Cardiomyopathy, Dilated ; etiology ; pathology ; therapy ; Humans ; Myocardium ; pathology

Abstract: Objective　To investigate the cause of poisoning leading to multi-organ damage in a patient with an unexplained condition, to confirm the type and exposure amount of the pathogenic factor, to identify the sources of pathogenic factors, and to provide references and bases for the clinical treatment and the prevention of such events. Methods　Starting with the unknown traditional Chinese medicine taken by patients for a long time, the targeted screening strategy was initially used to screen for alkaloid poisoning. Subsequently, a non-targeted screening strategy using Information-dependent Acquisition Mode (IDA) was used to screen the patient's blood, urine, and drug samples. Combining the toxicological effects of suspected compounds with the patient′s clinical manifestations, the main pathogenic factors were determined. Quantitative methods were established according to standard substances to quantify the pathogenic factors in all the samples. An epidemiological investigation was conducted to obtain the patient's medication history, and combined with the examination of the medication's specifications and content, the exposure dose of each pathogenic factor was determined. Finally, a Data data-independent acquisition (DIA) mode termed Sequential Window Acquisition of All Theoretical Fragment-Ion Spectra (SWATH) was used to screen all samples, unbiasedly collecting secondary mass spectrometry information of compounds, thereby verifying and supplementing the confirmed pathogenic factors. Results　Targeted screening ruled out common alkaloid poisoning. Tadalafil was detected in the patient's blood and urine. Tadalafil, sildenafil, chloropretadalafil, acetaminophen, and diclofenac were detected in unknown traditional Chinese medicine. The side effects of these compounds were consistent with the clinical manifestations of the patient. The highest daily average exposure doses of tadalafil, sildenafil, chloropretadalafil, acetaminophen, and diclofenac were 30.5 mg, 15.8 mg, 0.05 mg, 45.6 mg, and 3.2 mg respectively, which were seriously excessive. The SWATH mode also screened out the above five drugs. In addition, palmatine chloride was also detected. Conclusions　Combining the patient's clinical manifestations and epidemiological data, this study integrated targeted screening, untargeted screening, targeted quantitative strategies, data-dependent, and DIA mode to confirm that this case is a drug poisoning event caused by long-term overdose consumption of traditional Chinese medicine adulterated with chemical components. This study provides insights for the diagnosis and investigation of patients with poisoning for unknown causes, offering references for emergency detection and management of related poisoning incidents.

Factor VII Deficiency ; genetics ; Humans

Objective: To investigate the expressions of signal transducer and activators of transcription 3 (STAT3) and suppressor of cytokine signaling 3 (SOCS3) protein in the breast carcinoma tissue and their relationship with tumor differentiation, invasion, and metastasis. Methods: The expression of STAT3, phospho-STAT3 and SOCS3 protein were determined by tissue microarray and immunohistochemistry with EnVision system in 71 cases of archival breast carcinoma tissues and 41 cases of noncancerous tissues. The relationship between their expression and the clinical pathological parameters were analyzed. Results: (1) The positive rates of STAT3, phospho-STAT3, and SOCS3 was 78.9%, 69.0%, and 29.6%, respectively. The difference was significantly different compared with control (P<0.01, P<0.01, and P<0.05). (2) The expressions of STAT3 and phospho-STAT3 were positively related with the histological grade, the axillary lymph node metastasis, and the clinical stage (P<0.01), but not related with the age, the tumor size, and the histological grade of breast carcinoma tissues (P>0.05). The expression of SOCS3 was negatively related with the histopathologic grade and the axillary lymph node metastasis (P<0.05), but was not related with the age, histological type, the tumor size, and the clinical stage (P>0.05). (3) The expression of STAT3 and phospho-STAT3 had negative correlation with the expression of SOCS3 in breast carcinoma tissues (P<0.01). Conclusion: The overexpressions of STAT3 and phospho-STAT3 and the down-regulated expression of SOCS3 closely correlated with the tumor carcinogenesis, progression, invasion, and metastasis of breast carcinoma. Detection of their expression is helpful in accessing the malignant degree and the biological behaviors of breast carcinoma.

Animals ; Aortitis ; pathology ; Biopsy ; Dendritic Cells ; pathology ; Diagnosis, Differential ; Giant Cell Arteritis ; drug therapy ; etiology ; metabolism ; pathology ; Glucocorticoids ; therapeutic use ; Humans ; Interleukin-12 ; metabolism ; Oxidative Stress ; Polymyalgia Rheumatica ; pathology ; Temporal Arteries ; pathology

Child ; Female ; Humans ; Polyendocrinopathies, Autoimmune ; classification ; diagnosis ; therapy ; Treatment Outcome

Animals ; Cell Cycle Proteins ; biosynthesis ; genetics ; Cell Differentiation ; Cell Line, Tumor ; metabolism ; Gene Expression Regulation, Neoplastic ; drug effects ; Genes, Tumor Suppressor ; Humans ; Intracellular Signaling Peptides and Proteins ; Molecular Sequence Data ; Neoplasm Metastasis ; RNA, Messenger ; biosynthesis ; genetics ; Tretinoin ; pharmacology

OBJECTIVE:To analyze the rationality of the preventive use of antibiotics in Chinese ophthalmologic patients with type Ⅰ incision.METHODS:By means of retrospective study,a total of 1 273 ophthalmologic cases from 113 hospitals of 2006～2007 from National Monitoring Network of Ministry of Health for Clinical Application of Antibiotic with type Ⅰ incision involving preventive administration of antibiotics via different routes were analyzed.RESULTS:The local administration (eye drops and local injection) was rational on the whole,but the systemic administration (intravenous or oral administration) was irrational to some degree in which the drug grade was on the high side,the antibacterial spectrum was inappropriate,and the medication time was delayed.CONCLUSION:Preoperative local administration and rational use of dosage forms should be emphasized in the preventive use of antibiotics for patients undergoing ophthalmologic surgery.

Objective To observe the clinical therapeutic effect of Shudu Bushen Recipe (Recipe to strengthen the spine and reinforce the kidney) on ankylosing spondylitis at active stage.Methods Totally 165 patients with ankylosing spondylitis at active stage were randomly divided into a treatment group (85 cases) and a control group (80 cases).Both groups were treated with Sulfasalazine and Aceclofenac,and the trentment group was given Shudu Bushen Recipe additionally.Six-month treatment was one course.The clinical changes such as morning stiffness,joint pain and function,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),immunoglobulin (Ig),X-ray of sacroiliac joint,and adverse reaction were observed.Results In the treatment group,the total effective rate was 94.12%,superior to that in the control group (76.25%),with a significant difference (P0.05).The adverse reaction occurred in the treatment group was less than that of the control group (P

Objective To study the effect of melatonin on ultrastructural changes of aorta endothelium of insulin-resistant (IR) rats. Methods Insulin-resistant rat model was established with SD rats (n=20) aged 6-8 weeks by high-glucose diet (70% calories from glucose) for 6 weeks. All the IR rats were divided into 2 groups: with melatonin (MEL group, n=10) and without melatonin (control group, n=10). Rats in MEL group were filled with melatonin (10mg? kg -1?d -1) for 6 weeks. The ultrastructure of aorta endothelium was observed with transmission electron microscope (TEM). Results Systolic blood pressure (SBP), serum triglyceride (TG), low-density lipoprotein (LDL-c), insulin (Ins), and malondialdehyde (MDA) declined while the Serum high-density lipoprotein(HDL-c), superoxide dismutase (SOD) and insulin sensitive index (ISI) elevated in the rats of MEL group than that in control group (P