Objective To analyze the causes and outcome of conversion from tacrolimus (FK506) to cyclosporine-A (CsA) in recipients after liver transplantation.Methods 317 consecutive liver transplantation recipients in our department received anti-CD25 monoclonal antibody,FK506, mycophenolate mofetil and corticoid for prophylaxis of cellular rejection.The blood FK506 trough level was (10-15)?g/L within the first 30 days,(8-12)?g/L within next 60 days,and (5-8)?g/L was kept during 90 to 180 days after transplantation.All recipients reveived a follow-up of 6 months. Remits Sixteen out of 317 recipients (5.05%) required conversion from FK506 to CsA.The clinical indications for conversion included:neurological adverse effect of FK506 in 5 cases (31.25%),hema- tological adverse effect in 2 cases (12.5%),gastrointestinal effect in one case (6.25%),not capable of reaching therapeutic window concentration in 3 cases (18.75%),refractory hyperglycemia in 2 ca- ses (12.5%),and economic factor in 3 cases (18.75%).The majority of recipients demonstrated clinical improvement after the switch,except 2 of 16 patients (12.5%) had to be reconverted to FK506 due to renal disadvantage.No dead recipient and adverse effect correlated to immunosuppres- sive agent conversion were seen.Conclusion If necessary,conversion from FK506 to CsA in patients undergoing liver transplantation is safe and effective.

AIM: To evaluate the effect of flavored Siwu granules in the clinical adjuvant treatment for phlegm and blood stasis mutual junction retinal vein occlusion.
METHODS: Sixty patients (60 eyes) were randomly divided into treatment group and control group, both with retinal laser photocoagulation and intravitreal injection of triamcinolone acetonide, but the treatment group used flavored siwu granules. Vision, fundus change, fundus fluorescein angiography, clinical syndrome of traditional Chinese medicine ( TCM ), hemorheology examination and safety assessment were evaluated before and 8wk after treatment.
RESULTS: At 8wk after treatment, there were differences on vision improvement, retinal circulation time, whole blood low shear viscosity and total efficient rate of clinical syndrome of TCM, compared with control group(P<0. 05).
CONCLUSION: Flavored siwu granules adjuvant for phlegm and blood stasis mutual junction retinal vein occlusion can improve visual acuity and reduce the eye complications.

OBJECTIVETo observe the therapeutic effects of Berberine Capsule (BC) on patients with mild hyperlipidemia.

METHODSTotally 102 mild hyperlipemia patients were recruited. All patients were suggested to have proper diet and physical activity as basic therapy for 1 month of run-in period. Totally 97 patients completed it. Then they were randomly assigned to the berberine group (the treatment group, 49 cases) and the placebo group (the control group, 48 cases). Patients in the treatment group took BC 300 mg, while those in the control group took placebo 300 mg, thrice per day for 3 successive months. Then placebos and BC were interrupted for 2 months (as washout period). All subjects received only diet control and physical activity during washout period. After washout period, placebos and BC were re-administered to all patients in the same way for 3 months. Body mass index (BMI), fasting plasma glucose (FPG), TG, TC, LDL-C, and HDL-C were assessed after run-in period, washout period, at month 1, 2, 3 after the first therapy, at month 1, 2, 3 after second treatment, respectively.

RESULTSCompared with the end of run-in period, TG, TC, and LDL-C decreased, and HDL-C increased in the treatment group (P < 0.05) after first 3 months of treatment. Compared with 3 months after the first therapy, TG, TC, and LDL-C increased and HDL-C decreased in the treatment group after washout period (P < 0.05). Compared with the end of wash- out period, TC and LDL-C decreased in the treatment group at month 2 after second treatment (P < 0.05); TG, TC, and LDL-C decreased (P < 0.01, P < 0.05), and HDL-C increased (P < 0.05) at month 3 after second treatment. Compared with the control group at month 3 after second treatment, TG, TC, and LDL-C all decreased, and HDL-C increased in the treatment group (all P < 0.05).

CONCLUSIONBC was effective in improving blood lipid level in mild hyperlipidemia patients.

Berberine ; therapeutic use ; Blood Glucose ; analysis ; Body Mass Index ; Capsules ; Humans ; Hyperlipidemias ; drug therapy ; Lipids ; blood

Objective To compare the consistency between interstitial fluid glucose and arterial blood glucose in septic shock patients with different tissue perfusion levels.Methods A prospective investigative study was conducted. Sixty-one septic shock patients with ages above 18 years old admitted to the Department of Critical Care Medicine of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from April 2013 to December 2013 were enrolled. The real-time continuous glucose monitoring system (RTCGMS) and arterial blood gas analyzer were used to measure the patients' interstitial fluid glucose and arterial blood glucose, and according to the criteria of International Organization for Standardization (ISO) and the median of relative absolute difference (Median RAD), the consistency between interstitial fluid glucose and arterial blood glucose was calculated. Based on the lactate (Lac) level and pulse oxygen perfusion index (PI), the septic shock patients were divided into groups with different degrees of tissue perfusion, the consistency between the interstitial fluid glucose and arterial blood glucose among septic shock patients with different degrees of tissue perfusion was compared by using Bootstrap re-sampling technique.Results Negative correlation existed between PI and Lac (r= -0.272,P < 0.001), which showed the opposite change tendency of organism tissue perfusion. In patients with Lac > 8 mmol/L, their consistency between interstitial fluid glucose and arterial blood glucose was better than that in those with Lac > 2-4 mmol/L, and the 95% credibility intervals (CI) of ISO standardized deviation value was 0.026-38.710 (P < 0.05). In patients with PI ≤ 0.7%, their consistency between interstitial fluid glucose and arterial blood glucose was better than that in those with PI > 0.7%-1.4%, the 95%CI of median RAD difference value was 0.002-0.076, and the 95%CI of ISO standardized deviation value was -27.000 to -0.583 (allP < 0.05); in patients with PI > 3.0%, their consistency between interstitial fluid glucose and arterial glucose was better than that in those with PI ≤ 0.7%, PI > 0.7%-1.4% and PI > 1.4%-3.0%, and the 95%CI of ISO standardized deviation values were 3.322-28.302, 11.988-40.265 and 5.170-33.333 respectively (allP < 0.05).Conclusions When septic shock patients were under low tissue perfusion (Lac > 8 mmol/L or PI ≤ 0.7%), the worse the tissue perfusion, the better the consistency between interstitial fluid glucose and arterial blood glucose; when septic shock patients were under normal local tissue perfusion (PI > 3.0%), the better the local tissue perfusion, the better the consistency between interstitial fluid glucose and arterial blood glucose.

Objective To analyze the ultrasonic features of thyroid microcarcinoma (TMC) and the causes of misdiagnosis. Methods The ultrasonic features including shape, margin, echogenecity, microcalcification, vascularity and lymphadenopathy were analyzed retrospectively in 26 pathologically-proven TMC patients. Results In 26 cases, 11 cases were diagnosed correctly before operation (11/26, 42.31%), 12 cases were misdiagnosed (12/26, 46.15%) as adenoma or benign nodule, and 3 cases were missed diagnosed (3/26, 11.54%). Among the 23 cases detected on ultrasound, 21 cases were solid and hypoechoic (21/23, 91.30%);19 cases were ill-defined (19/23, 82.61%);12 cases were taller than wide in shape (12/23, 52.17%); 14 cases had microcalcification (14/23, 60.87%); 7 cases showed central or peripheral blood flow signals (7/23,30.43%) with arterial resistance index>0.70 in 3 lesions and<0.70 in 4 lesions. Conclusions Several ultrasonographic features are helpful in identiifcation of TMC, including hypo/iso-echogenecity, ill-deifned margin, taller-than-wide shape, microcalciifcation, arterial signals with high resistance index, and abnormal lymphadenopathy. Moreover, for cases with multiple lesions, to the potential co-existence of benign and malignant lesions should be considered.

To study the growth effects of differing concentrations of artemisinin on green algae and to evaluate the ecological risk. The effects of artemisinin on the growth and the content change of chlorophyll, protein, oxygen, conductivity, SOD, CAT, MDA in Chlorella pyrenoidosa and Scenedesmus oblique were studied through 96 h toxicity tests. Artemisinin accelerated the growth of algae at a lower concentration ( <40 microg . L-1) with content increase of chlorophyll or protein and so on, and it inhibited the growth of algae at higher concentration ( >80 microg . L-1). The content of chlorophyll or protein in algae cells reduced with the increasing concentration of artemisinin, exhibiting the good concentration-effect relationship. SOD and CAT activity was stimulated at low concentrations ( <40 microg . L-1 ) and inhibited at high concentrations ( >80 microg . L- 1). However, MDA content increased significantly with the increase of concentration. According to the seven kinds of indicators changes, the time-response and dose-response suggested that the surfactant first hurt in Ch. pyrenoidosa was damaging membrane by changing membrane lipid molecules soluble. And primary mechanism on Chlorophyta cells might be related to the oxidation damage of lipid and other biological large molecules caused by artemisinin. The large-scale intensive planting of Artemisia annua may reduce the surrounding water productivity.
Artemisinins ; pharmacology ; Chlorophyll ; metabolism ; Chlorophyta ; drug effects ; metabolism

OBJECTIVETo study the effects of different fertilization, measure of breeding seedling, breeding and sowing density on seedlings of Psoralea corylifolia.

METHODThe combination of field sowing and indoor test was applied.

RESULTAll agricultural measures showed positive effect on the growth and development of seedling of P. corylifolia.

CONCLUSIONThe suitable sewing time should be the first and second ten days in March. The suitable sowing density is 150 kg x hm(-2). The combined of application of organic manure and chemical fertilizer is better than using one of them alone.

Agriculture ; methods ; standards ; Animals ; Breeding ; Fertilizers ; Manure ; Plants, Medicinal ; anatomy & histology ; growth & development ; Psoralea ; anatomy & histology ; growth & development ; Quality Control ; Seasons ; Seedlings ; anatomy & histology ; growth & development

OBJECTIVETo explore the therapeutic efficacy of a combined treatment modality using transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) to treat hepatocellular carcinoma (HCC) complicated with main branch intraportal vein tumor thrombosis (PVTT).

METHODSClinical data was collected retrospectively for patients diagnosed with and treated for HCC plus main branch PVTT at our hospital between January 2007 and January 2010. The total study population (n = 51) consisted of 38 males and 13 females, with an average of 50.1 years (range: 24-73). Among these patients, 26 had been treated with TACE + PEI (group A) and 25 had been treated with TACE alone (group B). Short-term changes in PVTT (i.e. disappearance, shrinkage, and/or stability) and tumor (i.e. complete response, partial response, and/or stable disease) were assessed by using the t-test (continuous variables) or the Chi-squared or Fisher's exact tests (categorical variables). Between-group differences in survival time were assessed by the Kaplan-Meier analysis and log-rank test.

RESULTSThe follow-up time ranged from 3-24 months after treatment, and no serious treatment-related complications were recorded for any of the patients (0/51). The time of TACE treatment was significantly longer for the patients receiving the combination therapy (group A: 3.21.4 vs. group B: 2.40.9, t = 2.22, P = 0.032). The patients in group A received between 2-8 PEI treatments. The TACE + PEI combined treatment showed significantly better therapeutic efficacy for PVTT (group A: 19/26 vs. group B: 10/25, X2 = 5.685, P = 0.019). The tumor response was significantly better in patients treated with TACE + PEI at post-treatment month 3 (group A: 20/26 vs. group B: 18/25, X2 = 0.163, P = 0.705) and month 6 (group A: 17/20 vs. 10/19, X2 = 2.58, P = 0.027). Finally, the average survival time was significantly better in patients treated with TACE + PEI (group A: 12.856.02 months (range: 5-23) vs. group B: 8.653.39 months (range: 4-16), t = 3.051, P = 0.004).

CONCLUSIONTACE + PEI combination therapy for main branch PVTT in HCC patients is more efficacious than TACE alone, and is associated with a longer survival time.

Adult ; Aged ; Carcinoma, Hepatocellular ; complications ; pathology ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Ethanol ; administration & dosage ; Female ; Humans ; Injections, Subcutaneous ; Liver Neoplasms ; complications ; pathology ; therapy ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Portal Vein ; pathology ; Retrospective Studies ; Thrombosis ; complications

Isolated freshly rat islets were transferred to 24-well plates and incubated with different concentrations of glucose or resveratrol for 1 or 24 h.The results showed that resveratrol dose-dependently inhibited glucose-stimulated insulin secretion from isolated rat islets after 1 h incubation,with 10%,35%,and 80% (P<0.05 or P<0.01) decrease at the concentrations of 1,I0,and 100 μmol/L.10 μmol/L resveratrol decreased the intracellular calcium concentration by 60% (P<0.05).After incubation for 24 h,resveratrol increased palmitatesuppressed insulin secretion to 75% (P<0.01) of control.These results suggest that resveratrol acutely inhibits insulin secretion from primary pancreatic islet via regulating intracellular calcium ion concentration,and in the long run resveratrol may protect β-cells from lipotoxicity.

Objective To test the expression level of CD69+CD4+CD25-T cells in peripheral blood from patients with autoimmune pancreatitis,and further analyze its clinical significance.Methods Peripheral blood samples from 32 patients with AIP diagnosed in hematological department,Changhai Hospital and 32 health individuals examined at the same time were collected from September 2014 to December 2016,they were classified as experimental and control groups,separately.Peripheral blood mononuclear cells (PBMCs) was acquired by density gradient centrifugation,CD69+ CD4 + CD25-T cells in PBMCs were tested by flow cytometry,and the expression level of cytokines in plasm was by ELISA.The comparison of varies between the two groups was measured by two independent samples' t test.The relationship between the two measurement data was measured by pearson correlation coefficient.Results The expression levels of CD69 + CD4 + CD25-T in experimental and control groups were 10.36％±3.68％ vs 3.99％±1.45％ (t=9.110,P＜0.0001).The expression level of TGF-β was 399.86±121.88 vs 143.87±56.22 pg/ml (t=10.79,P＜0.000 1),both with statistical significance.The levels of CD69+CD4+CD25-T in experimental was positively correlated with TGF-β (r=0.653,P＜0.001) and negatively with IL-4,IFN-γ,IL-2 (r=-0.442,-0.567,-0.351,P＜0.05) and there was statistical significance.Conclusion CD69+CD4 +CD25-T cells might involve the immunopathology of AIP and could be the potential biomarker for clinical diagnosis and therapy.