Humans ; Liver, Artificial

Due to the importance of molecular mechanisms of drug actions, network pharmacology has become a new perspective on drug mechanism research and novel drug discovery. Drug target prediction using computational methods, is one of the key research topics in network pharmacology. This paper reviewed the related research on drug target prediction methods. Furthermore, general principles of drug target prediction methods and key steps of them in recent years were summarized. Given the diversity of Chinese medicine ingredients, the network controlla-bility of herbs and the lack of high-quality pharmacological data, the network regulation mechanism of Chinese herb research will meet even more difficulties than modern drug research. Therefore, this paper also discussed main is-sues and research trends of Chinese herb target prediction. Finally, combining with the actual consolidated network data of Chinese herbs, chemical structure similarity computation and link prediction methods, the network-based herb target prediction method was proposed to demonstrate key research steps. Furthermore, we discussed the most significant research topics that we should addressed to enhance the high quality results of herb target prediction.

Patients undergoing hemodialysis have a higher rate of hepatitis C virus infection than the general population, and due to various factors including hemodialysis and immunosuppression, it is difficult to make a diagnosis. The appearance of direct-acting antiviral agents greatly promotes the treatment of hepatitis C, but there are still no adequate data on their effect and safety in patients undergoing hemodialysis. This article discusses the prevalence, diagnosis, and treatment of hepatitis C in patients undergoing hemodialysis.

Circulating cell-free DNA (cfDNA) is considered a promising entry point of liquid biopsy for the diagnosis of early-stage liver cancer; however, many studies have confirmed that the diagnostic efficacy of cfDNA alone is not stable, especially that quantitative test alone cannot well reflect the situation of tumor. More and more studies have shown that cfDNA is suitable for combined measurement of multiple indicators or combined measurement with other diagnostic markers for liver cancer. This article reviews the articles on combined liquid biopsy based on cfDNA published up to July 2021, summarizes the existing methods for combined measurement, and briefly describes the birth and research advances in combined diagnostic methods, so as to further clarify the significance and potential of combined liquid biopsy based on cfDNA in the diagnosis of early-stage liver cancer and thus provide ideas for taking better advantages of the diagnostic markers for liver cancer in the future.

Objective To evaluate the feasibility of using noninvasive ultrasonic cardiac output monitor USCOM velocity time integral (VTI) as the observation index of PLR.Methods This prospective study recruited 36 septic shock or acute pancreatitis patients from October 2014 to October 2016 in the resuscitation room and EICU of Peking Union Medical College Hospital.The change of VTI and plus pressure before and after PLR (⊿VTIplr and ⊿pp),and the change of VTI and stroke volume before and after 500 mL of volume expansion (⊿VTIve and ⊿SV) were recorded.Fluid response positive was defined as stroke volume increase more than 15％ after volume expansion.Results ⊿VTIplr was positively correlated with ⊿SV (Spearman correlation coefficient r=0.888,P＜0.01).The predicting value of⊿VTIve,⊿VTIplr and ⊿PP in fluid response were as follows:the sensitivity of ⊿VTIve in ＞15％ was 94.7％,the specificity was 94.1％,area under the ROC curve was 0.989;the sensitivity of⊿ VTIplr in ＞12％ was 84.2％,the specificity was 88.2％,area under the ROC curve was 0.916;and the sensitivity of⊿ PP in ＞10.5％ was 78.9％,the specificity was 88.2％,the area under the ROC curve was 0.870.Conclusions ⊿ VTIplr measured by USCOM before and after the PLR is a sensitive and specific index.It is better than the classic index ⊿ PP.⊿ VTIplr measured by USCOM is completely noninvasive,which has very good application prospect in the emergency department.

Objective To compare the efficacy of two rapid lipid lowering methods as plasma exchange and insulin in the treatment of hyperlipidemic acute pancreatitis.Methods The clinical data of 98 patients with hyperlipidemic acute pancreatitis in Peking Union Medical College Hospital from January 2014 to December 2016 were retrospectively analyzed.All patients were divided into plasma exchange group (n =42) and insulin group (n=56) according to rapid lipid lowering method.Results There were no significant differences in the onset-to-treatment time,the proportion of patients with diabetes,the proportion of patients with pregnancy,the initial triglyceride level,Acute Physiology,Age and Chronic Health Evaluation l score and modified CT severity index score score and conditioning-test stimulus interval (CTSI) score between the plasma exchange group and the insulin group (P＞0.05).In addition,there were also no significant differences in the incidences of acute respiratory distress syndrome,acute kidney injury,shock and pancreatic abscess,and the proportion of moderate pancreatitis and severe pancreatitis,oral / jejunum nutrition tolerating start time,hospitalization time and mortality between the two groups (P＞0.05).The plasma exchange group had significantly less time to achieve the target triglyceride level and to reach normal free fatty acids level than the insulin group [(13.09±12.50) hvs.(46.92±20.92) h,t=3.291,P=0.001;(15.75±14.13) hvs.(73.21±38.49) h,t =3.291,P=0.001].The pancreatic pseudocyst incidence was significantly lower (7.14％ vs.23.21％,t =2.120,P=0.034),and the hospitalization cost was significantly higher [(81 794.92±33 719.69) yuan vs.(56 042.43±30 565.34) yuan,t =2.034,P =0.042] in the plasma exchange group than in the insulin group.Conclusions Both plasma exchange and insulin can rapidly lower blood lipids.Plasma exchange has certain advantages over insulin in lipid-lowering,for it is faster,and has lower incidence of pancreatic pseudocyst,thus can be applied in patients whose financial conditions permit.

Objective:To survey treatment and prognosis of hyperkalemia patients in the emergency department and to analyze factors associated with all-cause in-hospital mortality.Methods:We implemented electronic hospital information system, extracted demographic characteristics, underlying diseases, laboratory findings, potassium lowering therapy and prognosis of hyperkalemia patients [age ≥ 18 years, serum potassium (K +) concentration ≥ 5.5 mmol/L] in the emergency department of Peking Union hospital in Beijing between June 1st 2019 to May 31st 2020. The enrolled subjects were divided into the non-survival group and the survival group according to their prognosis. Univariate analysis and Cox regression model were adopted to analyze factors affecting all-cause in-hospital mortality of hyperkalemia patients. Results:A total of 579 patients [median age 64 (22) years; 310 men (53.5%) and 269 women (46.5%)] with hyperkalemia were enrolled, among which, 317 (54.7%), 143 (24.7%) and 119 (20.6%) were mild, moderate, and severe hyperkalemia, respectively. 499 (86.20%) patients received potassium-lowering therapy, forty-four treatment regimens were administered. Insulin and glucose (I+G, 61.3%), diuretics (Diu, 57.2%), sodium bicarbonate (SB, 41.9%) and calcium gluconate/chloride (CA, 44.4%) were commonly used for the treatment of hyperkalemiain the emergency department. The combination of insulin and glucose, calcium gluconate/chloride, diuretics and sodium bicarbonate (I+G+CA+Diu+SB) was the most favored combined treatment regimen of hyperkalemia in the emergency department. The higher serum potassium concentration, the higher proportion of administrating combined treatment regimen and/or hemodialysis (HD) (the proportion of administrating combined treatment regimen in mild, moderate, and severe hyperkalemia patients were 58.4%, 82.5% and 94.8%; the proportion of administrating HD in mild, moderate, and severe hyperkalemia patients were 9.7%, 13.3% and 16.0%, respectively). The proportion of achievement of normokalaemia elevated as the kinds of potassium lowering treatment included in the combined treatment regimen increased. The proportion of achievement of normokalaemia was 100% in the combined treatment regimen including 6 kinds of potassium lowering therapy. Among various potassium lowering treatments, HD contributed to the highest rate of achievement of normokalaemia (93.8%). 111 of 579 (19.20%) hyperkalemia patients died in hospital. Cox regression model revealed that complicated with cardiac dysfunction predicted higher mortality [hazard ratio ( HR) = 1.757, 95% confidence interval (95% CI) was 1.155-2.672, P = 0.009]. Achievement of normokalaemia and administration of diuretics attributed to lower mortality ( HR = 0.248, 95% CI was 0.155-0.398, P = 0.000; HR = 0.335, 95% CI was 0.211-0.531, P = 0.000, respectively). Conclusions:Treatment of hyperkalemia in the emergency department were various. Complicated with cardiac dysfunction were associated with higher mortality. Achieving normokalaemia was associated with decreased mortality.