Hepatoprotective effects of Xiaoyao San formula on hepatic steatosis and inflammation via regulating the sex hormones metabolism.

BACKGROUND: The modified Xiaoyao San (MXS) formula is an adjuvant drug recommended by the National Health Commission of China for the treatment of liver cancer, which has the effect of preventing postoperative recurrence and metastasis of hepatocellular carcinoma and prolonging patient survival. However, the molecular mechanisms underlying that remain unclear. AIM: To investigate the role and mechanisms of MXS in ameliorating hepatic injury, steatosis and inflammation. METHODS: A choline-deficient/high-fat diet-induced rat nonalcoholic steatohepatitis (NASH) model was used to examine the effects of MXS on lipid accumulation in primary hepatocytes. Liver tissues were collected for western blotting and immunohistochemistry (IHC) assays. Lipid accumulation and hepatic fibrosis were detected using oil red staining and Sirius red staining. The serum samples were collected for biochemical assays and NMR-based metabonomics analysis. The inflammation/lipid metabolism-related signaling and regulators in liver tissues were also detected to reveal the molecular mechanisms of MXS against NASH. RESULTS: MXS showed a significant decrease in lipid accumulation and inflammatory response in hepatocytes under metabolic stress. The western blotting and IHC results indicated that MXS activated AMPK pathway but inhibited the expression of key regulators related to lipid accumulation, inflammation and hepatic fibrosis in the pathogenesis of NASH. The metabonomics analysis systemically indicated that the arachidonic acid metabolism and steroid hormone synthesis are the two main target metabolic pathways for MXS to ameliorate liver inflammation and hepatic steatosis. Mechanistically, we found that MXS protected against NASH by attenuating the sex hormone-related metabolism, especially the metabolism of male hormones. CONCLUSION: MXS ameliorates inflammation and hepatic steatosis of NASH by inhibiting the metabolism of male hormones. Targeting male hormone related metabolic pathways may be the potential therapeutic approach for NASH.

[Analysis of deaths caused by secondary damages of road traffic accidents: 17 fatal cases].

OBJECTIVE: To explore the forensic identification points of deaths caused by secondary damages of road traffic accidents. METHODS: Seventeen deaths caused by secondary damages of road traffic accidents were collected. Through scene investigation and necropsy, the basic information of the accidents, distribution and property of the injuries, and other information were collected. According to the collected data, the scene was reconstructed in order to confirm the injury process, analyze the way, mechanism and severity of injury, distinguish antemortem injury from postmortem injury, and determine the cause of deaths. RESULTS: Certain features such as serious injuries, multiple traumas, combined injuries, co-existence of antemortem and postmortem injuries, multiple causes of wounds, complex injury mechanism, as well as the mutual damaging and overlapping injuries were quite characteristically noted in these secondary traffic accident cases. CONCLUSION: Forensic assessment of deaths caused by secondary damages of road traffic accidents should be synthetically analyzed and judged through scene investigation and necropsy.

[Disability evaluation of 204 cases of children with brain injury in road traffic accidents].

OBJECTIVE: To study the types, characteristics and common complications as well as disability assessment for the children with craniocerebral injury in the road traffic accidents. METHODS: Data from 204 cases of children with cranio-injury in road traffic accidents were collected and were statistically analyzed according to the location injured, complication, the type of complication and the severity of disability. RESULTS: There were 64 cases of simple diffuse primary craniocerebral injury, 80 cases of simple local primary cranio-injury, 24 cases of diffuse secondary craniocerebral injury and 36 cases of local secondary cranio-injury. The main complications included traumatic epilepsy (14, 6.9%), traumatic cerebral infarction (9, 4.4%), traumatic hydrocephalus (7, 3.4%) and traumatic mental disorder (5, 2.5%). CONCLUSION: Among the children with cranio-injury due to road traffic accidents, simple primary cranio-injury was the most common result, whereas the traumatic epilepsy and traumatic cerebral infarction were the major types of complications. The assessment criteria for body impairment of the children with craniocerebral injury in the road traffic accidents should be broadened accordingly, with addition of certain specific items for children.

[Forensic application of brainstem auditory evoked potential in patients with brain concussion].

OBJECTIVE: To investigate changes of brainstem auditory evoked potential (BAEP) in patients with brain concussion. METHODS: Nineteen patients with brain concussion were studied with BAEP examination. The data was compared to the healthy persons reported in literatures. RESULTS: The abnormal rate of BAEP for patients with brain concussion was 89.5%. There was a statistically significant difference between the abnormal rate of patients and that of healthy persons (P<0.05). The abnormal rate of BAEP in the brainstem pathway for patients with brain concussion was 73.7%, indicating dysfunction of the brainstem in those patients. CONCLUSION: BAEP might be helpful in forensic diagnosis of brain concussion.

[Epidemiological research and analysis on the impaired person in road traffic accident in Chengdu area].

OBJECTIVE: To analyze epidemiological characteristics of road traffic accidents that resulted in injuries in Chengdu area, to find out the cause and to provide scientific a base for accident prevention. METHODS: Appraisal data of the injured in road traffic accident from January 2003 to October 2006 were re-examined. Detailed statistics were made which include gender, age, transportation mode, person types, the accident date and day, and location. RESULTS: Six thousand three hundred and sixty four cases involving road traffic accident were analyzed. Among the injured, male to female ratio was 1.84:1, and the age group of 18-50 were the largest proportion (66.34%). Bicyclists, motorcyclists and pedestrians made up 80.90% of the injured persons. Different age groups, different genders and those who were injured in different regions varied greatly in terms of transport modes they employed. In terms of injured parts, lower limb injury took up the highest proportion (39.49%), with cranium & cerebrum ranking second (22.77%). CONCLUSION: Different approaches and measures shall be taken in regard to different age groups, different regions, different times and different transport modes, and corresponding policies shall be adopted.

[Forensic identification of floating shoulder injury].

OBJECTIVE: To discuss forensic identification of floating shoulder injury (FSI). METHODS: To analyze fifteen cases of FSI which were accepted from Jan. 1993 to Jan. 2006, including 15 shoulder neck fracture, 13 clavide stem fracture and 2 distal end clavide fracture, the function of shoulder joint was evaluated six months after injure considering the following three aspects: result of forensic examination such as X-ray photograph, CT and MRI, the injurers' symptom, objective sign and joint function, shoulder joint territory, degree of pain and local muscle power. RESULTS: Basing on the curative effect standard of Herscovic, all cases were divided into good. Modest, worst, which included 2, 4, 9 cases respectively; referring the standard of GA35-92, GB18667-2002, all cases were divided into six, seven, eight, nine and ten degree, which included 2,9,2,1,1 cases respectively. CONCLUSION: As a special powerful injure, FSI always companied with concurrent and multiple injure, and characterized by missed, incorrect and delayed diagnosis and infelicitous treatment, which lead to the high frequency and degree of injure. To prevent missed and incorrect forensic identification, we should have a full realization of the particularity of FSI, and evaluate the function of shoulder all-sidely, objectively and synseticaly.

[Analysis on body impairment assessment upon 447 thoracolumbar, spinal injury cases in traffic accidents].

OBJECTIVE: To discuss the relation between degree of body impairment and that of thoracolumbar spinal injuries resulting from road traffic accidents, and sum up the experiences in body impairment assessment and its regularity. METHODS: For comprehensive body impairment assessment, 477 cases of thoracolumbar spinal injuries in road accidents have been sorted out, reassessed and rediagnosed. In addition, analyses have been undertaken about their treatment, the assessment of the degree of their thoracolumbar dysfunction,nerve dysfunction and the relations between injuries and sequelaes. RESULTS: The analyses show that the degree of thoracolumbar dysfunction and that of the post-injury nerve dysfunction don't necessarily depend on the quantity and degree of spinal injuries. However, the position suffering from the thoracolumbar spinal injuries has an immense impact on the thoracolumbar dysfunction, and the nerve impairment result mainly from the T1-1L spinal injuries. The research also shows that there has been a high misdiagnosis rate in hospital about the spinal injuries. CONCLUSION: In body impairment assessment, the cause and effect relations between the injury and degree of injury extent should be analyzed, the injury extent should be employed as principal evidence, and the degree of spinal dysfunction should be taken into greater consideration.

[Time-series analysis on road traffic injury in China].

OBJECTIVE: To establish the predictive models of road traffic injury(RTI) in China, to know the trend of RTI, and to provide the reference data for controlling RTI in China. METHODS: The China RTI data from 1951 to 2003 were collected, and in view of the problem of missing values, the method of intrapolation was adopted. The Box-Jenkins technique was used to analyze and predict the trend of RTI in China. Following the process for stationary time-series analysis, model identification, parameter estimation and model diagnosis, the predictive equation for RTI would be established. RESULTS: A series of predictive equations on RTI were finally established based on ARIMA models. The curve fitting is effective and the predictive data of RTI in 2003 are close to the true statistical data. CONCLUSION: The time-series model thus established proves to be of significant usefulness in RTI prediction.

[A case-crossover study on road traffic injury].

OBJECTIVE: To explore the risk factors of road traffic injury (RTI), and to provide evidence for stretagy development on the prevention and control of RTI. METHODS: Case-crossover study was used. 402 drivers were face to face interviewed by specially designed questionnaire including the items as drinking alcohol before driving, onset anger scale (OAS), anxiety/irritation, Stanford sleepiness scale (SSS), vehicle breakdown, carelessness, violating the rules on right of way and traffic signs when driving. Tables related to case-control study on 1:1 matching was used for single factor analysis, and conditional logistic regression was used for multifactor analysis. RESULTS: The risk factors that were associated with RTI including high OAS (OAS = 5-7, OR = 114.88, 95% CI:4.29-3074.86), violating the rules on right of way (OR = 46.96, 95% CI:12.74-173.11), violating traffic signs when driving(OR = 24.57, 95% CI: 8.69-69.45), carelessness (OR = 14. 54,95% CI: 6.85-30.86), unsafe distance between vehicles( OR = 14.30,95% CI: 3.68-55.60), wrong judgement (OR = 14.67,95% CI:4.88-44.10), vehicle breakdown (OR = 8.57, 95% CI: 1.38- 53.27) and improper measure ( OR = 8.46, 95% CI: 2.46-29.14) etc. CONCLUSION: Improper driving behaviors, abnormal psychological status and driving skills of drivers were related to RTI, suggesting that it was necessary to carry out continous traffic security education to the drivers.