There have been increasing reports on liver injury induced by traditional Chinese medicine (TCM) and natural medicine in recent years. The risk of liver injury induced by TCMs has attracted more attention at home and abroad. In this paper,epidemiologic characteristics,risk factors,clinical features of TCMs induced liver injury were discussed. The myth about research and safety evaluation of TCMs induced liver injury was analyzed. Based on the property of TCMs and characteristics of their clinical use,this paper proposed the priorities of basic and clinical safety evaluation of TCMs induced liver toxicity. It is hoped that this study may provide reference for scientific evaluation of liver toxicity of TCMs.

OBJECTIVE:To investigate the effects of minocycline on clinical indexes,inflammatory factors and blood glucose of patients with moderate and severe chronic periodontitis complicated with type 2 diabetes(T2DM). METHODS:A total of 125 patients with moderate and severe chronic periodontitis complicated with T2DM selected from our hospital during Feb. 2013-Aug. 2015 were divided into control group(63 cases)and observation group(62 cases)according to random number table. Both groups were periodental non-surgical treatment as scaling and root planning. Control group was given iodine glycerin to fill periodontal pockets after surgery,2-4 times/d. Observation group was given Minocycline hydrochloride ointment,once a week,after surgery. Both groups were treated for 4 weeks. The levels of clinical indexes [probing depth,clinical attachment level(CAL),probing bleeding rate],serum inflammatory factors(CRP,TNF-α)and blood glucose(fasting blood glucose,glycosylated hemoglobin) were observed in 2 groups before treatment,3 months after treatment,and the occurrence of ADR was recorded. RESULTS:Be-fore treatment,there was no statistical significance in clinical indexes,serum inflammatory factors and blood glucose levels be-tween 2 groups(P>0.05). Three months after treatment,probing depth,probing bleeding rate and serum inflammatory factor lev-els of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statisti-cal significance(P<0.05). Compared to before treatment,CAL of 2 groups were increased,without statistical significance before and after treatment or between 2 groups(P>0.05). The levels of fasting blood glucose in 2 groups were decreased,with statistical significance(P<0.05),but no statistical significance between 2 groups(P>0.05). Compared to before treatment,the level of glycosylated hemoglobin in control group was decreased,without statistical significance(P>0.05);the level of glycosylated hemo-globin in observation group was decreased significantly,and the observation group was significantly lower than the control group, with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between observation group (3.23%) and control group (0)(P>0.05). CONCLUSIONS:For moderate and severe chronic periodontitis complicated with T2DM,minocycline effectively improves clinical indexes of periodontitis,reduces serum inflammatory factors and blood glucose with good safety.

Objective To investigate the clinical effects of open decompression drainage on acute pulpitis.Methods Totally 180 acute pulpitis patients hospitalized during January 2012 to September 2014 in our department were selected and randomly divided into control group and observation group (n=80 each).The control group was treated with pulp inactivating agent and the observation group was given open decompression drainage.The clinical effects,analgesia efficiencies at 7d after treatment,treatment course and the complications were compared between the 2 groups.Results There was significant difference in the effective rate between control and observation groups after treatment [61.3％ (49/80 cases) vs.86.3％ (69/80 cases),P＜0.05].The analgesia efficiencies at 7d after treatment was 46.3％ (37/80 cases) in control group and 73.8％ (59/80 cases)in observation group (P＜0.05).There was no significant difference in treatment course between two groups [(7.7±1.4) times vvs.(6.1± 1.2) times,P＞0.05]].6 patients developed periapical periodontitis in control group,and only 4 cases in the observation group (P＞0.05).Conclusions Early open decompression drainage has good clinical effects and analgesia efficiencies in treatment of acute pulpitis,which is worthy of clinical application.

Objective To establish the optimal section planes for observing ventricular septal defect(VSD) by real-time three dimensional echocardiography(RT-3DE).Methods In 6 pig hearts with different types of VSD, after high pressural perfusion with coupling reagent, two dimensional, dual plane and RT-3DE were performed with different section planes, estimating with half quantificational visional grade:4 marks,very clear;3 marks,clear;2 marks,not clear enough; 1 marks,not clear. Results Observation by RT-3DE, en-face view of atrial-ventricular(S2a) and en-face view of left ventricular septum(L1a) provided relatively ideal section planes in sub-arterial ventricular septal defect, S2a and en-face view of right ventricular septum(L2a) provided relatively ideal section planes in perimembranous and muscular VSD. Conclusions S2a reflects relatively ideal section plane in sub-arterial, perimembranous and muscular VSD.

Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in cardiac valvular diseases.Methods Preoperative and postoperative RT-3D-TEE studies were performed in 32 patients who had undertaken cardiac valve repair or valvular replacement using Philips iE33 with X7-2 probe,and quantitative analysed the mitral structure in cases of mitral valve prolapse by using online QLAB7.0 quantitative analysis software.Results RT-3D-TEE can demonstrate the anatomicsl structure clearly,evaluate the function of cardiac valves precisely,and reveal details of type,position and extent of lesions vividly in surgical view.RT-3D-TEE helped correct misdiagnose in 2 cases,revised surgical plans in 3 cases,and guided implementation of remedial surgery in 1 case.Conclusions RT-3D-TEE can present images lively,and it can provide adequate information for preoperative diagnosis,aid the formulation of surgical plan and evaluate surgical effect.

Objective To research the feasibility and accuracy on echocardiography measurement aortic annulus diameter(AAD)at the plane of three Junctions of aortic valve leaflets by real-time three-dimensional transesophageal echocardiography(RT-3D-TEE).Methods Twenty-three patients underwent echocardiography and aortic valve replacement because of acquired aortic valve disease.The AAD was measured in parasternal left ventricle long axis view(TTE-AAD)by transthoracic echocardiography(TTE)preoperative.The AAD was measured in left ventricle long axis view(TEE-AAD)and the distance of three iunctions of aortic valve leaflets (N,L,R) was measured in aortic short axis view by RT-3D-TEE intraoperative.The three-dimensional full volume images were analyzed by online QLAB 7.0 software.The AAD was measured by standard cylindrical valve sizer (OP-AAD)before aortic valve replacement surgery,too.Results Comparing with the three aortic valve leaflets of acquired aortic valve disease,the lines between their junctions constituted an approximate equilateral triangle regardless of the cause and degree of disease,and the length of the three groups was no significant difference(P>0.05).There was no significant difference between TTE-AAD and OP-AAD group(P>0.05),and the correlation was good(r=0.84).The N,L and R group compared separately with the OP-AAD group, there was no significant difference(P>0.05)and correlation was superior to TTE-AAD group(r=0.94, 0.97, 0.96).The difference between TEE-AAD and OP-AAD were significant(P<0.01).Conclusions Echocardiography measurement of AAD at the plane of three junctions of aortic valve leaflets is feasible,and it is better accuracy and repeatability comparing with parasternal left ventricle long axis view.

BACKGROUND:. Until now modern science cannot explain clearly aboutthe mechanism of acute alcoholic liver injury. Besides such methods as givingup drinking, or symptomatic treatment, there is no specific therapy and remedy. Traditional Chinese Medicine (TCM) has obvious advantages for this: Itcannot only improve the clinical symptoms, but also adjust organism immunefunction, and has very good development future. OBJECTIVE: To study the effects of radix bupleuri and radix scutellariae incompatibility with the ratio of different dosage (2:1, 1:1, 1:2) on acute alcoholicliver injury by regulating the system of endocrine-immunity network in rats. DESIGN: Groups are divided randomly and experiments are made underblank conditions. SETTING: TCM Clinical Laboratory of Pharmaceutical School, Henan University of TCM. MATERIALS: From September to November 2002 in TCM Clinical Laboratory of Pharmaceutical School, Henan University of TCM, the general condi tion of the animals were as follows: 96 healthy Wistar rats were divided into 8groups: blank group, model group, radix bupleuri group, radix scutellariaegroup, xiao-chaihu group, radix bupleuri-radix scutellariae 2:1 group, radix bupleuri-radix scutellariae 1:1 group, radix bupleuri-radix scutellariae 1:2 group. METHODS: ① According to the ratio of 2:1, 1:1, 1:2, radix bupleuri andradix scutellariae were taken respectively (480 g, 240 g; 360 g, 360 g; 240 g, 480 g) to produce the water decocting nedicine. Except the blank group(duplicated by saline of the same volume through consecutive gastric infusion), the other groups are duplicated through consecutive gastric infusionby 56 degrees of Er-Guotou White Spirit (7 mL/kg) two times a day for tendays until the model-making is finished. From the first day, the medicine wasgiven two times a day. The blank group and the model group were given thedistilled water of the same volume. The other groups were given the properwater decocting medicine. The dosage in xiao-chaihu group was 10 g/kg andin the other was all 12 g/kg. ② 16 hours later after the last time when thewhite spirit was given, blood was taken from stomach aorta to produceserum. Liver, spleen, chest gland, adrenal gland were quickly removed. Thecalculating formula of an organ index: An organ index= The weight of an organ (g)/The weight of a body (g) ×100%. The calculating formula of vitamin C content in adrenal gland (mg/g): Content of vitamin C= [(The Avalue of the testing tube-The A value of the blank tube)/ (The A value ofthe standard tube-The A value of the blank tube)] ×density of the standardtube (6 mg/L)×dilution times of the sample before tested/protein content(g/L). ③ Comparison between the groups was shown by using variancesimilar test and single-factor variance analysis.MAIN OUTCOME MEASURES: Index of rats' liver, spleen, chest gland, and adrenal gland (on the right side); the determination of vitamin C content in rats' right adrenal gland.RESULTS: During the experiment, 3 rats in the model group died. Tworats died in radix scutellariae group and radix bupleuri-radix scutellariae group respectively, In each of the other groups only one rat died. The condition of the number of the rats which were used for analyzing results:There were 12 in blank group; 9 in model group; 10 in radix bupleuri group, radix bupleuri-radix scutellariae 1:1 group respectively; 11 in each of the other groups. ① Comparison of index of rats in liver, spleen, chest gland, adrenal gland (right side) between different groups: There was no significant difference between the indexes of rats' liver in different groups.The index of spleen, chest gland, adrenal gland in the model group were all greatly less than in blank group (P ＜ 0.05-0.01). The index of spleen in the radix bupleuri group wcre greatly higher than in the model group, it could make the reduced spleen index return to normal (P ＜ 0.05); The index of chest in radix scutellariae group, radix bupleuri-radix scutellariae 1:1 group, radix bupleuri-radix scutellariae 1:2 group and xiao-chaihu group were greatly higher than in model group (P ＜ 0.05); The index of adrenal gland in radix bupleuri-radix scutellariae 1:2 group and xiao-chaihu group were greatly higher than in model group (P ＜ 0.05). ② Comparison of vitamin C content in rats' right adrenal gland between the groups: Compared with blank group, the vitamin C content of adrenal gland in the model group had no significant difference. While that of radix bupleuri group, xiao-chaihu group, radix bupleuri-radix scutellariae groups were greatly less than that of model group (P ＜ 0.05-0.01), especially radix bupleuri-radix scutellariae 1:1 group had the most significant influence (P ＜ 0.01).CONCLUSION: Interfering functional injuries of liver, spleen and suprarenal gland is one of the mechanisms of acute alcoholic liver injury.Generally speaking, bupleuri-radix scutellariae 1:2 group has the greatest effect on the testing index.

Objective To explore the surgical technique and analyze the clinical efficacy of tubular stomach reconstruction via the posterior mediastinal approach after Iovr-Lewis radical resection of esophageal cancer.Methods The clinical data of 63 patients with middle-lower esophageal cancer who were admitted to the First People's Hospital of Chengdu between April 2013 and April 2015 were retrospectively analyzed.All the patients underwent Iovr-Lewis radical resection of esophageal cancer and tubular stomach reconstruction via the posterior mediastinal approach.Video-assisted minithoracotomy (VAMT) was used for anastomosis of esophagus-gastric tube at the top of thorax after laparoscopic abdominal surgery, and then tubular stomach reconstruction via the posterior mediastinal approach was performed by placing gastric tube in the esophageal bed and closing the posterior mediastinal pleura.Patients received regular perioperative treatment.Intraoperative record included operation time, volume of blood loss, volume of blood transfusion and lymph nodes dissection.Postoperative anastomotic leakage was detected by observing thoracic drainage, symptoms of fever, chest pain and elevated hemogram, recovery of intestinal function and closed thoracic drainage-tube removal time.Follow-up was performed by telephone interview and outpatient examination up to April 2015, including with or without normal food intake, gastroesophageal reflux and tumor progression.Results All the patients underwent successful IovrLewis radical resection of esophageal cancer using tubular stomach reconstruction via the posterior mediastinal approach without perioperative death and intraoperative blood transfusion.The average operation time, average volume of intraoperative blood loss and average number of lymph nodes dissected were 230 minutes, 300 mL and 16, respectively.Patients received gastric tube removal at postoperative day 2 with a good condition of tubular stomach by CT examination.The average time of postoperative gastrointestinal tract recovery was 3 days.Patients took fluid diet at postoperative day 3-4, soft diet at postoperative day 7 and regular diet at postoperative day 10-12.Two patients complicated with slight pulmonary infection were cured by conventional treatment.The closed thoracic drainage-tube removal time was 4 days.All the patients were followed up for a median time of 8 months (range,1-24 months) with regular diet intake and without perioperative death, tumor recurrence, severe gastroesophageal reflux and other complications.Conclusions Iovr-Lewis radical resection of esophageal cancer using tubular stomach reconstruction via the posterior mediastinal approach is safe and feasible, with the advantages of preventing the esophageal anastomotic fistula, reducing postoperative pulmonary infection and promoting early diet intake and enhancing postoperative recovery of patients.

(0.05)).Conclusions RT3DE planimetry of MVA before and after PBMV is feasible and accurate.It provides a new quantitative way for MVA following up after PBMV.

0.05). Tanreqing intervention treatment had better influence on the pneumodynamics and arterial blood gas than the therapentic influence on that in the control group, the functional improvement rate of lung and extra-pulmonary organs of study group obviously outstripped the rate of control group, and the incidence of VILI and VAP was also obviously decreased in the former group. The mortality in ICU for multiple organ failure (MOF) of Tanreqing intervention group was 16%, which was obviously lower than that (48%) of the control group (P