Immunosuppressive drugs used in organ transplantation are highly effective in preventing acute rejection. However,the clinical use of the drugs is complicated by the fact that they display highly variable pharmacokinetics and pharmacodynamics among in-dividual patients. The influence of genetic variation on the interindividual variability in immunosuppressive drug disposition,efficacy and toxicity has been explored in recent years. The review summarized all kinds of immunosuppressants and their relationship with ge-netic polymorphisms,including the SNPs of related enzymes about pharmacokinetics and pharmacodynamics,the SNPs of donor and tar-get site. The review focused on the current situation and progress in the related research areas.

The relationship between genetic polymorphisms and onset or development of disease have become a hot point in medical research presently. So as to study the distribution of genetic polymorphisms of stroke associated genes in different people will aid to deepen cognition to pathogenic mechanism of stroke and heighten prevention and cure ability to this disease. The article summarizes the progress in genetic polymorphisms of some stroke associated genes (MTHFR,ACE,AGT,ApoE,eNOS).

Objective: To establish an HPLC-fluoremetry method for determination of the plasma concentration of mycophenolic acid ( MPA) in renal transplantation patients. Methods:The sample was subjected to precipitate proteins using acetonitrile, and the supernatant (20 μl) was used for the sample injection and determination on a Hypersil BDS C18 (250 mm × 4. 6 mm, 5 μm) column with temperature at 25℃. The mobile phase consisted of acetonitrile-methanol-0. 2 mol·L-1 dipotassium hydrogen phosphate buffer (pH=9. 0)( 18∶2∶80)with the flow rate of 1. 0 ml·min-1. The excitation wavelength (Ex) was 342 nm and the emission wave-length ( Em) was 425 nm. Results:The endogenous plasma impurities and drug combinations had no interference with the determina-tion. The calibration curve was linear over the range of 0. 25-50. 00 mg·L-1(r=0. 999 7), and the lower limit of quantification was 0. 25 mg·L-1 . The mean methodological recovery was 99. 12% and the mean extraction recovery was 93. 27%, the intra-day RSD was less than 2% and the inter-day RSD was less than 6%. Totally 10 cases of renal transplantation patients were with mycophenolate mofetil at the dose of 0. 5-1. 75 g·d-1 , and MPA in plasma was within the range of 0. 43-21. 58 mg·L-1 . Conclusion:The method is rapid, sensitive, accurate and convenient, which can be used in the quantitative determination of plasma concentration of MPA in re-nal transplantation patients.

Objective To examine the effect of berberine hydrochloride ( BER ) on the pharmacokinetic profiles of midazolam,a substrate of CYP3A,in rats. Methods The rats were intragastrically given different doses of BER (50,100, 200 mg?kg-1) or ketoconazole (75 mg?kg-1) for 10 days.Single-pass duodenum perfusion of 20 mg?kg-1 MDZ was performed and the inguinal artery was cannulated for blood sampling.Plasma concentrations of MDZ and 1'-OH-MDZ were analyzed by high performance liquid chromatography ( HPLC) with the CYP3A inhibitor ketoconazole serving as positive control. Results BER (50,100,200 mg?kg-1) and ketoconazole (75 mg?kg-1) could significantly increase the AUC(0-t),AUMC(0-t)and Cmax of MDZ in a dose-dependent manner ( P<0.05) ,and reduce the clearance rate ( CLz ) of MDA and its apparent volume of distribution in the body ( Vz ) ( P<0. 05). But they failed to dramatically affect the half-life ( t1/2z ) and the peak time ( tmax ) of MDZ. Additionally,BER ( 100,200 mg?kg-1 ) and ketoconazole ( 75 mg?kg-1 ) could significantly dose-dependently decrease the AUC(0-t),AUMC(0-t)and Cmaxof 1'-OH-MDZ,and profoundly increase the CLz,tmax and Vz of 1'-OH-MDZ (P<0.05),but they had no remarkable influences on the t1/2z.The ratio of AUC(1'-OH-MDZ)/AUC(MDZ) was decreased with the increase of BER concentration. Conclusion BER can inhibit the in vivo metabolism of MDZ in a dose-dependant manner, which is associated with the suppression of the activity of CYP3A.

Objective To establish a sensitive method for the determination of rhodamine 123 (Rh123) in rat plasma by high performance liquid chromatography (HPLC).Methods The plasma samples were extracted by acetonitrile,and then separated on a Hypersil BDS C18 colunm (4.6 mm×100 mm,5 μm) equipped with a guard column kept at 25 ℃.The mobile phase consisted of acetonitrile and phosphate buffer (0.02 mol·L-1,pH4.0) (60:40) and was pumped at a constant rate of 1.0 mL·min-1.The peak was detected using a fluorescence detector set at FLD1A:Ex=485 nm,Em=546 nm.Results In this study,the method was validated for the Rh123 range of 0.1 to 32.0 μg·L-1,and the lower limit of quantitation (LLO Q) was 0.1 μg·L-1.The intra-and inter-day precisions for Rh123 were less than 7%,and the mean recoveries of Rh123 were 87.93%,89.03%,86.11% at low,mid,and high concentrations,respectively.Conclusion A simple,rapid and reproducible HPLC method was developed for the determination of Rh123 in rat plasma,which was an applicable method in modeling and description of the possible pharmacological interactions between the medicines and P-glycolprotein transporter.

Objective To examine the occupational stability,training needs and capacity building requirements of the general practitioners purposely trained to work in rural communities,for improvement of policies regarding their training and issues related. Methods There counties were selected by stratified random sampling, where general practitioners graduated from such training completed an anonymous questionnaire. Focus group interviews were made to officials of the local Health and Family Planning Commission,those of primary healthcare institutions,and general practitioners themselves. Results The of the 190 valid questionnaires recovered, male accounted for 34. 2% and female 65. 8%. These general practitioners were mostly satisfied with their working environment, social status, work stress and job achievement,yet with lower satisfaction with their salary and availability of medical devices. Consideration of resignation was reported by only 5. 3% of them,with more males than females. As high as 63. 2% of them prefer to work in hospitals of county level. 91. 1% of them held it as necessary to participate in standard resident training,and 98. 4% held it as necessary to have on-job training. 94. 7% of them have participated in further education to gain a bachelor degree in medicine. Conclusions These doctors were found with high stability to work in rural communities and low turnover intention. Further studies are required to encourage these general practitioners to serve rural communities in a long term, and to improve the standard resident training mechanism,and their career development.

Objective To explore the functional orientation of township hospitals in developed areas to achieve goals of the ongoing health reform.Methods Two rounds of Delphi consultation was made among 18 experts from around the country to learn the degree of importance of every function.Results The experts' average seniority of service in their fields was 23.28±10.41 years.The positivity coefficients of the two-round consultation were 100％.Kendall' S coefficients of the two-round consultation were 0.226 and 0.265 (p＜0.01).These data are of statistical importance,suggesting consensus among these experts and the consultation meeting the needs of forecast.In these consultation,seven class-1 functions and and 27 class-2 functions were determined.Medical services and public health services account for similar proportion of work of township hospitals.Conclusion The functional orientation was feasible and forward looking,for reference of township hospitals in developed areas.

Atherosclerotic plaque is an important cause of ischemic stroke. High-resolution vessel wall magnetic resonance imaging (VW-MRI) has been widely used in the study of intracranial atherosclerotic plaques, which is of great value for the display of plaque distribution. This article reviews the distribution of intracranial atherosclerotic plaques based on VW-MRI.

AIM: To investigate the genes differential expression in cortex during rat focal cerebral ischemia. METHODS: cDNA microarray chips containing numerous cDNAs were used to investigate the gene expression pattern between samples of focal cerebral ischemia and sham-control operation rats. RESULTS: Two hundred and eleven genes differentially expressed were screened out, among these genes, up-and down-regulated genes were 199 and 12, respectively. CONCLUSIONS: The analysis of gene expression pattern of focal cerebral ischemia based on cDNA microarray can realize high-throughput screening of the genes associated with the focal cerebral ischemia. The differential expression of genes may be related to the pathogenesis of focal cerebral ischemic diseases.

With the development of imaging technology, high-resolution magnetic resonance vascular wall imaging technology has been gradually applied to the risk assessment of intracranial aneurysms rupture. It has provided more comprehensive information for clinicians to assess the stability of intracranial aneurysms. This article summarizes the indicators used for assessing the risk of intracranial aneurysms rupture in recent years with high-resolution magnetic resonance vascular wall imaging.