Objective To study the changes of 5-hydroxytryptamine(5-HT),its receptor,IL-2 and IL-6 in rats' ileum with spleen deficiency combined with gastric ulcer.To explore the pathogenesis of this disease and the therapic mechanism of sijunzi decoction. Methods Immunohistochemical technique,image analysis,radioimmunoassay and Western blotting were used. Results The 5-HT-positive cells of rat ileum were detected in mucosal and glandular cells.The 5-HTR-positive cells of rat ileum were found in the connective tissues between the intestinal villus and intestinal glands,and in neuroplex and smooth muscle tissues.The expression of 5HT and 5-HTR in ileum increased during the experimental spleen deficiency combined with gastric ulcer in rats.The 5-HTR level of rat ileum was higher.After treatment with Sijunzi decoction,all the changes have been reversed.The level of IL-2 and IL-6 increased during the early period of this disease.When the disease doveloped,the synthesis or secretion of IL-2 and IL-6 decreased. Conclusion The increased contents of 5-HT and its receptor in ileum tissues might be one of the causes of spleen-deficiency combined with gastric ulcer in rats.The mechanism of Sijunzi decoction is to reverse the changes.And the changed activity of IL-2 and IL-6 may be related with the degree of the disease.

Objective To explore the effect of the three level storehouse system on ward drug management.Methods The three level storehouse system was established in our hospital,which includes drug demanding quantity of ward,delivering quantity of the drug storehouse,and management supervision of pharmacy.Result After implementing three level storehouse system, the incidence of medicine expiry,improper storage,drug reception,confused marking ,improper placement and incorrect drug administration were decreased(P<0.05).Conclusion The three level storehouse system could improve the quality of hospital drug management as well as ensure clinical medication safety.

Objective To study the protective effect of cessation of enteral feeding on transfusionrelated necrotizing enterocolitis of newborn (TRNEC).Method Newborns who need blood transfusion in our neonatal intensive care unit (NICU) from January 2015 to February 2016 were randomly assigned to the cessative feeding group (fasting for 6 h when blood transfusion) and the feeding group according to the method of random number table.The abdominal perimeter,the level of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6),and the incidence of NEC within 48 hours after transfusion in these newborns were analyzed and compared.Result A total of 106 newborns with blood transfusion were included in this study,54 in the cessative feeding group and 52 in the feeding group.There were no significant differences between the two groups in gender,gestational age,birth weight,underlying diseases and abdominal perimeter before transfusion (P ＜ 0.05).The incidence of TRNEC in the cessative feeding group was significantly lower (3.7％) than that in the feeding group (17.3％) (P ＜ 0.05).The abdominal perimeters at 6 h and 12 h a fter blood transfusion in the cessative feeding group were both significantly lower than that in the feeding group (P ＜ 0.05).Within 48 h after blood transfusion,the incidence of vomiting,abdominal distention and bloody stools in the cessative feeding group were all significantly lower than that in the feeding group (P ＜0.05).Furthermore,at 6 and 12 h after receiving blood transfusion,the cessative feeding group both showed lower levels of the serum TNF-α and IL-6 than the feeding group (P ＜ 0.05).However,the levels of the serum TNF-α and IL-6 at 6 h after blood transfusion and 12 h after blood transfusion in both groups were all showed no significant differences (P ＞ 0.05).Conclusion Cessation of enteral feeding for 6 h during blood transfusion is a positive protective measure that can reduce the incidence of TRNEC.

Blindness, Cortical ; etiology ; Chemical and Drug Induced Liver Injury ; complications ; Humans ; Liver Diseases ; complications

Objective To investigate the effects of tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis (RA) curative effect and peripheral blood of patients with IL-6, effects of IL-10 and TNF- alpha. Methods 80 patients with RA from February 2014 to August 2016 in our hospital were retrospectively analyzed. According to the different treatment methods by for the observation group, the control group (40 cases). To compare and analyze the curative effect before and after short-term treatment and treatment of patients in the 2 groups were the main clinical symptoms and signs of change and ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index. Results The total effective rate of observation group (92.50％) was significantly higher than the control group (77.50％), the difference was statistically significant (P<0.05), 2 groups of patients before treatment of main clinical symptoms and signs, there was no significant difference, after treatment, clinical symptoms and signs of 2 groups of patients were compared with those before treatment was statistically significant to alleviate the differences (P<0.05), and the observation group of main clinical symptoms and signs were lower than the control group and the remission (down), the difference was statistically significant (P<0.05).Before ESR, the treatment of 2 patients with RF, CRP, TNF- IL-6, alpha, IL-10 index level, no statistical significance, the 2 groups after treatment in patients with ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index level than before treatment with significant difference (P<0.05), and the observation group ESR, RF, CRP, TNF- alpha, IL-6 average index of water compared with the control group decreased significantly, IL-10 index increased significantly than the control group. The difference was statistically significant (P<0.05). Conclusion Tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis And it can effectively inhibit the expression of peripheral serum L-6 and TNF- alpha, promote the expression of IL-10 and alleviate the inflammatory reaction

Objective There are few researches for the serum betatrophin level and diabetic nephropathy (DN) recently.The aim of this study was to investigate the change of serum betatrophin level and the correlation of serum betatrophin and urinary albumin-to-creatintine ratio (UACR) in patients with type 2 diabetes mellitus (T2DM).Methods A total of 150 Chinese subjects from Mar 2013 to Jul 2016 were enrolled in the study, including 90 patients with type 2 diabetes and 60 healthy controls.According to the level of UACR, the diabetic patients were divided into two groups:normal UACR group (UACR<30 mg/g, n=60) and abnormal UACR group(UACR>30 mg/g, n=30).Serum betatrophin was measured by enzyme linked immunosorbent assay (ELISA).UACR was measured by turbidimetric inhibition immune assay.Blood glucose blood lipid were measured simultaneously.Results The serum betatrophin level was significantly higher in abnormal UACR group than that in normal UACR group[677.37±59.02 vs 486.13±41.22 pg/mL, P<0.05];Serum betatrophin level in T2DM patients was positively correlated with age (r=0.246), waist hip ratio (WHR) (r=0.240), fasting blood glucose (FPG) (r=0.234), 2 hour plasma glucose (2hPG) (r=0.363), glycosylated hemoglobin (HbA1c) (r=0.346), fasting insulin (FINS) (r=0.249), insulin resistance index (HOMA-IR) (r=0.309), blood urea nitrogen (BUN) (r=0.223), creatinine (CREA) (r=0.277) and UACR (r=0.244) (P<0.05),and negatively correlated with glomerular filtration rate (GFR) (r=0.308) (P<0.01).Serum betatrophin level in normal UACR group was positively correlated with age, HbA1c and UACR (P<0.05);Serum betatrophin level in abnormal UACR group was positively correlated with WHR (r=0.504), 2hPG (r=0.600), HbA1c (r=0.449), HOMA-IR (r=0.395) (P<0.05).The WHR, HbA1c, HOMA-IR and GFR were the influential factors of the serum betatrophin level.Conclusion The level of serum betatrophin was significantly increased in T2DM patients with albuminuria, which suggests that the betatrophin might play an important role in the pathogenesis of DN.

OBJECTIVETo explore the clinical application and related factors of FibroTouch in the diagnosis of liver fibrosis in patients with chronic liver disease through comparison of the specificity and sensitivity of FibroTouch and multi-parameter models, and to identify whether FibroTouch is a more accurate and safe method in diagnosis of liver fibrosis and evaluation of the therapeutic effect.

METHODSA total of 190 patients with chronic liver disease were performed liver biopsy and underwent liver stiffness measurement (LSM) using FibroTouch in department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University from January 2014 to February 2015. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) were tested by enzymic method with automatic biochemistry analyzer. Blood platelet counts were detected by automatic blood cell analyzer. AST-to-PLT ratio index (APRI) and fibrosis index based on the 4 factor (FIB-4) were calculated. The diagnostic values of FibroTouch, APRI and FIB-4 for liver fibrosis degree were calculated and compared by receiver operating characteristic (ROC) curves. The related factors of LSM were analyzed by Spearman analysis.

RESULTSThere was significant correlation between LSM and histological fibrosis (r=0.804, P=0.000). The area under ROC curve of LSM for S(≥2, S≥3 and S=4 was 0.894, 0.938 and 0.961, respectively, which was significantly higher than APRI (0.678, 0.698 and 0.658) and FIB-4 (0.765, 0.785 and 0.775). On Spearman analysis, LSM was positively correlated with age, ALT, AST, TBIL ((≥2×ULN) and the grade of liver inflammation (r=0.309, 0.558, 0.504, 0.492 and 0.532, respectively) but negatively with PLT (r=-0.444), (all P<0.05).

CONCLUSIONSLSM is a convenient and reliable approach for diagnosis of liver fibrosis in patients with chronic liver disease. The sensitivity and specificity of Fibrotouch in diagnosis of hepatic fibrosis is superior to APRI and FIB-4, and age, high level ofALT, AST and TBIL (≥2×ULN) were independent predictors of LSM inaccuracy.

Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Biomarkers ; Biopsy ; Chronic Disease ; Humans ; Liver Cirrhosis ; Platelet Count ; ROC Curve

Objective To investigate the clinical features of drug-induced autoimmune hepatitis (DIAIH) and its therapeutic strategies,and to provide a reference for early diagnosis and treatment of this disease and prevention of chronicity.Methods The clinical data of 116 patients with drug-induced liver injury (DILI) or DIAIH confirmed by medical history,liver biochemistry,and liver biopsy were analyzed retrospectively.Among these patients,13 had DIAIH and 103 had simple DILI (30 patients in the hepatocytetype group and 73 in the cholestasis/mixed-type group).The population characteristics,major drugs inducing the diseases,clinical manifestations,liver biochemical parameters,liver pathological features,and clinical outcome were compared between groups.The Kruskal-wallis H test was used for comparison and the Mann-Whitney U test was used for comparison between any two groups.The chi-square test was used for comparison of categorical data,and the R×C chi-square test was used for comparison of rates between the three groups;in the case of significant differences,the R×C contingency table was used for comparison between any two groups.Results The patients with DIAIH had a mean age of 53.54±8.28 years,and the mean age was 35.13±13.46 and 46.99±14.82 years for the hepatocyte-type group and cholestasis/mixedtype group,respectively.The disease was mainly induced by a combination of various drugs.The patients with DIAIH had significantly higher serum levels of alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,and alkaline phosphatase and a significantly higher positive rate of anti-nuclear antibody than those with DILI (all P ＜ 0.05).In patients with DIAIH,the liver pathological features and the features of response to treatment were as follows:obvious interface hepatitis,proliferation of small bile ducts,and mixed inflammatory cell infiltration in the portal area,including eosinophils and plasma cells,and the short-term corticosteroid therapy had a good therapeutic effect.Conclusion DIAIH has a low incidence and is more common in the female population,with the features of tissue injury in both DILI and autoimmune hepatitis.The short-term corticosteroid therapy can prevent disease progression and reduce chronicity.

Objective: To investigate the role and mechanism of action of Yiqi Huoxue Recipe (YQHXR) in regulating autophagy and reversing liver fibrosis in rats with carbon tetrachloride (CCl4)-induced liver fibrosis. Methods: Healthy male Wistar rats were intraperitoneally injected with a mixture of CCl4 (30%) and olive oil (70%) twice a week for 8 weeks to establish a rat model of liver fibrosis. The rats administered normal diet were used as control group. Furthermore, YQHXR or Fuzheng Huayu Recipe (FZHYR) was intragastrically administered to the rats. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured using an automatic biochemical analyzer. Hematoxylin-eosin (HE) staining and Masson staining were performed to observe the degree of fibrosis in rat liver. The protein expression of α-smooth muscle actin (α-SMA) and type I collagen α1 chain (Col1A1) in liver tissue was measured by immunohistochemistry. Furthermore, the mRNA and protein expression of α-SMA, Col1A1, autophagy-related protein 7 (Atg7), microtubule-associated protein 1 light chain 3 (LC3), and ubiquitin-binding protein (SQSTM1/p62) were determined using qRT-PCR and Western blotting, respectively. Comparison between multiple groups was made by one-way analysis of variance, and comparison between any two groups was made using the LSD test. P < 0.05 was considered as statistically significant. Results: The YQHXR group and FZHYR group had significantly lower serum levels of ALT and AST than the model group (ALT: 66.8±10.42 U/L and 73.2±10.33 U/L vs 106.80±18.24 U/L, F = 31.672, P < 0.001; AST: 122.6±16.65 U/L and 125.4±16.92 U/L vs 278.4±66.14 U/L, F = 25.539, P < 0.001). The pathological grades of hepatic fibrosis were S5.64±0.22, S3.70±0.35, and S3.90±0.34 in the model group, YQHXR group, and FZHYR group, respectively (F = 362.188, P < 0.001). Compared with the control group, the YQHXR group and FZHYR group had significantly reduced mRNA and protein expression of α-SMA, Col1A1, Atg7, and LC3B and significantly increased expression of p62 (all P < 0.05), and the differences were greatest in the YQHXR group. Conclusion YQHXR and FZHYR can prevent or reverse liver fibrosis by regulating hepatocyte autophagy and inhibiting hepatic stellate cell activation and collagen deposition.

Optimizing operation management mode is the core task to promote the high-quality development of public hospitals.Drawing on the typical experiences and practices of operation and management of representative in-ternational hospitals in the United States,the United Kingdom,Singapore and West China Hospital of Sichuan Univer-sity,Shanghai Jiao Tong University School of Medicine Affiliated Xinhua Hospital,Jilin University China-Japanese Union Hospital of Jilin University,and carrying out a full range of comparative analyses.Put forward the new situation of China's public hospital operations and management to establish a"big operations management"concept.By iden-tifying the operation management role,rationalizing the operation management organization structure and training operation management compound talents to discuss stablishing a committee system,integrating multi-departmental resources to form a scientific and sound problem identificaiton,feedback,consultation and improvement of working mechanism,and promote the high-quality development of publit hospitals.