BACKGROUND:Whether determination of tacrolimus blood concentration by different immunoassay methods can influence predictive ability to immunosuppressive effects and toxicity, and whether it can be more sensitive to reflect blood concentration in patients with renal dysfunction are worthy of studying.
OBJECTIVE:To analyze the correlation of tacrolimus (FK506) concentrations determined by enzyme-multiplied immunoassay technique (EMIT) and enzyme linked immunosorbent assay (ELISA) in combination with renal function parameters.
METHODS:133 clinical blood samples were col ected. EMIT and ELISA techniques were used to determine the FK506 concentration. The correlation of two determination methods were analyzed, combined with renal function. RESULTS AND CONCLUSION:In patients with renal dysfunction, the mean results and standard deviation mensurated by ELISA were higher than those by EMIT. For blood concentration in 5-20μg/L by ELISA, the incidence of renal dysfunction occurred less than by EMIT. The overal mean results of blood concentration for two methods appeared no significant difference (r=0.904 5, P>0.05). When the concentration was less than 2.0μg/L, the concentration results by EMIT were higher than those by ELISA (P<0.01). When the concentration was more than 2.0μg/L, there was no significant difference between two determination methods (P>0.05). These findings indicate that EMIT and ELISA has good correlation, which are both suitable for clinical routine determination of plasma concentration. It is not recommended for applying EMIT method to determine low blood concentrations (<2.0μg/L). The reference range of concentration should be compartmentalized depending on combination of determination methods and renal function.

Background Medical refraction after cycloplegia is the preferable choice for precise measurement of degree of refractive error.Drugs used in China for cycloplegia include atropine and tropicamide,and the use of cyclopentolate is an alternative for ophthalmologist.However,the data for the evaluation and comparison of efficacy of the available drugs in cycloplegia is still lacking.Objective This system analysis was to evaluate the difference between atropine and cyclopentolate in cycloplegia in children.Methods A systematic literature retrieval was conducted in MEDLINE,EMbase,Google residual accommodation after cycloplegia by atropine and cyclopentolate were compared.Statistical analysis was performed using the RevMan 5.1.0 software.Results A total of 7 studies were included in this meta analysis,including 6 cohort study design and 1 randomized,doubleblinded clinical trial and 1232 eyes.For retinoscopic evaluation after cycloplegia,no significant differences were found between cyclopentolate and atropine in children with hyperopia and myopia (WMD =-0.21,95％ CI:-0.47-0.06,P=0.13 ; WMD =-0.10,95％ CI:-0.36-0.15,P =0.43).For residual accommodation after cycloplegia,no significant difference was seen between cyclopentolate and atropine in ammetropic children (WMD =0.30,95％ CI:-0.10-0.71,P =0.15).Conclusions Cyclopentolate shows the same effect on the cycloplegia as atropine in children,and it can take the place of atropine in cycloplegia in childhood.

China ; Congresses as Topic ; Fatty Liver ; Humans

OBJECTIVETo investigate the influence of the rate of morphologically normal sperm (MNS) on the clinical outcomes of conventional in vitro fertilization (IVF) in patients with one retrieved oocyte.

METHODSFrom January 2013 to January 2015, a total of 256 couples with one retrieved oocyte underwent conventional IVF in our center. According to the rate of MNS, the patients were divided into two groups: MNS < 4% (134 cycles) and MNS ≥ 4% (122 cycles). We compared the rates of no transferrable embryo cycles, fertilization, cleavage, normal fertilization, abnormal fertilization, high-quality embryo and transferrable embryo between the two groups. A total of 75 fresh embryo transfer cycles were performed, 43 in the MNS < 4% group and the other 32 in the MNS ≥ 4% group. We also compared the rates of implantation, clinical pregnancy and abortion between the two groups.

RESULTSThere were no statistically significant differences between the two groups in the rates of no transferrable embryo cycles, fertilization, cleavage, normal fertilization, abnormal fertilization, high-quality embryo and transferrable embryo (P > 0.05). The rates of implantation, clinical pregnancy and abortion exhibited no remarkable differences either in the fresh embryo transfer cycles between the two groups (P > 0.05).

CONCLUSIONThe rate of MNS does not affect the clinical outcomes of conventional IVF in patients with one retrieved oocyte.

Abortion, Spontaneous ; Cleavage Stage, Ovum ; Embryo Implantation ; Female ; Fertilization ; Fertilization in Vitro ; methods ; statistics & numerical data ; Humans ; Male ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate ; Single Embryo Transfer ; statistics & numerical data ; Sperm Count ; Spermatozoa ; physiology

The aim of this study was to develop the data element standard directory of traditional Chinese medicine (TCM) clinical pharmacy information, to provide application standards and models of TCM clinical pharmacy for the electronic medical record (EMR). The developed line of work is as follows: initially establish research through four forms: literature analysis, questionnaires, discussion groups, expert advice. The research range from the Chinese herbal medicine research, herbal origin, harvesting, processing, identification of traits, physical and chemical identification, modern research, character, taste, Indications, clinical application, processing, dispensing medicine, Chinese medicine specifications, usage, dosage, caution, efficacy indications to small packaging applications, drug research, management and other related issues, including traditional Chinese medicine theory, application and hospital management information; according to the general and part 16 content of the national "Health Information Data Element Standards", and the basic method of extracting data element to study and develop the data element of TCM clinical pharmacy information from the defining content. Correspondingly propose the ideas and methods of construction of the "Data Element Standard Directory of TCM Clinical Pharmacy Information", sort out medicine clinical information data element standard catalog, divided into basic categories, clinical application class, management class three parts, and set norms and standards of identifying data elements, definitions, allowable value of traditional Chinese medicine clinical information, and discuss the sources and standards of information collection, leaving the interface, standardized and scientific terminology, docking with the existing standards, maintenance and management program and oter issues.
China ; Data Mining ; methods ; statistics & numerical data ; Database Management Systems ; standards ; statistics & numerical data ; Electronic Health Records ; standards ; statistics & numerical data ; Evidence-Based Medicine ; methods ; statistics & numerical data ; Humans ; Information Dissemination ; methods ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods ; statistics & numerical data

Objective To evaluate the role of native ureter for the management of renal transplantation urological complications retrospectively.Method Twenty-six renal transplant recipients (18 males and 8 females) experienced the following urological complications:upper ureter injury,urinary leaks and moderate or severe ureteric obstructions secondary to ureterovesical anastomotic stricture.These complications have been managed with minimally invasive endourologic techniques or percutaneous nephrostomy as the first-line intervention.While endourologic treatment did not succeed,and the recipients have been treated with intraperitoneal open surgical correction.Urinary continuity was established by pyeloureterostomy or ureteroureterostomy using recipient native ureter.A pigtail ureteral stent was placed with the tip positioned in the pelvis of the graft and native bladder and removed after 4 to 6 weeks.Result The recipients were managed successfully during a follow-up period of 6 months to 6 years without occurrence of urological complications.One case underwent graft loss due to chronic rejection 5 years later postoperation,and the rest developed stable renal function with baseline serum creatinine.Conclusion Excellent outcomes have been achieved by the use of recipient native ureter for the management of urological transplant complications.This simple and efficient procedure should be considered as the superior choice for the recipients who experienced urological complications while less invasive endourologic techniques failed.

Background Central corneal thickness (CCT) is one of important parameters of the anterior eye segment.It plays a very important part in corneal refractive surgery and diagnosis of glaucoma.Contacted A-scan remains the gold standard for CCT measurement.Ophthalmologists are trying to look for a more convenient and noncontacted instrument to take place of contacted A-scan for CCT measurement.Objective This system analysis was to evaluate the difference between Pentacam and A-scan in CCT measurement.Methods A systematic literature retrieval was conducted from the MEDLINE,EMbase,Google Scholar,CBM disc and CNKI database with the limitation of publishing time from January 2005 to May 2011.The literature text was limited to the comparison of the CCT values measured by Pentacam and A-scan.The statistical analysis was performed using RevMan 5.1.0 software.Sensitive analysis was carried out and the publishing bias was analyzed using inverted funnel plot.Results A total of 26 studies met the requirement were included in this Meta-analysis with the 12 pieces of Chinese article and 14 pieces of English article,with the total eyes 3677.Heterogeneity was found anmong included studies (P =0.0003,I2 =56％) and random effects model was used.The differential value of CCT derived by Pentacam and A-scan was 1.74 μm,and no significant difference was found between Pentacam and A-scan (WMD =1.74,95％ CI:-0.69-4.16,P＞0.05).Fixed effects model was used to exclude the studies with the sample more than 100 eyes as the sensitive analysis.When fixed effect model was used,CCT by Pentacam was 2.73 μm more than A-scan,showing an insignificantly clinical difference.When studies with a sample more than 100 eyes were excluded,the CCT value by Pentacam was 2.64 μm more than A-scan,without clinically significant difference between them.No obvious publishing bias was seen in the included literature.Conclusions The difference between Pentacam and A-scan in CCT measurement is less and could be ignored.

Background Allograft rejection is a main cause of failure of penetrating keratoplasty,especially in the patient with high risk of rejection condition.Previous study on allograft rejection mechanism focused on limbal and corneal neovascularization,but these factors did not explain all the phenomena of allograft rejection.Research found that immune cells appeared in iris and ciliary body when rejection occurred,but the relationship between these immune cells and allograft rejection is unclear Objective This study was to evaluate the relationship between diversity of vascular permeability in the iris and ciliary body and allograft rejection after penetrating keratoplasty.Methods Seventy clean eight-week-old BALB/c mice were divided into allogeneic corneal transplantation group (60 mice) and blank control group (10 mice).Allogeneic corneal transplantation was performed with the same age of C57BL/6 mice as donor and BALB/c mice as the recipients.The grafts were examined under the slit lamp microscope and scored based on the criteria of Hegde.The mice were sacrificed and iris and ciliary tissue were obtained 5,10 days and rejection after surgery.Immunohistochemistry and reverse transcription PCR (RT-PCR) was used respectively to detect the expression diversities of occludin,zonula occludens protein-1 (ZO-1),matrix metalloproteinase-9(MMP-9),major histocompatibility complex-Ⅱ (MHC-Ⅱ),and CCR5,CCR7 and their mRNA in iris and ciliary body.Image-J image analysis software was used to calculate the quantity of positive cells on iris wholemount,and absorbance of target genes (A values).The use and care of the experimental animals complied the ARVO Resolution on the Use of Animals in Research.Results The mean survival time of corneal gratts was (17±3) days after operation.The mean score was 0.6 in 5 days and 0.5 in 10 days,and 3.3 in 18 days after operation.Expression of ZO-1 reduced significantly,and that of MMP-9 increased obviously at the time of rejection.MHC Ⅱ + cells were scattered in iris and ciliary body in normal mice,and the number of the positive cells (cells/field) was increased after operation with a peak value when rejection occurred.A significant difference was seen between normal mice and rejection mice (1559.67±350.29 vs.4021.83±495.18) (P=0.000).The expressions of occludin mRNA and ZO-1 mRNA in the iris and ciliary body decreased obviously in the rejection mice.Compared with normal mice,theA value of ZO-1 and occluding were 36.74±3.13 vs.110.11±11.88 and 57.54±3.41 vs.59.90±3.50respectively,with significant differences between them (all P＜0.05).The expressions of MMP-9 mRNA,CCR5 mRNA and CCR7 mRNA in the iris and ciliary body increased gradually with the time lapse after operation and peaked when the rejection appeared.The A value of MMP-9 mRNA,CCR5 mRNA and CCR7 mRNA were significantly higher than those of normal mice (20.29±1.19 vs.2.77±0.85 for MMP-9 mRNA; 35.43±2.56 vs.9.11±0.29 for CCR5 mRNA,and 60.83±0.87 vs.0.89 ±0.95 for CCR7 mRNA) respectively (all P＜0.05).Conclusions The permeability of vascules in the iris and ciliary body increase during the allograft rejection after penetrating keratoplasty.Increased antigen presenting cells were also detected.

Objective To estimate the current quality of the reporting of randomized controlled trials (RCTs) related to digestive diseases in China. Methods All the papers related to RCTs published in Chinese Journal of Digestion from 1999 to 2008 were hand-searched by professional staff then evaluated and analyzed them according to the international reference standard. ResultsIn the 3298 issues of the recent ten years, there were 92 research papers of RCTs which was accounting for 2.8%. The sample size ranged from 18 to 5241. Sixty-one (66.0%) trials included the exact standard of internalize and exclusion. Sixteen (17.4%) trails told the specific method of random allocation and 22(23.9%) were double-blinded. Fifty-eight (63.0%) trials compared the baseline condition of each groups. Seventy-three(79.3%) trails showed the specific approach of statistic. In the end, only 7(5.7%) trails were identified as the strictly-designed RCTs. Conclusions The quantity and quality of the clinical RCTs can not satisfy the demand of clinical practice. Strictly-scientific designed, multicentered, large sample prospective clinical RCT should be advocated.

Objective:To explore the clinical value of remote ECG consultation for primary medical institutions. Methods:Remote ECG consultation data for medical institutions of different levels in Hubei Jianli county were sta-tistically analyzed.Results:In county hospitals of this area,there were 1334 cases of ECG consultation,the positive rate was 41.00% (547/1334),and the three abnormal ECG types with highest incidence rate were arrhythmia (27.29%),left ventricular hypertrophy (LVH,9.15%)and ST-T change (2.62%)in order;in rural health rooms of this area,there were 723 cases of ECG consultation,the positive rate was 55.19%(399/723),and the three ab-normal ECG types with highest incidence rate were arrhythmia (34.02%),ST-T change (11.07%)and LVH (5.39%)in order.Conclusion:The remote ECG consultation is easy to perform.It can rise the detection rate of transient abnormal ECG events in rural area,where is lack of ECG equipment and personnel,so it is worthy of ex-tending.