BACKGROUND:Daclizumab can be special y combined with the inerleukin-2 receptor on the surface of activated T cells in human body, and this method can reflect the close of interleukin-2 receptor thus inferring the effect of induction therapy. At present, the daclizumab has been widely used in renal transplantation, but there is no consensus on its clinical application in liver transplantation. OBJECTIVE:To investigate the expression of serum CD25+T cells and soluble interleukin-2 receptor in the patients receiving daclizumab for liver transplantation during perioperative period. METHODS:A total of 58 patients received orthotopic liver transplant for the first time were included and then the patients were randomly divided into two groups:control group (n=28) and treatment group (n=30). The patients in the two groups were treated with tacrolimus, mycophenolate mofetil and corticosteroids triple immunosuppressive regimen. The patients in the treatment group received immune induction therapy with daclizumab, and the patients in the control group did not receive daclizumab. RESULTS AND CONCLUSION:Flow cytometry and enzyme-linked immunosorbent assay showed the expression levels of CD25+T cells in the treatment group were significantly lower than those in the control group at different time points after liver transplantation (P<0.01);and the expression levels of soluble interleukin-2 receptor in the treatment group were lower than those in the control group during transplantation and at the first day after transplantation (P<0.05, P<0.01). At 6 months after transplantation, the incidence of acute rejection was decreased in the treatment group (P<0.01). The results indicate that daclizumab can effectively suppress the expression level of CD25+T cells, as wel as the expression level of soluble interleukin-2 receptor in the peripheral blood in the early stage of liver transplantation, thus effectively reducing the rate of acute rejection.

OBJECTIVE:To study the effects of common percutaneous enhancers on transdermal permeability of cetirizine hy-drochloride(CET). METHODS:Using pH 7.4 phosphate buffer as receiving solution,accumulative permeation rate as index,mod-ified Franz diffusion cell was used to investigate the effects of common percutaneous enhancers on transdermal permeability of CET in skin of abdomen isolated from mice,such as azone (0.06%-2.5%),oleic acid (0.5%-10%),1,3-propanediol (0.5%-10%),propanetriol(0.5%-5%). RESULTS:1,3- propanediol had no improvement effect on the permeability of CET. 24 h accu-mulative permeation amount of CET in 0.06% azone,0.5% oleic acid and 1% propanetriol were the highest among same types, being 227.94,85.25 and 215.15 μg/cm2,respectively. CONCLUSIONS:Of four percutaneous enhancers,the transdermal enhanc-ing efficiencies from high to low are azone>glycerol>oleic acid>1,3-propanediol. Azone and glycerol have the conspicuous pene-tration enhancing effects.

Objective To assess the leading causes of death and disability adjusted life year (DALY) due to non-communicable disease (NCD) in China.Methods World Health Report 2004 published by the World Health Organization (WHO) was reviewed,including total deaths,deaths per 100 000,agestandardized death rate per 100 000,total DALYs,DALYs per 100 000 and age-standardized DALYs per 100 000 by cause and by member state.Diseases or injuries were assigned to three levels:communicable diseases,NCD and injuries (the first level); categories of disease or injure (the second level); specific diseases (the third level).R2.15 was used for data analysis.Results NCD causes 737.6 million deaths,141million total DALY years,627 age standardized mortality per 100 000,and 10 829 age-standardized DALYs per 100 000.NCD account for 79.4％ and 70.3％ total death or all-cause DALYs.Conclusions Cardiovascular disease,malignant neoplasm and respiratory disease were the leading causes of death,while neuropsychiatric disorder,cardiovascular disease and sense organ disease were the most important causes of DALYs.Among China,the United Kingdom,the United States,Canada,Japan,Korea and India,China ranked second in age-standardized mortality rate of chronic disease.DALYs of esophagus cancer and chronic obstructive pulmonary disease were 6 or 2 times of world average level.Besides,the increasing trend in the prevalence of diabetes mellitus remains impressive.

Objective To review the clinical features of drug-induced liver injury (DILI) in elderly Chinese patients.Methods A literature search was conducted with the key wordsdrug-induced liver injury ordrug-induced liver disease andelderly; four Chinese medical databases were used:including Chinese Biomedical Literature Database (CBM),Chinese Science and Technology Periodical Database (VIP),Wanfang Database and China National Knowledge Infrastructure (CNKI),from when the bases established to December 2011.Data from retrieved literatures of retrospective controlled studies of DILI were analyzed by SPSS 14.0 software.Results Five studies met the inclusion criteria,including 275 elderly patients (aged group) and 602 non-elderly patients (non-aged group) with DILL There was no significant difference in gender between the two groups (P ＞ 0.05).Clinical manifestations of jaundice,fatigue,anorexia,and skin itching were more commonly seen in the aged group (P ＜ 0.01).Cholestatic hepatic injury occurred more frequently in the aged group than in the non-aged group [24.9％ (61/245) vs.18.8％ (102/245),P ＜ 0.05],while hepatocellular type occurred more frequently in the non-aged group [64.3％ (350/544) vs.55.1％ (135/245),P ＜ 0.05].More DILI were induced by Chinese herb medicine and cardiovascular drugs in the aged group than in the non-aged group [47.0％ (79/168) vs.35.9％ (93/254) and 8.3％ (14/168) vs 1.2％ (3/259) respectively,P ＜ 0.05].As for the prognosis,there was no significant difference in clinical cure and improvement rate between the two groups [84.4％ (141/167) vs.81.5％ (291/357),P ＞0.05].Conclusion The elderly are more sensitive to the drugs and have a high risk of DILI.Prevention and timely diagnosis and treatment of DILI are particularly important for elderly patients.

Objective To compare the efficacy of total pelvic floor reconstruction with mesh patch and vaginal hysterectomy with anterior and posterior vaginal wall repair for presby-pelvic floor dysfunction patients.Methods We randomly chose 92 pelvic floor dysfunction inpatients of our hospital from September 2007 to February 2009 and divided them into 2 groups:total pelvic floor reconstruction group(n=70) underwent total pelvic floor reconstruction with mesh patch[12 patients of this group complicated with stress incontinence,4 patients received tension free vaginal tape-obturator(TVT-O) simultaneously];control group(n=22) received vaginal hysterectomy with anterior and posterior vaginal wall repair(3 patients of this group complicated with stress incontinence).A follow-up for 3 to 18 months after the surgery were taken in all the patients.Results In total pelvic floor reconstruction group,no recidivate case was found and the FOP scores and cure rate were 0 and 100% respectively.In control group,there were 7 recidivate cases,all of who were primary vagina anterior wall bulge patients.The cure rate of control group was 68%;For the patients complicated with stress incontinence,they were all cured by TVT-0 or by ascending the front patch in total pelvic floor reconstruction group,but 1 case was as before operation and 2 cases were even worse in control group.Conclusion Total pelvic floor reconstruction with vicarious materials had a definite efficacy for presby-pelvic floor dysfunction.

0.05) between two groups.Conclusion Two surgicel porcedures offer smilar results in the surgical treatment of primary spontaneous pneumothorax.Both techniques are equally safe,small traumatic,pain controllable,and there are little postoprerative complications and the relapse rate is very low.

Objective To observe the clinical effect of the quadruple therapy of integrated traditional Chinese and western medicine for treatment of patients with paralytic ileus.Methods A prospective randomized control trial was conducted.Ninty-five patients with paralytic ileus diagnosed by Tianjin First Central Hospital from January 2015 to February 2016 were randomly divided into a control group (47 cases) and a research group (48 cases).Routine western medical treatment was given to the patients in control group;on the basis of western medical routine treatment,quadruple therapy was applied to the patients in the research group,including alprostadil injection 10 μg,intravenous drip,once a day;Xuebijing injection 40 mL,intravenous drip,twice a day;liangge powder with modification (ingredients or their dosages being added and/or subtracted) composed of rhubarb 10 g,mirabilite 10 g,gardenia 15 g,weeping forsythia 20 g,scutellaria 15 g,glycyrrhiza 6 g,mint 6 g,bamboo leaves 10 g,honey 10 g.administered by gastric tube;point selection principle:zusanli (ST36),sanyinjiao (SP6),tianshu (S25),hegu (LI4),yanglingquan (GB34),zhongwan (CV12),xiawan (CV10),dachangshu (C07)etc.No.30 filiform needle was used to be perpendicularly inserted by moderate and equi-librious acupuncture technique,needle retaining being 30 minutes,once a day for 72 hours.The numbers of the patients with abdominal pain,abdominal distension,nausea and vomiting,absence of exhausting and defecation,gurgling sound attenuation or disappearance,abdominal X-ray abnormality,and the first defecation time,gurgling reappearance time,disappearance time of main symptoms were observed.The clinical effects of these two groups were statistically analyzed.Results After treatment in the two groups,the numbers of patients with abdominal pain,abdominal distension,nausea and vomiting,absence of exhausting and defecation,gurgling sound attenuation or disappearance,abdominal X-ray abnormality were all significantly reduced compared with those before treatment,except the nausea and vomiting symptom,the degrees of descent of other indexes were more remarkable in the research group (abdominal pain:7 cases vs.44 cases,abdominal distension:6 cases vs.45 cases,absence of exhausting and defecation:3 cases vs.48 cases,gurgling sound attenuation or disappearance:11 cases vs.43 cases,abdominal X-ray abnormality:12 cases vs.48 cases),the time of first defecation in research group (hours:22.65 ± 6.72 vs.34.35 ± 5.38),gurgling reappearance time (hours:40.36 ± 6.99 vs.51.33 ± 5.80),symptom disappearance time (hours:51.44 ± 9.41 vs.60.10 ± 5.48) in research group were all shorter significantly than those in control group (all P ＜ 0.05).The total effective rate in the research group was obviously higher than that of the control group [93.75％ (45/48) vs.87.37％ (37/47),P ＜ 0.05].Conclusions The therapeutic effects of the quadruple therapy of integrated traditional Chinese and western medicine are remarkable for treatment of paralytic ileus.

Objective To investigate the preventative effect of perioperative intervention to lower extremity deep venous thrombosis (DVT) after gynecologic surgery. Methods The 1062 patients, who received gynecologic surgery during 2007 June to 2008 June, were derided into intervention and nonintervention groups randomizely. According to the risk factors of DVT, the patients in intervention group were divided into 4 subgroups: low, mid, high and extremely high rise Each group had its own preventive measures. If patients had spontaneous pain, tenderness and swelling, positivity of Neuhof or Homan syndrome, and extension of one low extremity superficial vein, the low extremity color Doppler ultrasound would be carried out immediately. The ultrasound would also be routinely carried out in the high and extremely high risk groups in intervention group after 2 and 7 days after surgery. A prospective study was carried out investigating incidence of DVT and coagulation function perioperation. The vein blood samples were taken at in a week before surgery and 48 hours post-operation. Results The incidence of DVT of intervention group was 1.10% (6/546), and in nonintervention group, the incidence was 3.29% (17/ 516). There was significant difference between two groups (P<0.05). The incidence of DVT in extremely high risk subgroup was 21.05% (4/19), which was significantly higher than that of low(0), mid(0) and high risk groups[2.13% (2/94), P<0.05]. D-dimer, antithrombin-Ⅲ(AT-Ⅲ) post-operation were all higher than that pre-operation in the two groups, but there was no significant difference (P>0.05). The indexes of coagulation system, such as blood platelet count, prothrombin time (PT), active partial throraboplastin time (APTT), fibrinogen (Fbg), thrombin time (TT), tissue-plasminogen activator (t-PA), plasminogen activator inhibitor(PAI), were not significantly changed perioperation (P>0.05 in all pre-or post-operation indexes). Conclusions Perioperative intervention measurement according to different risk of DVT could cut down the incidence of DVT. DVT preventive intervention is suggested to high and extremely high risk people.

BACKGROUND: Orphanin, which was found in recent years, is an important bioactive polypeptide. Its extensive distribution in the central nervous system and peripheral tissue suggests a function of adjusting global behaviors.OBJECTIVE: To explore the correlation of plasm orphanin level and monoamine neurotransmitters in patients with postpartum depression by determining the levels of orphanin and monoamine neurotransmitters such as 5-hydroxytryptamine (5-HT) and dopamine(DA) in patients.DESIGN: Case-control experiment taking diagnosis as evidence.SETTING: Departments of Obstetrics and Gynecology, Changzheng Hospital and Changhai Hospital, Second Military Medical University of Chinese PLA.PARTICIPANTS: Twenty-five healthy women and seventeen women patients with postpartum depression after delivery who came in the Department of Obstetrics and Gynecology, Changzheng Hospital and Changhai Hospital, Second Military Medical University of Chinese PLA for further consultation during February 2002 to October 2004 were enrolled in this study, and served as control group and postpartum depression group, respectively. All the enrolled women, aged 21 to 43 years, with fair education levels, and voluntarily participated in this study. Women patients of 15 to 25 days after delivery suffered from the incipient postpartum depression with total scores of Edingburgh Postnatal Depression Scale (EPDS) above 13. Informed consents were obtained from all the subjects.METHODS: The levels of orphanin and monoamine neurotransmitters in venous blood from 25 healthy women and 17 women patients with postpartum depression were determined. ① Sample collecting: Blood was taken from women in the postpartum depression group 2 weeks after onset, while from control group 35 days after delivery. ② Assay method:The level of orphanin was determined with radioimmunoassay (RIA). The reagent kit was provided by phoenix company (USA) and the procedure was strictly performed according to the instructions on the reagent kit. The levels of 5-HT and DA were measured with high-performance liquid chromatography or electrochemical detection method.MAIN OUTCOME MEASURES: ① Changes in the levels of orphanin as well as 5-HT and DA in postpartum depression group and control group. ② Correlation of the total scores of EPDS and the levels of orphanin in postpartum depression group.RESULTS: Twenty-five healthy women and seventeen women patients with postpartum depression after delivery all participated in the result analysis. ① The level of orphanin in the postpartum depression group[(27.39±6.04) ng/L] was significantly higher than that in the control group [(10.37±3.65) ng/L](P ＜ 0.01),the levels of 5-HT in the postpartum depression group [(0.93±0.21) μmol/L] was remarkably lower than that in the control group[(1.43±0.36) μmol/L](P ＜0.05) ,and the levels of DA in postpartum depression group[(2.15±0.41) μmol/L] was obviously lower than that in the control group [(3.64±0.72) μmol/L]( P ＜ 0.01). ②The level of orphanin was negatively correlated with those of 5-HT and DA in postpartum depression group(r = -0.601 , -0.593,P ＜ 0.05). ③ The total scores of EPDS were significantly positively correlated with the level of orphanin (r = 0.512, P ＜ 0.05), and negatively correlated with the levels of 5-HT and DA (r = -0.571,-0.526, P＜ 0.05).CONCLUSION: The level of orphanin in patients with postpartum depression is increased and is negatively correlated with the levels of 5-HT and DA, but positively correlated with the total scores of EPDS.

Objective To investigate the effects of parathyroid hormone (PTH) on the synthesis and secretion of collagen Ⅲ and fibronectin (FN), and the expressions of plasminogen activator inhibitor-1 (PAI-1), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA in cultured human renal tubular epithelial cells (HK-2).Methods HK-2 cells were cultured in DMEM-F12 medium supplemented with 5% FBS. Cells were exposed to different concentrations of PTH (0, 10-12, 10-11, 10-10, 10-9, 10-8 mol/L) for 48 h, or 10-8 mol/L PTH at different time (0, 12, 24, 48, 72 h). The gene expressions of collagen Ⅲ,FN, PAI-1, MMP-1, and TIMP-1 were detected by semi-quantitative RT-PCR. The protein expression of collagen Ⅲ was detected by Western blotting. The level of FN in the supernatant was assayed by enzyme linked immunosorbent assay (ELISA). Results PTH increased gene expressions of collagen Ⅲ, FN, PAI-1 and TIMP-1 in a dose- and time-dependent manner, but decreased MMP-1 gene expression. Then the ratio of MMP-1/TIMP-1 was decreased. PTH increased the collagen Ⅲ protein expression in cultured HK-2 cells and the level of FN in the supernatant of cultured HK-2 cells in a dose- and time-dependent manner. Conclusion PTH can up-regulate PAI-1, TIMP-1 gene expressions, and down-regulate MMP-1 gene expression,resulting in elevation of extracellular matrix (ECM) synthesis and reductim of degradation.