Objective To explore prospectively the relationship between treatment of toxoplasmosis and pregnancy outcome. Methods Detected by ELISA and PCR,59 pregnant women and 91 women at reproductive age with infection were treated by oral spiramycin. Then their Tox-lgM and DNA negative conversing rates,intrauterine transmission rate and incidence of abnormal pregnancy outcome were studied in contrast to those of 60 women in pregnancy and 79 at childbearing age with infection but without management. Results In healing group,the seroconversion rate of Tox-lgM and Tox-DNA from positive to negative were 83.05% (49/59) in pregnant women and 70.33%(64/91) in women at childbearing age,respectively. The rates in control group were 35% (21/60) and 37.97% (30/79). The rates of intrauterine transmission and abnormal pregnancy outcomes of healing group were 8.4% (5/59) and 30% (15/50),respectively. While those of control group were 11.86% (7/59) and 40% (20/50) accordingly (? 2=11.4970,P

Objective To explore the influence factors both at birth and after birth to the brain development of small for gestational age(SGA) infants. Methods The cerebellar area, cerebellar circumference, vertical lengths of the vermis and maximum transverse width of the cerebellar body both in midline sagital view and coronal view as well as the width of cerebral hemisphere in coronal view were measured in SGA infants through anterior fontanels by inter cranial ultrasound, and the parameters were compared with that in AGA infants. Results The cerebellar area, cerebellar circumference, vertical length of the vermis and maximum transverse width of the cerebellar body both in midline sagittal view and coronal view correlated significantly with the gestational age and birth weight and the cerebellar area and circumference correlated best with the gestational age and birth weight of infants. The width of cerebral hemisphere were also correlated significantly with birth weight. The brain growth of SGA infant was retarded at birth. The rate of the brain growth and development of SGA was accelerated after birth. It was smilar to that of AGA group, but at the age of 12 months the brain development in SGA infants was still retarded. Conclusion The growth of brain both before and after birth were retarded. Better perinatal health care and early intervention after birth should be developed.

Objective To compare the efficacy and safety of twice-daily tacrolimus (Tacrolimus BID; Prograf) vs once-daily prolonged release tacrolimus (Tacrolimus QD; Advagraf), combined with steroids and mycophenolate mofetil in preventing acute rejection in De Novo renal transplantation patients. Methods 241 patients from 11 centers were randomized into two groups with 3 months observation period post-transplantation. Advagraf was administered as a single oral dose in the morning (initially 0. 1-0. 15 mg/kg every day) and Prograf was administered in two equal oral doses 12h apart (initially 0. 1-0. 15 mg/kg). Study visits were scheduled for days 1, 3, 7, 14, 28, 56, 84post-transplantion. The efficacy, safety, compliance and adverse effects were compared between two groups. Results Totally 223 patients completed the study. The two groups were comparable in age,gender and primary disease. There were 12 episodes of acute rejection in each group. There was no graft loss or patient death in both groups. The incidence of drug related adverse events was 32. 1 %and 33. 3% respectively in the control and experimental groups. Dosage was decreased in both groups and there was significant difference in each group. The trough level was similar at the initiate period.Twenty-eight days post-transplantation the trough level in the Advagraf group was lower than in the Prograf group. Conclusion Advagraf has the same efficacy, safety and drug related adverse effects as Prograf. It is practical and feasible for Advagraf substitute for Prograf in clinical practice.

OBJECTIVETo describe trends of changes in blood lead levels in children aged 1 - 6 years during the time period before and after introducing lead free gasoline in Shanghai 1997 and 1999.

METHODSBlood lead levels of 1 969 children aged 1 - 6 years were determined by a sampling survey in five districts of Shanghai in August and September, 1997. Blood lead levels of the same population were re-determined by the same method from April to June in 1998 and from August to September in 1999. Filter paper blood lead test was carried out monthly using the filter paper blood lead proficiency testing program of Centers for Disease Control in the United States. The results from blood lead samples were under acceptable ranges during the study.

RESULTSThe geometric means of blood lead levels were 83 microgram/L in 1997, 80 microgram/L in 1998 and 76 microgram/L in 1999, respectively. The prevalence rates of childhood lead poisoning (blood lead level was equal or more than 100 microgram/L) were 37.8% in 1997, 25.7% in 1998 and 24.8% in 1999. The amounts of decrease on average blood lead levels in the five districts between 1997 and 1999 were 10 microgram/L, 11 microgram/L, 6 microgram/L, 4 microgram/L and 2 microgram/L, respectively.

CONCLUSIONLead poisoning is a preventable disease. The average levels of lead in young children in Shanghai decreased significantly after the introduction of lead free gasoline to Shanghai. Lead emissions from vehicles running on leaded gasoline was one of the important contributors to increase the children's blood lead levels in Shanghai. Lead poisoning is not evenly distributed among children in Shanghai, resulting in the different levels of decline.

Child, Preschool ; China ; Environmental Monitoring ; methods ; standards ; Environmental Pollutants ; blood ; Gasoline ; standards ; Humans ; Lead ; blood ; Time Factors

Objective To document the impact of conversion to mycophenolate mofetil (MMF)at different time points after transplantation on the renal function of renal function.Methods A longterm,multicenter,non-interventional and observational study was done.Two cohorts were included:One was Switch cohort (340 cases) including renal allograft recipients who switched to MMF at least 6 months after renal transplantation and followed up for 4 years after switch; The other was Stay cohort (123 cases),including renal allograft recipients who received MMF treatment after transplantation and followed up for 4 years after enrollment.Results GFR values of patients in Switch cohort was significantly increased after switch,and the change in GFR slope was 3.1 mL· min-1 · year-1 (P＜0.01).GFR values of patients in Stay cohort kept steady before and after enrollment,and the change in GFR slope was 0.44 mL·min-1 ·year-1 (P＞0.05).Statistically significant difference in the onset time of GFR decline (defined as 20％ decline from the baseline) was observed among subgroups within Switch cohort (P＜0.01),but there was no significant difference among subgroups within Stay cohort (P＞0.05).Stay cohort was 12％ higher than in Switch cohort every year.Conclusion Conversion to MMF ＞6 months or even many years after transplantation can obviously improve the renal function of recipients.The earlier conversion can benefit improvement of the renal function.