Effect of recipient SLCO1B1 rs2291075 polymorphism on tacrolimus dose-corrected trough concentration in early postoperative period of liver transplantation / 中国临床药理学与治疗学

AIM: To explore the relationship between SLCO1B1 rs2291075 polymorphism and tacrolimus (FK506) dose-corrected trough concentration (C/D, ng•mL

Association of CYP3A5 and C5 polymorphisms with the individual dosage regimen of tacrolimus in Chinese liver transplantation recipients during the early post-transplantation period / 中华器官移植杂志

Objective To investigate the effect of CYP3A5 and C5 gene polymorphisms on the concentration/dose ratio of tacrolimus in Chinese liver transplant patients during the early posttransplantation period.Methods A total of 100 adult patients who underwent primary liver transplantation (LT) were enrolled.Tacrolimus dosage and trough blood concentration were detemined at first week after liver transplantation.Two single-nucleotide polymorphisms were genotyped and analyzed in both donor and recipient groups.The relationship between gene polymorphisms and tacrolimus concentration/dose ratio (C/ D ratio) was analyzed.Results The distribution of allele A in C5 rs17611 was 63.5 ％ among donors and 58.5％ among recipients.For CYP3A5,the rs776746 allele G represented the major alleles in both donors and recipients (71％ and 72％,respectively).The tacrolimus C/D ratio of recipients carrying allele AA in C5 rs17611 was significantly higher than that of recipients carrying the C5 rs17611 allele G.Both donor and recipient CYP3A5 rs776746 polymorphisms were highly correlated with the tacrolimus C/D ratio at first week after liver transplantation.No linkage disequilibrium between CYP3A5 rs776746 and C5 rs17611 polymorphisms was found (D'max =0.392,r2max =0.034).Recipient CYP3A5 rs776746 allele A,C5 rs17611 genotype AA,and donor CYP3A5 rs776746 allele A were associated with rapid tacrolimus metabolism.With increasing number of these alldes,tacrolimus C/D ratio was reduced during the one week after transplantation.Conclusion Recipient C5 rs17611 polymorphism is a new genetic locus that influences tacrolimus metabolism in patients after OLT during the early post-transplantation periocd.

Research on hospital PACS hardware infrastructure design under big data environment / 中国医学装备

Objective:To describe PACS hardware infrastructure experimental design and summary under big data environment.Methods: A real DICOM communication test of PACS hardware infrastructure experimental design.Results: Archive test figures of DICOM communication for 64 channel CT, 1.5T MRI and DR.Conclusion: Currently, an efficient, reasonable hardware infrastructure design is essential to guarantee large hospital PACS application.

Effect of post-liver transplantation administration of ursodeoxycholic acid on serum liver tests and biliary complications: a randomized clinical trial / 中华肝脏病杂志

<p><b>OBJECTIVE</b>Endogenous hydrophobic bile acids may be a pathogenetic factor of biliary complications after orthotopic liver transplantation (OLT).This study was designed to investigate the effects of hydrophilic ursodeoxycholic acid (UDCA), when administered early after OLT, on serum liver tests and on the incidence of biliary complications.</p><p><b>METHODS</b>A total of 112 adult patients undergoing OLT were randomly assigned to one of two groups for receipt of UDCA (13 to 15 mg/kg/d for 4 weeks, n=56) or a placebo (n=56). All patients underwent serum liver testing and measurement of serum bile acids during the 4 weeks following OLT.Patients with T-tube underwent measurement of biliary bile acids during the 4 weeks following OLT.Biliary complications, as well as patient and graft survival rates, were analyzed during the follow-up period (mean of 65.6 months).</p><p><b>RESULTS</b>At post-OLT days 7, 21 and 28, the UDCA-treated patients showed significantly lower levels of alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transpeptidase (all P less than 0.05).In addition, the UDCA-treated patients showed significantly lower incidence of biliary sludge and casts within the first year post-OLT (3.6% vs.14.3%; x2=3.953, P=0.047). However, there were no significant differences for the incidence of other biliary complications at post-OLT years 1, 3 and 5.The graft and patient survival rates were also similar between the two groups.</p><p><b>CONCLUSION</b>UDCA, when administered early after OLT, improves results from serum liver tests and decreases the incidence of biliary sludge and casts within the first postoperative year.</p>

The clinical efficacy and safety of intravenous cefmetazon for prevention of postoperative infections and treatment of infectioons in general surgery / 中华普通外科杂志

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.

Hydroxychloroquine treatment for primary Sj(o)gren's syndrome:a prospective,open labeled clinical trial / 中华风湿病学杂志

Objective To evaluate the efficacy and safety,particularly eye safety of hydroxychloro-quine(HCQ)treatment in primary Sj(o)gren's syndrome(pSS)patients.Methods Forty pSS patients were en-rolled and treated with HCQ 400 mg/day for 12 months.This is a prospective open-label study.Clinical mani-festations,clinical efficacy,biochemical and immunoserological parameters as well as ophthalmological exami-nations were investigated every three months to assess the safety and tolerability.Results There were signifi-cant decrease in the erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG),immunoglobulin M (IgM)and rheumatoid factor(RF)level after 6 months treatment with HCQ(P＜0.01 or P＜0.05).No changewas detected in serum antinuclear antibody(ANA),anti-SSA/SSB antibodies after treated for 12 months.Somepatients had partial improvement in symptoms such as dry mouth,dry eyes and arthralgia.During the treat-ment,no significant effect on serum alanine aminotransferase (ALT),blood urea (BUN),serum creatinine (Cr),whole blood count(WBC)or hemoglobin(Hb)could be discovered.Central semus retinopathv(CSR)was found in one patient after 6 months treatment with HCQ.However,its association with HCQ could not be confirmed since it was not compatible with the usual HCQ retinopathy.Conclusion HCQ can improve svmp-toms of some pSS patients and can significantly decrease ESR,IgG,IgM and RF level.The safety profile of HCQ is generally good.However,ophthalmological examination before and after a 6-month interval may be necessary in long term HCQ treatment.

Individual FKS06 administration in liver transplantation / 国际外科学杂志

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.

Overexpression of cyclin A in hepatocellular carcinoma and its relationship with HBx gene integration / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the frequency of cyclin A overexpression in hepatocellular carcinoma (HCC) and its relationship with clinical significance and HBx gene integration.</p><p><b>METHODS</b>PCR, 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.</p><p><b>RESULTS</b>Amplification 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.</p><p><b>CONCLUSION</b>Overexpression 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.</p>

One-stage combination of renopancreatic transplantation:a report of 5 cases / 中国普通外科杂志

Objective To summarize the clinical technique and experience of one stage combination of renopancreatic transplantation(SKPT) with portal venous drinage of pancreatic endocrine and enteric drainage of exocrine(PE).Methods Five patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with PE drainage.The clinical data,operative techbuque,and the prevention of non-technical complications were summarized.Results This procedure was successfully applied in the 5 patients.Three patients recovered excellently;but 2 died perioperatively,one died of sepsis due to pancreatic leakage,and one of FK506 toxicity.On postoperative day 3,in the 3 survivors,blood creatinine and urea nitrogen levels returned to normal;insulin administration was discontinued on 7d postoperatively,and the endogenous and exogenous secretory functions of the graft were normal.Conclusions SKPT with PE is a resonable procedure,because of its potential physiologic,metabolic,and immunologic advantages.PE drainage may become the prefer technique of pancreas transplantation.Intensive perioperative managements are effective methods to prevent complications and to improve the therapeutic effects.

Rapid liver and kidney graft procurement:a report of 138 cases / 中国普通外科杂志

Objective To summarize the experience of rapid liver and kidney graft harvesting. Methods From Jan 2001 to Sep 2003,a quick procedure for combined liver and kidney procurement were used in 138 cases. The procedure includes in situ perfusion through aorta and superior mesenteric vein(SMV) plus drainage through inferior vena cava. Liver,pancreas,spleen and kidney were harvested en bloc. Results The warm ischemia time averaged at 2 to 6 minutes for kidneys and 3 to 8 minutes for livers. The total procurement time averaged at 20 to 30 minutes. All aberrant arteries were preserved. After transplantation there was no primary non-function in all 131 liver grafts,and the peak sALT level during the first 3 post-operative days was (581?392) U/L. Acute tubular necrosis rate was 3.3%(9/274) in renal grafts. Conclusion[WT5”BZ] This rapid procurement protects the quality of liver and kidney simultaneously. It is a simple,effective,safe and reasonably standardized procedure.

Imaging Analysis for Giant Hypertrophy of the Gastric Mucosa / 实用放射学杂志

Objective To improve the understanding of giant hypertrophy of the gastric mucosa.Methods Giant hypertrophy of the gastric mucosa in 6 cases proved by operation or gastroscopy biopsy pathological examination were reviewed.Barium meal examination was performed in all cases,CT in 3 cases.B-type ultrasound in 2 cases.Results It was ease to be misdiagnosed giant hypertrophy of the gastric mucosa on the basis of the conventional imaging appearances.Laboratory data and gastroscopy biospsy played an important role in diagnosis and differential diagnosis.Conclusion Giant hypertrophy of the gastric mucosa is uneasily to correct diagnosed,comprehensive evaluation is necessary for it.

Effects of nifedipine on hypoxic pulmonary hypertension and right ventricular hypertrophy in young swine / 中国病理生理杂志

Effects of both hypOXia and nifedipine injected during hypoxia on hemodyhamic and blood-gas parameters were studied in 18 female swine.During hypoxia(at a simtllated high altitude 0f 4,000m),puImonary arterial pressure(Ppa)and puImonary vascLllar resistance(PVR)increased significantly.Systemic arterial pressure(Psa)and total peripheral resistance(TPR)increascd at the same time.N0 significant change in cardiac output(CO)was observed.After intravenous injection 0f nifedipine(40 ?g/kg)at 4,000 m,Ppa and PVR decreased significantly,Psa and TPR als0 decreased,and CO increased significantly. Swine which had received nifedipine (two times per day, 40?g/kg/time, IM)during chtortic intermittent hypOXia(exposed to a simulated high altitude of 4,000 m, 8 hrs/day for 30 days)did not develop right ventricular hypertrophy. It is evident that nifedipine can prevent hypoxic pulmonary hypertension and right ventricular hyper trophy induced by chronic imermittent hypoxia in swine.