Drug-induced liver injury (DILI) is a leading cause responsible for the failure of drug development and for the withdrawal of commercial drug products.The high frequency of DILI is due in part to the physiology of the liver,since in many cases elimination of drug molecules from the body is dependent on hepatic clearance via either metabolism or biliary excretion.Many of the mechanistic details underlying DILI remain poorly defined in spite of extensive studies of the pathogenesis.In this regard,metabolomics may become a powerful tool for investigation of DILI,leading to better mechanistic understanding and biomarkers identification.

Glaucoma is the second leading cause of irreversible blindness worldwide.The treatment of glaucomatous eyes is a long-term procedure.Laser treatment is becoming one of the three major methods to lower intraocular pressure (IOP) of glaucomatous patients.Selective laser trabeculoplasty (SLT) mainly targets to the pigment cells on the trabecular meshwork and makes it easier for fluid to flow out of the front part of the eye,decreasing pressure in the eye.But,the actual mechanism of this surgery is below understood now.Compared with other laser therapy,SLT uses a lower-level laser to open the drainage angle of the eye,and therefore cause rare or slight complication,so it is thought to be a repeatable therapy to the patients who needs further treatment.The principle,clinical application,efficacy,safety and study progress about SLT for glaucomatous eyes are reviewed.

Objective:To establish the granulocyte-differentiation model of the HL60 cells which are treated with All-trans retinoic acid(ATRA),and to use the modified two-dimensional electrophoresis conditions to analyze the differences of protein expression between treated and untreated HL60 cells.Methods:HL60 cells were induced through treatment with All-trans retinoic acid(ATRA).For selection of the appropriate drug concentration and induction time,MTT and flow cytometry are used to detect the HL60cell proliferation and the expression of differentiation antigens CD11b respectively.Cellular chemical staining was used for the verification of the differentiation of the treated HL60 cells.The protein of HL60 cell lines could be separated by modified two-dimensional electrophoresis(2-DE).PDQuest software was used to analyze the different protein expression between treated and untreated HL60 cells.The protein was analyzed by matrix-assisted laser desorption -time of flight mass spectrometry(MALDI-TOF).Results:ATRA could inhibit HL60 cell proliferation,and with the increase in drug concentration,the effect of inhibiting was more significant.Treated with 2? M ATRA for five days,there were more than 90% of HL60 cells expressing antigenCD11b.Cellular chemical staining also showed that ATRA could induce HL60 cells to granulocyte cells.By the analysis of modified 2-DE and PDQuest software,25 protein spots was detected in untreated cells,while 15 protein spots was promoted Some of them were oncogene protein and suppressor gene protein,while some of others are involved in apoptosis.Conclusion:ATRA could induce HL60 cells to granulocyte cells in selected drug concentration and induction time.Using the modified two-dimensional electrophoresis conditions,different protein expression can be found from the traditional two-dimensional electrophoresis.

Craniocerebral Trauma ; surgery ; Humans ; Maxillofacial Injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To observe the effect of pre-intervention with electroacupuncture on oxidative stress (OS) and inflammatory reaction after hepatectomy under portal occlusion.Method Thirty patients going to receive hepatectomy under Pringle's portal occlusion were randomized into an electroacupuncture group and a sham electroacupuncture group, 15 cases each. Three days prior to the surgery, the patients started to receive corresponding acupuncture or sham electroacupuncture treatment by selecting bilateral Riyue (GB24), Qichong (ST30) and Yanglingquan (GB34), once a day. The anesthesia method was general (inhalational and intravenous) anesthesia. Central venous blood was drawn before the surgery, and respectively 6 h, 24 h, 48 h and 72 h after the surgery to examine the OS-relatedparameters, superoxide dismutase (SOD) and malondialdehyde (MDA), as well as the inflammatory mediators, including tumor necrosis factor-α(TNF-α), interleukin (IL)-1, IL-6, and IL-10.Result Compared to the sham electroacupuncture group, the SOD activity significantly increased (241±11.4 U/mL,180±12.6 U/mL,P<0.05) and the MDA level significantly dropped in the electroacupuncture group at 6 h and 24 h after the surgery(11.0±0.8 mmol/L,10.0±0.9 mmol/L,P<0.05); there were no significant between-group differences in the rest indexes (P>0.05).Conclusion Pre-intervention with electroacupuncture can up-regulate the activity of SOD and down-regulate the level of MDA in patients after hepatic portal occlusion, and thus partially reduce OS, but it doesn't shownoticeable effecton inflammatory response.

Objective To compare the cardiorespiratory system effects of propofol-remifentanil and etomidate-remifentanil sedation in older patients undergoing diagnostic gastroscopy.Methods 400 older patients undergoing painless gastroscopy in endoscopy center of our hospital were chosen and randomly received intravenous propofol-remifentanil or etomidate-remifentanil sedation and divided into propofol group (n=200)and etomidate group(n=200).The diagnosis,endoscopic insertion time,operation time,wake up time,hemodynamics,adverse reaction and satisfactory of patients in each group were observed.Results There were no difference between two groups in diagnosis(P＞0.05);the onset time was earlier in the etomidate group (P＜0.05).Systolic pressure and diastolic pressure in propofol group were lower than etomidate group during and after operation(all P＜0.05);the heart rate in propofol group were lower than etomidate group after operation(P＜0.05);meanwhile,the SpO2 in propofol group were lower than etomidate group during operation(P＜0.05).All adverse events in propofol group were higher than etomidate group (P＜0.05).Incidences of hyoxemia and injection pain were higher in the propofol group (all P＜0.05),while those of body quiver and myoclonus were higher in the etomidate group (all P＜0.05).However,Satisfaction of physician and anesthetist in the propofol group were better the etomidate group (all P＜0.05).Conclusion Etomidate-remifentanil administration for sedation undergoing painless gastroscopy resulted in more stable haemodynamic responses and less adverse events in older patients.Etomidate-remifentanil administration was worth to be popularized in older patients.

Objective To explore the clinical application of two different fixation methods for nasal continuous positive airway pressure (NCPAP) in newborns. Methods One hundred and forty newborns who had NCPAP treatment were selected and divided into experimental group and control group with 70 cases in each group by random digits table method.The newborns in experimental group received self- made caps to fix the prong systems,while the newborns in control group received U shape towel. The incidence of nose, head of facial skin injury, frequency of detachment for nasal prongs and duration mechanical ventilation were compared between two groups. Results The frequency of detachment for nasal prongs per 24 h was (0.65±0.18) times in experimental group and (1.64±0.22) times in control group, and there was significant difference (t=28.68, P<0.01). The incidence of nose, head of facial skin injury were 8.6%(6/70), 2.9%(2/70) in experimental group and 27.1%(19/70), 14.3%(10/70) in control group,and there were significant differences ( χ2 =8.23, 5.83, P<0.01 or 0.05). There was no significant difference in duration mechanical ventilation between two groups(P>0.05). Conclusions Use of the self- made caps for NCPAP in newborns is associated with significant reduction in the incidence of nose, head of facial skin injury,and the frequency of detachment for nasal prongs.The fixation should be prompted in clinic.

Objective To study the clinical anesthetic effect of butorphanol combined with propofol in painless gastroscopy. Methods 90 patientswith stomachache check were randomly divided into observation group and control group,45 cases each. The observation group was received butorphanol combined with propofol and the control group were treated with fentanyl combined with propofol. The heart rate of pa-tients before anesthesia,during checking and conscious,the change of blood pressure and oxygen saturation,respiratory depression and anes-thetic effect were analyzed. Results The heart rate,blood pressure and oxygen saturation of two groups after treatment were decreased,the difference was not statistically significant(P>0. 05). The total volume of propofol and respiratory depression between the two groups were compared,the differences were statistically significant(P<0. 05). Conclusion Butorphanol combind with propofol in painless gastroscopy with long anesthesia time and low respiratory depression,which was worthy of promotion.

Objective To analyze the coordination and continuity of service delivery for hypertension patients in rural health network,so as to provide references for improving integrated service utilization.Methods Self-developed questionnaire of service coordination and continuity delivery according to the research literature at home and abroad was used as the tool,and the data was analyzed by descriptive statistics.Results 49.6％ patients were accompanied by one or more diseases.About 73.0％ had seeking care experience in township health centers.Patients with seeking care to two or more medical institutions accounted for 51.3％.Recommending referral institutions for patients with poor therapeutic effect by grassroots doctors were the biggest proportion with 28.4％ and 68.7％ respectively.The proportion that superior doctors treating patients according to the related information from subordinate institutions was less than 43.0％,the proportion that junior doctors continuing to treat referral patients according to early diagnosis and treatment information was just over 40％.Easier upward referral but harder downward referral also existed among medical settings of different levels.Conclusion The disease characteristics of rural patients increased the possibility of seeking care among vertical medical institutions,but the level of continuity and coordination service delivery was not high in this network.So all-sided service integration to rural tertiary health institutions should be strengthened.

Objective To explore the relationship between Monoamine oxidase A (MAOA) receptor gene,catechol-O-methyltransferase (COMT) receptor gene,dopamine D3 receptor(DRD3) gene and 5-HT2C receptor gene(5-HT2c) of Han population in northern China and obsessive compulsive disorder.Methods Polymerase chain reaction amplification determination of MAOA-T1460C,COMT-Val158Met,DRD3-Ser9Gly,5-HT2c-C ys23Ser four loci receptor gene polymorphism in 164 patients with OCD patients including 103 core pedigrees of fragment length polymorphism,and association and linkage disequilibrium (TDT)analysis.Results There was no significant difference of MAOA-T1460C,COMT-Val158Met,DRD3-Ser9Gly,5-HT2c-Cys23Ser four receptor gene in the patient group and the control group of genotype and allele distribution difference(P＞0.05),four receptor gene loci were in accordance with the balance of the H-W,the MAOA-T1460C receptor gene in female patients group and control group,the early group and control group,which has forced thinking and difference of compulsive behavior group and the control group,only the obsessional group and the control group of genotype and allele distribution was statistically significant(P＜0.05),and the family group between chain(P=0.0001) ;5-HT2c-Cys23Ser receptor gene in the case group and the control group,male both forced thinking and compulsive behavior group and control group differences in genotype and allele distribution was statistically significant (P＜ 0.05),and between family groups exist chain (P=0.0389) ; COMT-Val158Met receptor gene in the control experiments were no significant difference(P＞0.05),and with the house group does not exist between the chain (P=0.0622) ;DRD3-Ser9Gly receptor gene in the control experiments were no significant difference(P＞0.05),and with the family groups there is no chain(P=0.1101).Conclusion MAOA-T1460C receptor gene polymorphism and 5-HT2c-Cys23Ser receptor gene polymorphisms may be the susceptible gene of obsessive compulsive disorder.