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.

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.

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.

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

Objective: To observe the serum testosterone (T) level and androgen receptor (AR) mRNA expression in peripheral leukocytes and thyroid tissues of patients with Graves disease, so as to investigate the relationship between the testosterone and androgen receptor with hyperthyroidism. Methods: Blood samples were collected from 8 female patients with Graves disease, 8 female patients with thyroid adenoma and 8 healthy control subjects; the patients were paired in gender and age. The plasma concentrations of testosterone were determined by enzyme-linked immunosorbent assay (ELISA); the [3 H]-T specific binding sites in the peripheral leukocytes were determined by radioligand binding assay; the expression of AR mRNA in peripheral leukocytes were determined by RT-PCR; and the level of AR in thyroid tissues was determined by immunohistochemistry method. Results: The plasma concentrations of T were (660±80) ng/L and(620±100) ng/L in Graves disease group and control group, respectively(P>0.05); the [3 H]-T specific binding sites were (381 ± 105) sites/cell and (572±141) sites/cell in peripheral leukocytes, respectively(P<0.05). The mRNA expression of AR in Graves disease group was significantly higher than that in the control group(P<0.05). The result of immunohistochemistry showed that the level of AR in thyroid tissues was higher in Graves group than that in the control group. Conclusion: The plasma level of T in patients with Graves disease is similar to that of normal controls, but the mRNA expression of AR in peripheral leukocytes and thyroid tissue is higher in Graves disease group than in the control group, which is supposed to be a protective reaction. Moreover, the binding capability of AR is lower in Graves disease group than that in the control group, which is probably caused by the accelerated decomposition of AR.

Objective: To improve the low relief fund utilization rate, make the city minimal assurance relief patients enjoy double Medicaid assistance account and agricultural insurance or Medicare reimbursement policy. Methods: Based on the actual work, and actively explore, innovation, in the Oracle database platform, the transformation of His in outpatient service charge settlement system, establishing patient account data, through a patient's unique index related agricultural insurance or Medicare patient file information. Results:The outpatient service charge settlement system enabled for tailored low mental patients. Conclusion:the patients fully enjoy minimal assurance relief assistance account and agricultural insurance or Medicare reimbursement policy ofdouble Medicaid, andfirst diagnosis and treatment forbusiness conducted a preliminary exploration.

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 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 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.