Objective To elucidate the deleterious diabetogenic effect of tacrolimus on Chinese Han people.Methods According to patients' whole blood trough levels,the concentration of tacroli- mus was 5,15 and 25?g/L.Human islet cells cultured in vitro were exposed to various concentra- tions of tacrolimus for 72 h respectively,then stimulated by glucose at low (2.8 mmol/L) and high (16.7 mmol/L) levels.Glucose-stimulating insulin secretion during subsequent static incubation was measured using the ultrasensitive human insulin ELISA kit.The assessment of islet cell viability was studied with acridine orange (AO)-propidium iodide (PI).According to fasting plasma glucose,461 subjects were divided into normal glucosetolerance group (FPG＜5.55 mmol/L),impaired fasting glu- cose group (5.55 mmol/L＜FPG＜6.88 mmol/L) and posttransplant diabetes mellitus group (FPG≥6.89 mmol/L).A retrospective review of 461 non-diabetic kidney recipients completing at least 12 months of follow-up was performed to determine risk factors,incidence,and characteristics of post- transplant diabetes mellitus (PTDM).Results In vitro,lower tacrolimus concentration had not dele- terious effect on insulin secretion and viability of islet;high tacrolimus impaired?-cell survival as well as insulin secretion.Of the 461 patients with no history of diabetes at transplantation over the study period of 12 months,123 received tacrolimus and 338 received cyclosporine A (CsA).For patients receiving tacrolimus the cumulative incidence of PTDM was 13.8%,compared with 7.7% for pa- tients receiving CsA,showing no significant difference between them.The reduced tacrolimus level within the therapeutic window resulted in an increase in better glucose metabolism.Older age,family history of diabetes,acute rejection episodes and pre-transplant impaired fasting glucose were identified as risk factors for PTDM.Conclusion The diabetogenic effect of TAC is dose-dependent,and in the majority is reversible.Low initial doses,more rapidly tapering and lower maintenance levels of tacroli- mus decrease the incidence of PTDM in patients receiving tacrolimus.

The aim of this study was to explored the mechanism of inhibitory effect of chloroquine on IL-6 release induced synergistically by bacterial DNA and endotoxin. Before experiment mice were sensitized for 1 hour with D-GalN by I.P. injection. Mortality within seven days was observed after mice were challenged with CpG ODN or LPS with or without chloroquine treatment. ANA-1 cell line cells were cultivated in vitro. We investigated the influence of chloroquine on IL-6 release induced by both EC DNA and LPS. Expressions of TLR4 and TLR9 and activation of NF-?B p65 were investigated in cultured THP-1 cells pretreated with chloroquine and stimulated by EC DNA and LPS. The results showed that all mice died within 4 hours after challenged with CpG ODN and LPS. Only 4 or 5 mice pretreated with chloroquine (30mg/kg) died after challenged with CpG ODN and LPS (P

Objective To establish a method for calculating deferral periods of blood donors having taken traditional Chinese medicines based on the drug's pharmacokinetics.Methods The pharmacokinetic method was used.For drugs that are not known to cause anaphylaxis or teratogenesis,the interval between last dose of drug and safe blood donation equals to t max plus 7t 1/2 .For drugs with known teratogenic and anaphylactic risks,a deferral period of 20 plasma elimination half lives and t maxis necessary.There are some rules independent of the drug's half life.Results 22 intervals of traditional Chinese medicine are determined.Conclusion Our recommendations for deferral periods of blood donors after traditional Chinese medicine treatment,based on pharmacokinetics can increase the safety of donated blood.

Objective To monitor lung growth rule of normal middle-late pregnancy fetal. Methods 599 cases of 18 and 40 weeks normal singletons were grouped by every two weeks. The length of right lung in the sagittal plane and the cross-sectional plane were measured, and the growth curve was described. The ratio of right lung area (RLa) and head circumference (Hc),chest circumference (Tc) and of the chest area (Ta) in different gestational ages was calcalated. The correlation coefficient was obtained by applying statistical analysis. Results There was a linear relationship between RLa/Hc and RLa/Tc and growth of gestational age;the regression equation was:(RLa/Hc: ?Y= 0.948X-1.221, r2 =0.898, the RLa/Tc: ?Y=0.944X-1.800, r2 =0.894). RLa/Ta in different ges-tational age was in constant range:0.42~0.55. The length of right lung in the sagittal plane and the cross-sectional plane increased along with the gestational age, and the growth speed was:before and after diameter(the cross-sec-tional plane) > upper and lower diameter (sagittal plane) > about size (the cross-sectional plane). Conclusion Prenatal ultrasound can evaluate the growth rule of normal fetal lung and provide the basis for assessment of fetal lung maturity.

Objective To analyze the CT and clinical features of acute pancreatitis(AP) patients with perirenal space(PRS) invasion.Methods CT images and renal function tests(serum urea,creatine) changes of 64 AP patients were retrospectively studied. PRS invasion by inflammation on CT scan and the relation between PRS invasion and renal function changes were analyzed. Results 81% patients had PRS invasion in which 52% were grade B, 25% were grade C. CT features of the PRS invasion varied from mild inflammatory changes to fluid collection or phlegmonous.The PRS invasion was detected in 35 of 52 patients with mild pancreatitis and all severe pancreatitis. Renal function abnormity was 47%, only 3% patients had abnormal renal function in patients without PRS invasion compared to 44% patients with PRS invasion. PRS invasion in patients with abnormal renal function attenuated on CT scan after the pancreatitis was controlled. Conclusions The CT clearly reveals the features of PRS in acute pancreatitis patients. The attenuation of PRS invasion in acute pancreatitis patients on CT parallels renal function recover.

Objective To explore whether the presence of juxtapapillary duodenal diverticula (JPDD) risks biliary stone disease and recurrence.Methods 829 patients undergoing ERCP in our hospital from Aug 2008 to Dec 2012 were divided into four groups:biliary stone disease (n =609) non-stone biliary abnormality (n =124) common bile duct malformation with cholelithiasis (n =38) and normal control group (n =58).There were 206 patients with JPDD and 623 patients without JPDD.Biliary stoneformation,post-ERCP pancreatitis,cannulation failure,and stone recurrence were compared between those with JPDD and those without.Results The incidence of JPDD in biliary stone disease group (27.8％) was significantly higher than in non-stone biliary anatomical abnormality group (18.5 ％) (x2 =4.512,P ＜ 0.05).In biliary stone disease group,rates of post-ERCP pancreatitis were significantly higher in JPDD cases (33.7％) compared to those without JPDD (13.8％) (x2 =30.841,P ＜ 0.05).The cannulation failure rate was also higher in patients with JPDD (15.4％) compared to JPDD negative (6.8％) (x2 =0.731,P ＜0.05).Recurrence rates in biliary stone disease were significantly higher in patients with JPDD (19.5％) when compared to JPDD-lacking individuals (9.3％) (x2 =14.51,P ＜ 0.05).Conclusions JPDD is a risk factor for biliary stone formation.JPDD also is associated with post-ERCP pancreatitis,cannulation failure and biliary stone recurrence.

Objective To investigate the roles of CpG motifs in the release of cytokines induced by bacterial DNA. Methods Mice were sensitized with injection of D GalN (600 mg/kg) into the abdominal cavity 1 h before experiment. Mortality was observed after purified Escherichia coli DNA(EC DNA), calf thymus DNA(CT DNA), phosphorothioate backbone CpG oligodeoxy nucleotides (CpG ODN) and CG sequence inverted oligodeoxy nucleotides (non CpG ODN) were injected venously into mice. The injection dosage of DNA given was 30 mg/kg but ODN was 10 nmol/mouse. THP 1 cell lines were cultured in vitro . After the above reagents were added into the culture, TNF ?, IL 6, IL 1? levels were detected to observe the different abilities of these reagents to induce the release of cytokines. Results EC DNA and CpG ODN could induce the death of mice and the large amount of release of cytokines, but CT DNA and Non CpG ODN could not. Conclusion CpG ODN has the ability to induce macrophage to release cytokines largely. CpG motifs, which may play an important role in the release of cytokines induced by bacterial DNA, may probably be the structural basis of bacterial DNA.

Erchen Decoction is widely used to dampness-phlegm syndrome and it can be flexibly used in clinical application by my supervisor Professor OU Zheng-wu, especially in cough, pneumonia, asthma and influenza, which has obvious efficacy in treatment. This article reviewed five medical cases during the follow-up process with Professor OU in application of Erchen Decoction, with a purpose to share experience of famous doctors and improve TCM diagnosis and treatment level together.

Objective To investigate the protective effect of hydrogen sulfide (H2S) on chronic unpredictable mild stress (CUMS)-induced damage in hippocampus of rats and explore potential mechanisms.Methods 40 SD rats were divided into four groups,including controI,CUMS,CUMS co-treated with NaHS (1.68 mg/kg×14 d,ip) and CUMS co-treated with NaHS (5.6 mg/kg×14 d,ip) groups.After treatment with CUMS for 4 weeks,arrangement and morphology of hippocampal neuron were examined by HE staining,apoptosis of hippocampal neurons were measured by Tunel assay.Klotho expression was detected by ELISA.Meanwhile,the generation of H2S in the hippocampus was measured by spectrophotometry and the neurogenesis of hippocampus was detected by Brdu staining.Results The arrangement and morphology of CA3 hippocampal cells were disturbed and the neurogenesis in hippocampal DG region were inhibited in the CUMS group compared with control group.Moreover,the CUMS rats showed increased loss of hippocampal neurons (1.151±0.041,P＜0.01),and the expression of klotho(0.910±0.032) and generation of H2S((0.445± 0.025)nmol · mg-1 · min-1) in CUMS rats were decreased in contrast to the control((0.621±0.019) nmol · mg-1 · min-1,P＜0.05).The sparse neuron and inhibited neurogenesis by CUMS in hippocampus of rats were improved by NaHS administration,and the loss of hippocampal neurons in CUMS + 1.68 mg/kg NaHS (1.032±0.023) or CUMS +5.60 mg/kg NaHS(1.045±0.038) were decreased in contrast to the CUMS rats(P＜0.01).Compared with CUMS group,the expression of klotho in CUMS + 1.68 mg/kg NaHS group (1.045±0.021)or CUMS +5.6 mg/kg NaHS group(1.046±0.076) was up-regulated(P＜0.05) and the generation of H2S in CUMS + 1.68 mg/kg NaHS group((0.582±0.008) nmol · mg-1 · min-1) or CUMS +5.6mg/kg NaHS group ((0.585 ±0.029) nmol · mg-1 · min-1) was increased (all P＜0.05).Conclusion H2S can antagonize the neural injury-induced by chronic stress probably by upregulating the expression of klotho protein,facilitating the production of H2S and promoting neurogenesis in hippocampus.

Objective To investigate the adjustment of miRNA-155 on CD4+ CD25+ Treg regulative T cell in peripheral blood in patients with acute cerebral infarction (ACI) and its pathogenesis. Methods Sixty patients with ACI were divided into three groups according to clinical neurological deficit score. Twenty healthy volunteers were enrolled into the control group. The expression levels of plasma miR-155 mRNA and Foxp3 mRNA were detected by real-time quantitative PCR(qRT-PCR). IL-10 levels in plasma were detected by ELISA. Results Expression of miR-155, Treg, Foxp3 mRNA and levels of IL-10 were significantly increased in patients with ACI compared with normal control group, with statistical differences; Expression of miR-155, Treg, Foxp3 mRNA and levels of IL-10 were gradually increased. The values showed significant statistical difference among the mild, moderate and severe ACI groups (P < 0.01). Among the patients,the levels of miR-155, Treg, Foxp3 mRNA and levels of IL-10 in the survival group were obviously lower than those in the non (P<0.05 or P<0.01). There was a positive correlation between miR-155 and Treg, Foxp3 mRNA (P < 0.01). Conclusion This study suggests that miR-155 is involved in the cell proliferation regulation of CD4+ CD25+ Treg cells,and plays some role in the immunological dissonance with ACI.