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 evaluate the value of central compartment neck dissection for cN0 papillary thyroid carcinoma.METHODS The clinical data of 46 cases with cN0 papillary thyroid carcinoma in our hospital from Jan.1999 to June 2004 were retrospectively studied.The level Ⅵ lymph nodes were removed during the operation.RESULTS In 46 cN0 cases,there were 11 cases(23.9 %) pathologically proved lymph nodes metastasis after operation.Four patients developed neck recurrence and underwent neck dissection.CONCLUSION It is necessary to probe the level Ⅵ lymph nodes during the operation for cN0 papillary thyroid carcinoma patients.

Objective To compare the effectiveness of medicated γintrauterine device (IUD) and medicated genefix IUD inserted immediately after abortion. Methods A multicenter clinical trail was performed for the study from Mar. 2012 to Jan. 2013. Totally 840 women who volunteered to participate were randomly allocated to γ-group (medicated γ IUD) or genefix-group (medicated genefix IUD) immediately after abortion. While 464 abortion women who had not used IUD or steroids contraceptive methods were chosen as control group. The effectiveness of the IUD were followed up for 1 year. All women were required to record the number of vaginal bleeding days and blood volume of vaginal bleeding within 3 months after abortion. Results At the 12th month, the expulsion was the most common reason for termination. The expulsion rates of genefix-group and γ-group were 2.48/100 women years and 3.12/100 women years, respectively (P>0.05). For the expulsion reasons, IUD moving down could account for more than seventy percent. The removal rate for IUD usage of two IUD groups were almost equal (3.91/100 women years verus 4.35/100 women years), the differences were not statistically significant (P>0.05). At the 90th day after abortion, comparing with control group, the bleeding and (or) spotting days of genefix-group and γ-group extended by 3.9 and 2.6 days respectively, the differences had statistical significance between the three groups (P<0.05). Among the bleeding and (or) spotting days, spotting days prolonged significantly. At the 12th month, spotting days of genefix-group andγ-group were (9.2±5.9) days and (8.5±4.6) days respectively, more than (5.2 ± 4.0) days of control group. The differences had statistical significance between IUD with control group (P<0.05), and had not between the two kinds of IUD (P>0.05). Conclusion The insertion of medicated genefix IUD and medicated γ IUD immediately after abortion is safe, feasible, has slight side effects and could be effective contraception.

Objective To study the effect of metastasis-associated in colon cancer 1 ( MACC1 ) inhibition by small interference RNA( siRNA) on the formation of tumor cells that promote blood vessels, and to explore its possible molecular mechanism.Methods Synthesized MACC1 specific siRNA was transfected into human lung cancer cell lines XWLC-05. Then, the inhibitory effect of siRNA on the protein level of MET, MEK/p-MEK, ERK/p-ERK, and AKT/p-AKT was detected using Western blotting while the change in VEGF, bFGF and IL-8 protein level was detected using ELISA method. Results Western blotting results indicated that the expression level of MET, p-MEK and p-ERK was significantly decreased in the XWLC-05 cells transfected by MACC1 specific siRNA compared with control and nonsense siRNA groups, but the expression of total protein MEK and ERK did not change.Furthermore, the level of AKT and phosphorylated protein was not affected.ELISA results suggested that the secretion level of VEGF, bFGF and IL-8 was significantly suppressed at 48 h or 72 h compared with control and nonsense siRNA groups.Conclusion MACC1 may reduce the secretion levels of VEGF, bFGF and IL-8 via HGF/c-Met and MEK/ERK signal transduction pathways, and regulate angiogenesis of lung cancer.

Objective The Nuss procedure is a minimally invasive pectus repair.The aim of this study was to explore the changes in quality of life in patients who underwent a Nuss procedure.Methods 96 patients,who underwent a Nuss procedure in our institution,were interviewed at preoperation,1 year after operation with the bar in place,and before the planned bar removal.The Nuss Questionnaire modified by George Krasopoulos et al,which evaluates psychosocial and physical well-being,was independently used by patients.Results Most of the scoring of the individual questions and the total score of individual patients revealed a significant improvement,both in preoperation vs.1 year after operation and 1 year after operation vs.before the planned bar removal.Conclusion The Nuss procedure has been shown to improve the quality of life in patients with pectus excavatum deformity in the short term.

Objective A phase Ⅱ trial of anti-programmed death-1 (PD-1) monoclonal antibody CT-011,an anti PD-1 humanized monoclonal antibody combined with rituximab therapy in patients with relapsed follicular lymphoma (FL) were conducted.Methods In order to evaluate the safety and efficacy of CT-011,the impacts of CT-011 on immune cells both from the peripheral blood (PB) samples and tumor microenvironment were examined.PB and core needle biopsies from involved lymph nodes were collected prior to and on day 14 after the first infusion of CT-011.PB mononuclear cells (PBMC) were analyzed by multiparametric flow cytometry to determine various immune cell subsets.Whole genome gene expression profiling (GEP) was performed on core needle biopsies.Results A significant increase in the absolute number of PB immune cells were observed in day 14 samples compared with baseline including total lymphocyte count (P ＜ 0.01),CD+3 T cells (P =0.01),CD+4 T cells (P ＜ 0.01).Comparison of GEP from core needle biopsies obtained pretreatment and day 14 (n =8 pairs) showed up regulation of several genes associated with T cell activation.Conclusion Administration of CT-011 was associated with increase in the numbers of CD+4 T cells and resulted in activation of T cells in the PB and the tumor microenvironment in FL.These results provide insight into the mechanism of action of CT-011 and offer a predictive biomarker for selection of patients for future clinical trials with this class of agents in FL.

Objective To investigate the effects of down-regulation of Beclin 1, which is an autophagy regulatory molecule, expression induced by RNA interference on the proliferation and apoptosis in skin fibroblasts of naked mole rat. Methods The expression levels of Beclin 1 were detected after starvation or H2 O2 treatment.The fibroblasts were transi-ently transfected with specific siRNA targeting Beclin 1 and then screened by real-time PCR and Western blot.Cell prolifer-ation and apoptosis were determined using CCK-8 detection kit and flow cytometry ( FCM ) .The expressions of related genes were detected by Western blot.Results The expression of Beclin 1 gene at mRNA and protein levels was signifi-cantly lower in fibroblasts of the naked mole rat.Starvation and H2 O2 treatment induced changes of the Beclin 1 expression. Inhibition of Beclin 1 gene expression can inhibit cell proliferation and induce early and late apoptosis.The protein levels of p53, BAX, Bcl2, LC3B, p-AKT and mTOR were reduced after transient transfection with Beclin 1-siRNA.Conclusions The expression of Beclin 1 in fibroblasts of naked mole rat are changed in response to starvation or H2 O2 stimulation.Inhi-bition of Beclin 1 gene expression can inhibit cell proliferation and induce apoptosis.Therefore, Beclin1 gene may play a regulatory role in autophagy, proliferation and apoptosis in the skin fibroblasts of naked mole rat.

This study summarizes the skills training work of the National College Students' Clinical Skills Competition for 9 consecutive years, and explores a set of teaching methods suitable for the standardized training of residents of anesthesiology. This method is applied to the clinical operation, professional theory, clinical thinking, humanistic care, doctor-patient communication and other aspects of the standardized training of residents. The results show that the teaching effect of all aspects of standardized training of residents is more practical and efficient, and residents can quickly master the basic operation skills of anesthesia in a short time, indicating that the training method of clinical skills competition of college students can be applied in the standardized training of anesthesia residents, which can effectively improve the training effect.

Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.

ObjectiveTo investigate the mechanism of Danggui Shaoyaosan （DSS） in the improvement of the cognitive ability of SAMP8 mice with Alzheimer's disease （AD） via regulating the ubiquitin-proteasome pathway （UPP）. MethodFifteen SAMR1 mice were used as a normal group， and 60 SAMP8 mice were randomly divided into a model group and DSS high， medium， and low-dose groups （57.6， 28.8， and 14.4 g·kg^-1·d^-1）， with 15 mice in each group. Intragastric administration was conducted for eight continuous weeks. Place navigation and spatial capacity were evaluated by Morris water maze. Pathological structure changes in neurons in the hippocampal CA1 area was detected by hematoxylin-eosin （HE） staining. The protein expression levels of hippocampal β-amyloid protein（Aβ） and phosphorylation（p）-Tau were determined by immunohistochemical staining （IHC） and enzyme-linked immunosorbent assay （ELISA）， and the mRNA and protein expression levels of hippocampal ubiquitin （Ub）， ubiquitin ligase E3 （E3）， 26S proteasome， ubiquitin carboxyl terminal hydrolase-1 （UCHL1）， and UCHL3 were determined by real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultAs compared with the normal group， the escape latency was prolonged in the model group （P<0.05） with the reduced number of crossing platform quadrants and time ratio in the platform quadrant （P<0.05）. The model group decreased neurons and condensed cell bodies in the CA1 area， and increased β-amyloid precursor protein （β-APP） and p-Tau positive cells （P<0.05）. In the model group， the protein expression levels of Aβ and p-Tau were increased （P<0.05）， the mRNA and protein expression levels of Ub were increased （P<0.05）， and the mRNA and protein expression levels of E3， 26S proteasome， UCHL1， and UCHL3 were decreased （P<0.05）. As compared with the model group， the escape latency was shortened in the DSS high and medium-dose groups （P<0.05） with an increased number of crossing platform quadrants and residence time ratio （P<0.05）. The pathological changes in CA1 of each DSS group were significantly improved， and the number of β-APP positive staining cells decreased （P<0.05）. The number of p-Tau positive staining cells decreased in the DDS medium and low-dose groups （P<0.05）. The protein expression levels of Aβ and p-Tau in each DDS group decreased （P<0.05）， and the mRNA expression level of Ub in each group decreased （P <0.05）. The mRNA expression levels of 26S， E3， and UCHL3 in the DDS high and medium-dose groups increased （P<0.05）， and the mRNA expression level of UCHL1 in the DDS medium-dose group increased （P<0.05）. The protein expression level of Ub in each DDS group decreased， and the protein expression levels of 26S， E3， UCHL1+3 in the DDS high and medium-dose groups increased （P<0.05）. ConclusionDSS can improve the cognitive ability of SAMP8 mice， and its mechanism may be related to the reduction of the abnormal deposition of Aβ and p-Tau via decreasing the expression of Ub and increasing that of E3， 26S， UCHL1， and UCHL3 in the UPP.