Objective:To investigate the correlation between plasma concentration and effective dose of tacrolimus in the treatment of membranous nephropathy. Methods: Totally 41 patients with membranous nephropathy were given tacrolimus combined with hor-mone at low dose. The valley plasma concentration of tacrolimus was detected using a homogeneous enzyme multiplied immunoassay method. According to the changes of 24-hour urine protein,serum albumin and kidney function, the clinical efficacy was evaluated. The correlation between curative effect and plasma concentration and dosage of tacrolimus in the treatment of membranous nephropathy was analyzed. Results:The plasma concentration of tacrolimus was (7. 47 ± 2. 74) ng·ml-1 and the dosage of administration was (0.047 ±0.007)mg·kg-1·d-1 in complete remission group, that in partial remission group respectively was (5.72 ±1.19)ng· ml-1 and(0.049 ±0.008)mg·kg-1·d-1, and that in non-remission group was respectively (3.30 ±1.08 )ng·ml-1 and (0.052 ± 0. 01)mg·kg-1·d-1. Conclusion: The clinical efficacy of tacrolimus in the treatment of membranous nephropathy has close rela-tionship with the plasma concentration,and that is promising when the plasma concentration within the range of (5. 10-9. 32) ng· ml-1 . The plasma concentration of tacrolimus isn't increased with the dosage increase in some patients.

Objective To investigate the changes in plasma concentrations of IL-6 and IL-10, pHi and the difference between tissue and arterial PCO2 [(P(t-a)CO2 ] during pulmonary surgery and the effects of thoracic epidural anesthesia on cytokine production and gut mucosal perfusion. Methods Twenty ASA class Ⅰ - Ⅱ patients undergoing elective pulmonary surgery, were randomly assigned to be operated upon under general anesthesia (group GA , n = 10) or under general anesthesia combined with thoracic epidural anesthesia (group GEA, n - 10) . Premedication in both groups consisted of pethidine 50mg and scopolamine 0.3 mg im 30 min prior to surgery and oral ranitidine 150 mg the night and 1 h before operation. Anesthesia was induced with fentanyl 2 ug?kg-1 , droperidol 1 mg, propofol 1.5-2.5 mg?kg-1 and succinylcholine 1-2 mg?kg-1 and maintained with inhalation of 1%-2.5% isoflurane and 50% N2O in oxygen and intermittent iv boluses of fentanyl and vecuronium. In GEA group epidural catheter was inserted through the needl placed at T7-8 or T8-9 and advanced cephalad for 2.5-3.0 cm. A loading dose of morphine 2 mg was given followed by epidural infusion of 0.4% ropivacaine at a rate of 6 ml?h-1 during maintenance of anesthesia and the concentration of isoflurance inhaled was reduced to 0.6%-1. 5% . Postoperative analgesia was provided by epidural infusion of 0.25% ropivacaine at 6-8 ml/2h until the morning of the 3rd postoperative day. Blood samples were taken before induction, at incision and 2 h, 4 h and 6 h after the incision and on the 1st and the morning of the 3rd postoperative day for determination of IL-6 ( by radioimmunoassay) and IL-10 (ELISA) . P(t-a)CO2 and pHi were assessed by tonometry before induction, at incision and 1 h, 2 h, 4 h and 6 h after the incision. Results (1) IL-6 and IL-10 increased significantly during operation as compared with the baseline value before induction in both groups and there was no significant difference between the two groups. (2) pHi decreased significantly during operation in both groups and there was no significant difference between the two groups. pHi was negatively correlated with IL-6. (3) P(t-a)CO2 increased significantly during operation in both groups and was negatively correlated with pHi. P(t-a)CO2 was significantly higher in GA group than that in GEA group at 4h after skin incision. Conclusion Pulmonary surgery elicits both pro- and and-inflammatory cytokine response which is not affected by thoracic epidural analgesia. Thoracic surgery leads to gut mucosal hypoperfusion of which P(t-a)CO2 is an indicator. Thoracic epidural anesthesia can improve gut mucosal perfusion. There may be some correlation between cytokine production and gut mucosal hypoperfusion.

Objective:To explore the change of the behaviour, cognition and emotion of the public in Beijing during different prevalence of SARS Method: "Questionnaire on SARS" was designed by authors Through e-mails or websites, 473 valid copies were collected in Beijing Result:Facing with SARS, the public in Beijing faced high pressure from the environment They concerned with the information on SARS very much, and adopted more self-protection behaviours, such as wearing masks, paying more attention on personal hygiene Some people also showed irrational behaviours, such as storing cashes and food, taking the temperature too much times within one day and so on As for the cognition, people thought they should adjust themselves psychologically in order to overcome SARS related problems without being panic When the SARS cases increasing, physical and psychological stricture made people feel more nervous, panic, helpless, angry and pessimistic, as well as less excited, calm and numb The cognition, behaviour and the emotion of Beijing's public varied along with the situation in Beijing and in China

OBJECTIVE:To prepare Xiaocuo emulsion and to study its stability.METHODS:The formula and techniques were optimized with metronidazuo,cimetidine,chloramphenicol and salicylic acid as the chief ingredients,and with the uniformity of emulsion as the indicator.The stability test was performed using storage test and accelerated centrifugal test.RESULTS:The optimized formula was the following,5ml azone,4ml tween-80,1g metronidazole,2g cimetidine,2g chloramphenicol,1g salicylic acid and 100ml deionized water.CONCLUSION:The preparation is reasonable in formula,simple in preparative techniques,stable in quality and feasible in production.

Objective To study the antimicrobial resistance changes of common pathogenic bacterial isolates in Guangzhou. Methods Disc diffusion test was used to measure the antibiotic susceptibility of 5063 strains collected from 13 hospitals in Guangzhou from 1998 to 2000 (Fastidious bacteria were detected by E test). Results From 1998 to 2000, the percentage of methicillin resistant Staphylococcus aureus was 45.3%,53.0%, and 50.8%, respectively, and that of methicillin resistant coagulase negative Staphylococcus was 64.1%, 86.0%, and 79.0% accordingly. There was no resistance to vancomycin in the strains of Staphyloccocas and there were 40.7%, 31.8% and 36.4% in E.coli and 43.1%, 42.7%, and 31.5% in Klebsiella found to be extended spectrum lactamases producing in the 3 years. Resistant rates of Enterobacter spp against the third generation cephalosporins increased. Resistant rates of P.aeruginosa against cefoperazone/sulbactam, ceftazidime,amikacin were changed unmarkedly in recent years. Conclusions The antimicrobial resistance of common pathogenic bacteria is serious in Guangzhou area. The surveillance of antimicrobial susceptibility is of great significance.

Proinsulin(PI)_(AUC) increased,and insulin action index,HOMA-? and △I_(30)/△G_(30) decreased progressively from NGT(n=131) to IGT(n=120) to T2DM(n=107).Obese group had higher HOMA?,Ins_(AUC),C-P_(AUC) and PI_(AUC) than did the non-obese group.

With the popularization of rehabilitation and the development of the physiotherapy, some chronic diseases do not only mean the history of the patients, but also the objects of physiotherapy. The exercises will affect the cardiopulmonary function of the patient, and result in a high risk of accident. This article would review the risk factors and risk management in physiotherapy for chronic diseases.

OBJECTIVE:To investigate the significance of tacrolimus blood concentration monitoring to the therapy of mem-branous nephropathy. METHODS:41 patients with membranous nephropathy received tacrolimus,and the blood concentration of ta-crolimus reached to steady state. The trough concentration of tacrolimus was determined by EMIT. The patients were followed up, and clinical therapeutic efficacies were recorded. The relationship of blood concentration of tacrolimus with clinical efficacy was evaluated by SPSS 16.0 software. RESULTS:The blood concentration of tacrolimus was(7.47±2.74)ng/ml in complete remission (CR)group,(5.72±1.19)ng/ml in partial response(PR)group,and(3.30±1.08)ng/ml in no response(NR)group,with total remission rate of 75.61%. The blood concentration of CR group was the highest,followed by PR group and NR group,there was statistical significance among 3 groups(P<0.05). CONCLUSIONS:The clinical efficacy of tacrolimus in the treatment of nephrot-ic syndrome is correlate to the blood concentration intimately. Trough concentration monitoring of tacrolimus has important signifi-cance to the treatment of membranous nephropathy.

Objective:To investigate the relationship between gene polymorphisms of disease-relevant multiple cytokines including TNF-α,IL-6,IL-10,TGF-β1,IFN-γand acute graft versus host disease(aGVHD) in allogeneic hematopoietic stem cell trans-plantation ( allo-HSCT ) . Methods:32 cases of recipients received allo-HSCT and 36 cases of normal groups in January 2014 to December 2015 were selected as objects of study. We detected genotypes on specific SNP of target genes by polymerase chain reation ( PCR) combined with gene sequencing and observed the occurrence of aGVHD in postoperative recipients. The influence of cytokine gene polymorphisms on prognosis of allo-HSCT patients was analyzed,and the potential relationship between specific SNP mutation of the disease-relevant cytokine genes and severity of aGVHD was discussed. Results:Distribution of cytokines gene polymorphism including TNF-α-308(G/A),IL-6-174(G/C),IL-10-1082(A/G),TGF-β1+915(G/C),IFN-γ(T/A) had no significant differences with incidence of severe aGVHD(P>0. 05). However,the occurrence of severe aGVHD in allo-HSCT recipients with C/T genotype was significantly higher than C/C and T/T in SNP of TGF-β1+869(P<0. 01). Conclusion:Gene polymorphism of TGF-β1+869(C/T) in allo-HSCT patients was closely related to the occurrence of severe aGVHD. The research show allo-HSCT patients with C/T genotype occurred severe aGVHD more frequently, which is an important potential risk factor to induce the incidence of severe aGVHD. Therefore,detecting gene polymorphism of TGF-β1+869 ( C/T ) in allo-HSCT recipients and developing the appropriate therapeutic regimen may be helpful to reduce the incidence of aGVHD.

Objective To observe the influence of low or middle power microwave radiation on tissues adja-cent to titanium alloy implants. Methods Titanium alloy internal fixation plates were implanted into the upper femur of the right side of New Zealand white rabbits, the left femurs served as the control. Then the femurs were exposed to 20, 40, 60, or 80 W of microwave radiation at a frequency of 2450 MHz for 30 minutes, and real-time temperature of the implants and its adjacent muscles were recorded. The nerve conduction study of the sciatic nerve was performed by stimulating the nerve and recording from gastrocnemius in both groups. Finally, all the rabbits were sacrificed and histo-logical studies were performed on nerve and muscle sections. Results Compared to the control limbs, temperatures of limbs with titanium alloy implants increased significantly when exposed to microwave radiation at 60 and 80 W ( P<0.05) but no significant differences were revealed when exposed to radiation at 20 and 40 W ( P<0.05) . For the sciatic nerve conduction, significantly prolonged distal latency of CMAP ( P<0.05) and slower nerve conduction velocity ( P<0.05) were observed in the experimental limbs when exposed to microwave radiation at 60 and 80 W, but the decrease of CMAP amplitude was not significant (P>0.05). Pathological examination showed obvious congestion and bleeding in the intercellular spaces of skeletal muscle cells in the experiment group when exposed to radiation at 60 W, with no ob-vious pathological changes found in the sciatic nerve. However, when exposed to radiation at 80 W, vacuoles appeared in myocytes, the cellular structure was destroyed and the myelin sheath of the sciatic nerve swelled. Conclusion Ex-posure to microwave irradiation at 20 and 40 W, but not 60 and 80 W exerts no adverse effects on nerves and muscles adjacent to titanium alloy internal fixation plates. Consequently, continuous wave microwave irradiation at low powers (20~40 W) is a safer auxiliary treatment for limbs with titanium alloy implants.