Diagnosis and individualized drug therapy for the rejection with hyperglycemia after liver Transplantation / 中国临床药理学与治疗学

AIM: To establish individualized drug therapy strategy for patients with rejection and hyperglycemia after liver transplantation. METHODS: Clinical pharmacist collaborated with the surgeons and participated in the diagnosis and treatment of rejection and hyperglycemia after liver transplantation. Taking together liver function, therapeutic drug monitoring, drug-drug interactions between tacrolimus and wuzhi capsule, individualized drug therapy was adapted to improve the prognosis. RESULTS: The patient recovered well and survived in good health till now. CONCLUSION: It is highly suggested that clinical pharmacists actively involved in treatment of more severe and difficult-to-treat disease and design the individualized dosing regimens. This will largely contribute in reduced adverse drug reaction, improved safety and effectiveness in drug use as well as the quality of life in the "post-transplantation era".

Technical essentials and clinical experience of partial splenectomy / 中华肝胆外科杂志

In the recent years, the damage of the spleen has been increased due to trauma or neoplastic diseases. Traditional view holds the point that the damaged spleen should be completely removed, but with the development of spleen surgery, the important physiological function of the spleen has been widely recognized, and partial splenectomy has been well recognized by the surgeons. This paper summarized the clinical experience in partial splenectomy and raised some technical points.

Correlation of nutrient levels and state of severe cases with HFMD / 中国免疫学杂志

Objective:To detect the levels of PA,FN,RBP,CRP,Iron,Zinc,VitD in peripheral blood of children with HFMD and to explore the relationship between them and the disease .Methods:The levels of PA,FN,RBP and CRP were detected by immune turbidimetric assay;and the levels of Iron and Zinc were detected by flame atomic absorption spectrometry ;while the levels of VitD were detected by electro chemilumin escence .Results:The levels of PA,FN,RBP,Iron,Zinc and VitD in the severe group were lower than those in other groups ,while the levels of CRP were higher than those in other groups ( P0.05 ) .The levels of PA,FN,RBP,Fe,Zn and VitD in the convalescence were higher than those in the acute phase of the severe cases (P0.05).There were negative correlation between the levels of PA ,FN,RBP and the state of HFMD(P<0.05),while there were positive correlation between the levels of CRP and the state of HFMD (P<0.05). And there were low negative correlation between the levels of Iron , Zinc, VitD and the state of HFMD ( P <0.05 ), respectively.Conclusion:There were nutritional deficiency in severe cases of HFMD ,and the nutritional status should be assessed dy-namically,then proper amount of nutrition should be supplement .

The association between Has-miRNA-149 polymorphism and susceptibility of digestive tract cancer / 重庆医学

Objective To investigate the association between Has‐miRNA‐149 polymorphism and susceptibility of digestive tract cancer .Methods A systematic search of Pubmed ,EMBASE and Web of Science ,CNKI ,Wanfang was conducted for relevant studies .The odds ratios(OR) and 95% confidence intervals(95% CI) calculated by Stata12 .0 software were used to assess the asso‐ciation between Has‐miRNA‐149 polymorphism and risk of digestive tract cancer .The Q test ,I2 value and funnel plot were conduc‐ted to examine heterogeneity and publication bias ,respectively .Results A total of thirteen eligible studies containing 4 424 cases and 5 290 controls were included in this Meta analysis .There were significant relationships between Hsa‐miRNA‐149 polymorphism and susceptibility of digestive tract cancer (Domina model CT+CC vs .TT ,OR=0 .915 ,95% CI:0 .840-0 .996 ,P=0 .040 ;Hetero‐zygous model CT vs .TT ,OR=0 .880 ,95% CI:0 .803 -0 .965 ,P=0 .007) .In the stratified analysis ,it was found that the risk of colorectal cancer decreased in patients carrying CC/CT genotypes(OR=0 .834 ,95% CI:0 .715-0 .972 ,P=0 .021) ,especially in A‐sians (CT+CC vs .TT ,OR=0 .894 ,95% CI:0 .818-0 .977 ,P=0 .013) ,while that was not found in the Caucasoids .Conclusion Has‐miRNA‐149 polymorphism is associated with the susceptibility of digestive tract cancer .The CC/CT genotypes may decrease the risk of digestive tract cancer ,especially in Asians .

A Chinese multi-center study on the significance of monitoring imatinib plasma concentration in patients with gastrointestinal stromal tumor before and after administration / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the factors which may influence the imatinib plasma concentration in Chinese patients with gastrointestinal stromal tumor(GIST), and to illuminate the significance of monitoring imatinib plasma concentration in adjuvant therapy for patients with GIST.</p><p><b>METHODS</b>A cross-sectional study with 60 GIST patients who accepted the imatinib therapy after surgery was conducted. They were respectively administrated in 10 domestic hospitals from December 2014 to April 2016, including The First Affiliated Hospital of Nanjing Medical University(n=28), The Affiliated Hospital of Nantong University(n=9), The Affiliated Hospital of Xuzhou Medical College(n=6), Nanjing Drum Tower Hospital(n=5), The Second Affiliated Hospital of Nanjing Medical University (n=2), Jingling Hospital (n=2), The Second People's Hospital of Lianyungang(n=2), Shandong Provincial Hospital(n=2), Jiangsu Province Tumor Hospital(n=2), and The First Affiliated Hospital of Zhejiang University(n=2). Some specific time points for collecting blood sample before and after taking imatinib were determined, then liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used for monitoring imatinib plasma concentration in patients with GIST. Linear regression analysis was used for the correlation analysis of imatinib plasma concentration with dosage, clinicopathologic feature and side effect.</p><p><b>RESULTS</b>Patients who could not tolerate 400 mg imatinib per day(n=3) received 300 mg per day. There was no significant difference in imatinib plasma concentration between patients with 300 mg and those with 400 mg imatinib(n=53)(P=0.527). However, the imatinib plasma concentration in patients with 600 mg imatinib per day (n=4) was significantly higher as compared to those with 400 mg(P=0.000). Linear regression analysis indicated a negative correlation between the imatinib plasma concentration in patients with 400mg imatinib per day for 90 days continuously and body surface area(R=0.074, P=0.035), but no significant correlations of with age, creatinine clearance and serum albumin concentration were observed (all P>0.05). The differences in imatinib plasma concentration were not statistically significant between patients of different gender and those taking proton-pump inhibitor (PPI) or not (both P>0.05). Difference in imatinib plasma concentration between patients with different surgery was significant (P=0.026). Compared to patients who underwent wedge resection, enterectomy and other surgeries, the imatinib plasma concentration of patients with subtotal gastrectomy or total gastrectomy decreased significantly (all P<0.05). After 90 days of taking imatinib continuously, linear regression analysis revealed a negative correlation between imatinib plasma concentration in patients with 400 mg imatinib per day and white blood cell count (R=0.103, P=0.013), and a positive correlation with serum alanine aminotransferase (ALT) concentration (R=0.076, P=0.033).</p><p><b>CONCLUSIONS</b>The imatinib plasma concentration in patients with larger body surface area, subtotal gastrectomy or total gastrectomy may be lower. For these patients, dosage of imatinib should be considered to increase in order to achieve effective plasma concentration. Excessive imatinib plasma concentration can result in some side effects, such as decrease of white blood cells and liver damage. Therefore, it is significant for receiving optimal clinical therapeutic efficacy to monitor imatinib plasma concentration, adjust imatinib dosage timely and keep imatinib plasma concentration in effective and safe range.</p>

Laparoscopic-assisted pancreaticoduodenectomy: a case series of 5 patients / 中华胰腺病杂志

Objective To explore the feasibility of laparoscopic-assisted pancreaticoduodenectomy.Methods The clinical data of 5 patients in our hospital from January to May 2010 were analyzed. 2 patients were pre-operatively diagnosed to have lower common bile duct adenocarcinoma, and 2 patients were preoperatively diagnosed to have adenocarcinoma of the descending duodenum, 1 patient was intra-oparatively diagnosed to have pancreatic head cancer. During the operation, laparoscopic exploration was performed, then gallbladder, distant bile duct, distant stomach, duodenum, part of jejunum and head of pancreas were disassociated, then the digestive tract was reconstructed under open abdomen surgery. Results All the operations of the 5 cases were successfully performed, with an average operation time ( 339 ± 54) min and an intra-operative blood loss of (538 ± 106)ml, and there was no intra-operative blood transfusion. The patients'bowel function recovered (4.0 ± 1.0 ) d postoperatively and were discharged ( 15.8 ± 4.7 ) d postoperatively.1 patient developed pancreatic fistula and was cured with conservative treatment. Conclusions Laparoscopicassisted pancreatoduodenectomy is minimally invasive with short operation time and fast postoperative recovery,which is worth of further clinical study.

Simultaneous Determination of 16 Carcinogenic and Allergenous Dyestuffs in Toys by Ultra Performance Liquid Chromatography Tandem Mass Spectrometry / 分析化学

A comprehensive analytical method based on ultra performance liquid chromatography tandem mass spectrometry has been developed for the simultaneous determination of 16 carcinogenic and allergenous dye stuffs (acid red 26, basic red 9, disperse blue 1, acid violet 49, disperse blue 3, solvent yellow 1, dispersed blue 106, disperse orange 3, disperse yellow 3, basic violet 1, basic violet 3, disperse red 1, solvent yellow 3, disperse blue 124, solvent yellow 2 and disperse orange 37).Various toy samples, including textile, leath er, paper, wood, balloon, modeling clay, limitation tattoo and aqueous liquid, were extracted under ultrason ication.Qualitative and quantitative analysis was carried out for the analyte under the MRM mode after the chromatographic separation on Waters ACQUITY UPLC BEH C_(18)(50 mm x 2.1 mm, 1.7 μm) column.The limits of quantitation(LOQ) for the 16 dyestuffs were in the range of 1.0-8.0 μg/kg.The mean recoveries at the three spiked levels of 5-100 μg/kg were 81.3%-98.6%, with the intra-day precision less than 11% and the inter-day precision less than 14%.The method is accurate, rapid, sensitive, and adapt to the inspec tion of the 16 dyestuffs in toys.

Simultaneous Determination of Nonylphenol, Octylphenol and Bisphenol A in Textiles and Food Packaging Materials by Liquid Chromatography Tandem Mass Spectrometry / 分析化学

A comprehensive analytical method based on liquid chromatography tandem mass spectrometry has been developed for the determination of nonylphenol, octylphenol and bisphenol A in textiles and food packaging) materials. Various textile and food packaging material samples were extracted under the conditions of 10.3 MPa and 120 ℃ by accelerated solvent extraction method with two static cycles using ethanol as the extraction) solvent. The extract was cleaned up by Supelclean Envi-Carb solid phase extraction cartridge. Qualitative) and quantitative analyses were carried out for the analytes under the multiple reaction monitoring(MRM) mode after the chromatographic separation on Waters XBridge C_(18))(150 mm×2.1 mm, 3.5 μm) column) with methanol-0.1% NH_4OH gradient elution. The limits of detection(LODs) for alkylphenol, octyphenol and bisphenol A were 0.5 μg/kg. The mean recoveries for textile samples at the spiked level of 0.5-10 μg/kg were 86.9%-92.5%, with the relative standard deviation less than 9.1%. The mean recoveries for food packaging material samples at the spiked level of 0.5-10 μg/kg were 87.8%-93.0%, with the relative standard deviation less than 8.8%. The method is accurate, simple, rapid, and adapts to the inspection of nonylphenol, octylphenol and bisphenol A in textiles and food packaging materials.

Determination of Musk Xylene in Cosmetics by Solid Phase Extraction-Isotope Dilution-Gas Chromatography Tandem Mass Spectrometry / 分析化学

A comprehensive analytical method based on solid phase extraction-isotope dilution-gas chromatography tandem mass spectrometry has been developed for the determination of musk xylene in cosmetics. Various cosmetic samples, including cream, lotion, powder, shampoo and lipstick, were extracted under ultrasonication. The extract was centrifuged, and the upper solution was concentrated by rotary evaporator. The reconstructed solution was then cleaned up by Sep-Pak Silica solid phase extraction cartridge. Qualitative and quantitative analysis was carried out under the MRM mode after the chromatographic separation on DB-5 MS(30 m×0.25 mm, 0.25 μm) capillary column. The limit of quantitation(LOQ) for musk xylene was 5 μg/kg. The mean recoveries at the three spiked levels of 5-50 μg/kg were 81.1%-86.9%, with the intra-day precision less than 10% and the inter-day precision less than 12%. The method is accurate, rapid, sensitive and adapt to the inspection of musk xylene in cosmetics.

Laparoscopic Cholecystectomy for Gallstones Complicated with Acute Biliary Pancreatitis / 中国微创外科杂志

Objective To explore the feasibility and proper time of laparoscopic cholecystectomy(LC)for the treatment of gallstones complicated with acute biliary pancreatitis(ABP).Methods From January 1999 to August 2007,72 patients with gallstones complicated with ABP were treated with LC in our department.Among the patients,early LC was performed on 56 cases when their symptoms of pancreatitis were relieved,elective LC was carried out in 8 patients,while emergent LC was required in the other 8 patients because of failure of conservative treatment.Results The LC was successfully completed in all the cases with a mean operation time of 63 min(30-135 min),and a mean blood loss of 50 ml(20-230 ml).Intraoperative cholangiography was carried out in 5 patients,4 of them were diagnosed as having stones in the lower common bile duct,and were then cured by endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic sphincterotomy(EST)after LC.Only one patient was converted to open surgery.No perioperative death,or postoperative biliary hemorrhage or leakage occurred in this series.After the operation,pathological examinations revealed multiple small or sand-like stones in the resected gallbladders.The patients were followed up for 2 months to 8 years(mean 19 months);during this period,no recurrent pancreatitis or cholelithiasis was found.Conclusions LC is feasible and safe for patients with gallstones complicated with acute pancreatitis at early stage if perioperative treatments has been properly carried out.Preoperative MRCP,intraoperative cholangiography,and postoperative EST are essential auxiliary techniques for the treatment.

THE EFFECTS OF LPS, HRIL — 2 AND PROTAMINE ON THE PROLIFERATION OF RAT GLONERULAR EPITHELIAL CELLS (GEC) AND INCORPORATION OF 35 SULFATE INTO CELL LAYERS IN VITRO / 中华肾脏病杂志

The heparan sulfate proteoglycan(HSPG) is the major part of sulfated macromolecules synthesized by the cultured rat GECs, and plays an important role in maintaining the glomerular charge—selective function. We have investigated the effects of lipopolysaccharide (LPS, 6.25ng/ml), human recombinant interleukin—2, (HrI1—2, 2. 5u/ml), and protamine sulfate(PtS, 100?g/ml) on the proliferation of rat GEC and incorporation of 35 SO into cell layers in vitro. A method of 3 H—TdR and 35 S—Na_2SO_4 dual isotope labelling technique was used. Statistical analysis was done using analysis of variance for both 3 H—TdR uptake and 35 SO incorporation, and analysis of variance only for the latter. These results show that LPS, HrIL—2 and PtS inhibited the proliferation of rat GECs. HrIL—2 also directly inhibited the incorporation of 35 SO into cell layers, but the roles of LPS and PtS, which decreased 35 SO—content, only came from their inhibition effects on cell proliferation. We suppose that the decreased production of HSPG by GECs, may contribute to the development of proteinuria.