Objective To explore the adverse effect of arsenic trioxide (As2O3) on liver,kidney and heart function during treating children patients with acute promyelocytic leukemia (APL) at therapeutic dose.Methods Sixty-five APL cases received As2O3 by intravenous drip and organic toxicity were selected as our subjects.The indices of liver,heart and kidney were measured.Results Of all subjects,19 cases(29.2％) occurred liver damage,including 15 cases(23.1％) mild and 4 cases(6.2％) moderate toxicity.The levels of alanine aminotransferase of patients before treatment was (19.9 ±9.5) U/L,and (24.3 ± 11.8) U/L,(25.0 ± 14.4) U/L at 1 st and 2nd weeks after treatment,higher than those before the treatment (P ＜ 0.05).However,level of alanine aminotransferase was back to normal at 3th weeks after treatment.Meanwhile the levels of aspartate aminotransferase at 1st,2nd and 3th weeks after treatment were (38.3 ± 16.5),(39.1 ± 15.5),(35.3 ± 20.6) U/L respectively,higher than that before treatment((28.5 ± 8.8) U/L,P ＜ 0.05 or 0.01),and it was back to normal at 4th weeks.(2) The levels of urinary cystatin C were (2.51 ± 1.45) mg/L,(3.05 ± 1.13) mg/L,(2.46 ± 1.21) mg/L at 2nd,3th,4th weeks after treatment,significantly higher than that before treatment ((1.98 ±0.68) mg/L,P ＜0.05 or 0.01).And the levels of urinary β2 microglobulin at 2nd,3th,4th weeks after treatment were significantly higher than that before treatment (P ＜0.05 or 0.01) and back to normal at 5 weeks after treatment.(3) Nine cases at remission stage showed the symptoms of palpitation,precordial discomfort and increased heart rate,and all those symptoms were mild.And the symptoms disappear at the 3th week after the treatment.Creatine kinase at the 2nd weeks after treatment was (90.2 ± 32.5) U/L,higher than that before treatment ((78.5 ± 22.3) U/L).The levels of creatine kinase isoenzyme at 2nd,3th weeks after treatment were (8.3 ± 4.8) U/L,(8.5 ± 5.6) U/L,higher than that before treatment ((6.3 ± 3.5) U/L).The serum creatine kinase mass at 4th weeks((3.9 ±2.0) g/L) was significantly higher than that before treatment ((2.8 ± 1.9) g/L),and then gradually be back to normal.Conclusion The routine dose As2O3 in treatment of APL children show less toxicity in liver,kidney,and heart Those adverse effects are transient,reversible and they occurred at 1-3 week after As2O3 treatment.Serum alanine aminotransferase,aspartate aminotransferase and urinary cystine protease inhibitors,β2 micro ring protein and serum creatine kinase MB mass might be served as sensitive indicators of organ damage.

Animals ; Anti-Ulcer Agents ; therapeutic use ; Antineoplastic Agents, Phytogenic ; therapeutic use ; Gastrointestinal Diseases ; drug therapy ; Humans ; Liver Diseases ; drug therapy ; Plants, Medicinal ; chemistry ; Polysaccharides ; isolation & purification ; therapeutic use ; Stomach Neoplasms ; drug therapy ; Stomach Ulcer ; drug therapy

In order to successfully develop the effective population pharmacokinetic model to predict the concentration of propofol administrated intravenously, the data including the concentrations across both distribution and elimination phases from five hospitals were analyzed using nonlinear mixed effect model (NONMEM). Three-compartment pharmacokinetic model was applied while the exponential model was used to describe the inter-individual variability and constant coefficient model to the intra-individual variability, accordingly. Covariate effect including the body weight on the parameter CL, V1, Q2, V2, Q3 and V3 were investigated. The performance of final model was assessed by Bootstrapping, goodness-of-fit and visual predictive checking (VPC). The context-sensitive half-times and the infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were simulated to six subpopulations. The results were as follows: the typical value of CL, V1, Q2, V2, Q3 and V3 were 0.965 x (1 + 0.401 x VESS) x (BW/59)(0.578) L x min(-1), 13.4 x (AGE/45)(-0.317) L, 0.659 x (1 + GENDER x 0.385) L x min(-1), 28.8 L, 0.575 x (1 + GENDER x 0.367) x (1 - 0.369 x VESS) L x min(-1) and 196 L respectively. Coefficients of the inter-individual variability of CL, V1, Q2, V2, Q3 and V3 were 29.2%, 46.9%, 35.2%, 40.4%, 67.0% and 49.9% respectively, and the coefficients of residual variability were 24.7%, 16.1% and 22.5%, the final model indicated a positive influence of a body weight on CL, and also that a negative correlation of age with V1. Q2 and Q3 in males were higher than those in females at 38.5% and 36.7%. The CL and Q3 were 40.1% increased and 36.9% decreased in arterial samples compared to those in venous samples. The determination coefficient of observations (DV)-individual predicted value (IPRED) by the final model was 0.91 which could predict the propofol concentration fairly well. The stability and the predictive performance were accepted by Bootstrapping, the goodness-of-fit and VPC. The context-sensitive half-times and infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were different obviously among the 6 sub-populations obviously. The three-compartment model with first-order elimination could describe the pharmacokinetics of propofol fairly well. The involved fixed effects are age, body weight, gender and sampling site. The simulations in 6 subpopulations were available in clinical anesthesia. The propofol anesthesia monitor care could be improved by individualization of pharmacokinetic parameter estimated from the final model.

Objective Our purpose was to evaluate the association between hemoglobin concentration (Hb) and cognitive ability of children at 4-6 years of age in 21 counties/cities in China.Methods A total number of 7331 children born during 1993-1996 were randomly selected from 21 counties or cities in Hebei,Jiangsu and Zbejiang provinces,Hb concentration of children were measured followed by three tests including full-scale,verbal and performance intelligence quotient (IQ) test performed by Chinese-Wechsler Intelligence Scale for Children,one year later.Results There were a 0.7 point difference in mean verbal scale IQ(P=0.144) and a 0.9 point difference in both mean performance and full-scale IQ (P=0.055 and 0.079,respectively) between anemia and non-anemia groups.Compared with children with non-anemia,children with anemia were 1.3-fold more likely to score poorly in verbal IQ and operational IQ (95%CI:1.1-1.6,1.1-1.5,respectively) and 1 A-fold more likely to have had poor scores in full-scale IQ(95%CI:1.2-1.6) after controlled for children's gender,age at intelligence test,region,parity and mother's IQ,education level,occupation.Participants were divided into 5 sub-groups according to Hb concentration of every 20 percentile.Verbal IQ scores of the lowest(Hb＜110 g/L),moderate (117 g/L≤Hb＜122 g/L) and the highest Hb concentration groups (Hb≥130 g/L) were 90.6±18.1,94.0±17.6 and 91.0±16.4,respectively.Performance IQ scores were 102.2±15.7,104.6±14.8 and 100.5±14.9,respectively.Full-scale IQ scores were 95.94±17.3,99.0±16.4 and 95.2±15.6,respectively.Children with both low and high hemoglobin levels did poorly in all intelligence tests than children with moderate Hb concentration (P＜0.001).After controlling for confounding factors,children with the lowest concentration were 1.4-fold more likely to have had poor verbal and performance scores than children with moderate Hb concentration (95% CI:1.1-1.7,1.1-1.8,respectively) and 1.5-fold (95% CI:1.2-1.8) more likely to have had poor full-scale scores than those with moderate Hb concentration.The association between high Hb concentration and low IQ scores disappeared in the multivariate model.Conclusion Low Hb concentration might have adversely affected children' s cognitive development.

Objective The purpose of this study was to evaluate the effect of hemoglobin (Hb) level during early gestation on the cognitive development of children at 4-6 years of age.Methods A total number of 3609 children were randomly selected from all the live birth infants whose mothers participated in a community intervention trial during 1993-1996 in 13 counties or cities in Jiangsu and Zhejiang provinces. Hb concentration during early gestation was measured at first prenatal examination and intelligence quotients (IQ), including full-scale, verbal and performance were assessed using Chinese-Wechsler Intelligence Scale for Children in 2000-2001 when these children had a mean age of 68 months. Results Compared with children whose mothers were non-anemic during early gestation, children whose mothers were anemic had a 0.6 point higher mean verbal scale IQ, a 0.9 point higher mean performance IQ and a 0.8 point higher mean full-scale IQ.These differences were not statistically significant when children' s gender, age at intelligence test,region, parity and mother' s IQ, education level and occupation were adjusted for. When mother-child pairs were divided into 5 sub-groups of every 20 percentiles according to Hb concentration during early gestation, verbal IQ scores of the lowest(Hb＜ 103 g/L), the moderate(110 g/L≤ Hb＜ 116 g/L)and the highest Hb concentration group (Hb≥124 g/L) were 91.6 ± 18.9, 92.8 ± 18.2 and 90.3 ±18.6, respectively. The performance IQ scores were 104.7 ± 15.2, 1 04.5 ± 14.3 and 103.5 ±15.1, and full-scale IQ scores were 97.8 ± 17.3,98.4 ± 16.3 and 96.4 ± 17.4, respectively. After controlling for confounding factors, children whose mothers had highest Hb concentration were 54% (OR= 1.54,95%CI:1.13-2.11)more likely to have poor verbal scores and 53% (OR= 1.53,95%CI: 1.10-2.12)more likely to have poor full-scale scores than children whose mothers had moderate -Hb concentration. No statistical associations were noticed between high -Hb concentration and performance scores, or between low Hb concentration during early gestation and verbal, performance as well as full-scale score of pre-school children. Conclusion High maternal Hb concentration during early gestation might adversely affect children' s cognitive development.

In order to successfully develop the effective population pharmacokinetic model to predict the concentration of propofol administrated intravenously, the data including the concentrations across both distribution and elimination phases from five hospitals were analyzed using nonlinear mixed effect model (NONMEM). Three-compartment pharmacokinetic model was applied while the exponential model was used to describe the inter-individual variability and constant coefficient model to the intra-individual variability, accordingly. Covariate effect including the body weight on the parameter CL, V1, Q2, V2, Q3 and V3 were investigated. The performance of final model was assessed by Bootstrapping, goodness-of-fit and visual predictive checking (VPC). The context-sensitive half-times and the infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were simulated to six subpopulations. The results were as follows: the typical value of CL, V1, Q2, V2, Q3 and V3 were 0.965 x (1 + 0.401 x VESS) x (BW/59)(0.578) L x min(-1), 13.4 x (AGE/45)(-0.317) L, 0.659 x (1 + GENDER x 0.385) L x min(-1), 28.8 L, 0.575 x (1 + GENDER x 0.367) x (1 - 0.369 x VESS) L x min(-1) and 196 L respectively. Coefficients of the inter-individual variability of CL, V1, Q2, V2, Q3 and V3 were 29.2%, 46.9%, 35.2%, 40.4%, 67.0% and 49.9% respectively, and the coefficients of residual variability were 24.7%, 16.1% and 22.5%, the final model indicated a positive influence of a body weight on CL, and also that a negative correlation of age with V1. Q2 and Q3 in males were higher than those in females at 38.5% and 36.7%. The CL and Q3 were 40.1% increased and 36.9% decreased in arterial samples compared to those in venous samples. The determination coefficient of observations (DV)-individual predicted value (IPRED) by the final model was 0.91 which could predict the propofol concentration fairly well. The stability and the predictive performance were accepted by Bootstrapping, the goodness-of-fit and VPC. The context-sensitive half-times and infusion rates necessary to maintain the concentration of 1 microg x mL(-1) were different obviously among the 6 sub-populations obviously. The three-compartment model with first-order elimination could describe the pharmacokinetics of propofol fairly well. The involved fixed effects are age, body weight, gender and sampling site. The simulations in 6 subpopulations were available in clinical anesthesia. The propofol anesthesia monitor care could be improved by individualization of pharmacokinetic parameter estimated from the final model.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Anesthetics, Intravenous ; pharmacokinetics ; Body Weight ; Female ; Humans ; Male ; Middle Aged ; Models, Biological ; Nonlinear Dynamics ; Propofol ; pharmacokinetics ; Sex Factors ; Young Adult

OBJECTIVETo reassess the natural history of polycythemia vera (PV) in Chinese and evaluate the relationship between the incidence of thrombosis, post-polycythaemic myelofibrosis with myeloid metaplasia( PPMM) , leukemia transformation and the therapeutic outcome and prognostic factors.

METHODSThe clinical manifestations, laboratory parameters and treatment were retrospectively analyzed in 287 patients with PV. Univariate analysis of prognostic factors was performed using Log-rank model and multivariate analysis using COX model in term of the incidence of thrombosis, PPMM, hematologic or non hematologic cancers and mortality.

RESULTSOf the 287 patients, the median follow-up time was 46 (8-360) months. 208 thromboses were recorded in 115 patients. Twice or more thrombotic events occurred on 59 patients (51.34%). Most of these episodes occurred either at presentation or in the 2 years before diagnosis. Elder patients, prior thrombosis, poor response to therapy were associated with poor prognosis. With these three adverse prognostic factors, the patients could be separated into different risk groups. The incidence of thrombosis was higher in high risk group. 36 patients progressed to PPMM, the median time to PPMM was 80 (7-190) months. Higher WBC count, splenomegaly and treatment with alkylating agent and hydroxy-carbamide (HU) were associated with poor prognosis. 2 cases progressed to AML. 1 to lymphoma and 1 to nonhematologic cancer. 13 patients died, the cause of death was fatal thrombosis in 9 and AML in 2.

CONCLUSIONThe incidence of thromboembolism is higher and the time to myelofibrosis was shorter in Chinese PV patients than in western PV patients. The main factors that influence the survival of PV patients are thromboembolism and leukemia transformation.

Acute Disease ; Female ; Follow-Up Studies ; Humans ; Leukemia ; etiology ; Male ; Polycythemia Vera ; complications ; Primary Myelofibrosis ; etiology ; Prognosis ; Risk Factors ; Thromboembolism ; etiology

OBJECTIVEIn this randomized prospective single-center study, we compared the efficacy of adjunctive thrombectomy using Diver CE device (Linvatec, Italy) versus Guardwire Plus device (Medtronic, USA) before percutaneous coronary intervention (PCI) in patients with <12 h acute inferior myocardial infarction (AIMI) and Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 to 1. The primary end point was the magnitude of ST-segment resolution after PCI.

METHODSA total of 122 patients (61 in Diver CE group and 61 in Guardwire Plus group) were studied. The magnitude of ST-segment resolution, myocardial blush grade and slow flow or no re-flow 1 h after PCI were measured in study patients.

RESULTSBaseline characteristics were similar between groups: age (59.6 +/- 14 years vs. 60.1 +/- 13 years), males (82% vs. 84%), diabetes (31% vs. 28%), previous coronary artery disease (25% vs. 23%), onset-to-angiogram (350 +/- 185 min vs. 345 +/- 180 min), and glycoprotein IIb/IIIa inhibitor use (11% vs. 13%, all P > 0.05). The magnitude of ST-segment resolution was also similar in these two groups: ST-segment resolution > 70% (57% vs. 59%, P > 0.05). Slow flow/no reflow rate (8% vs. 7%), TIMI flow grade 3 (95% vs. 97%) and myocardial blush grade 3 (70% vs. 72%) post PCI were not different in the groups (all P > 0.05). Left ventricle ejection fraction (0.54 +/- 0.12 vs. 0.53 +/- 0.11), death (3% vs. 3%), re-myocardial infarction (2% vs. 0) and target vessel revascularization (2% vs. 2%) at one month post PCI were comparable (all P > 0.05).

CONCLUSIONEfficacy of removing thrombus burden with Diver CE device or Guardwire Plus device was similar in patients with < 12 h acute inferior myocardial infarction.

Aged ; Angioplasty, Balloon, Coronary ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Prospective Studies ; Stents ; Thrombectomy ; instrumentation

OBJECTIVETo investigate the feasibility, technique and significance of preserving the posterior branch of the great auricular nerve in parotid surgery.

METHODS48 cases with parotid tumor who underwent regular parotid surgery with cosmetic incision were included. The sensory testing was carried out in upper auricle, lobule, infra-auricular, pre-auricular and post-auricular region preoperatively and at 10 days, 1 month, 6 months and 12 months after operation.

RESULTSThe posterior branch of the great auricular nerve was preserved in 35 out of 48 patients. There was no sensory loss in the upper auricle and post-auricular region. Early after operation, sensory disturbance was found in lobule, infra-auricular region, but significantly in pre-auricular region. The sensory disturbance was recovered slowly to nearly normal level at six months after operation. 13 cases with sacrifice of the nerve had a significantly higher sensory disturbance and a longer recovery time.

CONCLUSIONSPreservation of the posterior branch of the great auricular nerve during parotid surgery is technically feasible and can reduce the postoperative sensory disturbance and possible permanent sensory loss. It further helps to improve the quality of life early after operation.

Adolescent ; Adult ; Aged ; Ear, External ; innervation ; Female ; Humans ; Male ; Middle Aged ; Parotid Gland ; innervation ; surgery ; Parotid Neoplasms ; surgery ; Postoperative Complications ; prevention & control ; Young Adult

This study was aimed to develop a sandwich ELISA kit for the diagnosis of bovine tuberculosis.And it was applied and evaluated in the quarantine of bovine tuberculosis.We established a bovine IFN-γ release method in vitro and developing three batches of kits.The sensitivity,repeatability and retention period of the kit were all evaluated.Totally 961 serum samples were tested using the developed sandwich ELISA kit tuberculin skin test and a commercial ELISA kit.Our results showed that the detection limit of this ELISA was 8.21 mg/mL.The repeatability tests showed good reproducibility in the intraassay and inter-assay.At the same time,the retention period of the kit was more than 12 months.Compared with the tuberculin skin test,the positive coincidence rate was 70.59％ and the negative coincidence rate was 99.20％,while the total coincidence rate was 98.44％.And compared with the BOVIGAMTM kit,the positive coincidence rate was 91.30％ and the negative coincidence rate was 99.78％,while the total coincidence rate reached 99.58％.At the same time,the sensitivity and specificity of the sandwich kit were 85.00％ and 100％,respectively.We established a bovine IFN-γ release method in vitro and developing corresponding kits successfully have a good application prospect.