A young male with abdominal distention and fever after cardiopulmonary resuscitation treatment / 世界急诊医学杂志（英文）

@#Abdominal distention after cardiopulmonary resuscitation (CPR) is a common phenomenon that presents in the emergency department. It is caused by a long period of bag-valve mask ventilation or esophageal intubation. However, a rare but life-threating diagnosis should be considered when distention progresses rapidly. Here, we reported a patient who developed a fever and abdominal pain that couldn’t be relieved by gastric decompression.

Etiology and clinical features of drug-induced liver injury diagnosed by liver biopsy / 解放军医学杂志

Objective To investigate the etiology and clinical features of drug-induced liver injury (DILI).Methods A total of 194 DILI in patients,who underwent liver biopsy in our hospital from January 2015 to December 2015,were enrolled in the study.The etiology,laboratory markers (such as alanine transaminase,aspartate aminotransferase,total bilirubin,gammaglutamyl transferase and alkaline phosphatase),and the pathological features were analyzed retrospectively.Then,all of the patients were followed up every 3 or 6 months,with a mean of 34.5 months.The risk factors associated with relapse,which was defined as liver enzymes (such as ALT or TBIL) rising at least 2 times of its upper limit of normal value (ULN),were analyzed with a logistic regression model.Results In terms of etiology,Traditional Chinese medicine (TCM) was the most common cause of DILI,which accounted for 46.9％ of patients,in return followed by acetaminophen-containing drugs (14.4％),antibiotics (9.3％),environmental toxins (4.6％),antidepressant (4.6％),dietary supplement (3.1％),lipid-lowering drugs (3.1％),chemotherapeutic agents (2.6％,and others unknown (11.3％).Of 194 DILI patients,hepatocellular type was observed in 78(40.2％) patients,cholestatic type in 63(32.5％),and mixed type in 53(27.3％).Histological findings showed that 70(36.1％) patients had an acute injury,124(63.9％) chronic damages,which composed by G0(9.8％),G,(19.1％),G2(21.6％),G3(9.8％),and G4(3.6％) in terms of inflammation level.Twenty-seven cases (21.8％) relapsed after discharge from hospital,multivariate analysis showed that cholinesterase is an independent risk factor which might predict the relapse of DILI patients.Conclusions The incidence of DILI is increasing,especially induced by TCM,therefore clinicians should master the clinical features of the disease in order to achieve correct diagnosis and establish the optimal treatment strategy.

Epigenetic Silencing of Eyes Absent 4 Gene by Acute Myeloid Leukemia 1-Eight-twenty-one Oncoprotein Contributes to Leukemogenesis in t(8;21) Acute Myeloid Leukemia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The acute myeloid leukemia 1 (AML1)-eight-twenty-one (ETO) fusion protein generated by the t(8;21)(q22;q22) translocation is considered to display a crucial role in leukemogenesis in AML. By focusing on the anti-leukemia effects of eyes absent 4 (EYA4) gene on AML cells, we investigated the biologic and molecular mechanism associated with AML1-ETO expressed in t(8;21) AML.</p><p><b>METHODS</b>Qualitative polymerase chain reaction (PCR), quantitative reverse transcription PCR (RT-PCR), and Western blotting analysis were used to observe the mRNA and protein expression levels of EYA4 in cell lines. Different plasmids (including mutant plasmids) of dual luciferase reporter vector were built to study the binding status of AML1-ETO to the promoter region of EYA4. Chromatin immunoprecipitation assay was used to study the epigenetic silencing mechanism of EYA4. Bisulfite sequencing was applied to detect the methylation status in EYA4 promoter region. The influence of EYA4 gene in the cell proliferation, apoptosis, and cell clone-forming ability was detected by the technique of Cell Counting Kit-8, flow cytometry, and clonogenic assay.</p><p><b>RESULTS</b>EYA4 gene was hypermethylated in AML1-ETO+ patients and its expression was down-regulated by 6-fold in Kasumi-1 and SKNO-1 cells, compared to HL-60 and SKNO-1-siA/E cells, respectively. We demonstrated that AML1-ETO triggered the epigenetic silencing of EYA4 gene by binding at AML1-binding sites and recruiting histone deacetylase 1 and DNA methyltransferases. Enhanced EYA4 expression levels inhibited cellular proliferation and suppressed cell colony formation in AML1-ETO+ cell lines. We also found EYA4 transfection increased apoptosis of Kasumi-1 and SKNO-1 cells by 1.6-fold and 1.4-fold compared to negative control, respectively.</p><p><b>CONCLUSIONS</b>Our study identified EYA4 gene as targets for AML1-ETO and indicated it as a novel tumor suppressor gene. In addition, we provided evidence that EYA4 gene might be a novel therapeutic target and a potential candidate for treating AML1-ETO+ t (8;21) AML.</p>

Expression of CAS in hepatocellular carcinoma tissues and its relationship with HBV infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore whether the cellular apoptosis susceptibility (CAS) protein could serve as a pathologic marker for HCC diagnosis and the roles of CAS expression in HBV infection associated HCC.</p><p><b>METHODS</b>The expression of CAS protein in HCC and its paracarcinoma tissues, non-tumor liver cirrhosis and hepatitis tissues were detected by immunohistochemistry. Meanwhile, HBsAg, HBcAg and HBV DNA in HCC tissues with HBV infection were examined by immunohistochemistry and in situ hybridization respectively.</p><p><b>RESULTS</b>The expression of CAS protein was significantly higher in HCC than in its paracarcinomas tissues (P < 0.01), and higher in paracarcinomas tissues than in non-tumor liver cirrhosis and hepatitis tissues (P < 0.01). Poorly differentiated tumors immunochemically stained stronger than moderately or well differentiated (P < 0.01). CAS protein expression was significantly higher in HBV-infected HCC tissues than that of in non-HBV infection (P < 0.01). Meanwhile, in HBV-infected HCC tissues, the staining intensity score of CAS protein in HBV DNA positive HCC tissues was significantly higher than HBV DNA negative tissues (P < 0.05).</p><p><b>CONCLUSIONS</b>Higher expression of CAS protein is found in HCC tissues,and the intensity of CAS protein expression is related closely to tumor differentiation. We suggested that CAS protein might serve as a marker for HCC diagnosis and differentiation estimation, and deduced that CAS might play an important role in the initiation of HBV infection associated HCC through upregulating expression of CAS.</p>

FibroScan can be used to diagnose the size of oesophageal varices in patients with HBV-related cirrhosis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study ability of FibroScan (FS) in diagnosing the size of oesophageal varices (OV) in patients with HBV-related cirrhosis.</p><p><b>METHODS</b>A total of 158 patients with HBV-related liver cirrhosis were enrolled in the study. The relation between the presence of OV assessed by endoscopy, and liver stiffness measurement by Fibroscan was studied, and ROC curves were drawn to assess the diagnostic ability of FS value.</p><p><b>RESULTS</b>For the patients without OV, mild OV, moderate OV, and severe OV, their corresponding FS values were (21.7 +/- 9.9) kPa, (32.1 +/- 13.6) kPa, (42.3 +/- 20.0) kPa and (54.5 +/- 16.2) kPa, respectively. Significant difference was found among the groups (P < 0.001) and also between any two groups (P < 0.05). ROC curve for the diagnosis of with vs. without OV, <moderate vs. > moderate OV, and < severe vs. severe OV were 0.798 (95% CI: 73.1%-86.5%), 0.823 (95% CI: 74.5%-90.0%) and 0.879 (95% CI: 80.8%-95.0%), respectively, with corresponding FS cut-off value of 23.3 kPa, 31.5 kPa and 34.6 kPa.</p><p><b>CONCLUSION</b>Liver stiffness measurement allows to predict the sizes of oesophageal varices in patients with HBV-related cirrhosis.</p>

Dynamic changes of B7-H1 expression on mDCs and T cells in chronic hepatitis B patients treated with PEG-IFN alpha-2a / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the dynamic changes of B7-H1 expression on myeloid dendritic cells (mDCs) and T cells in chronic hepatitis B (CHB) patients undergoing PEG-IFN alpha-2a therapy, and to analyze the association of the changes with the efficiency of interferon-alpha therapy.</p><p><b>METHODS</b>Expressions of B7-H1 on mDCs and T cells in 14 patients with chronic HBV infection, including 6 responders and 8 non-responders to the antiviral therapy, were monitored by using flow cytometric analysis. Peripheral blood mononuclear cells from patients were incubated in vitro and the numbers of IFN-gamma-producing antigen-specific T cells were measured using ELISPOT assay.</p><p><b>RESULTS</b>B7-H1 expressions by mDCs, CD4+ T cells and CD8+ T cells were all significantly upregulated at 4 weeks after starting PEG-IFN alpha-2a therapy. After this time point, B7-H1 expressions persistently decreased in the responders to the antiviral treatment, while non-responders maintained high levels of B7-H1 expression. In addition, the frequency of HBV-specific IFN-gamma-producing T cells significantly increased in the responders, but significantly decreased in the non-responders. Blocking the B7-H1 signal pathway increased the numbers of HBV-specific IFN-gamma-producing T cells in both the responders and non-responders.</p><p><b>CONCLUSION</b>Dynamic changes of B7-H1 expression by mDCs and T cells in CHB patients undergoing PEG-IFN alpha-2a therapy can predict the efficiency of the therapy. Blocking the B7-H1 inhibitory pathway likely enhances the antiviral cellular T-cell responses.</p>

Expressions and significance of B7-H1 and programmed death-1 in lymphocytes from patients with chronic hepatitis B virus infection / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To examine the expressions of B7-H1 and its receptor programmed death-1 (PD-1) on circulating T cells and myeloid dendritic cells (mDCs) in patients with chronic hepatitis B virus (HBV) infection and to investigate the correlation between their expressions and their disease status.</p><p><b>METHODS</b>The expressions of B7-H1 and PD-1 on mDCs and T lymphocytes in 30 patients with chronic HBV infection and 28 healthy controls were analyzed by a fluorescence-activated cell sorter (FACS). Real time-polymerase chain reaction (RT-PCR) was used to measure the serum HBV DNA load.</p><p><b>RESULTS</b>Both B7-H1 and PD-1 were significantly upregulated on T cells and mDCs in those patients. Their expressions were positively correlated with the patients serum ALT levels and HBV DNA loads.</p><p><b>CONCLUSION</b>B7-H1 and PD-1 expressions in our patients with chronic hepatitis B are closely associated with their disease status.</p>

Screening and cloning of the genes of protein interacting with the N-terminal protein of hepatitis B virus DNA polymerase by yeast-two hybrid technique / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To screen and clone the genes of protein interacting with the N-terminal protein (TP) of hepatitis B virus DNA polymerase.</p><p><b>METHODS</b>TP was amplified by polymerase chain reaction (PCR) and TP bait plasmid was constructed by using yeast two-hybrid system 3, then transformed into yeast AH 109. The transformed yeast was mated with yeast Y187 containing liver cDNA library plasmid in 2 x YPDA medium. Diploid yeast was plated on synthetic dropout medium (SD/-Trp-Leu-His-Ade) and that containing X-alpha-GAL for selecting two times and screening. Plasmids were extracted from blue colonies, and sequence analysis was performed by bioinformatics.</p><p><b>RESULTS</b>Forty-seven clones were obtained, these clones included human P36956 sterol regulatory element binding protein-1, RNA polymerase II subunit hsRPB7 mRNA, asialoglycoprotein receptor 2, transcript variant 3, ceruloplasmin (ferroxidase), transmembrane 4 superfamily member 2 and 19 of the hypothetical proteins and so on.</p><p><b>CONCLUSION</b>Genes encoding TP interacting proteins in hepatocytes were successfully cloned and the results suggest that TP has a wide variety of biological functions.</p>