We performed a multicenter study in Japan to assess the efficacy and safety of immunosuppressive therapy with high-dose mizoribine (MZR; 6 mg/kg) combined with basiliximab (Bas), cyclosporine (CyA), and a corticosteroid in 90 patients. MZR was adjusted to maintain a target trough level of 1 to 2 μg/mL. CyA was started at 7 mg/kg to maintain blood levels in the target therapeutic range of 200 ng/mL (trough [C0]), 1200 ng/mL (2-hour post-dose [C2]), and 6000 ngh/mL (area under the curve(0-9)). Bas (20 mg/body weight) was administered on the day of transplantation and on postoperative day 4. Rejection was diagnosed by episode and protocol biopsies. Cytomegalovirus (CMV) antigenemia (direct immunological staining of leukocytes using peroxidase-labeled monoclonal antibody [C7-HRP]) levels were measured every 2 weeks for 6 months. At 12 months, all patients and grafts were surviving except for one death from infection: the 1-year patient and graft survival rate was 98.9%. The acute rejection rate was 21.1%. The mean serum creatinine level at 1 year was 1.51 0.61 mg/dL. The incidence of CMV disease was 0% with 28.9%, CMV antigenemia and 5.6%, ganoyclovir treatment. The incidence of BK virus disease was 2.2%. The mean serum uric acid level was 7.15 1.79 mg/dL at 1 month and 7.06 1.78 mg/dL at 3 months. We observed that a high-dose MZR regimen in combination with CyA, Bas, and corticosteroid was safe and effective to reduce the frequency of CMV and BK virus-related events in renal transplant recipients.
Aerosol optical property is essential to the tropospheric ozone formation mechanism while it was rarely measured in ozone-rich environment for a specific study. With the retrieved products of the sun-photometer, a comparative investigation was conducted on aerosol optical depth (AOD), single scattering albedo (SSA) and size distribution during ozone-polluted episodes and clean background. Contrary to expectations, aerosol loading was found to be positively-correlated with ozone concentration: daily averaged AOD at 500 nm in ozone episodes ( 0.78) displayed 2.4 times higher than that in clean days ( 0.32). Large Ångström exponent ( 1.51) along with heavy aerosol loading indicated a considerable impact of fine particles on optical extinction. The dynamic diurnal fluctuation of these parameters also implied a complex interaction between aerosols and photo-chemical reactions. The bimodal lognormal distribution pattern for aerosol size spectra exhibited in both ozone-polluted and clean days. The occurrence of maximum volume concentration ( 0.28) in fine mode (radius < 0.6 μm) was observed at 3 p.m. (local time), when ozone was substantially generated. Pronounced scattering feature of aerosol was reproduced in high-concentration ozone environment. SSA tended to increase continuously from morning ( 0.91 at 440 nm) to afternoon ( 0.99), which may be associated with secondary aerosol formation. The scattering aerosol (with moderately high aerosol loading) may favor the ozone formation through increasing solar flux in boundary layer. Utilizing the micro-pulse lidar (MPL), a more developed planet boundary layer (PBL, top height 1.96 km) was discovered during ozone-polluted days than clean condition ( 1.4 km). In episodes, the maximum extinction ratio ( 0.5 km- 1) was presented at a height of 1.2 km in the late afternoon. The humidity profile by sounding also showed the extreme value at this altitude. It suggested that optical extinction was mainly attributed to the aerosol in middle PBL, where the intense photochemical reactions and hydroscopic growth may occur.
Fifty cases of first-episode schizophrenia patients and fifty age- and gender-matched healthy controls were tested by a computerized version of Tower of London (TOL) test. The scores of the Positive and Negative Syndrome Scale(PANSS) in the group of schizophrenia patients were over 60.
The numbers of the correct answer [x1 :(14.62 4.12), x2: (14.80 4.70)] during the first session and the second session of the TOL test of the patients group were significantly lower than that of the control group [x1: (17.48 3.79), x2:(18.68 3.19)], and the reaction times [t1: (9.27 4.37) seconds, t2: (9.51 5.58) seconds] of the two sessions of TOL were longer than the control group [t1: (7.28 2.04) seconds, t2: (6.67 1.51) seconds], P < 0.01. For the control group, x2 was significantly greater than x1, and t2 shorter than t1 (P < 0.01), while for the patients group, there was no difference between the performances of the first session and the second session. The scores of TOL in the schizophrenia patients were correlated with the negative symptom score of PANSS (P < 0.05) and were not correlated with the scores of other subscales of PANSS (P > 0.05).
INTRODUCTION: Recent studies suggesting an increased cancer risk with glucose-lowering agents have received widespread publicity. The objectives of this study were to evaluate the comparability in underlying cancer risk and patterns of cancer risk over time with different glucose-lowering agents. METHODS: The General Practice Research Database (GPRD) was used to identify cohorts of new users. Cancer outcomes were obtained from the GPRD, Hospital Episode Statistics and cancer registries. Relative rates of cancer comparing different glucose-lowering agents were estimated using Poisson regression. RESULTS: A total of 206,940 patients was identified. There was no difference in cancer risk and quartile for HbA(1c) value. There were differences in cancer incidence in the first 6 months after starting treatment (adjusted relative rate of 0.83 [95% CI 0.70, 0.99] with thiazolidinediones, 1.34 [95% CI 1.19, 1.51] with sulfonylureas and 1.79 [95% CI 1.53, 2.10] with insulin, compared with metformin). Insulin users had decreasing cancer incidence over time (adjusted relative rate of 0.58 [95% CI 0.50, 0.68] during months 6-24, relative rate of 0.50 [95% CI 0.42, 0.59] during months 25-60 and relative rate of 0.48 [95% CI 0.40, 0.59] during months 60+) compared with months 0-6 after starting insulin. Similar patterns were found with sulfonylureas and metformin. There were no increases over time with insulin glargine (A21Gly, B31Arg, B32Arg human insulin; relative rate of 0.70 [95% CI 0.52, 0.95], 0.77 [95% CI 0.56, 1.07] and 0.60 [95% CI 0.36, 1.02], respectively, for 6-24, 25-60 and >60 months). CONCLUSIONS: These findings do not provide evidence of either beneficial or adverse effects of glucose-lowering agents on cancer risk and are consistent with changes in diabetes treatment in the few months prior to the diagnosis of cancer. 153554b96e