1.Analysis of clinical characteristics of 105 cases of cholestatic drug-induced liver injury
Qiannan Chen ; Yan Xu ; Xiaochang Liu ; Qiao Mei ; Weiping Weiping ; Jianming Xu
Acta Universitatis Medicinalis Anhui 2023;58(6):1036-1040
Objective :
To explore the general information,clinical features,imaging findings and outcome of pa- tients with drug-induced cholestatic.
Methods :
The clinical data of patients diagnosed as cholestatic drug-induced liver injury in recent 5 years were analyzed retrospectively,and followed up for at least 6 months.
Results :
There were 105 patients with drug-induced cholestatic liver injury in the hospital,the median age was 55 years old (54. 3% male) ,most of them had no specific clinical symptoms ; there were nearly 80 kinds of drugs involved,the top three were traditional Chinese medicine (34. 3% ) ,antineoplastic drugs (22. 9% ) and antibiotics ( 10. 5% ) . Among the 49 patients with magnetic resonance cholangiopancreatography ( MRCP) ,7 ( 14. 3% ) had sclerosing cholangitis-like changes ; most of the patients were combined with multiple liver-protecting and enzyme-lowering drugs ; there were 53 cured (50. 5% ) ,41 improved (39. 0% ) ,7 uncured (6. 7% ) ,and 4 died (3. 8% ) among 105 patients,and the total effective rate was 89. 5%.
Conclusion
Drug-induced cholestatic liver injury mainly oc- curs in elderly patients,involving many kinds of drugs,mainly traditional Chinese medicine.Drugs can also cause changes similar to sclerosing cholangitis,so drug-induced liver injury (DILI) should be used as one of the differen- tial diagnosis of cholestasis and abnormal cholangiography.Liver disease and the number of drugs have no effect on the prognosis of the patients,while low Roussel Uclaf causality assessment method (RUCAM) score and hemoglobin count,short hospitalization time and high white blood cell count are poor prognostic factors.
2.Joint effects of meteorological factors and PM2.5 on age-related macular degeneration: a national cross-sectional study in China.
Jiayu HE ; Yuanyuan LIU ; Ai ZHANG ; Qianfeng LIU ; Xueli YANG ; Naixiu SUN ; Baoqun YAO ; Fengchao LIANG ; Xiaochang YAN ; Yang LIU ; Hongjun MAO ; Xi CHEN ; Nai-Jun TANG ; Hua YAN
Environmental Health and Preventive Medicine 2023;28():3-3
BACKGROUND:
Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM2.5) on AMD.
METHODS:
Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants' home addresses by latitude and longitude. Participants' individual PM2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM2.5 on AMD.
RESULTS:
The prevalence of AMD in the study population was 2.6% (95% CI 2.42-2.76%). The average annual PM2.5 level during the study period was 63.1 ± 15.3 µg/m3. A significant positive association was detected between AMD and PM2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM2.5, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM2.5 was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM2.5 and atmospheric pressure.
CONCLUSIONS
This study is among the first to characterize the coordinated effects of meteorological factors and PM2.5 on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD.
Humans
;
Adult
;
Middle Aged
;
Cross-Sectional Studies
;
Air Pollutants/analysis*
;
Particulate Matter/analysis*
;
China/epidemiology*
;
Macular Degeneration/etiology*
;
Meteorological Concepts