Acetaminophen(AAP)-induced hepatic injury is one of the common causes of drug-induced hepatic injury.Up to date,the mechanisms of AAP-induced hepatic injury are still incompletely understood.Recent advances suggest that reactive metabolite formation,glutathione depletion,alkylation of proteins,especially mitochondrial proteins and peroxynitrite formation are critical initiating events for the toxicity.This review will focus on more recent advances in mitochondrial dysfunction after AAP overdose.Additional,oxidative stress and inflammatory mediators are also important for the overall outcome.

Objective To observe the effect of Dahuangzhechongwan on protein excretion, serum cholesterol, TXB_2 and 6-keto-PGF_(1?) in rats with adriamycin-induced nephrosclerosis. Methods The rats received twice-intravenous injections of adriamycin after one kidney was removed, and were fed with hyperlipide food to establish an animal model for diffusion mesangioproliferation following with focal segmental glomerulosclerosis. The rats were randomly divided into shame-operated group, adriamycin nephrosclerosis group, Dahuangzhechongwan group, benazepril group. Urinary protein excretion, blood fat, TXB_2 and 6-keto-PGF_(1?) were observed. Result Proteinuria extract was decreased, the plasma cholesterol was significantly lower, the level of TXB_2 was cut down and 6-Ket-PGF_(1?) was increased by Dahuangzhechongwan. Conclusion Dahuangzhechongwan has the role of simutianeous application of elimination and tonification, promoting the circulation of Qi and blood, eliminating blood stasis, improving the hemodynamics. Dahuangzhechongwan has the renal protection on rat with adriamycin-induced nephrosclerosis, the mechanism may be relate with adjusting the balance of TXB_2 and 6-keto-PGF_(1?).

Objective Through gene reconstruction we generated pcDNA 3-survivin-mutant(Cys84Ala)plasmid, then the plasmid DNA was further transfected into gastric carcinoma cells by liposomal delivery. The effects of mutant survivin on cytokinetics of the gastric carcinoma cells were obversed. Methods By using immunohistochemical staining, the expression of survivin was detected in the gastric cancer tissues, and apoptosis was detected by flow cytometry. The PARP and cytochrome C expressions were determined by Western blot, the mitotic catastrophe was determined by immunofluorescence. Results Inhibition of survivin by mutant survivin cDNA could induce apoptosis, increase caspase-3 activity, cleave PARP and promote cytochrome C release in gastric cancer cells. Inhibition of survivin also caused mitotic catastrophe in gastric cancer cells. Conclusion Inhibition of survivin may induce apoptosis and mitotic catastrophe in gastric cancer. Survivin targeting gastric cancer therapy might be of potential benefit in the future.

Objective To assess CT, MR manifestations and diagnostic value in hepatic tuberculosis. Methods CT findings in 12 cases and MR findings in 4 cases with hepatic tuberculosis proved by surgery or biopsy were retrospectively analyzed. Results (1) CT findings: one case of serohepatic type of hepatic tuberculosis was multiple nodular lesions in the subcapsule of liver. Parenchymal type were in 10 cases, including multiple,miliary, micronodular and low density lesions with miliary calcifications in 2 cases, singular, low density mass with multiple flecked calcifications in 3 cases, multiple cystic lesions in 1 case, multiple micronodular and low density lesions fusing into multiloculated cystic mass or “cluster” sign in 3 cases, and singular, macronodular and low density lesion with multiple miliary calcifications in 1 case. One case of tuberculous cholangitis showed marked dilated intrahepatic duct with multiple flecked calcifications in the porta hepatis. (2) MR findings in 4 cases were hypointense on both T 1WI and T 2WI in one case, hypointense on T 1WI and hyperintense on T 2WI in 3 cases. Enhanced MR in 3 cases showed slightly peripheral enhancement or with multilocular enhancement. Conclusions Various types of hepatic tuberculosis had their different imaging findings. The typical CT and MR findings could suggest the diagnosis.

5,6 or 7 respectively,the specificity became gradually higher.But the sensitivity and the diagnoses according rate became lower.Conclusion Holter is a simple shortcut useful tool as a non-invasive means of assessing and filtrating OSAS.

Objective To explore the efficacy of closed reduction with cannlated compression screws for the treatment of elderly paitents with intertrochanteric fracture.Methods From April 2002 to July 2006,guided by a C-arm X-ray system,58 elderly patients with intertrochanteric fracture were treated by closed reduction with cannlated compression screws.Results The mean operation time was 55 minutes(40 to 70 minutes),and the mean blood loss was 35 ml(30 to 40).The patients were discharged from hospital in 3 to 10 days after the operation(mean,6.5 days).All of the 58 patients were cured.According to criteria for evaluating the outcomes of intertrochantenic fracture,28 cases were excellent,25 were good,3 were fair,and 2 were poor.The Rate of excellent and good outcomes was 91.4%(53/58).Conclusion Closed reduction with cannlated compression screws is effective for elderly paitents with intertrochanteric fracture.

Objective To assess the clinical value of low-frequency mini - probe sonography ( LFMPS) in preoperative localization of pancreatic endocrine tumors comparing with other imaging methods. Methods Twenty one cases with suspected pancreatic endocrine tumors were enrolled from June 2000 to June 2002, we compared the diagnostic results of LFMPS, transcutaneous ultrasonography ( US) , helico-computed tomography ( HCT) and magnetic resonance imaging (MRI) with surgical localization and histopathological results by using Fujinon 7. 5 MHz miniature probe and SP-701 ultrasonic system. Results Sixteen pancreatic insulinomas and 1 extra pancreatic VIPoma (vesoactive intestinal polypeptide tumor) were confirmed by surgery and histopathological examination in 17 of the 21 patients, and the rest 4 patients didn't receive surgical procedure because of the negative results in all imaging studies. Among pancreatic lesions, they located on head, body and tail in 9, 3 and 4 cases respectively; the average diameter of all 17 lesions was 2. 02cm. LFMPS correctly localized the tumor in 14 of 17 patients (82. 4% ) while CT in 15 of 17 patients (88. 2% ) , MRI in 12 of 17 patients (70. 6% ) and US in 9 of 17 patients (52. 9% ). Besides, the diagnostic accuracy of LFMPS in detection of small size (

Objective To investigate the clinical characteristics,pathogenic causes and treatment outcomes of acute kidney injury (AKI) in very old patients in order to improving the diagnosis and treatment.Methods 39 AKI patients aged ≥80 years in the department of geriatric medicine of our hospital were enrolled and followed up for 3 months.Clinical and laboratory data were analyzed and the pathogenic causes as well as the treatment outcomes were summarized.Results Among the 39 very old patients,31(79.5％) were male,8(20.5％) were female,and the mean age was (93.5±4.6) years.33 (84.6％)patients had chronic kidney diseases.The pathogenic causes of AKI were mainly as follows:urological infections (71.8％),blood volume deficiency (48.7％),cardiac dysfunction (23.1％) and hypotension (15.4％).2 to 4 pathogenic causes were co present in 64.1％ patients.Renal function was improved and recovered in 69.2 ％ patients and the death rate was 25.6％ after treatment.The main causes of death were septic shock (30.0％),multiple organ failure (20.0％),massive gastrointestinal hemorrhage (20.0％) et al.Conclusions Most of the very old patients may suffer from AKI on the basis of chronic kidney disease.AKI is often induced by multiple pathogenic causes.The main factors leading to AKI are urological infections,followed by blood volume deficiency and cardiac dysfunction.Most patients with AKI can recover after the precipitating factors are removed and supportive treatments are administered in time.Septic shock is the main cause of death.

Objective To analyze CT features of xanthogranulomatous cholecystitis(XGC)so that to improve the accuracy of diagnosis.Methods The data of CT,clinic and operation in 11 cases with XGC proved pathologically were analysed.The following CT features were analyzed:the cholecystic wall thickness,intramural hypoattenuated nodules,inner wall,mucosal line,patterns of enhancement of thickened wall,involved liver tissue and the presence of stones.The changes around the gallbladder were also noticed.Results The gallbladder wall was thickened and intramural hypoattenuated nodules were seen in all patients.The inner wall of gallbladder was smooth in 9 patients,the mucosal line was observed in 6 cases,the size of gallbladder was enlarged in 3 while 4 gallbladders were smaller than normal.Stones were found in 4 gallbladders.There were hepatic involvement in 6,pericholecystic infiltration in 3 and dilatation of biliary tract in 6 cases.Conclusion CT features of thickened gallbladder wall with intramural hypoattenuated nodules(sandwich sign)and continuous mucosal line were characteristic of XGC.

Objective To evaluate the various patterns of hepatic perfusion disorders with multi-slice spiral CT and to emphasize the significance of recognition for them . Methods In a period of 1 year, the all CT images of 1568 patients received multi-slice spiral CT examination of upper abdomen were analyzed retrospectively. The CT findings, etiologies and mechanisms of different pattens of hepatic perfusion disorders were investigated. Results 103 cases were demonstrated to have hepatic perfusion disorders. 69 cases were associated with tumors and the other 34 cases were non-tumor associated. The etiologies of various hepatic perfusion disorders were classified as (1)arterioportal fistulae(41.7%), (2) portal venous inflow obstruction(23.3%), (3) inflammartory hyperemic changes(17.5%), (4) steal phenomenon by hypervascular tumors(6.8%), (5) hepatic venous outflow obstruction(4.9%), (6) aberrant hepatic blood supply (3.9%) and (7) uncertain causes(1.9%). There was significant correlation between the CT images of perfusion disorders in shape and distribution and the causes of them. Conclusion Multi-slice spiral CT provides a new effective technique for demonstrating and understanding various hepatic perfusion disorders. Familiarity with the spiral CT appearances of these perfusion disorders will result in more accurate evaluation for various pathologic or physiologic states reflected by them.