ABSTRACT
Objective To analyze and summarize the clinical data of drug -induced liver injury (DILI), and to investigate the clinical features and prognosis of DILI.Methods A retrospective analysis was performed for the clinical data of 95 patients with DILI who were admitted to The First Affiliated Hospital of Xi′an Medical University from February 2010 to February 2016, including sex, age, medication history,underlying diseases, clinical manifestation, laboratory and imaging findings, treatment, and prognosis.A logistic regression analysis was used to investigate the influencing factors for prognosis .Results Respiratory system diseases ranked first among the underlying diseases treated by drugs that caused DILI and accounted for 25.26% (24/95), and of all patients, 23.16% (22/95) had tuberculosis.Among the drugs that caused DILI, traditional Chinese medicine ranked first and accounted for 44.21% (42/95), followed by antitubercular agents which accounted for 22.11% (21/95).DILI often occurred within 15 -30 days of medication.Poor appetite was the most common symptom of DILI, and jaundice was the most common positive sign .Elevated alanine aminotransferase was the most common laboratory result of DILI .Acute hepatocellular injury type was the most common type of DILI .Most DILI patients had good prognosis, and patients with response to treatment accounted for 95.79% (91/95), including those who were improved or cured .Age (odds ratio [OR] =0.054, 95% confidence interval (CI): 0.002 -0.076, P =0.037), alkaline phosphatase (OR =0.004, 95% CI: 0.001 -0.006, P =0.043), total bilirubin (OR =0.028, 95% CI: 0.001 -0.039, P =0.035), and direct bilirubin (OR =0.008, 95% CI: 0.001 -0.014, P =0.036) were independent risk factors for prognosis .Conclusion DILI does not have specific clinical manifestations and can easily be missed or misdiag - nosed.Clinicians should use drugs rationally, monitor the presence of hepatotoxicity , and strengthen the public health education on safe medication.
ABSTRACT
ABSTRACT:Objective To evaluate the clinical therapeutic effect and safety of tumor necrosis factor alpha (TNF-α)blockers in treating moderately to severely active ulcerative colitis (UC)by meta-analysis.Methods Such databases as the Cochrane Central Register of Controlled Trials,PubMed,OVID,Embase,ISI,CBM,CNKI, VIP,and WanFang Data were searched from establishment to June 2013.All randomized clinical trials (RCTs)on tumor necrosis factor alpha blockers in treating UC were collected,and then selected on the basis of the inclusion and exclusion criteria.We assessed the methodological quality,extracted the data from the included articles and performed the meta-analysis with Revman 5.1.Results A total of 13 RCTs involving 3334 patients were analyzed.TNF-αblockers group was superior to the control group in the short-term clinical response (OR =2.5 1, 95% CI 1.73,3.64),short-term clinical remission (OR =2.74,95% CI 1.80,4.1 6),long-term clinical response (OR =2.98,95% CI 1.98,4.47),1ong-term clinical remission (OR =2.64,95% CI 1.89,3.67),and mucosal healing (OR =1.89,95% CI 1.39,2.59)compared with control group.TNF-αblockers could also reduce the rate of colectomy (OR =0.61,95% CI 0.41,0.89)and improve inflammatory bowel disease questionnaire scores (MD=14.74,95% CI 1 1.43,18.06 ).There was no significant difference between the two groups in all reported adverse effects (OR =1.14,95% CI 0.97,1.34)and serious adverse effects (OR=0.78,95% CI 0.56,1.09).Conclusion Compared with conventional therapy or placebo,TNF-αblocking agents can improve the therapeutics effect on UC in clinical response,clinical remission and mucosal healing,and also can reduce the rate of colectomy. In patients with moderately to severely active UC treated with TNF-α blocking agents,it is easier to achieve the improvement of life quality.TNF-αblocking agents treatment is safe for UC.This conclusion should be verified with more large-scale and high-quality RCTs.
ABSTRACT
Objective To study the therapeutic effects and mechanism of Sodium Fendate(SF) on rats with severe acute pancreatitis(SAP) induced by L-arginine. Method A total of 60 adult SD rats were randomly and e-qually divided into control group, SAP group and SF group, with 20 rats in each group. The rat model of SAP wes established by injecting 2.5 g/kg L-arginine at a dose of intraperitoneally twice at an interval of 1 hour, and rats in SAP group and SF groups were administrated intraperitoneally with 20% L-arginine solution(2.5 g/kg×2) twice at an interval of 1 hour; rats in control group were injected intraperitoneally with the same volume of physiological saline twice alone.At 5 minutes after L-arginine administration,rats in SF group were injected with SF solution (100 mg/kg, qd×3 d) via the tail vein, and rats in the other two groups received a sham injection of the same volume of physiological saline alone. The characteristics of ascites, the pathological changes of pancreatic tissue and the serum levels of amylase(AMY), endothelin-l(ET-1), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and the contents of malonaldehyde (MDA), suede dismutase (SOD), reduced glutathioue (GSH) of pan-creatic tissue of rats and prognosis were compared at 72 hours after L-arginine administration. Measurement data were evaluated by oue-way ANOVA, and numeration data were assessed by Fisher' s exact test. P<0.05 was considered statistically significant. Results Compared with control group,at 72 hours after L-arginine administra-tion,rats in SAP group presented characteristically histopathological changes of SAP with significantly higher serum levels of AMY, ET-1, TNF-α, IL-6 and MDA of pancreatic tissue[(9715.5±301.3) IU/L vs. (729.2±134.2) IU/L;(25.32±3.67) ng/L vs. (14.32±2.69) ng/L;(102.95±11.24) ng/L vs. (38.62±3.87) ng/L; (538.63±9.53) ng/L vs. (186.35±1.19) ng/L;(34.8±3.9) mol/kg vs. (8.1±2.1) mol/kg, all P< 0.01], and lower GSH and SOD in the pancreatic tissue[(7.1±0.6) mg/kg vs. (16.9±1.9) mg/kg; (6423± 1978) kU/kg vs. (29905+2945) kU/kg,both P<0.01].Compared with SAPmodel group,at 72 hours after ad-ministration of L-arginiue, the pathological lesions of SAP in rats of SF group were significantly alleviated with lower pathological scores (P<0.05), lower serum levels of AMY, ET-1 ,TNF-α,IL-6 and MDA in the pancreatic tissue [(8104.6±149.9) IU/L vs. (9715.5±301.3) IU/L; (20.26±5.86) ng/L vs. (25.32±3.67) ng/L; (84.19±15.14) ng/L vs. (102.95±11.24) ng/L;(458±5.37) mol/kg vs. (538.63±9.53) rig/L;(28.3±2.5) moL/kg vs. (34.8±3.9) mol/kg,all P<0.05], and higher SOD and GSH in the pancreatic tissue[(8.5 ±1.4) mg/kg vs. (7.1±0.6) mg/kg;(10 316±2810) kU/kg vs. (6423±1978) kU/kg, both P<0.05].At 72 hours the death rate in SF group was lower than that in SAP group,but the difference had no significance (P= 0.2.5). Conclusions SF can scavenge oxygen-derived free radicals, upgrade the contents of SOD and GSH of pancreatic tissue,decrease the levels of serum proinflammatory cytokines and ET-1, ameliorate the pathological le-sions of pancreatic tissue in rats,and has the capability of decreasing death rate, so it possesses a distinct advantage for the treatment of SAP.
ABSTRACT
Objective To observe the effect of Tanshinone ⅡA on proliferation and apoptosis of human gastric adenocarcinoma cell line SGC-7901 and its mechanism.Methods The human gastric adenocarcinoma cell line SGC-7901was cultured in vitro and with Tanshinone ⅡA at various concentrations.Cytotoxicity was valuated by MTT assay,apoptosis-related alterations in morphology were ascertained by transmission electron microscopy.The cell cycle distribution and the apoptotic rate were investigated by flow cytometry.SGC-7901 cell apoptosis with nuclear chromatin concentration and fragmentation as well as cell shrinkage and the formation of apoptotic bodies were observed by TEM.Results The growth of SGC-7901 cells was inhibited significantly in a dose-dependent manner.Tanshinone ⅡA could induce the apoptosis in time-dependent manner.Conclusion Tanshinone ⅡA has effect in inhibiting SGC-7901 cells and inducing the apoptosis.The apoptotic rate and percentage of cells in G1 phase increased in the SGC-7901 cells treated by Tanshinone ⅡA.
ABSTRACT
Objective To explore the relationship of the microvessel density(MVD) and the expression of vascular endothelial cell growth factor(VEGF) with the pathological types and clinical stages of gastric cancers.Methods The MVD and expression of VEGF in 45 patients with gastric cancer were assayed by using SP immunohistochemical method.The relationship of the MVD and VEGF with the pathological TNM types and clinical stages of gastric cancer was analyzed.Results In the marginal area where the gastric cancer grew actively,the microvessel density(MVD) was the highest;the expression of vascular endothelial cell growth factor(VEGF) in the cancerous cell plasm was significantly higher than that in the neighboring noncancer tissues(P
ABSTRACT
Objective To investigate the expression of indu ci ble initric oxide synthase(iNOS) in gastric carcinoma and its relationship with angiogenesis and the prognosis. Methods Immunohistochemical staining method was used to det ect the expression of iNOS, VEGF CD34 in gastric carcinoma. Results The positive expression of iNOS in gastric carcinom a was 58.70% and iNOS was not detected in normal gastric tissue. The rate of the positive expression of iNOS in stage Ⅳ was higher than that in stageⅠ～Ⅲ. Th e positive expression of iNOS in gastric carcinoma with lymph node metastasis wa s higher than those with no metastasis. The MVD was 59.88? 18.02/HP and 55.5 9+ 19.39/HP in gastric carcinoma positive for iNOS and VEGF, repectively, obviou sly higher than those with negative expression of iNOS and VEGF, repectively ( P
ABSTRACT
Objective To investigate the effect of H.pylori infection on cyclooxygenase-2(COX-2)expression in gastric antral mucosa. Methods The expression of COX-2 in 20 patients with H.py lori -infected chronic gastritis and in 14 with uninfected chronic gastritis w ere investigated by immunohistochemical method. The expressions of COX-2 in the antral mucosa were compared before and after H.pylori eradication. Results The mean percentage of the cells stained with COX-2 was s ignificantly higher in H.pylori -infected mucosa than that in uninfected mucosa ( P
ABSTRACT
Objective To evaluate the relationship between the expression of cyclooxygenase-2(Cox-2) and inducible nitric oxide synthase (iNOS) and the angiogenesis in gastric carcinoma. Methods Immunohistochemical stain was used to detect the expression of Cox-2, iNOS and MVD in 45 resected specimens of gastric carcinoma. The monoclonal antibody against CD34 was used for displaying vascular endothelial cells, and MVD was detected by counting the CD34-positive vascular endothelia cells. Paracancerous tissues were examined as the control. Results The expression rates of Cox-2, iNOS and MVD in gastric cancer were significantly increased, compared with those in the paracancerous tissues (77.78% vs. 33.33%, 68.89% vs. 17.78%, 58.13?19.99 vs. 24.02?10.28, P