Objective To study the changes of 5-hydroxytryptamine(5-HT),its receptor,IL-2 and IL-6 in rats' ileum with spleen deficiency combined with gastric ulcer.To explore the pathogenesis of this disease and the therapic mechanism of sijunzi decoction. Methods Immunohistochemical technique,image analysis,radioimmunoassay and Western blotting were used. Results The 5-HT-positive cells of rat ileum were detected in mucosal and glandular cells.The 5-HTR-positive cells of rat ileum were found in the connective tissues between the intestinal villus and intestinal glands,and in neuroplex and smooth muscle tissues.The expression of 5HT and 5-HTR in ileum increased during the experimental spleen deficiency combined with gastric ulcer in rats.The 5-HTR level of rat ileum was higher.After treatment with Sijunzi decoction,all the changes have been reversed.The level of IL-2 and IL-6 increased during the early period of this disease.When the disease doveloped,the synthesis or secretion of IL-2 and IL-6 decreased. Conclusion The increased contents of 5-HT and its receptor in ileum tissues might be one of the causes of spleen-deficiency combined with gastric ulcer in rats.The mechanism of Sijunzi decoction is to reverse the changes.And the changed activity of IL-2 and IL-6 may be related with the degree of the disease.

Objective To study the changes in serum endotoxin level of the patients with primary biliary cirrhosis (PBC) and the relationship between endotoxin and serum biochemical parameters. Methods Clinical data of 63 cases PBC patients confirmed by liver puncture biopsy were retrospectively studied. The clinical features, results of laboratory tests, pathological findings of all the 63 patients were analyzed. Endotoxin level was determined by limulus amebocyte lysate test in the serum obtained from the 63 cases of patients with primary biliary cirrhosis, and then compared with that of 30 healthy individuals. Results The sex ratio (male to female) of PBC patients was 1 to 8, and the mean age was 43.8 years. The prevalent complaints were jaundice and fatigue. 70.3% patients showed AMA positive. The levels of ?-glutamyltransferase (r-GGT), alkaline phosphatase (ALP) and bilirubin in the serum were markedly elevated in the majority of the patients. Compared with the early stage, the levels of ALT and AST declined slightly during the advanced stage (P

Liver and gastrointestinal tumors greatly threaten human health and have poor therapeutic outcomes and prognosis.Tumor necrosis factor -alpha -induced protein 8 -like 2 (TIPE2)can negatively regulate innate immunity and adaptive immunity and maintain immune ho-meostasis.Recent studies have found that TIPE2 can affect various signaling pathways and thus exerts an inhibitory effect on the development and progression of tumors.This article briefly introduces the structure and function of TIPE2 and its regulatory effect on tumor -related sig-naling pathways such as Ras,Ral,and Rac and downstream molecules,as well as the role of TIPE2 in liver and gastrointestinal tumors,re-lated signaling pathways,and research advances.

Objective To study the effect of astragalus membranaceus on the interaction of mesangial cells and endothelial cells in the media of high glucose and lysophosphatidylcholine. Methods The model of intercellular interaction between endothelial cells and mesangial cells of diabetic nephropathy was established and divided into 4 groups:control, mannitol, high glucose and lysophosphatidylcholine, intervented with astragalus membranaceus. Endothelial cells and mesangial cells were co-cultured in DMEN with or without astragalus membranaceus in high glucose and lysophosphatidylcholine media up to 24 hours. The level of collagen Ⅳ and fibrocentin were determined by enzyme linked immunosorbent assay in the culture media. Results The level of collagen Ⅳ and fibrocentin of high glucose and lysophosphatidylcholine group was markedly higher than that of control group in co-culture and the ordinary monolayer cell culture (P

promoted by high glucose, which can enlarge the biological effect of PAF.

Objective To study the effect of high glucose and lysophosphatidylcholine (LPC) on the role of fibronectin and plate-let activating factor (PAF) via the interaction of endothelial cells and mesangial cells. Methods The model of intercellular interaction be-tween endothelial cells and mesangial cells was established and divided into 4 groups: control, mannitol, high glucose and LPC, and BN52021 group. The level of fibronectin and PAF were determined by enzyme linked immunosorbent assay in the culture media. Results The level of fibronectin and PAF of high glucose and LPC group were higher than those of control group in co-culture and monolayer cell cul-ture (P<0.05). Intervened by high glucose and LPC, the level of fibronectin and PAF of co-culture were higher than those from monolay-er cell culture (P<0.05). The level of fibrocentin in the BN52021 group was lower than that of high glucose and LPC (P<0.05). Con-clusions Exposed to high glucose and LPC, endothelial cells and mesangial cells can interact with each other to produce more fibrocentin and PAF. The increase of fibronectin is partly concerned with PAF.

Blindness, Cortical ; etiology ; Chemical and Drug Induced Liver Injury ; complications ; Humans ; Liver Diseases ; complications

The current status and training requirements for general practitioner (GP) were surveyed with questionnaires in 84 trainees from the first Beijing GP retraining program.Results showed that three most demanded skills of health service in community were electrocardiogram (98.8％),clinical lab results reading (96.4％),dressing change (90.5％).The services not provided but should be provided in community were aerosol rebreathing method (23.8％),resection of small superficial lumps (22.6％) and reading X-ray films (20.2％).The reasons for services not provided were insufficient resources (41.7％),lack of skilled personnel (35.7％) and staffing shortage (20.2％).The most required training skills were reading X-ray films (64.3％),electrocardiogram (54.8％) and laboratory results reading (51.2％).There were some skills inadequately trained including cricothyroid membrane puncture,suprapubic bladder puncture and resection of superficial small lumps.The results indicate that the required skills in community health service and individual demands of general practitioners should be the priority of the future training programs.

OBJECTIVETo explore the clinical application and related factors of FibroTouch in the diagnosis of liver fibrosis in patients with chronic liver disease through comparison of the specificity and sensitivity of FibroTouch and multi-parameter models, and to identify whether FibroTouch is a more accurate and safe method in diagnosis of liver fibrosis and evaluation of the therapeutic effect.

METHODSA total of 190 patients with chronic liver disease were performed liver biopsy and underwent liver stiffness measurement (LSM) using FibroTouch in department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University from January 2014 to February 2015. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) were tested by enzymic method with automatic biochemistry analyzer. Blood platelet counts were detected by automatic blood cell analyzer. AST-to-PLT ratio index (APRI) and fibrosis index based on the 4 factor (FIB-4) were calculated. The diagnostic values of FibroTouch, APRI and FIB-4 for liver fibrosis degree were calculated and compared by receiver operating characteristic (ROC) curves. The related factors of LSM were analyzed by Spearman analysis.

RESULTSThere was significant correlation between LSM and histological fibrosis (r=0.804, P=0.000). The area under ROC curve of LSM for S(≥2, S≥3 and S=4 was 0.894, 0.938 and 0.961, respectively, which was significantly higher than APRI (0.678, 0.698 and 0.658) and FIB-4 (0.765, 0.785 and 0.775). On Spearman analysis, LSM was positively correlated with age, ALT, AST, TBIL ((≥2×ULN) and the grade of liver inflammation (r=0.309, 0.558, 0.504, 0.492 and 0.532, respectively) but negatively with PLT (r=-0.444), (all P<0.05).

CONCLUSIONSLSM is a convenient and reliable approach for diagnosis of liver fibrosis in patients with chronic liver disease. The sensitivity and specificity of Fibrotouch in diagnosis of hepatic fibrosis is superior to APRI and FIB-4, and age, high level ofALT, AST and TBIL (≥2×ULN) were independent predictors of LSM inaccuracy.

Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Biomarkers ; Biopsy ; Chronic Disease ; Humans ; Liver Cirrhosis ; Platelet Count ; ROC Curve

Objective To investigate the clinical features of drug-induced autoimmune hepatitis (DIAIH) and its therapeutic strategies,and to provide a reference for early diagnosis and treatment of this disease and prevention of chronicity.Methods The clinical data of 116 patients with drug-induced liver injury (DILI) or DIAIH confirmed by medical history,liver biochemistry,and liver biopsy were analyzed retrospectively.Among these patients,13 had DIAIH and 103 had simple DILI (30 patients in the hepatocytetype group and 73 in the cholestasis/mixed-type group).The population characteristics,major drugs inducing the diseases,clinical manifestations,liver biochemical parameters,liver pathological features,and clinical outcome were compared between groups.The Kruskal-wallis H test was used for comparison and the Mann-Whitney U test was used for comparison between any two groups.The chi-square test was used for comparison of categorical data,and the R×C chi-square test was used for comparison of rates between the three groups;in the case of significant differences,the R×C contingency table was used for comparison between any two groups.Results The patients with DIAIH had a mean age of 53.54±8.28 years,and the mean age was 35.13±13.46 and 46.99±14.82 years for the hepatocyte-type group and cholestasis/mixedtype group,respectively.The disease was mainly induced by a combination of various drugs.The patients with DIAIH had significantly higher serum levels of alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,and alkaline phosphatase and a significantly higher positive rate of anti-nuclear antibody than those with DILI (all P ＜ 0.05).In patients with DIAIH,the liver pathological features and the features of response to treatment were as follows:obvious interface hepatitis,proliferation of small bile ducts,and mixed inflammatory cell infiltration in the portal area,including eosinophils and plasma cells,and the short-term corticosteroid therapy had a good therapeutic effect.Conclusion DIAIH has a low incidence and is more common in the female population,with the features of tissue injury in both DILI and autoimmune hepatitis.The short-term corticosteroid therapy can prevent disease progression and reduce chronicity.