Objective To investigate the relationship between individual pharmacokinetics characteristics of cyclosporine (CsA) and the occurrence of acute rejection episodes or CsA-induced nephrotoxicities in kidney transplants. Methods The whole blood CsA concentrations were assayed 7 days after oral admi- nistration with a dosage of 6 mg/kg daily in 47 recipients. The blood samples drawn just prior to ingestion of the dose and subsequently at 1, 2, 3, 4, 5, 6, 8, 10, 12 h later were monitored with TDX. Recipients were grouped according to the varied situations of kidney transplant functions within one month after pharmacokinetics monitoring. Pharmacokinetics parameters of C_0, C_ max , T_ max , CL/F, T_ 1/2(a) , T_ 1/2(e) and AUC in each group were calculated and compared among the groups. Results Of 47 recipients, 12 cases had experienced AR episodes, 7 cases had suffered CsA-NT, and the remaining 26 cases survived with stable graft functions. Major pharmacokinetics parameters in AR group were T_ 1/2(a) , T_ 1/2(e) , CL/F, T_ max and AUC, which were significantly different from the corresponding parameters in the group with stable graft function. Pharmacokinetics curve of AR group was characterized with a earlier T_ max (usually less than 2 h), a sharp absorb peak and a abbreviated AUC, T_ 1/2(e) , CL/F, T_ max , and AUC in CsA-NT group, which was also significantly varied from that in the stable group. The curve of CsA-NT group, with a delayed T_ max (often more than 2 h), a broad absorb peak or double peaks, however, was predominantly distinguished from the previous AR curve. Levels of C_0 in the three groups were comparable when AR or CsA-NT occurred. Conclusion Pharmacokinetics monitoring accomplished by multiple point CsA level samples over the entire 12 h dosing interval is a more accurate assessment for drug exposure. It is suggested that patients who absorb and eliminate CsA quickly are likely to experience AR episodes. Meanwhile, those poor eliminators are at risk to suffer CsA-NT.

OBJECTIVE:To observe efficacy and safety of reteplase combined with low-molecular heparin sodium intravenous thrombolysis in the treatment of early cerebral infarction.METHODS:102 cases of early acute cerebral infarction from Jan.2007 to Aug.2009 were received intravenous thrombolytic therapy.52 cases were treated with reteplase combined with low-molecular heparin sodium as observation group and 50 cases were treated with reteplase as control group.The neurological deficit scores(NIHSS) values at 1,7 and 14 d before and after treatment were compared between 2 groups.The complication of 2 groups were evaluated after treatment.RESULTS:The NIHSS score in observation group were decreased significantly as compared with control group,there were significant difference(P0.05).CONCLUSION:Intravenous administration of 10 MU reteplase combined with 5 000 U?12 h-1 low-molecular heparin sodium is superior to reteplase alone in the treatment of acute cerebral infarction.Reteplase combined with low-molecular heparin sodium does not increase the risk of bleeding in key site of patients(including the elderly).

AIM: To observe the effect of Shuanghuang Shengbai Granule (Radix astragli, Rhizoma polygonati, Fructus ligustri lucidi, Radix trichosanthis, Rhizoma drynariae, etc) (SHSB) on the proliferation of bone marrow cells and the growth of granulocyte-macrophage colony stimulating factor(GM-CSF) in leukopenia model mice, and to investigate the related mechanism. METHODS: Mouse leukopenia models were made by radiation, the proliferation of bone marrow cells was determined by MTT chromatoptometry, the content of GM-CSF in serum was measured by double antibody sandwich ELISA, and the protein expression of GM-CSF in cultured spleen cells was measured by SP immunocytochemistry. RESULTS: SHSB could promote the proliferation of bone marrow cells; increase the content of GM-CSF in serum and enhance the protein expression of GM-CSF in spleen cells. CONCLUSION: SHSB Granule has the improvement in enhancing the proliferation of bone marrow cells in leucopenia model mice, increasing the content of GM-CSF in serum and the protein expression of GM-CSF in spleen cells.

Objective To evaluate the effects of aqueous extract from Semen Lepidii seu Descurainiae(SLD) on myocardial hypertrophy induced by isoprenaline(ISO) and L-thyroxine(L-Thy) in experimental mice and rats.Methods The myocardial hypertrophy models of mice were prepared by daily sc ISO 2 mg/kg for 7 d and of rats by daily ip L-Thy 0.3 mg/kg for 10 d.The mice were given aqueous extract from SLD 6 and 12 g/kg or Metoprolol 0.06 g/kg by ig administration once a day for 7 d,then the changes of cardiac indexes,plasma concentration of cAMP,and angiontensin Ⅱ(AngⅡ) content in myocardium were measured.The rats were given the aqueous extract from SLD 4 and 8 g/kg or Captopril 0.02 g/kg once a day for 10 d,then the changes of cardiac indexes,plasma concentration of ALD,AngⅡ content in left ventricle,and hydroxproline(Hyp) level were measured.Results Compared with the normal mice,cardiac indexs,plasma concentration of cAMP,and Ang Ⅱ content were remarkably increased in the model group(P

Na +/H + exchanger 1 (NHE1) is a major contributor to ischemic and reperfusion injury. It is emerging that NHE 1 also contributes to myocardial hypertrophy and heart failure due to chronic maladaptive stimulation. It appears that NHE 1 may represent a common downstream mediator for various hypertrophic factor, such as angiotensinⅡ,beta (1) and alpha (1) adrenergic receptor activation. NHE 1 inhibition may be a effective new therapeutic approach for prevention and treatment of heart failure.-

Objective To study the MRI characteristics of osteoblastoma and to discuss its diagnostic value. Methods Nine patients with osteoblastoma proved by pathology were examined with T_2WI, nonenhanced T_1WI and Gd-DTPA enhanced T_1WI MR imaging before operation MR finding were analyzed. Results Of nine patients, tumor originated from spine in five patients, from skull in three patients and from pelvis in one patient. Of these patients, benign osteoblastoma were in six patients and malignant were in three patients. On MRI, the tumor was an expanded osteolytic lesion, osteoid production formation was low or equal signal intensity on T_1WI and medial or high signal intensity on T_2WI. MRI showed low signal intensity of the calcification or ossification in osteoblastoma on T_2WI, and low or equal signal intensity on T_1WI. The ossified ring of tumor was low signal intensity on both T_1- and T_2WI. The adjacent soft tissue masses were showed on MRI. All patients given gadolinium showed enhancement within the osteoid production and the adjacent soft tissue mass, and no enhancement with ossification and calcification, cystoid and the ossified ring on MRI. The boundary of malignant osteoblastoma was obscure, and adjacent tissue could be invaded.Conclusion MR imaging can show all the characteristics of osteoblastoma well . It is of important value in diagnosis, operative orientation and staging of osteoblastoma, especially for the lesion originated from spine and skull.

Objective To explore the effective treatment of acute deep venous thrombosis(DVT) of left lower extremity accompanied with Cockett syndrome.Methods The data of 16 patients with acute DVT of left lower extremity accompanied with Cockett syndrome,who were admitted to our hospital from August,2004 to January,2008,were analyzed retrospectively.Inferior vena caval filters were inserted and thrombectomy was done to all of the 16 patients;PTA and stent insertion were done in 13 patients and PTA only in the other 3 patients.Anticoagulation,thrombolysis and antiplatelet therapy were given postoperatively to all the patients.Results There was no death or pulmonary embolism in all 16 patients;Forteen patieats had good outcome,2 had acute DVT of left lower extremity one day after surgery,and limbs swelling subsided after anticoagulation,thrombolysis and antiplatelet treatment before their discharge.Forteen patients were followed up from 1 month to 25 months(average 11 months),and 2 patients had post-DVT syndrome,but the others had no swelling or varicose veins of the lower extremity.Conclusions Most patients with acute DVT of left lower extremity accompanied with Cockett syndrome could get satisfactory outcome with thrombectomy,PTA and stent insertion.

Objective To choose optimal concentration and volume of Gd-DTPA solution as a oral gastrointestinal negative contrast agent for MRCP.To evaluate the role of Gd-DTPA solution in improving image quality of MRCP.Methods In vitro experiment:Gd-DTPA solution was made with different concentrations.T1WI,T2WI,two-dimensional single slice fast spin echo sequence and three-dimensional half-fourier acquisition single-shot fast spin echo sequence were performed to measure the signal intensity of these contrast agents respectively,so Gd-DTPA solution with the optimal concentration can be decided as oral negative gastrointestinal contrast agent on MRCP.Clinical study:The Gd-DTPA solution with optimal concentration and volume was regarded as an oral negative gastrointestinal contrast agent of MRCP.Twenty-four patients were performed with MRCP before and after (5--10 minutes and 10--15 minutes)administration of oral negative gastrointestinal contrast agent and image quality was analyzed.Statistical analysis was performed using analysis of variance with SPSS 10.0.Results When the concentration of Gd-DTPA solution was ≤0.01 mol/L,the contrast agent was hyperintense on T1WI.On T2WI,when the concentration was ≥0.015 mol/L,it was as hypointense as basic ground; On 2D FSE MRCP images,controls were hyperintense and the contrast agent with concentration ranging from 0.0025 mol/L to 0.03 moL/L was hypointense.On 3D HEAST MRCP image,controls were hyperintense and when the eoncentration of Gd-DTPA was ≥0.01 mol,the contrast agent was hypointense.The Gd-DTPA solution with the concentration of 0.01 mol/L and the volume of 100 ml was chosen as MRCP oral negative gastrointestinal contrast agent.On MRCP images after oral administration of the contrast agent,in 10-15 minutes,the average grade scores within 24 patients of the intrahepatic bile duct,the common hepatic bile duct,the gall bladder,the common bile duct and pancreatic duct(the average grade scores were respectively 3.63,3.46,3.08,3.71,3.87,3.88,3.79,3.71,3.50) were somehow higher than in 5--10 minutes(the average grade scores were respectively 3.54,3.46,3.00,3.79,3.96,3.87,3.71,3.67,3.54),but showed no statistical difference(P>0.05).However,the scores of the third branch of the intrahepatic bile duct,the common bile duct and pancreatic duct after oral administration of the contrast agent were significantly higher than those before administration of oral contrast agent(the average grade scores were respectively 2.79,3.71,3.50,3.42,3.25) (F=4.36,4.75,7.86,8.05,7.55,P<0.05).Conclusion The0.01 mol/L oral Gd-DTPA contrast agent is optimal because it can suppress the high signal from the retention of the stomach and duodenum completely.It can be regarded as MRCP oral negative gastrointestinal contrast agent.After oral contrast administration,the image quality of MRCP is improved obviously and the pancreaticobiliary tree is clear 5-10 minutes later.

Objective To investigate the clinical application of ultrasound-guided percutaneous puncture aspiration and sclerotherapy of liver hydatid cysts.Methods Thirty-eight patients of hepatic hydatid cysts underwent ultrasound-guided percutaneous puncture aspiration and sclerotherapy;then 20%-25%septic hypertonic saline or 95%absolute alcohol were injected into the cysts (the volume was about 25%-50%of the aspirated fluid) ;and the fluid was reaspirated after 5-15 min.At last,5-10 ml sclerosing agent was injected again.Oral albendazole 30-50 mg/kg was administrated to all patients before and after the above procedures.Ultrasonic follow-up was performed at 3-month interval in the first year and once a year afterwards.Results The successful rate of once puncture was 100%.Aher 6 months,cysts volume reduced 50% in 16 patients,reduced 30% in 22 patients.One year later,34 patients were cured,3 were effectively treated and 1 was improved.All hydatid cysts volume gradually decreased and calcification occurred.The total cure rate was 100%. Conclusion Ultrasound-guided percutaneous puncture aspiration and sclerotherapy is a safe,effective and reliable treatment of liver hydatid cysts.

Objective To explore the effects of Shenfu injection combined with low-dose hydrocortisone on plasma lev?els of human leukocyte antigen (HLA)-DR and procalcitonin (PCT) in patients with septic multiple organ dysfunction syn?drome. Methods A total of 118 patients with septic multiple organ dysfunction syndrome were divided into three groups:control group (n=39), experimental group 1 (n=39) and experimental group 2 (n=40). The control group received conventioanl medicine therapy, while the experimental group 1 received Shenfu injection (100 mL, 2/d, for 7 d) combined with conventio?anl medicine therapy, and the experimental group 2 received Shenfu injection combined with low-dose hydrocortisone (200 mg/d, for 14 d) besides conventional medicine therapy. The peripheral blood samples were collected for the detection of HLA-DR, PCT and lipoperoxide (LPO) before treatment, 1 d, 3 d amd 7 d after treatment. The mortality in 14 d was record?ed. Results The mortality rates in 14 d were 61.5%(24/39), 41.0%(16/39) and 25.0%(10/40) for control group, experimen?tal group 1 and experimental group 2 (χ2=8.15, P<0.05). There were no significant differences in PCT, HLA-DR and LPO levels before treatment and 1 d after treatment between the three groups (P>0.05). The plasma levels of PCT and LPO were significantly decreased in control group, experimental group 1 and experimental group 2 after 3-d and 7-d treatment, but the levels of HLA-DR was significantly increased (P < 0.05). Conclusion The combination therapy of Shenfu injection and low-dose hydrocortisone can effectively reduce PCT level and increase HLA-DR level, which promotes the improve?ment of patients with septic multiple organ dysfunction syndrome.