A control study of steroid withdrawal protection strategy after kidney transplantation in children / 中华儿科杂志

Objective: To study the influence of steroid withdrawal protection strategy on height growth in pediatric patients after kidney transplantation. Methods: The prospective cohort study enrolled 40 stage 5 chronic kidney disease children receiving kidney transplantation from July 2017 to September 2022 at Guangzhou Women and Children's Medical Center. Based on the primary preoperative disease, patients with immune abnormality-associated glomerular diseases or unknown causes were assigned to the steroid maintenance group, in which patients received steroid tapering within 3 months after surgery to a maintenance dose of 2.5 to 5.0 mg/d. While patients with hereditary kidney disease or congenital urinary malformations were assigned to the steroid withdrawal group, in which patients had steroids tapered off within 3 months. The characteristics of height catch-up growth and clinical data were compared between the 2 groups at baseline, 6, 12, 18 and 24 months after kidney transplantation. T-test, repeated measurement of variance analysis, Mann-Whitney U test, and Fisher exact test were used for the comparison between the 2 groups. Results: Among the 40 children, 17 were males, 23 were females, 25 were in the steroid withdraw group ((7.8±2.8) years old when receiving kidney transplantation) and 15 cases were in the steroid maintenance group ((7.6±3.5) years old when receiving kidney transplantation). The study population was followed up for (26±12) months. The total dose per unit body weight of steroids in the steroid withdrawal group was lower than that in the steroid maintenance group ((0.13±0.06) vs. (0.36±0.19) mg/(kg·d), t=5.83, P<0.001). The height catch-up rate (ΔHtSDS) in the first year after kidney transplantation in the steroid withdraw and steroid maintenance groups was 1.0 (0.7, 1.4) and 0.4 (0.1, 1.0), respectively; in the second year, the ΔHtSDS in the steroid withdraw group was significantly higher than that in the steroid maintenance group (1.1 (0.2, 1.7) vs. 0.3 (0, 0.8), U=28.00, P=0.039). The HtSDS in the steroid withdrawal group at the five follow-up time points was -2.5±0.8, -2.0±0.8, -1.5±0.8, -1.3±0.9 and -0.5±0.3, respectively, while in the steroid maintenance was -2.4±1.3, -2.2±1.1, -2.0±1.0, -1.8±1.0 and -1.6±1.0, respectively. There were statistically significant differences in HtSDS at different follow-up time points in both 2 groups (F=19.81, P<0.01), but no statistical differences in overall impact between the 2 groups (F=1.13, P=0.204). The steroid treatment was interaction with the increase of follow-up time (F=3.62, P=0.009). At the 24th month after transplantation, the HtSDS in the steroid withdrawal group was significantly higher than that in the steroid maintenance group (P=0.047). Six patients in the steroid withdrawal group experienced antibody-mediated immune rejection (AMR), while 3 did in the steroid maintenance group. Moreover, there was no significant difference in AMR between the two groups (χ2=0.06, P=0.814). Conclusion: The steroid withdrawal protection strategy favors the height catch-up growth in pediatric patients after kidney transplantation and does not increase the risk of postoperative antibody-mediated immune rejection.

Advances in clinical determinants and mechanisms of calcineurin inhibitor pharmacokinetic disposition in vivo / 中国药理学通报

Tacrolimus and cyclosporine are both calcineurin inhibitors ( CNI) that widely used for immunosuppression and have the characteristics of great intra-and inter-variabilities in phar-macokinetics and pharmacodynamics.CNI undergoes extensive first-pass metabolism and is substrate for cytochrome P450 (CYP) 3A4, CYP3A5 and P-glycoprotein in intestine and liver.'Hie functions of the enzyme and transporter are determined by complex interactions including gene polymorphisms, induction or inhibition of drugs and endogenous substances ( such as inflam-matory factors).This review summarizes the clinical determinants of CNI treatment variability, including food intake, diarrhea and other intestinal diseases, anemia, hypoproteinemia, hyperlipidemia, liver and kidney disease and combination medications.The underlying mechanisms are also discussed.

Curcumin improves cardiac fibrosis by inhibiting endothelial-mesenchymal transition through NRF2-DDAH-ADMA-NO pathway / 中国中药杂志

The present study analyzed the correlations between curcumin(Cur), nuclear factor E2 related factor 2(NRF2)-dimethylarginine dimethylaminohydrolase(DDAH)-asymmetric dimethylarginine(ADMA)-nitric oxide(NO) pathway, and endothelial-mesenchymal transition(EndMT) based on SD rats with cardiac fibrosis, and explored the effect and mechanism of Cur in resisting cardiac fibrosis to provide an in-depth theoretical basis for its clinical application in the treatment of heart failure. The cardiac fibrosis model was induced by subcutaneous injection of isoprenaline(Iso) in rats. Thirty-two rats were randomly divided into a control group, a model group, a low-dose Cur group(100 mg·kg~(-1)·d~(-1)), and a high-dose Cur group(200 mg·kg~(-1)·d~(-1)), with eight in each group. After 21 days of treatment, cardiac function was detected by echocardiography, degree of cardiac fibrosis by Masson staining, expression of CD31 and α-SMA by pathological staining, expression of VE-cadherin, vimentin, NRF2, and DDAH by Western blot, and ADMA level by HPLC. Compared with the model group, the Cur groups showed alleviated cardiac fibrosis, accompanied by increased CD31 and VE-cadherin expression and decreased α-SMA and vimentin expression, indicating relieved EndMT. Additionally, DDAH and NRF2 levels were elevated and ADMA and NO expression declined. Cur improves cardiac fibrosis by inhibiting EndMT presumedly through the NRF2-DDAH-ADMA-NO pathway.

Clinical features of catch-up growth after kidney transplantation in children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of catch-up growth of body height after kidney transplantation in children and related influencing factors.@*METHODS@#A retrospective analysis was performed from the chart review data of 15 children who underwent kidney transplantation in Guangzhou Women and Children's Medical Center from July 2017 to November 2019. According to whether the increase in height standard deviation score (ΔHtSDS) in the first year after kidney transplantation reached ≥0.5, the children were divided into a catch-up group with 8 children and a non-catch-up group with 7 children. According to whether final HtSDS was ≥-2, the children were divided into a standard group with 6 children and a non-standard group with 9 children. The features of catch-up growth of body height and related influencing factors were compared between groups.@*RESULTS@#The data showed that median ΔHtSDS was 0.8 in the first year after transplantation, which suggested catch-up growth of body height. There was a significant difference in HtSDS between the non-catch-up and catch-up groups (P<0.05). Baseline HtSDS before transplantation was positively correlated with HtSDS at the end of follow-up (r=0.622, P<0.05) and was negatively correlated with ∆HtSDS in the first year after transplantation (r=-0.705, P<0.05). Age of transplantation and mean dose of glucocorticoid (GC) per kg body weight were risk factors for catch-up growth after kidney transplantation (OR=1.23 and 1.74 respectively; P<0.05), while baseline HtSDS and use of antihypertensive drugs were independent protective factors for catch-up growth (OR=0.08 and 0.18 respectively; P<0.05); baseline HtSDS and ΔHtSDS in the first year after kidney transplantation were influencing factors for final HtSDS (β=0.984 and 1.271 respectively; P<0.05).@*CONCLUSIONS@#Kidney transplantation should be performed for children as early as possible, growth retardation before transplantation should be improved as far as possible, and multiple treatment methods (including the use of GC and antihypertensive drugs) should be optimized after surgery, in order to help these children achieve an ideal body height.

Investigation of epidemic status of clonorchiasis sinensis in western regions of Jilin Province / 中国血吸虫病防治杂志

Objective To understand the epidemic status of clonorchiasis sinensis in western region of Jilin Province, so as to provide the evidence for formulating the planning and strategy of prevention and control of the disease. Methods In 2017, the areas where the residents had the customs of eating Sashimi were selected as the research areas in the western region of Jilin Province, and according to the cluster sampling, 25 villages in 25 towns (each village per town) of 5 counties in the region were selected as the investigation points. The basic information of crowd was collected by a questionnaire investigation. The Kato-Katz method was used for etiological examinations. The results were analyzed statistically. Results A total of 4 980 people in the 25 villages were investigated, and 1 220 people were infected with Clonorchis sinensis. The average infection rate was 24.50%. There was a significant difference among different counties (cities, districts) in the infection rate of C. sinensis (P < 0.01), and the infection rate in Daan City was the highest (53.82%). In addition, there were significant differences between/among the gender, nation, age, educational level, and occupation in the infection rate (all P values < 0.01). The infection rate of the male was higher than that of the female, the rate of Han was higher than that of other ethnic groups, the rate of the high age group was higher than that of the low age group, the rate of the college degree group was higher than that of the other educational level groups, the rate of the cadre was higher than that of the other occupation groups, and the rate of the group who had vermifuge before the investigation was lower than that of the group who did not have vermifuge. Conclusions The western region of Jilin Province is still the highincidence area of clonorchiasis sinensis. Therefore, the comprehensive control and prevention measures, such as giving vermifuge and health education, should be strengthened in key population and areas in the future.

Prognosis of BK polyomavirus nephropathy: 10-year analysis of 133 renal transplant recipients at a single center / 中华医学杂志(英文版)

BACKGROUND@#BK virus-associated nephropathy (BKVN) is an important cause of chronic allograft dysfunction. The objective of our study was to evaluate the prognosis of BKVN.@*METHODS@#We retrospectively reviewed the data of 133 renal transplant recipients with BKVN treated at the First Affiliated Hospital of Sun Yat-Sen University between July 2007 and July 2017. BK viral loads, graft function, and pathologic indexes were compared between initial diagnosis and last follow-up.@*RESULTS@#After a mean follow-up period of 14.4 (range, 0.3-109.6) months after diagnosis of BKVN, BK viruria, and BK viremia become negative in 19.5% and 90.2% of patients, respectively. The mean estimated glomerular filtration rate (eGFR) at last follow-up was lower than at diagnosis of BKVN (18.3 ± 9.2 vs. 32.8 ± 20.6 mL·min·1.73 m, t = 7.426, P < 0.001). Eight (6.0%) patients developed acute rejection after reducing immunosuppression. At last follow-up, the eGFR was significantly lower in patients with subsequent rejection than those without (21.6 ± 9.8 vs. 33.5 ± 20.9 mL·min·1.73 m, t = 3.034, P = 0.011). In 65 repeat biopsies, SV40-T antigen staining remained positive in 40 patients and became negative in the other 20 patients. The eGFR (42.6 ± 14.3 vs. 26.5 ± 12.3 mL·min·1.73 m), urine viral loads (median, 1.3 × 10vs. 1.4 × 10 copies/mL), and plasma viral load (median, 0 vs. 0 copies/mL) were all significantly lower in patients with negative SV40-T antigen staining than those with persistent BK involvement (all, P < 0.05). Five (3.8%) recipients lost their graft at diagnosis of BKVN, and 13 (9.8%) lost their graft during the follow-up period. The 1-, 3-, and 5-year graft survival rates after diagnosis of BKVN were 99.2%, 90.7%, and 85.7%, respectively. Higher pathologic stage correlated with lower allograft survival rate (χ = 6.341, P = 0.042).@*CONCLUSION@#Secondary rejection and persistent histologic infection in BKVN lead to poor prognosis.

Associations of IMPDH1 polymorphisms with pharmacodynamics of mycophenolic acid in renal transplant patients / 药学学报

The study was designed to investigate the effect of IMPDH1 gene polymorphism on the pharmacodynamics of mycophenolic acid in the renal transplant patients. 315 patients with renal transplantation were treated with triple immunotherapy (mycophenolic acid + tacrolimus + prednisone). The Agena MassARRAY assay was used to detect the IMPDH1 genotypes in patients above. The plasma drug concentration of mycophenolic acid (MPA) and its main metabolite mycophenolic acid glucuronide (MPAG) was detected by high performance liquid chromatography (HPLC). The correlation between IMPDH1 gene polymorphism (rs10954183, rs12536006, rs13242340, rs2278293, rs2288549) and rejection and postoperative infection in renal transplant recipients were analyzed by SPSS 21 software. The result showed that IMPDH1 rs2288549 GG is a risk factor for acute rejection after renal transplantation (PIMPDH1 rs2278293 CT is a risk factor for infection after renal transplantation (PIMPDH1 rs2288549 is an important factor of acute rejection after renal transplantation, IMPDH1 rs2278293 is an important factor affecting the emergence of infection after renal transplantation. The SNPs may help to optimize clinical medication to reduce the incidence of adverse reaction.

NQO1 dependent non-canonical necroptosis mediated by ROS and RIP1/RIP3 in parallel in glioma cancer cells / 中国药理学与毒理学杂志

OBJECTIVE Glioblastomas(GBM)are the most malignant brain tumors in humans and have a very poor prognosis. New therapeutics are urgently needed. Here, we reported 2-methoxy-6-acetyl-7-methyljuglone (MAM)-induced cell death in U87 and U251 glioma cancer cells. METHODS Cells were cultured and treated with MAM, the cell viability was determined by MTT assay and LDH assay. Intracellular reactive oxygen species (ROS) generation was observed by DCF fluorescence. The protein expression was determined by Western blotting. RESULTS MAM induced glioma cancer cell death without caspase activation. The cell death induced by MAM was attenuated by the pharmacological or genetic blockage of necroptosis signaling,including RIP1 inhibitor necrostatin-1s (Nec-1s)and siRNA-mediated gene silencing of RIP1 and RIP3,but was unaffected by caspase inhibitor z-vad-fmk or necrosis inhibitor 2-(1H-Indol-3-yl)-3-pentylamino-maleimide (IM54). MAM treated U87 and U251 glioma cancer cells induced RIP1/RIP3 complex formation, ROS level increased, ATP concentration decreased and loss of plasma membrane integrity, further confirmed this process was necroptosis.The essential role of ROS was confirmed by the protective effect of ROS scavenger NAC. Interestingly, MAM induced necroptosis both triggered by RIP1/RIP3 complex and ROS generation. Moreover, MAM induced necroptosis through cytosolic calcium (Ca2 +) accumulation and sustained c-Jun N-terminal kinase (JNK) activation. Both calcium chelator BAPTA-AM and JNK inhibitor SP600125 could attenuate cell death. Further, we found there exists a feedback loop between RIP1 and JNK activation.Finally,MAM induced necroptosis was inhibited by dicoumarol(a NQO1 inhibitor). Dicoumarol exposed glioma cancer cells were resistant to RIP1/RIP3 complex formation and ROS generation. MAM induced necroptosis was independent of MLKL. CONCLUSION MAM induced non-canonical necroptosis through the NQO1-dependent ROS and RIP1/RIP3 pathway.This study also provided new insights into the molecular regulation of necroptosis in human glioma cancer cells and a promising approach for GBM treatment.

Associations of VDR polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients / 药学学报

The paper was aimed to investigate the association of VDR polymorphisms with tacrolimus (FK506) concentration in Chinese renal transplant recipients. A total of 114 renal transplant recipients receiving tacrolimus were genotyped for VDR rs1540339 and rs2853559 by Agena Bioscience MassARRAY® system and CYP3A5*3 by PCR-RFLP method. Trough concentrations of tacrolimus on day 7 after renal transplantation were collected from clinical data. Statistical analysis was performed with Spearman's correlation, Mann-Whitney U test and Kruskal-Wallis H test. The dose-adjusted concentration of tacrolimus in VDR rs2853559 GA and GG carriers were considerably higher than that of AA carriers. After stratification by CYP3A5*3 genotypes, VDR rs2853559 GA and GG carriers had a higher dose-adjusted tacrolimus concentration than that in AA carriers in CYP3A5 nonexpresser. CYP3A5*3 and VDR rs2853559 explained 45.6% variability of tacrolimus C0/D. In CYP3A5 non-expressers, VDR rs2853559 explained 14.4% variability of tacrolimus C0/D. The results illustrated that VDR rs2853559 polymorphisms was associated with tacrolimus concentrations, and the determination of this SNP may be useful for individualized medicine of tacrolimus.

The characteristics of affective intensity and cognitive emotion regulation in borderline personality disorder / 中华行为医学与脑科学杂志

Objective To examine the characteristics of affective intensity and cognitive emotion regulation in subjects with borderline personality disorder ( BPD) . Methods The BPD subscale of personal-ity disorder questionnaire( PDQ-4+) was used to assess the BPD symptoms,the short affective intensity scale (SAIS) and cognitive emotion regulation questionnaire (CERQ) were used to measure affect intensity and cognitive emotion regulation strategy,respectively. 765 subjects with BPD and 776 healthy controls were se-lected. The independent-samples t test was used to analyze the differences between BPD group and controls and logistic regression analysis was used to examine the related factors affecting the BPD. Results Com-pared with the control group(negative intensity:(3.08±0.66),negative coping dimension:(37.20±5.94), BPD group got higher scores in negative intensity((3.88±0.74), t=22.29, P0.8)and negative coping dimension((44.77±6.36), t=24.16, P0.8). The logistic regression anal-ysis showed that negative intensity(B=1.38,Exp(B)=3.97,95%CI for EXP(B):3.15~5.00, P<0.01) and negative cognitive regulations strategy(B=0.19,Exp(B)=1.21,95% CI:1.18-1.25, P<0.01) could affect the prevalence of BPD. Conclusion Subjects with BPD traits have more significant negative affective inten-sity and tend to use negative cognitive regulations strategy.

Associations of SLCO1B1 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients / 药学学报

The study aims to investigate the associations of SLCO1B1 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients. Blood samples and clinical data were collected from 89 renal transplant recipients with tacrolimus treatment. CYP3A5*3 genotypes were detected by PCR-RFLP method and SLCO1B1 (rs2306283, rs4149032) genotypes were detected by Agena Bioscience Mass ARRAY ® system. Trough concentrations of tacrolimus on day 7 after renal transplantation were collected from clinical data. Correlations between genetic polymorphisms and tacrolimus concentrations were analyzed by SPSS. In CYP3A5 nonexpressers, the dose-adjusted concentration of tacrolimus in SLCO1B1 rs2306283 CC carriers was considerably higher than that in CT and TT carriers. The results illustrated that SLCO1B1 rs2306283 polymorphisms were associated with tacrolimus concentrations, and genotyping for this SNP may be usefulfo r individualized medicine of tacrolimus.

Activation of necroptosis in a rat model of acute respiratory distress syndrome induced by oleic acid / 生理学报

The present study was aimed to investigate the role of necroptosis in the pathogenesis of acute respiratory distress syndrome (ARDS). The rat model of ARDS was induced by intravenous injection of oleic acid (OA), and observed for 4 h. The lung injury was evaluated by arterial blood gas, lung wet-dry weight ratio (W/D) and histological analyses. Simultaneously, bronchoalveolar lavage fluid (BALF) was collected for total and differential cell analysis and total protein determination. Tumor necrosis factor alpha (TNF-α) level in BALF was determined with a rat TNF-α ELISA kit. Expressions of receptor interacting protein kinase 1 (RIPK1), RIPK3 and mixed lineage kinase domain-like protein (MLKL) in lung tissue were determined by Western blot and immunohistochemical staining. The interaction between RIPK1 and RIPK3 was explored by immunoprecipitation. The results showed that, compared with those in control group, total white blood cells count (WBC), polymorphonuclear percentage (PMN%), total protein concentration, TNF-α level in BALF, W/D, and the alveolar-arterial oxygen tension difference (P(A-a)O) in OA group were significantly increased at 4 h after OA injection. Western blot and immunostaining further showed remarkably increased expressions of RIPK1, RIPK3 and MLKL in lung tissue from OA group. Additionally, immunoprecipitation results indicated an enforced interaction between RIPK1 and RIPK3 in OA group. Collectively, the TNF-α level in BALF and the RIPK1-RIPK3-MLKL signaling pathway in lung tissue were found to be upregulated and activated with the process of ARDS. These findings implicate that RIPK1/RIPK3-mediated necroptosis plays a possible role in the pathogenesis of ARDS, which may provide a new idea to develop novel drugs for the therapy of ARDS.

Associations of SUMO4 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients / 药学学报

The study aims to investigate the associations of SUMO4 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients. Blood samples and clinical data were collected from 132 renal transplant recipients with tacrolimus treatment. CYP3A5*3 genotypes were detected by PCR-RFLP, and SUMO4 (rs237024, rs237025) genotypes were detected by Sequenom® MassARRAY system. SUMO4 rs237024 and rs237025 genotypes were in complete linkage disequilibrium (D' = 1). The dose-adjusted concentration of tacrolimus in SUMO4 rs237024A-rs237025A (GA-GA +AA-AA) carriers was considerably higher than that in GG-GG carriers (P < 0.05). After stratification by CYP3A5*3 genotypes, SUMO4 rs237024A-rs237025A carriers (GA-GA+AA-AA) had a higher dose-adjusted tacrolimus concentration than that in GG carriers in CYP3A5 expresser (P < 0.05). The results illustrated that SUMO4 rs237024 and rs237025 polymorphisms were associated with tacrolimus concentrations, and the test of these genotypes may be useful for individualized medicine of tacrolimus.

Effects of Blood Activating Wind Dissipating Acupuncture on Blood Pressure of Prehypertension Patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of blood activating wind dissipating acupuncture (BAWDA) on blood pressure (BP) of prehypertension (PHT) patients.</p><p><b>METHODS</b>Totally 60 PHT patients were assigned to the control group and the acupuncture group according to random digit table, 30 in each group. All patients were intervened by life style. BAWDA was additionally performed in patients in the acupuncture group for 6 weeks (30 times). The improvement of BP after intervened by acupuncture was observed. BP success rates and the proportion of PHT progressing to hypertension (HT) were also observed after 6-week intervention of acupuncture and at 1-year follow-up.</p><p><b>RESULTS</b>Systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased after 6-week intervention in the acupuncture. The BP control rate was 56.7% (17/30 cases) in the acupuncture group vs.10.0% (3/30 cases) in the control group with statistical difference (chi2 = 14.70, P < 0.01). At 1-year follow-up BP success rate was 36.7% (11/30 cases) in the acupuncture group, remarkably higher than that of the control group [13.3%, (4/30 cases)] (chi2 = 4.36, P < 0.05).</p><p><b>CONCLUSIONS</b>BAWDA showed BP regulating roles in a gradually stable decreasing tendency. It also could elevate BP success rate of PHT, and reduce the risk of PHT progressing to HT.</p>

Effect of Bear Bile Powder and Its Succedaneum on Peripheral Blood and Bone Marrow Megakaryocytes in Mouse Model with Thrombocytopenia Induced by Cytosine Arabinoside / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of bear bile powder and ursodesxy cholic acid (UDCA) on peripheral blood, bone marrow megakaryocyte and immune organs in mouse model with thrombocytopenia, so as to provide a reference for studying the curative effects of bear bile powder and its succedaneum on thrombocytopenic purpura (TP).</p><p><b>METHODS</b>The mouse model with thrombocytopenia indued by cytosine arabinoside (Ara-C) was established, a total of 70 mice were randomly divided into normal group, model group, prednisone group, bear bile (middle and high dose) powder group and UDCA (middle and high dose) group. From the first day of making model mice in the each group, 0.4 ml/(20 g·d) corresponding drug was administered by infusion. At day 10 after treatment the peripheral blood, spleen and thymus organ index, the number of bone marrow megakaryocyte in each group were compared.</p><p><b>RESULTS</b>compared with the normal group, the Plt, WBC and megakaryocyte counts in model group decreased, the spleen index increased obviously (P<0.05), but the WBC count returned to normal by 10 days; after treatment, compared with model group, the Plt, WBC and megakaryocyte counts of treated groups increased, spleen index decreased significantly (P<0.05), but the WBC count in prednisone group decreased, which in bear bile powder (high) group and UDCA (high) group were particularly significant.</p><p><b>CONCLUSION</b>The bear bile powder and UDCA have been confirmed to have therapeutical effect on thrombocytopenia models induced by Ara-C, UDCA can substitute bear bile powder as a treatment drug for thrombocytopenic purpura.</p>

Study design and the preliminary results on the modes of smoking cessation in general hospitals / 中华流行病学杂志

To study the intervention programs on smoking cessation in a general hospital and to evaluate its effects of the programs. Four methods including: a) the intervention through specialists in the smoking cessation clinic, b) short-time intervention in the out-patient department,c) free medical intervention, d) group intervention, were adopted for different smokers, with health counseling, psychological intervention and drug treatment. Intervention effect was evaluated by standard methods. During the 20-month period of the project, we treated 690 cases and 402 completed 6-month follow-up. Preliminary results in 402 cases showed that the three methods of smoking cessation interventions could reduce the amount of cigarette smoking and increase the quitting rate. Motivation to quit smoking, intervention methods and intensity of intervention seemed cessation clinic (31.6%) and in the group intervention (30.9%) was higher than short-time intervention in free medical events (15.1%). The successful rate of smoking cessation depended on the motivation of quitters, and the attitude, methods and intervention skills of the physicians.Therefore, it is necessary to explore and develop smoking cessation service models suitable to national context and individual intervention methods in China.

Protective effects of IGF-1 on cell injuries and tau hyperphosphorylation induced by okadaic acid / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the effects of insulin-like growth factor-1 (IGF-1) on cell injuries and tau hyperphosphorylation induced by okadaic acid (OA).</p><p><b>METHODS</b>The experimental groups were designed as follows: (1) SH-SY5Y culture (control group); (2) SH-SY5Y exposed to 40 nmol/L OA for 24 hours (OA group); (3) SH-SY5Y exposed to OA for 24 hours in the presence of 2 hour pretreatment with 100, 200 and 400 ng/ml IGF-1 (IGF-1 pretreatment groups). The changes of cell morphology were observed by inverted microscope. The viability of cells was detected by MTT. The injuries of cells were examined by Hoechst 33258 staining and the activity of caspase-3. Western-blot was applied to determine the expression of phosphorylation of tau protein.</p><p><b>RESULTS</b>In IGF-1 pretreatment group, the cell morphology was improved, the viability of cells was increased, and caspase-3 activation and hyperphosphorylation of tau (Ser396) were reduced.</p><p><b>CONCLUSION</b>IGF-1 can protect the SH-SY5Y cells from cell injuries induced by OA by inhibiting tau hyperphosphorylation.</p>

Simultaneous liver and kidney transplantation: analysis of a single-center experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Simultaneous liver and kidney transplantation (SLKT) has been proven to be a favorable treatment for combined renal and hepatic end-stage disease. However, recipients receiving SLKT have a long medical history, poor general condition that is often accompanied by anemia, hypoalbuminemia, coagulopathy, water-electrolyte imbalance and acid-base disorders. This study aimed to explore the indications, surgical techniques, therapeutic experience, prevention and treatment of postoperative complications of SLKT.</p><p><b>METHODS</b>The clinical data of 22 SLKTs cases performed at the First Affiliated Hospital of Sun Yat-sen University from January 2001 to December 2008 were retrospectively studied. Indications for SLKT, surgical techniques, perioperative fluid management, immunosuppressive regimen and experience in prevention and treatment of postoperative complications were analyzed.</p><p><b>RESULTS</b>All operations were successfully performed. Postoperative complications occurred in 13 cases (59.1%), including pleural effusions (7), intra-abdominal bleeding (2), biliary complications (2), repeated upper gastrointestinal bleeding (1), and acute liver graft rejection (1). All complications were treated conservatively. In this study, there were five deaths during follow-up, in which three perioperative deaths occurred due to serious conditions. Mortality at 3 months was 13.6%. The one and three year patient survival rate was 81.3% and 73.9% respectively.</p><p><b>CONCLUSIONS</b>SLKT is an effective therapy for end-stage liver disease with chronic renal failure or severe damage to renal function. It is a complex surgical procedure, causing a large disturbance of circulation and fluid balance, and more postoperative complications. The SLKT surgical techniques selected are based on the experience of surgeons, the anatomy of the recipient and primary diseases. It is essential to use the correct perioperative fluid management, reasonable immunosuppressive regimen, and prevention and treatment of postoperative infections, to improve the long-term patient survival after SLKT.</p>

Ningbo thyroid dysfunction prevalence study: a cross-sectional survey in an employees-cohort / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The prevalence and the spectrum of thyroid dysfunction in the mainland of China are not adequately understood. We performed a population-based study to determine the prevalence of major thyroid dysfunctions including overt and subclinical hyper- and hypothyroidism in a stable cohort.</p><p><b>METHODS</b>All active and retired employees aged 20 years and older (11 067) of Sinopec Zhenhai Refining & Chemical Company in Ningbo participated in the cross-sectional survey with a questionnaire and blood samples.</p><p><b>RESULTS</b>A total of 10 405 individuals attended for screening. Using biochemical definitions 95.5% were euthyroid. The prevalence of former diagnosed hyperthyroidism was 1.1% in females and 0.4% in males, hypothyroidism 1.7% and 0.3%, and thyroid surgery 1.2% and 0.3%, respectively. In both sex the prevalence increased with age. Twenty-four percent of individuals with thyroid surgery or medications had abnormal thyroid-stimulating hormone (TSH) levels. In individuals without a history of thyroid disease, the prevalence of pathological TSH values in females and males were TSH > or = 10 mU/L 0.60% and 0.29%; TSH 4.8-9.9 mU/L 5.71% and 2.25%; TSH < 0.3 mU/L 0.87% and 0.41%, respectively. Overt hyper- and hypothyroidism were uncommon (0.2%, 0.3%, respectively). The prevalence of subclinical hyper- and hypothyroidism was 0.4% and 3.4%, respectively. Subclinical hypothyroidism was more common in females (male 2.4% vs. female 5.8%, P < 0.001) and with increasing age (P < 0.001).</p><p><b>CONCLUSIONS</b>The prevalence of thyroid dysfunction is 4.5% in the cohort. Among individuals with thyroid medications or surgery, only 75.7% were within the normal range of TSH. These results indicate that thyroid dysfunction is common in Chinese adults.</p>

Anatomy character of renal artery and treatment of living-donor renal transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To study the anatomy characters of renal artery and the treatment of multiple arteries in living donor renal grafts.</p><p><b>METHODS</b>Records of 142 living donors were analyzed in our center. We analyzed the anatomic structure of renal arteries by DSA and CTA pre-transplantation. Thirty-one kidneys with multiple arteries were transplanted after reconstruction. Then clinical effects were compared between multiple-renal-arteries group (n=31) and single-renal-artery group (n=111).</p><p><b>RESULTS</b>The incidence of multiple renal artery was 30.99%, and there was no difference between both sides (left kidney 22.54%, right kidney 22.13%). If the multiple artery occurred in left or right kidney, the incidence of the multiple artery occurred in the other side was 56.25% and 60.00%, respectively. The diameter of left main renal artery was more magnanimous (P=0.001) and the first branch was more closed to abdominal aorta (P=0.004). Operation time and warm/cool ischemia time were longer in the multiple-renal-arteries group. However, estimated blood loss, delayed graft function, acute rejection and flow rate of arcuate artery were similar in both groups, the same as serum creatinine and serum creatinine clearance rate on day 7, 1 month and 3 month post-operation. It was shown by repeated measures ANOVA that graft with multiple arteries didn't affect the tendency of renal function at early time post-operation.</p><p><b>CONCLUSION</b>Comprehending the character of renal artery and accurate treatment of multiple artery anastomosis are critical for the effect of the living kidney transplantation.</p>