OBJECTIVE:To determine the plasma concentration of mycophenolic acid (MPA) in renal transplantation patients by HPLC-Fluoremetry. METHODS: The sample was subjected to precipitation of proteins using 5% Zinc Sulfate methanol saturated solution,and the supernatant (20 ?L) was taken for sample injection and determination on Zorbax Eclipse XDB C18 with mobile phase consisted of acetonitrile-methanol-0.2 mol?L-1 glycine buffer(18∶2∶80,pH=9.0) at a flow rate of 1.0 mL?min-1. The column temperature was of 25℃;the excitation wavelength(EX) was 342 nm and the emission wavelength(EM) was 425 nm. RESULTS: The linear range of MPA was 0.5～40 mg?L-1,with its lowest limit of quantitation at 0.5 mg?L-1. The methodology recovery was 98.23%～101.00%;the extraction recovery of MPA was 91.56%～94.46%;the intra-day RSD was 0.64%～3.22% and the inter-day RSD was 5.12%～6.10%. CONCLUSION: The method is sensitive,rapid,accurate,convenient,and applicable for the quantitative determination of plasma concentration of MPA in renal transplantation patients.

Objective To evaluate the applicability of the simplified equation of MDRD to predict glomerular filtration rate(GFR)from serum creatinine in Chinese patients with chronic kidney disease(CKD),and refit the MDRD equation parameter estimates with Chinese patients data.Methods A total of 760 hospitalized CKD patients were investigated from 2002 to 2005.Patients'sex,age,height and body weight were recorded;plasma creatinine and ~ 99m Tc-GFR(standardized by body surface area)were measured in all patients;GFR was estimated with simplified equation of MDRD and Cockcroft-Gault;the accurancy of estimated GFR with MDRD and CG were compared with~ 99m Tc-GFR in different stage of CKD.Totally 670 patients were randomly selected as the training sample,the remaining 90 patients constituted the validation sample.We used stepwise multiple regression to refit the equation of MDRD and the regression models were developed by using the training sample.The refitting equation was then tested and compared with the other equation in the validation sample.Results (1)Both the MDRD and CG-GFR prediction equations seemd to systematically underestimate GFR,but the accurancy of MDRD equation was better than CG-GFR in stage Ⅰ~Ⅲ of CKD.(2)The bias of estimated GFR(MDRD or CG-GFR equation)with ~ 99m Tc-GFR was lower in stage Ⅰ~Ⅲ than in stage Ⅳ~Ⅴ of CKD.(3)Refitting of the MDRD equation parameter estimates to Chinese patients data set resulted in the following prediction equations:GFR=234.96?(Scr)~ -0.926 ?(Age)~ -0.280 ?0.828(Female).(4)Comparing with~ 99m Tc-GFR,the bias of estimated GFR calculated by the refitting MDRD equation was lower than that of estimated with MDRD or CG especially in the stage Ⅳ~Ⅴ of CKD in Chinese patients.Conclusion the simplified equation of MDRD can estimate GRF accurately,but the equation must be refitted in Chinese patients.

Background Excimer laser corneal refractive surgery is one of the major methods to correct refractive error.Centration of the ablation zone is an important factor that affects visual quality after surgery.The pupil center and its shift is a major factor to determine the ablation center.Therefore further study on pupil centroid shift with illumination level alteration is needed.Objective This study aimed to study the characteristics of the pupillary centroid shift along with the change of pupil size under the different illumination conditions and the possible clinical application of the curve of pupillary centroid shift in exeimer laser corneal refractive surgery.MethodsThe variation of pupil size induced by illumination and the changes of pupil center were measured on 114 moderate myopia eyes of 57 subjects with Astra MaxTM Corneal Topographer.Illumination of placido target and image snap model of the topographer was customized to provide 5 illumination levels as follows:0.8,4.4,18.9,82.3,355.0 Lx.Vectorial analysis was used to graph the change of pupil center related to the Coaxially Sighted Corneal Reflex (CSCR).Raw data is converted to relative value to analyze the pupiilary centroid shift.The mean relative change of the pupil size(△P)and the mean of relative pupillary centroid shift(△C)in the form of percentage were used to attenuate the variation among subjects.The original value of illumination(darkest)is defined as 0％ and maximum value(lightest)was as 100％.Results With the increase of illumination,the shift of the pupil center towards nasal side when pupil constrict was found.The mean change of pupil size under the 5 illumination levels were 0,(1.28 +0.40)mm,(2.34 ±0.53)mm,(3.34+0.54)mm,(4.03 ±0.56)mm respectively,and the △P values was 0％,32％,58％,83％,100％ respectively.The mean of pupil centroid shift under the 5 illumination levels were 0,(78±33)μm,(116±60)μm,(143 ±66)μm,(170±71)μm respectively,and the △C was 0％,46％,68％,84％,100％respectively.There was a linear relation between the relative pupil centroid shift and the relative change of pupil size (r=0.980,P=0.025).The amount of pupil centroid shift has a positive correlation with amplitude of the change of pupil size(r=0.480,P＜0.01).Conclusion Pupil center shifts with the change of pupil size.The linear relation between relative pupil centroid shift and the relative change of pupil size can be applied in eximer laser corneal refractive surgery to improve the visual quality with customized ablation center location.

Objective To analyze the features of EMU survived casualties and the rescue during a head -on- rear collision between two EMU trains on 23 July 2011 ( July 23 train collision accident) at Wenzhou station.Methods The casualties treated in many major hospitals in Wenzhou were surveyed within 24 hours after the accident occurred.The data of age,gender,type of injury and injury severity of the wounded were analyzed.Results A total of 136 casualties were treated within the first 24 hours after the accident occurred,and the male patients and female patients accounted for 55.89％ and 44.11％ respectively,blunt trauma was the main cause of injuries.The percent of multiple injuries in the wounded survivals accounted for 79.41％.The most common injury site of the survived casualties was chest,followed by four limbs and spine.All the wounded were rescued on the spot and were referred to the hospitals with better medical facilities.Conclusions There was no significant difference in gender of the wounded.Blunt trauma was the leading cause of injuries,and the chest,four limbs and spine were the liable parts of body to be traumatized.Saving life,triaging and transferring the wounded as soon as possible were the major algorithm during the initial stage of medical rescue after the accident occurred.

Objective To observe the effects of repeated +10 Gz stress on cerebral lipid peroxidation,liver and renal function in rats and the prophylactic effects of antioxidant tea polyphenols(TP).Method Twenty-four male Wistar rats were randomly divided into three groups(n=8 each):group A(control),group B(+10 Gz),and group C(TP).Group B and C were exposed to repeated +10 Gz stress(each for 30s,onset rate about 0.5 G/s,3 times/d with +1 Gz 1 min intervals,3 d/wk,4 weeks in total),but group A was only submitted to +1 Gz.TP(200 mg/kg) was given orally in group C about 1 h prior to the +Gz experiment,while distilled water was given in group A and B.Lipid peroxidation in the brain,liver and renal functions and serum lipids were determined.Results As compared with the control,lipid peroxidation in rat cerebral homogenate,mitochondria and cytoplasm was significantly increased( P<0.05),and serum creatinine concentration was markedly elevated after repeated +10 Gz stress(P<0.01).But,TP had significant inhibitory effect on +10 Gz stress induced peroxidative injury in rat brain and reduced the serum creatinine level.There were no differences of serum triglyceride and total cholesterol concentrations and glutamic-pyruvic transaminase activity among the three groups.Conclusion These results indicated that repeated high +Gz stress could bring about peroxidative injury in brain and harmful effect on renal function,and natural antioxidant TP had signficant protective effects.

OBJECTIVE:To observe the efficacy and safety of olanzapine combined with ziprasidone in the treatment of refrac-tory schizophrenia in elderly patients. METHODS:120 elderly patients with schizophrenia were randomly divided into control group and study group. Control group was orally treated with Olanzapine tablet 10-20 mg,once a day;study group was orally treat-ed with Ziprasidone hydrochloride capsule 80-120 mg,twice a day+Olanzapine tablet(the usage was the same as control group). The clinical efficacy in 2 groups was evaluated after 2 weeks,PANSS score,FPG,2 h PG,TC,TG,HDL-C,LDL-C,body weight, BMI before and after treatment and incidence of adverse reactions were observed. RESULTS:There were no significant difference in the total efficacy and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the PANSS scores at different time point in 2 groups were significantly lower than before,and 12 weeks<8 weeks<4 weeks<2 weeks,the differences were sta-tistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). There were not signifi-cant differences in the indexes of blood glucose and lipid,body mass and BMI in study group before and after treatment (P>0.05);after treatment,the blood glucose after 8 and 12 weeks and LDL-C,TG,TC,body mass and BMI after 4,8 and 12 weeks in control group were significantly higher than before and study group same time,the HDL-C was significantly lower than before and research group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy and safety of both olan-zapine combined with ziprasidone and olanzapine alone in the treatment of refractory schizophrenia in elderly patients is similar, however,it is better than olanzapine alone in terms of controlling blood glucose and lipid.

Objective To build rat orthotopic liver transplantation model and use this model as an experimental animal model for further research about liver transplantation.Methods Based on the classic two-cuff technique,a variety of skills were integrated,such as abdominal aorta perfusion first before ligation,suprahepatic inferior vena cava single continuous suture,preoperative and postoperative rehydration,hepatic portal vein and infrahepatic vena cava blocked by mosquito's haemostatic forceps.At last,the postoperative survival rates of 2 days and 2 weeks were recorded.Results Donors' operation time was (35±2) min,cuffing time was (7.0±1.5) min,receptors' operation time was (80±15) min,anhepatic phase was (21±3) min.The 2-day survival rate was 92 ％ (46/50) and 2-week survival rate was 86 ％ (43/50).Conclusion To some extent,the improved methods can not only reduce the difficulty of orthotopic liver transplantation operation,but also to create a uniform,stable and reliable orthotopic liver transplantation model.

AlM: To investigate and evaluate the prevalence of xerophthalmia among aerospace science and technology staff and its influencing factors for the eye health guidance.
METHODS: The staff underwent physical examination in our examination center from September 2013 to June 2014 were preliminary screened, and those patients with symptoms of dry eye were investigated with questionnaires and diagnosed by basic lacrimal secretion test ( Schirmer l ) , breakup time of tear film ( BUT ) test and fluorescein ( FL) staining test .
RESULTS: There were 606 complaints of dry eye symptoms of the 1 000 premiers, distributed in random (60. 6%), and 432 employees were diagnosed (43. 2%). The positive rate of dry eye was 71. 3%. The causes of xerophthalmia, besides of gender, age, also include a variety of factors such as air-conditioner, heating, video terminals, sleep time, etc.
CONCLUSlON: Dry eye, an epidemic disease, has a variety of symptoms and complex etiology, the main causes of aerospace science and technology staff with dry eye is working environment and some local factors. We can give appropriate health guidance according to the different factors. Meanwhile the relevant series of dry eye screening should also be taken as a routine examination in ophthalmic examination.

Objective: To study the chemical constituents and antifungal activitiy of phloroglucinol derivatives from Dryopteris fragrans. Methods: The phloroglucinol derivatives were isolated by silica gel column chromatography, Sephadex LH-20 column chromatography, and pre-HPLC. The chemical structures were elucidated on the basis of physicochemical and spectral properties. The antifungal activities against Trichophyton rubrum and Microsporum gypseum were tested by CLSI M38-A2 broth microdilution methods. Results: Two phloroglucinol derivatives were isolated and identified as disflavaspidic acid PB (1) and flavaspidic acid PB (2). The minimum inhibitory concentration (MIC) of compounds 1 and 2 were 13.33 and 1.875 μg/mL against T. rubrum respectively, 10 and 1.325 μg/mL against M. gypseum. Conclusion: Compound 1 is a new compound named disflavaspidic acid PB. Compound 2 is isolated from D. fragrans for the first time. Compounds 1 and 2 are a pair of isomers with promising antifungal activity.

Objective To better characterize the clinical and histopathological manifestations, diagnosis and differential diagnosis of epithelioid sarcoma (ES).Methods Clinical data were collected from nine patients with ES diagnosed and treated at the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from 2000 to 2014.The clinical and histopathological manifestations, immunophenotype, treatment and prognosis of ES were reviewed retrospectively.Results The median age at onset of ES was 34.5 years in these patients, and the average disease duration was 8.3 years.Lesions began on the extremities in 8 patients, and manifested as nodules,ulceration and lymphedema.Histopathological examination showed that tumor cells mainly consisted of spindle cells and epithelioid cells, some of which were in a palisade arrangement with central necrosis.Cytokeratin, epithelial membrane antigen (EMA) and vimentin were coexpressed by tumor cells.Recurrence was observed at the original site in 6 patients after lesion resection, and pulmonary metastasis occurred in 4 patients.Five patients were followed up and two of them died of pulmonary metastasis.Conclusions Local recurrence is frequent in patients with ES after lesion removal.Lymph node and pulmonary metastases of ES are common, and pulmonary metastasis is usually associated with a poor prognosis.