Objective To investigate the average serum level and risk factors of serum cystatin C in Chinese healthy adults.Methods A total of 15 918 healthy adults who received health assessments in Peking Union Medical College Hospital during January 2012 and March 2013 were enrolled in this crosssection study.Serum cystatin C was measured.Estimated glomerular filtration rate was calculated by creatinine (eGFRcr).Multivariable linear regression analysis was used to assess factors that contribute to cystatin C variability.Results The mean serum cystatin C level was (0.79 ±0.14) mg/L (95％ reference interval (RI) was 0.56-1.08 mg/L).Male showed significantly higher cystatin C level than female (mean (0.84 ±0.13) vs (0.73 ±0.13) mg/L; RI 0.64-1.11 mg/L and 0.54-1.03 mg/L,respectively; P=0.000).Differences between genders are still significant after subgrouped by age.In the young-age group (age≤44 years old),the mean serum cystatin C level was (0.81 ±0.11)mg/L in male and (0.68 ±0.09)mg/L in female,P =0.000.In the middle-age group (45-59 years old),the mean cystatin C level was (0.85 ±0.12) mg/L in male and (0.75 ±0.12) mg/L in female,P =0.000.In the elderly group (≥60 yrs),the mean serum cystatin C level was (0.97 ±0.18) mg/L in male and (0.89 ±0.19) mg/L in female,P =0.000.Serum cystain C was increased with ages (in male:r =0.274,P =0.000 ; in femal,r =0.470,P =0.000).Differences between each two age groups are all significant for both gender,P =0.000.Cystatin C level in male is respectively (0.81 ±0.ll)mg/L,(0.85 ±0.12) mg/L and (0.97 ± 0.18) mg/L in the young-age,middle-age and elderly group.Cystatin C level in female is respectively (0.68 ±0.09) mg/L,(0.75 ±0.12) mg/L and (0.89 ±0.19) mg/L in the young-age,middle-age and elderly group.Male gender,older age,lower body weight,lower eGFRcr,lower high-density lipoprotein cholesterol,lower fasting blood glucose,increased mean blood pressure,higher body mass index and triglyceride were significantly associated with increased serum cystatin C level.Body weight,total cholesterol and low-density lipoprotein cholesterol were not risk factors of cystatin C.Conclusion Serum cystatin C level may be influenced by gender,age and other factors in Chinese healthy adults.

ObjectiveTo explore the accuracy of judging the T-staging of rectal cancer by biplane transrectal ultrasound.MethodsPathological enteroscopic biopsy was carried out for 197 cases of rectal cancer.Cases of middle and lower rectal cancer without serious obstruction were examined by means of transrectal biplane ultrasound through which to observe the changes of the echoes and to detect the depth of the infiltration in the intestinal walls and the presence of invasions in prostate glands,seminal in male or vesicles,uterine cervix in female.On the basis of the findings,the preoperative tumor staging was made.Postoperatively,the ultrasound results were compared with the pathological examination.Their consistency was evaluated by using Kappa test.ResultsTransrectal biplane ultrasound examination showed the total accuracy rate in T-staging of rectal cancer was as high as 83.8％ with the diagnostic sensitivity rate for T1to T4 as 77.8 ％,73.1％,89.3％ and 94.4％,while its diagnostic specificity rate degree was 97.3％,93.1 ％,85.1 ％,97.8％ respectively,The k -value was 0.732 which suggested that the ultrasound staging was highly consistent with the pathological staging(P＜0.05).ConclusionsTransrectal biplane ultrasound has a great value in the preoperative T-staging of rectal cancer and is helpful in the planning of treatment.

Objective To investigate the association of the gene polymorphism of endothelial nitric-oxide synthase(eNOS) with pregnancy induced hypertension(PIH). Methods Sixty-six gravidas with PIH and 91 normal pregnant women(control) in the third trimester were investigated. The G894T mutation at exon 7 of the endothelial nitric-oxide synthase gene was studied by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The frequencies of eNOS GG, GT and TT genotypes were 62.1%, 34.8% and 3.1% in PIH group and (79.1%,) 20.9% and 0.0% in control group, respectively (P0.05). Conclusions The variant (G-T) of 894 polymorphism site of eNOS is associated with the genesis of PIH, but not related to the severity of PIH. T allele may be a susceptible gene to PIH.

AIM:To compare the analgesic efficacy and safety of intravenous morphine or epidural morphine combined with bupivacaine in postoperative children.METHODS:48 children scheduled for selective inferior belly or lower limb surgery under general anaesthesia or epidural anesthesia for ASA I or II,age from 3 to 10 years old,were randomly divided into 3 groups(n=16 each).Group A was given intravenous morphine for postoperative analgesia,group B was given epidural morphine in combination with bupivacaine,group C was given nonsteroidal anti-inflammatory drugs orally or pethidine intramuscularly in need as the control group.When the patients were fully awake in the recovery area,heart rate(HR),blood pressure,peripheral oxygen saturation(SpO2),respiratory rate and pain were recorded at 2,4,8,12,24 and 48 h postoperatively,side-effects were also noted.Pain was assessed using an objective pain score(OPS).RESULTS:There was no significant difference of OPS between group A and B,and the efficacy and duration of analgesia in group A and B were significantly better than those in group C(P

The occurrence rate of long QT syndrome is 1/2 000,which accounts for approximately 10％ of cases of the sudden infant death syndrome.The morbidity is decreased after receiving appropriate therapy in early stage.Electrocardiogram (ECG) screening,with reliable results,is simple and feasible in infancy and can be used to conduct appropriate genetic testing.Neonatal screening is controversial because of individual differences in ECG results.Even there are some defects,it is still necessary to perform neonatal ECG screening which can improve prognosis in children with long QT syndrome.

Objective To investigate the training methods decreasing parrot speech and producing active speech for autistic children.MethodsOne autistic child with parrot speech was trained with methods of closure, stress, rhyme and tongue antitheses.ResultsAfter 5 months training, the parrot speech of the child decreased and active speech increased significantly.ConclusionThe parrot speech of autistic children can be improved with educational training and multi-sensory input.

Knee osteoarthritis (KOA) is a common degenerative joint disease. Biomechanics of lower extremity plays an important role in KOA. Foot progression angle, with the advantages of non-invasive, convenience, has been attached great importance by people gradually. Changing foot progression angle may effect the knee adduction torque, tibia rotation, muscle activity, which leads to change the load of the knee joint, and alleviate the pain, improve the function of knee joint and the quality of life of the patients.

Objective Toexploretheclinicalefficacyandtoxicityofintensitymodulatedradiationtherapy(IMRT)combined with high intensity focused ultrasound(HIFU) for inoperatable recurrent hepatic carcinoma after operation and TACE .Methods Total 60 patients with inoperatable recurrent hepatic carcinoma after operation and TACE were randomly divided into two group ,30 patients in observation group received IMRT and HIFU ,while 30 patients in control group received only IMRT .For both groups , the same radiotherapy technic was given with IMRT in 6 MV X‐ray ,the total dose was 54 -70 Gy/6 -7 weeks .In observation group ,HIFU was carried out concurrently with IMRT (5 days/week ,6-7 weeks) .Results The difference of the short‐term effi‐cacy between the observation group and the control group was statistically significant (P<0 .05) ,there was no significant difference in acute radioactive toxicity between the two groups (P>0 .05) .The one and two year overall survival rate 89 .9% ,78 .9% in obser‐vation group ,while 72 .8% ,36 .2% in control group ,the differnces were statistically significant (P<0 .05);the one and two year progression‐free survival rate were 85 .9% and 50 .9% in observation group ,while 64 .3% and 28 .1% in control group ,the differ‐ences between two groups were statistically significant (P<0 .05) .The medium survival time was 36 months in observation group , and 24 months in control group;the medium progression‐free survival was 27 months in observation group ,and 17 months in control group .Conclusion For recurrent unresectable or reject surgery after TACE in patients with primary hepatic carcinoma ,the efficacy of IMRT combined with HIFU treatment is effective ,the toxicity can be tolerated ,and has certain application value .

Objective To explore the application of three-dimensional (3D) ultrasonography in screening the defects of fetal brain and skull.Methods Thirty-one cases of the fetal were detected in 3D ultrasonography.The ultrasonic data were compared with magnetic resonance imaging(MRI) and pathology.Results Among 31 cases according to 3D ultrasonography,there were 2 of anencephaly, 1 of exencephaly,2 of encephalocele,5 of holoprosencephaly,2 of arachnoidcyst, 1 of vein of Galen aneurysm,2 of agenesis of the corpus callosum, 1 of schizencephaly, 3 of Dandy-Walker syndrome, 7 of ventriculomegaly, and 5 of enlargement of cisterna magna.Compared with the results of MRI,the diagnostic accordance rate was 100% by 3D,it was 93.5% by 2D.Conclusions The structure of fetal brain and skull were viewed more clearly in 3D ultrasonography than 2D ultrasonography and the defects of fetal brain and skull can screened more exactly.

The purpose of this study is to investigate the effects of multiple-trough sampling design and nonlinear mixed effect modeling (NONMEM) algorithm on the estimation of population and individual pharmacokinetic parameters. Oxcarbazepine and tacrolimus were used as one-compartment and two-compartment model drugs, respectively. Seven sampling designs were investigated using various number of trough concentrations per individual ranging from 1-4. Monte Carlo simulations were performed to produce state-steady trough concentrations. One-compartment model was used to fit simulated data from oxcarbazepine and tacrolimus. The accuracy and precision of the estimated parameters were evaluated using the median prediction error (PE), the median absolute PE and boxplot. The results indicated that trough concentrations could yield reliable estimates of apparent clearance (CL/F). For oxcarbazepine, as the number of trough concentrations per subject increased, the accuracy and precision of CL/F, between-subject variability (BSV) of CL/F and residual variability (RUV) tended to be improved. For tacrolimus, however, although no improvement were observed in the accuracy of CL/F and BSV of CL/F, the PE distribution ranges were significantly narrowed and the RUV estimates were less bias and imprecise. In terms of algorithm, Monte Carlo importance sampling (IMP) and IMP assisted by mode a posteriori estimation (IMPMAP) were consistently better than other methods. Additionally, the sampling design had no significant effects on the individual parameter estimates, which were only depended on the interaction between BSV and RUV in various algorithms. Decreased in BSV and RUV levels can improve the accuracy and precision of the estimation for both population and individual pharmacokinetic parameter estimates.
Algorithms ; Bayes Theorem ; Carbamazepine ; analogs & derivatives ; pharmacokinetics ; Humans ; Immunosuppressive Agents ; pharmacokinetics ; Models, Biological ; Monte Carlo Method ; Nonlinear Dynamics ; Regression Analysis ; Tacrolimus ; pharmacokinetics