Objective To analyze the clinical characteristics of drug-induced liver injury (DILI) from Chinese literatures published in Chinese Periodical Full-text Database (CNKI) from 2007 to 2011.Methods Using drug-induced liver injury as key words,the literatures in CNKI were searched,and the data of age,gender,medication,clinical manifestation and prognosis were analyzed.Results In search of CNKI,281 literatures were collected; finally 111 relevant papers were obtained.Total 10 693 cases of DILI were included with a male/female ratio of 1.14:1 and a mean age of 45.6 y ranging from 7 months to 93 y.Among 1093 cases with the age grouped,the highest incidence of DILI was in age 41-60 y(38.52％)and 20.68％ patients were over 60 y.Among 6592 cases with clinical manifestation recorded,43.51％ patients were asymptomatic and abnormal liver function was detected in health check-up; and others presented nonspecific gastrointestinal symptoms,including fatigue,nausea,vomiting and jaundice.In 9340 cases with medication recorded,the 6 most common drugs inducing DILI were antituberculotics (32.74％),Chinese herbs(22.12％),antibiotics(9.18％),antineoplastics(6.34％),NSAIDs (4.80％)and antithyroid drugs (4.37％).The most common type of toxicity was hepatocellular injury (63.66％,4438/6971).In general the prognosis was good with a fatality rate of 1.67％.Conclusions Antituberculotics and Chinese herbs are the main causes of DILI.Some DILI patients have occult onset and others have nonspecific gastrointestinal symptoms.Most patients have good prognosis if they are treated timely.

Telemedicine includes remote teleradiology, remote ultrasound diagnostics, telesurgery, telemedicine consultation, and other forms. Telemedicine consultation is the most used form of telemedicine. However, the traditional telemedicine consultation is limited by a lack of communication and presentation methods, and its wide application is greatly limited. Mixed reality technology cuts through the boundaries between virtual reality and actual reality, bringing a new method of remote consultation.

Objective To analyze the clinical effect of biliary-enteric anastomosis and biliary stent to palliative treatment of malignant obstructive jaundice.Methods A total of 40 patients with inoperable malignant obstructive jaundice were enrolled in this study,and 20 patients were performed biliary stent placement (stent group),simultaneously 20 patients were performed biliary-enteric anastomosis (operation group).The fatality rate after operation,the level of total bilirubin before treatment and after treatment for 4,7,14 d,the rate of hyperpyrexia,nausea and vomiting,postoperative recurrence of jaundice were compared between two groups.Results There were no dead in two groups.The level of total bilirubin was decreased after treatment,and there was no significant in two groups before treatment and after treatment for 4,7,14 d (P ＞ 0.05).The rate of hyperpyrexia in operation group was significantly lower than that in stent group (0 vs.4/20) (P ＜ 0.05).Conclusion For palliative treatment of malignant obstructive jaundice,the biliary-enteric anastomosis should be performed first if there is no significant contraindication.

Objective To study the clinical significance of the expression of D-amino acid oxidase(DAO) in hepatocellular carcinoma(HCC) tissues.Methods The gene expression profiles and related clinical data of 214 HCC cases were collected.Univariate and multivariate analyses were conducted to investigate the association between DAO expression levels,clinical traits,the prognosis.Results Univariate analysis indicated that there were a lower level of blood alpha fetoprotein(AFP,P=0.001),a smaller number of nodules(P=0.042),a better TNM stage(P=0.014),a lower metastasis risk(P=0.001) and a better prognosis(P=0.011)in the samples with high DAO expression.Multivariate analysis also indicated a lower AFP level(OR:0.162,95%CI:0.078-0.336) and metastasis risk(OR:0.140,95%CI:0.069-0.284) in the samples with high DAO expression,as well as a better prognosis(OR:0.833,95%CI:0.700-0.992).Conclusion DAO expression was associated with blood AFP levels,metastasis risk and prognosis in HCC,and its high expression was a protective factor for HCC.

Objective CD44, a cell surface glycoprotein, plays an important role in tumor growth and glycolysis.The aim of this study was to investigate the effects of neutralizing CD44 antibodies on the growth and glycolytic metabolism of B16 cells in melanoma in vitro.Methods B16 cells were treated with control antibodies (50 μg/mL) or different concentrations of CD44 antibodies (2, 10, and 50 μg/mL) for 24 hours, followed by examination of the activation of the AKT pathway in the B16 cells by Western blot.Then the tumor cells were also treated with control antibodies (50 μg/mL) or CD44 antibodies (50μg/mL) after pretreated with API-2 (4 μmol/L) in a parallel test.After 48 hours of treatment, the expression of lactate dehydrogenase A (LDHA) in the B16 cells and the level of lactate in the culture supernatant were detected by immunofluorescence and colorimetry, respectively.Lastly, the B16 cells were treated with control antibodies (50μg/mL), API-2 (4 μmol/L), CD44 antibodies (50μg/mL), or API-2 + CD44 antibodies for 96 hours, followed by measurement of the proliferation of the cells by MTT and their apoptosis by AO/EB and AnnexinV staining.Results In comparison with the control antibody group, the level of AKT phosphorylation (p-AKT) in the B16 cells showed a concentration-dependent increase in the 2, 10, and 50 μg/mL CD44 antibody groups (1.00±0.25 vs 2.51±0.32, 3.89±0.46, and 4.07±0.42, P<0.01), and the expression of LDHA was increased by (2.13±0.24) times, with the lactate level in the culture supernatant significantly elevated from (35.32±3.24) to (56.34±8.19) mmol/L (P<0.01) after 96 hours of treatment with 50 μg/mL CD44 antibodies.Treatment with API-2+CD44 antibodies, however, suppressed the increase in the LDHA expression and reduced the level of lactate.Compared with the control antibody group, the proliferation rate of the B16 cells was markedly decreased in the API-2, CD44 antibody, and API-2+CD44 antibody groups ([103±12.91] vs [84.87±19.35], [71.35±16.23], and [41.16±9.15]%, P<0.05), while the apoptosis rate remarkably increased ([5.23±0.96] vs [13.65±4.27], [19.21±3.53], and [43.21±7.87]%, P<0.01).Conclusion Neutralizing the function of CD44 in the B16 cells in vitro can inhibit the growth of the cells and promote AKT-mediated glycolytic metabolism, while suppressing the AKT pathway may enhance the antitumor activity of the CD44 antibody.

OBJECTIVETo prepare nanofibrous membranes of poly (vinyl alcohol)/chitosan (PVA/CS) loaded with varied salvianic acid A sodium (SAS) contents.

METHODSUltrafine fiber mats were prepared with PVA/CS as matrix and SAS as model drug. The structure and morphology of the nanofibrous membranes were characterized by FT-IR and SEM. Drug-loading amount and drug release profiles of these membranes were determined by UV VIS spectra, and the degradation of the membranes was also investigated.

RESULTSAverage diameters of PVA/CS/SAS nanofibers with different SAS contents were 280 ≊390 nm. Drug-loading amount of these nanofibrous membranes was high and exhibited sustained and controlled release behavior for SAS.

CONCLUSIONThe PVA/CS/SAS nanofibrous membrane prepared in this study loads drug uniformly and has remarkably sustained release behavior, which may offer strategies for the research and development of novel topical drug delivery systems.

Chitosan ; chemical synthesis ; Drug Carriers ; Membranes, Artificial ; Nanofibers ; Polyvinyl Alcohol ; chemical synthesis

Objective To investigate the value of serum and biliary carcinoembryonic antigen (CEA),carbohydrate antigen 19-9 (CA19 -9),and carbohydrate antigen 24-2 (CA24-2) in the diagnosis of benign and malignant biliary obstructive diseases.Methods A total of 40 patients with benign biliary obstructive diseases and 40 with malignant ones,who were diagnosed and treated in The Central Hospital of Enshi Autonomous Prefecture from June 2015 to December 2016,were enrolled.Serum samples collected on admission and bile samples collected during surgery were used to measure the levels of tumor markers CEA,CA19-9,and CA24-2.The t-test was used for comparison between two groups,and a receiver operating characteristic (ROC) curve analysis was performed for each tumor marker in the diagnosis of benign and malignant biliary obstructive diseases.Results Compared with the benign group,the malignant group had significantly higher serum levels of CA19-9 and CA24-2 (t =5.899 and 3.223,both P ＜ 0.05) and biliary levels of CEA,CA19-9,and CA24-2 (t =3.304,7.615,and 7.279,all P ＜0.05).In the patients with malignant biliary obstructive diseases,the levels of CEA,CA19-9,and CA24-2 in the bile were significantly higher than those in serum (t =3.297,4.975,and 3.993,all P ＜ 0.05).Biliary CA24-2 had the highest Youden index (0.75) and area under the ROC curve (AUC) (0.946);biliary CA19-9 had a Youden index of 0.74 and an AUC of 0.937,and serum CA19-9 had a Youden index of 0.68 and an AUC of 0.898.These three indices had a relatively high diagnostic value.Combined measurement of biliary CA24-2,serum CA19-9,and biliary CA19-9 had a sensitivity of 94.75％,a negative predictive value of 93.50％,and a Youden index of 0.82 in the diagnosis of malignant biliary obstructive diseases.Conclusion Biliary tumor markers have a great value in the diagnosis of malignant biliary obstructive diseases,and the combined measurement of biliary CA24-2,serum CA19-9,and biliary CA19-9 has the highest value in the differential diagnosis of benign and malignant biliary obstructive diseases.

OBJECTIVETo compare quantitatively the enhanced thin CT section with pathologic findings in pulmonary carcinoma, pulmonary inflammatory pseudotumor (IPT) and pulmonary tuberculoma so as to demonstrate the relation of degree of enhancement and the vascular structure within the lesion with special emphasis on pulmonary carcinoma.

METHODSEnhanced thin CT sections were obtained in 35 cases with nodular or patchy lesions in the peripheral lung field which are difficult to differentiate clinically. There were pulmonary carcinoma 21, inflammatory pseudotumor 7 and tuberculoma 7. The number of small vessels (inner diameter 0.02 approximately 0.1 mm), relatively large vessels (inner diameter > 0.1 mm) and their vascular bed areas were analyzed by computed image analyzing system. The relation between CT average attenuation and the number of vessels or the vascular bed areas were statistically evaluated.

RESULTS1. The differences of average attenuation in carcinoma, inflammatory pseudotumor and tuberculoma were statistically significant (P < 0.05). 2. The differences in number of small vessels, relatively large vessels and vascular bed areas among these three types of lesion were also significant (P < 0.05). 3. A positive correlation was found in the average CT affenuation of lung carcinoma and its number of small vessels and relatively large vessels and 4. A positive correlation was found between the average CT attenuation in these three lesions and the relatively large vessels, total vascular amount and vascular bed areas.

CONCLUSIONS1. The average degree of attenuation, being divided into four degrees, is of practical value in the differentiation of lung carcinoma, inflammatory pseudotumor and tuberculoma. 2. The average CT attenuation of lung carcinoma, inflammatory pseudotumor and tuberculoma is in direct proportion to the number of vessels and vessel bed areas and 3. The characteristic CT enhancement in lung carcinoma reflexes the condition of vessels and blood supply within the tumor.

Adult ; Aged ; Female ; Humans ; Lung ; blood supply ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Plasma Cell Granuloma, Pulmonary ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods ; Tuberculoma ; diagnostic imaging ; pathology ; Tuberculosis, Pulmonary ; diagnostic imaging ; pathology

Thirteen compounds were isolated from the stem bark of Bombax ceiba L. by silica gel, and Sephadex LH-20 column chromatography. Their structures were identified by spectroscopic analysis as: lupeol(1), lupeone(2), betulinic acid(3), zeorin(4), oleanolic acid(5), 3-oxooleanolic acid(6), cleomiscosin A(7), (±)-lyoniresinol(8), desmosterol(9), stigma-3, 6-dione(10), (+)-lasiodiploidin(11), aurantiamide acetate(12), and(2S, 3S, 4R, 10E)-2-［(2R)-2-hydroxytetracosanoylamino］-10-octadecene-1, 3, 4-triol(13). Among them, compounds 3, 4, 6, 7-13 were isolated from this plant for the first time.

Objective: To explore the molecular mechanism of miR-200b-3p regulates the proliferation, invasion, migration and apoptosis of pancreatic cancer cells by targeting vascular endothelial growth factor A (VEGFA). Methods: The expression of miR-200b-3p in pancreatic cancer tissues and cell lines was detected by quantitative real-time fluorescence PCR (qRT-PCR). Pancreatic cancer PANC-1 cells were divided into NC group, miR-200b-3p mimic group, si-VEGFA group and si-VEGFA+ miR-200b-3p inhibitor group. The proliferation, migration and invasion of PANC-1 cells were measured by CCK-8 and Transwell assay. The apoptosis of PANC-1 cells was detected by Annexin V-FITC/PI double staining flow cytometry assay. The targeted relationship of miR-200b-3p and VEGFA was estimated by dual luciferase reporter gene assay and Western blotting. Results: The expression of miR-200b-3p in pancreatic cancer tissues and cell lines was decreased. After miR-200b-3p was overexpressed in PANC-1 cells for 48 h, the cell viabilities of PANC-1 cells in NC group and miR-200b-3p mimic group were 1.250±0.028 and 0.983±0.044, the numbers of migrated cells were 402.700±21.530 and 158.000±17.620, the numbers of invaded cells were 478.300±31.050 and 170.000±32.470, and the cell apoptosis rates were (5.280±0.352)% and (7.430±0.393)%. The cell viability, migration and invasion of PANC-1 cells in miR-200b-3p mimic group were significantly decreased than those in NC group (t=5.060, P=0.007; t=8.796, P=0.001; t=6.863, P=0.002). The cell apoptosis rate in miR-200b-3p mimic group was significantly higher than that in NC group (t=4.076, P=0.015). The fluorescence intensity in VEGFA-WT group was 1.000±0.027, which was significantly higher than that in VEGFA-WT+ miR-200b-3p mimic group (0.632±0.048; t=6.637, P=0.003). The fluorescence intensities in VEGFA-MUT group and VEGFA-MUT + miR-200b-3p mimic group were 1.000±0.049 and 0.868±0.047, with no statistically significant difference (t=1.944, P=0.124). After miR-200b-3p was overexpressed in PANC-1 cells for 48 h, the expressions of VEGFA in NC group and miR-200b-3p mimic group were 1.000±0.058 and 0.762±0.020, respectively. The expression level in miR-200b-3p mimic group was lower than that in NC group (t=3.908, P=0.017). After transfection of PANC-1 cells with si-VEGFA or si-VEGFA + miR-200b-3p inhibitor for 48 h, the cell viabilities of PANC-1 cells in NC group, si-VEGFA group and si-VEGFA + miR-200b-3p inhibitor group were 1.300±0.058, 0.943±0.047 and 1.143±0.023, the numbers of migrated cells were 446.000±17.350, 206.300±19.360 and 428.300±30.330, and the numbers of invaded cells were 510.300±24.550, 175.700±24.290 and 473.700±35.530, with statistically significant differences (F=15.830, P=0.004, F=33.530, P=0.001, F=38.860, P<0.001). The cell viability, migration and invasion of PANC-1 cells in si-VEGFA group were significantly decreased than those in NC group (P=0.003, P<0.001, P<0.001). There was no significant difference between si-VEGFA + miR-200b-3p inhibitor group and NC group (P=0.107, P=0.854, P=0.671). The cell apoptosis rates in NC group, si-VEGFA group and si-VEGFA+ miR-200b-3p inhibitor group were (3.810±0.577)%, (7.373±0.482)% and (3.650±0.514)%, with a statistically significant difference (F=16.020, P=0.004). The cell apoptosis rate in si-VEGFA group was significantly higher than that in NC group (P=0.007), but there was no significantly difference between si-VEGFA + miR-200b-3p inhibitor group and NC group (P=0.975). Conclusion miR-200b-3p suppresses the proliferation, invasion and migration and promotes the apoptosis of pancreatic cells by down-regulating VEGFA.