The American College of Gastroenterology( ACG)released the first clinical guideline for drug-induced liver injury( DILI)in June,2014:the diagnosis and management of idiosyncratic drug-induced liver injury( IDILI), which includes all aspects of IDILI,such as risk factors,diagnosis,differential diagnosis and treatment. The guideline discusses especially the issues on herbal and dietary supplements( HDS)induced liver injury and DILI in patients with chronic liver disease. The guideline is of great value for standardizing the clinical diagnosis and treatment,providing the best recommendations for management of the patients with DILI. Since the evidence of research in the field of DILI is relatively weak at this moment,the clinicians should consider the possible individual difference of the patients under the frame of guideline for making the best clinical decision.

ObjectiveTo investigate the clinical efficacy of primary and connecting point combination acupuncture in treating mild and moderate depression.MethodPatients meeting the inclusion criteria were randomly allocated to observation and control groups. Both groups of enrolled patients took fluoxetine hydrochloride (Prozac). The observation group received meridian-unblocking acupuncture at yuan-primary points and luo-connecting points and the control group, acupuncture at routinely selected points in the eleventh-five textbook. Treatment was given for four consecutive weeks. The Hamilton Depression Scale (HAMD) 24-item score was recorded in the patients before and after one month of treatment. The therapeutic effects were evaluated according to the score reduction rate in the two groups.ResultThere wasa statistically significant post-treatment difference in the HAMD 24-item score between the two groups (P<0.05). The total efficacy rate was83.3% in the treatment group and70.0% in the control group. There was a statistically significant post-treatment difference in therapeutic effect between the two groups (P<0.05). ConclusionMeridian-unblocking acupuncture at yuan-primary points and luo-connecting points is more effective than conventional acupuncture in proving the symptoms in patients with mild or moderate depression.

Objective:To explore therapeutic effect of rosuvastatin and atorvastatin treatment on levels of lipoprotein and inflammatory factors in patients with acute coronary syndrome (ACS) .Methods :A total of 74 ACS patients , who were treated in our department of cardiology from Mar 2008 to Feb 2014 ,were selected .According to random number table ,they were randomly and equally divided into rosuvastatin group and atorvastatin group .Therapeutic effect on 24d after administration ,levels of low density lipoprotein cholesterol (LDL‐C) ,high density lipoprotein cholesterol (HDL‐C) ,interleukin (IL)‐18 and C reactive protein (CRP) before and four weeks after treatment were compared between two groups .Results:On 24d after treatment ,total effective rat of rosuvastatin group was significantly higher than that of atorvastatin group (83.8% vs .75.7% , P< 0.05);after four‐week treatment , compared with atorvastatin group ,there were significant reductions in levels of LDL‐C [ (1. 8 ± 0. 2 ) mmol/L vs . (1.4 ± 0.1) mmol/L] ,IL‐18 [ (1.8 ± 0.2) vs .(1.4 ± 0.1)] and CRP [ (1.9 ± 0.3) pg/ml vs .(1.4 ± 0.2) pg/ml],andsignificantriseinHDL‐Clevel[(1.4±0.2)mmol/Lvs.(1.9±0.3)mmol/L]inrosuvastatingroup,P<0.05 all .Conclusion:Rosuvastatin therapy can achieve better adjusting lipid and anti‐inflammation effect than those of atorvastatin in patients with acute coronary syndrome ,which is worth clinical extending .

Objective To explore the clinical value of Thinprep cytology test (TCT)combined with h -TERC and c -myc in the diagnosis of cervical cancer.Methods hTERC amplification was detected by dual -color interphase fluorescence in situ hybridization (FISH),and the results were compared with TCT and histological examination.Examination the positive which TCT,h -TERC and c -myc by pathological examination.The final diag-nosis was determined by the pathological examination.Results TCT was abnormal in 26.4% of 500 case,18.0%abnormal h -TERC gene,16.0% abnormal c -myc gene.In 270 cases according to the cervical biopsy,the positive rate of chronic inflammation,cervical intraepithelial neoplasia (CIN)Ⅰ,CINⅡ,CINⅢ and cervical cancer:44.4%, 38.2%,36.4%,18.2%,and 7.3% respectively.The positive rates of h -TERC were 18.1%,45.4%,52.5%, 65.9% and 100.0%,respectively.The positive rates of c -myc were 21.4%,48.9%,56.7%,59.9% and 100.0%.With increased pathological grade,the expressions of h -TERC and c -myc were high.Conclusion TCT combined with h -TERC and c -myc can test cervical cancer more effective.

Bacterial meningitis is one of the most common infectious diseases of the central nervous system in childhood,with high mortality and disability rate despite available treatment.Studies have shown that the host's immunity dysfunction after the infection plays a central role in neurological sequelae.The deposition and activation of complement component C3 on the bacterial surface is a key step in the complement cascade leading to elimination of the microbe,and the level of complement component C3 or C5 in cerebrospinal fluid may predict outcome of bacterial meningitis.After the microorganisms cross the blood-brain barrier,bacterial compounds are recognized by pattern recognition receptors,triggering the production of excessive cytokines,attracting leukocytes and generating oxidative stress,which contributes to neuron injury irreversibly.This review focuses on current research progress on immunology associated with pneumococcal meningitis.

BACKGROUND:Bone grafting is often needed in posterolateral lumbar spinal fusion, but bone mass is often not enough to finish this operation. Part of the autologous iliac bones from patients are needed to take as supplement. OBJECTIVE:To investigate the safety and effectiveness of application of nano-hydroxyapatite/colagen/ poly(L-lactide) for posterolateral lumbar spine fusion. METHODS:The clinical data of 52 patients with lumbar degenerative disease who had received the treatment in Meishan Orthopedics Hospital of Sichuan Province, China during February 2013 to February 2014 were retrospectively analyzed. The patients al received posterolateral lumbar spine fusion with bone grafts made of autologous iliac bone particles and nano-hydroxyapatite/colagen/poly(L-lactide). RESULTS AND CONCLUSION:Among the 52 patients, wound healing by primary intention occurred in 51 patients, increased skin temperature, skin sweling, pains and fluid leaking were not observed. The lumbar spine function and pain symptoms of patients al improved to different degrees after internal fixation, The posterolateral lumbar spine fusion rate was 13%, 54% and 84% at 3, 6 and 12 months after internal fixation respectively, and there was no pseudarthrosis. During the 12 months of folow-up period, no screw loose or displacement , adjacent segment slippage or displacement were observed in any patient. These results suggest that the application of nano-hydroxyapatite/colagen/poly(L-lactide) for posterolateral lumbar spine fusion can achieve good results. The nano-hydroxyapatite/colagen/poly(L-lactide) bone graft material is highly biocompatible and safe.

Despite that improved neonatal intensive care unit therapies have reduced the mortality of preterm neonates, neo-natal neurodevelopmental morbidity persists at high rates. There is increasing recognition that following perinatal brain injury, cognitive deifcits in preterm neonates can often occur in the absence of signiifcant impairment and cerebral palsy often due to non-severe white matter injury (WMI). Minicystic and diffusive white matter lesions that need MRI detecting make up the predominant role in the preterm brain injury. The target cells and tissue of WMI in the preterm infant not only focus to preoligodendrocytes and white matter, but also involve neurons and grey matter. In fact, brain developmental trajectory in the premature infant with WMI is a mixed disorder of destructive and dysmature processes. Current MRI applied with high resolution could detect the punctate and diffusive WMI at early stage, distinguish the hemorrhagic lesions from reactive gliosis, analyze cerebral metabolism, and even describe the developmental progresses of myelination, ifber tract, cortex and cerebral connectome. But the predictive value of dif-ferent MRI techniques in brain development requires more and long-term research through the all life stages.

Frequently,there is a lack of safety data about diagnostic method and drug therapy of digestive diseases during pregnancy. It is profitable to understand the limited evidences of safety data about diagnosis and drug therapy of digestive diseases during pregnancy,which will allow the accurate evaluation and risk assessment on diagnostic method and treatment during pregnancy. High-quality clinical study on patients with pregnancy is helpful for the management of common digestive diseases among this special population.

Current definition of apnea of prematurity (AOP) with the time of breathing cease equal or more than 20 seconds,or less than 20 seconds accompanying with bradycardia and(or) cyanosis was absence of strong clinical evidence and arbitrary.We have no consensus on the treatment of AOP,but severe AOP will lead to the intermittent hypoxic episodes(IHE) and severe fluctuation of oxygen saturation associated with severe retinopathy of prematurity and bad neurodevelopmental outcome.IHE occurred not only due to AOP,but also in the processes of continuous positive airway pressure and invasive ventilation.Decreasing the IHE is one of key problems of preterm respiratory support.Optimal target oxygen saturation should be regulated dynamically,the target oxygen saturation of 90％ ～ 95％ lowers IHE and mortality,but likely increases retinopathy of prematurity.Caffeine,the first choice of AOP,may be no of effect in the mixed or obstructive AOP which may need more respiratory support to reduce the lung volume loss and airway resistance.

Objective To investigate the clinical efficacy of trimetazidine combined with atorvastatin in the treatment of patients with coronary heart disease and its influence on serum lipid and hemorheology.Methods 140 cases with coronary heart disease were randomly divided into two groups.The control group was given trimetazidine on the basis of the conventional treatment,while the observation group was given atorvastatin on the basis of the control group.The clinical efficacy,changes of hemorheology and blood lipid were compared between the two groups.Results The effective rate of the observation group was 95.71％,which was significantly higher than 77.14％ of the control group (x2 =10.620,P ＜ 0.05).After treatment,TC,TG,LDL-C and HDL-C of the observation group were (2.54 ± 0.32) mmol/L,(1.41 ± 0.32) mmol/L,(1.53 ± 0.33) mmol/L and (0.73 ± 0.35) mmol/L,which were significantly lower than those of the control group (t =7.42,8.09,8.11,9.03,all P ＜ 0.05).After treatment,the nbh,nbl,np and HCT of the observation group were (5.11 ± 0.51) mPa/s,(8.03 ± 1.12) mPa/s,(1.02 ± 0.21) mPa/s and (40.34 ± 3.28) ％,which were significantly lower than those of the control group(t =8.33,9.14,8.08,9.44,all P ＜ 0.05).Conclusion Trimetazidine combined with atorvastatin in the treatment of coronary heart disease can significantly improve patients' lipid and hemorheology,and it can be promoted and applied in clinical practice.