Objective:To explore the drugs and clinical characteristics causing drug-induced liver injury (DILI) in recent years, as well as identify drug-induced liver failure, and chronic DILI risk factors, in order to better manage them timely.Methods:A retrospective investigation and analysis was conducted on 224 cases diagnosed with DILI and followed up for at least six months between January 2018 and December 2020. Univariate and multivariate logistic regression analyses were used to identify risk factors for drug-induced liver failure and chronic DILI.Results:Traditional Chinese medicine (accounting for 62.5%), herbal medicine (accounting for 84.3% of traditional Chinese medicine), and some Chinese patent medicines were the main causes of DILI found in this study. Severe and chronic DILI was associated with cholestatic type. Preexisting gallbladder disease, initial total bilirubin, initial prothrombin time, and initial antinuclear antibody titer were independent risk factors for DILI. Prolonged time interval between alkaline phosphatase (ALP) and alanine aminotransferase (ALT) falling from the peak to half of the peak (T 0.5ALP and T 0.5ALT) was an independent risk factor for chronic DILI [area under the receiver operating characteristic curve (AUC)?=?0.787, 95%CI: 0.697~0.878, P ?

BACKGROUND: Dabrafenib+Trametinib/Dabrafenib targeted therapy has been approved for V-RAF murine sarcoma viral oncogene homolog B1 with amino acid substitution for valine at position 600 (BRAF V600E) in lung cancer patients, however, the targeted therapy strategy for lung cancer patients with BRAF non-V600E mutations has not been determined yet. This study intends to explore the efficacy of targeted therapy for BRAF non-V600E mutant lung cancer, and provide a reference for clinical treatment. METHODS: Computer search of PubMed, Cochrane Library, Embase, Web of Science, Clinicaltrials.gov, CBM, CNKI, Wanfang database. Collect the relevant literature relevant on the targeted therapy of BRAF non-V600E mutant lung cancer, and conduct a descriptive analysis of the included literature. RESULTS: There were 10 articles that met the inclusion criteria, including 3 cohort studies and 7 case reports. 18 patients with BRAF non-V600E mutant lung cancer were ineffective to vermurafenib; 1 patient obtained partial response (PR) after applying vermurafenib, 5 patients did not respond to BRAF inhibitors; 9 patients showed a potential clinical benefit rate of 34% after monotherapy with trametinib; 7 patients have different degrees of benefit from dabrafenib and trametinib on progression-free survival (PFS); 1 patient is effective to sorafenib. CONCLUSIONS At present, there is no standard treatment specification for BRAF non-V600E mutation targeted therapy. The challenge lies in the heterogeneous mutation of BRAF gene. Different mutation types respond differently to targeted therapy. In addtion, real-world research evidence is scarce, so it is necessary to carry out further large-sample high-quality research to provide reference for clinical practice.
Animals ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Humans ; Lung Neoplasms/genetics* ; Mice ; Mutation ; Protein Kinase Inhibitors/therapeutic use* ; Proto-Oncogene Proteins B-raf/genetics*

Objective: To compare the efficacies of two training protocols, i.e. the multimedia instruction and the conventional method, in periodontal surgery teaching for undergraduate students. Methods: One hundred and twenty-three dental undergraduates in their pre-clinical training course were recruited and divided into two groups according to the learning grade matching principle: the experimental group (multimedia instruction, 60 students) and the control group (conventional method, 63 students). The teaching aim was to train the students gingivectomy and periodontal flap surgery by using the pig jaws. The conventional teaching method of teacher-demonstrating and student-practicing was used in the control group, and the practice time of the students′ for each surgery was 45 minutes. A standardized teaching video combined with the teachers′ explanations of the key steps was used in the experimental group. The students′ practice time for each surgery was 60 minutes. The efficacy of teaching protocol was evaluated by the teachers according to the scoring criteria set by the teaching group. Results: In gingivectomy training, accuracy of fixed points, angle of postoperative gingival margin and morphology of gingiva of the experimental group were better than those of the control group. The experimental group also had more complete and continuous excised gingivae and more thorough adjacent gingival removal. The total scores of the experimental group were significantly higher than those of the control group (92.8±2.6 vs. 89.9±3.7, P<0.05). In periodontal flap surgery training, the experimental group operated the blade around the shape of the tooth better in internal bevel incision than the control group. Additionally, the incision position of internal bevel incision, periosteal integrity after flapping and flap depth of the experimental group were better than those of the control group. Besides, the experimental group had smoother flap edge and more thorough debridement. The total scores of the experimental group were significantly higher than those of the control group (92.2±4.1 vs. 89.2±4.4, P<0.05). Conclusions The teaching efficacy of multimedia instruction was better than that of the conventional method. Its value needs to be further tested in future teaching practice.

Objective To compare laparoscopic Keyhole parastomal hernia repair with re-ostomy technique or without re-ostomy in the treatment of stoma hernia,then analyze the advantages of reconstruction ostomy,and summarize the key technical points of the reconstruction operation.Methods From Jan 2010 to Dec 2016,68 stoma hernia patients underwent laparoscopic Keyhole parastomal hernia repair with reostomy technique,52 patients underwent laparoscopic Keyhole parastomal hernia repair without re-ostomy technique.The preoperative,intraoperative and postoperative parameters were analyzed.Results Compared to without re-ostomy group,the re-ostomy reconstruction group had low incidence rate of intestinal fistula (x2 =5.411,P =0.033),patch infection (x2 =6.823,P =0.014),the incidence of postoperative serous swelling and serum swelling (x2 =14.266,P ＜0.001),postoperative recurrence (x2 =8.688,P =0.005) and postoperative appearance dissatisfaction (x2 =9.479,P =0.004).Conclusion Laparoscopic parastomal hernia repair and re-ostomy technique reduces the incidence rate of intestinal fistula,patch infection and serous swelling and serum swelling,decreases the postoperative recurrence rate and appearance dissatisfaction.

BACKGROUNDBased on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs.

METHODSThe Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation.

RESULTSA total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).

CONCLUSIONWe first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Disease ; Female ; Health Status ; Humans ; Male ; Veterans ; statistics & numerical data

Objective To research the expression of the estrogen receptor alpha ( Erα) and estrogen receptor beta ( Erβ) in uvea tissues of the female rats, and to provide molecular biology data for further studies of the relation estrogen to uvea diseases. Methods Twenty-two adolescent SD female rats were selected. All rats were killed by dislocation of cervical vertebra, the eyeballs were in paraffin imbedding and made to a series of sections, using immunohistochemical method;Erα and Erβ distribution were investigated in uvea tissue of rats;and quantitied by Tanaka scores analytical method. The uteri of rats was used as positive control and PBS as negative control. The level of estradiol in serum of the rats were examined by radioimmunoassay. Results The expression level of Erβ was moderate or highter in stroma cell, anterior pigment epithelium as well as pasterior pigment epithelium of the iris, unpigmented epithelium, pigmented ciliary epithelium and vascular endocemet of the choroid layers. But Erα was not obviously expressed in uvea tissues. The expression rate of Erβ was higher than Erα in these tissues(P＜0.05). Immnoreactivity positive substance was granule, which was distributed in the cytoplasm or in the nucleus. The level of estradiol in serum of the rats was (22.13±3.54)ng/L.Conclusion The expression of either Erα or Erβ in uvea tissues of rats is mainly in Erβ. The results indicate that uvea tissue is regulated directly by estrogen throught Erβ.

Objective To investigate the expression and clinical significance of the estrogen receptor beta isoforms and survivin in thyroid tumors. Methods The pathological data of 125 patients with thyroid tumors were, collected from june 2003 to june 2007 in our institution, including thyroid carcinoma (86 cases), thyroid follicular adenoma (39 cases) and normal thyroid tissue (10cases). SP immunohistochemistry was used to measure the expressions of ERβ and survivin in the thyroid tumors. Results ERβ not only was detected in the thyroid epithelial cell plasma and nuclear, but also in the stroma. The positive rate of ERβ in cases with thyroid carcinoma, adenoma and normal thyroid tissue were 83.72 %, 51.28 % and 20.00 % respectively. There was significant difference between carcinoma and the adenoma or normal thyroid tissue (P<0.05). The positive rate of survivin in cases with carcinoma, adenoma and normal thyroid tissue were 59.30 %, 17.95 % and 0 respectively. There was significant difference between carcinoma and the adenoma or normal thyroid tissue (P<0.05). The expressions of ERβ and survivin correlated with TNM staging and lymph node metastasis of thyroid carcinoma (P<0.05). Conclusion ERβ may play a role in accelerating proliferation in the occurrence of the thyroid carcinoma. The expressions of ERβ and survivin are related to invasion and metastasis of thyroid carcinoma.

OBJECTIVE: To investigate the expression of fibroblast growth factor-2 (FGF-2) and osteopontin (OPN) in non-small cell lung cancer (NSCLC) tissues and analyze the correlation between FGF-2 and OPN. METHODS: Immunohistochemical SP method was used to detect the expression of FGF-2 and OPN in 76 patients with NSCLC and 15 normal lung tissues. The effect of FGF-2 on OPN expression at mRNA and protein level in A549 cell was examined by RT-PCR and Western blot. RESULTS: The positive expression of FGF-2 (65.8%) and OPN (60.5%) in the NSCLC tissues was significantly higher than that in the normal lung tissues (13.3% and 0, respectively ) (P<0.01). The expression of FGF-2 and OPN was closely related to TNM stages and the lymph node metastasis (all Ps<0.01), but not to histological types, sex, and age of NSCLC patients (all Ps>0.05).A positive correlation was found between the expression of FGF-2 and OPN in NSCLC (r=0.552,P<0.01). The expression of OPN protein and mRNA was up-regulated by FGF-2 in A549 cells. CONCLUSION The overexpression of FGF-2 and OPN is related to the metastasis and invasion of NSCLC.FGF-2 may promote the metastasis and invasion of NSCLC depending on the upregulation of OPN expression.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Female ; Fibroblast Growth Factor 2 ; genetics ; metabolism ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Osteopontin ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism

Objective To assess the efficacy and safety of dl-3-butylphthalide on the treatment of acute ischemic stroke. Methods A total of 197 patients who were in the period of 72 hours of first attack of ischemic stroke of internal carotid artery with NIHSS from 5 to 25 scores were enrolled in this multi-center, randomized, double-blind and aspirin-control study. Compound " Dan Shen" was used as a baseline therapy. Results Basical recovery plus significant improvement was seen in 74.7% of the patients in dl-3-butylphthalide group and 60.9% in aspirin group (CMH value 4.0,P=0.047);There was a significant improvement for dl-3-butylphthalide group regarding NIHSS total score, total score difference value and Barthel index on the day 11th and 21st after treatment compared with control group. The main adverse reaction of dl-3-butylphthalide was increased aminotransferase and mainly the slight increase of aspartate aminotransferase, by 4.34% and 0 respectively. Conclusion dl-3-butyiphthalide should be regarded as an effective and safe treatment for ischemic stroke and a treatment without severe side effects.

Aim To investigate the influences on the aortal structure of rats with long-term high fat forages diet.Methods 14 SD rats were divided into two groups:the control group and the test group. The test rats were fed with high fat forages.12 weeks later, the aortas of the rats were observed with a light microscope, transmission electron microscope(TEM) and scanning electron microscope (SEM).Results In the test group, the aortic tunica intima thickening, endotheliocyte injury and monocyte adhesion were found with a light microscope; the elastic lamina being broken and the smooth muscle cells proliferated. Under TEM, the endothelial cell membrane of the aorta in the test rats was destroyed and appeared to be worm-eclipsed shape.Mitochondria exhibited swelling,vacuole degeneration and its cristae was dissolved, broken or some disappeared.Rough endoplasmic reticula (RER) expanded. The endothelial cell spaces were enlarged and the cell junctions deformed. Monocytes adhering to the endothelial cell stretched out pseudopodia and intruded into the endothelial crevice and the subendothelial layer. Some basement membranes completely sloughed following with endothelial cell. ERE and ribosomes increased in smooth muscle cells. SEM observation showed that the endothelial cells became swelling and the surface of endothelial cell was worm-eclipsed or crater shape. There were deeper crevices between endothelial cells.Conclusions Long-term high fat forages diet can induce injury of the endothelium and elastic lamina, adhesion of the monocytes and its intrusion into endothelial layer and subendothelial layer, proliferation of the subendothelial layer and smooth muscle in the aorta of rats.