ObjectiveThe clinical features, bacteria distribution and antibiotic resistance proifle of blood stream infection(BSI) were investigated in the patients with decompensated liver cirrhosis for better management of such infections.MethodsThe clinical data of BSI were collected in the patients with decompensated liver cirrhosis between January, 2012 and December, 2014, and reviewed retrospectively in terms of risk factors, diagnosis and treatment, pathogen distribution and prognosis.ResultsOf the 1 071 patients with decompensated liver cirrhosis and suspected bacterial infection, 154 (14.4%) were diagnosed as BSI evidenced by blood culture. Of these patients, the leukocyte count in the peripheral blood was higher than 10×109/L in only 48 (31.2%) patients; neutrophil proportion>0.75 in 133 patients (86.4%); serum procalcitonin level>0.5 ng/mL in 74 patients (68.5%). A total of 155 bacterial strains were isolated, including 115 strains of gram-negative bacilli and 40 strains of gram-positive cocci. Most patients (68.8%) recovered and 31.2% died or discharged from hospital voluntarily. All these BSI patients had Child-Pugh grade C liver function. Some patients also had other serious systemic diseases or repeated hospitalization.ConclusionThe prevalence of BSI is high in the decompensated liver cirrhosis patients with poor prognosis. Gram-negative bacilli are the major pathogens of such septicemia. Early diagnosis and proper use of antibiotics based on antimicrobial susceptibility testing are important to improve patient outcome.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; drug therapy ; pathology ; Humans ; Lymph Nodes ; pathology ; Male ; Retrospective Studies ; Treatment Outcome

Heme oxygenase-1 (HO-1) is a cellular stress protein, and its expression plays an important regulatory role in a lot of physiological and pathological processes. Although the expression of HO-1 in most tissues of body is low, a number of clinical and pharmacological experiments have proved that many compounds can induce HO-1 expression. The increase of HO-1 expression is the result of regulating different signaling pathways and transcription factors, and this induction of HO-1 is suggested to be partially therapeutic efficacy of these compounds. This article summarizes some kinds of compounds in this field of research at home and abroad over the last 10 years, and provides a brief analysis of the mechanism.
Animals ; Antineoplastic Agents ; pharmacology ; Antioxidants ; pharmacology ; Coumarins ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Enzyme Induction ; drug effects ; Gene Expression Regulation, Enzymologic ; Heme Oxygenase-1 ; genetics ; metabolism ; Humans ; Lovastatin ; pharmacology ; Nitric Oxide ; pharmacology ; Peptide Hormones ; pharmacology ; Probucol ; pharmacology ; Signal Transduction ; Transcription Factors ; metabolism

BACKGROUND:Studies have demonstrated that tetrandrine has protection on acute spinal cord injury,but the specific mechanism remains poorly understood.OBJECTIVE:To study the protection of tetrandrine on rat acute spinal cord injury and to study its mechanism from apoptosis pathway.METHODS:A total of 100 rats were randomly divided into 4 groups.All rats were prepared for spinal cord injury models using modified Allen method except that in the sham-surgery group.Methylprednisolone and tetrandrine was injected into rats in the methylprednisolone and tetrandrine groups by tail intravenous injection prior to and at 24,48 hours after model preparation.The same volume of physiological saline was injected in the sham-surgery and model groups.Basso-BeatUe-Bresnahan(BBB score)was recorded at 8 hours,1,3,7 and 14 days after model preparation.The morphological changes of spinal cord injury sites were observed by hematoxylin-eosin staining and the expressions of bcl-2 and bax were determined by immunohistochemistry.RESULTS AND CONCLUSION:The BBB score of methylpradnisolone and tetrandrine groups were significantly higher than that model group at 7 and 14 days(P<0.05),but there were no significant difference between the methylprednisolone group and tetrandrine group(P>0.05).Hematoxylin-eosin staining showed that the spinal cord injured severely at 3-7 days,the injury degree in the methylpradnisolone group and tetrandrine group was slighter than that of the model group,with smaller bax expression and greater bcl-2 expression(P<0.01).The findings demonstrated that,tetrandrine is able to protect neurons from apoptosis and promote the nerve function recovery by inhibiting the expression of Bax and promoting the expression of Bcl-2.Its effect is not inferior to methylprednisolone.

Objective This study was to investigate the role of lactoferrin and C-reactive protein (CRP)assay in ascitic fluid for diagnosis of spontaneous bacterial peritonitis (SBP)in the patients with decompensated liver cirrhosis.Methods Ascites was collected from the inpatients with decompensated liver cirrhosis before and after treatment from May to December 2011 for anal-ysis of polymorphonuclear cells (PMN)and bacterial culture.The level of lactoferrin and C-reactive protein in the ascites were determined.Results A total of 117 ascites samples were collected from 66 patients.Twenty-six patients met the criteria of SBP with PMN ≥ 250×106/L in ascites,were assigned to SBP group.Of these patients,11 presented with fever 37.3℃ to 38℃, and 11 patients had elevated peripheral blood white cell count > 10 × 109/L.Eleven patients had neutrophil cell percentage >0.75.Only 8 patients in this group had positive bacterial culture.Another 12 patients met the criteria of suspected SBP,and assigned to suspected SBP group.The remaining 28 patients did not satisfy the criteria of SBP,and assigned to non-SBP group.The pretreatment lactoferrin level was (768.46 ± 611 .70)ng/mL and (98.28 ± 56.81 )ng/mL in SBP and non-SBP group,respectively.The pretreatment CRP level was (9.397 ±3.737 )mg/L and (1 .786 ±0.52 )mg/L in SBP and non-SBP group,respectively.The lactoferrin and CRP levels decreased sharply after antibacterial and support-ive treatment in SBP group,which were 657.05 ng/mL and 8.13 mg/L,respectively.The cut-off value of lactoferrin for diagnosis of SBP was 233 ng/mL with sensitivity 96.2% and spe-cificity 97.5%.The cut-off value of CRP for diagnosis of SBP was 4.390 mg/L with sensitivity 92.3% and specificity 92.5%. However,lactoferrin combined with CRP had a sensitivity of 99.70% and specificity of 90.18% for diagnosis of SBP.Conclu-sions Lactoferrin and CRP levels in the ascites of patients with liver cirrhosis are useful for diagnosis of SBP with high specifici-ty and sensitivity.

Objective To investigate the clinical effect of traditional Chinese medicine(TCM)for treating HBeAg positive chron-ic hepatitis B virus(HBV)carriers with liver stagnation and spleen deficiency syndrome.Methods The patients with HBeAg and HBV DNA positive,normal serum ALT and AST for successive 3 times within 1-year follow up,complicating different degrees of symptoms were included.Among them,the patients with liver stagnation and spleen deficiency syndrome according to the TCM dif-ferentiation were selected as the treatment obj ects and treated by the prescription of soothing the liver,tonifying spleen and detoxifi-cation.The changes of clinical symptoms and HBV markers after 6-month therapy were observed and followed up for 3 months for evaluating the effect persistance.348 cases were recruited,161 cases in the control group and the other 187 cases in the treatment group.Treatment group underwent traditional Chinese medicine treatment.Results 168 cases finished the therapy with the total effective rate of 80.3%(135/168),6 cases were HBeAg negative conversion and 14 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades;157 patients finished 3-month follow-up and the effective rate was 80.9%(127/157),4 cases were HBeAg negative conversion and 1 1 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades.The curative effect of treatment group was higher than that of control group.Conclusion The TCM prescription of soothing the liver,tonifying spleen and detoxification has definite effect for treating HBeAg positive chronic HBV carriers with liver stagnation and spleen deficiency syndrome,the symptoms can be significantly improved.

Objective To study the function of core protein (CORE) of genotype 1b hepatitis C virus (HCV) of different strains (T: derived from tumor tissues; NT: derived from non-tumor tissues; C191: HCV-J6) and different domains (1-172, 1-126, 1-58, 59-126, 127-172 AA) of T CORE in the pathogenesis of HCV infection and to find the therapy target. Methods Different truncated genotype 1b HCV CORE eukaryotic expression plasmids (T, NT, C191) and different domains of T CORE were constructed and transfected to HepG2 cells. Cell apoptosis and necrosis were quantified by flow cytometry. Cell growth curves were observed with real time cell growth instrument. Results COREs from different strains of genotype 1b and different domains of CORE induced cell apoptosis and necrosis, and inhibited HepG2 cell growth at different levels. CORE derived from T induced apoptosis and necrosis and inhibited cell growth higher than that derived NT and C191. N terminal 1-58 AA of CORE derived from T induced cell apoptosis and necrosis and inhibited cell growth higher than any other domains. Conclusion COREs from different strains of genotype 1b HCV and different domains of CORE from the same HCV strain play different roles in their molecular pathogenesis of HCV. Among different domains of CORE, N terminal 1-58 AA might play an important role in its pathogenesis and be one target of gene therapy.

The tail suspension test (TST), forced swimming test (FST) and chronic unpredictable mild stress (CUMS) model were used to evaluate the anti-depressant effect of supercritical CO2 extract from Compound Chaigui Fang (FFCGF). A nuclear magnetic resonance (NMR)-based metabonomics combined with multivariate statistical analysis was performed to explore the mechanism of FFCGF. Rats were conducted by CUMS procedure for 28 days and drugs were administrated at the same time. The body weight, sucrose preference, crossings and rearings in open-field tests were evaluated and the urine was collected simultaneously. The metabonomic profiles of rats' urine were analyzed by NMR and potential biomarkers were searched by multivariate statistical analysis. The results showed that administration of FFCGF significantly decreasing the immobility time in FST and TST and improving rats' body weight, sucrose preference, crossings and rearings in CUMS, which were indication that the anti-depressant effect of FFCGF was abvious. Significant differences in the metabolic profile of the CUMS treated group and the control group were observed, which were consistent with the results of behavioral tests. Decreased levels of acetic acid, succinic acid, 2-oxidation glutaric acid and citric acid and increased glycine and pyruvic acid in urine were significantly affected by the CUMS procedure and the 6 biomarkers were reversed evidently after administration of FFCGF. These changes were suggestion that the anti-depressant mechanism of FFCGF was associated with energy metabolism, lipid metabolism and amino acid metabolism.
Animals ; Antidepressive Agents ; chemistry ; isolation & purification ; pharmacology ; therapeutic use ; Behavior, Animal ; drug effects ; Body Weight ; Carbon Dioxide ; chemistry ; Depression ; drug therapy ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; therapeutic use ; Male ; Mice

Antineoplastic Agents ; pharmacology ; therapeutic use ; Benzenesulfonates ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Cell Adhesion ; drug effects ; Cell Proliferation ; drug effects ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; Neoplasm Metastasis ; prevention & control ; Neovascularization, Pathologic ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; therapeutic use ; Signal Transduction ; drug effects

To elucidate the anti-depressive effect of Fufang Chaigui prescription and its mechanism and investigate its effect on neuroendocrine hormone, rats were included into a chronic unpredictable mild stress (CUMS) model for 28 d, and drugs were administered at the same time. During the period, rats' behaviors were observed and the blood was collected by using ELISA to determine representative hormone concentrations of HPAA, HPTA and HPGA. The changes in endogenous metabolites were analyzed by using H NMR metabolomics to seek the potential biomarkers. Results showed Fufang Chaigui prescription could improve the behaviors of CUMS rats obviously, increase contents of ACTH, CORT, T₃and decrease contents of TSH and TESTO and regulate the levels of lactate, α-glucose, choline, N-acetylglycoprotein, trimethylamine oxide and leucine to get closer to the contents of control group. The results of correlation analysis indicated that HPTA was associated with glycometabolism, amino acid metabolism and choline metabolism. And HPAA was related to glycometabolism and amino acid metabolism. However, HPGA was only correlated with glycometabolism. In conclusion, Fufang Chaigui prescription could show an obvious anti-depressive effect and its underlying mechanism might involve regulations of neuroendocrine function and pathways of glycometabolism, amino acid metabolism and choline metabolism.
Animals ; Antidepressive Agents ; administration & dosage ; Behavior, Animal ; Depression ; blood ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Hormones ; metabolism ; Humans ; Male ; Metabolomics ; Neurosecretory Systems ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serum ; chemistry ; metabolism