Effects of glycaemic control and CYP3A5 polymorphisms on tacrolimus trough concentrations after adult kidney transplantation / 中国临床药理学与治疗学

AIM: Diabetes mellitus affects the pharmacokinetics of cytochrome P450 3A4 / 5 (CYP3A4/5) substrates. We evaluated the relationship between haemoglobin A1c (HbA1c) levels and the pharmacokinetics of controlled-release tacrolimus. METHODS: This retrospective observational cohort study included kidney transplant recipients (>18 years) receiving controlled-release tacrolimus orally. CYP3A5 genotypes were categorized as expressers (*1/*1 or *1/*3) and non-expressers (*3/*3). Multiple linear regression analysis determined the predictors for trough concentration / dose-normalized by body weight (C/D) ratio of tacrolimus at 7 days, 6 months and 12 months after administration. Correlations between the C/D ratio and HbA1c levels at baseline, 6 and 12 months after tacrolimus initiation were evaluated with Bonferroni correction. RESULTS: Out of 42 patients (CYP3A5 expressers, n=56, and non-expressers, n= 83), the multiple linear regression analysis showed that the C/D ratio on Day 7 was marginally higher in CYP3A5 non-expressers than in CYP3A5 expressers. Factors affecting the elevation of tacrolimus C/ D ratio after 6 and 12 months of treatment were male sex and CYP3A5 non-expressers and increased HbA1c levels and CYP3A5 non-expressers, respectively. The C/D ratio and HbA1c levels after 12 months was positively correlated in CYP3A5 non-expressers (y=54.6x+194.6, R=0.63, P=0.004, Bonferroni correction). Furthermore, intra-individual changes in the C/D ratio and HbA1c levels from 6 to 12 months were nearly correlated (y=54.5x + 20.2, R=0.41, P=0.036, Bonferroni correction). CONCLUSION: HbA1c and CYP3A5 genotypes might be considered to understand the inter- and intra-individual variability in blood tacrolimus concentrations after 6 months post-kidney transplantation.

Effects of temperatures variation between neighboring days on mortality risk in Changsha 2010-2019: a time series analysis / 公共卫生与预防医学

Objectives To analyze the features on temperature and mortality of Changsha in 2009-2019, and to explore the association between temperatures variation between neighboring days (TVN) and mortality by using time-series analysis. Methods A Poisson generalized linear regression model combined with a distributed lag non-linear model was used to analyse the association between TVN and mortality. Results A total of 404 328 deaths were studied in Changsha during 2010-2019，the proportion of people aged over 65 years, males respiratory disease, and cardiovascular disease were 74.1761%, 58.9842%, 11.11% and 54.4671%, respectively. During the 3652-day study period, the daily mean maximum and minimum temperature were 35.8℃ -2.8℃. The TVN varied from -12.30℃ to 10.8℃,and a significant correlation was found between TVN and mortality risk, with 1.12% (RR=1.0112，95% CI：1.0061~1.0164) mortality risk increased for 1℃ rise in TVN, and the greatest effect of TVN on mortality was at 4 days lag. Based on age, gender and  group study For cardiovascular disease and respiratory disease，a 1℃ increased in TVN were associated with 2.97% and 1.52% death risk increase respectively. The effect appeared on the first day after exposure and lasted for 7 days, the maximum affection came on the fourth day. According to the analysis on age, gender and death-cause, the elderly man over 65 years old, respiratory disease people were more vulnerable to the temperature change between day by day. Conclusion This study provides a comprehensive picture of the non-linear associations between temperature variation and mortality, and there is a certain lag effect. The findings on vulnerability characteristics can help improve clinical and public health practices to reduce disease burden associated with current and future abnormal weather.

Obstetric factors for maternal depression/anxiety / 中华围产医学杂志

Objective To investigate the current situation of depression/anxiety in gravidas and to analyze the related obstetric factors.Methods A questionnaire survey was conducted among 6 923 gravidas who registered for their first prenatal examination at Obstetrics and Gynecology Hospital of Fudan University from September 2015 to September 2016.Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were completed during the survey and general obstetric conditions and medical history were reviewed.Related obstetric factors were statistically analyzed by Chi-square test and logistic regression.Results In this study,the positive rates of depression and anxiety screening were 23.15％ (1 603/6 923) and 9.56％ (659/6 893),respectively.Univariate analysis showed that maternal depression was associated with maternal age,gravidity,parity and history of adverse pregnancies (all P＜0.05),while anxiety was related to maternal age,gravidity and history of adverse pregnancies (all P＜0.05).Multivariate analysis showed that younger gravidas (＜25 years old) had higher risks of depression and anxiety than those aged between 25 and 35 (OR=2.945,95％CI:2.266-3.829;OR=1.959,95％CI:1.381-2.780;both P＜0.05).Compared to primiparas with a history of conception,the first-time pregnant women had lower risks of depression and anxiety (OR=0.732,95％CI:0.630-0.851;OR=0.630,95％CI:0.512-0.775;both P＜0.05),and the risk of anxiety in multiparas was also decreased (OR=0.748,95％CI:0.561-0.996,P＜0.05).In addition,gravidas with previous adverse pregnant outcome showed higher risks of depression and anxiety (OR=1.549,95％CI:1.123-2.137;OR=1.712,95％CI:1.138-2.577;both P＜0.05).Conclusions The positive rates of depression and anxiety are high in gravidas,especially younger or primiparas with a history of conception and those with history of adverse pregnancies.Clinicians should pay attention to any obstetric factors related to maternal depression and anxiety.

Subject Map and Author Group of the Development of Chinese Medical Ethics:Bibliometrical Study on Chinese Medical Ethics / 中国医学伦理学

Objective: To present the evolutionary path of Chinese Medical Ethics, analyze the development vein of periodical, explore the journal' s research focuses, and provide reference for related personnel to understand the development of the current research status in the field through visualization technology. Methods:Using biblio-metric method,taking "China National Knowledge Infrastructure" as source of data collection, we used the visual-ization software CiteSpace to draw scientific knowledge maps and analyzed literatures published from 1990 to 2014 in Chinese Medical Ethics. Results:The annualvolume of journal articles fluctuated upwards,with peaks in 1992, 2000 and 2009, and of which the most was in 2009, with 393 articles. "Medical Ethics" and "Doctor-patient Relationship" were hotwords in this field. The publications of domestic and foreign scholars promoted the interna-tional exchange and the development of Chinese medical ethics, and the most productive institutions were often col-leges or universities. Conclusion:Chinese Medical Ethics has effectively promoted the development of bioethics in China, more and more scholars are involved in the relative research of medical ethics, and the old, middle and young scientists and research teams inherit, cooperate and develop with each other. The cross-regional, inter-a-gency and interdisciplinary collaboration remains very limited, whichwill become the important factorinfluencingthe development of the field of Chinese medical ethics in the future.

Study on sleeping quality of medical students and its influential factors / 中华健康管理学杂志

Objective To understand the quality of sleeping in medical students, and provide a reference basis for designing sleep health management program for college students. Methods The survey was conducted at a medical college in Shanxi province with stratified random sampling and Pittsburgh Sleep Quality Index (PSQI) scale. Totally 210 individuals were enrolled, 199 completed the questionnaire, with a response rate of 93.5%. SPSS 21.0 statistical software was used for data analysis. Descriptive statistical analysis was carried out for socio-demographic data. Independent t-test, one-way analysis of variance and non-parametric test were used to compare the scores of PSQI between participants. Multiple stepwise linear regression was used to determine influencing factors of sleep quality. Results The average score of PSQI for the 199 medical students interviewed was (6.74±2.42), the incidence of sleep disorder was 50.25%, the overall sleep quality was not high. Learning pressure of medical student had statistically significant in PSQI (Completely unmatched, 5.14 ± 2.32, Mostly unmatched, 5.93 ± 2.73, Mostly matched, 6.70 ± 2.42, Absolutely matched, 7.39 ± 2.10, F=3.366, P=0.020), employment pressure of medical students in PSQI (Completely unmatched, 6.50 ± 0.71, Mostly unmatched, 6.80 ± 3.24, Mostly matched, 5.98 ± 2.14, Absolutely matched, 7.14 ± 2.35, F=3.134, P=0.027). Grade (β=-0.172, P<0.05) and learning pressure (β=0.210, P<0.01) were the main influence factors for students. Conclusion Sleep quality of medical students was not high, upper grade was worse than low grade, the incidence of sleep disorder had increasing trend as learning pressure and degree of employment pressure worsen.

Effects of Doxorubicin Perfusion Therapy on Therapeutic Efficacy and Related Indexes in Patients with Superficial Bladder Cancer underwent TURBT / 中国药房

OBJECTIVE:To investigate the effects of doxorubicin perfusion therapy on therapeutic efficacy and related indexes in patients with superficial bladder cancer underwent transurethral resection of bladder tumor (TURBT).METHODS:Medical records of 96 patients with superficial bladder cancer were analyzed retrospectively and divided into observation group and control group according to drug use,with 48 cases in each group.Observation group was given perfusion therapy of 0.9％ Sodium choride solution 40 mL containing 20 mg doxorubicin 7 d after surgery.Control group was given TURBT combined with equal amount of 0.9％ Sodium chloride solution.Both groups received treatment for consecutive 10 months,once a week in first 8 weeks,later once a month.The recurrence rate and disease progression of 2 groups were observed and compared,and the levels of sICAM-1 and sVCAM-1,the levels of tumor marker DKK1 and VEGF were observed before and after treatment.The occurrence of ADR was recorded.RESULTS:After 24 months of treatment,remission rate and control rate of observation group were significantly higher than control group,with statistical significance (P＜0.05).There was no statistical significance in the progressive survival rate between 2 groups (P＞0.05).Before treatment,there was no statistical significance in the levels of sICAM-1、sVCAM-1、DKK1 and VEGF between 2 groups (P＞0.05);after treatment,the levels of sICAM-1、sVCAM-1 、DKK1 and VEGF in 2 groups were significantly lower than before treatment,the observation group was significantly lower than the control group,with statistical significance (P＜ 0.05).The recurrence rate,the incidence of frequent/urgent urination,hematuria and dysuria in observation group after treatment were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:For patients with superficial bladder cancer underwent TURBT,doxorubicin perfusion therapy can significantly reduce recurrence rate,relieve tumor deterioration and reduce tumor activity with good safety.

Effect of health management on community hypertensive patients' self efficacy / 中华健康管理学杂志

Objective To understand the effect of health management to enhance the community hypertensive patients' self-efficacy. Method With the method of stratified random sampling, 347 patients who come from communities were diagnosed as hypertension were selected as research subjects from the range of Yingze in Taiyuan of Shanxi province. There were 191 males and 156 females, the age ranged from 38 to 72 (55.90±9.60) years. The self efficacy promotion plan was conducted on high blood pressure patients. A comparison before and after six months of health management was made among the self efficacy scores, daily life scores, health behavior scores, drug behavior scores, medical compliance behavior scores by using self-efficacy scale. Excel 2007 and SPSS 19.0 were used for data analyses. Result Before the implementation of health management, the self efficacy scores of research subjects were 26.96 ± 0.77. After the implementation of health management, the value increased to 29.51 ± 0.86 (t=-41.23, P<0.05). In four dimensions, daily life (before and after management 6.85 ± 0.20 and 7.49 ± 0.31, t=-40.66), drug behaviors (before and after management 7.52 ± 0.21 vs. 7.98 ± 0.23, t=-26.93) and medical compliance behavior scores (before and after management 5.26±0.15 vs. 6.78±0.19, t=-115.97) were higher than those before the health management except health behaviors (before and after management 7.25 ± 0.40 vs. 7.26 ± 0.40, t=-1.94, P<0.05). Conclusion Health management regulated the self care behavior of patients with hypertension, improved the patients' compliance and enhanced self efficacy, which played an important role in controlling the development of disease.

Comparison of three kinds common methods in detection of hepatitis B / 中国医师进修杂志

ObjectiveTo investigate the clinical application value of enzyme-linked immunosorbent assay (ELISA) and time-resolved fluorescence analysis(TRFIA) and latex immune chromatography (GICA) in detecting hepatitis B serum markers.MethodsOne hundred and forty-five suspected patients of hepatitis B were detected serum markers of hepatitis B by ELISA,TRFIA and GICA method,and the results were compared and analyzed.ResultsWhen TRFIA method was as gold standard,the positive coincidence rate of ELISA and GICA method in HBsAg,HBeAb,HBcAb was 71％ (57/80),45％ (36/80),and in HBsAb,HBeAb,HBcAb was 33％( 1/3),0 (0/3),and there were significant differences between two methods (P＜0.05 ) ; the others were no significant differences (P ＞ 0.05 ).There was significant difference in the sensitivity of HBsAg between ELISA method and GICA method (P ＜ 0.05 ),but there was no significant difference in HBsAb,HBeAg,HBeAb,HBcAb(P ＞ 0.05 ).There was no significant difference in the specificity of HBsAg,HBsAb,HBsAg,HBeAb and HBcAb between ELISA method and GICA method (P ＞0.05).There was significant difference in HBsAg among three methods(P ＜0.05),but there was no significant difference between ELISA method and TRFIA method (P＞0.05),and there was significant difference between GICA method and TRFIA method (P＜0.05).There was no significant difference in HBsAb,HBeAg,HBeAb and HBcAb among three methods (P ＞ 0.05 ); there was significant difference in both HBsAb and HBeAb positive among three methods (P ＜ 0.05),and there was significant difference between ELISA method,GICA method and TRFIA method (P＜ 0.05).ConclusionTRFIA method has supreme measuring range,sensitivity and specificity supreme,but the price is higher;ELISA method is in the intermediate level of three methods and price is cheap,and it as well as TRFIA is suitable for the batch detection; GICA accuracy is low,but quick and simple,it is more suitable for the complement of the first two methods.

Clinical observation on the effect of hysteroscopy combined with laparoscopy in treatment of 102 patients with infertility / 中国基层医药

Objective To investigate the role of hysteroscopy combined with laparoscopy in treatment of infertility.Methods 102 patients with infertility treated by hysteroscopy combined with laparoscopy were retrospectively analyzed.Results Of 102 cases of infertility,there were 57 cases with Pelvic adhesions and tubal obstruction,24 cases with endometriosis,12 cases with polycystic ovary syndrome,4 cases with endometrial polyp,3 cases with hysteromyoma and 2 cases with uterus septum.The first three cases were chronic pelvic inflammatory with salpingemphraxis ( 55.88% ), endometriosis Ⅰ -Ⅱ (23.53% ) and polycystic ovary syndrome (11.76% ).The postoperative pregnancy rate was 41.18%, 3 patients with ectopic pregnancy (7.14%) and 4 spontaneous abortion (9.52%).Conclusion Laparoscopy with hysteroscopy played an important role in treatment of infertility.It was an effective method and worthy to be widely used.

Cognitive Function in Chronic Schizophrenic Patients with Tardive Dyskinesia / 中国临床心理学杂志

Objective: To explore the cognitive function of chronic schizophrenic patients with tardive dyskinesia(TD).Methods: 82 chronic schizophrenic patients with TD,70 chronic schizophrenic patients without TD were accepted 3 neuropsychological tests including WMS,WCST and TMT.Results: Compared with non-TD group in WCST,TD group had poorer performance in the number of error responses,the selective error rate,error thinking time,the number of perservation of responses and the rate of conceptualization responses.Additionally,TD group had poorer performance in TMT-PartB.Conclusion: Chronic schizophrenic patients with TD had significantly cognitive impairment,involving the frontal cortex.

Thiamphenicol in Bacterial Vaginosis Treatment:A Clinical Analysis / 中华医院感染学杂志

0.05).The side effects of thiamphenicol was more little than the other.CONCLUSIONS The treatment bacterial vaginosis with thiamphenicol is effective and safe and the side effects is a little.

Monocyte chemoattractant protein-1 and its correlation with lipoprotein inpolycystic ovary syndrome / 北京大学学报(医学版)

Objective: To measure serum monocyte chemoattractant protein-1 (MCP-1) levels and study its associations with lipoproteins in patients with polycystic ovary syndrome (PCOS). Methods: Sixty-five PCOS women and 20 ovulating normal women with body mass index (BMI)