c-Jun N-terminal kinase signaling pathway in acetaminophen-induced liver injury / 中华危重病急救医学

Acetaminophen (APAP) is the most common antipyretic, analgesic and anti-inflammatory drug, but its overdose often leads to acute liver injury, even acute liver failure, and death in some severe cases. At present, there is still a lack of specific treatments. The c-Jun N-terminal kinase (JNK) signal pathway is one of the potential therapeutic targets identified in recent years in overdose APAP-induced acute liver injury. This article reviews the JNK signaling pathway of APAP in liver metabolism, the activation of JNK signaling pathway and the amplification of oxidative stress, other pathways or cellular processes related to JNK signaling pathway, and the possible challenges of drugs targeting JNK, so as to provide direction and feasibility analysis for further research and clinical application of JNK signaling pathway targets in APAP hepatotoxicity, and to provide reference for searching for other targets.

Role of thymic stromal lymphopoietin in liver diseases / 临床肝胆病杂志

Thymic stromal lymphopoietin (TSLP) is a type I interleukin 2 family cytokine composed of four short-chain α-helix bundles and has homology with interleukin-7. TSLP plays an important role in many allergic diseases or autoimmune diseases, such as asthma, atopic dermatitis, eosinophilic esophagitis, and inflammatory bowel disease, and promotes the development of these diseases. At present, there are some reports on TSLP in liver diseases, and some studies showed that it can promote the development and progression of liver diseases, while others showed that it plays a protective role in liver diseases. This article reviews the molecular composition and biological features of TSLP and the role of TSLP in benign liver diseases and liver tumors and elaborates on the research advances in TSLP in liver diseases.

Epidemiological analysis of traumatic cervical spinal cord injury / 中华急诊医学杂志

Objective To describe the epidemiological characteristics of cervical spine fracture combined with trauma cervical spinal cord injury (TCSCI) in Guangxi province. Methods A total of 385 patients met the inclusion criteria were enrolled for retrospective investigation. Detailed information included age, sex, marital status, occupation, date of admission, mechanisms of trauma, level of injury, ASIA grade, concomitant injuries, length of hospital stay, complications, and mortality. Results The ratio of Male/Female was 4.4:1. The average age of the patients was 47.9 years, and 88.8％ of the patients were married. 72.9％ of TCSCI occurred between the age of 35-64 years. Farmers accounted for the largest number of patients with TCSCIs, and 63％ of patients with TCSCI were caused by falling. The damage was located at the C3-C5 level, accounting for 63.8％. More than half of the patients with CSCI had brain injury. The most common complication was respiratory infection (54.5％). Among the injury levels, the proportions of ASIA grade A, B, C, and D were 34.8％, 8.5％, 35.5％, and 21％, respectively. During the treatment, 58 patients required cardiopulmonary resuscitation, and 36 patients required mechanical ventilation. The average length of hospital stay was (26.5±21.6) d. Of the 375 patients discharged from the hospital, 51.2％ patients had no improvement in the muscle strength. Conclusions Falling is the main cause of CSCI and men are more likely to be exposed to the injury. Patients with TCSCI have long treatment time and poor treatment results. Additionally, complications during the treatment should not be ignored.

Clinicopathologic characteristics and prognosis in multinodular and multicentric occurrence hepatocellular carcinoma / 中华普通外科杂志

Objective To analyze the clinicopathologic characteristics and prognosis in multinodular and multicentric occurrence of hepatocellular carcinoma (HCC). Methods Study group (multinodular HCCs) involved 42 multinodular HCCs patients with a total of 112 HCC nodules. 16 patients with single HCC nodule, and 4 patients with portal vein tumor embolus, 5 normal livers served as controls. MtDNA D-Loop sequences were compared among multinodular lesions in the study group, between inconsecutive tumor tissues and between tumor and embolus tissues in the study group with regard to their clinicopathologic characteristics. Results In study group, for the multinodular HCCs 20 cases were categorized as multicentric occurrence (MO) based on their variant mtDNA D-Loop sequences in each nodule from the same patient. 22 cases were characterized as intrahepatic metastasis (IM) based on the identical sequences found in each nodule from the same patient. In all 20 cases for the rest of the study group (16 patients with single HCC nodule and 4 patients with portal vein tumor embolus), the inconsecutive tumor tissues or the portal vein tumor embolus and original tumors shared identical sequences. HBeAg (P =0. 008), tumor size ( sizes of all nodules) ( P = 0. 029), position of nodules (P = 0. 040), cirrhosis ( P =0. 011 ), portal vein and microscopic tumor embolus ( P = 0. 023 ) and differentiation ( Edmondson grade) of the main nodule (P = 0. 027 ) were significantly different between the IM and MO HCCs, thus were considered to be the important factors in determinning the clonal origin of multinodular HCC. Positive HBeAg, cumulative diameter of all nodules ≤7 cm, nodules located in different lobes, cirrhosis, negative for portal vein or microscope tumor embolus and/or well/moderate differentiation of main nodular histopathology were found in high rate in MO. Tumor-free survival of the MO subjects was significantly longer than that of the IM subjects (21.6 ±4. 2) months vs. (8.7 ±2. 5) months, P =0. 031 ). Similarly, overall survival of the MO subjects was longer than that of the IM subjects (29. 6±4. 7) months vs. ( 14. 6 ±2. 9) months, P = 0. 034). Multivariate analysis revealed that the IM/MO characteristic was an independent factor influencing both tumor-free survival ( P = 0.012 ) and overall survival ( P = 0.011 ).Conclusions HBeAg, tumor size ( sizes of all nodules), position of nodules, cirrhosis, portal vein and microscopic tumor embolus and differentiation of the main nodule are important factors in differentiating IM and MO. Positive HBeAg, cumulative diameter of all nodules ≤ 7 cm, nodules located in different lobes, cirrhosis, negative for portal vein or microscopic tumor embolus and/or well/moderate differentiation of main nodular histopathology are frequent phenomena in MO. MO HCC patients might have a favorable outcome compared with IM patients.

Clinical Imaging Diagnosis of Endobronchial Tuberculosis:A Report of 30 Cases / 实用放射学杂志

Objective To discuss the imaging characteristics of endobronchial tuberculosis(EBTB).Methods Roentgenographic,CT and bronchoscopic findings of EBTB in 30 cases were retrospectively analyzed.Results X-ray plain film showed that EBTB was often in company with pulmonary tuberculosis.CT showed bronchial stenosis and bronchoscopy showed edema,inflamation and granulomatosis in bronchial mucous membrane.Conclusion X-ray,CT and bronchosopy are of important value in diagnosing EBTB.