Objective:To analyze the clinical features of the patients with drug-induced liver injury ( DILI) combined with hepati-tis B to improve the awareness and attention to the disease by medical workers. Methods:Using retrospective analysis, the patients di-agnosed with DILI combined with hepatitis B from a tertiary-hospital were analyzed from January 2013 to January 2014. Results:Total-ly 30 cases of DILI combined with hepatitis B were collected, the number of male patients was higher than that of female patients, and most of them were elderly patients. The symptoms included weak, anorexia, yellow skin and sclera, tired of the oil, nausea, abdominal distension and so on. The patients with severe liver damage accounted for 80. 0%, 16. 7% was with moderate liver damage, and 3. 3%was with mild liver damage. Thirteen cases were mixed type, ten cases were hepatocellular type, and seven cases were cholestatic type. Conclusion:Middle-aged men may be prone to the disease, and the clinical manifestations are complex and diverse. Severe liver damage is majority, and often shows as mixed liver injury.

Background Flickering light is different from the normal light environment.Animal experiment proved that flickering light can induce myopia.But its mechanism remains unclear.Objective This study was to investigate the expression of c-fos gene in retina of myopic C57BL/6J mice induced by flickering light and monocular form deprivation.Methods Ninety clean C57BL/6J mice aged 28-day-old with the similar refraction in both eyes were randomly assigned to five groups.Fifteen mice in the control group were exposed to continuous white light environment.The white flickering light with the frequency of 10,5,2 Hz were used to irradiate the mice respectively in high frequency flickering group (15 mice),moderate frequency flickering group (15 mice) and low frequency flickering group (15 mice),respectively.The right eyes of other 30 mice were monocularly occluded with a semitransparent hemispherical thin plastic shell to establish the form deprivation models and then were exposed to white light environment.The diopter and ocular axial length were measured by murine-specific eccentric infrared photorefraction and A-scan ultrasonography before experiment and two weeks after the treatments.At the end of experiment,the mice were sacrificed by neck dislocation.Mice eyes were enucleated and retinal samples were prepared for the detect of c-fos protein and its mRNA by immunohistochemistry,Western blot and reverse transcription polymerase chain reaction (RT-PCR),respectively.Results Immunohistochemistry showed that the expressing rate ofc-fos protein in retina was (68.000±10.368)％,(51.000±6.519)％,(46.000±6.519)％,(31.000±7.416)％ and (25.000 ± 7.071)％ in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group respectively 2 weeks after experiment.The expression rates of c-fos protein in retina in different frequencies of flickering light groups and form deprivation group were significantly lower than that in the control group (t =3.104,4.017,6.490,7.661,all P＜0.05),with the lowest rate in the form deprivation group (P＜0.05).The expression of c-fos detected by Western blot assay exhibited that the relative values of c-fos protein in retina (c-fos/GAPDH) was 0.804±0.050,0.687±0.047,0.667±0.036,0.558±0.036 and 0.532 ±0.056,respectively in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,illustrating significantly lowing in different frequencies of flickering light groups and form deprivation group compared with control group (t =2.961,3.184,6.971,6.276,all P＜0.05),whereas the c-fos in the low frequency group and form deprivation group,c-fos protein was less expressed in comparison with the higher frequency flicking group (P＜0.05).The expression level of c-fos mRNA (c-fos mRNA/GAPDH mRNA) in retina was 0.820±0.056,0.663±0.061,0.627±0.034,0.521±0.041 and 0.474 ±0.045 in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,respectively.These results demonstrated a significant decline in the expression of c-fos mRNA in different frequencies of flickering group and form deprivation group compared with the control group(t=3.262,5.070,7.173,8.305,all P＜0.05),and the inhibition ability of low frequency of flickering group and form deprivation group was much stronger.Conclusions The c-fos gene level in the retina has a negative relationship with the severity of myopia induced by flickering light and form deprivation.

Objective To evaluate the diagnostic value of shear wave elastography on deep venous thrombosis in different stage.Methods Models of rabbits'deep venous thrombosis have been established to noninvasively measure Young's moduli of thrombosis in day 1 ,4,7,10 and 14 respectively by shear wave elastography.Results The elastic modulus of thrombosis increased with increment of the stages of thrombosis.Specifically,the mean Young's moduli of thrombosis increased from (4.0±1 .42)kPa (day 1)to (25.71 ±6.09)kPa (day 14),with statistical differences between each two observation time points (P <0.05).Conclusions Shear wave elastography can effectively reflect the elasticity of thrombosis in different stages,and the stage of thrombosis can be estimated judging by quantitative ultrasound elasticity preliminarily.

Objective:To evaluate the stability and bio-safety of warming moxibustion gel-unguentums( WMG) . Methods: With the commercially available package and at 40℃ ± 2℃, RH (75% ± 5%) for six months,the stability of WMG was inspected. Guinea pig skin sensitization test, rabbit skin irritation test and cell toxicity test were used to investigate the safety. Results:Compared to the results of 0 month, there was no difference in the sample character, containing paste percentage, adhesion, shape, weight difference and all theindices in TLC identification. Cell toxicity test showed that WMG had slight cytotoxicity. Guinea pig skin sensitization test and rabbit skin irritation test indicated that the grade of skin reaction was zero and the primary stimulus index of skin tissues was also zero. Conclusion:The quality of WMG is stable and the production preparation technology is feasible. Moreover, it is safe in transder-mal administration.

Objective:To investigate the use of proton pump inhibitors ( PPIs) in the patients with cirrhosis or hepatitis in one hospital and evaluate the use rationality .Methods:A retrospective study was carried out on 211 patients with the diagnosis of hepatitis or cirrhosis in the infectious disease ward between 2013 and 2014 , and the use rationality of PPIs was evaluated .Results: A total of 211 cases were inspected, and among them, 192 ones were treated with PPIs (91%) with 62 ones treated with PPIs irrationally, which accounted for 29.3%of the total cases.The main irrational use of PPIs was long treatment course (24.5%), inadequate prophylaxis indications (5.7%) and purposeless use (2.6%).Conclusion: Irrational use of PPI is common in hepatitis or cirrhosis patients . Clinical pharmacists should strengthen pharmaceutical care to improve the rational drug use .

OBJECTIVE:To learn the application and tendency of hepatoprotective drugs in a third grade class A hospital dur-ing 2011-2014,and to provide reference for rational drug use. METHODS:DDDs analysis and consumption ordering method were adopted to analyze the change of DDDs,DDC and other index of hepatoprotective drugs in this hospital from 2011 to 2014. RE-SULTS:2011-2014,the amount and DDDs of Hepatoprotective injection in this hospital increased year by year,while oral dosage form decreased year by year. DDC order of each drug kept stable during 2011-2014;DDC and DDDs of drugs for promoting ener-gy metabolism were all in high level,and ornithine aspartate and ademetionine always took up the first 2 places in 4 years. Polyene phosphatidylcholine and Reduced glutathione injection were cheap,but had higher DDDs. Except Glutathione tablet,DUI of other hepatoprotective drugs had no great difference in 3 years,and fluctuated in 2014;hepatoprotective drugs with DUI>1 and DUI<1 occupied a large proportion. From 2010 to 2014,compared with previous year,the drugs with consumption sum/DDDs ratio num-ber close to 1 reduced significantly in the next year,decreasing year by year. CONCLUSIONS:In this hospital,injections are used too frequently,and overuse of drugs for promoting energy metabolism exist. Polyene phosphatidylcholine and Reduced glutathione injection can be used as a valuable drug in the clinic,and their cost are more acceptable,but not in excess.

Aspergillosis, Allergic Bronchopulmonary ; diagnosis ; drug therapy ; Child ; Humans ; Male

Objective Combined with susceptibility weighted imaging (SWI) and proton magnetic resonance spectroscopy (1H-MRS) to study the hippocampus in the first-episode depression patients for exploring the causal relationship.Methods 20 first-episode depression patients and 20 healthy volunteers underwent SWI scanning and hippocampal 1H-MRS image,analysis and comparison the changes between the venous system and metabolism of two groups.Results Proton spectroscopy analysis showed that compared with the control group,bilateral hippocampal NAA/Cr(left hippocampus:depression group 0.95±0.77,control group 1.78±0.82; right hippocampus:depression group 1.12±0.74,control group 1.91 ± 0.80) and Cho/Cr (left hippocampus:depression group 1.08±0.83,control group 1.75±0.73 ; right hippocampus:depression group 0.91±0.68,control group 1.95 ±0.74) in the depression group was significantly lower,the difference was significant(NAA/Cr:t value in left and right were -3.14,-3.49,P＜0.05; Cho/Cr:t value in left and right were-3.25,-3.19,P＜0.05),however MI/Cr had no obvious changes (t value in left and right were 1.24,-1.27,P＞0.05).Magnetic sensitive scan showed depression group compared with the control group was significantly reduced in lateral vein diameter,length and branches (t value were 3.23,4.56,2.66,P＜0.05).Conclusion The SWI sequence and 1H-MRS imaging methods can become a new research idea about the central nucleus,and this idea may explain the causal relationship between the hippocampus in depression patients of vascular abnormalities and hippocampal neuronal metabolic abnormalities.

OBJECTIVETo observe the effect of purgation and detoxification therapy on gastrointestinal dysfunction of critically ill patients undergoing abdominal surgery.

METHODSTotally 56 inpatients with severe gastrointestinal dysfunction after abdominal surgery at ICU of Guangdong Provincial Hospital of Traditional Chinese Medicine were assigned to the treatment group and the control group, 28 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took Modified Huanglian Jiedu Decoction (MHJD) and received electroacupuncture (EA) for 7 days. The first exhaust time, defecation time, scores for gastrointestinal dysfunction, mechanical ventilation time, ICU hospitalization time, and 28-day fatality rate were observed. Furthermore, serum levels of diamine oxidase (DAO) and D-lactic acid were detected at day 1, 3, and 7 after treatment.

RESULTSThe first exhaust time and the first defecation time in the treatment group were ahead of schedule, when compared with those of the control group (P <0. 05). Scores for gastrointestinal dysfunction, mechanical ventilation time, serum levels of DAO obviously decreased in the treatment group (P <0. 05). There was no statistical difference in serum levels of D-lactic acid, ICU stay time, the incidence of pulmonary infection, and 28-day mortality between the two groups (P >0. 05). Results of Logistic analysis showed that scores for gastrointestinal dysfunction were related with the incidence of pulmonary infection (P <0. 05).

CONCLUSIONMHJD combined EA could promote the recovery of gastrointestinal function in critically ill patients after abdominal surgery via improving intestinal barrier function, which was benefit for shortening mechanical ventilation time.

Critical Illness ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electroacupuncture ; Gastrointestinal Diseases ; drug therapy ; Humans ; Lactic Acid ; Medicine, Chinese Traditional

A method was developed for the determination of tetrodotoxin in marine organisms by high perfor-mance liquid chromatography-mass spectrometry with immunoaffinity column. The samples were extracted with 1% acetic acid methanol solution and diluted with phosphate buffer at pH 7-8. After cleaned up by immuno-affinity column, the samples were analyzed by LC-MS/MS and quantitatively determined by external standard method. The chromatographic separation was performed on an ACQUITY UPLC BEH Amide column with gradient elution by using acetonitrile and 5 mol/L ammonium acetate solution containing 0. 1% formic acid as mobile phase. Detection was carried out by electrospray positive ionization mass spectrometry in the multiple reaction monitoring mode. Linear ranges of TTX was in the range of 0. 3 -20. 0 μg/L with correlation coeffi-cient more than 0. 997. The quantification limit of the method was 0. 3 μg/kg. The recoveries of standard addition for tetrodotoxin were 88. 7%-102. 3%, and the relative standard deviation was 2. 0%-6. 4%. The method could be used to identify and quantify tetrodotoxin in marine organisms with satisfactory reproducibility and sensitivity.