With the wide application of epoxy resin (EP) in modern industry, the demand for its multifunctionality and high performance has become increasingly critical. In this study, we developed an innovative multifunctional nanohybrid material, BZrP@CoSn(OH)6 , through a combination of in situ growth and ionexchange strategies. This nanohybrid was uniformly incorporated into the EP matrix, delivering transformative improvements to its properties. At an optimized loading of 5 wt%, BZrP@CoSn(OH)6 enabled the composites to achieve the vertical combustion test (UL-94) V0 rating, alongside notable reductions in peak heat release rate (pHRR), total smoke production (TSP), peak carbon monoxide release (pCOP), and total volatile products by 54.0 %, 48.1 %, 46.9 %, and 63.3 %, respectively. The synergistic action of zirconium phosphate and bimetallic catalysis greatly improves the residue yield, and the formation of a strong char layer acts as an effective physical barrier. The mechanical interlocked structure between BZrP@CoSn(OH)6 and the matrix facilitated a strong interfacial bond, leading to substantial improvements in mechanical performance, with tensile strength and elongation at break increasing by 40.4 % and 63.7 %. Additionally, the nanohybrids enhanced the thermal conductivity and endowed the composite with remarkable antibacterial and ultraviolet (UV) shielding properties. This work demonstrates the synergistic effect of interface engineering and nanohybrid materials in achieving a harmonious balance between flame retardancy and multifunctionality, offering a promising strategy for the design and application of high-performance epoxy resin composites. (c) 2025 Published by Elsevier Ltd on behalf of The editorial office of Journal of Materials Science & Technology.

To address the safety challenges arising from the trend of miniaturization and high integration of electronic and communication devices, efficient flame retardants capable of simultaneously enhancing flame retardancy, thermal conductivity, and mechanical properties of polymers has earned significant attention. In this work, to address the surface chemical inertness and poor compatibility of boron nitride (BN), hierarchical 0D-2D nanohybrid (BNP@NiCoFe-PBA) was fabricated by deposition of phytate-doped polyaniline coatings on BN surface and in situ growth of Prussian blue analogs (PBA). The BNP@NiCoFe-PBA was employed as a filler to enhance the properties of the epoxy resin (EP). Compared to pure EP, the thermal management properties of EP composites were significantly improved with a 32.4% increase in thermal conductivity. Inspiringly, the fire risk of EP composites was notably mitigated. In UL-94 testing, EP composites received a V0 rating. Additionally, cone calorimetry tests revealed substantial reductions in key metrics: the peak heat release rate (pHRR), total heat release (THR), total smoke production (TSP), and peak CO production (pCOP) were decreased by 47.53%, 33.54%, 34.39%, and 34.40%, respectively, compared to the pure EP. Furthermore, mechanical testing showed a 39.5% increase in tensile strength. This work provides valuable insights into designing high performance multifunctional polymer composites.

With the widespread application of fiber-reinforced composites in the automotive, aerospace, and military industries, there is an increasing demand for Basalt Fiber Reinforced Polymers (BFRPs) with enhanced strength and toughness to keep pace with rapid advancements in these fields. In this study, tannic acid (TA) was copolymerized with the silane coupling agent KH550 to form TA-KH nanoparticles, which were subsequently deposited onto the surface of basalt fibers. This surface treatment effectively improved the interfacial properties between basalt fibers (BF) and epoxy resin (EP), thereby enhancing the mechanical properties of BFRPs. Experimental results revealed that, compared to BF/EP, the interfacial shear strength (IFSS) and interlaminar shear strength (ILSS) of (TA-KH)-ABF/EP were increased by 39.0% and 53.2%, respectively. Additionally, the flexural and impact strengths were enhanced by 25.0% and 38.0%, respectively.

The use of ustekinumab in pediatric patients with inflammatory bowel disease (IBD) is off-label and the data are limited. We conducted a systematic review evaluating the efficacy and safety of ustekinumab in pediatric IBD. We systematically searched PubMed, EMBASE and Cochrane databases for studies of ustekinumab in children and adolescents with IBD investigating clinical remission, clinical response, corticosteroid-free (CS-free) remission, endoscopic remission/response, or safety up to March 17, 2023. A random-effects model was used for calculating summary estimates. Eleven studies, comprising 370 patients were included. For Crohn’s disease (CD), the pooled clinical remission rates were 34

In this paper, a flame-retardant, UV-cured coating was prepared on the fiber composites' (FC) surface via a thiol-ene click reaction using pentaerythritol tetra(3-mercaptopropionate) (PETMP), triallyl cyanurate (TAC), and 2-hydroxyethyl methacrylate phosphate (PM-2). The synergistic effectiveness of phosphorus (P), nitrogen (N), and sulfur (S) was studied in detail by changing the proportion of these reactants. Sample S-4(N3P2)(6,) with a molar ratio of N and P elements of 3:2, and the thiol and vinyl groups of 4:6 had the highest LOI value (28.6%) and was self-extinguishing in the horizontal combustion test. It had the lowest peak heat release rate (PHRR) value (279.25 kW/m(2)) and total smoke production (2.18 m(2)). Moreover, the thermogravimetric analysis (TG) showed that the decomposition process of the coated composites was delayed. The conversion rate of the double bond and the thiol of S-4(N3P2)(6) was 100% and 92.0%, respectively, which showed that the cross-linked network structure was successfully formed. The tensile strength and the flexural strength of coated composites improved, and the transparency of the coating can reach 90%. These characteristics showed that the UV-cured coatings could be used in industrial production to effectively prevent fires.

Risk factors and consequences associated with Clostridioides difficile infection (CDI) in children and adolescents with inflammatory bowel disease (IBD) are still uncertain. We conduct a systematic review and meta-analysis to assess risk factors and outcomes associated with CDI in children and adolescents with IBD. PubMed, EMBASE and Cochrane Library databases were searched from inception to 24th February, 2021. Studies investigating risk factors, bowel surgery rate in pediatric IBD patients with and without CDI were included. Random-effects model was used for calculating summary estimates. Newcastle–Ottawa scale (NOS) was used for quality assessment. Fourteen studies, comprising 17,114 patients, were included. There was a significant association between 5-aminosalicylic acid (5-ASA) use and CDI [odds ratio (OR) = 1.95, 95% confidence interval (CI) 1.26–3.03], with minimal heterogeneity (I2 = 0.00%). Increased risk of active disease (OR = 4.66, 95% CI 2.16–10.07) were associated with CDI in those studies performed in high quality score (NOS > 6) and significantly higher CDI rates in studies conducted outside USA (OR = 2.94, 95% CI 1.57–5.58). The bowel surgery rate in IBD with CDI was 3.8–57.1%, compared to that in IBD without CDI (0–21.3%). All studies were of moderate to high quality. 5-ASA use and active disease might be risk factors associated with CDI in children and adolescents with IBD. Bowel surgery rates associated with CDI in IBD patients varied greatly. Large-scale clinical studies on CDI in children and adolescents with IBD are still needed to verify risk factors and outcomes.

1病史资料 患儿,女(病例号11433718),14岁,体质量56 kg,33月前因间断发热、腹泻、咳嗽40余天于2015年8月24日就诊于我院,行肠镜检查提示克罗恩病,给予英夫利昔单抗治疗3个疗程发生严重过敏性休克,于2016年4月开始使用硫唑嘌呤(AZA)治疗,50mg qd.2017年1月复查血常规出现白细胞计数、中性粒细胞计数减少,开始加用沙利度胺片12.5mg qd(规格:25mg/片厂家:常州制药厂有限公司批号:18041931),并进行AZA减量(每2个月减6.25 mg).

The causes of gastrointestinal (GI) bleeding in pediatrics are diverse. Unlike Meckel's diverticulum, anal fissure, polyps, inflammatory bowel disease, and infectious colitis, vascular malformation is not typically considered an etiology of GI bleeding in pediatrics, which can easily cause a delay in diagnosis or be misdiagnosed as reported (Abdoon, 2010; Al-Mehaidib, Alnassar, & Alshamrani, 2009). Vascular malformation, as an important cause of lower GI bleeding, is usually diagnosed in the elderly (Sami, Al-Araji, & Ragunath, 2014). It can affect any segment of the tract, usually the cecum and right colon in adults (Nishimura et al., 2015). Previous studies on children have shown that segmental lesions in the GI tract were found (Abdoon, 2010; Al-Mehaidib et al., 2009; Chuang et al., 2011; de la Torre Mondragón, Gómez, Mora Tiscarreño, & Ramírez Mayans, 1995; Uhlig, Stephan, Deutscher, Kiess, & Richter, 2004), but involvement of the entire colon is rare. In this case, we report an Asian boy presenting with GI bleeding diagnosed as diffused vascular malformation of the entire colon. Case A 13-year-old Asian boy was admitted into the hospital due to discontinuous hematochezia for 2 years and abdominal pain for over 1 month. The boy had no history of disease, surgery, medication, or family history. There was not much blood in his stool and bleeding would stop spontaneously. Either bright red or dark red bloody stools were seen in the course of his disease. At physical examination, he was generally in good condition, but had had a mild anemic appearance and complained of mild tenderness across the entire abdomen. The palpation of his abdomen was soft with no venous exposure. No hemorrhoids were found and no other abnormalities were observed. Blood routine examination showed the hemoglobin level decreased slightly as 92 g/L, and other parameters, such as white blood cell count, neutrophils, red blood cell count, and platelet count, were all within the normal range. Different tests were performed to determine the presence of the following pathogens: test for urine routine, coagulation routine, liver function, kidney function, and stool parasite were normal. Antibodies to hepatitis B/C viruses, Treponema pallidum, and HIV were all negative. The levels of ceruloplasmin and alpha fetoprotein were both normal. The ultrasonography of the intestines, liver, spleen, kidneys, and heart were without any abnormalities. Furthermore, under gastroscopy, no thickened vessels were seen in the esophagus and gastric fundus. Colonoscopy showed normal mucosal but with blood vessels dilated, tortuous, and thickened throughout the entire colon (Figure 1). The terminal ileum and ileocecal valve were normal. Capsule endoscopy was also performed showing no abnormalities of the small intestine.FIGURE 1.: Colonoscopy of vascular malformation in different sites of colon. (A) The ascending colon. (B) The transverse colon. (C) The descending colon. (D) The sigmoid colon. (E) The rectum. (F) The anal tube.The pathological results suggested that there was a little infiltration of lymphocytes and plasma cells in the intestinal tract with eosinophils 2–3/hpf. Therefore, vascular malformation was considered an etiology of the GI bleeding. To further clarify the bleeding site, digital subtraction angiography was recommended but the boy did not obtain his parents' permission. The boy was totally freed from hematochezia and abdominal pain after using octreotide for 5 days and was discharged. Discussion The frequency of vascular malformation of the colon as a cause of lower GI bleeding is 0.6% among adults in a recent study (Tsai et al., 2018) and is unknown for children. In adults, advanced age, especially over 60 years old, heart disease, use of anticoagulant drugs, etc. have been considered risk factors of vascular malformation (Nishimura et al., 2016), whereas scarce data have been identified in children. The mean age of clinical onset was 2.3 years and average delayed diagnosis was 2.9 years (de la Torre Mondragón et al., 1995). Vascular malformation can be incidentally found with various clinical manifestations, of which GI bleeding is the most common problem. Patients may present with chronic and recurrent bleeding, as was in our case. In previous studies, lesions were segmental, and any segment of the GI tract can be affected (Chuang et al., 2011; de la Torre Mondragón et al., 1995; Uhlig et al., 2004). However, the boy in our study presented with diffused lesions of the entire colon, which is rarely reported. Endoscopy and angiography are widely used in diagnosis of vascular malformation, of which endoscopy is the main tool (Sami et al., 2014). At the time of endoscopy, prominent lesions might be visualized and treated with endoscopic therapy. However, there are limitations; for example, lesions or bleeding sites can be missed during endoscopy due to a variety of reasons, such as poor visibility, size, and location of lesions (Sidhu, Sanders, Morris, & McAlindon, 2007). Angiography, as a supplemental tool, could be used to locate lesions or bleeding sites. In our case, the boy underwent endoscopy but did not undergo angiography without his parents' permission. We were unable to identify the bleeding sites, but the boy recovered well after taking octreotide. Due to the lack of evidence on outcome and treatment of vascular malformation, it is suggested that the disease management should be individualized depending on the lesion site, severity of bleeding, and general impairment. Conclusion This case highlights that vascular malformation should be kept in mind when dealing with GI bleeding, even in children; especially when patients have recurrent bleeding. Endoscopy is an essential tool for making this diagnosis.

1病例资料 患者,女,55岁,因口干、眼干4年,间断活动后气短5个月,加重1周于2019年3月7日入院,诊断为结蹄组织病,间质性肺炎.患者14年前诊断为雷诺氏病,硬皮病,未系统治疗,患者间断不规律口服醋酸泼尼松片10 mg,qd.4年前出现眼干口干,猖獗齿,未在意,未规律治疗.5月前在当地行肺CT查提示间质性肺炎,未治疗,一月前因活动后气短加重在我院呼吸科明确诊断为间质性肺炎,给予吡非尼酮胶囊(北京康蒂尼药业有限公司,批号180502)200 mg,tid,现为进一步治疗进入我科.

BACKGROUND:Eighty milliliter per kilogram of polyethylene glycol (PEG) for bowel preparation (BP) has been recommended, but the amount of liquid orally without nasogastric intubation is difficult to achieve. This study is to compare the efficacy and tolerability of two different low-volume PEG electrolyte solutions for BP in children. METHODS:The randomized, double-blind, controlled trial enrolled 150 children aged 6-18 years undergoing colonoscopy in our center. Patients were randomly assigned to receive 60 ml/kg (PEG-ELS 60) or 40 ml/kg (PEG-ELS 40) of PEG electrolytes (PEG-ELS) 4000. The Boston Bowel Preparation Scale was used for bowel cleansing evaluation. Primary end point was overall colon cleansing. Tolerability was also evaluated. RESULTS:PEG-ELS 40 and PEG-ELS 60 had similar efficacy in bowel cleansing for both whole colon and various colonic segments. The proportions of patients experiencing any adverse symptoms, or those who were willing to have BP repeated if necessary were similar in both groups. More patients considered the BP solution easy to take and be satisfied with the preparation in PEG-ELS 40 than PEG-ELS 60. CONCLUSIONS:Low volume of PEG-ELS for BP has good efficacy in bowel cleansing. PEG-ELS with 40 ml/kg volume was not inferior to that of 60 ml/kg. IMPACT:PEG-ELS 40 and PEG-ELS 60 had similar efficacy in bowel cleansing for whole and various colonic segments. The proportions of patients experiencing any adverse symptoms, or those who were willing to have BP repeated if necessary were similar in both groups. More patients considered BP solution easy to take and be satisfied with the preparation in PEG-ELS 40 than PEG-ELS 60. This study showed that low-volume PEG-ELS monotherapy was effective in bowel cleansing and explored a possibly feasible BP method for pediatrics in China that PEG-ELS 40 was comparable to PEG-ELS 60 regimen.

A 12﹣year﹣old female pediatric patient received a continuous pumping of somatostatin 3 mg (added to 210 ml of 0. 9% sodium chloride injection)by an intravenous detaining needle on the back of her left hand and an IV infusion of pantoprazole sodium for injection 25 mg(added to 100 ml of 0. 9% sodium chloride injection)by an intravenous detaining needle on the back of her right hand at the same time for acute pancreatitis. About 5 minutes after the initiation of administration,cyanosis appeared on her both hands,her left hand was cold,and red rashes scattered on her left wrist and upper arm. It was considered as drug﹣induced anaphylaxis,and the drugs were discontinued immediately. About 40 minutes after drug withdrawal,her above symptoms relieved completely. Pantoprazole for injection was given again that day,and no allergic symptoms were observed. On day 2,a subcutaneous injection of 0. 1 g octreotide acetate injection( an analogue of somatostatin)was given. About 10 minutes later,the patient developed headache,nausea,and vomiting, which relieved spontaneously after 30 minutes. It was considered that the anaphylaxis was caused by somatostatin and its analogue octreotide.

The effectiveness of budesonide (BUD), a locally active steroid, on eosinophilic gastroenteritis (EGE) is not well understood. This study is to retrospectively evaluate the efficacy of BUD in children with EGE. Forty-four children, diagnosed with EGE, were enrolled from 2013 to 2017 in our center. According to patients’ preference, all the patients were treated with dietary elimination (DE) and montelukast therapy, or combined with prednisone (PRED)/BUD. Patients’ clinical manifestations, treatments, and outcomes were reviewed from the medical records. Twenty-four patients (7 PRED, 7 BUD, 10 DE) received therapy for ≥8 weeks, followed by repeat endoscopy and biopsies. Histological response was defined as <20 eos/hpf (eosinophils per high-power field). Significant number of patients in DE+PRED (6/7, 85.7%) and DE+BUD (6/7, 85.7%) groups achieved histological response than in the DE group (3/10.30%) (p = 0.024). Mean post-treatment peak eos/hpf in the DE+PRED group was 16.57 ± 6.85 vs. 10.00 ± 5.07 in the DE+BUD group vs. 36.60 ± 24.57 in the DE group (p = 0.009). Change of eos/hpf from pre- to post-treatment was −49.86 ± 45.02 vs. −34.29 ± 23.44 in the BUD group vs. −0.3 ± 23.95 in the DE group (p = 0.011). There were no significant differences between DE+PRED and DE+BUD groups (p = 0.470, p = 0.363, respectively). BUD is effective in the treatment of EGE and has similar effectiveness with PRED.

1 病例资料 患者女,50岁,因“间断心前区不适加重1个月”于2018年1月2日入院.查体:体温36.5℃,脉搏76次/min,血压107/70 mmHg.神志清,双肺呼吸音清,未闻及干湿罗音.心率80次/min,律整,各瓣膜听诊区未闻及瓣膜杂音及额外心音.既往体健,规律体检,患者一个月前无明显诱因出现心前区不适,表现为胸闷,阵发性,伴后背部酸胀感,持续时间数分钟,就诊于当地医院诊断为心肌缺血,未规律服药,近日加重为系统治疗收入院.患者否认家族遗传病史,药物过敏史.入院后查心脏彩超:提示左室舒张功能降低,主动脉瓣钙化.

A 27﹣year﹣old male patient underwent left maxillary masses excision for periapical cysts in the left maxillary under general anesthesia. During the surgery,a venous access was established from the peripheral vein of the patient′s left lower extremity,and anesthetic drugs(propofol injection,succinylcholine chloride injection,remifentanil hydrochloride for injection,dexmedetomidine hydrochloride injection)were given. On day 2 after surgery,the patient developed topical redness and swelling along the blood vessel on his left lower extremity,which gradually developed into a cord﹣like redness and swelling,with increased blood vessel stiffness. He was diagnosed with thrombophlebitis of the left great saphenous vein after a ultrasound examination of the blood vessel. Treatments such as subcutaneous injection of enoxaparin sodium, oral administration of extract of horse chestnut seeds, topical mucopolysaccharide polysulfate cream, physiotherapy,and etc. were given. On day 10 after surgery,the redness and swelling on the patient′s left lower extremity disappeared,and the blood vessel was softened. At 2 months of follow﹣up,ultrasound examination revealed partial recanalization of the left venous trunk( the calf part ) of saphenous vein. According to the drug labels and literature reports,it was considered that the patient′s thrombophlebitis might be associated with propofol injection.

Rationale: Oseltamivir-induced alimentary tract hemorrhage and liver injury are rarely reported in children and adult individuals. In this study, we described the clinical features and outcomes of oseltamivir-induced alimentary tract hemorrhage and liver injury in a child. Patient concerns: Here, we present a case of a 6-year-old Asian boy with hematemesis and elevated alanine aminotransferase (ALT) (80 U/L) and aspartate aminotransferase (AST) (69 U/L) levels on day 2 of oseltamivir administration. The presence of alimentary tract hemorrhage and liver injury was diagnosed. The ALT level reached 1931.3U/L, accompanied by an increase in total bilirubin (TBIL) to 53.3 mu mol/L on day 15 after oseltamivir administration. Additional tests were performed to determine the presence of viruses that can cause hepatitis and autoantibodies, and the results from these tests were all negative. Diagnosis: Drug-induced liver injury was considered. Interventions: This patient was treated with compound glycyrrhizin and reduced glutathione and glucocorticoid. Outcomes: The liver enzymes recovered within 6 weeks without any symptoms of liver-related diseases after treatment with glucocorticoid. This treatment therefore helps reduce ALT and TBIL levels and protects the liver from further injury. Lessons: Oral oseltamivir is widely used to treat influenza and the adverse effects of this drug were mostly mild. However, clinicians should always be alert for oseltamivir-induced alimentary tract hemorrhage and liver injury when prescribing oseltamivir for children.

抽取2017年1月至9月我院使用非甾体类抗炎药(NSAIDs)的类风湿性关节炎(RA)住院患者用药医嘱,统计患者基本信息、胃肠道(GI)和心血管(CV)危险因素以及用药情况,在共计180例RA患者中,只有1.1％的患者使用了NsNSAIDs,绝大多数患者使用选择性环氧合酶-2(COX-2)抑制剂.本院医生应用NSAIDs治疗RA存在用药不合理、不安全的情况,很可能导致不良反应发生率升高,需要探讨改进,以期为临床合理应用NSAIDs提供参考.

Purpose: To determine the expression of protein tyrosine phosphatase-1B (PTP-1B) and insulin receptor substrate-2 (IRS-2) in the liver tissue of obesity-induced insulin-resistant rats. Methods: Insulin resistance (IR) was induced in Wistar rats by placing them on a high fat diet for 6 weeks, and ursolic acid (UA) was administered. Metformin served as positive control drug. The rats were divided into 5 groups based on the treatments given: normal group, positive control group, metformin group, high-dose UA group, and low-dose UA group. The general conditions of the rats were assessed 4 and 8 weeks after the various treatments. Liver glycogen levels were measured, and liver histological examination carried out after tissue processing and staining with hematoxylin and eosin (H & E). Real-time polymerase chain reaction (RT-PCR) was employed for the determination of hepatic expressions of PTP-1B and IRS-2 mRNAs, while expressions of PTP-1B protein and IRS-2 protein, and phosphorylation of IRS-2 tyrosine were assayed by Western blotting. Results: Liver glycogen levels were significantly increased in the UA-treated groups (p < 0.05). Moreover, UA provoked reductions in the expression of PTP-1B protein (p < 0.05), but up-regulated the expression of IRS-2 protein (p < 0.05), and enhanced IRS-2 tyrosine phosphorylation (p < 0.05). Conclusion: These results suggest that UA mitigates IR through blockage of PTP-1B expression and up-regulation of the expression of IRS-2 mRNA. Therefore, PTP-1B is a potential target for the treatment of type 2 diabetes.

1病例资料 患儿男,3个月18天,体重7.7 kg,因腹泻半个月、间断发热7d于2017年8月28日入院.入院时患儿生命体征:T38℃,P 126次/min,R 30次/min,血压未测.既往无食物、药物过敏史.一般状态及精神状态可,枕部可见明显枕秃,口腔黏膜可见白色膜状物附着,肠鸣音活跃,余无特殊.血常规:白细胞(WBC) 6.63×109·L-1,中性核细胞百分比(NE)0.35,淋巴细胞百分比(LY) 0.47,C-反应蛋白(CRP) 39.2 mg.L-1.入院诊断:“迁延性腹泻、鹅口疮”.患儿CRP明显升高,考虑存在细菌感染.在头孢曲松皮试阴性后于8月29日给予注射用头孢曲松钠(上海罗氏制药有限公司,批号:SH6284)0.6 g +5％葡萄糖注射液50 ml,ivd,qd.使用3d患儿无异常.第4天(9月1日),患儿在静脉滴注头孢曲松(滴速1 ml-min-1)约2 min后,突然出现剧烈哭闹,颈部频繁后仰,既而出现颜面部及口周青紫,双眼向上凝视,随后意识丧失,阵发性咳嗽,喉中痰鸣,四肢末梢发凉,拟诊断:过敏性休克.立即停用头孢曲松,给予地塞米松注射液3 mg iv、盐酸肾上腺素注射液0.3 mg im,同时给予吸氧及心电监护,患儿心率波动于180 ～210次/min,呼吸维持在30～ 50次/min,经皮血氧饱和度波动于95％以上,1min后患儿症状缓解,立即进入睡眠状态,后生命体征逐渐平稳,血压70/55 mmHg,心率120次/min.患儿复查血常规基本正常,CRP 4.19 mg·L-1,血培养回报为阴性.因患儿病情基本好转,给予出院继续口服罗红霉素25 mg,bid.

To summary the key points of pharmaceutical care for posttransplant diabetes mellitus who received tacrolimus,because of membranous nephropathy. Literatures concerning PTDM published in domestic and international journals were reviewed. The patients were instructed to use drugs correctly. The patient′s blood glucose were improved compared with that at the beginning of diagnosis and the dosage of insulin was decreased obviously. PTDM induced by tacrolimus should be paid attention to. Clinical pharmacist could help patients to know PTDM,instruct the patients to monitor serum glucose regularly and use drugs correctly to prevent the hypoglycemia.