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<p><b>OBJECTIVE</b>To analyze the etiology, clinical features and prognosis of liver injuries caused by different drugs.</p><p><b>METHODS</b>The types of suspected drugs related to liver injury, clinical manifestations, liver biochemical parameters, clinical outcomes and other associated data were retrospectively assessed for 140 patients with drug-induced liver injury (DILI). The Roussel Uclaf Causality Assessment Method (RUCAM) was used to assess the causality between drugs and liver injury.</p><p><b>RESULTS</b>The most prevalent agents inducing DILI were Chinese traditional drugs (62.1%), followed by antipyretic analgesic drugs (10%) and antibiotics (5%). The ratio of male to female patients in the study cohort was 1:1.69, with 71 of the total patients (50.7%) being between the ages of 40 and 60 years-old. The RUCAM scale was not less than 3 points for any of the patients.In general, the clinical manifestations and biochemical results were not specific. The percentages of hepatocellular injury type, cholestatic injury type and mixed injury type were 51.4%, 30.7% and 17.9% respectively. The median age of patients with cholestatic liver injury was 55.6 years, which was older than that of patients with hepatocellular injury (47.1 years) or mixed injury (49.9 years).</p><p><b>CONCLUSION</b>Although antipyretic analgesics and antibiotics are considered as common drugs that can induce DILI, Chinese traditional drugs have emerged as another important group of liver injurious agents. Cholestatic DILI was found to occur more often in elderly patients than in younger patients.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anti-Bacterial Agents , Chemical and Drug Induced Liver Injury , Cholestasis , Medicine, Chinese Traditional , Prevalence , Prognosis , Retrospective StudiesABSTRACT
Objective To investigate the epidemiological and clinical characteristics of an outbreak of tsutsugamushi disease in Chuzhou region, Anhui Province, and to clarify the new changes of epidemic focus of tsutsugamushi disease in China. Methods Field epidemiological investigation and analysis of clinical features were done. The detections of specific antibodies against Rickettsia tsutsugamushi were conducted to diagnose tsutsugamushi disease using colloidal gold immunochromatography assay combined with Well-Felix reaction. The geomorphic and climatic characteristics of the new epidemic focus were investigated. Results The outbreak occurred from October to November, 2007. The epidemic focus located on mountainous brushland regions, and the air temperature fluctuated from 20-4 ℃. Nineteen cases of tsutsugamushi disease in the new-found epidemic focus were finally diagnosed, 9 cases out of them were hospitalized, another 9 had recovered when diagnosed by serological tests; the remaining one had classical manifestations of tsutsugamushi disease but did not receive the serological test for certain cause. The main clinical symptoms were chilly in 14 cases, fever in 19 cases, headache in 15 cases; among the 9 hospitalized patients, the symptoms were lymphadenectasis in 8 inpatients, skin rash in 7 inpatients, splenomegaly in 4 inpatients and skin eschar and ulcer in 7 inpatients and Weil-Felix reaction by OXκantigen positive in 4 cases; the specific antibodies against Rickettsia tsutsugarnushi of 18 tested cases were all positive. No severe complications occurred in all patients. Before the first case was identified, all other cases were not diagnosed in time and did not receive correct antibiotic treatment. Nine hospitalized patients recovered rapidly with the treatment of doxycycline. Conclusions The outbreak of tsutsugamushi disease in Anhui Province in 2007 is type of emerged in autumn and transitional epidemic focus. There is epidemic focus of tsutsugamushi disease in northern region of Anhui Province. Doxycycline is rapid and effective for the treatment of tsutsugamushi disease.
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Objective To establish immortalized B lympho-blastcell line(LCL) from patients with hepatitis B virus(HBV) infection in vitro.Methods Immortalized B-lymphoblastoid cell lines were established by EB virus transformation of the peripheral blood B lymphocytes and Cyclosporin A(Cys A) restraining T cells.HLA-A gene were measured in blood mononuclear cells by PCR-SSP.Results Altogether 16 immortalized lymphoblastoid cell lines were established successfully in vitro.HLA-A alleles were detected,including 1101,0201,0101,2403,et al.Conclusion The LCLs by EB virus transformation provides a resource of target cell for further research on the cellular immunity of patients with HBV infection.
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Objective To investigate the effects of HBcAg-specific CD8+T cells on inhibiting HBV replication in vitro,and to search the cytokine of noncytolytic mechanisms in viral clearance. Methods By the method of coculture of HepG2.2.15 cell (target cells) with HLA-A2 matched HBcAg-specific CD8+T cell clone (effector cells) at E:T ratios of 1:50,and monitoring HBV production (HBsAg,HBeAg,and HBV-DNA)in coculture supernatants at 24h,48h and 72h,the percentage of decrease in HBV replication level was observed. Furthermore,blocking experiment with neutralizing mAbs to IFN-? was performed to evaluate the effect of this cytokine. Results CD8+T clone produced high levels of IFN-?following coculture with 2.2.15 cells. HBsAg,HBeAg and HBV-DNA in coculture supernatants were significantly reduced,and the greatest effect was observed at 72h by 54.55%,50.36% and 74.55%,respectively. The reduction of HBV DNA was decreased followed by using neutralizing mAbs to IFN-?. The maximum activity of cytotoxicity of target cells was at 24h by 15.66%. Conclusion ①HBV-specific CD8+T cells inhibit HBV replication by cytolytic and noncytolytic mechanisms.②The effect of noncytolytic mechanisms is mainly mediated by IFN-?.
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Thirty-four patients with severe chronic active viral hepatitis were divided into 2 groups. One group was treated with prostaglandin E_1, (PGE_1,) and supportive therapy, and the other was treated with supportive therapy only and served as the control. The effects of PGE_1, on plasma lipid peroxides (LPO) level, plasma prostacyclin (PGI_2) and thromboxane A_2 (TXA_2), plasma cyclic nucleotide and liver function were determined to investigate the mechanism of PGE1. It was found that PGE_1 could achieve the following effects.1. Reduction of plasma LPO level (P