Objective:To investigate the pharmacokinetics of mycophenolic acid( MPA)and its metabolites in different stages af-ter the administration of enteric-coated mycophenolate sodium( EC-MPS)tablets in Chinese liver transplant recipients. Methods:The blood samples of 24 patients were collected in 0-12h of the 1st and 3rd week after the administration of EC-MPS. The concentrations of MPA,AcMPAG and MPAG in plasma were measured by LC-MS/MS developed in our lab. The pharmacokinetic parameters of MPA and its metabolites were estimated by non-compartmental method. Results:After 1-and 3-week therapy with EC-MPS,Cmax ,AUC0-12 and t1/2 was(18. 1 ± 8. 75)and(20. 7 ± 16. 0)μg ml-1 ,(42. 7 ± 17. 5)and(47. 1 ± 23. 9)μg·h·ml-1 ,(3. 33 ± 2. 81)and (3.30 ±1.89)h for MPA;(2.50 ±1.86)and(1.78 ±1.72)μg·ml-1,(14.5 ±11.7)and(6.97 ±6.57)μg·h·ml-1, (4. 48 ± 2. 53)and(3. 76 ± 1. 8)h for AcMPAG;(171. 6 ± 135. 4)and(152. 2 ± 115. 9)μg·ml-1 ,(1299 ± 1 204)and(1 051 ± 561)μg·h·ml-1 ,(8. 73 ± 4. 25)and(7. 75 ± 2. 87)h for MPAG,respectively. There was no significant difference in the PK parameters of MPA after the 1-and 3-week therapy. The Cmax ,Tmax and t1/2 of MPA in the patients received EC-MPS were significantly higher than those in the patients received MMF(P<0. 05). Cmax and AUC0-12 of MPAG in the patients received EC-MPS were signifi-cantly higher than those in the patients received MMF after the 3-week therapy(P<0. 05). Conclusion:There is no significant accu-mulation of MPA after the therapy with EC-MPS at different stages. The absorption of MPA is delayed after the therapy with EC-MPS compared with that with MMF. There is no difference in MPA exposure between EC-MPS and MMF in Chinese liver transplant patients.

Objective To observe the expression of leukocyte-function-associated antigen-1(LFA-1)immunoreaction in children with febrile seizures(FS),and explore the neuroimmunomodulation mechanisms in the pathogenesis of FS.Methods Adopting flow cytometry(FCM),the levels of LFA-1 contained in blood serum and peripheral blood mononuclear cells(PBMC)of 60 cases [simple FS(SFS)30 cases;complex FS(CFS)30 cases] with febrile convulsion were analyzed,and compared with those in a normal group(30 cases).Out of 60 children with FS group,the LFA-1 mRNA in 20 cases with SFS and 20 cases with CFS was analyzed,and LFA-1 mRNA in19 health children taken out from control group(30 cases)was analyzed.The real-time PCR was used to detect the expression of PBMC LFA-1 mRNA.Results The expression of LFA-1 in the surface of PBMC of the 3 groups,the highest LFA-1 level was in the SFS group(50.89?21.36),the lowest LFA-1 level was in the CFS group(34.35?11.45),and control group was(41.39?16.30).Significant differences were found in 3 groups(Pa

Objective To compare the results of surgical treatment of cardiac carcinoma through left thoracic approach and abdominal approach.Methods After finished cardiac carcinoma resection and gastroesophagus anastomosis in thorax through left thoracic approach,standard D2 regional lymph nodes dissection or/and combined pancreas and spleen resection were performed immediately through abdominal approach in 19 patients.Two surgical specimens were examined individually.Results 122 lymph nodes were founded in the abdominal surgical specimens,in which 23 were metastasis lymph nodes founded in 7 patients (7/19,37 %).Conclusion Left thoracotomy alone can no achieve complete resection for advanced gastric cardiac carcinoma.It should be treated through the combined abdominal and thoracic approach.

Accidents, Occupational ; Chronic Disease ; Hexanes ; poisoning ; Humans ; Shoes

Objective To investigate the clinical effects of the modified Kock method of bladder re- construction with ileum,and to provide the objective basis for wide application of this technique.Methods A total of 51 patients with bladder cancer(T_2N_0M_0 stage tumor in 37 cases,T_3N_0M_0 stage tumor in 14; and pathologic gradeⅡ-Ⅲin all)were included.After radical cystectomy,modified Kock reconstruction of bladder with ileum was performed in them.The procedure consisted of preparing the segment of the ileum for reconstruction of the reservoir,anastomosing the low part of the neobladder with the urethra and regaining the original urinary conduit.Results The mean operative time was 6.5h(range,5.5-8.5h);mean in- traoperative blood loss was 650ml(range,300-1200ml),with blood transfusion in 31 cases.Perioperative complications included stress ulcer in 6 cases and urinary leakage in 1.The other 44 cases had no severe complications.Four cases died of cancer metastasis at 6-18 months after operation.During a follow-up of 8 -32 months,the other 47 cases recovered well and have been alive till now.Two cases had ureteral urine reflux with no impairment of renal function.The daytime urinary continent rate was 100%;and nocturnal uri- nary incontinence occurred in 6 cases.Conclusions The modified Koek reconstruction of bladder with il- eum can improve the patients'quality of life with fewer complications,therefore is a better treatment choice for infiltrative bladder cancer after radical eystectomy.

Objective To study the association between clinical symptoms,psychosomatic factors and autonomic nervous function in patients with gastroesophageal reflux disease (GERD).Methods Thirty-four patients with GERD diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 15 healthy control subjects were enrolled in this study.All the subjects were divided into two groups,one with normal scores of Zung's self-rating anxiety scale (SAS) and Zung's depression scale (SDS) as GERD (-) and the other with abnormal scores of SAS and SDS as GERD (+).Reflux symptom score was recorded for both groups at the same time.Autonomic nervous function was assessed by their heart rate variability (HRV) on dynamic electrocardiogram (DCG).The time domain parameters analyzed included standard deviation (SD) of average R-R interval during 24 hours (SDNN),SD of average 5-minute sinus heart rate (SDANN),mean square root of the difference of adjoining two R-R interval (rMSSD),and proportion of the heart beats with difference of R-R interval more than 50 ms from the total heart beats (PNN 50),and the frequency domain parameters analyzed included low-frequency (LF),high-frequency (HF) and ratio of LF to HF.Results Average scores of SAS and SDS were significantly higher in patients with GERD than those in healthy controls (48?9 vs 38?6 and 48?11 vs 41?6,respectively,P

Tripterygium glycosides preparation which extracted from the traditional Chinese herb Tripterygium wilfordii (TWHY), was widely used to treat the autoimmune diseases. Previous works demonstrated that TWHF had potent anti-inflammatory and immunosuppressive properties. But the different quality and high incident rate of side effects of different manufactures inhibited its clinical application. Since TWHF had been generally known to play a therapeutical effect by synergism of multiple constituents, it was necessary to build the relationship between the HPLC fingerprint and bioactivity so as to ensure the quality safety and efficacy. The HPLC fingerprint showed that description and content of peaks from different manufactures were diverse. Only 11 common peaks were found. In this study, mice spleen cells stimulated by Con A were used to test the proliferation inhibition bioactivity of TWHF preparations, which were incubated with 30, 15, 7.5, 3.75, 1.88 and 0.94 mg x L(-1) TWHF preparations for 48 h. The results showed that mice spleen cells proliferation was inhibited by all TWHF preparations significantly compared with the control group, which suggested the TWHF preparations showed immune suppress activity. The TWHF preparations from 7 manufacture showed different IC50 value, which might belong to different contents which showed in the HPLC fingerprint. Moreover, a relationship between the HPLC fingerprint and the bioactivity were established to identify important constituents by grey relational analysis (GRA). The result showed that all the contents were relative with the IC50, especially No. 5 and 10 peaks, but No. 1 peak, which was proved to be triptolide, had few contribute to the inhibition of mice spleen cells proliferation. The study of relationship between the HPLC fingerprint and the IC50 by GRA could help to investigate mechanism of bioactive and provide an evidence for the quantification of multi-constituents.
Animals ; Anti-Inflammatory Agents ; analysis ; pharmacology ; Cell Proliferation ; drug effects ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Glycosides ; analysis ; pharmacology ; Male ; Mice ; Mice, Inbred BALB C ; Spleen ; cytology ; drug effects ; Tripterygium ; chemistry

Objective To evaluate the relationship between the amount of grafted cells and the incidence of acute graft versus host disease (aGVHD) after haploid hematopoietic stem cell transplantation (haplo-HSCT). Methods Data of 68 patients who underwent haplo-HSCT from Jan 2009 to Dec 2013 were analyzed retrospectively. Influences of different factors on the incidence of Ⅲ-Ⅳ degree of aGVHD after HSCT were evaluated. Results 68 patients including 42 males and 26 females were 5/10-9/10 HLA match with 19 father donors, 24 mother donors, 16 sibling donors and 9 children donors. 51 patients not suffered Ⅲ-Ⅳdegree of aGVHD included 32 males and 19 females with the mean age of 20 years old (5-55 years old). 17 patients sufferedⅢ-Ⅳdegree of aGVHD including 10 males and 7 females with the mean age of 23 years old (5-54 years old). There were no significant differences in the amount of the grafted mononuclear cells (MNC) and CD34+cells, and the white blood cell counts (WBC) and platelet count (Plt) recovered time between two groups (P>0.05). However, MNC number was related to CD34+cell number (P<0.05) and WBC recover time (P<0.05), and the CD34+cells number was related to WBC and Plt recover time (P< 0.05). Conclusion The incidence of Ⅲ-Ⅳ degree of aGVHD is unrelated to the amount of grafted MNC, and CD34+cells.

Objective To explore the clinical characteristics of bronchial carcinoma in elder patients and determine the operative indication, surgical technique, and management in the perioperative period. Methods 16 patients with bronchial carcinoma aged 80 and over received major pulmonary resection through muscle sparing mini-thoracotomy. The operative procedures were lobectomy(8 cases), bilobectomy (3 cases), sleeve lobectomy (2 cases), pneumonectomy (1 case), and lobectomy plus wedge resection (2 cases). Clinical data were analyzed retrospectively. Results Of the 16 patients, 6 with stage Ⅰ disease, 3 with stage Ⅱ and 7 with stage Ⅲdisease. There were no perioperative death occurred. The most popular postoperative complications were cardiac arrhythmia, pulmonary infection and hypoxemia. Conclusion Major pulmonary resection is a rational choice for part of the octogenarian patients with lung cancer.

Objective To assess the proficiency of water monitoring laboratory at rural, county, and provincial levels in Guangdong province, to ensure the province's drinking water monitoring results accurate and reliable. Methods State quality of certified reference materials as water arsenic, fluoride and chloride of 90 copies each were numbered and distributed to 90 monitoring laboratories in the province for testing, The measurement results of the participatory labs were evaluated through normative values and expanded uncertainty, and were compared with those of robust statistics method. Results All participatory labs had timely feedback of their measurement results. The qualified rate was higher when arsenic was tested by hydride generation atomic fluorescence spectrometry and zinc-new silver salt of sulfuric acid spectrophotometric system, while fluoride and chloride by ion chromatography. The average qualified rates of water arsenic, fluoride and chloride of the province's rural drinking water quality monitoring laboratory were 66% (59/90), 72% (65/90) and 72% (65/90), respectively.Seven participatory labs failed the proficiency testing of all three analytes and unqualified rate was 7.8% (7/90)among the ninety participated monitoring labs. The qualified rates of robust statistics method for arsenic fluoride and chloride were greater than those evaluated by the expanded uncertainty, and large deviations with small sample sizes. Conclusions The testing ability of drink-water monitoring labs in Guangdong province has improved.However, by comparison with the requirements of national quality control and testing skills, there is still a gap. It is suggested that internal quality control be included in routine inspeetion to improve laboratory testing technology.