Research Progress of Radiation-induced Brain Injury for Nasopharyngeal Carcinoma / 肿瘤防治研究

Radiation-induced brain injury (RBI) is a common long-term complication of radiotherapy for nasopharyngeal carcinoma (NPC) and seriously affects the quality of life and overall survival of patients. In the era of intensity-modulated radiation therapy (IMRT), the long-term complications after radiotherapy, especially RBI, are becoming increasingly concerning because a number of treated patients with NPC obtain long-term survival. At present, the understanding of RBI is still being explored, and its pathogenesis and treatment methods are continuously updated. This article reviews the research progress of RBI in patients with NPC.

Analysis of success rate of organoid construction of nasopharyngeal carcinoma by first-day suspension method / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the efficacy of the first-day suspension method for improving the success rate of construction of nasopharyngeal carcinoma-patient derived organoids (NPC-PDO). Methods: The tumor samples of 14 nasopharyngeal carcinoma(NPC) patients, i.e.,13 males and 1 female, with a mean age of 43.0±12.0 years old, were collected from the Affiliated Tumor Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangxi Medical University from January 2022 to July 2022. The tumor samples of 3 patients were digested into single cell suspension and divided into 2 groups, for comparing the efficacy of NPC-PDO construction by the direct inoculation method and the first-day suspension method. The remaining 11 patients were randomized to receive either the direct inoculation method or the first-day suspension method for NPC-PDO construction. The diameter and the number of spheres of NPC-PDO constructed by the two methods were compared by optical microscope; the 3D cell viability detection kit was used to compare the cell viability; the survival rates were compared by trypan blue staining; the success rates of the two construction methods were compared; the number of cases which could be successfully passaged for more than 5 generations and were consistent with the original tissue by pathological examination was counted; and the dynamic changes of cells in suspension overnight were observed by live cell workstation. The independent sample t-test was applied to compare the measurement data of the two groups, and the chi-square test was used to compare the classification data. Results: Compared with the direct inoculation, the diameter and the number of spheres of NPC-PDO constructed by the first-day suspension method were increased, with a higher cell activity, and the success rate of construction was obviously improved (80.0% vs 16.7%, χ2=4.41, P<0.05). In the suspension state, some of the cells aggregated and increased their ability to proliferate. Conclusion: The first-day suspension method can improve the success rate of NPC-PDO construction, especially for those whose original tumor sample size is small.

Identification of Levisticum officinale Adulterated in Angelica sinensis by PCR-RFLP / 中国实验方剂学杂志

Objective:To establish a rapid method to identify <italic>Levisticum officinale </italic>adulterated in<italic> Angelica sinensis</italic> by polymerase chain reaction -restriction fragment length polymophism（PCR-RFLP）. Method:By comparing sequences restriction sites in ribosomal DNA Internal Transcribed Spacer（ITS） of <italic>A. sinensis</italic> and <italic>L. officinale</italic>，the specific restriction site Fnu4HI of <italic>L. officinale</italic> was selected，and the primers for PCR-RFLP reaction were designed. Different <italic>A. sinensis</italic> and <italic>L. officinale</italic> were amplified by PCR. The conditions affecting the PCR-RFLP reaction，such as annealing temperature，primer concentration，cycle number and enzyme digestion reaction time，were optimized，and the accuracy of the method was investigated. The established PCR-RFLP identification method was used to investigate the applicability of <italic>L. officinale </italic>adulterated<italic> in A. sinensis</italic> with different aduleration ratios and different origins. Result:A PCR-RFLP method for identifying <italic>A. sinensis</italic> mixed with <italic>L. officinale</italic> was established. When the annealing temperature was 62 ℃ and the number of cycles was 30，when the <italic>L. officinale </italic>adulterated in<italic> A. sinensis</italic> could be digested by Fnu4H I restriction endonuclease after amplification with specific primers，and the two single DNA bands were detected between 100-500 bp，the <italic>A. sinensis</italic> were all negative. The minimum detection limit of this method for adulterated <italic>L. officinale</italic> in <italic>A. sinensis</italic> was 3%，which could be used for the detection of adulterated <italic>L. officinale</italic> in <italic>A. sinensis</italic>. Conclusion:The established PCR-RFLP identification method is sensitive and accurate in detecting whether there is <italic>L. officinale</italic> in <italic>A. sinensis</italic>，and it provides inspection reference and basis for the quality control of <italic>A. sinensis</italic>，with great significance to ensure the safety of its clinical medication.

A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis / 华西口腔医学杂志

OBJECTIVE@#A study was conducted to systematically evaluate the clinical efficacy of inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy.@*METHODS@#We searched the databases of CNKI, Wanfang, CBM, PubMed, Embase, and Cochrane Library from inception to December 2019. Two reviewers independently collected all literature related to inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. These factors include C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The literature was screened according to the inclusion and exclusion criteria. The quality of the studies was strictly evaluated, and the data were extracted. The literature of randomized controlled trials in accordance with the standards was Meta-analyzed with Revman 5.3 software.@*RESULTS@#Six randomized controlled trials were included. Compared with the control groups, the results of meta-analysis showed that non-surgical periodontal therapy significantly reduced the levels of CRP [MD=-0.58, 95%CI (-1.13, -0.02), P=0.04] and IL-6 [MD=-2.76, 95%CI (-5.15, -0.37), P=0.02] in these patients but not that of TNF-α [MD=-3.87, 95%CI (-8.79, 1.05), P=0.12].@*CONCLUSIONS@#Simultaneous regular renal treatment and non-surgical periodontal therapy can help relieve the periodontal damage on patients with chronic kidney disease and periodontitis. Moreover, it can improve the status of some inflammatory factors. This finding is conducive to the control and treatment of chronic kidney disease and periodontitis and needs to be a focus of research and in clinical operation.

Efficacy of clarithromycin in the adjuvant treatment of chronic periodontitis: a Meta-analysis / 华西口腔医学杂志

OBJECTIVE@#To evaluate the clinical efficacy of clarithromycin (CLM) in the adjuvant treatment of chronic periodontitis systematically, obtain reasonable conclusions through evidence-based medicine, and provide guidance for clinical rational drug use.@*METHODS@#Literature about CLM in the adjuvant treatment of chronic periodontitis was searched in CNKI, VIP, Wanfang, Chinese Biomedical Literature Database, PubMed, ScienceDirect, and Embase databases from inception to February 2019 using a computer. Meta-analysis was performed on the homogeneous study using RevMan 5.3 software after two independent reviewers screened the literature, evaluated the quality of the study, extracted the data, and evaluated the risk of bias in the included studies.@*RESULTS@#Six randomized controlled trials were included in 316 subjects. The meta-analysis showed that compared with the scaling and root planning (SRP) group, the probing depth (PD) was reduced in patients with CLM and SRP [MD=-1.00, 95%CI (-1.55, -0.45), P=0.000 04]. Clinical attachment loss was obtained [MD=-0.03, 95%CI (0.43, 0.65), P<0.000 01], and the difference between the groups was statistically significant. The modified sulcus bleeding index (mSBI) was reduced [MD=-0.01, 95%CI (-0.14, 0.19), P=0.66]. No significant difference was observed between the groups, but the decrease in mSBI was more significant in CLM combined with SRP group.@*CONCLUSIONS@#CLM combined with subgingival SRP can achieve remarkable results in treating chronic periodontitist.

A study of the home care model based on the Omaha system for elderly maintenance hemodialysis patients / 中华老年医学杂志

Objective:To analyze the application effect of the home care model based on the Omaha system for elderly maintenance hemodialysis patients.Methods:A total of 73 elderly patients undergoing maintenance hemodialysis in the First People's Hospital of Longquanyi District, Chengdu city from December 2018 to December 2019 were enrolled.According to the randomization and double-blind principle, they were divided into the control group receiving the clinical routine care mode(n=32)and the intervention group undergoing the home care mode based on Omaha system(n=41). The Quality of Life Score, care satisfaction and awareness rate of health knowledge of patients were compared between the two groups before and after the care intervention.Results:Compared with before intervention, the quality of life scores was increased after caring in both two groups.And the scores in all dimensions were better in the intervention group than in the control group( t=3.173, 3.833, 3.514 and 4.593, P=0.001, 0.000, 0.000 and 0.000). The awareness rates of nutrition knowledge, water-intaking knowledge, iron supplementation knowledge, potassium and phosphorus limitation and dialysis mode were better in the intervention group than in the control group( χ2=7.592, 5.423, 8.494, 6.161 and 6.962, P=0.011, 0.011, 0.000, 0.010 and 0.011). The total satisfaction rate was 97.6%(40/41)in the intervention group, which was superior to that in the control group(75.0% or 24/32)( χ2 =8.460, P=0.000). Conclusions:The extended home care model based on the Omaha system can effectively improve patients' awareness of health knowledge, improve patients' quality of life and improve the satisfaction with care in elderly maintenance hemodialysis patients with a low education level, and it is worthy of clinical promotion.

Effects of Cyclosporine A on the Development of Metanephros in the Pregnant BALB/c Mice / 中华医学杂志(英文版)

<p><b>Background:</b>Cyclosporine A (CsA) is a commonly used clinical immunosuppressant. However, CsA exposure in rabbits during the gestation period was shown to cause a postnatal decrease in the number of nephrons, with the effects remaining unknown. In this study, we aimed to explore the effects of CsA on metanephros development in the pregnant BALB/c mice.</p><p><b>Methods:</b>Pregnant mice were randomly divided into two groups, and CsA (10 mg·kg·d) was subcutaneously injected from gestation day 10.5 to day 16.5 in the CsA group, whereas a comparable volume of normal saline was given to the control group. All of the mice were sacrificed on gestation day 17.5 and serum CsA concentration was measured. The fetuses were removed and weighed, and their kidneys were prepared for histological assessment and polymerase chain reaction assay. In an in vitro experiment, embryo kidneys of fetal mice on gestation day 12.5 were used, and CsA (10 μmol/L) was added in the culture of the CsA group. The growth pattern of the ureteric bud and nephrons was assessed by lectin staining.</p><p><b>Results:</b>No significant differences in the weight of embryo (4.54 ± 1.22 vs. 3.26 ± 1.09 mg) were observed between the CsA and control groups, the thickness of the cortical (510.0 ± 30.3 vs. 350.0 ± 29.7 μm, P < 0.05) and nephrogenic zone (272.5 ± 17.2 vs. 173.3 ± 24.0 μm, P < 0.05), and the number of glomeruli (36.5 ± 0.7 vs. 27.5 ± 2.1, P < 0.05) were reduced in the CsA group when compared to the control group. The cell proliferation of Ki-67 positive index between control and CsA group (307.0 ± 20.0 vs. 219.0 ± 25.0, P < 0.05) in the nephrogenic zone was decreased with the increase of apoptotic cells (17.0 ± 2.0 vs. 159.0 ± 33.0, P < 0.05). The mRNA expression of WT-1, Pax2, and Pax8 was downregulated by CsA treatment. As for the in vitro CsA group, the branch number of the ureteric bud was decreased in the CsA-treated group with the nephrons missing in contrast to control after the incubation for 24 h and 72 h (all P < 0.0001).</p><p><b>Conclusion:</b>Treatment of CsA suppressed metanephros development in the pregnant mice; however, the potential action of mechanism needs to be further investigated.</p>

Effect of P-glycoprotein on the transmembrane absorption and metabolism of quercitrin on Caco-2 cells / 国际药学研究杂志

Objective To explore the role of P-glycoprotein(P-gp)on cellular uptake and metabolism in the transmembrane transport of quercitrin.Methods Caco-2 cell monolayer and P-gp inhibitor Cyclosporin A(CysA)were used in the study.Quercitrin, quercetin,isorhamnetin and tamarixetin were determined by LC-MS to study cellular uptake and metabolism of quercitrin on Caco-2 cells.Results Uptake of quercitrin by Caco-2 cells:in different concentration groups of quercitrin coincubating with and without Cy?sA,intracellular accumulation presented the following characteristics:the amount of quercitrin first rose,reached the peak in 60 min and then declined to a steady-state in 120 min.And meanwhile there were significant differences between the two different processing groups incubating with and without CysA(P<0.05);quercetin was detected in all groups(3.0,9.0 and 27.0 mg/L).But in the higher concentration groups incubating with and without CysA,the intracellular quercetin presented a characteristics similar to its original glycosides and showed a significant difference(P<0.05),while the other groups showed no concentration-and time-dependence.At the same time,isorhamnetin and tamarixetin were detected in two higher concentration groups incubating with and without CysA, which showed the trend similar to the original glycosides but no significant difference was obtained between the two processing groups(P>0.05).Isorhamnetin and tamarixetin were not detected in the low and middle concentration groups.Transmembrane transport:on the basal lateral of all groups,the content of the quercitrin in 150 min incubation time showed a trend of continuous rise,and there was no significant difference between the two processing groups.Quercetin,isorhamnetin and tamarixetin were not detected.Conclu?sion Intact quercitrin could be absorbed into the Caco-2 cells and transported across the Caco-2 cell monolayer,and suffered a series of further metabolism in the Caco-2 cells and the basal side of Caco-2 cell monolayer,leading to different characteristics between intra?cellular accumulation and transmembrane transport.P-gp reduces the transmembrane transport of quercitrin by its efflux function,but did not involved in quercitrin metabolism.

Treatment Practice of Clinical Pharmacists for One Case of Complexity Urinary Tract Infection with Septic Shock Induced by Cellulitis / 中国药师

Objective:To investigate the role of clinical pharmacists in the anti-infective treatment of one patient with complexity urinary tract infection with septic shock induced by cellulitis. Methods:Clinical pharmacists participated in one case of complexity uri-nary tract infection with septic shock induced by cellulitis, and according to the clinical curative effect and the patient' s condition change, clinical pharmacists adjusted the medication nine times and provided individualized pharmaceutical care and service in the whole process. Results:Physician accepted the suggestions of clinical pharmacists, the infection was controlled after the 38-day treat-ment, and then the patient was discharged from the hospital. Conclusion:Clinical pharmacists should participate in the clinical treat-ment, provide whole process of pharmaceutical care for severe patients and assist physician in drug treatment decisions to promote safe, effective and economical drug use.

Dynamic changes of serum HBsAg levels at different grades of liver inflammation and stages of hepatic fibrosis in HBeAg-negative hepatitis B patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the dynamic changes in serum levels of hepatitis B surface antigen (HBsAg) and their relation to hepatic parenchyma cell volume (hepatic cell quantity) at different grades of liver inflammation and stages of hepatic fibrosis in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B.</p><p><b>METHODS</b>Serum HBsAg levels were detected by electrochemilumineseence. Serum HBsAg levels were apportioned according to the hepatic parenchyma cell volume and compared among liver histological inflammation grade (1, 2, 3 and 4) and hepatic fibrosis stage ( I, II, III and IV), respectively.</p><p><b>RESULTS</b>The levels of serum HBsAg among the four liver histological inflammation grades were:1:6,036.4+/-2,729.4 COI/ml; 2:6,704.6+/-2,457.5 COI/ml; 3:6,332.2+/-2,409.0 COI/ml; 4:6,226.2+/-2,716.0 COI/ml. There were no differences among the groups before apportion (Fbefore apportion=0.564, P=0.640).Serum HBsAg levels apportioned by the hepatic parenchyma cell volume among liver histological inflammation grades were:1:9,174.8+/-4,142.0 COI/ml; 2:10,743.1+/-3,950.3 COI/ml; 3:11,078.0+/-4 230.0COI/ml; 4:11,540.5+/-5,058.8 COI/ml. There were significant differences among the groups after apportion (Fafter apportion =27.354, P<0.001). Serum HBsAg levels among hepatic fibrosis stages were: I: 6,222.1+/-2,665.4 COI/mL; II: 6,706.8+/-2,623.8 COI/ml; III:6 004.5+/-2,625.5 COI/ml; IV:6,455.6+/-2,344.4 COI/ml. There were no differences among groups before apportion (Fbefore apportion=0.768, P=0.513).Serum HBsAg levels apportioned by the hepatic parenchyma cell volume (hepatic cell quantity) among hepatic fibrosis stages were: I :9 417.5+/-4,034.2 COI/ml; II :10,093.3+/-4,183.4 COI/ml; III:10,177.1+/-4,445.0 COI/ml; IV:12,166.6+/-4,418.5 COI/ml. There were significant differences among the groups after apportion (Fafter apportion=57.077, P<0.001).</p><p><b>CONCLUSION</b>Serum HBsAg levels apportioned by the same hepatic parenchyma cell volume (hepatic cell quantity), rather than serum HBsAg levels, increased with hepatic pathological progress.</p>

Expression of p53 in breast cancer and regulatory effects of 5-aza-2′-deoxycytidine on p53 / 医学研究生学报

Objective Tumor suppressor gene p53 can inhibit tumor cell growth, arrest cell cycle, and promote apoptosis.Howev-er, the effects of p53 on the pathogenesis of breast cancer have not been fully elucidated.The aim of this study was to explore the expression of p53 protein and the correlation with clinical pathologic features in breast cancer.Furthermore, the regulatory effects of 5-aza-2′-deoxycyti-dine on p53 in breast cancer cell line were also studied. Methods The expression of p53 protein in 80 cases of breast cancer and normal and adjacent tissue were determined by the immunohistochemical staining .The expressions of p53 mRNA and p53 protein in breast cancer cell line were determined by RT-PCR and Western blotting. Results The positive rate of p53 in breast cancer (41.25%) was higher than that in the normal and adjacent tissue (22.5%) (P0.05).The low expression of p53 both in mRNA and in protein levels were found in breast cancer cell line of MCF-7.The expres-sion of p53 increased after 5-aza-2′-deoxycytidine administration . Conclusion p53 is highly expressed in breast cancer , which may play an im-portant role in the development and progression of breast cancer. 5-aza-2′-deoxycytidine, up-regulating the p53 expression in breast cancer cell line, which provides the evidents for the development of therapeutic drugs for the patients with low expression of p53 breast cancer.

Determination of morroniside concentration in rat plasma by high performance liquid chromatography-tandem mass spectrometry / 中国中药杂志

Morroniside, an iridoid glycoside extracted from Cornus officinalis, has multiple pharmacological effects such as neuroprotection. This study took the lead in establishing a method for determining morroniside concentration in rat plasma by high performance liquid chromatography-tandem mass spectrometry. Plasma samples were processed with protein precipitation method, with hyperoside as the internal standard. An Inertsil C8-3 column (2. 1 mm x 50 mm, 5 microm) was adopted, with a mobile phase composed of water (containing 1 mmol L-1 Sodium formate)-acetonitrile (gradient elution) at a flow rate of 0.4 mL . min -1. Electrospray ionization (ESI) was adopted in the positive ion mode for multi-reaction monitoring (MRM). Morroniside showed a good linear relationship ranging between 2-5 000 microg L-1 (r = 0. 995 7), with the minimum limit of quantification of 2 microg L-1. Its precise, accuracy, recovery and matrix effect were all in line with the biological sample measurement requirements. Therefore, the method described above was proved to be suitable for the determination of morroniside concentration in rat plasma. To use the method in the pharmacokinetic study on morroniside in rats, oral administration dose shall be set at 20 mg . kg - to map the plasma concentration-time curve. Main pharmacokinetic parameters were calculated by DAS 2. 0. Specifically, AUC0-inifinity was (587.6 +/- 290. 7) microg min L-1, Cmax was (334.2+/-148.0) microg L-1, Tmax was (0.6 +/-0.3) h, t1/2 was (0.7+/-0.3) h.

Lamivudine versus entecavir for patients with HBeAg-negative acute-on-chronic liver failure / 中华传染病杂志

Objective To evaluate the short-term efficacy of lamivudine versus entecavir for patients with HBeAg-negative acute-on-chronic liver failure (ACLF) with different pretreatment liver failure degrees.MethodsA total of patients with HBeAg-negative ACLF were enrolled into this retrospective study.Seventy-two cases were treated with lamivudine 100 mg daily,while 93 cases were treated with entecavir 0.5 mg daily.Biochemical items,model for end-stage liver disease (MELD)score,hepatitis B virus (HBV) DNA level and mortality were observed.The efficacies of the two drugs were analyzed in patients with different degrees of liver failure.The comparison of rates was done using chi-square test and the measurement data were compared by t test.ResultsAmong the patients with pretreatment MELD scores above 30,the post-treatment HBV DNA levels in lamivudine group and entecavir group were (3.6 ± 1.1) lg copy/mL and (3.7 ± 1.4) lg copy/mL,respectively (t=0.181,P=0.859) and the mortalities were 92.0％ and 91.8％,respectively (χ2 =0.002,P=0.680).For the patients with pretreatment MELD scores from 23 to 30,the post-treatment HBV DNA levels in two groups were (3.2± 1.1) lg copy/mL and (3.2±2.3) lg copy/mL,respectively (t=0.760,P=0.455) and the mortalities were 42.9％,54.1％,respectively (χ2 =0.799,P=0.455).In patients with pretreatment MELD scores below 23,the post-treatment HBV DNA levels in two groups were (3.1±1.0) lg copy/mL and (2.8±1.5) lg copy/mL,respectively (t=-0.740,P=0.464) and the mortalities were 3/19 and 6.3％,respectively (χ2=1.227,P=0.455).In lamivudine group,the mortalities were significantly different among patients with three different ranges of pretreatment MELD scores (χ2 =26.967,P =0.000).The similar differences were also found in entecavir group (χ2 =41.260,P=0.000).ConclusionsAmong treatment na?ve patients with HBeAg-negative ACLF,the short-term efficacy of lamivudine versus entecavir is equal if the degree of pretreatment liver failure is similar.Meanwhile,the degrees of pretreatment liver failure significantly affects the outcome of the treatment.

Dynamics of serum HBV DNA levels during the terminal phases of acute-on-chronic hepatitis B liver failure with different HBeAg status / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the dynamics and clinical significance of serum hepatitis B virus (HBV) DNA levels during the terminal phase of acute-on-chronic liver failure (ACLF) with different hepatitis B e antigen (HBeAg) status.</p><p><b>METHODS</b>One-hundred-and-seven patients with terminal ACLF were tested for HBeAg status by electrochemiluminescence immunoassay and serum HBV DNA levels by real-time PCR at three chronological time ranges, representing increasing severity of disease phases prior to death (day 0): 29-56 d, 15-28 d, and 0-14 d.</p><p><b>RESULTS</b>In the 37 HBeAg(+) patients, HBV DNA levels at above-mentioned phases were 6.10+/-1.63, 5.61+/-1.50, and 5.29+/-1.96 log10 copies/mL. In the 70 anti-HBe(+) patients, HBV DNA levels were 4.63+/-1.82, 5.81+/-1.78, and 4.93+/-1.73 log10 copies/mL. Phase to phase comparisons revealed that the HBV DNA level in the HBeAg(+) group was significantly higher than that in the anti-HBe(+) group at 29-56 d (P less than 0.05), and that 15-28 d and 0-14 d were not significantly different (P more than 0.05). Intragroup comparisons of phases revealed no significant differences in the HBeAg(+) group (P more than 0.05), but a significant difference between 15-28 d and 0-14 d (P less than 0.05) for the anti-HBe(+) group.</p><p><b>CONCLUSION</b>Serum levels of HBV DNA in patients with HBeAg positivity are higher than those in patients with anti-HBe positivity as the disease phase of ACLF nears fatality. Following the deterioration to liver failure, the HBV DNA load in HBeAg(+) patients remains stable while that in anti-HBe(+) patients decreases.</p>

The relationship of HBeAg status with HBV DNA loads, MELD scores in patients with acute-on-chronic hepatitis B liver failure during terminal phases / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relationship and clinical significances of HBeAg status with serum HBV DNA loads, model for end-stage liver disease (MELD) scores in patients with acute-on-chronic hepatitis B liver failure during terminal phase.</p><p><b>METHODS</b>120 fatal patients were enrolled. At three phases of 0 -14 d, 15-28 d and 29-90 d before death, they were detected serum HBeAg, HBV DNA loads order meanwhile MELD scores were calculated.</p><p><b>RESULTS</b>In 51 patients with HBeAg positive, HBV DNA levels were (5.25 +/- 1.99), (5.45 +/- 1.47) and (6.06 +/- 1.77) log10 copies/ml while MELD scores were (30.33 +/- 5.25), (26.36 +/- 6.43) and (20.13 +/- 6.47) respectively. In 69 patients with HBeAg negative,HBV DNA loads were (5.14 +/- 1.84), (5.49 +/- 1.75 ) and (4.62 +/- 1.65) log10 copies/ml while MELD scores were 32.38 +/- 9.95, 28.17 +/- 6.82 and 26.19 +/- 5.56 in sequence. Compared with the same phase between HBeAg-positive group and HBeAg-negative group, significant differences in both HBV DNA loads and MELD scores were found only at the phase of 29-90 d (P < 0.05). In multiple comparisons among three phases, regardless of the HBeAg status,there wasn't significant difference for HBV DNA loads (P > 0.05). But increasing MELD scores are associated with the disease exacerbation and significant differences were found (P < 0.05).</p><p><b>CONCLUSIONS</b>To initiate acute-on-chronic hepatitis B liver failure, serum HBV DNA loads of HBeAg-positive patients are higher than that of HBeAg-negative ones. Once ACLF has been initiated,sustained high HBV DNA loads may promote the disease worsened and be fatal regardless of the HBeAg status.</p>

Effects of Tongxinluo on neuron ultrastructure and endothelial cell self-repairing ability in hypoxia preconditioning mice / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To observe the ultrastructure changes of cerebral cortex neuron and endothelial cell in hypoxia preconditioning mice and the effects of Tongxinluo (TXL, Chinese traditional medilihe) on them.</p><p><b>METHODS</b>Mice were randomly divided into 4 groups: control group, hypoxia group, hypoxia preconditioning (HP) group and Tongxinluo (TXL) group. The hypoxia preconditioning mice were exposed by repetitive hypoxia for 5 runs. The animal's tolerance time of each hypoxia run was recorded. The ultrastructure change of cerebral neuron and endothelial cell were studied by electron microscope.</p><p><b>RESULTS</b>The hypoxic tolerance time in HP and TXL groups were significantly increased run by run. Compared with HP group, the tolerance time of TXL group were increased in every run. The ultrastructure of cerebral neuron and endothelial cell in hypoxia group changed obviously, mitochondrion and endoplasmic reticulum destroyed. However they were slighter in HP group than those in hypoxia group. The change in TXL group had no obvious differentce with control group and were slighter than those in HP group.</p><p><b>CONCLUSION</b>Hypoxia preconditioning shows that organism has a strong self-repairing ability. Tongxinluo self-repairing; could increase self-repairing ability and adaptive ability of mice to hypoxia obviously.</p>

Effect of chronic psychological stress on vascular endothelial dysfunction rats and intervention tongxinluo on it / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of chronic psychological stress on vascular endothelial dysfunction rats and to explore the intervention and mechanism of Tongxinluo (TXL) on it.</p><p><b>METHODS</b>Forty male Wistar rats were randomly divided into the normal control group (with no modeling), the endothelial dysfunction group (the HCY group), the psychological stress group (the model group), and TXL group, ten in each group. Rats in the latter three groups were fed with 3% high methionine diet to duplicate vascular endothelial dysfunction (VED) model. In addition, chronic psychological stress was applied in VED rats using repeated binding method. TXL at the dose of 1.2 g/kg body weight was given by gastrogavage. The plasma endothelin (ET) and angiotensin II (Ang II), serum cortisone (CORT) were detected by radioimmunoassay. The serum nitric oxide (NO) was detected by nitrate reductase. Ultrastructural changes of aortic endothelial cells were observed by transmission electron microscope. Serum levels of norepinephrine (NE) and epinephrine (E) were detected by enzyme linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>Compared with the plasma ET level and the serum NO level in the HCY group (161.70 +/- 13.96 pg/mL and 26.82 +/- 13.03 micromol/L), the plasma ET level obviously increased (178.25 +/- 21.85 pg/mL) (P < 0.05) and the serum NO level decreased (24.91 +/- 9.95 micromol/L, P > 0.05), levels of CORT, NE, and E obviously increased in the model group (all P < 0.05). Ultrastructural changes of aortic endothelial cells were obviously injured. Compared with the model group, the plasma ET level (154.74 +/- 13.27 pg/mL), Ang II, CORT, NE, and E obviously decreased (P < 0.05, P < 0.01), the serum NO level obviously increased (34.44 +/- 18.35 micromol/L, P < 0.05). Ultrastructural changes of aortic endothelial cells were obviously improved.</p><p><b>CONCLUSIONS</b>Chronic psychological stress could obviously aggravate endothelial injury in VED rats. TXL showed protection on the vascular endothelial structure and function.</p>

Thinking through survey of medical ethics practice of medical students / 中华医学教育探索杂志

Objective To investigate meclical ethits level of first-year mecdical stuclents in Guangzhou medical college,which contributes to provide guidance of medical ethics education for interns. Methods To investigate 183 cases of first-year medical students. They were asked to deal with a case of 'a vagrant needed emergency treatment'. The statistics datum were classified according to 'norms of medical ethics and ways of implementation made by the Ministry of Health for medical staff'.Results 99.45% of them thought they should immediately save patients' live;but less than 28.96%thought of using cheap and fine medicines;only 38.80% mentioned the patients' mood. And there was no significant difference between boys and girls(P>0.05). Conclusion Medical students have already established a 'life-saving' awareness when they are freshman, but they also need to learn how to put ethics into practice.

Alanine aminotransferase and aspartate aminotransferase levels are sensitive indicators for liver inflammation grading in HBeAg-negative chronic hepatitis B patients / 中华传染病杂志

Objective To investigate the relationship between serum levels of alanine aminotransferase (ALT)or aspartate aminotransferase (AST)apportioned by the same hepatic parenchyma cell volume and liver histological necroinflammation grades in HBeAg-negative chronic hepatitis B (CHB)patients.Methods A total of 145 CHB patients were divided into four groups:Gl,G2,G3 and G4 based on the liver histological necroinflammation grade.The serum ALT and AST levels were determined by automatic biochemical instrument in these four groups.Furthermore,serum ALT and AST levels were then apportioned by the same hepatic parenchyma cell volume.The data were analyzed by ANOVA.Results Mean serum ALT levels in G1,G2,G3 and G4 groups were (35.3±29.1),(91.6±120.4),(111.6± 116.1)and (118.0±122.1)U/L,respectively,and the serum ALT levels apportioned by same hepatic parenchyma cell volume were ( 54.0 ± 45.1 ),( 144.2 ± 184.9 ),(191.3± 204.8)and (215.1 ± 226.5)U/L,respectively.The pairwise comparison between G1 and other three groups all showed statistically significant difference (P＜0.05).Meanwhile,AST levels in G1 to G4 groups were (35.5± 29.0),(64.9±71.7),(96.0±81.9)and (102.8±77.0)U/L,respectively and the serum AST levels apportioned by the same hepatic parenchyma cell volume were (54.3±44.6),(102.3± 107.9),(165.2±148.7)and (189.4±145.4)U/L,respectively.The pairwise comparison between G1 and G3,G1 and G4,G2 and G3,G2 and G4 all showed statistically significant difference (P＜0.05).Conclusion Both AST and ALT levels are sensitive indicators for liver inflammation grading in HBeAg-negative CHB patients during the natural history of the disease.

Relationship between fatal severe from hepatitis occurred during chronic hepatitis B and superinfections of hepatotropic B e system status / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To clarify the relationship between fatal severe form hepatitis occurred during chronic hepatitis B and superinfections of hepatitis A, C, D or E virus as well as hepatitis B e system status and to adopt corresponding measures to reduce the mortality of chronic hepatitis B.</p><p><b>METHODS</b>This study detected the superinfections with hepatitis A, C, D or E virus and hepatitis B e system status in 219 patients with fatal severe form hepatitis occurred during chronic hepatitis B by enzyme linked immunosorbent assay.</p><p><b>RESULTS</b>The superinfections with hepatitis A, C, D or E virus were found in 1.4% (3/219), 9.6% (21/219), 1.8% (4/219) and 30.1% (66/219) of the patients, respectively, altogether 42.9% (94/219); hepatitis E was prominent and steady in superinfection rate in recent ten years. The causes of 57.1% (125/219) patients were not clear. The positive rate of HBeAg and anti-HBe were 17.0% (16/94) and 54.2% (51/94) in the group of superinfections with hepatitis A, C, D or E virus; and were 27.2% (34/125) and 47.2% (59/125) in the group with unknown causes, respectively.</p><p><b>CONCLUSION</b>These results suggested that the patients with superinfections reached 42.9% (94/219), and the superinfections may be a part of causes of fatal severe form hepatitis, and the mortality of chronic hepatitis B may be decreased by strict food sanitation and use of safe blood products. There were no significant relation between hepatitis B e antigen seroconversion and the fatal severe form hepatitis occurred during chronic hepatitis B.</p>