OBJECTIVE:To discuss the accuracy of detecting tacrolimus(FK506) concentration in whole blood by ELISA and its application in organ transplantation.METHODS:The ELISA was used to detect FK506 valley point concentrations in 5 liver transplanted recipients at different postoperative periods .Based on the results combined with clinical findings, the dosages were adjusted.The accuracy of the method and guidance action in FK506 clinical application were described.RESULTS: In 131 detections of 350 samples, the results of quality control samples were all in the control range .The detecting RSDs of high and low concentration quality control samples were 9.09% and 11.90%, respectively.The control range of FK506 concentrations in whole blood were similar to that reported in literature .CONCLUSION :ELISA is a sensitive and specific method for routine FK506 concentration monitoring in whole blood,which is suitable for application in hospital.

Objective To observe the changes and significance of blood fat and myocardial enzymes in patients with hypothyroid myopathy before and after substitutional treatment.Methods The levels of TC, TG, LDL-C,AST, LDH, HBDH and CKMB were detected in 72 cases with hypothyroid myopathy patients before and after substitutional treatment and 60 healthy controls. Results The levels of TC,TG and LDL-C in hypothyroid myopathy patients before substitutional treatment were significantly higher than those in control group ( all P ＜ 0. 05 ), and then significantly low after treatment,which had no significant difference with control group( all P ＞0. 05). The levels of AST,LDH,HBDH and CKMB in hypothyroid myopathy patients before substitutional treatment were significantly higher than those in control group( all P ＜ 0. 05 ) ,and then significantly low after treatment,which had no significant difference with control group( all P ＞0. 05). Conclusion The levels of blood fat and myocardial enzymes were significantly increased in hypothyroid myopathy patients, and recovery to normal after substitutional treatment.

Objective To assess the symptoms of patients due to indwelling double ureteral stent and their impact on quality of life. Methods Sixty patients were assessed by the specific questionnaire. Average time of indwelling stent was 21.4 d. All patients finished the special questionnaire when the stent was removed by cystoscope, including specific urinary symptoms, IPSS (international prostate symptom score), VAS (visual analogic scale) and QOL (quality of life). To assess the pain feeling, the patients were divided into 3 groups by varied methods of anesthesia, including local anesthesia, balance anesthesia and general anesthesia. Results Insertion or removal of ureteral stents with local anesthesia provoked pain in 11 of 12 (91%) patients and 8 of 10 (80%) patients in balance anesthesia group. But 38 patients of general anesthesia group did not feel any pain when inserting stents. In 54 of 60 (90%) patients, the indwelling catheter provoked one or several urinary symptoms: nocturia (70%), frequency (65%), urgency (60%), tenesmus (58%), dysuria (52%), hematuria (35 % ) and incontinence (30 %). 75 % of the patients experienced pain, in the flank and lower abdomen. 29 (48 %) patients were found to be unsatisfied with their quality of life due to the indwelling stent. Among them, 18 (62%) patients demonstrated that the provoked overactive bladder symptoms were the main influence factor of QOL, compared with 5(17 %) patients complaining pain feeling. Conclusions Urinary symptoms and pain associated with indwelling double J ureteral stents could interfere the daily activities and 50 % of patients were found reduced quality of life. Overactive bladder symptoms were the main influence of QOL during the time of indwelling stent.

Objective To investigate the effect of small interfering RNA (siRNA) interference in the expression of epidermal growth factor receptor (EGFR) on the radiosensitivity of esophageal squamous carcinoma (Eca-109) and esophageal adenocarcinoma (OE-19) cell lines.Methods Human Eca-109 and OE-19 cell lines were selected as study subjects.Various EGFR-siRNA and negative siRNA were synthesized chemically through lipofection.Reverse transcription-polymerase chain reaction and Western blot were applied to measure the expression of EGFR before and after transfection,and the CCK8 assay was applied to analyze the influence of transfection on cell proliferation.Blank control groups of Eca-109 and OE-19 cells (O1 and O2 groups),simple irradiation groups (R1 and R2 groups),and EGFR-siRNA irradiation groups (E-R1 and E-R2 groups) were set,and the doses for single irradiation were 0,2,4,6,and 8 Gy.The colony-forming assay was applied to calculate survival fraction (SF) and sensitization enhancement ratio (SERD0 ratio),and flow cytometry was applied to evaluate the influence of EGFR-siRNA combined with radiotherapy on cell cycle distribution and apoptosis rate,and the dose for single irradiation was 6 Gy.Results The expression of EGFR in both cell lines was significantly down-regulated by EGFR-siRNA,and the inhibition rate of cell proliferation by transfection was＜5％ (4.9％ and 4.5％,respectively).The results of colony-forming assay showed that the cells in the E-R1 and E-R2 groups had a lower SF than those in the O1 and O2 groups,with an SERD0ratio of 1.40 and 1.01,respectively.The results from flow cytometry showed that compared with the E-R2 group,the E-R1 group had a higher proportion of cells in G2/M phase and a lower proportion of cells in S phase after irradiation (P=0.016 and 0.028),as well as a higher apoptosis rate (P=0.007).Conclusions Compared with the cell line OE-19,the cell line Eca-109 has a significantly increased radiosensitivity when treated with siRNA interference in EGFR expression.

Objective To investigate the prevalence of obesity and metabolic syndrome(MS)of children and adolescents in Longquan mountainous area in Zhejiang province.Methods A representative sample involving 2 135 children and adolescence aged 10 to 15 years were randomly surveyed and a total of 2 125 had available data(male/female ratios as:1 109/1 016).Using the standard methods,we measured the weight,height,waist circumference,hip circumference,blood pressure,detected fasting plasma glucose (FPG),high density lipoprotein cholesterol (HDL -C),triglyceride(TG),total cholesterol(TC),and calculated non-high density lipoprotein cholesterol(non-HDL). The prevalence of obesity and MS among the 10 to 15 years old children and adolescence in Longquan was compared with that in six cities in China(Beijing,Tianjin,Shanghai,Zhejiang,Chongqing and Guangxi).Results The preva-lence of obesity was 4.7% in 10 -15 -year -old teenage,in which the male obesity prevalence was 6.3%(70/1 109),female obesity prevalence was 3.0%(30 /1 016).The prevalence of overweight was 9.4% and the prevalence of boys was 11.0%,while the girl was 7.6%.The prevalence of obesity and overweight was 16.4%(299/2 125).The prevalence of MS was 2%(42/2 125)in the survey,but 42.0%in the obesity.The prevalence of obesity in Longquan(4.7%)was lower than that in the national six cities(8.1%)among the children and adoles-cents from 10 to 15 years old(χ2 =31.09,P=0.000).But in the obesity students,the prevalence of MS(42.0%)in Longquan was higher than that in six cities(28.8%)(χ2 =5.43,P=0.02).Conclusion The prevalence of obesity in Longquan mountainous area was lower than that in the national six cities among the children and adolescents from 10 to 15 years old.However,the prevalence of MS among the obesity in Longquan was higher than that in six cities.

Objective To analyze the expression of Galectin-3 in thyroid follicular tumors and its clinical significance in differential diagnosis between benign and malignant thyroid follicular tumor.Methods The expression of Galectin-3 in 120 cases of thyroid follicular carcinoma and 80 cases of thyroid follicular adenoma was detected by immunohistochemical technique.Results The expression rate of Galectin-3 in thyroid follicular carcinoma was significantly higher than that in follicular adenoma(84％ vs 19％,P ＜ 0.01).Strong positive expression of Galectin-3 was found in 40％ cases of thyroid follicular carcinoma and no case of thyroid follicular adenoma.Conclusions The expression of Galectin-3 can be regarded as an important parameter for differential diagnosis between benign and malignant thyroid follicular tumor.

Objective To explore the clinicopathologic characteristics and treatment of medullary thyroid carcinoma(MTC).Methods The data of 42 cases of MTC admitted to Fujian Medical University Provincial Clinical College from Jan 1995 to Feb 2010 were retrospectively analyzed.Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.Results Surgery was performed in all the 42 cases.All were proved to be MTC by pathology.The lymph node metastasis rate was 76.19％ (32/42).The central lymph node metastasis rate was 61.90％ (26/42).All the 42 cases were followed up for 1 to 502 months with 102 months as the median.35 cases(83.33％)were followed up for more than 5 years and the 5-year overall survival rate was 85.71％ (30/35).Death occurred in 5 cases.Conclusions The lymph node metastasis rate of MTC is high.The treatment should be based on the principle of radical resection.Total thyroidectomy should be recommended to treat primary tumor.Lymph node dissection should be as thorough as possible.Central compartment neck dissection should be done in all cases.

Objective To summarize the experience of diagnosis and treatment strategy of pancreatic injury.Methods The data of 36 cases of pancreatic injurics admitted to Fujian Medical University Provincial Clinical College from 1990 to 2011 were analyzed retrospectively.Results 14 cases(39％)were diagnosed preoperatively,and the other cases were diagnosed during the laparotomy.2 cases underwent non-surgical treatment.34 cases underwent surgical treatment,among whom 23 cases underwent pancreatic debridement and drainage,6 cases underwent distal pancreatectomy(4 cases undergoing distal pancreatectomy plus splenectomy included),4 cases underwent distal Roux-Y pancreajejunostomy plus proximal pancreas closure,and 1 case underwent pancreatoduodenectomy.31 cases (86％) were cured,and 5 cases died (14％).Conclusions Most of the pancreatic injury is diagnosed through laparotomy.Surgical opcration is the main approach to treat pancreatic injury.Nonsurgical treatment is primarily limited to grade Ⅰ and Ⅱ pancreatic injury without obvious peritonitis,major pancreatic duct injury,and associated injuries.Surgical procedure should be selected based on the grading scale of pancreatic injury,associated injuries and overall conditions of the patient.

Objective To study the effect of pirfenidone (PFD) on the transformation of rat corneal stromal cells into fibroblasts in vitro and further explore the anti-fibrotic effect of PFD. Methods The corneal stromal cells from SD rat was isolated and cultured ,and was determined by vimentin stain. The experiment was divided into control group(DMEM+10%FBS),TGF-β1 group(2 ng/mL TGF-β1+DMEM+10%FBS)and PFD group(1 mg/mL PFD+ 2 ng/mL TGF-β1+DMEM+ 10%FBS). Cell proliferation was detected by CCK-8 assay. Collagen Ⅰ,Collagen Ⅲ,Keratocan and CD99 expression were detected by Western blot. Results Compared with control group and TGF-β1 group,the cell proliferation were significantly decreased in PFD group(P<0.05). Western blot showed that PFD can up-regulated Collagen Ⅰand Keratocan but down-regulated Collagen ⅢCD90 expression(P < 0.05). The ratio of Collagen Ⅲ/Collagen Ⅰ in PFD group was lowest in all groups(P < 0.05). Conclusion PFD can resistant fibration in corneal stromal cells may through the inhibition of TGF-β ,which affect the collagen synthesis and Keratocan,CD90 expression.

Objective To investigate the composition of symptom clusters in early postoperative breast cancer patients and analyze the sentinel symptoms of each cluster of symptoms.Methods A total of 309 patients who underwent mastectomy were conveniently sampled and surveyed using the Chinese version of the Anderson Symptom Inventory.Principal component analysis and varimax or-thogonal rotation were employed to analyze the symptom clusters,and their associations were analyzed using the Apriori algorithm model to identify the sentinel symptoms of each cluster of symptoms.Re-sults Three symptom clusters were identified in early postoperative breast cancer patients:neuro-sleep symptom cluster[fatigue(weakness)-distress-pain-sleepiness-restless sleep],sensory-perception symptom cluster(numbness-forgetfulness-shortness of breath-sadness-dry mouth),and digestive system symptom cluster(nausea-vomiting-loss of appetite).Fatigue was the sentinel symptom of the neuro-sleep symptom cluster,numbness was the sentinel symptom of the sensory-perception symptom cluster,and nausea was the sentinel symptom of the digestive system symptom cluster.Conclusion Early postoperative breast cancer patients experience multiple symptom clusters,with sentinel symptoms ex-isting in each cluster.Healthcare staff should develop intervention measures based on sentinel symp-toms to improve the efficiency of symptom management and reduce the degree of symptom distress for patients.