Objective To compare the clinical efficacy and safety differences between the triple immunosuppressive regimen of mizoribine (MZR) or mycophenolate mofetil (MMF) combined with tacrolimus (Tac) and glucocorticoids of kidney transplant recipients in one year after transplantation. Methods A single-center retrospective cohort study design was adopted. The clinical data of 156 patients who underwent the first allogeneic kidney transplantation at the Third Hospital of Peking University from January 2022 to December 2024 were included. The patients were divided into the MZR group (78 cases) and the MMF group (78 cases) based on the initial immunosuppressive regimen after transplantation. The baseline data, medication use in one year after transplantation, blood routine indicators, adverse events and clinical outcomes were compared between the two groups. For the repeated-measurement longitudinal data, repeated-measurement analysis of variance was used to evaluate the main effects of the groups, time and their interaction effects. Results At the primary efficacy endpoint, there were no statistically significant differences in the one-year survival rate, graft survival rate and incidence of acute rejection between the two groups (all P > 0.05). In terms of medication patterns and laboratory test indicators, there were significant time main effects and "time × group" interaction effects for Tac dosage (all P < 0.05). The Tac dosage in the MZR group was lower than that in the MMF group from 2 to 3 months after transplantation, and it was higher in the MZR group than in the MMF group from 7 to 12 months and one year after transplantation. White blood cell count in the MZR group was higher at one month after transplantation, and the platelet count was higher one year after transplantation (all P < 0.05). In terms of infection, the incidence of novel coronavirus and Pneumocystis jirovecii pneumonia infections in the MZR group was lower (all P < 0.05). In terms of metabolic indicators, the post-transplantation uric acid level was better in the MZR group than in the MMF group, but the total cholesterol level was higher one year after transplantation (all P < 0.05). In terms of liver function, there was a brief and mild increase in transaminase in the early stage after transplantation in the MZR group. Conclusions During the one-year follow-up after transplantation, both the MZR and MMF regimens demonstrate comparable immunosuppressive efficacy and overall safety in Chinese kidney transplant recipients. The MZR regimen shows clear advantages in reducing specific infection risks, alleviating bone marrow suppression and improving uric acid metabolism, but its potential impact on blood lipids needs to be monitored. Therefore, the MZR regimen may be an effective and safe alternative immunosuppressive option for kidney transplant recipients, especially those with high infection risk, poor hematological tolerance, or comorbid hyperuricemia.

OBJECTIVE:To provide reference for the rational application of antimicrobial drugs. METHODS:Medical records of all acute exacerbation of chronic obstructive pulmonary disease(AECOPD)hospitalized patients were collected from respiration department of our hospital during Sept. 2013 to Apr. 2014 and May 2014 to Dec. 2014,73 and 88 cases respectively. The applica-tion of antimicrobial drug was analyzed comparatively,and the rationality of drug use in AECOPD patients was evaluated. RE-SULTS:After the special rectification activities,the antimicrobial use intensity dropped from 217.74 to 91.58;drug combination rate dropped from 67.12% to 6.82%;no reason to change the antimicrobials conditions dropped from 15.07% to 0;hospital stay shortened from(10.21±3.44)d to(7.13±3.14)d;the total cost of medical treatment dropped from(6 117.73±1 164.52)yuan to (4 574.82±997.28)yuan;percentage of medicine expenses and antimicrobial drug expenses dropped from(61.83±11.49)% and (28.84±9.55)% to(43.52±9.97)% and(20.07±6.43)%,respectively;there was statistical significance(P<0.05),and the clinical treatment effect were uninfluenced. CONCLUSIONS:The special rectification activities of antimicrobial drugs could effec-tively improve the rational application of antimicrobial drugs and enhance the efficacy of antimicrobial drugs and decrease the cost of drug use.

Objective:To explore the clinical value of qualitative determination of C-reactive protein (CRP) in the differential diagnosis of benign and malignant pleural effusions or ascites .Methods :CRP in 3820 cases of pleural effusions and ascites were qualitatively examined by latex agglutination method .Specimen and latex reagent were added to the wells of the reaction plate successively .The result was observed after 2 minutes’ thorough mixing .The result was judged as positive if agglutination par-ticles were visible .Results:The positive rate of CRP in 672 cases of malignant pleural effusions and ascites was 6 .1% .The positive rate of CRP in pleural effusions and ascites was 75 .0% in 32 cases of hematopoietic and lymphoid tissue tumors ,and 2 .7% in 640 cases of epithelial malignant tumors .The positive rate of CRP in pleural effusions and ascites in 3148 cases of be-nign diseases was 21 .8% .The positive rate of CRP in benign pleural effusions and ascites was higher than that in malignant pleural effusions and ascites(P<0 .05) .The positive rate of CRP in pleural effusions and ascites of patients with hematopoietic and lymphoid tumors was higher than that of patients with epithelial malignant tumors .Conclusions :Qualitative determination of CRP in pleural effusions and ascites can be used to differentiate benign and malignant pleural effusions and ascites ,and to differentiate pleural effusions and ascites of hematopoietic and lymphoid tissue tumors and epithelial malignant tumors .

Objective To assess the high risk factors associated with the positive margin of conization in patients with cervical intraepithelial neoplasia (CIN). Methods From January 2000 to February 2008, 1699 consecutive patients with CIN undergoing conization was reviewed retrospectively in order to analyze the relationship between the positive margin of conization with clinical prognostic factors,such as patients age, disease grade, size of lesion, the procedure of excision and menopause. X<'2> tests was used to compare the different frequencies of factors in groups of positive and negative margin conization, then seven factors with positive margin were processed into unconditional logistic regression analysis. Results The rate of the positive margin in 1699 patients was 14.01% (238/1699). The mean age of patients with positive margins was (39±9 ) years old, while patients with negative margins was ( 39±8 ) years old, which didn't reach statistical difference(P>0.05). The rate of the positive margin was 8.63% in cold knife cone (CKC) and 18.66% in loop electrosurgical excision procedure (LEEP), which showed significant difference( P<0.01 ). Among 1699 patients, 90 patients were with CIN Ⅰ ,339 patients were with CIN Ⅱ ,1113 patients were with CIN Ⅲ [ including 972 with severe dysplasia and 141 with cancer in situ(CIS) ],87 patients were with cervical cancer stage Ⅰ al, 70 patients were with stage Ⅰ a2 or advanced stages. The rate of positive margin was 1.11% ( 1/90), 3.83% ( 13/339), 10.70% (104/972), 26.24% (37/141),35. 63% (31/87) and 74.29% (52/70),respectively. There was statistic difference among them, except CIN Ⅰ and CIN Ⅱ . When combined CIN Ⅰ with CIN Ⅱ , then compared with CIN Ⅲ, cervical cancer withⅠ al and Ⅰ a2, it also showed statistical difference (P<0.05 ) . The rate of positive margin in postmenopausal women was 21.54% (28/130), which was significantly higher than 13.38% (210/1569)in premenopausal women (P=0.010 ). The logistic regression analysis showed that the procedure of excision, grade of disease, size of lesion, surface of cervix, and menopause were high risk factors associated with the positive margin, the risk ratio were 5.147, 3.048, 1.271, 1.905 and 1.860, respectively.Conclusions High grade, the extent of CIN disease, LEEP and postmenopausal age are high-risk factors associated with positive margin in patients treated by conization. It should be warranted in those patients when designing conization treatment.