OBJECTIVE:To study induction effect of entecavir on the apoptosis of hepatocellular carcinoma HepG2 cells and its mechanism. METHODS:After treated with 0(normal control),10,30 and 100 μmol/L(low,medium and high concentration groups)entecavir for 48 h,MTT method was adopted to detect HepG2 cell viability. AnnexinⅤ-PI flow double staining was used to detect cell apoptosis. Western blot was used to determine the phosphorylation of nuclear factor kappa B p65(NF-κB p65)and nu-clear factor kappa B inhibitor α(IκBα),and the protein expression of Bax,Bcl-2,Survivin and C-myc. RESULTS:Compared with normal control group,the cell viability,the phosphorylation of NF-κB p65 and IκBα,and the protein expression of Survivin, C-myc and Bcl-2 of entecavir low,medium and high concentration groups all decreased;the apoptotic rate,the protein expression of Bax increased(P<0.05 or P<0.01),in concentration-dependent manner. CONCLUSIONS:Entecavir can decrease viability of HepG2 cells and induce cell apoptosis,which is related to up-regulation expression of Bax,down-regulation expression of Sur-vivin,C-myc and Bcl-2,and blocking the activation of NF-κB/IκBαsignaling pathway.

Objective To explore the clinical efficacy and adverse reactions of transarterial chemoembolization(TACE)combined with sorafenib for the treatment of liver carcinoma.Methods Forty-eight cases of intermediate-advanced liver carcinoma patients were divided into TACE combined with sorafenib group(test group)and TACE only group(control group)according to the wishes of the patient,with 24 patients in each group.The median Survival Time(mOS),clinical efficacy,quality of life,liver function indexes and adverse reactions were compared in two groups.Results Until the deadline of follow-up time,the mOS in test group(15.9 months)was significantly higher than that in control group(9.3 months).The difference was statistically significant(P<0.05).The ORR,CBR in test group(58.3%,87.5%)were significantly higher than those in control group(33.3%, 54.2%).The difference was statistically significant(P<0.05).The quality of life improvement rate in test group(79.2%)was significantly higher than that in control group(37.5%).The differences were statistically significant (P<0.05 ).The ALB,TBIL increased significantly after treatment than before treatment in both groups.The differences were statistically significant(P<0.05 ).Conclusion TACE combined with sorafenib is more efficiency than TACE only treatment,and it could effectively extend the period of life to guarantee the quality of life.What's more,it has well tolerated adverse reactions,which is worthy of promoting.

Hair can be easily collected,the collection method does not cause any harm to body.It can provide long and convinced information about drug uses.It possess irreplaceable advantages of blood,urine and other biological samples.The review summarizes the basic information and recent studies of hair analysis.It introducs the hair-shaft structure,the mechanisms of drug incorporation,extraction/purification methods and all kinds of analytical techniques.The advantages,drawbacks and promising prospects about hair in drug monitoring are also discussed.

Objective To analyze the radiological images of osteonecrosis in rare positions in recovered SARS patients, and to study the correlation with the hormone application.Methods The extremities of 41 SARS patients in the recovery stage from June to August in 2003 were examined by using X-ray and 0.5T MR scanner, then the correlation of MR examination results and the application of hormone was analyzed.The mean time interval between the imaging examination and initial hormone application was 88.2 days (66～106 days), the mean maximum hormone (metastab) dose was 392 mg (320-480 mg), and the average medication time was 47.2 days (30-70 days).Results The osteonecrosis of rare positions was revealed in 5 cases involving 11 positions, including bilateral heads of humerus (3), right scaphoid bone (1), right talus (1), bilateral calcaneus (1), and right ischium (1).The main MR manifestation was irregular abnormal signal.Osteonecrosis of right ischium was demonstrated on plain film in only one case.Conclusion MR examination, especially the multi-location scan is necessary in finding the osteonecrosis in SARS patients in the earlier phase.The hormone dose, the medication duration, the sensitivity to hormone, and the difference of individuals are important causes of osteonecrosis.

Objective To determine the contents of elements Fe, Mn, Ni, Cu, Zn, Ca, Mg and Cr in Gentiana macrophlla and Gentiana officinalis. Methods The contents of elements were determined by flame atomic absorption spectrometry. Results The recovery rates obtained by standard addition method were between 88.1%～114.5%, and the RSDs were lower than 3.18%. Gentiana macrophlla is rich in the trace elements such as Fe, Ni, Cu, Ca, Mg, and Gentiana officinalis is rich in the trace elements such as Mn, Zn, Cr. Conclusion There are some difference between wild and planted Gentiana officinalis in element content, that may be related to their growing environment.

Objective To investigate the clinical characteristics of diffuse alveolar hemorrhage. Methods 12 patients with diffuse alveolar hemorrhage hospitalized in Guangzhou NO.1 Hospital were included in the research, whose clinical characteristics were analyzed. Results 7 cases of the 12 diffuse alveolar hemorrhage cases were male and 5 cases were female. 8 cases were caused by ANCA associated vasculitis , 1 cases by connective tissue disease, 1 cases by poisoning, and 2 cases of unknown etiology (medication could be considered). The clinical manifestations were fever (91.67%), hemoptysis (100%), anemia (100%), and dyspnea (3.33%). Conclusion Diffuse alveolar hemorrhage is a life-threatening clinical syndrome. It can be caused by many causes. It should be considered if there is the presence of hemoptysis, dyspnea, anemia, etc. Timely examination and early intervention can effectively improve the prognosis of the disease.

ObjectiveTo investigate the protective effect of combination of triptolide and irbesartan on the podocytes in a type 2 diabetic(T2DM) rat model,and evaluate its mechanism.Methods T2DM rats were induced by fed with high-sucrose-high-fat diet combined with a low dose of streptozocin.The rats were randomly divided into 5 groups:normal control group ( NC,n =10),diabetes group ( DM,n =11),triptolide treatment group (DT,n =12),irbesartan treatment group (DI,n =12) and triptolide combined with irbesartan treatment group (DTI,n =13). Ultrastructure of podocytes was observed by electronic microscopy and urinary albumin (UAL) excretion by ELISA was determined after 8 weeks.The expression of nephrin and bone morphogenetic protein-7(BMP-7), connective tissue growth factor (CTGF),transforming growth factor (TGF)β1 mRNA and proteins were detected by immunohistochemistry,real-time PCR and Western blot. Results Increased UAL was significantly attenuated in all treatment groups.Compared to NC group,UAL in DM group was increased significantly (0.45 ± 0.09 vs 6.36 ± 0.87,P ＜ 0.01 ),while decreased in triptolide or irbesartan alone treatment group (2.48 ± 0.37 and 2.68 ±0.42,both P ＜ 0.01 ).Compared with those in control groups,kidney expression of nephrin,BMP-7 mRNA and proteins were downregulated while CTGF, TGFβ1 mRNA and proteins were significantly upregulated in T2DM rats. Triptolide or irbesartan each alone moderately ameliorated albuminuria and podocyte damage.However,their combined usage showed a dramatic therapeutic synergism,manifested by prevention of progressive albuminuria,restoration of the glomerular filtration barrier,reversal of the decline in slit diaphragm proteins,reduction expression of CTGF,TGFβ1,and upregulation of BMP-7.Conclusion Our findings show that triptolide can increase the efficacy of irbesartan,leading to a more effective prevention of kidney disease in T2DM rat model,which may through upregulation of BMP-7 and inhibition the overexpression of CTGF and TGFβ1.

Objective To review the clinical features,etiology and differential diagnosis of hypopituitarism.Methods The clinical data of 260 patients with hypopituitarism admitted to our hospital during 2007 to 2011 were retrospectively analyzed.Results In 260 patients 96 were males and 164 were females,the average age of female patients was significantly higher than that of males[ (44 ± 16) vs.(32 ± 20) years; t =3.821,P =0.001 ].Patients under 20 years accounted for the highest proportion in male cases (38/96,39.6％) ; while patients aged 40 - 60 years were the highest proportion for female cases (86/164,52.4％).Pituitary tumor and postoperative damage was the most common cause for hypopituitarism accounting for 36.2％ (94/260),followed by Sheehan syndrome (86/260,33.1％).The most common manifestation of hypopituitarism was anemia (102 eases) ; 26 cases presented all pituitary function failure.The causes leading to hypopituitarism usually showed specific manifestations in imaging examinations.The overall misdiagnosis rate was 40.4％ (105/260)in this series,while that of etiological diagnosis was 25.4％ (66/260).Conclusions This study suggests that hypopituitarism caused by different causes can be diagnosed by disease history,clinical manifestations and pituitary imaging examination.

Objective To observe the effect of Shengmai Injection (a Chinese herbal medicine preparation) on the serum levels of TNF-α used as indicators of organ function in post cardiopulmonary resuscitation rabbits.Methods Rabbit cardiac arrest model was made with asphyxia by clamping the trachea of rabbit.A total of 30 rabbits were randomly (random number) divided into two groups,namely the normal saline group (n =15) and the Shengmai injection group (n =15).Rabbits in Shengmai injection group were injected with 2 ml/kg Shengmai Injection immediately at the beginning of cardiopulmonary resuscitation (CPR),and the same dose of Shengmai injection given 10 min after CPR.Rabbits in saline group were injected with the same volume of physiological saline instead at the same intervals as previous group.The rate of restoration of spontaneous circulation (ROSC) and survival rates at 6,12,24 and 48 h after ROSC were observed.The serum levels of TNF-α were measured by enzyme-linked immunosorbent assay (ELISA).Biochemical methods were used to detect myocardial MB-isoenzyme of creatine kinase (CK-MB),alanine aminotransferase (ALT),creatinine (Cr),glucose (Glu) and arterial partial pressure of oxygen (PaO2) before resuscitation and 12,24 and 48 h after ROSC simultaneously in the two groups.Results There was no statistically significant difference in the ROSC rate and survival rate after resuscitation between the two groups (P ＞ 0.05).Before asphyxia,there was no significant difference in the level of TNF-α found between the two groups (P ＞ 0.05),but at 12,24 and 48 h after ROSC,the levels of TNF-α in Shengmai group were much lower than those in Saline group (P ＜ 0.05).At 24 h after ROSC,the levels of serum CK-MB,ALT,and Cr in Shengmai group were much lower than those in Saline group (P ＜0.05).Furthermore,at 48 h after ROSC,the levels of CK-MB and ALT in Shengmai group were still lower than those in Saline group (P ＜ 0.05),but there was no significant difference in the level of Cr between the two groups (P ＞ 0.05).There was also no significant difference in the blood glucose and arterial partial pressure of oxygen between the two groups (P ＞ 0.05).Conclusions Shengmai Injection has significant inhibiting effect on the serum level of TNF-α in post cardiopulmonary resuscitation rabbits,and it also has more or less some degrees of protective effect on organ function of heart,liver and kidney in rabbits after ROSC.

Objective To assess the relationship between lactate clearance and prognosis of patients with multiple organ dysfunction syndrome following resuscitation.Methods Data of 42 eligible patients with multiple organ dysfunction syndrome after resuscitation admitted from January 2009 to December 2011 were collected for retrospective analysis.The patients included were adult patients who survived more 24 hours after CPR for cardiac arrest with subsequent multi-organ failure.Exclusion criteria were traumatic heart arrest and the end-stage diseases.All the patients were divided into survival group and death group on the 3rd day and the 7th day after restoration of spontaneous circulation.The differences in the age,gender,mean arterial pressure,oxygenation index (PaO2/FiO2),APACHE Ⅱ score,white blood cell count (WBC),initial lactate level and 6h lactate clearance rate between the two groups were compared by using the Mann-Whitney U-tests and logistic regression analysis.Results Of 42 patients,the mean age was (59.57±14.68) years and mean APACHE Ⅱ score was (26.79 ±7.77),and 23 (54.8％) patients survived until the 3rd day and 14 (33.3％) patients survived to the 7th day after restoration of spontaneous circulation (ROSC).Univariate analysis showed that APACHE Ⅱ score in death group was significantly higher and 6 h lactate clearance was significantly lower than those in survival group (P ＜ 0.05) on the 3rd day and the 7th day after ROSC,and other biomarkers were not significantly different between the two groups.The results from logistic regression analysis showed that there were statistically significant difference in APACHE Ⅱ score (RR =2.143,P =0.028) and 6-h lactate clearance (RR =0.887,P =0.040) between survival group and death group on the 7th day after ROSC,although no significant differences in APACHE Ⅱ score and 6 h lactate clearance were found between the two groups on the 3rd day after ROSC.Conlusions Post-cardiac arrest patients with low lactate clearance in the early stage after ROSC have a poor prognosis.Lactate clearance may be an independent predictor of mortality in post-cardiac arrest patients in the recovery phase.