OBJECTIVE:The preparation of microspheres was optimized by central composite design in order to improve the lung targeting of tetrandrine chitosa microspheres. METHODS:Microspheres were prepared using an emulsion-chemical crosslink technique.Effects of three independent variables i.e. weight percent of tetrandrine and christon, volume percent of water phase and organic phase and christon concentration in aqueous phase were investigated on four response variables.Response variables selected in the research were yield,drug loading, envelop efficiency, mean diameter and span of dispersity.Second-order polynomial and linear equations were fitted to the data,and the resulting equations were used to produce three dimensional response surface graphs,by which optimal experimental conditions were selected. RESULTS:Five response variables were found to be dependent on three independent variables. According to optimal experimental conditions.An optimized formulation contained weight percent of tetrandrine and christon was 61.97%, volume percent of water phase and organic phase was 13.51% and christon concentration in aqueous phase was 2.37%. CONCLUSION:The central composite design can be used to optimazation of preparation formulation,diameter of the microspheres optimized by it can meet the demands of lung-targeting.

Objective To explore the effect of kidney transplantation from donation after brain death (DBD) donors with terminal acute renal failure (ARF).Method The clinical data of kidney transplantation from DBD donors with ARF were retrospectively analyzed,and only standard criteria donors (SCD) were included.The results of kidney transplants from ARF donors were compared with those of kidney transplants from DBD donors with normal renal function (serum creatinine ＜ 133μmol/L) performed from January 2012 to March 2014.Result There were 13 donors with ARF and 27 donors with normal renal function (non-ARF donors).The ARF donors had significantly higher terminal serum creatinine than the non-ARF donors (394.9 ± 176.8 vs.75.4 ± 28.6 μmol/L,P＜0.001),but the initial serum creatinine (79.1 ± 17.2 vs.71.0 ± 22.8 μmol/L) and the best creatinine clearance rate (128.3 ± 33.0 vs.129.8 ± 46.8 ml/min) of two groups showed no significant difference (P＞0.05).Twenty-six recipients received kidney transplants from ARF donors (ARF group) and 54recipients received kidney trangplants from donors with normal renal function (non-ARF group).There was no significant difference in the incidence of delayed graft function and acute rejection between ARF and non-ARF kidneys (0 vs.1.9％,and 11.5％ vs.7.4％,respectively).The ARF group had significantly lower estimated glomerular filtration rate (eGFR) at 1st month after transplantation (54.3 ± 16.9 vs.62.5 ± 14.2 mL·min 11.73 m 2,p =0.025),but the eGFRs of two groups were similar at 6th and 12th month after transplantation.During a mean follow-up period of 11.5 months (range 3 to 28 months),actual patient and graft survival rate for both groups were 100％.Conclusion Kidneys from DBD donors with terminal ARF have excellent short-term outcomes and may represent another potential method to safely expand the donor pool.

ObjectiveTo investigate a reasonable perioperative nutrition support therapy for combined ‘en bloc’ liver/pancreas transplants (CLPT).MethodThe clinical data of 10 patients,5 with gastrointestinal malignancy and liver metastasis and the other 5 with end-stage liver cirrhosis complicated with insulin-dependent type 2 diabetes mellitus ( T2DM),who had undergone CLPT in our center from May 2004 to September 2010 were retrospectively analyzed.All these patients received preioperative nutrition support,including normal food combined with nutrient solution before surgery,and total parenteral nutrition (TPN) to parenteral nutrition (PN) +enteral nutrition ( EN ) and to EN after surgery.The intestinal absorption,nutritional status,laboratory test results,and complications were recorded.ResultsAll recipients experienced a smooth recovery from the procedure,with normal or almost normal liver,pancreas,and duodenum graft functions.Three patients suffered from intestinal fistula,and all of them received TPN therapy; two patients died of multiple organ failure and one recovered from the complication.The remaining seven patients had smooth transition from TPN to EN.Of the 5 patients with malignancies,three died of multiple organ failure and 2 died of cancer recurrence.Of the 5 patients with liver cirrhosis and T2DM,four patients survived and 1 patient died of graft-verse-host disease.ConclusionRational perioperative nutrition support is important for the successful recovery after CLPT.

Acute Disease ; Glucocorticoids ; Graft Rejection ; Heart Rate ; Humans ; Hyperglycemic Hyperosmolar Nonketotic Coma ; Liver Transplantation

Objective To investigate the real-world factors influencing the clinical outcome of Febrile neu-tropenia(FN)in oncology patients.Methods We conducted a retrospective analysis of clinical data from 130 FN patients admitted to our hospital between January 2020 and December 2022.The patients were categorized into three groups based on their clinical efficacy:cured group,effective group,and ineffective group.A comparison was made among the three groups regarding general data and laboratory examination results.Univariate and ordered multicategorical logistic regression analyses were performed to identify factors affecting the clinical efficacy of FN.Results The overall effective rate of FN in our hospital was 86.15%.Univariate analysis revealed statistically significant differences among the three patient groups regarding the duration of granulomatous defects,Physical Status Score(PS Score),procalcitonin(PCT)levels,and timing of administration(P＜0.05).Ordinal multicat-egorical logistic regression analysis demonstrated that patients with PS scores＜2,granulomatous defects lasting less than 7 days,and PCT levels below 0.5 ng/mL exhibited better clinical treatment outcomes.Conclusion In the management of FN,it is crucial to prioritize patients with high PS scores and elevated PCT levels while optimizing drug utilization to enhance clinical efficacy.Timely intervention should be implemented to address granulopathy and improve overall clinical outcomes.

OBJECTIVE To investigate the improvement effect and mechanism of calycosin （CA） on acute inflammatory injury secondary to intracerebral hemorrhage. METHODS Male C57BL/6 mice were injected with type Ⅶ collagenase into the basal ganglia to establish an intracerebral hemorrhage model， which were divided into sham-operation group（phosphate buffered saline instead of collagenase）， model group， and different CA dose groups（15，30，60，120 mg/kg）. Based on the modified neurological severity score （mNSS） to screen the intervention doses， the volume of intracerebral hemorrhage， brain water content， the expressions of ionized calcium-binding adaptor molecule 1 （Iba1） in brain tissue， Toll-like receptor 4 （TLR4） and its downstream inflammatory factors [tumor necrosis factor-α （TNF-α）， inducible nitric-oxide synthase （iNOS）， interleukin-1β （IL- 1β）] in brain tissue， and the apoptosis of cells in brain tissue were detected. Primary microglia were cultured in vitro， and the expressions of TLR4 and its downstream inflammatory factors were detected. Primary neurons and primary microglia were co- cultured in vitro， and the apoptosis of neurons was detected. RESULTS The doses of 30 mg/kg and 60 mg/kg were selected as intervention doses of CA for subsequent experiments. Compared with the sham-operation group， the mice in the model group had cerebral hemorrhage， the volume of cerebral hemorrhage and brain water content were significantly increased （P＜0.05）； the positive expression rate of Iba1 protein in brain tissue was significantly increased， and the relative expression levels of TLR4， TNF-α， IL-1β and iNOS protein in brain tissue were up-regulated significantly. The apoptosis rate also increased significantly （P＜0.05）. Compared with model group， the above indexes of the mice in the 30 and 60 mg/kg CA groups were significantly improved （P＜0.05）. CA significantlyreduced the relative expression levels of TLR4 and its downstream inflammatory factors in microglia， and reduced the apoptosis of neurons in the co-culture system of primary neurons and primary microglia （P＜0.05）. CONCLUSIONS CA can exert a protective effect on the brain， which may be related to relieving the secondary acute inflammatory injury after intracerebral hemorrhage by inhibiting TLR4-mediated inflammatory response.