Multi-point fixation with absorbable cartilage screws for the treatment of osteochondral fracture caused by patellar instability / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of multi-point fixation with bioabsorbable cartilage screws for the treatment of osteochondral fracture caused by patellar instability.</p><p><b>METHODS</b>During the period from August 2014 to Steptember 2016, there were 21 patients with osteochondral fracture caused by patellar dislocation, including 7 males and 14 females, ranging in age from 12 to 42 years old, with an average of 27 years old. During the operation, free fractures fragments of cartilage were found with a open surgery, and the patients were treated with fixation by absorbable cartilage screws combined with lateral retinaculum release and medial retinaculum shrinkage. The Lysholm scoring scale was used to evaluate the knee joint functions before and after operation. The retrospective study analyzing the data was carried out.</p><p><b>RESULTS</b>All the patients underwent successful surgeries and were followed up with a mean period of 12 months(ranged, 8 to 22 months). The CT and X-ray examinations were performed after the operation which showed the fracture fragments were on good positon. The exercise level in all the patients basically returned to the pre-injury level. The postoperative Lysholm score was 86.11±4.97.</p><p><b>CONCLUSIONS</b>The absorbable cartilage nail can effectively fix the free cartilage fragments of the osteochondral fracture due to the patellar instability, which is a simple operation, and worthy of clinical promotion.</p>

Immunohistochemically stained sections against different anti-Mam-A epitopes for in situ breast cancer diagnosis / 军事医学

Objective To investigate the difference between mammary gland tissues and breast cancer tissues.Methods Monoclonal antibodies against Mam-A immunized epitopes were screened for immunohistochemical staining of normal breast tissues and breast cancer tissues.The average optical density was used as an index to identify the quantitative data by computer-aided technology to screen epitope-specific antibodies with significant difference in staining characteristics between two types of tissues.Furthermore the feasibility and effectiveness of breast cancer diagnosis were evaluated.Results Four anti-Mam-A epitope-specific monoclonal antibodies,mAb1152,mAb11617,mAb995 and mAb656,were obtained.Immunohistochemical staining showed that the average density of mAb1152,mAb11617 and mAb995 was significantly different between the two types of tissues.The difference was significant between normal breast tissues and breast cancer tissues under the same conditions.The results showed that mAb11617 was better than mAb1152 and mAb995.At the best working point,mAb11617 was the best,the specificity was 90％ and the sensitivity was 59.62％.Further analysis showed that the sensitivity of mAb11617 combined with mAb995 in the diagnosis of in situ breast cancer was 81.48％ and the specificity was 90％,which was of great diagnostic significance.Conclusion There is significant difference between breast tissues and breast cancer tissues in Mam-A protein immunological activity or expression.This difference,which can be recognized by the specific antibody staining and computer aided technology,is of important diagnostic value.

Occupational hazard risk assessment with Singapore exposure semi -quantitative evaluation methods in energy -saving lamp industry / 预防医学

Objective To explore and establish an appropriate occupational risk assessment model for energy -saving lamp industry in China,and further to provide reference for risk management.Methods Based on actual conditions on site of 3 different scale energy -saving lamp manufacture factories,Singapore exposure semi -quantitative evaluation methods was used to analyze and evaluate the harm of the work sites contacted with chemical factors,according to which can provide a proposal for risk management.Results The primary occupational chemical hazards in these 3 factories include carbon monoxide,carbon dioxide,aluminium oxide dust,butyl acetate,mercury metal(vapor)and cement dust(free SiO2 <10%).Mercury -injecting of the big scale one has medium risk besides all work sites have low risks or below.Conclusion This methods has confirmed the actual risk levels of the work sites,using the test data in work place,but has a shortage while the sites contacted with physical agents such as noise and heat.

Effects of Simvastatin on Expression of Multidrug Resistance Gene and Protein of SHI-1 Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects of simvastatin(SIM) and serum free medium(SFM) on the expression of multidrug resistance gene(MDR1) and protein of SHI-1 cells.</p><p><b>METHODS</b>Trypan blue exclusion assay was used to detect the proliferation level and viability of SHI-1 cells after treatment with SIM and culture in SFM; The multi-drug resistant protein p-gp was measured by flow cytometry after culture in SFM for 1 to 3 days and treatment with various concentration of simvastatin. The effect of SFM culture and SIM treatment on the expression of MDR1 trascript was detected by qPCR; ELISA was used to measure the change of cellular cholesterol after culture in SIM and SFM. Chemosensitivity assay was performed after treatment with SIM for SHI-1 cells.</p><p><b>RESULTS</b>Compared with control group, the growth of SHI-1 cells cultured in SFM decreased in a time-dependent manner. The growth-inhibitory effect was markedly increased when SHI-1 cells were treated with SIM and SFM. The mRNA level of MDR1 gene decreased after SIM treatment or/and culture in SFM. P-gp protein was downregulated in SHI-1 cells cultured in SFM or/and treated with SIM. The cellular cholesterol level increased when the cells were cultured in SFM. Total cellular cholesterol level decreased in SHI-1 cells treated with SIM and cultured in SFM. Chemosensitivity assays found that pre-treatment with SIM could increase the cytotoxicity of DNR to SHI-1 cells.</p><p><b>CONCLUSION</b>Culture with SIM and SFM can downregulate the expression of MDR1 gene and p-gp protein in SHI-1 cells. SIM also can enhance the chemotherapeutic sensitivity of SHI-1 cells.</p>

A study on dose -response relationship between human hearing loss and non -stationary noise among workers / 预防医学

Objective To investigate the incidence and risk factors of hearing loss among the workers exposed to non -stationary noise.Methods A cross -sectional study was conducted among the participants.571 male workers without any history of ear disorder were enrolled in this study.They had been exposed to non -stationary noise for one year or more. The history of noise exposure,smoking and drinking behavior were interviewed by using a questionnaire.The noise exposure in the workplace was measured at eight -hour equivalent noise level (LEX.8h )and the thresholds of hearing at 500,1 000,2 000,3 000,4 000 and 6 000 Hz were detected.Results The prevalence of high -frequency hearing loss of two ears was 52.54%,while the prevalence of hearing loss of one ear was 71.98%.There were significant differences of prevalence among different groups of workers in LEX.8h ,duration of noise exposure and the cumulative noise exposure (CNE)(P <0.01).There was a dose response relationship between noise exposure and the risk of hearing loss (P <0.01).Conclusion Non -stationary noise exposure may contribute to hearing loss of workers.There is a good dose -effect relationship between the hearing loss and non -stationary noise.

Effect of oxymatrine on p16/cyclinD1/CDK4 pathway in human colon adenocarcinoma SW620 cells / 中草药

Objective: To explore the antitumor effect of oxymatrine and detect the mechanism involved. Methods: The Anti-proliferative effects of oxymatrine in human colon adenocarcinoma SW620 cells were assessed using MTT assay. SW620 cells treated with oxymatrine were assessed with Hoechst 33258 staining and cell cycle distribution assay was performed by flow cytometry. The quantitative real-time PCR assay was used to evaluate the expression of p16, cell cycle-related cyclinD1 and CDK4 mRNA at the genetic level. To investigate the molecular mechanisms underlying alterations in cell apoptosis, the proteins p16, cell cycle-related cyclinD1, and CDK4 were determined by Western blotting analysis. Results: Oxymatrine could significantly inhibit the growth of SW620 cells compared with the control group, the IC50 was 4.02 μmol/L. Its anticancer activity was related to the alteration in expression of p16, cyclinD1, and CDK4 (P<0.05, 0.01). Conclusion: These results suggest that oxymatrine produces the obvious antitumor effects on SW620 cells in vitro, induces the cell arrest in G1 phase which is related to the regulation on the protein expression of p16, cyclinD1, and CDK4.

Hexavalent chromium pollution and exposure level in electroplating workplace / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the pollution of hexavalent chromium in the electroplating workplace and screen the biomarkers of chromium exposure.</p><p><b>MATERIAL</b>Field occupational health investigation was conducted in 25 electroplating workplaces. 157 electroplating workers and 93 healthy unexposed controls were recruited. The epidemiological information was collected with face to face interview. Chromium in erythrocytes was determined by graphite furnace atomic absorption spectrophotometer.</p><p><b>RESULTS</b>The median of short-term exposure concentration of chromium in the air at electroplating workplace was 0.06 mg/m(3) (median) and ranging from 0.01 (detect limit) to 0.53 mg/m(3)). The median concentration of Cr (VI) in erythrocytes in electroplating workers was 4.41 (2.50 ∼ 5.29) µg/L, which was significantly higher than that in control subjects [1.54 (0.61 ∼ 2.98) µg/L, P < 0.01]. After stratified by potential confounding factors such as gender, age, smoking status and alcohol consumption, significant differences still existed between electroplating workers and control subjects, except for the subjects of age less than 30 years old (P = 0.11).</p><p><b>CONCLUSION</b>There was hexavalent chromium pollution in electroplating workplace. Occupational hazards prevention measures should be taken to control the chromium pollution hazards.</p>

Clinical study of umbilical cord-derived mesenchymal stem cells for treatment of nineteen patients with steroid-resistant severe acute graft-versus-host disease / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of umbilical cord-derived mesenchymal stem cells (MSCs) infusion in patients with steroid-resistant severe acute graft-versus-host disease (aGVHD).</p><p><b>METHODS</b>A total of 19 patients with steroid-resistant severe aGVHD received MSCs infusion treatment. The treatment response, transplantation-related mortality, events associated with infusion and relapse rate were analyzed.</p><p><b>RESULTS</b>Two patients with grade II, 5 patients with grade III and 12 patients with grade IV aGVHD received a total of 58 infusions of MSCs. The mean total dose of MSCs was 2.13 (range 0.60 - 7.20)×10(6) cells per kg bodyweight. Seven patients received one infusion, 2 patients received two infusions, and 10 patients received three or more infusions. Eleven patients had a complete response and 4 had a partial response and 4 had no response. No patients had side-effects during or immediately after infusions, and no MSCs related tumorigenesis was detected to date. Eleven patients survived and 8 died, 4 for aGVHD, 1 for infection and 2 for aGVHD with concomitant infection and 1 for underlying leukemia relapse. The cell viability of freshly prepared MSCs is 93% (92% - 95%) by trypan blue staining. The cell viability of programmatically frozen and thawed MSCs is 72% (70% - 74%).</p><p><b>CONCLUSION</b>Infusion of umbilical cord-derived MSCs expanded in vitro is an effective therapy for patients with steroid-resistant severe aGVHD without negative impact on relapse. Freshly prepared MSCs are superior to frozen and thawed cells in terms of cell viability.</p>

Effects of simvastatin on proliferation and apoptosis of acute monocytic leukemia cell line SHI-1 / 中国实验血液学杂志

The purpose of this study was to investigate the effect of simvastatin (SIM) on proliferation and apoptosis of acute monocytic leukemia cell line SHI-1 and its mechanism. Experiments were divided into control and test groups (5 µmol/L, 10 µmol/L, 20 µmol/L SIM groups). The growth inhibitory rate of SHI-1 cells was detected using methyl thiazolyl tetrazolium (MTT) method. The cell cycle distribution and apoptotic rate were measured by using flow cytometry. The expression of BCL-2, caspase-3 mRNA were determined by reverse transcription polymerase chain reaction (RT-PCR). The expression of BCL-2, caspase-3 protein levels were analyzed by Western blot. The results demonstrated that SIM inhibited the growth of SHI-1 cells in time- and does-dependent manners. Cell cycle analysis showed that SHI-1 cells significantly arrested in S phase (p < 0.05) after treating with SIM for 48 hours, as compared with control group. 5 µmol/L SIM in test group significantly blocked cell cycle progression, but can not induce apoptosis. The expressions of BCL-2 mRNA and protein were down-regulated and caspase-3 mRNA and protein were up-regulated along with the increase of SIM concentration (p < 0.05). It is concluded that SIM is able to inhibit proliferation and induce apoptosis of SHI-1 cells, the mechanism may be associated with downregulating the expression of apoptosis-related gene BCL-2, upregulating the expression of caspase-3.

Acute T cells lymphoblastic leukemia with a t(1;19)(q23;p13) and E2A-PBX1 in an adult: one case report and literature review / 中华血液学杂志

<p><b>OBJECTIVE</b>To report a case of T cell acute lymphoblastic leukemia (ALL) with t(1;19)(q23;pl3) and E2A-PBX1 fusion gene, which is a characteristic translocation of childhood B cell ALL (B-ALL).</p><p><b>METHODS</b>The chromosome, karyotype, immunophenotype and mRNA for fusion gene of the leukemic cells were examined by cytogenetic analysis, flow cytometry (FCM) and reverse transcriptase PCR (RT-PCR), respectively.</p><p><b>RESULTS</b>The cytogenetic karyotype of the patient was 47, XY, 9p+, 15p+, 17q-, der(19), t(1;19)(q23;pl3)\[5\]/46, XY\[15\], and E2A-PBX1 was positive. The leukemic cells expressed T cell markers. The patient was induced with hyper CVAD regimen (cyclophosphamide, vincristine, adriamycin, and dexamethasone), and achieved complete remission with normal cytogenetic karyotype 46 XY\[10\], and negative E2A-PBX1.</p><p><b>CONCLUSION</b>t(1;19)E2A-PBX1(+) can be implicated in adult T-ALL, besides childhood B-ALL.</p>

Protective effect of Oviductus Ranae capsules on the reproductive organs of aged mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the protective effect of Oviductus Ranae (OR) capsules on the reproductive organs in an aged mouse model established by D-galactose injection.</p><p><b>METHODS</b>Forty-eight female Kunming mice were randomly divided into 4 equal groups, namely the high- and low-dose OR groups, diethylstilbestrol (DT) group, and model group. The mice received subcutaneous injection of D-galactose for 6 weeks to establish aging models. Another 12 mice were injected daily with normal saline (NS) to serve as the normal control group. From the third week of the experiment, the mice were given oral OR at low or high doses (in the OR groups) or vegetable oil (in the model or control groups) till the sixth week. In the last two weeks, the vaginal smears were obtained from the mice for evaluating the changes of the vaginal keratinocytes and counting the days of estrus. After completion of drug administration, all the mice were sacrificed and the serum content of estradiol (E(2)) was detected by radioimmunoassay, with the ovarian and uterine indices determined. The ovarian and uterine pathologies were observed using HE staining, and SOD and MDA activities in the ovary and uterus were also assessed.</p><p><b>RESULTS</b>OR obviously increased E(2) level and the ovarian and uterine indices in the aged mice, also alleviating the pathological change of the ovary and uterus. OR substantially depressed MDA content and enhanced SOD activity in the ovary and uterus.</p><p><b>CONCLUSION</b>OR has definite antioxidative effects and ameliorates the degenerative changes of the reproductive organs in mouse models of aging.</p>

Overexpression of CHIP in chronic myeloid leukemia K562 cells induces mitotic abnormality / 中国实验血液学杂志

This study was aimed to investigate the possible influence of a novel E3 ubiquitin ligase CHIP (carboxyl terminus of Hsc70/Hsp70-interacting protein) on biological characteristics of cancer cells. Stable overexpression models in CML K562 cells were established via lipofectamine-mediated wild type CHIP and its TPR or U-box deletion mutants gene transfection. Followed G418 pressure selection, K562-CHIP stable transfected cell clones were obtained by limited dilution. The proliferation status and cell cycle were observed by MTT assay and FACS. The expression of related proteins and morphological changes were detected by Western blot and Wright-Giemsa staining. The results showed that overexpression of wild type CHIP did not inhibit cell proliferation, but slightly increased cell ratio of G(2)/M phase. CHIP gene had no effect on the stability of BCR-ABL kinase protein. HDAC inhibitor FK228-induced BCR-ABL degradation did not enhanced by CHIP. Notably the enlarged cells and abnormal mitotic cells remarkably increased in K562 WT-CHIP cells, indicating that CHIP may involve in the regulation of mitotic process. It is concluded that wild type CHIP induces mitotic abnormity in K562 cells.

Inhibitory effect of Biejiajianwan pills on tumor growth and proliferating cell nuclear antigen expression in mice bearing H22 cell-induced tumor / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the anti-tumor effect of Biejiajianwan pills and explore its mechanism.</p><p><b>METHODS</b>Mice bearing neoplasm induced by H22 cell inoculation were randomized into 4 groups, namely the negative control group, positive control group (with cyclophosphamide treatment), and high- and low-dose Biejiajianwan pill group. The tumor-bearing mice received corresponding treatments for 15 consecutive days, after which their thymuses and spleens were isolated and weighed to calculate the thymus and spleen indices. The tumor mass was also weighed and the tumor inhibition rate calculated. Immunohistochemistry was performed to evaluate the expression intensity of proliferating cell nuclear antigen (PCNA) in the tumor tissue.</p><p><b>RESULTS</b>The pills significantly inhibited the growth of the implanted tumor and reduced the expression of PCNA in the tumor.</p><p><b>CONCLUSION</b>One of the possible mechanisms of the anti-tumor effects of Biejiajian pills might be associated with the inhibition of PCNA expression in the tumor.</p>

Effects of Yifuning soft gelatin capsules on pathology and biomechanical indexes of ovariectomied rats / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effects of Yifuning soft gelatin capsules (YFN) on pathology and biomechanical indexes of ovariectomied female rats.</p><p><b>METHOD</b>Sixty female Sprague-Dawley rats without pregnancy and delivery were used,50 of them were ovariectomized and randomly divided into 5 groups: ovariectomy(OVX), OVX with diethylstilbestrol tables (DT), OVX with YFN (high dose,middle dose and low dose), the others were sham-operated group. The rats began to take the rats drugs in the fifth week after the operation. After 12 weeks of treat ment the rats were killed, and the bones were collected to inspect. The pathology of bone was observed with the HE stain and the area of trabecular was detected. The electronic testing device was used to detect the biomechanical properties.</p><p><b>RESULT</b>The results indicated that the rat model of postmenopausal osteoporosis (PMO) was a success. Compared with the model group, after application of the drugs, the observation of HE showed different repairing around trabecular. The biomechanical parameters also increased significantly.</p><p><b>CONCLUSION</b>YFN can effectively prevent the loss of bone in OVX rats and strengthen bone quality, and has a good effect on PMO oostmenopausal osteoporosis.</p>

The experimental researches on the use of triamcinolone acetonide for the prevention of implant capsular contracture / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the use of triamcinolone acetonide for the prevention of implant capsular contracture.</p><p><b>METHODS</b>20 rabbits were randomly undivided into 2 groups of 10 animals each. Every 10 ml silicone implant was implanted beneath the panniculus carnosus muscle of one rabbit. At the same time, a modified expander catheter was mounted on the implant. This catheter has many lateral holes and the end was blind. Triamcinolone acetonide (10 mg/3 ml) was infused through the expander pot and catheter as the experimental groups. On the other hand, 3 ml saline was used as the control group at 1, 2, and 3 months. At 6 months, measures related to contracture and capsular histology examinations were performed on anesthetized animals.</p><p><b>RESULTS</b>Baker scores, capsular incision width and capsular thickness of the saline groups were evidently higher than that of triamcinolone acetonide groups (P < 0.01). Implant compression of the saline groups was evidently lower than that of triamcinolone acetonide group. Histology revealed a thinner capsules and less fibrous tissue deposition around the triamcinolone acetonide group, as compared with saline group.</p><p><b>CONCLUSIONS</b>It is effective to deliver triamcinolone acetonide to reduction of capsular contracture through the catheter and its pot.</p>

Interdigitating dendritic cell sarcoma-a case report with literature review / 中华血液学杂志

<p><b>OBJECTIVE</b>To report a case of interdigitating dendritic cell sarcoma (IDCS).</p><p><b>PATIENT MATERIAL</b>The patient was a 41-year-old man with a lymph node bulging in the left neck. Laboratory examination of peripheral blood and bone marrow was abnormal. The diagnosis of IDCS was made by immunohistochemistry and electron microscopy. Treatment of this patient with ABVD regimen (adriamycin, bleomycin, vinblastine, dacarbazine) resulted in obvious improvement, but did not control the tumor infiltration.</p><p><b>CONCLUSION</b>IDCS has no distinctive clinical or pathohistological characteristics. Immunohistochemistry and electron microscopy are crucial in distinguishing it from other histiocytic/dendritic cell neoplasms. IDCS displays an aggressive behaviour, and the responses to chemotherapy are variable.</p>

Localization assessment of kidney with ectopic ureter:analysis of 58 girls / 中华泌尿外科杂志

Objective To present the means of localizing the kidney with ectopic ureter in order to provide the reliable ground for surgical strategy. Methods Clinical manifestation study,IVU,SPECT imaging and cystoscopy were conducted.All the 58 patints are female with a mean age of 3.4 years.According to the creteria presented in reference,5 were type Ⅰ,42 type Ⅲ,1 type Ⅳ,8 type Ⅴ and 2 type Ⅵ. Results Operative finding revealed the accurate localization and diagnosis rate of IVU has been 95%(40/42) in type Ⅲ ectopic ureter,B-ultrasonograph 27%(12/53),SPECT 37%(6/16).With the combined consideration of imaging procedures and cystoscopy,the accurate localization and diagnosis rate has been 98%(57/58). Conclusions Combined use of imaging procedures and cystoscopy would improve the localization and diagnosis rate.Cystoscopy is the most reliable except in type Ⅲ ectopic ureter.

The mechanism of arsenic trioxide-inducing apoptosis of K562 cells / 中国实验血液学杂志

The aim was to investigate the mechanism of arsenic trioxide (ATO) inducing apoptosis of K562 cells that express P210Bcr-Abl. Apoptosis was analyzed by cell proliferation assay, morphological changes, DNA-PI staining and cell cycle analysis. ELISA kits were also used to analyze the concentration of cytosolic cytochrome C and activation of caspase-3. Transcriptional levels of Bcl-XL and Bcr-Abl were assayed by semiquantitative reverse transcription polymerase chain reaction (RT-PCR). The results showed that K562 cells were induced to apoptosis after exposure to 2.5 micromol/L ATO for at least 48 hours, and the cell cycle of K562 cells was arrested at the G2/M phase. Caspase-3 was activated and there was a cytosolic accumulation of cytochrome C. ATO could only reduce the transcriptional level of Bcl-XL, but could not down-regulate the Bcr-Abl transcriptional level. In conclusion, ATO can induce K562 cells to apoptosis. The signal pathway mediated by the cytosolic translocation of mitochondria cytochrome C is one of the mechanisms for ATO inducing apoptosis. And the decrease of Bcl-XL may induce more apoptosis.

Breast reconstruction with multiple miniprostheses / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a new technique for breast reconstruction with multiple miniprostheses,</p><p><b>METHODS</b>Each silicone miniprosthesis(10 approximately 15 ml) was implanted one by one beneath the prepared muscle pocket until the desired volume was achieved.</p><p><b>RESULTS</b>Seven patients were treated with the above mentioned technique, including five after gland fibroadenoma excision, one hemangioma excision and one reduction mammoplasty. The results were satisfactory.</p><p><b>CONCLUSION</b>The above mentioned technique with the miniprostheses may be another good way for breast augmentation and breast reconstruction with many advantages such as smaller incision, easy intraoperative assessment of the ideal size of the breast, easy handling the technique, perhaps low incidence of capsular contracture.</p>

Blood Drug Concentration Monitoring of Sustained-Release Valproate Sodium in Children with Epilepsy / 实用儿科临床杂志

Objective To explore the blood drug concentration monitoring of sustained-release valproate(DK)in children with epilepsy,focusing on the selection of sampling time and evaluation of the results.Methods Two hundred and seventy-one children taking DK and 155 children taking sodium valproate syrup(VPA Syr)were involved and their serum were taken when achieved steady state to determine the valproic acid level using fluorescence polarization immunoassay.They were divided into 4 groups,which were DK taken once daily group(DK qd group,126 children),DK taken once daily at night and sampled on morning group(DK qn group,26 children),DK taken every 12 h group(DK q12 h group,119 children),VPA Syr q12 h group(155 children).Determine the proportion of the blood drug concentration of each group below,ithin and above the therapeutic range for valproate(50-100 mg/L)were determined.The data were analyzed by t test.Results The Cmin of DK qd group were(73.09?19.91)mg/L,significantly lower from the serum concentration of DK qn and sampled on morning group [(94.94?25.44)mg/L](P0.05).Conclusions DK qn should sampled at night before the night dose.The Cmin of DK q12 h was higher according to the therapeutic range,it's favorable range still needs clinical practice.