AIM:To investigate the effects of five drugs which were usually used simultaneously with aza- thioprine(AZA)in patients with kidney transplantation: ciclosporin,hydrocortisone,nifedipine,captopril and al- lopurinol on erythrocyte thiopurine methyltransferase (TPMT)activity.METHODS:The erythrocyte TPMT activity of healthy volunteers was measured by high-per- formance liquid chromatography(HPLC).Sixteen volun- teers were chosen,in which 8 cases with intermediate TPMT activity and others with normal TPMT activity.The mean inhibition ratio of each drug concentration and the mean IC_(50)values of the inhibitors were determined.RE- SULTS:Ciclosporin,hydrocortisone,captopril and allo- purinol had nearly no impacts on TPMT activity.Nifedip- ine highly inhibited TPMT activity in vitro,the mean IC_(50)value in intermediate TPMT activity group was(24?17)?g/mL and in normal TPMT activity group was(12?10)?g/mL.CONCLUSION:The co-administration of nifedipine and thiopurines may lead to drug interactions.

BACKGROUND: The parameters of blood platelet(B-PLT) can reflect its thrombo-function, but the variation of blood-platelet parameters in patients with thrombotic disease is controversial and not unanimous.OBJECTIVE: To observe the changing rule of the B-PLT parameters in patients with cerebral infarction(CI), and investigate whether blood cell counter can be used in the evaluation of the variation of B-PLT parameters in CI patients.DESIGN: A case-control and experimental study based on patients and healthy people.SETTING: Department of laboratory and internal medicine in a university.PARTICIPANTS: During the January and March 2002, 37 CI patients including 28 males and 9 females aged 45 - 87 years were selected from Department of Neurology, Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology. Among 37 healthy people,20 males and 17 females aged 40 - 60 years were selected as control group.METHODS: Platelet distribution width (PDW), mean platelet volume (MPV), platelet-large cell ratio(P-LCR) and the changing quantity of B-PLT of 37 CI patients were analyzed with blood cell counter, meanwhile,the healthy people were analyzed as control subjects.MAIN OUTCOME MEASURES: Changes of B-PLT parameters in two groups respectively.RESULTS: A positive relation between PDW and P-LCR was observed and between P-LCR and MPV as well( r = 0. 99, 0.92, P ＜ 0. 001 ). A negative correlation between B-PLT quantity and MPV was observed and also between B-PLTquantity and P-LCR(r= -0.58, -0.59, P ＜0.05) .In CI patients, PDW, MPV and P-LCR were(14.51 ± 2. 88)%, (10.95 ± 1.48) fl and(34.24 ± 11.23)% respectively, which were higher than those of healthy people [ (12. 86 ± 2.02)%, (10. 19 ± 1.29) fl, (28.47 ± 9.41 )% ]respectively, and the difference was significant( P =0. 019 31, 0. 021 77 and 0.026 35), but there was no significant difference between the two groups in B-PLT quantity.CONCLUSION: The blood platelets' parameters in CI patients, which reflect the function of the B-PLT, are significantly higher than those in healthy people. It shows that the enhanced function of platelet is a risk factor of cerebral infarction, the use of blood cell counter in analysis can observe the variation of the platelets' function rapidly and accurately. It can be a useful method of the therapy and prevention in CI patients.

Objective To investigate treatment effect of prednisone to withdrawal headache in patients with medication overuse headache (MOH). Methods From June 2009 to June 2013, 96 patients with MOH were chosen as study objective for the randomized double-blind and placebo controlled study.All patients were divided into 2 groups: 48 in study group ( treated with prednisone, 100 mg/d ) and 48 in control group (treated with placebo, 100 mg/d).The clinical features of two groups were compared.After treatment, the primary endpoints, secondary endpoints , further results and the use of analgesics were compared.Results Before treatment, the age, sex gender,primary diagnosis, duration and frequency of headache, medicine had no statistical difference between two group.After treatment, the duration of headache and the rate of drug rescue had no statistical difference between two groups.The rate of withdraw symptoms had no statistical difference between two groups.The use of analgesics was less in study group than that in control group, the difference had statistical significance (P<0.05).Conclusion During withdrawal in MOH, prednisone reduces rescue medication without decreasing the severity and duration of withdrawal headache.

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Objective To explore clinical characteristics and treatment of the thrombotic microangiopathy (TMA) induced by malignant hypertension, and provide a better understanding of the disease. Methods The clinical manifestations, laboratory examinations, therapeutic methods and prognosis of 15 TMA patients induced by malignant hypertension were analyzed retrospectively. Results The clinical manifestations were characterized by microangiopathic hemolytic anemia, thrombocytopenia and kidney injury. None of the patients required plasma exchange therapy. After antihypertensive treatment, all of 15 patients were discharged with improved clinical condition, remoglobin levels and platelet count. Conclusions The TMA induced by malignant hypertension is different from the classic TMA. Improving the understanding of TMA induced by malignant hypertension will contribute to early diagnosis and targeted treatment.

Objective To explore the effects of dopamine and dobutamine on thyroid stimulating hormone(TSH),total thyroxine(T4) and growth hormone(GH) in preterm infants with hypotension.Methods Forty-seven preterm infants with hypotension were enrolled in the stu-dy,and 38 preterm infants remained hypotensive after two dose of isotonic saline solution,who were divided into two groups and assigned to receive dopamine or dobutamine.Drug infusion were all started at 4 ?g /(kg?min) and the dose increased by 2 ?g /(kg?min) in a stepwise fashion until either the mean blood pressure normalized or a maximal dose 20 ?g /(kg?min) was reached.Haemodynamic variables and se-rum levels of TSH,T4,and GH were assessed during the first 72 h of treatment and the first 3 d after stopping treatment.Microplate luminometer was used to test TSH,T4,GH levels.Results Necessary cumulative and mean drug doses and maximum infusion required to normalize blood pressure were significantly higher in the dobutamine group than those in the dopamine group(Pa0.05].Conclusions Dopamine and dobutamine both increase the syste-mic blood pressure,with higher drug doses in dobutamine group.Dopamine reduces levels of serum TSH,T4 and GH in preterm infants but such suppression is quickly reversed after treatment is stopped.

Objective To explore influence of different positive end expiratory pressure(PEEP)level on ventilative efficincy of premature infant with respiratory distress syndrome(RDS).Methods Forty preterm infants who were diagnosed RDS and needed ventilation were randomly assigned to lower PEEP(0.49~0.59 kPa)and high PEEP(0.59~0.78 kPa)group.They were treated by ventilation and pulmonary surfactant(PS).When they were medically stable,blood gas was done at 15 min,2,6,12,24 h after ventilation.Then the ratio of pa(O2)/FiO2,oxygen index(OI),ventilation index were calculated.Result The ratio of pa(O2)/FiO2,OI,ventilation index were better in lower PEEP group than those in high PEEP group(Pa

Objective: To explore the influence of silencing Survivin expression by RNA interference on the radiosensitivity of cervical carcinoma SiHa cells. Methods: The recombinant eukaryotic expression plasmid pSurvivin-shRNA was constructed and transfected into SiHa cells. The mRNA and protein expressions of Survivin were determined by RT-PCR and Western blotting, respectively. The activity of caspase-3 was measured by kinase activity determination method. The apoptotic rate was determined by flow cytometry. The changes of radiosensitivity were explored by colony formation test. Results: Compared with SiHa cells transfected with pNeg-shRNA (SiHa/ pNeg-shRNA cells) and untransfected SiHa cells, the expressions of survivin in the cells transfected with pSurvivin-shRNA (Si-Ha/ pSurvivin-shRNA cells) were inhibited significantly at both mRNA and protein levels. The activity of caspase-3 in SiHa/pSurvivin-shRNA cells was significantly enhanced, and the D405 was 1.34 ± 0.05 (P < 0.05). The apoptotic rate of SiHa/pSurvivin-shRNA cells was (5.13 ± 0.81)% and (11.27 ± 1.89)% after 24 hand 48 h X-ray irradiation at 6 MV and 8 Gy, respectively, which was significantly higher than SiHa/pNeg-shRNA cells and untransfected cells (P < 0.05). The colony formation ability of SiHa/pSurvivin-shRNA cells was markedly decreased after irradiation (P < 0.05), which indicated that the sensitivity of SiHa/pSurvivin-shRNA cells was enhanced. Conclusion: The inhibition of Survivin by RNAi could enhance the radiosensitivity of SiHa cells by increasing caspase-3 activity and inducing apoptosis.

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Objective To investigate the effect of 6 % hydroxyethyl starch (HES) 200/0.5 infusion before operation on postoperative immne function in patients. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 21-58 yr weighing 47-79 kg were randomly divided into 2 groups ( n = 20 each): 6% HES 200/0.5 group (group H) and compound sodium acetate group (group A). 6% HES 200/0.5 10 ml/kg or compound sodium acetate solution was infused intravenously over 15 min before anesthesia induction. Anesthesia was induced with iv injection of propofol, fentanyl and vecuronium and maintained with target-controlled infusion of propofol and infusion of remifentanil. Venous blood samples were collected before operation and at 1 h, 1 day and 3 days after operation to detect the serum concentrations of IL-6, IL-8, TNF-α, IL-2, IL-10, IgG, IgA andIgM. Results Serum concentrations of IL-6, IL-8, TNF-α, II-2 and IL-10 were significantly higher after operation in the two groups, and serum concentrations of IgA and IgG were significantly lower after operation in group A than those before operation ( P ＜ 0.05 or 0.01 ). Serum concentrations of IL-6, IL-8 and TNF-α were significantly lower, while serum concentrations of IL-2, IL-10, IgA and IgG were significantly higher after operation in group H than in group A ( P ＜0.05). Conclusion Preoperative infusion with 6% HES 200/0.5 can improve the immune function after operation in patients.