Time of Liver Function Abnormal Identification on Prediction of the Risk of Anti-tuberculosis-induced Liver Injury.

Background and Aims: Anti-tuberculosis (anti-TB) drug-induced liver injury (AT-DILI) is the most common side effect in patients who received anti-TB therapy. AT-DILI management includes monitoring liver function until symptoms arise in patients without high-risk factors for liver damage. The present study aimed to investigate the effect of liver function test (LFT) abnormal identification on the risk of DILI, including liver failure and anti-TB drug resistance in patients without high-risk factors. Methods: A total of 399 patients without high-risk factors for liver damage at baseline and who experienced LFT abnormal during the 6 months of first-line anti-TB treatment were enrolled. The Roussel Uclaf Causal Relationship Assessment Method (RUCAM, 2016) was applied in suspected DILI. The correlations between the time of LFT abnormal identification and DILI, liver failure, and anti-TB drug resistance were analyzed by smooth curve fitting and multivariable logistic regression models. Results: Among all study patients, 131 met the criteria for DILI with a mean RUCAM causality score of 8.86±0.63. 26/131 and 105/131 were in the probable grading and highly probable grading, respectively. The time of abnormal LFT identification was an independent predictor of DILI, liver failure, and anti-TB drug resistance in the crude model and after adjusting for other risk patient factors. The time of abnormal LFT identification was positively correlated with DILI, liver failure, and anti-TB drug resistance. The late identification group (>8 weeks) had the highest risk of DILI, followed by liver failure compared with the other two groups. Conclusions: The time to identification of LFT was positively correlated with DILI, liver failure, and anti-TB drug resistance. The risk of DILI and liver failure was significantly increased in the late identification group with abnormal LFT identified after 8 weeks compared with 4 and 8 weeks. Early monitoring of LFT is recommended for patients without the high-risk factor of DILI after anti-TB treatment is initiated.

What is the spatiotemporal relationship between urbanization and ecosystem services? A case from 110 cities in the Yangtze River Economic Belt, China.

Rapid urbanization has altered landscape patterns and ecological functions, causing a decline in ecosystem service and generating many ecological and environmental issues. Studying the spatiotemporal interaction between urbanization and ecosystem service (ES) can provide effective supports for regional sustainability and policy formulation. This research utilizes the Yangtze River Economic Belt (YREB) as a case to analyze the spatiotemporal interaction between multi-urbanization indicators and multi-ESs over a large-scale region. The results show that the urbanization process in the YREB evolves from a rapidly growing state to a steady state with a slower rise. The urbanization level of the Yangtze River Delta urban agglomeration is relatively higher than the other regions. The distribution pattern of urbanization shows an overall characteristic of lower urbanization in the west and higher in the east. From 2009 to 2016, ecosystem service value (ESV) in the YREB decreased first and then increased, ESV in 2016 showed a reduction of 12.768 billion yuan compared with the 2009 level. ESV increases gradually from highly urbanized areas to those with lower levels of urbanization. Areas with high ESV levels are distributed at the middle reaches of YREB. There is a U-shaped curve relationship between urbanization and ESV, the ESV sharply increased when the urbanization index exceeded 0.6 in 2012. Land urbanization has the greatest impact on ESV among the four subtypes of urbanization indicators. Urbanization and ESV show the synergy relationship mostly in the eastern region, accounting for 18.18% of the total 110 cities. By contrast, they present the trade-off relationship in northern, southern and central regions, occupying 47.27% of the total observations. This study is helpful to provide scientific suggestions regarding the development of new urbanization, the protection of ESV, and the issue of how to achieve synergistic and sustainable development between them.

[Palatal fistula rate after Huaxi Sommerlad-Furlow palatoplasty].

OBJECTIVE: This study aimed to determine the palatal fistula rate, explore the influencing factors of Huaxi Sommerlad-Furlow (SF) palatoplasty. METHODS: A retrospective review of 385 consecutive cleft-palate cases was performed to determine the incidence of postoperative fistula and assess the possible contributing factors, such as sex, weight, age, cleft type, operator skills, preoperative white blood cell, preventive antibiotic use, and postoperative temperature. RESULTS: Fistulas occurred in 15/385 patients (3.9%). Among them, 1 fistula was located at the junction of the hard and soft palates, 12 fistulas in hard palate, and 2 fistulas in alveolar near the hard palate. No evidence suggested that sex, weight, age, preoperative white blood cell, preventive antibiotic use, and postoperative temperature are associated with fistula formation. The incidences of cleft palate fistulas as encountered by senior professors (3.03%) and associate senior professors (2.23%) were significantly lower than those by attending doctors (14.29%, P<0.05). The incidences of cleft palate fistulas in bilateral completely cleft palate cases (20.6%) were significantly higher than those in hard and soft (3.6%) and unilateral cleft palate cases (2.6%, P<0.05). CONCLUSIONS: Huaxi SF palatoplasty can avoid the inhibited maxillary growth without requiring lateral relaxing incision, which poses an acceptable risk of fistula formation. The palatal fistula rate is not related to the sex, weight, age of operation, prophylactic use of antibiotics before operation, infection before operation, temperature after operation and other factors. The occurrence of the fistula is related mainly to cleft type and experience level of the surgeon.

Oridonin promotes G2/M arrest in A549 cells by facilitating ATM activation.

Previous studies have demonstrated that oridonin, a tetracyclic diterpenoid compound extracted from Rabdosia rubescens, inhibits proliferation and induces apoptosis in several tumor cell lines. However, the mechanism by which oridonin inhibits the cell cycle remains poorly understood. In the present study, possible mechanisms by which oridonin affects cell cycle progression were explored in A549 lung cancer cells. Flow cytometry analysis indicated that oridonin inhibited the proliferation of A549 cells by inducing G2/M cell cycle arrest in a dose­dependent manner. Western blot analysis revealed that in oridonin treated cells, phosphorylated (p­)ATM serine/threonine kinase (S1981), p­checkpoint kinase 2 (CHK2) (T68), p­p53, and phosphorylated H2A histone family member X protein levels were visibly increased, indicating that oridonin promoted G2/M arrest in A549 cells through the ATM­p53­CHK2 pathway. This data suggests that oridonin promotes G2/M arrest in A549 cells by facilitating ATM activation, which is likely a common mechanism in other tumor cell types when using this drug for cancer treatment.

Expression of cyclooxygenase-2 and clinicopathologic features in human gastric adenocarcinoma.

AIM: To study the expression of cyclooxygenase-2 (COX-2) gene in gastric cancer and the relationship between COX-2 expression and clinicopathologic features of gastric cancer. METHODS: With reference to the expression of beta-actin gene, COX-2 mRNA level was examined in cancerous tissues and adjacent noncancerous mucosa from 33 patients by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). Quantitation of relative band Adj volume counts was performed using molecular Analyst for windows software. The COX-2 index was determined from the band Adj volume counts ratio of COX-2 to constitutively expressed actin. RESULTS: The COX-2 index in gastric carcinoma was significantly higher than that in normal mucosa (0.5966+/-0.2659 vs 0.2979+/-0.171, u=5.4309, P<0.01). Significantly higher expression of COX-2 mRNA was also observed in patients with lymph node involvement than that in those without (0.6775+/-0.2486 vs 0.4105+/-0.2182, t=2.9341, P<0.01). Furthermore, the staging in the UICC TNM classification significantly correlated with COX-2 overexpression (F=3.656, P<0.05), the COX-2 index in stage III and IV was significantly higher than those in stage I and II (q=3.2728 and q=3.4906, P<0.05). The COX-2 index showed no correlation with patient's age, sex, blood group, tumor location, gross typing, depth of invasion, differentiation, and the greatest tumor dimension (P>0.05). CONCLUSION: Expression of COX-2 mRNA in gastric carcinoma was significantly higher, which may enhance lymphatic metastasis in patients with gastric carcinoma. The staging in the UICC TNM classification was significantly correlated with COX-2 over-expression. COX-2 may contribute to progression of tumor in human gastric adenocarcinoma.