In this paper, a remote monitoring system based on three tiers framework of ″Home-Community-Hospital″ for home monitoring is introduced. Its characteristics include multiuser concurrency operation, multiple testing parameter, real-time interactivity, dependable and secure data communication, high-speed link with database and load balancing. According to user's requirements, various applications can be developed to perfect medical information system based on B/S mode. A portable multiparametric tester based on embedded system has the functions of wireless data transmission and network communication, whose hardware and software designs are modularized.

AIM: To establish the quality standard of Siang Pure Oil (menthol, peppermint oil, camphor, cassia oil, basil oil, etc.). METHODS: TLC was used for the identification of cassia oil and basil oil. Capillary gas chromatography (CGC) was used for the identification and determination of camphor and menthol. RESULTS: The TLC and CGC identification were highly specific. The standard curves of camphor and menthol were linear in the range of 0.1018～0.1832?g, and of 0.5947～1.3875?g, respectively. The average recoveries of camphor and menthol were 102.4%, 99.2% and the RSD were 2.3%, 1.4%, respectively. CONCLUSION: This quality standard is capable of effectively controlling the quality of Siang Pure Oil.

AIM:The different factors on stability of salvianolic acid B in Danshen freeze-dried powder injection was investigated to provide the experimental data for clinical application and storage of the preparation. METHODS: The stability of salvianolic acid B for lamplight,temperature,sodium chloride injection and glucose injection in Danshen freeze-dried powder injection were studied and the content of salvianolic acid B was determined by HPLC. RESULTS: The content of salvianolic acid B in Danshen freeze-dried powder injection didn't almost change under the condition of lamplight(3000lx) in 60 d.Its expiry date estimated by Q_(10) method was(2.39) a.The preparation was matched respectively with(0.9%) sodium chloride injection and 5% glucose injection,the content of salvianolic acid B was invariable and insoluble particles were qualified under the condition of 25 and 37 ℃ in 24 h. CONCLUSION: Danshen freeze-dried powder injection is stable for lamplight and clinical injection and the expiry data of the preparation is(2.39) a.

OBJECTIVES:To evaluate the efficacy of rapamycin(RPM)oral liquid plus cyclosporine(CsA)on the preven?tion of early acute rejection after renal allograft.METHODS:20patients undergoing primary renal allografting were randomly divided into RPM trial group and Azathioprine(Aza)control group,10cases in each group,who were respectively assigned to receive CsA and adrenocortial hormones-based immunosuppression for6months,indexes including survival rates of recipients/kidneys,incidences of acute rejection and adverse reactions between2groups were compared.RESULTS:For the17patients who had finished6-month treatment,the survival rates(recipients/kidneys)were100%.Only2episodes of acute rejection occurred in one case in Aza group.Both groups had2cases of severe adverse episodes.CONCLUSIONS:The combined therapy pf RPM plus CsA is effective in the prevention of acute renal allograft rejection,and it can maintain renal function at a good level.Nevertheless,it may increase the hepatotoxicity of CsA.

Objective To review the first case of paired-exchange kidney transplantation between two couples in China.Methods In April 2006,two cases of paired-exchange living kidney transplantations were successfully performed.Husband 1 in blood type O received a kidney donated from husband 2 in blood type O,while wife 2 in blood type A received a kidney from wife 1 in blood type A.Results The transplantation was performed smoothly.Renal graft in husband 1 functioned for 21 months,and the recipient died at 9th month due to infection.Graft survival and patient survival in wife 2 were 30 month and 31 month respectively.Conclusion Paired-exchange of living-related kidney donation and transplantation,as an effective pathway to resolve the shortage of organ,could be programmed with cautious medical guideline,ethical consideration and legal framework in China.

Objective To determine the long-term results after combined pancreas-kidney transplantation at a single-center institution.Methods Fifty-three consecutive patients with insulin-dependent diabetes mellitus and end-stage nephropathy were followed up for more than three years after combined pancreas-kidney transplantation. Immunosuppressive protocol consisted of tacrolimus ( TAC ),mycophenolate mofetil (MMF),and steroids,and antithymocyte globulin or anti-CD25 receptor mAb.The impact of different risk factors was analyzed on long term patient and graft survival.Results The 3-,5- and 8-year survival rate in recipients was 90.1％,89.1 ％ and 80.0％,respectively.The 3-,5- and 8-year survival rate of pancreas grafts was 84.9％,84.8％ and 60.0％,and that of kidney grafts was 83.0％,82.6％ and 53.3％,respectively.Principal causes of death were Infection (n =4),renal failure (n =2),cardiovascular events (n =1 ),and cerebrovascular accident (n =1 ).Graft failure for the pancreas was caused by death with a functioning graft (n =6),rejection (n =2),thrombosis (n =1 ) and pancreatitis (n =1 ).Graft failure for the kidney was due to rejection (n =9),and death with a functioning graft (n =9).Conclusion This series representing the largest experience with long-term follow up in China confirms an excellent long-term survival.Infection,rejection and surgical complication were the major risk factors leading to deaths and graft loss.

Objective To evaluate the role of native ureter for the management of renal transplantation urological complications retrospectively.Method Twenty-six renal transplant recipients (18 males and 8 females) experienced the following urological complications:upper ureter injury,urinary leaks and moderate or severe ureteric obstructions secondary to ureterovesical anastomotic stricture.These complications have been managed with minimally invasive endourologic techniques or percutaneous nephrostomy as the first-line intervention.While endourologic treatment did not succeed,and the recipients have been treated with intraperitoneal open surgical correction.Urinary continuity was established by pyeloureterostomy or ureteroureterostomy using recipient native ureter.A pigtail ureteral stent was placed with the tip positioned in the pelvis of the graft and native bladder and removed after 4 to 6 weeks.Result The recipients were managed successfully during a follow-up period of 6 months to 6 years without occurrence of urological complications.One case underwent graft loss due to chronic rejection 5 years later postoperation,and the rest developed stable renal function with baseline serum creatinine.Conclusion Excellent outcomes have been achieved by the use of recipient native ureter for the management of urological transplant complications.This simple and efficient procedure should be considered as the superior choice for the recipients who experienced urological complications while less invasive endourologic techniques failed.

Objective To report the modified technique and the short-term results of simultaneous pancreaticoduodenum-kidney transplantation (SPK) with the enteric drainage (ED) of exocrine secretions. Method Between June 2000 and Jan 2006, thirty-five patients with diabetes and uremia underwent SPK. The pancreas graft is placed intraperitoneally with its exocrine secretions drained into the proximal jejunum without Roux-en-Y procedure. The mean cold ischemic times of kidney was 6. 92?2. 17 hours and that of pancreas, 9. 65?2. 02 hours. Quadruple immunosuppressive therapy with antilymphocyte globulin or antiCD25 monoclonal antibody ( Zenapax ) , tacrolimus, mycophenolate mofetil and steroids was adopted. Results Postoperative patient and graft survival rates were 97. 3%. All patients achieved insulin-free euglycemia at 8.3?4.5 days postoperatively. Preoperative patient's mean fasting insulin and C-peptide values were 7.45?7. 35 mU/L and 5. 68?4. 66 mU/L. After operation, patients had fasting insulin and C-peptide values of 11. 9?5.70 mU/L and 5. 57?4. 90 mU/L, respectively, which peaked to an insulin level of 57. 9?46.6 mU/L and a C-peptide level of 11.75?6.99 mU/L with stimulation. The pancreas grafts also functioned well as evidenced also by normal serum amylase values of 92. 10?12. 24 U/L on 10th postoperative day. There were five cases of delayed renal graft function. All other patients achieved immediate renal graft function. No graft losses occurred due to leakage or intra-abdominal infection. The most commn surgical complications were wound infection (n - 11) , enteric anastomostic hemorrage ( n = 5) , and peri-renal hemorrage (n =2). Conclusions SPK is a effective treatment option for patients with diabetes mellitus and uremia. Enteric exocrine drainage by direct side-to-side anastomosis (without Roux-en-Y loop) seems to be a simple and reliable technique.

Objective To discuss the curative effect of transplantation using donation after cardiac death (DCD) according with Chinese standard Ⅲ (C-Ⅲ).Methods The organs were obtained from 4 DCDs from 2011 to 2012,and the clinical data of DCD transplantation were retrospectively analyzed.Withdrawal of life support occurred in the operating room.Donor warm ischemia time was 7-15 min.Results The biopsy of liver was performed on the 3rd DCD.Eight cases were subjected to renal transplantations,and 3 to liver transplantations.One patient exhibited delayed graft function of the kidney from the 4th DCD.All patients made an uneventful recovery and were discharged from the hospital without rejection or surgical complication.They were followed up in outpatient department.Conclusion The use of DCD according with C-Ⅲ is an effective way to increase the number of organs available for transplantation,and can obtain satisfactory effects.