The exploration of drug toxicity and mechanisms is a vital component in ensuring the safe use of drugs in clinical practice, as this topic has attracted widespread concern. The intestinal flora holds great significance for drug metabolism, efficacy and mechanism, and is an instrumental metabolic organ that facilitates material information transfer and biotransformation. However, an increasing number of studies have shown that intestinal bacteria are closely related to the toxicity of specific drugs. On the one hand, drugs are transformed into toxic metabolites under the influence of intestinal bacteria, thus inducing direct drug toxicity. On the other hand, the composition and function of the intestinal flora are altered under drug influence, resulting in disruption of endogenous metabolic pathways. Consequently, this disruption compromises the intestinal barrier and affects other organs, leading to indirect drug toxicity. This review meticulously compiles recent examples of drug toxicity attributed to intestinal bacteria, explores in depth the contention that metabolic enzymes of gut microbiota may be of great influence on oral drug toxicity, and outlines prospective avenues for future research on gut microbiota and drug toxicity and mechanisms. This not only provides novel perspectives for the judicious clinical utilization of drugs but also offers insights for the safety assessment of innovative pharmaceuticals.

Fibrinolytic Agents ; adverse effects ; Humans ; Male ; Middle Aged ; Thrombocytopenia ; chemically induced

Objective To investigate the clinical effect of low molecular weight heparin (LMWH) and pressure pump on perioperative deep vein thrombosis (DVT) in patients with hip fracture and analyze the effect of LMWH on coagulation function. Methods Retrospective analysis of 95 cases hip fractures patients with clinical data, according to the preventive medication of DVT were divided into LMWH group of 42 cases and LMWH joint pressure pump group of 53 cases. The incidence rate of DVT and the degree of limb swelling after operation in two groups were observed. The differences of blood coagulation function indexes, blood rheology and hip function recovery were compared between the two groups. Results The the incidence rate of DVT in combination group was 1.89% (1 cases ), lower than LMWH group of 14.29% (6 cases )(χ2=5.278,P=0.022). After two weeks' treatment, the difference of anterior thigh circumference and calf circumference in combination group was less than LMWH group (P<0.05). The prothrombin time (PT) and activated partial thromboplastin time (APTT) in two groups post-treatment were lower than those pre-treatment, the D-dimer (D-D) was higher than that pre-treatment(P<0.05), but there was no significant difference between two groups. After 3 months' treatment, the Harris functional independence measure (FIM) in combination group was higher than that in LMWH group (P<0.05). Conclusion LMWH combined with pressure pump could significantly reduce the incidence of perioperative DVT in patients with hip fracture, improve the blood coagulation function and hip function.

Background Takayasu arteritis is a non specificity inflammation of aorta and its branch.The incidence of Takayasu arteritis is low and its ocular secondary disease is rare.The correct diagnosis of Takayasu arteritis is very important for its early treatment in clinic.Objective This study is to analyze the fundus findings and characteristic of fundus fluorescein angiography (FFA) of Takayasu retinopathy.Methods The FFA and clinical data of 12 patients (24 eyes) with Takayasu arteritis were retrospectively reviewed.Written informed consent was obtained from all the patients before and initiation of any study protocol.Results In 12 patients,chronic ischemic retinopathy was found in 15 eyes of 9 patients.The arm to retina circulation time(A RCT) prolonged to (19.20±2.95) s in 5 eyes,and the retinal circulation time (RCT) delayed to 10.62±6.15 s in 5 eyes.Peripapillary arteriovenous anastomosis was found in 2 eyes of 2 patients.Macular arch ring was incomplete in 6 eyes of 4 patients.Eight patients (14 eyes) had telangiectasis and microaneurysm,and 2 eyes of 2 patients presented neovascularization on the disc or elsewhere.In 12 patients,hypertensive retinopathy was found in 4 eyes of 3 patients,showing narrow retinal artery,arteriosclerosis,hemorrhage,cotton wool spots and hard exudates.Ten patients were diagnosed as Takayasu arteritis before FFA examination,and 2 patients were determinedly diagnosed after FFA was performed.Conclusion The main features of Takayasu retinopathy are hypertensive retinopathy and chronic ischemic retinopathy.It is important for ophthalmologist to correctly recognize the clinical features of TA.

From an ethanol extract of Euphorbia micractina roots, seven steroids fifteen aromatic derivatives were isolated by a combination of various chromatographic techniques, including column chromatography over macroporous resin, silica gel, and Sephadex LH-20 and reversed-phase HPLC. Their structures were elucidated by spectroscopic data analysis as stigamast-5-ene-3beta, 7alpha-diol(1), stigamast-5-ene-3beta,7beta-diol(2), stigmast-5-en-3beta-ol-7-one(3), stigmast-4-en-6beta-ol-3-one(4), stigmast-1, 4-dien-3-one(5), stigmast-3,6-dione(6), beta-sitosterol(7), scopoletin(8), aesculetin(9), 6-hydroxy-5,7-dimethoxycoumarin(10), quercetin(11), 3,3', 4'-tri-O-methylellagic acid(12), p-hydroxyphenylethyl anisate(13), m-hydroxyphenylethyl alcohol(14), (E)-cinnamic acid(15), (E)-ferulic acid(16), 3,4-dihydroxybenzoic acid(17), vanillic acid(18), p-hydroxybenzoic acid(19), ethyl 3,4-dihydroxybenzoate (20), ethyl gallate(21), and methyl gallate(22). These compounds were obtained from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; Euphorbia ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Steroids ; chemistry

OBJECTIVETo compare the differences between computer aided identification and ultra-thin layer slicing in measuring the lesions of femoral head necrosis,and to confirm the accuracy and practicability of computer aided method.

METHODSFrom June 2012 to December 2013, the X-ray and MRI of 24 patients (24 hips on unilateral) were reviewed, who had avascular necrosis of the femoral head (ANFA) at late stage (stage III and IV) according to the ARCO international staging system. There were 15 males and 9 females, with an average age of (65.1 ± 8.8) years old, ranged 33 to 74 years old. Based on the software system with seeds point identification, the ragional adaptive search method with computer aid was used to calculate the volume of necrotic lesion in femoral on MRI. Then the pathological slices of those intraoperative femoral heads were made to measure the gross volume of necrotic lesion in femoral head,and the values were compared with the data in the computer.

RESULTSFor 24 hips, by the calculation of computer, the necrotic volume was (20.00 ± 3.04) cm (ranged, 18.72 to 21.29 cm³). Under the pathological section, the necrotic volume of the femoral head was (19.89 ± 3.17) cm³ (ranged, 18.55 to 21.23 cm³). In computer and pathology two kinds of measurement, the two entire femoral head volume had no significant difference using these two measurements (t = -1.227, P = 0.232).

CONCLUSIONComputer aided identification for necrotic area of femoral head adaptive can demonstrate the morphology of femoral head necrosis accurately and reliably, which will help surgeon better understand the morphology and orientation in femoral head.

Adult ; Aged ; Diagnosis, Computer-Assisted ; Female ; Femur Head Necrosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

Traumatic brain injury is always associated with hemorrhage and coagulopathy, leading the occurrence of anemia, platelet function inactivation, platelet and coagulation factor consumptive reduction. Theoretically, transfusion therapy should be given to supplement the missing component in an appropriate range. However, whether the transfusion therapy can improve the prognosis of patients with traumatic brain injury, and the indications of transfusion, have been the focus of academic debate for a long time. This article reviews the latest progress of transfusion therapy in traumatic brain injury, and provides reference for better guidance of transfusion in clinical treatment.

AIM:To evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment 6, 12 and 18mo with blood oxygenation level dependent - function magnetic resonance imaging techniques ( BOLD-fMRI) .
METHODS: In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children which was the first phase of research for amblyopic treatment. Functional MRI data were processed by using SPM8 which based on the Matlab 7. 12. 0. 635. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test.
RESULTS: The functional area that was left occipital lobe (BA18), middle occipital gyrus (BA19), limbic lobe (BA19), lingualis gyrus of the right occipital lobe (BA17) and the bilateral parietal lobe ( BA7 ) expanded after amblyopia treatment 6, 12mo, compared those treatment phase, mean t value was 1. 5762, 1. 6856 respectively (P<0. 001). However, the difference of activated intensity was lower after 18mo, mean t value was 1. 1473 (0. 001 CONCLUSION: In children anisometropic amblyopia, the speed of function reconstruction about visual cortical functional mediating stereopsis increase slowly after amblyopia treatment 1a.

Objective:This study aimed to establish a mouse model of breast cancer by inoculating human breast cancer cells into mice with normal immune function. Methods:Forty female BALB/C mice were randomized into four groups, with 10 mice in each group. The four groups were established according to the dosage of cyclophosphamide and prednisone, namely, the control group, low dose group, medium dose group, and high dose group. The mouse models of breast cancer were established by injecting human breast cancer cells into the fat pad of the right second breast of mice in the groups. Mice in the four groups were observed based on the time of tumorigenesis, rate of tumor formation, tumor imaging and pathological features, and metastasis of vital internal organs. Results:In the high dose group, the time of tumor formation was lower than that of the other groups, but the rate of tumor formation was high. Some visceral metastases occurred in the mice. By contrast, the medium dose group revealed completely opposite results. No death and tumor formation in both the control and low dose groups were reported. Conclusion:A human breast carcinoma model in mice was successfully established. Using this model, the onset and development of breast cancer could be much better imitated in the normal immune system of mice.

OBJECTIVETo observe clinical therapeutic effects of acupuncture for pattern of liver-stagnation and spleen-deficiency in diarrhea-predominant irritable bowel syndrome (D-IBS) and its impact on cell factors.

METHODSForty cases were selected and divided into an acupuncture group (21 cases) in which acupuncture was applied and a medicine group (19 cases) in which oral administration of dicetel and bifidobacterium lactobacillus triple viable capsules were applied. The symptom scores, level of Th1-type cytokine (IFN-gamma, IL-2) and Th2-type cytokine (IL-4, IL-10) and ratio of IFN-gamma to IL-4 were compared in two groups before and after treatment to analyze acupuncture effect.

RESULTSThe clinical symptoms were improved after one-week treatment in the acupuncture group (P<0.05), which had faster onset than the medicine group (P<0.05). The total effective rate was 90.48% (19/21) in the acupuncture group, which was superior to 78.95% (15/19) in the medicine group (P<0.05). Compared with medicine treatment, imbalanced condition of Th1/Th2 was turning towards the direction of Th2 after acupuncture, indicating a tendency to recover the balance.

CONCLUSIONThe clinical efficacy of acupuncture for D-IBS has close relationship with effectively improving balance of Th1/Th2 in patients with liver-stagnation and spleen-deficiency.

Acupuncture Therapy ; Adult ; Aged ; Cytokines ; immunology ; Female ; Humans ; Irritable Bowel Syndrome ; immunology ; physiopathology ; therapy ; Liver ; physiopathology ; Male ; Middle Aged ; Spleen ; physiopathology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Young Adult