Chronic liver diseases are a group of diseases in which the liver is subjected to a variety of injuries over a long period of time， resulting in irreversible pathological changes that last longer than 6 months. Emodin （EMO） is a natural anthraquinone derivative derived from Rheum officinale， and its pharmacological effect has been extensively studied， exhibiting a variety of biological properties and involving multiple signaling molecules and pathways. Western medicine or surgical treatment is currently the main treatment regimen for chronic liver diseases， and the advance in treatment is limited by various reasons such as side effects and high costs. Due to its natural origin and efficacy， EMO has unique advantages in the treatment of chronic liver diseases and has now become a research hotspot. This article summarizes the therapeutic effect of EMO on chronic liver diseases and its mechanism， in order to provide a certain scientific basis for the traditional Chinese medicine treatment of chronic liver diseases and the development of drugs in clinical practice.

Objective To investigate the incidence of anaemia in patients with psoriatic arthritis(PsA)and explore the relationship between serum hemoglobin(Hb)levels and disease activity and treatment outcomes.Methods Clinical data of PsA patients who visited the Department of Rheuma-tology and Immunology of the First Affiliated Hospital of Nanjing Medical University from March 2019 to May 2024 were collected.Anemia was determined based on Hb values(female＜110 g/L,male＜120 g/L),and clinical characteristics were compared between anemic and non-anaemic patients.Multivariate Logistic regression analysis was used to identify factors associated with treatment response.Results Among anemic patients,the proportion of males was higher than that of females,and the difference was statistically significant(P=0.03).The incidence of skin lesions(P=0.002),pe-ripheral arthritis(P＜0.001),spondylitis(P＜0.001),and enthesitis(P＜0.001)was higher in the anemic group than in the non-anemic group,with statistically significant differences.Patients with anemia had higher composite psoriatic disease activity index(CPDAI)(P＜0.008)and acute-phase reactant levels(P＜0.001),and the differences were statistically significant.Multivariate logistic re-gression analysis showed that patients with concomitant anemia were less likely to achieve the Ameri-can College of Rheumatology 20％improvement criteria(ACR20)than those without concomitant anemia(OR=0.36,P=0.02).Conclusion Anaemia is a common complication of PsA,associated with high disease activity and is a predictor of poor treatment response.

ObjectiveTo explore and establish the liver injury risk prediction model of indirect toxicity of Chinese medicinals under the condition of compound formulas， and provide new ideas and methods for the study of evaluation of liver injury of Chinese medicinals based on indirect toxicity. MethodsTaking Buguzhi （Fructus Psoraleae） pre-parations as model drug， the combined Chinese medicinals with Buguzhi （Fructus Psoraleae） of high frequency are screened out， and their components and action targets were obtained through TCMSP， TCMIP and PharmMapper databases. The association strength value and risk value of Chinese medicinals that acted on the nuclear factor κB （NF-κB） pathway were analyzed. For those having greater values than the median association strength value and risk value were regarded as indirect Chinese medicinals of liver injury risk. In this way， a prediction model of liver injury risk of Chinese medicinals was constructed based on immune activation-related indirect liver injury process （taking NF-κB pathway as an example）. And verification of the prediction model was performed using Heshouwu （Radix Polygoni Multiflori） preparations. ResultsThe prediction model of liver injury risk based on important immunoactivated pathway （taking NF-κB pathway as an example） found that Yinyanghuo （Herba Epimedii） （association strength value = 0.18， risk value = 0.25） was a Chinese medicinal with potential risk of indirect liver injury within Buguzhi （Fructus Psoraleae） prepartions， which may increase the risk of liver injury by positively regulating Bruton's tyrosine kinase （Btk） and protein kinase C theta （PKCθ） on NF-κB pathway. Further verification of prediction model by Heshouwu （Radix Polygoni Multiflori） preparations showed that Buguzhi （Fructus Psoraleae） （association strength value = 0.25， risk value = 0.33） and Tusizi （Semen Cuscutae） （Semen Cuscutae， association strength value = 0.34， risk value = 0.33） may increase the liver injury risk of Heshouzu. ConclusionThe liver injury risk prediction model of indirect toxicity of Chinese medicinals has been constructed in this study， providing metho-dological reference for the identification of Chinese medicinals of indirect liver injury risk under the condition of compound formulas.

Objective: To investigate the correlation between age-related hearing loss and cognitive impairment. Methods: 201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People′s Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly. Results: Of the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05); The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05). Conclusions Age-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.

Objective To explore the clinical characteristics,prevention,and treatment of acute liver injury (AHI) induced by intravenous amiodarone.Methods The medical records data of 5 patients with AHI caused by intravenous amiodarone in our hospital were collected and retrospectively analyzed,and in the meantime,case reports on intravenous amiodarone-induced AHI in PubMed,CNKI and Wanfang Data were searched.The clinical data of 5 patients in our hospital and case reports from the literature were summarized and the clinical characteristics of AHI induced by intravenous amiodarone were analyzed.Results The 5 patients with AHI induced by intravenous amiodarone in our hospital included 3 males and 2 females with ages of 22-70 years.The total doses of amiodarone were 450-750 mg,incubation periods (the period from drug use to AHI occurrence) were 24-48 h,and the types of liver injury were all hepatocyte type,of which 2 patients' were liver failure.A total of 59 patients with amiodarone-induced AHI were collected (5 in our hospital and 54 from the literature),including 40 males (67.8％) and 19 females (32.2％) with ages from 1 year and 10 months to 93 years and a median age of 69 (58,75) years.In these 59 patients,the incubation periods ranged from 6 hours to 8 days and the median period was 2 (1,3) days,and that of 55 patients (93.2％) were less than or equal to 3 days.The incubation periods of 17 patients with liver failure and 42 patients with non-liver failure were 1 (1,2) days and 2 (1,3) days respectively,and the difference was statistically significant (P =0.033).The peak values of ALT,which were recorded in 55 patients,ranged from 178 to 8 400 U/L,and the median value was 2 418 (922,4 250) U/L.The peak values of AST,which were recorded in 56 patients,ranged from 165 to 17 471 U/L,and the median value was 2 658 (1 205,7 250)U/L.The AST peak values of 16 patients with liver failure and 42 patients with non-liver failure were 6 195 (3 370,6 850) U/L and 2 383 (1 115,5 040) U/L,respectively,and the difference was statistically significant (P =0.032).Among the 59 AHI patients,44 patients' liver function returned to normal,4 patients' liver function improved,and 11 patients died,of whom 9 (81.8％) developed liver failure.Conclusion AHI induced by intravenous amiodarone is an acute onset and severe disease with a short incubation period,and should be monitored timely.

Objective To explore the clinical characteristics,prevention,and treatment of acute liver injury (AHI) induced by intravenous amiodarone.Methods The medical records data of 5 patients with AHI caused by intravenous amiodarone in our hospital were collected and retrospectively analyzed,and in the meantime,case reports on intravenous amiodarone-induced AHI in PubMed,CNKI and Wanfang Data were searched.The clinical data of 5 patients in our hospital and case reports from the literature were summarized and the clinical characteristics of AHI induced by intravenous amiodarone were analyzed.Results The 5 patients with AHI induced by intravenous amiodarone in our hospital included 3 males and 2 females with ages of 22-70 years.The total doses of amiodarone were 450-750 mg,incubation periods (the period from drug use to AHI occurrence) were 24-48 h,and the types of liver injury were all hepatocyte type,of which 2 patients' were liver failure.A total of 59 patients with amiodarone-induced AHI were collected (5 in our hospital and 54 from the literature),including 40 males (67.8％) and 19 females (32.2％) with ages from 1 year and 10 months to 93 years and a median age of 69 (58,75) years.In these 59 patients,the incubation periods ranged from 6 hours to 8 days and the median period was 2 (1,3) days,and that of 55 patients (93.2％) were less than or equal to 3 days.The incubation periods of 17 patients with liver failure and 42 patients with non-liver failure were 1 (1,2) days and 2 (1,3) days respectively,and the difference was statistically significant (P =0.033).The peak values of ALT,which were recorded in 55 patients,ranged from 178 to 8 400 U/L,and the median value was 2 418 (922,4 250) U/L.The peak values of AST,which were recorded in 56 patients,ranged from 165 to 17 471 U/L,and the median value was 2 658 (1 205,7 250)U/L.The AST peak values of 16 patients with liver failure and 42 patients with non-liver failure were 6 195 (3 370,6 850) U/L and 2 383 (1 115,5 040) U/L,respectively,and the difference was statistically significant (P =0.032).Among the 59 AHI patients,44 patients' liver function returned to normal,4 patients' liver function improved,and 11 patients died,of whom 9 (81.8％) developed liver failure.Conclusion AHI induced by intravenous amiodarone is an acute onset and severe disease with a short incubation period,and should be monitored timely.

Objective To explore the impact of intermittent androgen deprivation therapy on prostate volume and lower urinary tract symptoms (LUTS) in patients with prostate cancer combined with prostatic hyperplasia (BPH),and to evaluate the clinical effect of intermittent androgen deprivation therapy as compared with conventional drug in patients with BPH.Methods Patients with prostate cancer (n=57) and BPH (n=83) were respectively treated with intermittent androgen deprivation therapy and finasteride combined with alpha-receptor antagonist.Prostate volume,international prostate symptom score (IPSS),quality of life index (QOL) and maximum urinary flow rate (Qmax) in patients were observed before and 1,3,6 and 12 months after treatment.Results The improvements in prostate volume,IPSS,QOL and Qmax were higher in prostate cancer patients treated with intermittent androgen deprivation therapy than in BPH patients treated with finasteride combined with alpha-receptor antagonist (P ＜ 0.05).Conclusions Intermittent androgen deprivation therapy can significantly reduce prostate volume and improve LUTS in patients with prostate cancer,and has a better clinical effect than finasteride combined with alpha-receptor antagonist treatment.

Objective To explore the value of the ultrasound contrast agent in conjunction with advanced contrast imaging techniques in the evaluation of the renal cortical perfusion. Methods The animal model was established with ligating renal artery to cause the renal cortical perfusion decrease of rabbits. Real-time harmonic gray scale imaging was performed to visualize the contrast enhancement of the renal cortex. After bolus injection of contrast agent SonoVue, dynamic image was observed and recorded during the first three minutes. According to the time-intensity curve (TIC), accelerating time (AT),Peak intensity (A), time to half of peak intensity (T), difference between peak and base (PBD), slope rate of the curve (β) and the product of A and β (A·β) were obtained before and after the renal artery operation. The t test and correlation analysis was used to examine the above parameters. Results Before the renal artery operation, renal cortex enhanced rapidly and obviously, the way of the enhancement was renal artery-cortex-pyramids. After ligation of renal artery, AT prolonged evidently (P<0.001), A decreased obviously (P<0.001), T obviously shortened (P<0.001), PBD decreased markedly (P<0.001), while the decline of βinduced (P<0.002) and A·βobvious dropped(P<0.001). AT, BPD and A·βcorrelated with stenosis level of renal artery. Compared with 31%－69% group, AT prolonged evidently (P<0.001). A decreased obviously (P<0.029), PBD decreased obviously (P<0.001), A·β was dropped markedly (P<0.02) in 70%-93% stenosis group. Conclusions Contrast agent combining with developed contrast specific imaging is able to detect changes of renal cortical microcirculation sensitively with the help of analysis of TIC.

Objective To investigate the effects of acupoint massage on labor analgesia efficacy and it's related clinical factors,so to definite the analgesia mechanism and the relationship between the neurotransmitter dopamine and analgesia mechanism.Methods We choosed patients who have been hospitalized in No.1 hospital from March 2009 to September 2009,and divided them into two groups randomly: observation group and control group.Patients in the observation group were treated with acupuncture massage when the production process went into the active phase.Control group indicated that childbirth was naturally without any treatment.We observed the analgesic effect of point massage and the impact of pressure on the uterine contractions.We tested the dopamine level in the blood by fluorescent spectrophotometry before and afte the acupoint massage.We explored the effects of the point massage on the dopamine level in the puerpera.Results The observation group′s pain decreased more than that of the control group.The intensity of contractions in observation group was decreased more obvious than that of the the control group.The serum dopamine levels was significantly lower than that pre-massage(P

0.05). The main toxicities were well tolerated and consisted of leukopenia,nausea/vomiting and peripheral neuritis. Grades Ⅲ-Ⅳ nausea/vomiting,renal toxicity and cardiac insufficiency occurred more frequently in the control group,peripheral neuritis occurred more frequently in the study group (P