BACKGROUND: Recent studies have suggested that conversion from cyclosporine A (CsA) to tacrolimus (FK 506)-based regimen can improve renal allograft function and survival rate. But little is known about whether the conversion from CsA to tacrolimus(FK 506) plus mycophenolate mofetil (MMF)-based regimen exhibits the same or similar clinical efficacy. OBJECTIVE: To investigate the clinical efficacy and safety of converting CsA to FK506 plus MMF in treatment of different types of chronic allograft nephropathy (CAN). DESIGN, TIME AND SETTING: An observational and controlled trial was performed at the Center for Organ Transplantation, Zhujiang Hospital, Southern Medical University from January 2005 to October 2007. PARTICIPANTS: Fifteen-nine enrolled patients received CsA-based regimen after renal allografting. Following pathological confirm and typing, all patients were assigned to two groups: CAN with chronic rejection (CR, n = 31) and CAN without chronic rejection (non-CR, n = 28). FK 56 was purchased from Fujisawa Pharmaceutical Company, Ltd., Japan. MMF was sourced from Shanghai Roche Pharmaceutical Co., Ltd., China. METHODS: When patients were diagnosed CAN, the CsA regimen was conversed to FK506 plus MMF regimen. FK506 initiated at a dose of 0.08 mg/kg per day and then was adjusted to achieve steady-state whole blood trough levels of approximately 5-8 μg/L. MMF was used at a fixed dosage, 1.0 g/d, twice a day, only if relative adverse events occurred. All patients were followed up at least 6 months. MAIN OUTCOME MEASURES: Serum creatinine(Scr), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), 24-h proteinuria, glomerular filtration rate (GFR), and complications. RESULTS: All initial 59 patients were included in the final analysis. At 6 months after regimen conversion, the levels of Scr, TC, TG, LDL, and 24-hour proteinuria were significantly reduced in non-CR, in particular CR, groups, compared with prior to conversion (P< 0.05). GFR was markedly increased in both the CR and non-CR groups (P< 0.05). In the CR group, 20 patients obtained improved results, 7 got stable results, and 4 showed ineffective results. The effective rate of regimen conversion was 64.5% and 32.1% in the CR and non-CR groups, respectively, and significant difference existed between the two groups (P < 0.05). Compared with prior to conversion, the incidence of hypertension and hyperlipemia was significantly decreased after regimen conversion (P< 0.05). There was no significant difference in diabetes mellitus, opportunistic infection, and malignancy between prior to and after regimen conversion. CONCLUSION: FK506 plus MMF-based regimen can markedly improve the function of renal graft of CAN, in particular CR, patients.

Adult ; Benzene ; poisoning ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; statistics & numerical data ; Young Adult

Humans ; Occupational Diseases ; epidemiology ; prevention & control ; Risk Assessment

Objective To explore the most accurate T staging and optimal surgical method of lung adenocarcinoma of trans-lobe type, and to provide supportive diagnosis as well as therapeutic evidences for this disease. Methods A total of 192 postoperative patients, hospitalized in Tianjin Medical University General Hospital from January 2008 to June 2013, who were diagnosed with lung adenocarcinoma were recruited. Patients were divided into three groups according to the 7th edition of TNM staging criteria issued by the IASLC in 2009. A total of 163 patients with T2 stage were selected as Group T2, and 12 patients with T3 stage were selected as Group T3, both of which were considered as control groups. Other 17 pa?tients who were diagnosed as trans-lobe type of lung adenocarcinoma, were Group trans-lobe. The clinical data and progno?sis were compared between three groups. The trans-lobe type of lung adenocarcinoma was diagnosed based on imaging and pathological examination. Subtypes of trans-lobe lung adenocarcinoma were identified by referring to 2011 international mul?tidisciplinary classification standard of lung adenocarcinoma. Kaplan-Meier method was used to analyze the prognosis of dif?ferent subtypes and surgical modus in patients with lung adenocarcinoma of trans-lobe type. Results By comparison, the postoperative survival rate was significantly lower in patients diagnosed with trans-lobe type of lung adenocarcinoma than that of Group T2 (P<0.05), and no significant difference in survival rate compared with Group T3 (P>0.05). There were no significant differences in survival rates between different surgical modus (P<0.05). Seventeen patients with trans-lobe type of lung adenocarcinoma consisted of four subtypes, including 8 solid predominant, 5 acinar predominant, 3 papillary predomi?nant and 1 invasive mucinous adenocarcinoma. There were no statistical significances in postoperative survival time and sur?vival rates between four subtypes. Conclusion The clinical stage of trans-lobe type of lung adenocarcinoma should be clas?sified as stage T3. Both pulmonary bilobectomy and lobectomy combined with resection of proximal invaded lobe can be used as effective surgical therapies for trans-lobe type of lung adenocarcinoma.

OBJECTIVETo investigate the regulatory effect of miR-181a with abnormal expression on the expression of c-fos in cochlear hair cells undergoing oxidative damage.

METHODSHouse Ear Institute-Organ of Corti1 (HEI-CO1) cells were assigned to 50, 100, and 200 µmol/L tert-butyl hydroperoxide (t-BHP) exposure groups and control group. The HEI-CO1 cells in the exposure groups were exposed to 50, 100, or 200 µmol/L t-BHP for 12 h. Then, total RNA and total protein were extracted from the HEI-CO1 cells, and the expression of miR-181a/-181d was measured by qPCR. The miR-181a with abnormal expression was selected as the subject of study. The putative miR-181a target sequence in the 3' untranslated region (3'-UTR) of c-fos was predicted by searching on a bioinformatics website. The HEI-CO1 cells were transfected with miR-181a mimics by lipofection, and the transfection efficiency was measured by qPCR. The mRNA and protein expression of c-fos was measured by qPCR and Western blot. The pGL3-c-fos-3'UTR-WT plasmid was constructed, and the luciferase activity of the plasmid in the case of high miR-181a expression was measured using the Dual-Luciferase Reporter Assay System.

RESULTSCompared with those in the control group, the expression of miR-181a in 100 and 200 µmol/L t-BHP exposure groups was significantly decreased, with expression ratios of 0.744 and 0.766 (P < 0.01), while the expression of miR-181d in 50 µmol/L t-BHP exposure group was significantly increased, with an expression ratio of 1.29 (P < 0.01). There was no significant difference in miR-181a expression between the 100 and 200 µmol/L t-BHP exposure groups (P > 0.05). The predication results revealed that c-fos was regulated by miR-181a in humans and mice, with complete complementarity to the seed region of miR-181a, and there was high degree of target sequence conservation across species. The expression of miR-181a in the HEI-OC1 cells transfected with miR-181a mimics was elevated 892.979 times at 24 hours after transfection. As compared with those of controls, the mRNA and protein expression levels of c-fos in the transfected HEI-OC1 cells were significantly increased (P < 0.05 and P < 0.01). The luciferase activity of pGL3-c-fos-3'UTR-WT plasmid was not suppressed but increased in the case of high miR-181a expression.

CONCLUSIONmiR-181a has no direct inhibitory effect on the mRNA and protein expression of c-fos, which may not be the target gene of miR-181a. Bioinformatic prediction might produce false-positive results.

Animals ; Apoptosis ; drug effects ; genetics ; Cell Line ; Hair Cells, Auditory ; cytology ; drug effects ; metabolism ; Mice ; MicroRNAs ; genetics ; Proto-Oncogene Proteins c-fos ; genetics ; metabolism ; RNA, Messenger ; genetics ; Transfection ; tert-Butylhydroperoxide ; toxicity

Administration, Oral ; Adult ; Atrial Flutter ; drug therapy ; physiopathology ; Digoxin ; therapeutic use ; Echocardiography ; Female ; Fetal Diseases ; drug therapy ; physiopathology ; Humans ; Hydrops Fetalis ; drug therapy ; physiopathology ; Infant, Newborn ; Male ; Pregnancy

OBJECTIVE: To analyze the clinical characteristics and treatment effects of children with acute megakaryoblastic leukemia without down syndrome (non-DS-AMKL). METHODS: The clinical data of 19 children with non-DS-AMKL treated in the Pediatric Hematology Ward in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2008 to April 2018 were analyzed retrospectively. The clinical characteristics, laboratory test and treatment methods of the children were concluded. All patients were followed up to evaluate the effect of treatment. RESULTS: The 19 cases of children included nine male and ten female, the median age of onset was 2 years old. The clinical manifestations showed nonspecific. The median white blood cell of peripheral blood was 15.88×10 CONCLUSION Non-DS-AMKL was rare in children and difficult to be diagnosed. Determination of MICM classification as early as possible was helpful for diagnosis, and genetic testing played an important role for diagnosis and prognosis evaluation. Early hematopoietic stem cell transplantation in patients with CR after chemotherapy might be an effective way to cure AMKL.
Child ; Child, Preschool ; DEAD-box RNA Helicases ; DNA Helicases ; Down Syndrome ; Female ; Humans ; Leukemia, Megakaryoblastic, Acute/genetics* ; Male ; Prognosis ; Retrospective Studies ; Trisomy

Paracetamol was used as a model drug in this study to investigate the synergetic effects of lipid coating and beta-cyclodextrin (beta-CD) inclusion for masking the bitter taste of poorly soluble drugs. To control the concentration as low as possible of the free drug which produced a bitter taste, a kinetic model was established to calculate the drug distribution theoretically among the free drug in medium, lipid coated particles and molecular inclusion on the basis of the preparation and characterization of the lipid microspheres, so as to select the proper amount of beta-CD. Finally, the synergetic drug delivery systems were prepared and characterized by 1H nuclear magnetic resonance (1H NMR), molecular simulation and the electronic tongue. As a result, the drug release rate constant (k) of the lipid microspheres coated with octadecanol was determined as 0.001 270 s(-1). Then, the synergetic drug delivery systems were prepared with the ratio of 6.74 : 1 (w/w) for beta-CD and paracetamol. The chemical shift values for the fingerprint peaks of paracetamol all increased and hydrogen bonds were formed between the oxygen on the phenolic hydroxyl group, the nitrogen on the imino in paracetamol and the hydrogens on the hydroxyl groups in beta-CD. The results tested by the electronic tongue indicated that the paracetamol, lipid microspheres, beta-CD inclusion and their mixture showed different taste characteristics, with the bitterness order of the synergetic drug delivery systems approximately lipid microspheres < beta-CD inclusion < paracetamol, which confirmed the synergetic taste masking effects of lipid coating and beta-CD molecular inclusion. In summary, the synergetic taste masking was jointly achieved through the retard of the drug release by the lipid coating and the inclusion of the free paracetamol by beta-CD through hydrogen bonds.
Acetaminophen ; administration & dosage ; chemistry ; Administration, Oral ; Drug Delivery Systems ; Electrical Equipment and Supplies ; Electrochemical Techniques ; instrumentation ; methods ; Hydrogen Bonding ; Kinetics ; Lipids ; chemistry ; Microspheres ; Solubility ; Taste ; drug effects ; beta-Cyclodextrins ; chemistry

OBJECTIVETo evaluate the effectiveness of open reduction and internal fixation and repair of palmar ligment in treating trans-scaphoid perilunate dislocation.

METHODSFrom June 1995 to June 2001,14 patients with trans-scaphoid perilunate dislocation were treated with open reduction and internal fixation and repair of palmar ligment. Among them,there were 13 males and 1 female,the ranging in age from 21 to 38 years,averaged 25.4 years. All patients were posterior dislocation and all operations were performed within 2 weeks after injury.

RESULTSAll patients were followed up from 24 to 60 months with an average of 28.3 months. Thirteen scaphoid fractures were primary healed and functions of wrist joint were good. Bone disunion was found in 1 case and part functions of wrist joint were limited. No found necrosis of lunate and scaphoid. According to clinical scoring system of Cooney, 9 case got excellent results, 3 good, 1 fair and 1 poor.

CONCLUSIONOpen reduction and internal fixation and repair of palmar ligament is effective in treating trans-scaphoid perilunate dislocation,which can early provide steady fixation for scaphoid,and profit to recover blood supply of lunatum and subterminal scaphoid.

Adult ; Early Diagnosis ; Female ; Humans ; Joint Dislocations ; diagnosis ; physiopathology ; surgery ; Lunate Bone ; injuries ; physiopathology ; Male ; Recovery of Function ; Scaphoid Bone ; injuries ; physiopathology ; Treatment Outcome ; Young Adult

Objective: To investigate the antibacterial activity to Streptococcus mutans of a nisin-containing single-bond universal adhesive. Methods: Nisin was mixed into the bonding agent to produce concentrations ranging from 0.01 g/mL to 0.05 g/mL for the experiments, and adhesive without nisin was used as the control. Dentin-resin specimens were prepared for the microtensile strength test to evaluate changes in the bonding strength. The proper concentrations were selected for more tests. ① An agar diffusion test was applied with filter paper to detect the release of nisin, and adhesive without nisin was used as the negative control, 0.01 g/mL Nisin aqueous solution was used as the positive control. ② Solidification; resin adhesive specimens were prepared for the assessment of direct contact inhibition activity. ③ Confocal laser scanning microscopy was used to examine the effect of the adhesive on the biological film activity and the ability of Streptococcus mutans to produce extracellular polysaccharides. Results : Nisin did not significantly reduce the bond strength of the modified adhesive at 0.01-0.03 g/mL (P < 0.05); these concentrations were selected for the subsequent antibiosis experiment. Rings could not be observed in the agar diffusion test, except for in the group of adhesive modified with 0.01-0.03 g/mL nisin. Resin adhesive with 0.01-0.03 g/mL nisin could significantly inhibit the proliferation of Streptococcus mutans on the surface of the specimens. The confocal laser scanning microscopy results indicate that only the adhesive resin modified with nisin could reduce the bacteria in the biofilm and the production of extracellular polysaccharides. Conclusion Single-bond universal adhesive with 0.01-0.03 g/mL nisin can inhibit the growth of Streptococcus mutans and its biofilms on the bonding interface, as well as decrease the production of extracellular polysaccharides, and thus has the potential to decrease the occurrence of secondary caries.