Aromataseinhibitors(AI)aretheleadingcarefortheadjuvanttreatmentofhormone responsive carcinoma of the breast as demonstrated in a number of large international phase III randomised tri-als.Aromatase inhibitor-associated arthralgia (AIA )was a somewhat unexpected side effect of this class of agents and has proven to be potentially problematic in clinical practice.The pathogenesis of AIA is not very clear currently,with the cause of most research focusing on estrogen deprivation,immune abnormalities,tenosy-novial changes and joint effusions.It is extremely urgent that we evaluate this syndrome and select appropriate therapeutic strategies to reduce the incidence of AIA,thereby improving breast cancer-related outcomes.

Objective To observe the influence of bony extracts of Myospalox fontanierii(MF)on immune function in rats with hypersensitive reactive inflammation induced by Freund's complete adjuvant(FCA).Methods Levels of lymphocyte transferring factor(TF)and interleukin-1(IL-1)were detected by immunological methods.Results Extracts of MF reduced the levels of IL-1 and TF in rats with hypersensitive reactive inflammation induced by FCA;it could also depressed the lymphocytic transformation rate.Conclusion Extracts of MF exert inhibitory effect on rats with hypersensitive reactive inflammation induced by FCA and its mechanism may be related with immunosuppressive action and the inhibition of IL-1 formation.

Objective To observe the positive rate of serum anti-cardiac troponin Ⅰ autoantibodies (anti-cTnI) in the patients with coronary atherosclerotic heart disease(CHD) and its clinical significance.Methods A total of 200 CHD patients and 200 healthy controls from the Department of Cardiology,Drum Tower Hospital of Nanjing University Medical School during September 2015 and May 2016 were collected in the case-control study.Serum anti-cTnI was detected with an indirect ELISA method.Meanwhile,the general data,chnical biochemical parameters and coronary vascular lesion from the two groups were analyzed.Results The positive rate of anti-cTnI in CHD patients(21/200,10.5％) was significantly higher than that in healthy controls(4/200,2.0％,P ＜ 0.01).According to the detection results of serum anti-cTnI,the participants were divided into three groups,including anti-cTnI positive group with CHD,anti-cTnd negative group with CHD and anti-cTnI positive group in healthy controls.The median age and serum Glu level in the anti-cTnI positive group with CHD were significantly higher than those in the anti-cTnI positive group in healthy controls (P ＜ 0.05),while the levels of serum HDL-C and apoA I were inverse (P ＜ 0.01).The median age and Gensini score in the anti-cTnⅠ positive group with CHD were significantly higher than those in the anti-cTnI negative group with CHD,while the level of serum HDL-C was inverse (P ＜ 0.05).Conclusion Anti-cTnI may be more likely to occur in old CHD patients with severe coronary artery lesions,and the low levels of serum HDL-C and apoA Ⅰ may correlate to the production of anti-cTnⅠ.

Objective To study the expression of skin aspartic protease (SASPase) in lesions of cutaneous lupus erythematosus (CLE) and its role in the pathogenesis of CLE.Methods Skin samples were resected from the lesions and normal skin of 9 patients with CLE,including 3 cases of subacute cutaneous lupus erythematosus (SCLE),4 cases of discoid lupus erythematosus (DLE) and 2 cases of acute cutaneous lupus erythematosus (ACLE).Keratinocytes were isolated from the tissue samples and cultured in serum-free medium.Total proteins were extracted from the keratinocytes and separated by two-dimensional gel electrophoresis.ImageMaster 2D analysis software was used to assess differentially expressed proteins in keratinocytes between the lesional and normal skin,which were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS).The expression levels of SASPase were further determined by Western blot.The data were analyzed statistically by Student's t test.Results Keratinocytes were isolated from the tissue samples and successfully cultured in vitro.Two-dimensional electrophoresis profiles of proteins from the keratinocytes were obtained with high resolution and reproducibility,and the average matching protein spots were about 1200 with the matching rate higher than 80％.As Western blot showed,the relative expression level of SASPase was 0.463 ± 0.018 in keratinocytes from the lesional skin,and 0.145 ± 0.011 in those from the normal skin (P ＜ 0.05).The Western blot results were consistent with those of two-dimensional electrophoresis.Conclusion The initiation and progression of CLE seem to be associated with the abnormal activation and overexpression of SASPase.

Objective To investigate the CT and MRI features of ovarian fibroma.Methods CT and MRI findings of 42 patients with ovarian fibroma confirmed by operation and pathology were analyzed retrospectively.Twenty-one patients were examined by CT,26 cases was examined by MRI,and 5 cases were examined by CT and MRI.Results In 42 cases of ovarian fibroma,there were simple type in 29 cases,degenerative type in 11 cases,and special type in 2 cases.All the cases had single lesion,morphology were round or elliptic or lobulated,clear boundary in 40 cases,partial fuzzy boundary in 2 cases,3 cases with calcification,hemorrhage in 1 case.The maximum tumor diameter were 1.4-26.7 cm,median value was 5.5 cm.Simple type of ovarian fibroma were equal density on CT,low signal on T1WI and T2WI.Degeneration type was patchy,fissure,low density areas on CT or high signal on T2WI,and the tumor parenchyma was almost no enhancement or only slight enhancement.A large number of hemorrhages had been found in 1 special type patient,and significantly enhanced in the other special type patient.Special type were misdiagnosed as malignant tumor.Conclusion CT and MRI performance of ovarian fibroma has some characteristics,but diagnosis still need to rely on pathology.

Objective To summarize the experience in prevention and treatment of bile duct injury during laparoscopic cholecysteclomy(LC). Methods Retrospective analysis on the clinical data of 31 cases of LC was carried out. Of them, 27 underwent one stage operative repair and 4 underwent palliative external drainage of the bile duct first. Results 16 cases succeeded and 11 failed in the one stage operative repairing.There were 15 cases underwent 2～4 operations in this series,and the re-operation rate was 48.4%. 29 patients was cured while 2 died. Conclusions During LC, the operative rule should always be strictly observed, and the key to preventing bile duct injury is to avoid clipping, cutting and coagulation blindly.

Objective To investigate the diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones.Methods The retrospective cohort study was conducted.The clinical data of 460 patients with gallbladder stones who were admitted to the Affiliated Hospital of Zunyi Medical College from June 2012 to June 2016 were collected.Of 460 patients,106 combined with asymptomatic secondary common bile duct stones and 354 with gallbladder stones were allocated into the common bile duct stone group and gallbladder stone group,respectively.The serum liver function test was applied to the 2 groups,including alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil),direct bilirubin (DBil),glutamyltransferase (GGT) and alkaline phosphatase (ALP).The receiver operating characteristic (ROC) curve was built using significant statistical indicators,and correspondent cut-off value,sensitivity and specificity were calculated according to ROC curve.Observation indicators:(1) comparison of serum liver function indicators (ALT,AST,TBil,DBil,GGT,ALP) between the 2 groups;(2) analysis result of ROC curve.Measurement data with normal distribution was represented as x±s.The comparison between groups was evaluated with the independent-sample t test.The comparison of count data were analyzed using the chi-square test.The ROC curve analysis was done for significant statistical indicators.Results (1) Comparison of serum liver function indicators between the 2 groups,the levels of ALT,AST,TBil and DBil were (32±8)U/L,(35±8)U/L,(12.8±2.5)μmol/L,(2.6±0.4)μmol/L in the common bile duct stone group and (30±7)U/L,(32±7)U/L,(12.2± 2.4)μmol/L,(2.5 ±0.4)μmol/L in the gallbladder stone group,respectively,with no statistically significant difference (t=0.891,0.786,0.924,1.026,P＞0.05).The levels of GGT and ALP were (162±43) U/L and (145±37) U/L in the common bile duct stone group and (36± 10)U/L and (128±23) U/L in the gallbladder stone group,respectively,with significantly statistical differences (t =20.859,2.483,P＜0.05).(2) Result of ROC curve showed that areas under the curve of GGT and ALP were respectively 0.963 [95％ confidence interval (CI):0.938-0.988] and 0.621 (95％CI:0.561-0.684).The correspondent cut-off value of diagnostic accuracy,sensitivity and specificity of GGT and ALP were 92.5 U/L and 139.5 U/L,91.6％ and 50.7％,95.7％ and 76.5％,respectively.Conclusion The abnormally elevated levels of serum GGT have major diagnostic value for patients with gallbladder stones combined with asymptomatic secondary common bile duct stones,with an advantage of convenient and fast operation,and it is worth to be applied and popularized.

Tripterygium wilfordii has exihibited multiple pharmacological activities, such as anti-inflammatory, immune modulation, anti-tumor and anti-fertility. T. wilfordii have been used for the therapy of inflammation and autoimmune diseases including rheumatoid arthritis, immune complex nephritis and systemic lupus erythematosus clinically. However, it is well known that T. wilfordii has small margin between the therapeutic and toxic doses and could cause serious injury on digestive, reproductive and urogenital systems. Among all the organs, liver is one of the most remarkable targets of T. wilfordii-induced toxicities, and the damage is more serious than others. It is generally accepted that T. wilfordii-induced liver injury is a result of the combined effects of toxic elements of T. wilfordii. It is reported in several studies that the mechanism of T. wilfordii-induced liver injury may be related to lipid peroxidation, cell apoptosis and immune damage, and so on. Licorice is one of the most commonly used Chinese herbal medicine, with effects of heat- clearing and detoxicating, anti-inflammatory and hepatoprotective, reconciling various drugs, and so on. Licorice often accompany T. wilfordii in clinical application which can significantly reduce the liver injury induced by T. wilfordii. The attenuated effect is exact, but the mechanism is still a lack of in-depth study. This paper reviews the studies on T. wilfordii-induced liver injury and the related mechanism as well as licorice and other traditional Chinese medicine accompany T. wilfordii to reduce the injury in recent years, so as to provide reference for related research in the future.
Animals ; Chemical and Drug Induced Liver Injury ; etiology ; prevention & control ; Glycyrrhiza ; Humans ; Inactivation, Metabolic ; Medicine, Chinese Traditional ; Tripterygium

HBV reactivation is commonly seen during immunosuppressive therapy and is associated with high incidence and mortality rates due to hepatitis outbreak and liver decompensation, and therefore, it should be taken seriously. However, the prevention and management of this potential complication is still a difficulty in clinical practice. This article reviews the diagnostic criteria and clinical outcomes of HBV reactivation, discusses the association of immunosuppressive therapy with the risk of HBV reactivation, and outlines the strategies for the prevention of HBV reactivation and recent advances. It is pointed out that early identification of patients with HBV infection before immunosuppressive therapy is of vital importance, and the initiation of antiviral therapy at the right moment based on risk stratification can effectively reduce the risk of HBV reactivation. We hope that this review can increase the awareness of HBV reactivation among clinicians and provide an effective reference for optimizing the management and prevention of HBV infection.

ObjectiveTo review the clinical characteristics of patients with gastric mucosa-associated lymphoid tissue(MALT) lymphoma and to investigate the effects of Helicobacter pylori (Hp) eradication therapy in these patients.MethodsClinical data of ninety-five patients with gastic MALT lymphoma were reviewed with respect to their clinical manifestations,endoscopic features,histopathological features and Hp infection.The follow-up data of patients treated by Hp eradication therapy were analyzed.The survival curve was calculated with Kaplan-Meier,while the predictive factors for resistance to Hp eradiation were then analyzed by using Cox proportional hazards model.ResultsThe clinical manifestations and endoscopic features of 85 patients with gastric MALT lymphoma were non-specific.Hp positive was found in 97.9％ (93/95) patients at presentation,and 36 patients were treated by Hp eradication with a median follow-up duration of ( 58.1 ± 29.9) months.Total remission was achieved in 94.4％ ( 34/36),including 24 complete remission 10 partial remission.Therapy failure occurred in 2 patients.3-year survival rate of patients treated by Hp eradication were 86.2％ (25/29). Cox multivariate analysis showed that age ( ≥60 years),multiple lesions and non-superficial lesions were independent predictors of resistance to Hp eradication therapy.ConclusionGastric MALT lymphoma is associated with Hp infection.Eradication of Hp can effectively induce remission in these patients.