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.

Objective To explore the influence of intestinal trefoil factor (ITF) on interleukin-6(IL-6) in neonatal rat with necrotizing enterocolitis(NEC) ,and to discuss the protective machanism of ITF on NEC.Methods Thirty-two neonatal rats were divided randomly into four groups,group A as control group,group B as NEC group,group C as NEC+NS 0.2 mL group,group D as NEC+ITF 0.2 mg group.NEC model of neonatal rats were established.On the 4th day,all the subjects were put to death.Intestinal tissue within the boundary of ileum and cecum was obtained to observe histological changes.Other intestinal tissue was treated into homogenate.After the homogenate was centrifuged,supernates were used to test the density of IL-6.Results The density of IL-6 significantly decreased in group A,D than those in group B and C (Pa0.05).The pathological lesions indicated that intestinal tissue necrosis was severe in group B and C,which was graded as 3 points,but obviously lessen in group D,which was graded as 1 point,with ITF interfering.Conclusions Intestinal inflammation is ameliorated after ITF are injected hypodermically or intraperitoneally.ITF may provide a brand-new way for the therapy of NEC in neonatal rats.

Objective To construct safety management barriers and protecting barriers to ensure patient safety.Methods The management barrier including the safety management system,work flow of safety nursing,and quality supervision system,as well as the protecting barrier including the hazardous medicines obstacle,three colored marks,and predicted alarm systems were developed and applied in clinical practice.Results This practice reduced the rate of adverse nursing events,enhanced nurses' ability to detect and correct errors,and controlled the risk factors of patient safety.Conclusion Constructing multiple barriers can ensure patient safety.It is suggested that nurses should detect the defects and consolidate the barriers consistently.

Older people generally had low health literacy, age related cognition decline and some even progress into dementia, burden on society was aggravating. Cognition decline of the elderly could lead to the decrease of health literacy. Meanwhile, higher level of health literacy was a protective factor against cognition decline in the elderly. This paper aimed to explore the relationship between health literacy and cognitive function in the elderly population without dementia, and to provide a theoretical basis for improving the health literacy and cognitive function of the elderly.

OBJECTIVETo analyze the changes of patients with type 2 diabetes in different stages in glucagon (GC) and free fatty acid (FFA) in fasting, OGT and L-Arg experiments, and discusses the role of pancreatic alphabeta cells in diabetes pathogenesis by studying the relations among indexes such as glucagon (GC), free fatty acid (FFA) and blood glucose (BG), insulin, insulin homeostasis model (HOMA) and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes.

METHODStudy objects were divided into the T2DM group (45 cases), the IGT group (28 cases) and the NGT group (30 cases) for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose (FBG), insulin (F), glucagon (FGC), free fatty acid (FFA) were detected to calculate HOMA-beta, insulin sensitivity index (ISI) and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUC(BG), AUC(INS) and AUC(GC).

RESULTObvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-beta and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-beta and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-beta, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM > IGR > NGT in AUC(GC) in the OGTT experiment and T2DM > IGR > NGT in in AUC(GC) in the L-Arg experiment, with the significant positive correlation between AUC(GC) and AUC(BG) and significant negative correlation with AUC(INS).

CONCLUSIONGlucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated with blood glucose and HOMA-IR and negatively correlated with INS, HOMA-beta and ISI. The increase in glucagons of T2DM and IGT patients indicated inappropriate secretion of pancreatic alphabeta cells among patients with type 2 diabetes.

Adult ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; Fatty Acids, Nonesterified ; metabolism ; Female ; Glucagon ; blood ; Humans ; Insulin ; secretion ; Islets of Langerhans ; secretion ; Male ; Middle Aged

Adult ; Embolism, Amniotic Fluid ; etiology ; therapy ; Female ; Humans ; Pregnancy

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.

Objective To identify the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) gargle in patients who had oral mucositis after allogeneic hematopoietic stem cell transplantation. Methods A total of 134 patients were enrolled in this study from 2014 to 2015. They were randomly divided into two groups:the experimental group (n=65) and the control group (n=69). Both groups received preventive measures for oral mucositis. But once oral mucositis occurred, the control group continued with the routine nursing measure, while the experimental group added GM-CSF gargle based on previous routine nursing measure. The effective rate and healing time were compared between two groups. Results The effective rate of the experimental group (81.54%, 53/65) was significantly higher than that of the control group (24.64%,17/69) (χ2=43.434, P=0.000). The median healing time in the experimental group was 4.5 days, shorter than 9.0 days in the control group (Z=-5.379, P< 0.01). Conclusions GM-CSF gargle can control the oral mucositis after allogeneic hematopoietic stem cell transplantation.

Objective:To explore the mechanism of the embolism and sclerotherapy of fibrin glue combined with bleomycin (FG/BLM) for the treatment of cervicofacial vascular malformations by color doppler ultrasound.Methods:10 patients with venous malformation(VM) and 10 patients with arterio-venous malformation(AVM) were included.All patients underwent embolism and sclerotherapy of FG/BLM guided by ultrasound.Color doppler ultrasound was used to record the real-time two-dimensional ultrasonography and color doppler image.The flow and distribution of FG/BLM after injection into the lesions were observed.Results:Two-dimensional ultrasonography showed clumps or flake strong echo after immediate injection of FG/BLM into the cavity of VMs,then floated in the abnormal venous lumen and diffused throughout the cavity.At the later stage the lesions were filled by a large number of flocculent and netted low echo,and patchy strong echo.The volume of VMs cavity expanded dramaticlly,and the blood flow signal was significantly decreased.After injection of FG/BLM into the lumen of AVMs,clumps or flake strong echo were observed,then most of the snowflake strong echo rapidly filled or scattered along with blood stream to the distal part of the vessels.The color doppler showed significantly decrease of blood flow signal.Conclusion:FG/BLM injection can embolize and block the draining vein of VM,and play a role on the storage of sclerozing agent.FG/BLM injection can embolize both the dilated blood vessels and capillary network of AVM.