Drug-induced liver injury (DILI) is a leading cause responsible for the failure of drug development and for the withdrawal of commercial drug products.The high frequency of DILI is due in part to the physiology of the liver,since in many cases elimination of drug molecules from the body is dependent on hepatic clearance via either metabolism or biliary excretion.Many of the mechanistic details underlying DILI remain poorly defined in spite of extensive studies of the pathogenesis.In this regard,metabolomics may become a powerful tool for investigation of DILI,leading to better mechanistic understanding and biomarkers identification.

Objective:To establish the granulocyte-differentiation model of the HL60 cells which are treated with All-trans retinoic acid(ATRA),and to use the modified two-dimensional electrophoresis conditions to analyze the differences of protein expression between treated and untreated HL60 cells.Methods:HL60 cells were induced through treatment with All-trans retinoic acid(ATRA).For selection of the appropriate drug concentration and induction time,MTT and flow cytometry are used to detect the HL60cell proliferation and the expression of differentiation antigens CD11b respectively.Cellular chemical staining was used for the verification of the differentiation of the treated HL60 cells.The protein of HL60 cell lines could be separated by modified two-dimensional electrophoresis(2-DE).PDQuest software was used to analyze the different protein expression between treated and untreated HL60 cells.The protein was analyzed by matrix-assisted laser desorption -time of flight mass spectrometry(MALDI-TOF).Results:ATRA could inhibit HL60 cell proliferation,and with the increase in drug concentration,the effect of inhibiting was more significant.Treated with 2? M ATRA for five days,there were more than 90% of HL60 cells expressing antigenCD11b.Cellular chemical staining also showed that ATRA could induce HL60 cells to granulocyte cells.By the analysis of modified 2-DE and PDQuest software,25 protein spots was detected in untreated cells,while 15 protein spots was promoted Some of them were oncogene protein and suppressor gene protein,while some of others are involved in apoptosis.Conclusion:ATRA could induce HL60 cells to granulocyte cells in selected drug concentration and induction time.Using the modified two-dimensional electrophoresis conditions,different protein expression can be found from the traditional two-dimensional electrophoresis.

Glaucoma is the second leading cause of irreversible blindness worldwide.The treatment of glaucomatous eyes is a long-term procedure.Laser treatment is becoming one of the three major methods to lower intraocular pressure (IOP) of glaucomatous patients.Selective laser trabeculoplasty (SLT) mainly targets to the pigment cells on the trabecular meshwork and makes it easier for fluid to flow out of the front part of the eye,decreasing pressure in the eye.But,the actual mechanism of this surgery is below understood now.Compared with other laser therapy,SLT uses a lower-level laser to open the drainage angle of the eye,and therefore cause rare or slight complication,so it is thought to be a repeatable therapy to the patients who needs further treatment.The principle,clinical application,efficacy,safety and study progress about SLT for glaucomatous eyes are reviewed.

Craniocerebral Trauma ; surgery ; Humans ; Maxillofacial Injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Autoimmune pancreatitis (AIP), which is always associated with autoimmune manifestations, was introduced in 1995 and has been recognized as a type of chronic pancreatitis. Despite numerous studies in Japan, Europe and the United States in recent years, no consensus has been reached about the diagnostic criteria for AIP that may be difficult to distinguish from pancreatic cancer(PC). Nevertheless, the results find it dramatically responds to steroid therapy.

Objective To determine and evaluate the method of localization of anal verge by mutislice spiral CT. To provide an imaging reference for operative guidance of low-rectal cancer. Methods Forty eight consecutive adult patients suspected of abnormalities other than rectal disease were evaluated with abdominal and pelvic CT scans since August, 2009. They were divided into two groups based on sex and age. There were 23 men and 25 women. The ages of young group were 28 to 50 years and the average age was 41 years. The ages of elderly group were 52 to 81 years and the average age was 64 years. A small cotton ball dipped with contrast media was put at the anal verge as a marker and CT scans were performed with 64-slice spiral CT scanner. The distances between the cotton balls and the lower margin of the pubis combination (La), the lower margin of the 5th sacral vertebra (Lb), the inferior aperture of minor pelvis(Lc) and the lower margin of the basement of external anal sphincter (Ld) were measured on the midsagittal images obtained by MPR. The averages, the standard deviations(s), the 95% and 80% confidence intervals of La, Lb, Lc and Ld were calculated. We took the intervals of ± 1.96 s or ± 1.28 s ＜ 5 mm as the standard of meeting the clinical requirement. The distances meeting the clinical requirement between different sex groups or age groups were compared with t test. Results The Ld was (9.8 ± 1.2) mm, ofwhich intervals of ± 1.96 s and ± 1.28 s were 4. 8 mm and 3.0 mm respectively, meeting the clinical need.This distance was also measured conveniently. There were no significant differences ( P ＞ 0.05 ) between two different sex groups [ male group, ( 10.0 ± 1.2) mm], female group, (9.6 ± 1.2) mm and between two age groups [ young group, (9.6 ± 1.2) mm, elderly group, ( 9.9 ± 1.3 ) mm ]. Conclusions The lower margin of the basement of external anal sphincter was a useful anatomic lanmark for localizing the anal verge,and could be definitely identified on the middle sagittal pelvic CT image. The distance between the structure and anal verge is constant enough and can be used in measuring distance from low rectal lesion to the anal verge.

Objective To explore the clinical application of two different fixation methods for nasal continuous positive airway pressure (NCPAP) in newborns. Methods One hundred and forty newborns who had NCPAP treatment were selected and divided into experimental group and control group with 70 cases in each group by random digits table method.The newborns in experimental group received self- made caps to fix the prong systems,while the newborns in control group received U shape towel. The incidence of nose, head of facial skin injury, frequency of detachment for nasal prongs and duration mechanical ventilation were compared between two groups. Results The frequency of detachment for nasal prongs per 24 h was (0.65±0.18) times in experimental group and (1.64±0.22) times in control group, and there was significant difference (t=28.68, P<0.01). The incidence of nose, head of facial skin injury were 8.6%(6/70), 2.9%(2/70) in experimental group and 27.1%(19/70), 14.3%(10/70) in control group,and there were significant differences ( χ2 =8.23, 5.83, P<0.01 or 0.05). There was no significant difference in duration mechanical ventilation between two groups(P>0.05). Conclusions Use of the self- made caps for NCPAP in newborns is associated with significant reduction in the incidence of nose, head of facial skin injury,and the frequency of detachment for nasal prongs.The fixation should be prompted in clinic.

Objective To observe the effect of pre-intervention with electroacupuncture on oxidative stress (OS) and inflammatory reaction after hepatectomy under portal occlusion.Method Thirty patients going to receive hepatectomy under Pringle's portal occlusion were randomized into an electroacupuncture group and a sham electroacupuncture group, 15 cases each. Three days prior to the surgery, the patients started to receive corresponding acupuncture or sham electroacupuncture treatment by selecting bilateral Riyue (GB24), Qichong (ST30) and Yanglingquan (GB34), once a day. The anesthesia method was general (inhalational and intravenous) anesthesia. Central venous blood was drawn before the surgery, and respectively 6 h, 24 h, 48 h and 72 h after the surgery to examine the OS-relatedparameters, superoxide dismutase (SOD) and malondialdehyde (MDA), as well as the inflammatory mediators, including tumor necrosis factor-α(TNF-α), interleukin (IL)-1, IL-6, and IL-10.Result Compared to the sham electroacupuncture group, the SOD activity significantly increased (241±11.4 U/mL,180±12.6 U/mL,P<0.05) and the MDA level significantly dropped in the electroacupuncture group at 6 h and 24 h after the surgery(11.0±0.8 mmol/L,10.0±0.9 mmol/L,P<0.05); there were no significant between-group differences in the rest indexes (P>0.05).Conclusion Pre-intervention with electroacupuncture can up-regulate the activity of SOD and down-regulate the level of MDA in patients after hepatic portal occlusion, and thus partially reduce OS, but it doesn't shownoticeable effecton inflammatory response.

Objective To study the clinical anesthetic effect of butorphanol combined with propofol in painless gastroscopy. Methods 90 patientswith stomachache check were randomly divided into observation group and control group,45 cases each. The observation group was received butorphanol combined with propofol and the control group were treated with fentanyl combined with propofol. The heart rate of pa-tients before anesthesia,during checking and conscious,the change of blood pressure and oxygen saturation,respiratory depression and anes-thetic effect were analyzed. Results The heart rate,blood pressure and oxygen saturation of two groups after treatment were decreased,the difference was not statistically significant(P>0. 05). The total volume of propofol and respiratory depression between the two groups were compared,the differences were statistically significant(P<0. 05). Conclusion Butorphanol combind with propofol in painless gastroscopy with long anesthesia time and low respiratory depression,which was worthy of promotion.

Objective To compare the cardiorespiratory system effects of propofol-remifentanil and etomidate-remifentanil sedation in older patients undergoing diagnostic gastroscopy.Methods 400 older patients undergoing painless gastroscopy in endoscopy center of our hospital were chosen and randomly received intravenous propofol-remifentanil or etomidate-remifentanil sedation and divided into propofol group (n=200)and etomidate group(n=200).The diagnosis,endoscopic insertion time,operation time,wake up time,hemodynamics,adverse reaction and satisfactory of patients in each group were observed.Results There were no difference between two groups in diagnosis(P＞0.05);the onset time was earlier in the etomidate group (P＜0.05).Systolic pressure and diastolic pressure in propofol group were lower than etomidate group during and after operation(all P＜0.05);the heart rate in propofol group were lower than etomidate group after operation(P＜0.05);meanwhile,the SpO2 in propofol group were lower than etomidate group during operation(P＜0.05).All adverse events in propofol group were higher than etomidate group (P＜0.05).Incidences of hyoxemia and injection pain were higher in the propofol group (all P＜0.05),while those of body quiver and myoclonus were higher in the etomidate group (all P＜0.05).However,Satisfaction of physician and anesthetist in the propofol group were better the etomidate group (all P＜0.05).Conclusion Etomidate-remifentanil administration for sedation undergoing painless gastroscopy resulted in more stable haemodynamic responses and less adverse events in older patients.Etomidate-remifentanil administration was worth to be popularized in older patients.