Antirheumatic Agents ; administration & dosage ; therapeutic use ; Biological Products ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Evidence-Based Medicine ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Lupus Erythematosus, Systemic ; drug therapy ; pathology ; Lupus Nephritis ; drug therapy ; pathology ; Severity of Illness Index

Objective To explore the method and feasibility of preparing MTX+VCR-loaded erythrocytes using healthy adult erythrocytes. Methods We used the modified hypotonic pre-swelling and isotonic resealing technique to prepare MTX+VCR-loaded erythrocytes. The loading parameters and releasing rate were evaluated with high penformance liquid chromatograph (HPLC) and auto-cytoanalysis. We observed the osmotic fragility of MTX+VCR-loaded erythrocytes conventionally. The change in innate immune activity of co-encapsulated erythrocytes was measured by counting the rosette rate of MTX+VCR-loaded erythrocytes adhering to S180. Results The concentration of MTX showed significant influence on the co-encapsulation efficiency (P0.05). Conclusions The preparation and biological characteristics of MTX+VCR-loaded erythrocytes were not different from those of mono-loaded erythrocytes, and erythrocytes were practically capable to be used as carriers for co-encapsulation of MTX and VCR.

According to the international accepted criteria, some suggestions were provided in this paper on the clinical study of traditional Chinese medicine. Firstly, allocate the participants randomly, rather than deliberately perform that to balance the baseline characteristics in groups. Secondly, use the international standard to evaluate the clinical effectiveness, rather than just use the simple criteria as cure rate, markedly effective rate, and effective rate. Thirdly, record and manage the missing data with proper statistical methods. Fourthly, objectively report the results of study, especially avoiding selective bias. In addition, the low limit effects should be avoided when assessing the effects of TCM in treating difficult and uncertain diseases; furthermore, the ethical problems should also be considered.
Clinical Medicine ; methods ; standards ; Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; methods ; Randomized Controlled Trials as Topic ; Research Design

The purpose of this study is to investigate the effects of multiple-trough sampling design and nonlinear mixed effect modeling (NONMEM) algorithm on the estimation of population and individual pharmacokinetic parameters. Oxcarbazepine and tacrolimus were used as one-compartment and two-compartment model drugs, respectively. Seven sampling designs were investigated using various number of trough concentrations per individual ranging from 1-4. Monte Carlo simulations were performed to produce state-steady trough concentrations. One-compartment model was used to fit simulated data from oxcarbazepine and tacrolimus. The accuracy and precision of the estimated parameters were evaluated using the median prediction error (PE), the median absolute PE and boxplot. The results indicated that trough concentrations could yield reliable estimates of apparent clearance (CL/F). For oxcarbazepine, as the number of trough concentrations per subject increased, the accuracy and precision of CL/F, between-subject variability (BSV) of CL/F and residual variability (RUV) tended to be improved. For tacrolimus, however, although no improvement were observed in the accuracy of CL/F and BSV of CL/F, the PE distribution ranges were significantly narrowed and the RUV estimates were less bias and imprecise. In terms of algorithm, Monte Carlo importance sampling (IMP) and IMP assisted by mode a posteriori estimation (IMPMAP) were consistently better than other methods. Additionally, the sampling design had no significant effects on the individual parameter estimates, which were only depended on the interaction between BSV and RUV in various algorithms. Decreased in BSV and RUV levels can improve the accuracy and precision of the estimation for both population and individual pharmacokinetic parameter estimates.
Algorithms ; Bayes Theorem ; Carbamazepine ; analogs & derivatives ; pharmacokinetics ; Humans ; Immunosuppressive Agents ; pharmacokinetics ; Models, Biological ; Monte Carlo Method ; Nonlinear Dynamics ; Regression Analysis ; Tacrolimus ; pharmacokinetics

Azacitidine ; analogs & derivatives ; therapeutic use ; Clinical Trials, Phase III as Topic ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Multicenter Studies as Topic

Objective To investigate the relationship among age,menopausal status,serum 25 (OH)VD and skeletal metabolism index as PTH (Parathyroid Hormone),CA(Calcium),P (Phosphorus) and boned mineral density (BMD) of climacteric female in Xi'an.Methods 352 cases of healthy women at the age of 40～60 were collected who did routine examination in outpatient building of the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to April 2016.According to the results of skeletal density test,all subjects were divided into 3 groups as the normal group (T＞-1),the reduction group (-2.5＜T＜-1),the osteoporosis group (T＜-2.5).Electrochemiluminescent immunoassay (ECLIA) was used to detect levels of serum 25 (OH)VD,PTH,CA and P.Kruskal-Wallis test and chi-square test were used to analyze differences of age,serum 25(OH)VD,PTH,CA and P in different levels of bone mineral density groups.Results Compared with bone density normal group 2.24(2.18～2.29)mmol/L,serum CA levels of bone mineral density reduction group 2.27 (2.20 ～ 2.32)mmol/L and osteoporosis group 2.27(2.23～2.33)mmol/L were significantly higher (Z=9.669,P＜0.01).Serum P levels of bone mineral density reduction group 1.15 (1.09～ 1.23)mmol/L and osteoporosis group 1.18 (1.09～ 1.25)mmol/L were obviously higher than bone density normal group,1.11 (0.99 ～ 1.23) mmol/L (Z =13.64,P＜ 0.01).Ages of osteoporosis group 54(50～57) years and bone mineral density reduction group 51 (47～ 54) years were significantly older than Bone density normal group 47(43～50) years (Z=73.08,P＜0.01).The rate of menopause in osteoporosis group and bone mineral density reduction group were significantly higher than in bone density normal group (x2 =13.81,P＜ 0.01).There was no statistical difference in serum 25(OH)VD and PTH between groups.Conclusion This study found boned density of climacteric women is more likely correlated with age,menopause status and levels of serum CA and P.There was not enough evidence to prove that 25 (OH)VD and PTH have effect on skeletal density.Therefore,to monitor and detect the menopause status and levels of serum CA and P of climacteric female is critical for the prevention and treatment on osteoporosis of women.

Objective To discuss the diagnosis of refractory epilepsy (RE) in children, and to study the association of the single nucleotide polymorphisms (SNPs) of muhidrug-resistance gene (MDR1) C3435T with pharmaco- resistant epilepsy. Methods Four hundred children with epilepsy were retrospectively or prospectively identified from multiple sources in our hospital in Shanghai and were followed-up for the occurrence of refractory epilepsy. The clinical features of RE regarding age at onset, gender, seizure type, electroencephalogram, neuroimaging, development of central nervous system, etiology and prognosis etcetera were investigated. DNA samples were obtained from 132 patients with epilepsy (70 RE and 62 responsive epilepsy) and 62 health children by DNA extraction kit. Genotype of the C3435T polymorphism was determined by DNA sequence analysis after traditional polymerase chain reaction. The frequency of genotypes and alleles among the three groups was compared by Chi-square test. Results Eighty-three (20.8%) out of total 400 patients were RE. Among them 65 (78.3%) patients failed at least 2 drugs in six months. Forty-two (50.6%) were administered at least 3 drugs on the last follow-up. Medical treatment showed remarkable effective in 6 (7.2%) RE patients, effective in 40 RE patients (48.2%). No effectiveness was seen in another 37 (44.6%) RE patients, however 25 out of 37 presented symptomatic alleviation. Significant difference in genotype (CC, CT, Tr) frequency was neither found between RE and responsive epilepsy patients nor between RE patients and healthy controls. No association between the C3435T polymorphism in the human MDR1 gene and refractory epilepsy was found by logistic analysis. Conclusions Refractory epilepsy could be diagnosed in 6 months after being treated with anti-epilepsy drugs (AEDs) in children with average attack once per month at least and failed more than 2 AEDs. Multiple AEDs were necessary for treatment. No association between the C3435T polymorphism in the human MDR1 gene and refractory epilepsy was found by logistic analysis in this study.

For medical service provision for the Olympic Games, a special medical service mechanism for important international sport events eventually took shape, based on task analysis and medical services provided in test games for two years including 2006 and 2007 Qingdao Sailing Regatta. This mechanism features the following: First, "7-Special" sport event medical practice - Medical zones, medical teams, service flows, service signs, medical papers, and drug management, all exclusively earmarked for the event; Second, medical services up to international standard; Third, special flows for medical rescue; Fourth, Special system for information reporting. Thanks to this special mechanism, the hospital provided its medical assurance for the Olympic Games successfully, and upgraded its routine medical services as a result.

Objective To investigate the prevalence and risk factors of Toxoplasma gondii infection among key populations in Wuxi City,Jiangsu Province,so as to provide evidences for developing preventive and control interventions for T. gondii in-fection. Methods A questionnaire was designed to conduct face-to-face interviews to HIV/AIDS carriers/patients,tumor pa-tients,pregnant women and pet breeders. The blood samples were collected to test anti-Toxoplasma IgM and IgG antibodies by using ELISA method. Results Totally 404 participants were investigated,and 38 were positive in testing T. gondii antibodies (9.4%),and among these,37(97.4%)were IgG positive and 1(2.6%)was IgM positive. The multivariate logistic regression indicated that age,regularly contacting cats/dogs and being HIV positive were associated with the infection of T. gondii(OR=2.1,2.6 and 2.3,all P < 0.05). Breeding pets,being HIV positive and being tumor patients were more likely to infect T. gondii than being pregnant(OR = 1.5,8.1 and 2.8,all P < 0.05). Conclusion The high infection rate of T. gondii is observed among key populations in Wuxi City,so that the effective measurements should be taken to enhance the intervention among key popula-tions including immunocompromised people,pet breeders or people having bad dietary habits of eating raw food.

This device is composed of dissolving bucket,magnetic pump,four-passage valve,heater, stirrer,filter,speed-changing equipment,dividedfilling controller and etc.It can be used for preparing and filling various liquid medicament,such as oral or external-use solution,colloid,emulsion and suspension. The proposed device is highly automatic and efficient.Time and labour saving,simple and safe.Moreover, its performance is reliable and stable,and the working capacity is large.