OBJECTIVE: To explore the therapeutic window concentration of tacrolimus(FK506) suitable for Chinese renal transplant recipients. METHODS: The whole blood valley concentration level in 56 renal transplant recipients 12h after oral administration with FK506 was determined by MEIA (Microparticle Enzyme Immunization). The rejections and the renal toxic reaction were observed as well. RESULTS: The recommended therapeutic window concentration of FK506 for Chinese renal transplant recipients were the following: 9～14?g/L during the first month; 8～12?g/L during the second to the third month; 6～10?g/L during the fourth to the sixth month; 4～6?g/L during the seventh to the twelfth month. CONCLUSION: FK506 has a satisfactory immune suppression effect while reducing incidences of rejections and renal toxic reactions if used within the above therapeutic window concentration.

OBJECTIVE:To study the therapeutic window of peak blood concentration at different time in domestic renal transplant recipients2h after administration with cyclosporine A(CsA).METHODS:The valley bottom levels(C 0 )and the peak levels(C 2 )were determined simultaneously by fluorescence polarization immunoassay(FPIA)in92patients2h after oral administration with CsA,the rejection and the hepatic and renal drug toxicities were observed.RESULTS:The recommended therapeutic window concentration of CsA(C 2 )in Chinese renal transplant recipients was1000～1300?g/L within the first month,950～1250?g/L within the second to third month,900～1100?g/L within the fourth to sixth month,750～1000?g/L within the seventh to twelfth month,600～800?g/L from the twelfth month after renal transplantation.CONCLUSION:Within the above therapeutic window concentration range,CsA is of ideal immuno-suppressive action meanwhile it can less rejection and minimize the hepatic and renal drug toxicities.

0.05),the toxi?cation rate of the low dose group was lower than that of the routine group(P0.05),the effective concentration of the low dose digoxin group was significantly lower than the routine group(P

0.05), respectively; the costs were 640.50yuan and 1 151.21yuan, respectively; the cost-effectiveness ratios were 7.01 and 12.28, respectively; the incremental cost-effectiveness ratio of Group B versus Group A was 220.1. CONCLUSION: The sequential therapy of levofloxacin is preferable in the treatment of lower respiratory infection.

Objective To evaluate the clinical features and guanosine triphosphate cyclohydrolase 1 (GCH-1) gene mutation in a family with dopa-responsive dystonia (DRD).Methods The clinical features of this family were collected and their peripheral blood samples were screened for mutation in GCH-1 gene using PCR and DNA direct sequencing.Results The clinical features among each patient in this family were different.But all affected family members had quite a good response to levodopa treatment without significant adverse reactions.DNA test showed an AT deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene in 5 affected members and 1 asymptomatic immediate family member.Conclusions Clinical heterogeneity is an important characteristic of DRD and clinical symptoms vary intra-families.Same gene type may cause different phenotype and not all carriers are patients.The deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene should be considered as a pathogenic mutation for DRD.

OBJECTIVETo describe the prevalence of depressive and/or anxiety symptoms in patients with some neurological diseases in the general hospitals of major cities in China.

METHODSA hospital-based cross-sectional study was conducted in four big cities in China in 2004. 1197 eligible subjects with Stroke, Parkinson's disease and Epilepsy were recruited from the outpatient or inpatient departments within three months. Face-to-face interview was used in data collection together with the self-completed Hospital Anxiety and Depression (HAD) scale for depressive and/or anxiety symptom, were screened. Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with Hamilton anxiety scales and Hamilton depression scales by the licensed psychologists or psychiatrists.

RESULTSThe prevalence rates of "self-scaled" depressive and/or anxiety symptoms were 19.5%, 24.1% and 21.9% respectively in patients with stroke, Parkinson's disease and epilepsy. Among cases with "self-scaled" depressive and/or anxiety symptoms, the prevalence rates of depressive and/or anxiety symptoms were 50.8%, 73.1% and 38.6% respectively; less than 17% of subjects had obtained a diagnosis of depressive disorders and had been treated but only 4% of the subjects having obtained a diagnosis of anxiety disorders and been treated prior to the study. The sex specific prevalence varied over the somatic diseases. In patients with Parkinson's disease, the prevalence of "self-scaled" anxiety symptom was significantly higher in females than in males (21.1% vs. 12.2%; chi2 = 5. 679, P = 0.017),and the total prevalence of "self-scaled" depressive and/or anxiety symptoms was also higher in female (30.3% vs. 20.5%; chi2 = 4.978, P = 0.026); in patients with stroke while the prevalence of depressive and anxiety symptoms in female was higher than that in male (52.2% vs. 20.0%; chi2 = 6.009, P = 0.014), and a higher prevalence of depressive symptoms in female patients with epilepsy was also reported (32.4% vs. 13.6%; chi2 = 4.108, P = 0.043).

CONCLUSIONIt was of great importance to remind the healthcare providers and health policy makers that high prevalence of depressive and/or anxiety symptoms was found in patients with somatic diseases but with low percentages of previous diagnosis or treatment in the departments of neurology at the general hospitals in urban China.

Anxiety ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Depression ; epidemiology ; Female ; Humans ; Male ; Nervous System Diseases ; psychology ; Prevalence ; Urban Population

OBJECTIVETo study the expression of nNOS and ultrastructural changes in the penile tissue of rats with prolactinoma-induced erectile dysfunction (ED).

METHODSWe established the model of prolactinoma in 20 male Westar rats by peritoneal injection of diethylstilbestrol (DES) and treated the control rats with normal saline (n = 10) or sterilized arachis oil (n = 10). After 8 weeks, we performed the apomorphine test and measured the weight of the pituitary gland and the levels of serum prolactin (PRL) and testosterone (T) to confirm the successful construction of the prolactinoma-induced ED model. Then we determined the expression of nNOS in the penile tissue by immunohistochemistry and examined the ultrastructural changes of the penile cavernosum under the transmission electron microscope.

RESULTSThe prolactinoma-induced ED model was successfully established in 15 rats. The weight of the pituitary gland was significantly increased in the rats treated with DES as compared with the normal saline and sterilized arachis oil controls ([46.7 ± 15.5] vs [11.7 ± 2.4] and [12.4 ± 2.3] mg, both P < 0.05). The level of serum PRL was markedly higher while that of T remarkably lower in the former than in the latter two groups ([1,744.9 ± 304.5] vs [11.5 ± 2.4] and [10.6 ± 1.9] ng/ml, both P < 0.0l; [1.54 ± 0.46] vs [3.11 ± 1.08] and [3.04 ± 1.11] ng/ml, both P < 0.05). The rate of penile erection was significantly reduced in the prolactinoma-induced ED model rats in comparison with the normal saline and arachis oil controls (16.7% vs 100% and 87.5%, both P < 0.05), and so was the expression of nNOS in the penile tissue (0.024 ± 0.011 vs 0.066 ± 0.019 and 0.058 ± 0.021, both P < 0.05). Transmission electron microscopy manifested significant ultrastructural changes in the endothelial and smooth muscle cells of the cavernous tissue in the prolactinoma-induced ED models.

CONCLUSIONThe ultrastructural changes of the penile cavernous tissue and the reduced expression of nNOS in penile tissue may be the most important mechanisms of prolactinoma-induced ED in rats.

Animals ; Apomorphine ; Carcinogens ; Diethylstilbestrol ; Erectile Dysfunction ; etiology ; Humans ; Male ; Myocytes, Smooth Muscle ; ultrastructure ; Nitric Oxide Synthase Type I ; metabolism ; Organ Size ; Penile Erection ; Penis ; enzymology ; ultrastructure ; Pituitary Neoplasms ; chemically induced ; complications ; Prolactin ; blood ; Prolactinoma ; chemically induced ; complications ; Rats ; Rats, Wistar ; Testosterone ; blood

While receiving cardiac resynchronization therapy (CRT) ,traditional left ventricular lead implantation may fail due to anatomical abnormality of heart vein ,poor left ventricular pacing threshold ,lead dislocation and ra-dial nerve stimulation etc .So left ventricular quadripolar leads rise in response to the proper time and condition .The present article made a brief review on research progress of application of left ventricular quadripolar leads in clinic .

Objective To explore the impact of chronic complications of type 2 diabetic mellitus (T2DM)on quality of life(QOL)among T2DM outpatients in urban China.Methods A cross.Sectional study was carried Out in 1524 T2DM outpatients recruited from 15 hospitals in 4 major cities of China.Questionnaire interviews were used to collect data on general characters and complications of T2DM.SF-36 questionnaire(version 1)was used and self-completed by patients under the help from interviewers for those having difficulties in reading.T test,one-way ANOVA and generalized linear model were used to explore the association between complications of T2DM and quality of life.Results Complication Was a significant predictor leading to poorer SF-36 subscale scores(decreased by 4.68-16.06 scores)and two summary scores (PCS,MCS).The scores of role-physical subscale(decreased by 22.45％)and role-emotionsl subscale(decreased by 16.28％)decreased much more than the other subscales in patients with complication.Overall,QOI Was reduced by 11.02％in patients with complication.The QoL had a gradual decrease with the increasing number of complications.The average scores descended from 2.82 to 10.33 in the eight subscales with the increase of one complication.Conclusion Having complication or multiple complications seemed to be predietors of poor QOL among T2DM outpatients.

Objective:To investigate the relationship between neutrophil/lymphocyte (NLR), red blood cell distribution width (RDW), platelet/lymphocyte (PLR), platelet mean volume (MPV), platelet hematocrit (PCT) and platelet distribution width (PDW) and the disease activity of Takayasu arteritis (TA).Methods:A retrospective analysis was conducted on 86 TA patients (TA group) in Anzhen hospital from January 2017 to June 2019. Meanwhile, 85 healthy controls (control group) whose age and gender matched with TA were selected from the health examination center of Beijing Anzhen hospital. The blood samples were collected to measure the neutrophil/lymphocyte (NLR), red blood cell distribution width (RDW), platelet/lymphocyte (PLR), platelet mean volume (MPV), platelet hematocrit (PCT) and platelet distribution width (PDW) by resistance method. TA activity was determined according to the national institutes of health (NIH) score and India TA clinical activity score (ITAS2010). Spearman correlation analysis was used to evaluate the relationship between whole blood cell count indicators and ESR and hs-CRP. ROC curve was used to determine the threshold of TA disease activity.Results:The NLR, RDW and PDW in the TA group were higher than those in the control group [3.00 (1.78-3.48) vs. 1.76 (1.34-2.01), 14.10 (13.00-14.83) vs. 13.08 (12.50-13.35) and 13.65 (11.20-16.00) vs. 12.24 (11.20-13.20), P<0.000 1]. MPV and PCT in the TA group were lower than those in the control group [10.06±1.11 vs. 10.44±0.83 and 0.25 (0.20-0.28) vs. 0.27 (0.23-0.31), P = 0.011 and 0.014, respectively]. RDW and PCT in the active group of TA patients were both higher than those in the inactive group [14.61 (13.38-15.48) vs. 13.81 (12.88-14.33) and 0.27±0.07 vs. 0.23±0.06], with P values of 0.007 and 0.008, respectively. PCT in the active group of TA patients was positively correlated with ESR ( r=0.33, P=0.002). The optimal RDW threshold for determining the activity of TA disease was 14.150 (sensitivity was 55.0%, specificity was 100.0%, area under ROC curve was 0.802). The optimal threshold for judging the activity of TA disease by PCT was 0.245 (sensitivity was 66.7%, specificity was 92.3%, area under ROC curve was 0.84). The optimal threshold for PLR to determine the activity of TA disease was 131.257 (sensitivity was 71.7%, specificity was 76.9%, area under ROC curve was 0.714). Conclusion:RDW and PCT may be helpful to judge the activity of TA, however, the other indexes of whole blood cell count were not closely related to the activity of TA.