Metabolomic screening for diagnostic biomarkers of drug-induced chronic liver injury related cirrhosis / 药学学报

About 15%-20% of drug-induced liver injury (DILI) will progress to chronic manifestation (CH-DILI), which sometimes advances rapidly to liver cirrhosis (LC-DILI) within 0.5-1 year with deteriorative clinical prognosis. Therefore, it is important to find a non-invasive diagnosis for early detection of liver cirrhosis. In this study, the metabolomic profiles revealed significant differences in the metabolites from the plasma of LC-DILI versus CH-DILI. We found 35 differential metabolites through principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Through pathway enrichment analysis, some up-regulated metabolic pathways reflected impaired liver functions such as bile acid, lipid synthesis and decomposition during cirrhosis. Five biomarkers were found to exhibit effective diagnosis value (AUC > 0.6), including phosphatidylcholine, lysoPC (18:1 (9Z)), creatine, taurochenodeoxycholic acid and taurocholic acid. Furthermore, we found that the relative content ratio between phosphatidylcholine and lysoPC (18:1 (9Z)) had a better distinguishing ability (AUC = 0.867). The relative content ratio also had the feature to reduce systematic errors of sample processing and instrument detection, therefore having a greater value for clinical application.

Practice and Reflection of Intelligent Construction in Our Hospital Pharmacy / 现代医院

Objective To provide referential information for intelligent construction in hospital pharmacy. Methods Combined with the practical application, this paper introduces the practice and experience of the intelligent construction of pharmacy in our hospital. Results The construction of intelligent hospital pharmacy improves the drug management level, improves work efficiency and increases the accuracy of the drug dispensing, increases medication guide time, improves patient compliance and satisfaction and reduces the work intensity of pharmacists. Conclusion The intelligent construction of hospital pharmacy has promoted the development of pharmacy and laid a good foundation for the comprehensive and in-depth development of pharmaceutical care.

Metabolomic study on the hepatotoxic or hepatoprotective effects of rhubarb to normal or hepatic fibrosis rats / 药学学报

Focusing on the TCM-related adverse drug reactions, especially those conventionally non-toxic TCM induced hepatotoxicity, this paper has proposed and established the disease-syndrome-based toxicology evaluation pattern and approach for TCM, not only the normal rats, but the hepatic fibrosis model rat were studied hepatotoxic or hepatoprotective effects of rhubarb, meanwhile liver histopathology changes by histological tests such as HE and TUNEL staining. The metabolomics analysis method will be employed to screen the key metabolites and possible metabolic pathway of the dual effects of rhubarb in rats. The results showed that rhubarb could result in significant liver injury in normal rats, indicated by the elevation of plasma serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities (P L-arginine, creatine, L-valine, retinyl ester, and prostaglandin F2α were confirmed by multivariate statistical analysis and metabolic pathways enrichment analysis linked to six metabolic pathways, including taurine and hypotaurine metabolism, primary bile acid biosynthesis, arginine and proline metabolism, arachidonic acid metabolism, retinol metabolism and valine, leucine and isoleucine biosynthesis. In summary, the results suggested the dual effects of rhubarb screened by taurine and hypotaurine metabolism, primary bile acid biosynthesis and arginine and proline metabolism may be the key metabolic pathway related to You Gu Wu Yun phenomenon of rhubarb. This study will provide new vision and illustration of scientific evidences for the hepatotoxicity assessment and rational use of those drugs containing anthraquinones.

Clinical Observation of Tripterygium Glycosides Combined with Valsartan in the Treatment of Idiopathic Membranous Nephropathy / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of tripterygium glycosides combined with valsartan in the treatment of idiopathic membranous nephropathy(IMN). METHODS:A total of 85 patients with IMN were enrolled and randomly divided into observation group(42 cases)and control group(43 cases). Based on routine treatment(reducing lipid,anti-platelet ag-gregation,protein dietary restriction),control group was additionally given oral valsartan,with initial dose of 80 mg/d,and gradu-ally adding the amount to 160 mg/d if there was no obvious ADR;based on control group,observation group was additionally giv-en Tripterygium glycosides tablet 40 mg,tid,and reducing the amount to 20 mg,tid after complete remission. 2 groups were treat-ed for 12 months. RESULTS:Total effective rate of observation group was 92.86%,which was significantly higher than that of con-trol group(74.42%),with statistical significance(P<0.05). Compared with before treatment,the levels of 24 h urine protein,TC and TG of 2 groups were decreased after treatment,and serum albumin(ALB)of observation group increased;24 h urine protein and TG of observation group was lower than control group,while the serum level of ALB was higher than control group,with sta-tistical significance(P<0.05 or P<0.01). No obvious ADR was found in 2 groups. CONCLUSIONS:Tripterygium glycosides com-bined with valsartan can improve the kidney function and blood lipid level of IMN patients with high safety.

Effects of optic disc topography and retinal nerve fiber layer thickness measurement by spectral-domain OCT on diagnosis of glaucoma / 中华实验眼科杂志

BackgroundGlaucoma is an optic neuropathy caused by structural damage of the optic nerve,and its early diagnosis is critical for arresting the irreversible damage of visual function. Optical coherence tomography (OCT) allows an early diagnosis of glaucoma by the measurements of the optic disc and retinal nerve fiber parameters. Objective This study was carried out to evaluate the effects of optic disc tomography and the measurement of the retinal nerve fiber layer (RNFL)thickness by spectral-domain OCT on the diagnosis of glaucomatous eye. MethodsIt was a noninterventional, cross-sectionalstudy. The optic disctopographic parameters and total and regional RNFL thickness were measured by RTVue OCT in 62 normal eyes and 67 glaucomatous eyes. The area under the receiver operating characteristic curve( ROC ) was used to assess the ability to differentiate glaucoma eyes from normal eyes of each testing parameter. This trial complied with the Helsinki Declaration and was approved by the Clinical Trial Ethic Committee of Beijing TongrenHospital. All of the participants signed the written informed consent before any medical examination. Results In the comparison of demography ,the ages of patients, the mean deficiency( MD ) and pattern standard difference( PSD ) of perimetry were obviously larger in the glaucoma group, primary open angle glaucoma ( POAG ) group and primary closure-angle glaucoma(PACG) group than those of normal controls( P＜0. 01 ). No significant differences were found in the disc area between a total glaucoma group, POAG group or PACG group and normal group ( P =0. 101,0. 741 and 0. 652, respectively) ;however, the average RNFL thickness between normal eyes and glaucomatous eyes were significantly different( 109. 758 μm versus 79. 539 μm, P＜0. 01 ). Among the eight regions around the optic disc, the thickest RNFL located at the inferotemporal( 150. 109 μm) and superotemporal( 146. 105 μm) regions in normal eyes,and at the superotemporal( 104. 354 μm) and inferotemporal( 102. 436 μm) regions in glaucomatous eyes. Both in normal and glaucomatous eyes,the thinnest RNFL located at the nasal(NU+NL) and temporal(TU + TL) regions. For optic disc topographic parameters,the highest ROC were observed in rim volume( ROC--0. 850,0. 841 and 0. 862 in total glaucoma,POAG and PACG, respectively) and vertical cup/disc ratio( ROC =0. 840,0. 849 and 0. 830 in total glaucoma,POAG and PACG,respectively), and the sensitivities for specificity cutoff set at 80％ were 73.1％ and 76. 1％ in total glaucoma,73.0％ and 81.1％ in POAG and 73.3％ and 70.0％ in PACG, respectively. For RNFL thickness ,the highest ROC was observed in average RNFL( ROC =0. 925,0. 910 and 0. 942 in total glaucoma, POAG and PACG,respectively) ,and the sensitivities for specificity cutoff set at 80％ were 89. 6％ ,89.2％ and 90. 0％ in total glaucoma,POAG and PACG, respectively. Among the eight regions around the optic disc, RNFL thickness of region IT achieved the highest ROC, RNFL thickness of region TU and TL had the lowest ROC. Conclusions RTVue OCT appears to be of fair discriminating ability in distinguishing normal from glaucomatous eyes. RTVue OCT shows promise for the diagnosis of glaucoma.

99Tcm-MDP bone scan for the diagnosis of SAPHO syndrome / 中华核医学杂志

Objective To investigate the clinical value of bone scintigraphy for the diagnosis of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Methods The characteristics of SAPHO syndrome on 99Tcm-MDP imaging of 8 cases were retrospectively analyzed. Results The 99TcmMDP bone scan was positive for all patients. Seven cases were found lesions in the costoclavicular region, 3cases involved with unilateral sacroiliac joint, 2 cases involved with spine and 1 patient with extremity. Four lesions were found without relevant clinical symptoms. Conclusion Bone scintigraphy is useful for the diagnosis of SAPHO syndrome, especially for those lesions with no clinical symptoms.

Detection of sarcoglycanopathy with 99Tcm-MIBI gated myocardial perfusion imaging / 中华核医学杂志

Objective To investigate the clinical value of 99Tcm-MIBI gated G-MPI in detecting the myocardial damage in sarcoglycanopathy.Methods 99 Tcm - MIBI G - MPI was performed in 8 patients (3 males,5 females,age ranged from 10 to 30 y) with sarcoglycanopathy confirmed by clinical results and molecular pathology and 4 healthy persons as control group.Quantitative gated SPECT (QGS) software was used for processing and interpretation.Myocardium of left ventricle was divided into 7 segments and 20 subsegments.A five-point scoring system was used to evaluate the myocardial damage.Results Seven patients showed positive results in G-MPI (7/8).Fifty-nine sub-segments of injured myocardium were detected in the 140 sub-segments of 7 abnormal patients.One abnormal segment was observed in 1 patient,two abnormal segments were detected in 2 patients,and ≥3 abnormal segments were observed in 4 patients.Enlarged left ventricles were detected in 5 patients (5/8),and the LVEF of 3 patients among them decreased to (43.1 ±2.8)％.Conclusion 99Tcm-MIBI G-MPI can detect myocardial damage in sarcoglycanopathy as a direct and non-invasive method,and can be used in the early diagnosis and long-term follow-up in sarcoglycanopathy.

Measurement of anterior chamber volume with rotating scheimpflug camera and anterior segment optical coherence tomography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT).</p><p><b>METHODS</b>Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT.</p><p><b>RESULTS</b>Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CI) for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 microl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between -41.7 to 10.1 microl).</p><p><b>CONCLUSIONS</b>Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.</p>

Comparison of glomerular filtration rates by dynamic renal scintigraphy and dual-plasma sample clearance method in diabetic nephropathy / 中华核医学杂志

Objective To evaluate the accuracy of renal scintigraphy for the estimation of glomerular filtration rates (dGFR) in patients with diabetic nephropathy as compared to the conventional dual-plasma sample clearance method (pscGFR). Methods Forty-six patients with diabetic nephropathy underwent both dynamic renal scintigraphy and dual-plasma sample measurement after 99Tcm-DTPA injection. Paired student t-test and correlation analysis were performed to compare dGFR and pscGFR (normalized to body surface area,1.73 m-2). Results The mean dGFR was higher than mean pscGFR ((51.08±26.78)ml·min-1vs (44.06±29.43)ml·min-1,t=4.209,P=0.000). The dGFR correlated with pscGFR ( r=0.923,P=0.000) linearly (regression equation:pscGFR=1.015×dGFR-7.773,F=254. 656,P=0.000).Conclusions dGFR correlated well with pscGFR. Although it could not absolutely replace the latter in patients with diabetic nephropathy,dGFR could reasonably evaluate the filtration function for these patients.

Quality of life of epilepsy patients in Zhuang populations in Guangxi Guixi area / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the quality of life (QOL) and its influence factors in epilepsy patients in Zhuang population in Guangxi Guixi area.</p><p><b>METHODS</b>Totally 78 epilepsy patients in Zhuang populations and 60 healthy controls were enrolled, and their QOL was assessed with Quality of Life in Epilepsy Inventory-31 (QOLIE-31). The QOLIE-31 scores of patients between different sexes, anti-epileptic drugs (AEDs) usage, duration of seizure, and seizure types were compared.</p><p><b>RESULTS</b>QOL score was significantly lower in epileptic group (53.9 +/- 8.0) compared with control group (77.0 +/- 7.1) (P < 0.01). No difference was found in QOLIE-31 scores of patients between men and women (P > 0.05). Patients with single AED, shorter duration of seizure, and tonic-clonic seizure had higher QOLIE-31 scores than those with multiple AEDs, longer duration of seizure, and other seizure types (P < 0.01, P < 0.05, P < 0.01, respectively).</p><p><b>CONCLUSIONS</b>QOL is lower in epilepsy patients than normal people in Zhuang populations in Guangxi Guixi area. Medication and seizure type affects the QOL in patients with epilepsy.</p>

Effection of observation Xinnaoxin capsules in treatment of chronic cerebral circulatory insufficiency / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Xinnaoxin capsules in patients with chronic cerebral circulatory insufficiency.</p><p><b>METHOD</b>Patients with chronic cerebral circulatory insufficiency were divided randomly into two groups: a Xinnaoxin capsules group (n = 60, treated by Xinnaoxin capsules for four 4 weeks), a control group (n = 58, treated by Nimodiping for four weeks). The transcranial doppler (TCD) was used to determined mean velocity (Vm) and auto-viscometer measured hemorheological indices before and after being treated.</p><p><b>RESULT</b>After 4 weeks treatment, the hemorheological indices and mean velocity were obviously improve in Xinnaoxin capsules group (P <0.05), there is significant difference between the effective rate of two groups (88.3%, 70.7%).</p><p><b>CONCLUSION</b>Our study suggest that Xinnaoxin capsules have therapeutic function on chronic cerebral circulatory insufficiency.</p>

Effect of Panax notoginseng saponins on serum neuronal specific enolase and rehabilitation in patients with cerebral hemorrhage / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Panax notoginseng saponins (PNS) on serum content of neuronal specific enolase (NSE) and function recovery in patients with cerebral hemorrhage (CH) for exploring the therapeutic action of PNS in treating CH.</p><p><b>METHODS</b>Fifty CH patients with their course of disease not more than 5 days were randomly assigned to two groups, 27 in the PNS group and 23 in the control group, all were treated with conventional treatment, while PNS was given additionally to the PNS group. The serum levels of NSE before and after treatment were determined by electrochemiluminescence, and the recovery of patients, including their neuro-function deficit and daily living activity, was assessed according to scoring by the National Institute of Health Stroke Scale (NIHSS) and Barthel Index (BI) respectively.</p><p><b>RESULTS</b>Before treatment, the difference between the two groups in serum NSE content and scores of NIHSS and BI was insignificant (P > 0.05). However, after 3 weeks of treatment, the level of NSE and score of NIHSS were significantly lower, while score of BI was significantly higher in the PNS group than those in the control group respectively (all P < 0.01). In the PNS group, the level of NSE showed a positive correlation with the score of NIHSS (r = 0.757, P < 0.05), and a negative correlation with the score of BI (r = - 0.803, P < 0.05).</p><p><b>CONCLUSION</b>PNS can effectively protect the neuron and promote functional rehabilitation in patients after CH.</p>