OBJECTIVE:To provide reference for rational drug use. METHODS:107 patients with drug-induced liver injury (DILI)admitted to liver disease department of our hospital during Jan. 2011 to Dec. 2015 were divided into TCM group and chemi-cal medicine group according to the type of medicine. DILI clinical characteristics,prognosis,medicine types of DILI were com-pared and analyzed between 2 groups. RESULTS:47 cases of DILI were induced by TCM,which mainly were health care and body beauty medicines(19.1%),rheumatism and arthritis medicines(14.9%)and dermatological medicines(10.6%). 60 cases of DILI were induced by chemical medicine,which mainly were antineoplastics(21.7%),antimicrobial(20.0%)and antituberculot-ics (11.7%). Gender,average age,the time from primary medication to disease attack and clinical classification were no signifi-cant difference between 2 groups(P>0.05). The clinical manifestations of the 2 groups were similar,except that fatigue was more common in the TCM group,with statistical significance(P<0.05). The liver function indicators of TCM group as ALT,AST, TBIL and ALP were higher than those of chemical medicine group,while ALT and TBIL were significantly different between 2 groups(P<0.05). The liver injuries were more serious in the TCM group than in chemical medicine group,with statistical signifi-cance(P<0.05). After treatment,the prognosis and the prognosis of liver function indicator in 2 groups were not statistically sig-nificant(P>0.05). CONCLUSIONS:Doctors and pharmacists should cooperate to master medication indication strictly,develop ADR monitoring and conduct blood concentration monitoring of high-risk DILI medicines,especially the hepatotoxicity of TCM so as to reduce the occurrence of DILI and guarantee the safety of clinical drug use.

Objective To investigate the changes of monoamine neurotransmitters of the brain in physical dependence induced by morphine in rats.Methods A physical dependent rat model was established with morphine in a gradually in creasing doses and the withdrawal syndrome was scored after naloxone precipitation.The conditioned place preference(CPP)in rats induced by morphine was used to investigate psychic dependence in rats.Contents of norepinephrine(NE0,dopamine(DA)and serotonin(5-HT)in hypothalamus of rats were assayed with a fluorescent method. Results (1)In naloxone-precipitated withdrawal test of morphine-dependent model rats,after morphine had been withdrawn,morphine-abstinent rats presented marked withdrawal symptoms and signs,their withdrawal scores were significantly increased,and the levels of NE and 5-HT in the rat brain were obviously enhanced,but the content of DA was reduced.(2)In CPP test,morphine caused a marked place preference in rats and the levels of DA and 5-HT in the rat brain were obviously enhanced,but the content of NE was reduced.Conclusiion Morphine dependence development and withdrawal are closely connected with monoamine neurotransmitters in CNS.In the physical dependent model induced by morphine in rats,the rising of NE and 5-HT in the rat brain were significant,but in psychic dependent model induced by morphine in rats,the levels of DA in the rat brain were enhanced p-redominately.

Objective To investigate the changes of monoamine neurotransmitters of the brain in two tat models of morphine dependence,and to explore the effects of sinomenine on morphine dependence.Methods A physical dependent rat model was established with morphine at a gradually increasing dosage and the withdrawal syndrome was scored after naloxone precipitation.The conditioned place preference(CPP)in rats induced by morphine was used to investigate psychic dependence in rots.Contents of norepinephrine(NE),dopamine(DA)and serotonin(5-HT)in hypothalamus of rats were assayed with a fluorescent method.Results 1.In naloxone precipitated withdrawal test of in morphine-dependent rats,after morphine withdrawal,the rats presented marked with drawal symptoms and signs,their withdrawal scores were significantly increased,and the levels of NE and 5-HT in hypothalamus of the rats were significantly increased than the control group Ⅰ(7.07±1.406μg/g wet tissue and 1.15±0.346 μg/g wet tissue,respectively,P<0.01),but the content of DA was markedly reduced than the control group Ⅰ(0.28±0.121 μg/g wet tissue,P<0.05).2.In CPP model,morphine caused a marked place preference in rats and the levels of DA and 5-HT in hypothalamus were significantly increased than the control group Ⅱ(1.13±0.359 μg/g wet tissue and 1.23±0.343μg wet tissue,respectively,P<0.01),but the content of NE was not significantly changed(3.28±1.098 μg/g wet tissue,P>0.05).Sinomenine could significantly inhibit the withdrawal syndrome and development of CPP induced by morphine in rats,and could suppress the rising of monoamine neurotransmitters of the brain in two morphine dependent models in rats.Conclusion In the physical dependent model induced by morphine in rats,the rising of NE and 5-HT in the rat brain were significant,but in CPP model induced by morphine in rats,the levels of DA in the rat brain were enhanced predominately.Sinomenine could inhibit the withdrawal syndrome and development of CPP in rats,and regulate and improve the function of monoamine nerve system.

Objective To establish a methamphetamine-dependent model in zebrabfish.Methods On the basis of conditioned place preference (CPP) in drug-dependent experiment,place preference box for zebrafishes was designed.According to the natural characteristics of zebrafishes,their preference side and non-preferred side were determined.After intraperitoneal injection of methamphetamine,zebrafishes were placed in non-preferred side(drug box).After intraperitoneal injection of normal saline,zebrafishes were placed in preference side (non-drug box).CPP training was five days and then the methamphetamine-induced place preference in zebrafish were observed.Results After five days training,the staying time of zebrafishes of control group in drug box was not significantly lengthened to compared with before training(.( 287.5 ± 80.18 ) s,(276.3 ± 85.04) s),P＞ 0.05 ).The staying time of zebrafishes of model group in drug box was markedly extended after training.In comparison with before training or control group,the significant differences were observed ( (465.5 ± 113.49 ) s,( 247.9 ±95.62)s,(276.3 ±85.04)s,P＜0.01).Conclusion Methamphetamine can induce conditioned place preference in zebrafishes.The CPP model in zebrafish established in this study can be used as a new animal model in drug dependence.

Objective To investigagte the effect of high dose folic acid(FA) combined with vitamin B_(12) to homocysteine plasma level in maintenance hemodialysis(MHD) patients.Methods 52 MHD patients were randomly divided into 4 groups,receiving of FA 0,15,30,60mg/d orally for 3 months and those who receiced folic acid were given vitamin B_(12) 500?g/d,im.The levels of plasma FA,vitamin B_(12) and total homocysteine(tHcy) at 0,1,2,3,6 month were detemined by radioimmunoassay and flurescence polarization immunoassay respectively.Results Levels of tHcy in MHD patients were significantly higher than those in healthy controls.Both high dose and low dose FA could lower tHcy plasma concentrations,but had no significant difference in homocysteine reduction ratio,and could not normalize it.Three doses of FA combined with vitamin B_(12) treatment could effectively increase the plasma FA and vitamin B_(12) concentrations.Conclusion tHcy is elevated in the majority of MHD patients.Low dose of FA combined with vitamin B_(12) can decrease tHcy plasma levels,but cannot normalize it.

Objective To explore the clinical effect of salt-hot compress based on the theory of“Maiweiji”on mechanical phlebitis after PICC catheterization. Methods According to random number table, 202 patients after PICC catheterization were divided into the control group including 100 cases and the experimental group including 102 cases. The study were divided into the prevention stage and the treatment stage. In the prevention stage, the control group were given routine nursing while the experimental group were received routine nursing plus salt-hot compress. In the treatment stage, all the patients in mechanical phlebitis after the prevention stage were randomly divided into the group of salt-hot and the group of wet-hot by lottery, meanwhile, the group of salt-hot were given salt-hot compress, the group of wet-hot were received wet-hot compress. Results In the prevention stage, the mechanical phlebitis rate of the experimental group was 8.82%(9/102), and it was 21%(21/100) in the control group, the difference had statistically significant (Z=-2.28, P<0.05). In the treatment stage, the cure rate in 3 days and 7 days of the Group of Wet-hot were 5/15 and 10/15, and were 9/15 and 6/15 in the Group of Salt-hot, the average treatment time were (3.71±1.82) d and (4.31±1.58) d respectively, but the difference had no statistically significant(P > 0.05). Conclusions Salt-hot compress has the positive effect of preventing mechanical phlebitis. Besides, the therapeutic effect on mechanical phlebitis between the group of salt-hot and the group of wet-hot is about the same. Because of the simple operation, bargain price, being not contaminated clothing, salt-hot compress is more advantage.

Objective To study the anatomic characteristics of Zuckerkandl's tubercle (ZT) and its clinical relevance as an anatomic landmark of the recurrent laryngeal nerve (RLN) in thyroid surgery.Methods This study involved 147 (106 with benign thyroid diseases and 41 with malignancies) patients who underwent thyroidectomy.ZT was measured and classified based on the Pelizzo classification.The relationship between ZT and the RLN and the relationship between the RLN and the inferior thyroid artery were recognized and classified.Results 233 (107 left and 126 right) thyroid gland lobes were dissected and ZT was identified in most patients (left in 93.5％ and right in 96.0％).The distribution of ZT according to grade was as follows:Grade 0,left 16.0％ and right 13.2％ ; Grade Ⅰ,left 32.0％ and right 27.3％ ; Grade Ⅱ,left 46.0％ and right 44.6％ ; Grade Ⅲ,left 6.0％ and right 14.9％.There was no significant difference on classification between the left-sided and right-sided ZTs.In terms of the relationship between the ZT and the RLN,it was classified as follows:Type A,left 92.9％ and right 93.3％ ; Type B:left 0 and right 0; Type C:left 7.1％ and right 6.7％.Similarly,there was no significant difference between the left sided and the right sided.The ZT grade was correlated with the course of the RLN:the higher the ZT grade was (that is,the greater the size of the ZT),the more often was the course of RLN behind the back of the ZT; the lower the ZT grade (that is,the smaller the size of the ZT),the more often was the course of RLN running by the lateral of the ZT.Considering the incidence of being dangerous type of RLN,the right sided (19.0％) was higher than the left sided (8.3％).The relationship between the ZT and the RLN does not relate to RLN course across the inferior thyroid artery.Conclusions As an important anatomic landmark,the ZT is essential for locating and dissecting the RLN during thyroid surgery,and its classification is a guide to RLN dissection and preservation.

Objective To study changes of AMPA receptors expression in nucleus accumbens and hypothalamus of methamphetamine dependent rats,and the therapeutical effect of rhynchophylline.Methods SPF male rata were randomly divided into normal control group,model group of methamphetamine,low dose of rhynchophylline group and high dose of rhynchophylline group(n=8 in each group).Experiment of conditioned place preference(CPP)was used to build the model of methamphetamine dependent rata.Western blotting was used to examine the changes of GluR2/3 subunits expression.The time of staying in drug-paired compartment of rats was used independent-samples t test to gather statistics,and the photodensity of proteinum strap was used One-Way ANOVA to gather statistics.Results Compare with rats in normal control group(the time of staying in drug-paired compartment of rats was(383.00±38.20)s),the rats produced CPP after treated with methamphetamine(the time of staying in drug-paired compartment of rats was(536.20±57.49)s),and low(30mg/kg) and high (60 ms/kg)dose of rhynchophylline(the time of staying in drug-paired compartment of rats were(299.80±15.96)s and(189.40±59.02)s)both could eliminate CPP effect.Compare with rats in normal control group (the ratio of value of average gray scale were(0.54±0.04)INT·mm~2 and (0.70±0.04)INT·mm~2),GluR2/3 subunits expression in nucleus aecumbens increased significantly in model group(the ratio of value of average gray seale was(0.89±0.03)INT·mm~2)and low dose of rhynchophylline group(the ratio of value of average gray seale was (0.93±0.03)INT·mm~2,P<0.01),which decreased significantly in hypothalamus(the ratio of value of average gray scale were (0.53±0.03)INT·mm~2 and (0.52±0.02)INT·mm~2,P<0.01).But GluR2/3 subunits expression in nucleus accumbens and hypothalamus of rats in high dose of rhynchophylline group(the ratio of value of average gray scale were (0.57±0.06)INT·mm~2 and (0.65±0.01)INT·mm~2) just liked the expression of normal control group(P>0.05).Conclusion GluR2/3 subunits expression of methamphetamine-induced CPP rats increased in nucleus accumbens but decreased in hypothalamus.High dose of rhynchophylline can reverse such changes and rebound the expression to normal level.

Objective To analyze TORCH infection situation in 6 027 cases of pregnant women,puerperae and neonates.Methods The TORCH IgM and IgG was detected by using ELISA for 6 027 cases of pregnant women,puerperae and neonates,and the positive rates of the antibodies to variant TORCH pathogens were analyzed.Results The positive rates of HSVⅠ-IgM,HSVⅡ-IgM,RV-IgM,TOXO-IgM and CMV-IgM were 0.02%,0.02%,0.12%,0.12% and 0.20% respectively.The positive rates of HSVⅠ-IgG,HSVⅡ-IgM,RV-IgM,TOXO-IgM,and CMV-IgM were 63.32%,13.31%,52.83%,12.68% and 58.57% respective-ly.Positive rate of CMV-IgM in neonates was higher than that in pregnant women,the difference was statistically significant(P <0.05).There were totally 28 cases of neonataes detected with acute CMV infection.Conclusion TORCH screening in pregnant women,puerperae and neonates helps the detection of infection disease in perinatal period.

Objective To explore the relationship between homocystine(HCY) and diabetic nephropathy and uremia in the patients with type 2 diabetes mellitus.Methods 20 cases with type 2-DM,20 cases with incipient diabetic nephropathy and 17 cases with uremia were collected.The plasma levels of HCY were measured by FPIA,the fasting blood sugar were measured by standard automated clinical chemistry laboratory methods.The plasma levels of HCY were compared with each other with t test.Results The plasma levels of HCY between the type 2-DM and diabetic nephropathy were significantly different,(26.16?12.31)?mol/L vs (8.79?3.51)?mol/L,P