Objective To investigate the clinical features of non-steroidal anti-inflammatory drugs (NSAIDs) caused gastrointestinal bleeding in the elderly.Methods We performed a retrospective analysis ofNSAIDs caused gastrointestinal bleeding with 308 cases admitted to Department of Gastroenterology,The Second Hospital of Tianjin Medical University.Patients were divided into elderly group(≥65 years,n =208) and young group (＜ 60 years,n =100) to make a comparative analysis of two group differences in clinical characteristics.Results The NSAIDs in the elderly taking were mainly Aspirin (55.8 ％ (116/208)),which was significantly more frequent than that of young group (37.0％ (37/100),x2 =9.517,P ＜ 0.05).There was no significant difference on the blood routine and coagulation between the two groups (P ＞ 0.05).The recent bleeding rate of the elderly group (21.2％ (44/208)) was lower than the young group (63.0％ (63/100))(x2 =52.161,P ＜0.05).The two groups had no significant difference on the history of uleer and Hp infection (P ＞ 0.05).Conclusion The clinical characteristics of NSAIDs caused gastrointestinal bleeding on the elderly were different with young or middle-aged.This infers that elderly patients need individualized treatment.

Objective To study the expression of Vascular Endothelial Growth Factor (VEGF),Malondialdehyde (MDA),Hypoxia Inducible Factor-1 α (HIF-1 α) in the Non-Steroidal Anti-Inflammatory Drug (NSAID)-associated gastric mucosa injury tissue,and to understand the mechanism of NSAID induced gastric mucosa injury.Methods We collected 114 biopsy specimen of gastric mucosa under endoscope from patients admitted to our hospital,including 70 cases with NSAID-associated chronic erosive gastritis or gastric ulcer (NSAID group) and 44 cases with chronic superficial gastritis who never take NSAID as controls (the control group).Immunohistochemistry technique was used to detect the positive expressions of VEGF,MDA,HIF-1α in patients.Results The positive rate of VEGF expression in the NSADI group was significantly lower than that in the normal control group (25.7％ (18/70) vs.54.5％ (24/44),x2 =9.70,P ＜ 0.05).The positive rates of MDA and HIF-1α in the NSADI group were significantly higher than these in the normal control group (MDA:62.9％ (44/70) vs.27.3％ (12/44),x2 =13.70,P ＜0.05; HIF-1α:45.7％ (32/70) vs.13.6％ (6/44),x2 =12.50,P ＜ 0.05).Conclusion NSAID drugs may induce gastric mucosa injury by decreasing the expression of VEGF and increase the levels of MDA and HIF1-α in gastric mucosa tissue.

The blood-brain barrier in humans significantly restricts the effective delivery of drugs into the brain, resulting in poor therapeutic efficacy and difficulty in brain disease management. In recent years, innovative strategies and novel preparations have been studied and developed in order to circumvent the blood-brain barrier, achieve efficient drug entry into the brain, minimize the incidence of peripheral adverse effects, and bring significant therapeutic outcomes to patients. This review summarizes some key development strategies for treating encephalopathy, to provide some insights for the development of the next generation of drugs.

Objective To explore the role and mechanism of thymosin β4 (Tβ4) in the treatment of non-alcoholic fatty liver disease (NAFLD).Methods Forty male C57BL/J6 mice were divided into normal group,NAFLD group,low dose Tβ4 group and high dose Tβ4 group with 10 mice in each group.NAFLD mice model was established by feeding with high fat and high sugar diet for 16 weeks.The mice in low-dose Tβ4 group and high dose Tβ4 group were intraperitonealy injected with Tβ4 at 0.05 mg · kg-1 · d-1 and 0.20 mg · kg-1 · d-1,respectively,for eight weeks.The liver function indexes and serum tumor necrosis factor-α (TNF-α) level were detected;the pathological changes of liver tissue were observed under optical microscope and non-alcoholic fatty liver disease activity score (NAS) was evaluated.The protein expression levels of nuclear factor-κB p65 (NF-κB p65) and nuclear factor κB inhibit protein a (IκBa) at the protein level in liver tissue were measured by Western blotting method.The expression of TNF-α in liver tissue was detected by immunohistochemistry.Mean integral absorbance (MIA) was calculated.T test was performed for groups comparison.Results The levels of alanine aminotransferase (ALT),γ-glutamine transferase (GGT) and serum TNF-α levels of high dose Tβ4 group were all lower than those of NAFLD group ((28±17) U/L vs.(76±29) U/L,(61±39) U/L vs.(102±56) U/L,(144.1± 48.2) ng/L vs.(187.3±58.8) ng/L,respectively),and the differences were statistically significant (t=4.52,2.78 and 2.30,all P＜0.05).The NAS of low dose Tβ4 group and high dose Tβ4 group were both lower than that of NAFLD group (3.7±40.4,2.3±0.3 vs.4.6±0.3),and the differences were statistically significant (t=5.69 and 17.14,both P＜0.01).The relative expression level of Tβ4 protein of NAFLD group was lower than that of normal group (0.2±0.1 vs.1.4±0.6),and the difference was statistically significant (t=6.24,P＜0.01).The relative expression levels of Tβ4 and IκBa of high dose Tβ4 group were higher than those of NAFLD group (1.0±0.3,0.5±0.3 vs.0.2±0.1),and the differences were statistically significant (t=8.00 and 3.00,both P＜0.01).The relative expression level of NF-κB p65 in liver tissue of high dose Tβ4 group was lower than that of NAFLD group (0.6±0.3 vs.1.5±0.7),and the difference was statistically significant (t=3.74,P＜0.01).The MIA of high dose Tβ4 group was lower than that of NAFLD group (0.4±0.2 vs.0.7±0.3),and the difference was statistically significant (t=2.63,P＜ 0.01).Conclusion Tβ4 can effectively treat NAFLD probably through inhibiting the NF-κB pathway.