The Toll-like receptor （TLR）/nuclear transcription factor-κB （NF-κB） pathway and the NOD-like receptor protein 3 （NLRP3） inflammasome pathway play a proinflammatory role， while the transient receptor potential vanilloid subtype 1 （TRPV1） and transient receptor potential ankyrin 1 （TRPA1） play a protective role in the occurrence of atherosclerosis. We reviewed the relevant studies published in the last 10 years. The results showed that activation of TRPV1/TRPA1 could activate endothelial-type nitric oxide synthase （eNOS） and inhibit the generation of reactive oxygen species （ROS） and cholesterol crystal （CC） to modulate the TLR/NF-κB and NLRP3 inflammasome pathways， thereby inhibiting TLR/NLRP3-mediated inflammatory response. A variety of compound prescriptions and active components of Chinese medicinal materials can activate TRPV1/TRPA1 or its downstream pathway to regulate the TLR/NLRP3 pathway in atherosclerosis. This paper introduces the mechanisms of compound prescriptions and active components of Chinese medicinal materials in regulating the TLR/NLRP3 pathway via TRPV1/TRPA1 in atherosclerosis. This review provides new ideas for the research on the interactions between Chinese medicines in the treatment of atherosclerosis and provides a new strategy for the clinical treatment of atherosclerosis with traditional Chinese medicine.

[Mechanism and experimental verification of "Polygoni Cuspidati Rhizoma et Radix-Ligustri Lucidi Fructus" combination in treatment of acute gouty arthritis based on network pharmacology].

Based on network pharmacology, the mechanism of Polygoni Cuspidati Rhizoma et Radix-Ligustri Lucidi Fructus(PL) combination against acute gouty arthritis(AGA) was explored and preliminarily verified by animal experiment. The chemical components and corresponding targets of PL were retrieved from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). The active components with oral bioavailability(OB)≥30% and drug-likeness(DL)≥0.18 were screened based on literature, and the related protein targets were collected. Then the protein targets were standardized with the help of UniProt database. The AGA-related targets were searched from GeneCards, NCBI, and DrugBank. The common targets of the disease and the medicinals were yielded by FunRich V3, and the protein-protein interaction(PPI) network was constructed to screen the key targets, followed by Gene Ontology(GO) term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis of the key targets. Afterwards, some of the key targets were verified by sodium urate crystal-induced AGA mouse model. A total of 25 active components and 287 targets of PL, 811 targets of AGA, and 88 common targets were screened out. PPI network analysis showed that tumor necrosis factor(TNF), interleukin-6(IL-6), and interleukin-1ß(IL-1ß) may be the core targets of PL in the treatment of AGA. The key targets were mainly involved in 566 GO terms(P<0.05), including multiple biological processes such as inflammatory response and immune response. Moreover, they were related to 116 KEGG pathways and these pathways were involved in inflammation and immunity, mainly including NOD-like receptor signaling pathway and TNF signaling pathway. Animal experiment confirmed that PL can alleviate ankle swelling, improve abnormal gait, and down-regulate the protein expression of TNF-α, IL-6, and IL-1ß in AGA mice, indicating that PL can treat AGA through TNF-α, IL-6, and IL-1ß and the feasibility of network pharmacology to predict drug targets. This study preliminarily discussed the key targets and biological signaling pathways involved in the treatment of AGA with PL combination, which reflected the multi-pathway and multi-target action characteristics of Chinese medicine. Moreover, this study laid a scientific basis for research on the treatment of AGA with PL combination, as well as the mechanism of action.

Hepatic Artery Injection of 131I-Metuximab Combined with Transcatheter Arterial Chemoembolization for Unresectable Hepatocellular Carcinoma: A Prospective Nonrandomized, Multicenter Clinical Trial.

This prospective nonrandomized, multicenter clinical trial was performed to investigate the efficacy and safety of 131I-labeled metuximab in adjuvant treatment of unresectable hepatocellular carcinoma. Methods: Patients were assigned to treatment with transcatheter arterial chemoembolization (TACE) combined with 131I-metuximab or TACE alone. The primary outcome was overall tumor recurrence. The secondary outcomes were safety and overall survival. Results: The median time to tumor recurrence was 6 mo in the TACE + 131I-metuximab group (n = 160) and 3 mo in the TACE group (n = 160) (hazard ratio, 0.55; 95% CI, 0.43-0.70; P < 0.001). The median overall survival was 28 mo in the TACE + 131I-metuximab group and 19 mo in the TACE group (hazard ratio, 0.62; 95% CI, 0.47-0.82; P = 0.001). Conclusion: TACE + 131I-metuximab showed a greater antirecurrence benefit, significantly improved the 5-y survival of patients with advanced hepatocellular carcinoma, and was well tolerated by patients.

Mechanism and experimental verification of "Polygoni Cuspidati Rhizoma et Radix-Ligustri Lucidi Fructus" combination in treatment of acute gouty arthritis based on network pharmacology / 中国中药杂志

Based on network pharmacology, the mechanism of Polygoni Cuspidati Rhizoma et Radix-Ligustri Lucidi Fructus(PL) combination against acute gouty arthritis(AGA) was explored and preliminarily verified by animal experiment. The chemical components and corresponding targets of PL were retrieved from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). The active components with oral bioavailability(OB)≥30% and drug-likeness(DL)≥0.18 were screened based on literature, and the related protein targets were collected. Then the protein targets were standardized with the help of UniProt database. The AGA-related targets were searched from GeneCards, NCBI, and DrugBank. The common targets of the disease and the medicinals were yielded by FunRich V3, and the protein-protein interaction(PPI) network was constructed to screen the key targets, followed by Gene Ontology(GO) term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis of the key targets. Afterwards, some of the key targets were verified by sodium urate crystal-induced AGA mouse model. A total of 25 active components and 287 targets of PL, 811 targets of AGA, and 88 common targets were screened out. PPI network analysis showed that tumor necrosis factor(TNF), interleukin-6(IL-6), and interleukin-1β(IL-1β) may be the core targets of PL in the treatment of AGA. The key targets were mainly involved in 566 GO terms(P<0.05), including multiple biological processes such as inflammatory response and immune response. Moreover, they were related to 116 KEGG pathways and these pathways were involved in inflammation and immunity, mainly including NOD-like receptor signaling pathway and TNF signaling pathway. Animal experiment confirmed that PL can alleviate ankle swelling, improve abnormal gait, and down-regulate the protein expression of TNF-α, IL-6, and IL-1β in AGA mice, indicating that PL can treat AGA through TNF-α, IL-6, and IL-1β and the feasibility of network pharmacology to predict drug targets. This study preliminarily discussed the key targets and biological signaling pathways involved in the treatment of AGA with PL combination, which reflected the multi-pathway and multi-target action characteristics of Chinese medicine. Moreover, this study laid a scientific basis for research on the treatment of AGA with PL combination, as well as the mechanism of action.

Multi-template molecularly imprinted solid phase extraction and its application in the extraction and separation of multi-components from traditional Chinese medicine / 药学学报

Multi-template molecularly imprinted solid phase extraction not only has the advantages of high selectivity, large adsorption capacity, easy preparation, reuse and low environmental pollution, but also can realize the enrichment and separation of many kinds of compounds. It has attracted wide attention in the extraction and separation of traditional Chinese medicine components. This study summarizes the latest development of multi-template molecularly imprinted solid phase extraction. At the same time, based on the classification of active components of traditional Chinese medicine (flavonoids, alkaloids, phenylpropanol, terpenes, etc.), the latest application of multi-template molecular imprinting solid phase extraction in multi-component separation of traditional Chinese medicine was reviewed, with a view to better application of multi-template molecularly imprinted polymer in active multi-component extraction and separation of traditional Chinese medicine and provide reference for the material basic research of the efficacy of traditional Chinese medicine.

The mechanism study of protecting kidney of Erzhi Pill based on network pharmacology / 药学学报

Based on the concept of network pharmacology, the main nephroprotective components in Erzhi Pill reported in previous studies, were used to predict the targets through the PharmMapper method. Molecular docking was applied to screen for potential targets and biological information annotation databases (DAVID) was used to analyze the molecular function and biological process of the action targets. The Cytoscape software was used to construct the “ingredient-target-pathway” network of Erzhi Pill for renal injury treatment. TTD and GAD database were then applied to screen for the targets of renal disease for building “ingredient-core target” network. We found that 17 major active ingredients of Erzhi Pill regulated 32 targets (including ESR1, ESR2, GCK, MMP3) and affected 6 pathways, such as PI3K-Akt signaling pathway, estrogen signaling pathway and purine metabolism. This study reflected the nature of traditional Chinese medicine as multi-ingredients, multi-targets and multi-pathways, providing new clues for basic science research on the nephroprotective pharmacological mechanism of Erzhi Pill.

Treatment outcomes of vitiligo in Asian children.

This retrospective study aimed to identify factors that predict treatment response in a cohort of Asian children with vitiligo. Shorter duration of vitiligo was associated with better repigmentation. Patients with focal vitiligo of short duration have a good chance of achieving repigmentation with topical agents alone.

Network pharmacology-based study on mechanism of liver protection of Erzhi Pill / 药学学报

This study was designed to construct a "drug-core target-pathway" network of Erzhi Pill for hepatic injury treatment in an effort to explore the "multi-components, multi-targets, multi-pathways" mechanism. ADME/T calculation method was used to screen the active components of Erzhi Pill, and then predict the potential targets according to the reverse pharmacophore matching method. Biological information annotation databases (DAVID) was used to analyze the molecular function and biological process of the action targets. The Cytoscape software was used to construct the "ingredient-core target-pathway" network of Erzhi Pill for hepatic injury treatment. It was found that 39 major active ingredients of Erzhi Pill regulated 321 targets (HRAS, DCK, HSD17B1, UCK2, et al) and affected 51 pathways, such as insulin signaling pathway, FoxO signaling pathway, metabolic pathways and glycolysis/gluconeogenesis. The method revealed the action features of traditional Chinese medicine as multi-ingredients, multi-targets, multi-pathways, providing new clues for further basic study on the hepatic injury pharmacological mechanism of Erzhi Pill.

Laparoscopic surgery for repairing biliary duct defect in type Ⅱ, Ⅲ Mirizzi syndrome / 中华全科医师杂志

Twenty nine patients with biliary duct defect in type Ⅱ,Ⅲ Mirizzi syndrome were treated by laparoscopic surgery at department of surgery,Luoyang Second Traditional Medicine Hospital from May 2010 to April 2017.Among them,23 cases were treated by pedicle gallbladder flap with laparoscopy and 6 cases were converted to open surgery.The postoperative T-tube sustention was lasted for 4-7 months.When the cholangiopancreatography showed no obstruction,the T-tube was closed for a week;then the tube was pulled out if there was no further obstruction.The patients were followed-up for 4-84 months,all patients were cured and no complications occurred.Laparoscopic repair of biliary duct defect in type Ⅱ,Ⅲ Mirizzi syndrome with pedicle gallbladder flap is an effective procedure for physiological function integrity of biliary duct.

Research progress on clinical diagnosis and treatment for external snapping hip / 中国骨伤

External snapping hip(ESH) is a vague term used to describe palpable or auditory snapping with hip movements with or without pain. The pathogenesis of ESH is related to the specific anatomical structure and friction factor. The clinical symptom is auditory snapping during activities, physical examination, X-ray, magnetic resonance imaging(MRI), dynamic ultrasound and other imaging techniques can be used to diagnose. Conservative medical management includes rest, avoidance of aggravating activities, and antiinflammatory medications. Treatment Patients with mild symptoms can achieve good results by medication, rest and physiotherapy. Surgical treatment for patients with ineffective conservative treatment was performed. All kinds of open surgery method can achieve good clinical curative effect, arthroscopic surgery is gradually been promoted due to small trauma, less complications. Besides, there are some reports that traditional treatments such as massage, acupuncture and acupotomology have achieved good clinical results, which deserve further study and promotion.

Application of immunoassay in fast quality evaluation of traditional Chinese medicine / 中国中药杂志

The quality evaluation of traditional Chinese medicine can be divided into two aspects, effectiveness and safety. The existing methods for evaluating the quality of traditional Chinese medicine(TCM) are mostly based on the testing instruments, which can not meet the practical needs of simple, rapid and on-site in production and life. Immunoassay, characterized by simple, rapid, sensitive, specific, low-cost and high-throughput, is widely used in the fields of clinical diagnosis, environmental pollution monitoring, food safety testing, and other fields. In recent years, immunoassay technology has been gradually applied in the field of quality control of TCM, involving quantitative detection of effective components of TCM, detection of harmful substances in TCM, and detection of exogenous pollutants in TCM. This paper summarizes the principle of the wide application of ELISA and colloidal gold immunostrip technology and its application in quality evaluation of TCM, this technique has a good application prospect in the field of rapid detection of the quality of TCM. In this paper, the principles of the widely used ELISA and colloidal gold immune test strip technology as well as their application in quality evaluation of TCM were reviewed, and the results showed that this technique had a good application prospect in the field of rapid detection of the quality of TCM.

Antifungal effects of three medicinal crops on Phytophthora nicotianae / 中国中药杂志

Tobacco black shank is one of the most harmful soil-borne diseases infected by Phytophthora parasitica. In order to probe the control method to this disease, in this study, the mycelial growth rate method was employed to investigate the antifungal effects of extracts from stem-leaf and root, root exudates, and their combination of Scrophularia ningpoensis, Chuanmingshen violaceum and Pinellia ternata The results showed that: ①Stem-leaf and root extracts of S. ningpoensis, C. violaceum and P. ternata exhibited different antifungal activities, and the inhibition increased with the increase of extract concentration. The antifungal effect of S. ningpoensis extracts at 0.5 g•mL⁻¹ was the strongest than other medicinal plants, the inhibition rate of steam-leaf and root extracts reached 74.88%, 69.27%, respectively. The inhibitory effect of C. violaceum and P. ternata was relatively lower, however, there is a significant gain effect after combination of steam-leaf and root extracts of C. violaceum. ②The root exudates of S. ningpoensis, C. violaceum and P. ternata showed fungistasis to Phytophthora nicotianae, and fungistasis was enhanced with the increase of root exudate concentration. The antifungal effect in the order of C. violaceum > S. ningpoensis > P. ternata. ③The antifungal activity of combination of extract and root exudate from S. ningpoensis was similar with the effect of C. violaceum, they were both stronger than P. ternata, and the antifungal activity for three combination were located between the antifungal activity of their extracts and root exudates. S. ningpoensis and C. violaceum can be potentially applied to prevent and control the tobacco black shank.

Perforators, the Underlying Anatomy of Acupuncture Points.

Context • As a critical concept in acupuncture, acupuncture points, or acupoints for short, are currently believed to be 3-dimensional structures composed of skin, muscles, tendons, nerves, blood vessels, lymph nodes, and other special tissues. No known specific tissue or organ has been confirmed to be an acupoint. However, from a microsurgeon's point of view, a special vascular structure exists around each acupoint (ie, perforators or arterioles of 0.3-1.5 mm that pierce deeply through the fascia). Objective • The current research team investigated the theory that perforators are the anatomical basis of acupoints. Design • A reference list of acupoints and of perforators near the acupoints was proposed, and the distributions were analyzed. Using the World Health Organization (WHO) list, "Standard Acupuncture Point Locations in the Western Pacific Region," 2 experienced acupuncturists identified the needling depth and angle as well as verified the acupoint locations. Perforators with amplitudes of 1 cm or more were identified by 3 veteran microsurgeons. Setting • The study was carried out in an osteopathic research center at the 89th Hospital of the People's Liberation Army, in Weifang, Shandong, China. From October 2013 to October 2014, patients who required skin flap transplantation were enrolled for observation. Outcome Measures • To evaluate the theory, the current research team observed subcutaneous perforating points in flap donor sites and operative incision areas and compared those points with the acupoints located by acupuncturists. Results • The perforators and acupoints were found to be closely correlated. Several distribution patterns of acupoints and perforators have emerged and further confirmed the research team's theory. Conclusions • The hypothesis could facilitate theoretical understanding of the mechanism and essence of acupuncture.

Twelve-month and sixty-month outcomes of noncultured cellular grafting for vitiligo.

BACKGROUND: Noncultured cellular grafting is a known surgical technique for vitiligo. OBJECTIVE: This study evaluated our center's 12-month repigmentation outcome and its maintenance up to 60 months, factors influencing repigmentation and safety data. METHODS: Clinicoepidemiologic and repigmentation data were reviewed for patients with vitiligo who had undergone noncultured cellular grafting from March 2006 to December 2012 at the National Skin Center, Singapore. RESULTS: All 177 patients who received noncultured cellular grafting during the study period were included. For those with available data, good to excellent repigmentation was present in 83% at 60 months. At 12 months, 88% of patients (n = 52) with segmental vitiligo achieved good to excellent repigmentation compared with 71% (n = 55) with nonsegmental vitiligo (P < .05). More patients on collagen dressings (82%) achieved good to excellent repigmentation compared with those who received hyaluronic acid (63%) (P < .05). Sites of lesions and postgrafting phototherapy did not significantly affect repigmentation outcome. Adverse reactions were uncommon and mild. LIMITATIONS: The study is limited by its retrospective nature, the progressive loss to follow-up of patients, the absence of blinding, and the lack of use of standardized assessment tools. CONCLUSION: Noncultured cellular grafting was successful in allowing more than 80% of patients to achieve good to excellent repigmentation for at least 60 months.

Study on toxicity of vinegar-processed Kansui Radix on basis of symptom-based prescription theory / 中国中药杂志

<p><b>OBJECTIVE</b>To study the differences in the toxicity of vinegar-processed Kansui Radix on normal and cancerous ascites model rats.</p><p><b>METHOD</b>Normal and cancerous ascites model rats were taken as the research objects and orally administered with different doses of vinegar-processed Kansui Radix for 7 d. Pathological sections were prepared to observe the damages in liver, stomach, intestinal tissues in rats and detect the impacts on serum, liver, stomach and intestinal tissues and the oxidative damage index.</p><p><b>RESULT</b>Compared with the blank group, all of normal administration groups and model groups showed significant damages in liver, stomach and intestinal tissues. Compared with the model groups, all of normal administration groups revealed notable alleviation in damages. Compared with the blank group, the model groups showed significant increases in AST, ALT and MDA in serum and liver (P < 0.01) and a significant decrease in GSH in serum and liver, stomach, intestinal tissues (P < 0.01). Compared with the blank group, the results showed significant decreases in ALT, AST in serum and ALT in liver in model low, medium and high dose groups and AST activity in liver tissues in the normal high dose group (P < 0.05, P < 0.01); significant decreases in GSH in serum and stomach tissues in normal low, medium and high dose groups and GSH content in liver and intestinal tissues in normal medium and high dose groups (P < 0.05, P < 0.01); notable rises in MDA in liver tissues in normal low, medium and high dose groups and MDA content in serum and stomach and intestinal tissues in normal medium and high dose groups (P < 0.05, P < 0.01). Compared with model groups, data revealed significant decreases in ALT, AST in serum in model low, medium and high dose groups, AST in liver tissues of model medium and high dose groups and ALT activity in liver in the model high dose group (P < 0.05, P < 0.01); significant increases in GSH content in serum and stomach tissues of model low, medium and high dose groups, GSH in liver tissues in model medium and high dose groups and GSH in intestinal tissues in the high dose groups (P < 0.05, P < 0.01); and notable declines in MDA content in serum in model low, medium and high dose groups, MDA in liver tissues of model medium and high dose groups and MDA in stomach and intestinal tissues the high dose group (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>According to the study, vinegar-processed Kansui Radix showed a significant lower toxicity liver, stomach, and intestines of cancerous ascites model rats, which provided a basis for clinical safe application of vinegar-processed Kansui Radix based on symptom-based prescription theory.</p>

Preparation and immunogenicity identification of artificial antigen for luteoloside / 中国中药杂志

Lonicerae Japonicae Flos was one of the most widely used traditional Chinese medicine for its special biological activities. The content of luteoloside, one of its major compounds, was an important standard for the quantity control of Lonicerae Japonicae Flos. The major method used for the detection of luteoloside was instrumental analysis. Compared with the ELISA method, instrumental analysis was time-consuming, complex pretreatment and low-throughout. Thus, it was significantly important to develop an enzyme-linked immunosorbent assay (ELISA) for luteoloside analysis. Here, the conjugates of luteoloside-bovine (LG-BSA) and luteoloside-ovalbumin (LG-OVA) were produced as the immunogen and coating antigen by the carbodiimide ( CDI) method, respectively. The conjugation ratio of carrier protein and the hapten in the conjugate were determined by UV-Vis spectrophotometry (UV). LG-BSA conjugate was used to immunize Bal b/c mice to produce antiserum. The titer and specificity of antiserum were detected by ELISA. The conjugation ratio of hapten and carries protein were 3. 7: 1 (LG-BSA) and 1. 0: 1 (LG-OVA). The antiserum titer was higher than 2 000 with the linear range of 18.4-4 852.4 μg x L(-1), R2 = 0.988 4 and IC50 = 298.7 μg x L(-1). The result showed that the conjugate antigen LG-BSA was synthesized successfully and the mice can produce specific antiserum injected with artificial antigen.

Filtration of active fractions with function of expelling water retention with drastic purgative from Kansui Radix stir-baked with vinegar / 中国中药杂志

To study the function of expelling water retention with drastic purgative of different polarities of Kansui Radix stir-baked with vinegar on the cancerous ascites model rats, the furosemide was taken as positive control drug, and the cancerous ascites model rats were respectively orally administered with different polarities of Kansui Radix stir-baked with vinegar for 7 d. The amount of urine and ascites, the level of urinary sodium, potassium, chloride ion and pH, and the content of PRL1, AII, ALD in serum were investigated. Compared with model groups, ethyl acetate extract group showed a decreasing trend in ascites; the amount of urine of showed a significant increase (P < 0.05); the level of urinary sodium, potassium, chloride ion (P < 0.05, P < 0.01), pH (P < 0.05), and the content of PRL1, AII, ALD in serum all showed a significant decrease (P < 0.01). The effects of petroleum ether extract and n-butanol extract were weaker than that of ethyl acetate extract. The water exact was the weakest. The results showed that ethyl acetate extract is the active part of Kansui Radix stir-baked with vinegar on the function of expelling water retention with drastic purgative on the cancerous ascites model rats, alleviating the water-electrolyte disorder and body fluid acid-base imbalance, regulating the renin angiotensin aldosterone system.

Cordycepin down-regulates multiple drug resistant (MDR)/HIF-1α through regulating AMPK/mTORC1 signaling in GBC-SD gallbladder cancer cells.

Gallbladder cancer is the most common malignancy of the bile duct, with low 5-year survival rate and poor prognosis. Novel effective treatments are urgently needed for the therapy of this disease. Here, we showed that cordycepin, the bioactive compound in genus Cordyceps, induced growth inhibition and apoptosis in cultured gallbladder cancer cells (Mz-ChA-1, QBC939 and GBC-SD lines). We found that cordycepin inhibited mTOR complex 1 (mTORC1) activation and down-regulated multiple drug resistant (MDR)/hypoxia-inducible factor 1α (HIF-1α) expression through activating of AMP-activated protein kinase (AMPK) signaling in gallbladder cancer GBC-SD cells. Contrarily, AMPKα1-shRNA depletion dramatically inhibited cordycepin-induced molecular changes as well as GBC-SD cell apoptosis. Further, our results showed that co-treatment with a low concentration cordycepin could remarkably enhance the chemosensitivity of GBC-SD cells to gemcitabine and 5-fluorouracil (5-FU), and the mechanism may be attributed to AMPK activation and MDR degradation. In summary, cordycepin induces growth inhibition and apoptosis in gallbladder cancer cells via activating AMPK signaling. Cordycepin could be a promising new drug or chemo-adjuvant for gallbladder cancer.

The significance of serum parathyroid hormone level on the first day after total thyroidectomy / 中华内分泌外科杂志

Objective To determinate whether the first post-operative day serum parathyroid hormone (PTH) is more effective than serum calcium in predicting hypocalcemia after total thyroidectomy.Methods According to PTH level on the first post-operative day,104 patients after total thyroidectomy were divided into different groups.Patient's serum calcium was measured,the number of patients who developed hypocalcemia and the time for calcium supplement were recored.Results Serum PTH was more accurate in predicting hypocalcemia than serum calcium.There were 26 patients whose PTH value was ＜ 5 pg/ml,among whom 7 patients had transient hypocalcemia and symptoms,while 5 of them developed hypocalcemia for long time and needed long-term calcium supplement.The positive predictive value of group PTH value ＜ 5 pg/ml was 28％,and the accurate rate was 46％,higher than other groups.Besides,the positive predictive value and the accurate rate of PTH value ＜ 5 pg/ml was higher than serum calcium.Conclusion Serum PTH is more effective in determining hypocalcemia after total thyroidectomy than serum calcium,and PTH value ＜ 5 pg/ml on the first post-operative day is a reliable marker in predicting hypocalcemia after total thyroidectomy.