Objective To study the effect of Jiedu-xiaozheng decoction on theUltrastructure changes and quantitative analysis of SGC-7901 in vitro and its mechanisms. Methods The compound prescription Jiedu-xiaozheng decoction was used to prepare serum containing drug. Serologic pharmacology methods was applied. The decoction was used to co-culture the gastric cells for24 h and 72 h, and the ultrastructure of tumor cells was observed by the transmission electron microscope. Then the parameters of the nucleus and mitochrondria were determined in SGC-7901 cells, including volume density(Vv) ,form factor PE( PE), average volume(V) ,length(L) average surrace area(S),contrasting to cytoplasma. The SIS powervision was applied to analyze their difference. Results Jiedu-xiaozheng decotion can result in reduced microvilli, deflated volume, decreased mitochondrion volume and reduced ridge. The volume density(Vv) ,form factor PE(PE) ,average volume(v) ,length (L) average surrace area(S) reduced in the 24 h group clearly in Jiedu-xiaozheng decoction group compared to control group. Conclusion Jiedu-xiaozheng decoction can significantly induce SGC-7901 cells apoptosis, exhibiting certain early ultrastructure changes such as marginated heterochromatin and mitochondrion pyknosis. The quantity analysis by electronic imaging system may objectively reveal the ultrastructural changes of cell nucleus and mitochondria.

Background:Drug-induced liver injury( DILI)is a kind of commonly seen diseases,in which typical clinical manifestations are lacking and misdiagnosis and missed diagnosis are frequently occurred. Aims:To investigate the clinical characteristics of patients with DILI. Methods:Clinical data of patients with DILI at Zhongshan Hospital,Xiamen University from January 2014 to December 2015 were collected. Clinical characteristics were retrospectively analyzed and the relationship between clinical characteristics and prognosis was investigated. Results:A total of 51 patients with DILI were enrolled,the ratio of male to female was 1∶ 1. 32,the average age at diagnosis was(50. 6 ± 17. 9)years old,the highest proportion(43. 1% )of patients were aged 60 and older. Hepatocellular damage was the main type of liver injury (84. 3% ). Chinese herbs,cardiovascular drugs,hormone and endocrine drugs were the most common drugs causing DILI, which accounted for 51. 0% ,19. 6% and 9. 8% ,respectively. Concomitant diseases of DILI covered many systems. The clinical manifestation of DILI was atypical,and the laboratory examination also lacked specificity. The positivity rate of autoimmune antibody was 5. 9% . Most patients had good prognosis,and the cure rate and improvement rate were 21. 6%and 66. 7% ,respectively. The mortality rate was 5. 9% with the cause of death being liver failure. Levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),albumin,prothrombin time(PT) and international normalized ratio( INR) at admission were correlated significantly with prognosis( P ﹤ 0. 05 ). Conclusions:DILI commonly occurs in elderly population,and inappropriate use of Chinese herbs maybe the important cause. The clinical manifestation of DILI is not typical,and most patients have good prognosis. Levels of ALT,AST, TBIL,albumin,PT and INR at admission are correlated significantly with prognosis.

BACKGROUND:Tougu Xiaotong capsule is the clinical prescription for the treatment of osteoarthritis in Fujian University of Traditional Chinese Medicine, and the previous studies mainly focus on effect to cartilage.
OBJECTIVE:To observe the effect of Tougu Xiaotong capsule on the proliferation and differentiation of osteoblasts as wel as the expressions of bone remodeling correlated factors.
METHODS:Rat osteoblast-like cel line ROS17/2.8 cel s were incubated with Tougu Xiaotong capsule. The ROS17/2.8 cel s were divided into blank control group and Tougu Xiaotong capsule groups with different
concentrations. The cel proliferation was determined by methylthiazolyldiphenyl-tetrazolium bromide assay. Osteoblast differentiation biomarkers alkaline phosphatase activity, osteocalcin and bone mineralized nodules were measured with colorimetry, enzyme-linked immunosorbent assay and alizarin red staining, respectively. The real-time PCR and enzyme-linked immunosorbent assay were used to detect the expressions of bone remodeling factors osteoprotegerin/receptor activator of nuclear factorκB ligand.
RESULTS AND CONCLUSION:Compared with the control group, the Tougu Xiaotong capsule with the
concentration of 0.25-2 g/L could significantly promote the ROS17/2.8 cel proliferation (P<0.05), up-regulate the alkaline phosphatase activity, osteocalcin expression level and mineralized nodules area, and increase the
percentage of bone remodeling factors osteoprotegerin/receptor activator of nuclear factorκB ligand (P<0.05). The mechanism of Tougu Xiaotong capsule protecting osteoarthritis may partly result from the regulation of
proliferation and differentiation of osteoblasts and bone remodeling.

BACKGROUND:Mineralized nodules are the mature marker of osteoblast differentiation, and the observation methods mainly use alizarin red staining.
OBJECTIVE:To compare the observation results of mineralized nodules by three methods, and to explore their characteristics and advantages, as wel as further application in the research of bone disease.
METHODS:The rat osteoblast-like cellline UMR-106 were cultured in the fresh medium that was changed every day, for 14 days. Alizarin red staining-light microscope, tetracycline fluorescence labeling-laser confocal scanning microscopy, and scanning electron microscopy were used to observe mineralized nodules. The calcium content of mineralized nodules was quantified using scanning electron microscopy and energy dispersive spectroscopy. In addition, tumor necrosis factor alpha that could inhibit the proliferation and differentiation of osteoblasts was used as the control.
RESULTS AND CONCLUSION:The three morphology methods could be used to observe the mineralized nodules of normal osteoblasts. As for tumor necrosis factor alpha, no mineralized nodules of osteoblasts were observed by alizarin red staining-light microscopy;smal mineralized nodules were observed by tetracycline staining-laser scanning confocal microscopy and scanning electron microscopy, suggesting tetracycline staining and scanning electron microscopy were more sensitive in the observation. Scanning electron microscopy could be used to observe the submicroscopic structures of mineralized nodules in the osteoblasts, and the formation of mineralized nodules, including the calcium secretion. Additional y, scanning electron microscopy combined with energy dispersive spectroscopy analysis can successful y quantify and position the mineralized nodules, indicating a potential application in the research of bone diseases.

Objective To investigate mutation patterns in core promoter(CP)region of hepatitis B virus(HBV).Methods HBV DNA was extracted from sera of patients with chronic HBV infection.The CP sequence was amplified by polymerase chain reaction(PCR)and cloned into pMD19 T vector.The positive clones were then sequenced.The sequences were compared with known HBV genome in GenBank to identify the mutation sites and patterns of patients with chronic HBV infection.Results There were 74 clones from 21 patients with chronic HBV infection which were sequenced.The sequence comparisons showed that there was a 234-nucleotide deletion in CP region of HBV genome in 54 clones and a 245-nucleotide deletion in one clone.These deletion regions included CP,HBeAg initiation codon and direct repeat sequence(DR)Ⅰ regions,which named CP deletion(CPD).A1585T replacement mutation was also found in HBV strain with CPD,which indicated that there was linkage between these two mutations.Conclusions A novel mechanism of HBeAg negative chronic hepatitis B is observed,which includes deletions of CP and HBeAg initiation codon.Meanwhile,a simple and useful PCR method is developed to detect CPD.

Objective:To explore the application value of different methods of segmented latissimus dorsi myocutaneous flap in repairing chest wall defects after local advanced breast cancer surgery.Methods:The clinical data of 64 patients with unilateral locally advanced breast cancer admitted to Shanxi Cancer Hospital from Feb. 2019 to Jan. 2020 were selected. All patients underwent modified radical mastectomy for breast cancer. The patients were divided into two groups according to the random number table method. Antegrade (group A, n=32 cases) and retrograde (group B, n=32 cases) were used to design and cut the segmented latissimus dorsi myocutaneous flap to repair the defects. The range of skin island cut was 14 cm×6 cm-19 cm×7 cm; The donor area of the flap was closed directly. The application effects of the two groups of methods were compared. Results:In group A, one antegrade flap was partially necrotic, while in group B, six retrograde flaps were partially necrotic ( P>0.05). The delayed healing rate of donor site incision in group A was 6.25%, significantly lower than that in group B (25.00%) ( χ2=4.267, P=0.039). All the patients in both groups were followed up for 12 to 24 months, and the appearance and texture of the flaps were satisfactory; Only linear scar was left in the donor area, and the shoulder joint activity was not affected. The mean survival time was 20.8 months. Conclusion:The antegrade latissimus dorsi myocutaneous flap can repair the large area defect of chest wall after LABC, which can ensure the blood supply of the flap to the greatest extent, reduce the closing tension of the donor area, the incidence of postoperative complications, and promote the healing of the incision.

ObjectiveTo summarize the liver biopsy and clinical features of patients with liver injury of unknown origin， and to investigate the value of ultrasound-guided percutaneous liver biopsy in the diagnosis of liver injury of unknown origin. MethodsA retrospective analysis was performed for the clinical data and ultrasound-guided percutaneous liver biopsy results of 94 patients with liver injury of unknown origin who were admitted to Zhongshan Hospital， Xiamen University， from January 2018 to February 2023. According to the proportion of the patients with different final diagnoses， the patients were divided into autoimmune liver disease （AILD） group， metabolic associated fatty liver disease （MAFLD） group， drug-induced liver injury （DILI） group， alcoholic liver disease （ALD） group， and unknown group. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Bonferroni analysis or the Dunnett’ T3 test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups； the Fisher’s exact test was used for comparison of categorical data between multiple groups. ResultsAll 94 patients with liver injury of unknown origin underwent ultrasound-guided percutaneous liver biopsy after admission， among whom 90 patients （95.7%） had a confirmed diagnosis based on liver biopsy and clinical features. There were 43 patients （45.7%） with AILD， 21 （22.3%） with MAFLD， 15 （16.0%） with DILI， 6 （6.4%） with ALD， 1 （1.1%） with AILD and MAFLD， 1 （1.1%） with hemochromatosis， 1 （1.1%） with Budd-Chiari syndrome， 1 （1.1%） with congenital hepatic fibrosis， and 1 （1.1%） with idiopathic portal hypertension， while 4 patients （4.3%） still had an unknown etiology after liver biopsy. There were significant differences between the patients with top five diagnoses in age （F=4.457， P<0.05） ， body mass index （BMI） （F=3.245， P<0.05）， aspartate aminotransferase （AST） （H=11.128， P<0.05）， gamma-glutamyl transpeptidase （GGT） （H=24.789， P<0.05）， alkaline phosphatase （ALP） （H=26.013， P<0.05）， IgG （H=19.099， P<0.05）， IgM （H=21.263， P<0.05）， AMA-M2 positive rate （P<0.05）， and ANA positive rate （P<0.05）. Compared with the MAFLD group， the AILD group had significantly higher age， AST， GGT， and ALP and a significantly lower BMI； compared with the MAFLD group and the DILI group， the AILD group had significant increases in IgG and IgM； the AILD group had significant increases in the positive rates of AMA-M2 and ANA compared with the other four groups. ConclusionAILD， MAFLD， and DILI are the most common causes in patients with liver injury of unknown origin. Ultrasound-guided percutaneous liver biopsy plays an important role in determining the cause of liver injury of unknown origin， but it is still needed to make a comprehensive analysis based on clinical history， different types of liver injury， laboratory markers， and imaging data.