Objective To understand the present situation of therapeutic drug monitoring(TDM)on cyclosporine A(CsA) application in renal transplant recipients.Methods The clinical data of the first postoperative month of 50 renal transplant cases admitted to our hospital during May 2000 to March 2005 were collected and retrospectively analyzed.Results Total 50 cases(male∶female= 3∶1) had accepted the trigeminy of CsA,prednisone and azamun.The average initial dose and average maintenance dose for the male were higher by 59.94 mg/d and 52.00 mg/d than that for the female(P

Ethmoid Bone ; injuries ; Facial Bones ; injuries ; Humans ; Nasal Bone ; injuries ; Orbital Fractures ; surgery ; Osteogenesis, Distraction ; Skull Fractures ; surgery

Objective To summarize the meticulous nursing experience of indwelling urinary catheter between the children with hypospadias during perioperative. Methods 317 cases of indwelling urethral only in the silicone Foley tube, and without other urinary diversion with hypospadias were retrospectively analyzed, summarized the fine points of nursing, including preoperative children with comprehensive risk assessment, standardized preoperative skin preparation and postoperative protective constraint, effective properly fixed catheter keep the urine drainage unobstructed, close observation of urine drainage characteristics, maintain urine collection system tightness, maintain perineal skin clean and improved extubation nursing method, and do a good job after extubation nursing. Results 266 cases were cured with a cure rate of 83.9%(266/317);the incidence of urine leakage in 42 cases, the incidence rate was 13.2%(42/317); 7 cases of urethral stenosis, the incidence rate was 2.2%(7/317); 2 cases of urethral closing, the incidence was 0.6% (2/317), none of the patients had accidental extubation. Conclusions The meticulous nursing has a better effect in hypospadias patients during the perioperative period and it can reduce the incidence of postoperative complications;shorten the time of hospitalization and alleviate the suffering of children;improve the quality of nursing service, which is worthy of clinical application.

Objective To investigate the significance of serum IP-10 levels in different types of diabetic patients. Methods Serum IP-10 level in 78 cases with type 1 diabetes,49 cases with type 2 diabetes and 33 cases of healthy controls was measured with ELISA assays. Type 1 diabetic patients were divided into classic type 1 diabetes (n=39) and latent autoimmune diabetes in adults (LADA,n=39) according to their disease process,and they were also divided into autoimmune type 1 diabetes (n=58) and idiopathic type 1 diabetes (n=20).Type 2 diabetic patients,according to carotid intima-media thickness (IMT),were divided into patients with (n=24) or without atherosclerosis (n=25). Results 1) Serum IP-10 levels were not statistically different among type 1 diabetes,type 2 diabetes and healthy controls. 2) Serum IP-10 concentrations in autoimmune type 1 diabetes with positive islet autoantibody were higher than those in healthy controls(184.96?104.48pg/ml vs 146.10?74.61pg/ml,P=0.03);while there were no difference in type 1 diabetes with variable disease durations. 3) No difference in IP-10 levels was found between type 2 patients with(173.5?69.6pg/ml) and without atherosclerosis (188.5?79.7 pg/ml). Conclusions Serum IP-10 level is augmented in autoimmune type 1 diabetes.

Objective To re evaluate the diagnosis and outcome in patients with inflammatory bowel disease (IBD) by long term follow up at Wuhan University Zhongnan Hospital in Wuhan, China. Methods One hundred patients with ulcerative colitis (UC) and 15 with Crohn's disease (CD) treated in this hospital from 1980 to 1999 were re evaluated with the uniform diagnostic criteria proposed by National Workshop of Chronic Non infectious Intestinal Diseases, 1993. All patients were followed up by questionnaire, telephone and face to face interview 1～16 years after the initial diagnosis. Results Of 115 patients with IBD, 75(65%) were available for follow up study. Of 64 cases of UC, 46 had their diagnosis confirmed, 9 diagnosed as possible UC, and 9 cases were reclassified as other diseases. Of 11 cases with CD, 7 were diagnosed correctly, 2 were possible CD, and 1 were intestinal tuberculosis. In the remaining 55 UC, 3 died and 1 due to complication of UC. Other 52 UC, 37 had relapse. In the 10 patients with CD, 1 died due to complication. In other 9 cases 7 had relapse. In 46 patients with UC and 6 patients with CD there were symptom free or symptoms improved. Conclusions At follow up 1 to 16 years after the diagnosis of IBD, the initial diagnosis of UC and CD was confirmed in 86% and 82% respectively. Relapse rates of UC and CD were 71% and 78% respectively. The prognosis of patients with UC is better with 88% symptom free and improvement, while only 67% of patients with CD were symptom free and symptoms improved.

Benzoates ; urine ; Gas Chromatography-Mass Spectrometry ; methods ; Humans

Objective To investigate the role of erythrocyte complement receptor type 1 (CR1) in the pathogenesis of chronic urticaria.Methods Venous blood samples were collected from 59 patients with chronic urticaria (including 14 cases of dermatographism and 45 chronic idiopathic urticaria) and 29 healthy human controls.Flow cytometry was carried out to quantify the expression level of CR1,and double-antibody sandwich enzyme-linked immunosorbent assay to determine the serum level of immunoglobulin E (IgE),complement C3,C4 and 50％ complement hemolytic activity (CH50).Differences in these parameters were analyzed by one-way ANOVA and independent samples t-test,and correlation between these paramenters by Pearson correlation analysis.Results The expression level (expressed as mean fluorescence intensity per 10 000 erythrocytes) of CR1 was significantly higher in patients with dermatographism and chronic idiopathic urticaria than in the healthy controls (35.06 ± 2.06 and 29.17 ± 1.53 vs.20.46 ± 2.57,t =4.20 and 3.33,both P ＜ 0.05),while no statistical difference was observed between the patients with dermatographism and chronic idiopathic urticaria (P ＞ 0.05).Increased total serum IgE levels were observed in patients with dermatographism and chronic idiopathic urticaria compared with the healthy controls ((769.89 ± 123.0) μg/L and (340.09 ± 29.74) μg/L vs.(107.63 ± 88.79) μg/L,t =5.58,5.85,both P ＜ 0.05),and in patients with dermatographism compared with those with chronic idiopathic urticaria (t =3.49,P ＜ 0.05).For patients with chronic urticaria,there was a statistical difference in the expression level of CR1 between individuals (n=22) with total serum IgE levels ranging from 0 to 240 μg/L and those (n =17) higher than 500 μg/L (24.45 ± 10.83 vs.33.09 ± 11.86,t =3.33,P＜ 0.05).The total serum IgE levels were positively correlated with the level of CR1 (r =0.27,P ＜ 0.05),but uncorrelated with that of complement C3 (r =0.16,P ＞ 0.05) or C4 (r =-0.08,P＞ 0.05).The level of complement C3 was positively correlated with that of C4 (r =0.54,P ＜ 0.01).One-way ANOVA revealed no significant difference in the serum levels of complement C3,C4,or CH50 between the patients with dermatographism,patients with chronic idiopathic urticaria and healthy controls (all P ＞ 0.05).Conclusion CR1 is abnormally expressed in patients with chronic urticaria.

Objective To study the effect of overexpression of tumor necrosis factor-α (TNFα) in failing heart on contractile function of mouse diaphragm. Methods Diaphragms excised from transgenic mice with cardiac specific overexpression of TNF-α and from wild-type littermate controls were studied in vitro with direct electrical stimulation. Cytosolic oxidant levels were measured with 2',7'-dichlorofluorescin diacetate (DCFH-DA). Emissions of the oxidized product were detected by fluorescence microscopy. Results The diaphragm contractile force in transgenic animals with heart failure was 47% less than in controls [(13. 2±0. 8) N/cm2 vs. (25.1±0. 6) N/cm2 , P＜O. 01]. The weakness was associated with greater intracellular oxidant levels (P＜0. 05) and was partially reversed by 30-minute incubation with the antioxidant N-acetylcysteine (NAC) 10 mmol/L ( P ＜ 0. 01 ).Exogenous TNF-a 500 mmol/L increased oxidant production in diaphragm of wild-type mice and caused weakness that was inhibited by NAC. Conclusions Overexpression of TNF in failing heart causes oxidative stress which leads contractile dysfunction in mouse diaphragm.

Objective To investigate the relationship between urine IgG of the first hospitalized children suffered allergic purpura and recurrence within one year. Methods Used immunoturbidimetry to determine acute-stage and convalescent urine IgG of 43 children suffered allergic purpura in the first hospitalized and no recurrence within one year (no recurrence group), and of 29 children suffered allergic purpura and recurrence within one year (recurrence group), and of 28 hospitalized children suffered primary nephrotic syndrome during the corresponding time period before hormonal therapy (nephrotie syndrome group), and of 30 children done medical examination in out-patient clinic (control group), then analyzed.Results There was no significant difference of the urine IgG level in acute-stage between no recurrence group [(1.391± 0.743) g/L] and recurrence group [(1.474 ±0.658) g/L](P>0.05), while they were all lower than that in recurrence group [(2.808 ± 0.683) g/L] (P < 0.01). The level of convalescent urine IgG in nephrotic syndrome group [(0.202 ± 0.154) g/L] was obviously higher than that in no recurrence group [(0.115 ±0.103) g/L] and control group [(0.109 ±0.098) g/L](P<0.05). Conclusion Urine IgG is a significant index to judge the activity and recurrence and prognosis of pedo-allergie purpura.

The Medical Healthcare Service Center,located at the Youxian District,Mianyang City of Sichuan Province,successfully rescued the people affected by the Wenchuan earthquake and the Tangjiashan barrier lake with great help from the senior hospitals.We suggest that the community healthcare service center could play an important role in emergency response system.