Tacrolimus, an immunosuppressant used after liver transplantation, has a narrow therapeutic range and its pharmacokinetic variability complicates its daily dose assessment. Therapeutic drug monitoring after liver transplantation, which is the mainstay to clinical immue suppression adjustment, still has its short- age. The development of pharmacogenomics depends on genetic polymorphism provides more reasonable di- rections to individualized immunosuppressive therapy. At present, the researches of the therapy mainly focus on the genetic polymorphism of coding gene of P450, PgP and nuclear receptor.

Objective To explore the effect of posterior internal fixation surgery with pedicle screw/rod instrument system in the treatment of thoracic vertebrae fracture-dislocation complicated with a severe thoracic injury. Methods In the 8 cases examined, the range of injury was from T5 to T9, including 1 case of compression fracture-dislocation and 7 cases of burst fracture-dislocation according to Hanley and Eskey’ s classification. According to Frankle’ s classification, 4 were grade A, 3 were grade B, 1 was grade C. All cases were complicated with multiple fractures of bilateral ribs, pulmonary contusion and haemothorax. After the pathogenic condition being stable, reduction and internal fixation were performed with the posterior surgery pedicle screw/rod instrument system. In 5 cases, spinal canal anterolateral decompression was performed homeochronously. The intervals between accidents and operation were 3 to 9 days. Results Operations were performed safely in all patients. The reposition of the alignment and height of vertebraes was good. Postoperative CT scanning showed: in 2 cases, bone block occupied about 10% volume of vertebral canal, and 1 was 50%. The follow-up were 4～36 months, averaging 15 months. No postreduction disposition, internal fixation loosening or breakage occurred. The Frankel’ s classification of neurological function was improved by 1 grade on average. Conclusions After a positive treatment of thoracic injury, it is safe and feasible to treat the fresh thoracic vertebrae fracture-dislocation with the posterior surgery pedicle screw/rod instrument system, and the curative effects are satisfied.

OBJECTIVETo investigate the frequency of cyclin A overexpression in hepatocellular carcinoma (HCC) and its relationship with clinical significance and HBx gene integration.

METHODSPCR, RT-PCR and Western blot were used to detect the gene, mRNA and protein level of cyclin A in the tumor and nontumorous tissue. PCR and Southern blot were used to detect the integration of HBx gene in HCC.

RESULTSAmplification of cyclin A gene was found in 1 of 35 patients; overexpression of cyclin A mRNA and protein was found in 16 of 35, 21 of 35 patients, respectively. Overexpression of cyclin A protein was correlated with patient's age, tumor size and HBx integration.

CONCLUSIONOverexpression of cyclin A occurs in the early stage of HCC carcinogenesis. It may be one of the important approaches by which HBV affects the normal cell cycle of hepatocyte.

Adult ; Aged ; Carcinoma, Hepatocellular ; genetics ; metabolism ; physiopathology ; virology ; Cyclin A ; genetics ; Female ; Gene Expression ; Genes, Viral ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; genetics ; metabolism ; physiopathology ; virology ; Male ; Middle Aged ; RNA, Messenger ; Trans-Activators ; genetics ; Virus Integration

OBJECTIVETo study the cytochrome P450 2C19(CYP2C19) gene polymorphism in 4 Chinese nationality populations.

METHODSThe genotypes of the unrelated Miao, Buyi, Tu and Dulong subjects were analyzed by polymerase chain reaction and restriction fragment length polymorphism (RFLP).

RESULTSCYP2C19*2 allele frequencies were 0.291, 0.329, 0.315 and 0.349 in Miao, Buyi, Tu and Dulong population, respectively. The four populations were consistent with Hardy-Weinberg expectations (P>0.05).

CONCLUSIONThe frequencies of CYP2C19*2 were in agreement with those of other published data on Asian, but were different from those data on European and African.

African Continental Ancestry Group ; genetics ; Aryl Hydrocarbon Hydroxylases ; Asian Continental Ancestry Group ; genetics ; China ; ethnology ; Cytochrome P-450 CYP2C19 ; Cytochrome P-450 Enzyme System ; genetics ; European Continental Ancestry Group ; genetics ; Gene Frequency ; Genetics, Population ; Humans ; Mixed Function Oxygenases ; genetics ; Polymerase Chain Reaction ; methods ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

ObjectiveTo evaluate the clinical efficiency and safety of cefmetazon in the prevention Department of General Surgery,First People's Hospital,Shanghai Jiaotong University,Shanghai 200080,Chinaand or treatment of infections in general surgery. MethodsA multicenter,prospective and open-labeled trial was conducted. In the prevention group,1700 patients were enrolled in clean-infection surgery,cefmetazon was given 1 g iv half an hour before the surgery started,and 1 g iv twice daily after the surgery for 3 days.Clinical response was evaluated in terms of both cure ( disappearance of pre treatment symptoms)and pathogen. In the treatment group,897 patients were diagnosed as peritonitis, cholecystitis and cholangitis,the patients were given cefmetazon 2 g iv twice a day for 7 - 14 days,clinical response and microbiological efficacy were assessed.ResultsIn prophylactic group,1449 patients were finally included.The clinical efficacy was 100％ (1449/1449).In the treatment group,a total of 897 patients were enrolled,and 110 patients failed for assessment of clinical efficacy,787 patients were included in the PPS population,the clinical efficacy was 90.7％ (714/787); Bacterial eradication rate was 92％ (46/50).Adverse reaction rates in prevention group and treatment group were 1.3％ (22/1700) and 1.2％ (11/897),including mild nausea and vomitting.ConclusionsCefmetazon is effective and safe in prevention and treatment of Postoperative infections in general surgery.

Primary liver cancer (PLC) is one of the most common malignant tumors with characteristics of strong invasiveness and poor prognosis. The morbidity and mortality of PLC rank among the top malignant tumors in the world. More than half of the world′s liver cancer occurs in China, which seriously threatens the health and life of Chinese people. Due to the imperceptible initial symptoms, most patients are not diagnosed until their tumors have progressed to be in advanced stage, and lose the chance for curative hepatectomy. At present, non-surgical treatment options, including interventional embolization, ablation, radiotherapy, chemotherapy, and systemic chemotherapy, play an increasingly prominent role in the comprehensive treatment of liver cancer. The authors briefly review the current status and research progress of the non-surgical treatment for liver cancer.

Objective To explore the efficacy of double low-profile visualized intraluminal support (LVIS) stent assisted embolization in the treatment of acute intracranial wide-neck aneurysms and its relation with levels of soluble intercellular adhesion molecule-1 (SICAM-1) and S100B. Methods A total of 114 patients with acute intracranial wide-neck aneurysms admitted to our hospital from June 2014 to December 2018 were collected. According to different treatment options, the patients in the study group (n=58) were treated with double LVIS stent-assisted embolization, while those in the control group (n=56) were treated with LVIS stent-assisted embolization. The embolization degrees of intracranial wide-necked aneurysms were evaluated by Raymond grading immediately after surgery, the efficacy of the patients was evaluated by modified Rankin scale (mRS) at discharge, and the serum SICAM-1 and S100B protein levels of the patients with different treatment methods and different curative effects before and after surgery were compared. Results As compared with those in the control group, the degrees of arterial embolization immediately after surgery and good therapeutic effect rate at discharge were significantly higher in the study group (P<0.05). After treatment, the serum levels of SICAM-1 and S100B were significantly lower in the study group than those in the control group (P<0.05). The levels of SICAM-1 and S100B in patients with good therapeutic effect ([147.5±9.8] mg/mL and [0.106±0.027] mg/mL) were significantly lower than those in the patients with poor therapeutic effect ([172.8 ±4.0] mg/mL and [0.158±0.002] mg/mL, P<0.05). Conclusions The embolization rate and therapeutic effect can be significantly improved in patients with acute intracranial wide-neck aneurysms after double-LVIS stent-assisted embolization. The serum levels of SICAM-1 and S100B are significantly increased in patients with poor therapeutic effect.

Objective:To investigate the effect of radiofrequency radiation (RF) from 5G mobile phone communication frequency bands (3.5 GHz and 4.9 GHz) on the permeability of the blood-brain barrier (BBB) in mice.Methods:A total of 24 healthy adult male C57BL/6 mice (6-8 weeks old) were randomly divided into Sham, 3.5 GHz RF and 4.9 GHz RF groups, and 8 mice in each group. Mice in the RF groups were systemically exposed to 5G cell phone radiation for consecutive 35 d(1 h/d) with 50 W/m 2 power density. The BBB permeability of mice was detected by Evans Blue (EB) fluorescence experiment. The expression levels of the BBB tight junction-related proteins (ZO-1, occludin and claudin-11) and the gap junction-related protein Connexin 43 were determined by Western blot. Results:The number of spots, fluorescence intensity and comprehensive score of EB were significantly increased in 3.5 GHz RF group and 4.9 GHz RF group compared with the Sham group ( t=12.98, 17.82, P<0.001). Compared with the Sham group, the content of S100B in mouse serum was significantly increased in 3.5 GHz RF group and 4.9 GHz RF group ( t=19.34, 14.68, P<0.001). The BBB permeability was increased in the RF group. The expression level of occludin protein was significantly reduced in the 3.5 GHz RF group ( t=-3.13, P<0.05), and this decrease was much profound in the 4.9 GHz RF group ( t=-6.55, P<0.01). But the protein levels of ZO-1, Claudin-11 and Connexin 43 in the cerebral cortex of the RF groups had no significantly difference in comparison with the Sham group( P>0.05). Conclusions:The continuous exposure of mobile phone RF at 3.5 GHz or 4.9 GHz for 35 d (1 h/d) induces an increase of BBB permeability in the mouse cerebral cortex, perhaps by reducing the expression of occludin protein.

Objective:To establish a practical and systematic pre-deployment base-based training course for medical units in peacekeeping level-II hospitals.Methods:We surveyed the current status of pre-deployment training of medical teams in peacekeeping level-II hospitals, and organized expert discussions to preliminarily construct centralized training course contents. At the same time, the Delphi method was used to conduct two rounds of questionnaire-based consultation to evaluate the overall framework design of the course and the rationality and importance scores of each module. The contents of the pre-deployment training course were further selected and optimized based on the positive coefficient (%), authority coefficient (Cr), coefficient of concordance ( W), and coefficient of variation (Cv). Results:The contents of the pre-deployment training course for the medical units of peacekeeping level-II hospitals were preliminarily established. The experts scored high for the combat onsite first-aid skills module [rationality score, (9.32±0.75) points; importance score, (9.45±0.65) points] and the combat wound treatment module [rationality score, (9.33±0.75) points; importance score, (9.28±0.74) points], and scored lowest for the field survival module [rationality score, (7.95±2.28) points; importance score, (7.87±2.16) points].Conclusions:The established contents of the pre-deployment base-based training course for the medical units of peacekeeping level-II hospitals are reasonable and practical, which lays the foundation for perfecting the pre-deployment training system of peacekeeping medical teams.