Objective To investigate the application of ultrasound and blood indicators in diagnosis of early liver cirrhosis (S4) for patients with chronic hepatitis B (CHB).Methods Data of blood and ultrasound examinations of 631 patients with CHB who received liver biopsy in the Sixth People' s Hospital of Shenyang during April 2002 and March 2011 were collected.Logistic regression analysis was performed to determine the factors independently correlated with early liver cirrhosis,and the diagnostic model was established using these indicators.The diagnostic value of the established model was assessed by using area under receiver operating characteristic curve (AUROC) and compared with FIB-4 index,aspartate aminotransferase (AST)/platelet (PLT) ratio index (APRI) and S index.Results Logistic regression analysis indicated that age,PLT,albumin globulin ratio (A/G) and splenic square area (SPS) in ultrasound findings were independently correlated to early liver cirrhosis (Wald =10056,46.236,3.751 and 10.669,P ＜0.01).AUROC of the model based on the above factors in diagnosing early liver cirrhosis was 0.908,which was higher than those of FIB-1 index,APRI index and S index (Z =8.322,4.334 and 4.087,P ＜ 0.05).Taking 0.063 as cut-off value,the sensitivity,specificity,positive predict value and negative predict value of the established model in diagnosis of early liver cirrhosis were 90.1％,77.8％,50.0％ and 97.1％,respectively.Taking ＜0.060 and ≥0.110 as the cut-off values to exclude,and diagnose early liver cirrhosis,69.7％ (440/631) patients could avoid liver biopsy.Conclusion The model based on age,PLT,A/G and SPS can effectively predict early liver cirrhosis,and can reduce liver biopsy.

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[Summary] Dyslipidemia after organ transplantation is one of the important risk factors of postoperative cardiovascular disease and graft dysfunction. There are many factors that result in postoperative dyslipidemia. However, the factors influencing serum lipid levels are changing with the development of organ transplantation. In this article the effects of different anti-rejection drugs such as cyclosporine, azathioprine, mycophenolate mofetil, tacrolimus, rapamycin ( sirolimus ) , corticosteroids, and monoclonal antibody on dyslipidemia after organ transplantation were summarized in different eras.

BACKGROUND:Lumbar spinal stenosis is clinical repaired with decompression, bone fusion and internal fixation, and different internal fixation materials can be chosen during the surgery. OBJECTIVE:To explore the influence of polyetheretherketone (PEEK) pedicle screw fixation combined with interbody fusion on the bone fusion rate of patients with lumbar spinal stenosis. METHODS:A retrospective analysis was performed in 63 cases of lumbar spinal stenosis undergoing decompression and interbody fusion. These patients were divided into control group (titanium internal fixation system,n=31) and experimental group (PEEK pedicle internal fixation system,n=32) according the internal fixation materials folowed by posterior spinal decompression with interbody fusion. The Oswestry dysfunction index scores before and 4, 12, 24 weeks postoperatively and bone fusion rates at 4, 12, 24 weeks postoperatively were compared between the two groups. RESULTS AND CONCLUSION:Oswestry dysfunction index scores showed a gradual decline in both two groups before and 4, 12 and 24 weeks after treatment, but there was no difference at different time (P > 0.05). At 4 and 24 weeks after treatment, there was no difference in the bone fusion rates between the two groups (P > 0.05), but at 12 weeks after treatment, the bone fusion rate in the experimental group was better than that in the control group (P < 0.05). During the surgery, no infection and other adverse events occurred in the two groups. These results indicate that both PEEK and titanium internal fixation systems for lumbar tube stenosis have obtained good results, but PEEK material has a better role in the bone fusion at 4-12 weeks after internal fixation.

ABSTRACT:To understand the species distribution of nontuberculous mycobacteria (NTM ) in Fujian Province of China , we collected clinical Mycobacterium isolates in the Fuzhou Pulmonary Hospital from 2009 to 2012 .A total of 6 362 clinical My‐cobacteria isolates were identified as 5 713 (89 .8% ) M .tuberculosis complex and 649 (10 .2% ) NTM strains by conventional identification method .Then ,by means of hsp65‐and rpoB‐PCR‐RFLP methods ,649 NTM strains were identified as 24 spe‐cies or complex of NTM ,in which the top three species or complex with the highest occurrence frequency were M .intracellular , M .avium and M .abscessus ,accounting for 48 .5% ,21 .3% and 12 .5% respectively .The prevalence rate of NTM was 10 .2%among Mycobacterium culture‐positive patients .There are lots of NTM species infecting human being ,and the most prevalence NTM species was M .avium complex accounting for 67 .8% in Fujian Province .

Objective To compare the clinical data of patients with chronic hepatitis B virus (HBV) carriers and chronic hepatitis B so that to provide pathological evidence for management of chronic HBV carriers with different alanine aminotransferase (ALT) levels.MethodsLiver biopsies were performed in totally of 292 cases of chronic HBV infection.The subjects were divided into HBV carrier group (G0-G1 and S0-S1) and hepatitis group (G＞ 1 and/or S＞ 1) according to the pathological diagnosis. The relationships between different age subgroups, different ALT level subgroups and pathological diagnosis were analyzed. Meanwhile,other clinical,biochemical,and iconographic indexes which were possibly related to the pathology diagnosis were compared. The multivariate analysis was done by Logistic regression equation (withdrawal method, maximum likelihood method) to definite the independent influencing factors of pathologically diagnosed with chronic HBV carrier.ResultsAmong the 292 patients,140 (47.9％) were pathologically diagnosed with chronic HBV carries and 152 (52.1％)were chronic hepatitis B. There were statistical differences between ≤35 years group and 36-40 years,＞40 years group (x2 =3.936 and 8.534,respectively; P =0.047 and 0.003,respectively). There were statistical difference among patients with ALT＜0.5×upper limit normal (ULN),(0.5-1.0) ×ULN,(1.1-1.5) ×ULN,(1.6-2.0) ×ULN and ＞2.0 × ULN (x2 =55.314,P＜0.01),while there was no significant difference between (1.1-1.5) × ULN and ＞2.0 × ULN (x2 =3.810,P=0.051). Multivariate analysis indicated that course of disease,alcohol consumption,ALT,HBV DNA level and the surface of liver (smooth or not smooth)detected by ultrasonography were independent influencing factors of pathological diagnosis of chronic HBV carriers (OR =0.995,0.224,0.516,1.308 and 0.270,respectively; P=0.005,0.007,0.000,0.025 and 0.001,respectively).ConclusionLiver biopsy is much meaningful in patients with age ＞35 years old and ALT (1-2)× ULN.

ObjectiveTo investigate the renal protective effect of recombinant lentivirus encoding adiponectin gene on streptozocin-induced early diabetic nephropathy(DN) mice,and to explore its potential mechanism.Methods Forty C57BL/6 mice were randomly divided into normal control group(NC group,n=10),diabetic nephropathy group(DN group,n=10),LentiIRES-EGFP treatment group(DL group,n=10) and Lenti-Acdc-IRES-EGFP treatment group (DA group,n=10).After 8 weeks of recombinant lentivirus injection,kidney to body weight ratio (KW/BW),mean glomerular volume(MGV),fractional mesangial area(FMA),24 h urinary protein excretion(UTP),Scr,BUN,serum albumin and adiponectin were measured.Renal pathological changes were evaluated by electron microscopy.Proliferation of glomendar and tubulointerstitial cells was assessed by immunohistochemistry using PCNA antibody.The phosphorylation of AMP-activated protein kinase(AMPK) and mammalian target of rapamycin protein(mTOR) were detected by Western blotting.Results Adiponectin was successfully over-expressed in STZ-induced DN mice after lentivirus injection.KW/BW,MGV,FMA and UTP were significantly decreased in DA group as compared to DN group and DL group(P＜0.05),but were increased as compared to NC group(P＜0.05).DA group animals had significantly fewer PCNA-positive cells than DN group and DL group(P＜0.01).DA group mice had higher p-AMPK level and lower p-mTOR level as compared to DN group and DL group(P＜0.01).Conclusion Over-expression of adiponectin has beneficial effect on early DN and attenuates aberrant proliferation of renal cells via AMPKmTOR pathway.

[Summary] Interleukin-2 receptor antagonist (IL-2Ra,ie,basiliximab and daclizumab),a new antibody agent,is widely employed in lowering the risk of acute rejection after organ transplantation,but it meanwhile causes increasing concerns on the effect it exerts on glucose metabolism in transplant recipients,and so far the exact effect still remains controversial.New onset diabetes after transplantation (NODAT) is one of the most influential metabolic complications affecting graft survival and patients' long-term outcomes.Some of the current researches indicate that IL2Ra may improve glucose metabolism in the transplant recipients,some show just the opposite,yet others show no effects.Hence further investigations focusing this aspect are needed.

Objective To evaluate the effects of recombinant lentivirus encoding human apM1 gene ( LentiapM1-EGFP) on platelet-derived growth factor (PDGF) induced human mesangial cell (HMC) proliferation and intracellular AMP-activated protein kinase(AMPK) signaling pathway.Methods Protein expression of apM1 in cell culture supernatant of HMC transfected with Lenti-apM1-EGFP was detected by ELISA.The effect of human adiponectin on cell proliferation and cell cycle was assessed by [ 3 H ] thymidine incorporation assay and Flow cytometry respectively.The phosphorylation of AMPK was detected by Western blotting.Results Lenti-apM1-EGFP had no significant toxicity on HMC.The 50 multiplicity of infection (MOI) of the Lenti-apM1-EGFP efficiently infected HMC,and made it stable expression of adiponectin protein ( 149.6 ± 12.8 ) μg/L.PDGF-induced HMCs proliferation was significantly inhibited by adiponectin.When co-treatment with compound C,an AMPK inhibitor,the inhibitory effort was reversed.The phosphorylation level of AMPK was increased in HMC transfected Lenti-apM1-EGFP compared to that of control.Conclusions Adiponectin antagonizes stimulatory effect of platelet-derived growth factor on mesangial cell proliferation by AMPK signaling.

Objective:To investigate the pharmaceutical care methods for the patients with drug-induced liver injury. Methods:The participation process of clinical pharmacists in 3 cases of typical drug-induced liver injury was with detailed introduction and analy-sis in the paper. Results:The case 1 indicated that new drugs probably with drug-induced liver injury should be warned in the process of clinical medication. The case 2 suggested that TDM, as a useful assessment weapon, could be fully used to find the source medi-cines when drug-induced liver injury occurred. The case 3 showed the specific cases, especially the patients with abnormal liver func-tion, should be focused on, the medicines with high liver toxicity should be avoided and the medicines with mild liver toxicity could be chosen. Conclusion:Clinical pharmacists should participate in the clinical practice of drug-induced liver injury with multi-channel and multi-link, and pay attention to the drugs with high risk of liver injury. Meanwhile, clinical pharmacists should perform TDM monito-ring to provide positive evidence for the diagnosis of drug-induced liver injury, and focus on the liver and kidney functions to provide better pharmaceutical care for the patients.