Objective To investigate the association between the polymorphisms of apolipoprotein M gene (ApoM) and the risk for cerebral infarction in Han population in northern China.Methods The polymorphisms of ApoM gene were identified by PCR-DNA sequencing analysis and were subsequently detected by PCR-RFLP in 560 patients with cerebral infarction and 550 control subjects in northern China. Statistic analysis was conducted using the SPSS 10.0 program. The linkage disequilibrium (LD) was analyzed by EH and SHEsis softwares. Results Three single nucleotide polymorphisms were found in intron 1 and intron 5 of ApoM gene. The frequencies of GA+AA genotype and A allele of rs805264, GT +TT genotype and T allele of rs707922, CA+AA genotype and A allel of rs707921 were significantly higher in the patients (33.8% and 17.9%, 34.5% and 18.3%, 33.4% and 17.8%, respectively) than in controls (21.1% and 11.2%, 21.8 % and 11.5%, 20.9% and 11.1%, respectively). The LD was found in rs805264, rs707922 and rs707921 of ApoM gene (χ2=2595.03, P<0.01). There was strong LD between each pair of the three markers (D′=0.972 to 0.992). Multiple logistic regression analysis revealed that the A-T-A haplotype of the ApoM gene was an independent risk factor for cerebral infarction (OR=1.780;95%CI=1.333-2.376, P<0.01). Conclusions GA genotype and A allele of rs805264, GT genotype and T allele of rs707922, CA genotype and A allele of rs707921 may be genetic risk factors for cerebral infarction. A-T-A haplotype of ApoM gene may be a susceptible genotype of cerebral infarction.

Chinese herbal medicine (CHM) has been widely used in the treatment of Sjogren's syndrome. However, there remains no systematic review to assess the effectiveness and safety of CHM.

Background: The conventional therapy for chronic hepatitis C is the combination of interferon-alpha and ribavirin. However, it has some adverse effects and does not response to some patients, and it is also very expensive. Objective: To assess the efficacy and safety of Chinese medicinal herbs for chronic hepatitis C virus infection. Search strategy: Electronic and manual searches were conducted and the search ended in July 2009. Inclusion criteria: We included randomized clinical trials testing Chinese herbal medicine vs placebo, non-specific treatment, antiviral treatment, or Chinese herbal medicine combined with antiviral treatment vs antiviral treatment alone. Data extraction and analysis: Selection of trials for inclusion, assessment of methodological quality, data extraction and data syntheses were conducted according to the protocol of a Cochrane systematic review by the authors. Results: Fifty-one randomized trials (involving 3 678 patients) with various methodological quality were included. The studies published in English had good quality, while studies published in Chinese were of poor quality. The pooled results showed that Chinese herbal medicine alone or in combination with antiviral treatment was generally better than non-specific treatment or antiviral treatment alone, and herbal medicine appeared equal to antiviral treatment regarding comprehensive clinical effect in terms of symptoms, liver function and virological response. Regarding virological response including loss of serum hepatitis C virus (HCV) RNA and anti-HCV antibodies, herbal medicine was better than non-specific treatment, equal to antiviral treatment, and the combination of herbs and antiviral treatment was better than antiviral treatment alone. Similar positive findings were found for liver function improvement. Adverse effects were observed among herbal injections and interferon treatment, and few cases had severe adverse effects. Conclusion: Herbal medicines included in this review have effects in improving symptoms, liver function, and loss of HCV markers in patients with chronic hepatitis C. However, for majority of the included trials were published in Chinese and had low quality, the promising effects from some herbs need to be confirmed in rigorous clinical trials, and the design and reporting of trials should follow international standards. Systematic review registration: http://www.cochrane.org, 380700081611301089.

CT findings of hepatic abscesses in 80 patients were retrospectively analyzed. The results showed that most of hepatic abscesses tended to be round or oval (62/80, 77.5%) because of higher osmotic pressure within the cavities. All intrahepatic foci appeared as the hypodense area on CT scans, and their CT attenuation values varied with the amount of fibrin, fatty degenerated leukocytes and necrolic sequesters. The enhanced CT scans showed the lesions more clearly than the unenhanced. Rim enhancement in the wall of abscess was the typical finding (62/80, 77.5%). The detection of “target sign” is highly suggestive of abscess formation and diagnosis of abscess is more valid if there is the gas within the cavities. But some of abscesses were hetrogenerous in density and appeared as “cluster sign” which was composed of the numberous small abscesses and may evolule the larger cavities with multisepta. The chest findings companicd with hepatic abscesses are much common (72/80, 90%). It is difficult to diagnose hepatic abscesses when the margin of lesions is poorly defined and not enhanced after contrast. In (general, CT is an effective, tool in diangosis of abscesses(74/80,accuracy 92.5%).

In order to elucidate the mechanism of liver damage due to acute biliary sepsis,the changes of hepatocyte mitochondria were observed during biliary sepsis in the rat.The accompanied liver function changes were also studied.Mitochondrial calcium content,and lysosome fragility of the hepatocytes,lipid peroxide (LPO) level of liver tissue,ornithine carbamoytransferase (OCT),mitochondrial glulamicoxloacetic transaminase (m-GOT),and hepa-toplastin were determined.It was found that there were overloading of calcium in mitochondria,increase of lysosome fragility,and accumulation of LPO in the liver.These events would result in adverse effects on mitochondrial function.The activity of serum OCT and m-GOT was significantly increased,which suggests that mitochondria are seriously damaged since the 2 enzymes mainly come from hepatocyte mitochondria.And the liver reserving function declined progressively.Our study indicates that mitochondrial damage does exist during acute biliary sepsis,which might play an important role in liver damage.

The phagocytic function of Kupffer cells (KC) during acute obstructive cholangitis was observed in 244 Wistar rats.The rats were killed in the 6th,12th,24th,and 48th hour after operation,and the uptake of colloidal carbon by KC,plasma endotoxin and fibronectin(Fn)were determined and the morphology of KC was observed.It was found that in the rats with acute obstructive cholangitis,the phagocytic function of KC and plasma Fn significantly elevated in the 6th hour and markedly reduced in the 48th hour after operation as compared with those of the control (P

The pathological changes of the damages on many vital organs during acute obstructive cholangitis were observed in 45 rats under optical and electron microscopy.The morphological changes of the vital organs were characterized by disturbance of blood circulation,degeneration and/or necrosis of the tissues and cells,and inflammatory reactions.The hepatic damage appeared earlier and more severe thna the other organs during acute obstructive cholangitis.

The changes of acid phosphatase(ACP)and cytochrome oxidase(CO)in the hepatic acini were investigated with image analysis in 90 Wistar rats after acute obstructive cholangitis was inflicted.It was found that the activity of ACP was significantly increased in the 2nd hour after surgery and markedly decreased in the 12th hour and these changes were predominantly located in acinur zone 1 of the hepatocytes.The activity of CO was decreased progressively after surgery,and these changes were quite marked in the acinur zone 3 of the hepatocytes.These findings indicate that the reactions towards acute obstructive cholangitis are different in the different acinur zones of the hepatocytes.

The relationship between the behavior of the mononuclear phagocyte system(MPS)and acute pulmonary injury during acute obstructive cholangitis(AOC)was investigated in 90 Wistar rats.After the operation to induce actue obstructive cholangitis,the animals were killed in the Oth,6th,12th,24th and 48th hour,and the phagocytic function of Kupffer's cells,the number of alveolar macrophages in the lung lavage fluid,and the extravascular water content of the lungs were measured.And the pulmonary levels of lipid peroxidase and supperoxide dismutase were determined as well.It was found that when the phagocytic function of Kupffer's cells was suppressed,the alveolar macrophages were activated by the invading bacteria to release some inflammatory mediators such as free radicals resulting in acute pulmonary injury.It seems that there is a close relationship between the fuctional status of mononuclear phagocyte system and the development of pulmonary injury,and the functional failure of mononuclear phagocyte system plays an important role in the pathogenesis of multiple organ failure especially of acute pulmonary injury.