Objective:To analyze the occurrence and risk factors of drug-induced liver injury (DILI) in patients with novel coronavirus pneumonia (COVID-19).Methods:The medical records of patients with COVID-19 who were discharged from the First Hospital of Changsha from January 15 to March 7, 2020 were collected and the patients were divided into the DILI group and the non-DILI group based on DILI diagnostic criteria. Basic information of patients in the 2 groups including gender, age, underlying diseases, classification of COVID-19, liver function test results on admission and after medication, drug use, time to DILI onset after medication, and treatments and outcomes of DILI were recorded and compared. The incidence of DILI in patients with COVID-19 was calculated, and the factors whose P<0.05 in inter-group comparison were included in the multivariate logistic regression analysis to calculate the odds ratio ( OR) and95% confidence interval ( CI). Results:A total of 203 discharged patients with COVID-19 met the inclusion criteria. Of them, 36 patients developed DILI, the incidence was 17.73%. Between the DILI group and the non-DILI group (167 patients), the differences were statistically significant in gender distribution, proportion of patients with underlying diseases such as hypertension, fatty liver, and cholelithiasis, clinical classification of COVID-19, and the kinds of drug use ( P<0.05 for all), but not statistically significant in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) on admission ( P>0.05 for all). The levels of ALT and AST in patients in the DILI group after medication were higher than those before medication, and the differences were statistically significant ( P<0.001 for all). The median time for time to DILI onset after medication was 8 (6, 11) days and none of the patients had obvious clinical signs and symptoms. After the occurrence of DILI, 16 patients stopped the suspicious drugs and received liver-protective treatments, 6 patients only stopped the suspicious drug without additional treatments, and 14 patients received liver-protective treatments without drug withdrawal. Among the 36 patients in the DILI group, liver function were improved in 34 patients but did not returned to normal in 2 patients when they were discharged from the hospital. Multivariate logistic regression analysis showed that male ( OR=3.939, 95 %CI: 1.426-10.883, P=0.008), being severe and critical in clinical classification ( OR=6.433, 95 %CI: 2.411-17.162, P<0.001), fatty liver ( OR=3.815, 95 %CI: 1.298-11.215, P=0.015), cholelithiasis ( OR=16.347, 95 %CI: 1.267-210.990, P=0.032), and the kinds of drug use >8 ( OR=10.181, 95 %CI: 3.606-28.744, P<0.001) were the independent risk factors of DILI in patients with COVID-19. Conclusions:The incidence of DILI in COVID-19 patients discharged from the First Hospital of Changsha is 17.73%. Male, being severe and critical in clinical classification of COVID-19, fatty liver, cholelithiasis, and the kinds of drug use >8 are the independent risk factors for DILI patients with COVID-19.

Objective:To analyze the occurrence and risk factors of drug-induced liver injury (DILI) in patients with novel coronavirus pneumonia (COVID-19).Methods:The medical records of patients with COVID-19 who were discharged from the First Hospital of Changsha from January 15 to March 7, 2020 were collected and the patients were divided into the DILI group and the non-DILI group based on DILI diagnostic criteria. Basic information of patients in the 2 groups including gender, age, underlying diseases, classification of COVID-19, liver function test results on admission and after medication, drug use, time to DILI onset after medication, and treatments and outcomes of DILI were recorded and compared. The incidence of DILI in patients with COVID-19 was calculated, and the factors whose P<0.05 in inter-group comparison were included in the multivariate logistic regression analysis to calculate the odds ratio ( OR) and95% confidence interval ( CI). Results:A total of 203 discharged patients with COVID-19 met the inclusion criteria. Of them, 36 patients developed DILI, the incidence was 17.73%. Between the DILI group and the non-DILI group (167 patients), the differences were statistically significant in gender distribution, proportion of patients with underlying diseases such as hypertension, fatty liver, and cholelithiasis, clinical classification of COVID-19, and the kinds of drug use ( P<0.05 for all), but not statistically significant in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) on admission ( P>0.05 for all). The levels of ALT and AST in patients in the DILI group after medication were higher than those before medication, and the differences were statistically significant ( P<0.001 for all). The median time for time to DILI onset after medication was 8 (6, 11) days and none of the patients had obvious clinical signs and symptoms. After the occurrence of DILI, 16 patients stopped the suspicious drugs and received liver-protective treatments, 6 patients only stopped the suspicious drug without additional treatments, and 14 patients received liver-protective treatments without drug withdrawal. Among the 36 patients in the DILI group, liver function were improved in 34 patients but did not returned to normal in 2 patients when they were discharged from the hospital. Multivariate logistic regression analysis showed that male ( OR=3.939, 95 %CI: 1.426-10.883, P=0.008), being severe and critical in clinical classification ( OR=6.433, 95 %CI: 2.411-17.162, P<0.001), fatty liver ( OR=3.815, 95 %CI: 1.298-11.215, P=0.015), cholelithiasis ( OR=16.347, 95 %CI: 1.267-210.990, P=0.032), and the kinds of drug use >8 ( OR=10.181, 95 %CI: 3.606-28.744, P<0.001) were the independent risk factors of DILI in patients with COVID-19. Conclusions:The incidence of DILI in COVID-19 patients discharged from the First Hospital of Changsha is 17.73%. Male, being severe and critical in clinical classification of COVID-19, fatty liver, cholelithiasis, and the kinds of drug use >8 are the independent risk factors for DILI patients with COVID-19.

The body is equipped with kinds of transporters which generally exist in liver,kidney,and intestine.Multidrug and toxin extrusion proteins(MATEs;SLC47A)are predominantly expressed in the brush-border membrane of proximal tubule epi-thelial cells in the kidney and the canalicular membrane of hepa-tocytes.Functionally,MATEs act as efflux transporters for or-ganic compounds.The article discusses type,structure,poly-morphism and function of MATE1and MATE2-K,and also dis-cusses the effect of single nucleotide polymorphisms (SNPs)in the SLC47A1 gene and SLC47A2 on the pharmacokinetics and pharmacodynamics of metformin and platinum-based chemothera-peutic agents.

OBJECTIVE:To establish a method for simultaneous determination of the confents of calycosin-7-glucoside,calyco-sin and formononetin in Shenqi granule. METHODS:HPLC was performed on the column of Welch Ultimate XB-C18 with mobile phase of acetonitrile-0.2% Formic acid solution (gradient elution) at flow rate of 1.0 ml/min,detection wavelength was 250 nm, column temperature was 35 ℃,and injection volume was 10 μl. RESULTS:The linear range of sample quantity was 0.008-0.32 μg for calycosin-7-glucoside(r=0.999 9),0.005-0.20 μg for calycosin(r=0.999 7)and 0.007-0.28 μg for formononetin(r=0.999 8);RSDs of precsion,stability and reproducibility tests were no more than 1.59%;recoveries were 98.17%-99.17%(RSD=0.67%, n=6),98.03%-99.66%(RSD=0.57%,n=6) and 98.16%-99.12%(RSD=0.43%,n=6). CONCLUSIONS:The method is sim-ple,accurate and reliable,and can be used for the content determination of Shenqi granule ofiso flavones.

Objective To explore the effects of continuing care on the quality of sleep and neurological function rehabilitation in patients after stroke. Methods 60 patients with sleep disorder and hemiplegia after stroke discharging from our hospital during January to December 2014 were randomly assigned to control group (n=30) and intervention group (n=30). The control group received routine discharge instruction, while the intervention group received continuing care. They were assessed with Pittsburgh Sleep Quality Index (PSQI), simplified Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were when discharged and 3 months after intervention. Results The scores of PSQI were lower, the scores of FMA and MBI were higher in the intervention group than in the control group 3 months after intervention (P<0.05). The nursing satisfaction was higher in the intervention group than in the control group (P<0.001). Conclusion Continuing care could improve the sleep quality, and promote the neurological function recovery for patients with sleep disorder after stroke.