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OBJECTIVE To provide reference for rational use of cyclin-dependent kinase 4/6 （CDK4/6） inhibitors. METHODS Retrieved from Web of Science， PubMed， SpringerLink， CNKI， Wanfang Data and VIP database， and so on， the literature about lung toxicity related to CDK4/6 inhibitors were collected and analyzed statistically with Excel 2013 software. RESULTS A total of 12 literature which met the inclusion and exclusion criteria were included； 13 patients were involved， among which 3 cases were from the United States， 3 from Japan， 2 from India， and 1 from Israel， Spain， France， Australia and Saudi Arabia respectively； all patients were female， aged between 43-89 years， of whom 8 were treated with palbocicilib， 3 with abemacilib， and 2 with ribociclib. The lung toxicity of patients after medication occurred from 1 week to 15 months； the majority of patients were hospitalized with the symptom such as difficulty breathing， chest tightness， shortness of breath， dry cough， etc. The lung toxicity mainly manifested as interstitial lung disease， eosinophilic pneumonia， mediastinal and pulmonary granulomatous reaction， drug-induced pneumonia， diffuse alveolar damage， organizing pneumonia and so on. The shortest treatment duration was 3 weeks， and the longest was 6 months. The treatment measures included drug withdrawal， intravenous use of antibiotics， intravenous use of systemic steroids， oxygen inhalation， and so on； after treatment， 8 patients improved or recovered， and 5 patients died due to deterioration. One patient developed lung toxicity again after reuse of such drugs and must stop drugs permanently. CONCLUSIONS Lung toxicity related to CDK4/6 inhibitors possibly cause mortality. It is necessary to make early judgment， stop the drug in time， and give patients systemic steroids， oxygen inhalation and other treatment measures as soon as possible.
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As a chronic liver inflammation disease caused by the lack of immune tolerance, autoimmune hepatitis is regulated by various signaling pathways, such as the NF-κB/NLRP3 pathway, the SIRT1/Nrf2/HO-1 pathway, the Hippo-YAP/TAZ pathway, the JAK/STAT pathway, the PI3K/Akt pathway, and the TRAF6/JNK pathway. These pathways can play a role against autoimmune hepatitis by participating in the processes including the proliferation and apoptosis of cytokines, immune response, and oxidative stress. In view of the problems of suboptimal response, obvious adverse reactions, and high recurrence rate in the clinical application of hormones and immune preparations for the treatment of autoimmune hepatitis, this article summarizes the research articles on autoimmune hepatitis-related signaling pathways and the mechanism of effective constituents (glycosides, terpenoids, flavonoids, quinones, and phenols) in traditional Chinese medicine intervening against the disease process of autoimmune hepatitis through the above signaling pathways, in order to provide a theoretical basis for scientific and effective utilization of effective constituents in traditional Chinese medicine to develop anti-autoimmune hepatitis drugs.
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OBJECTIVE To e xplore the research hots pots and development frontiers of ursolic acid in recent 20 years，and to provide reference for researchers in this field. METHODS Research literatures related to ursolic acid in Web of Science from Jan. ， 1，2002 to Dec. 31，2021 were collected ，and visualization analysis was performed on countries or regions ，research institutions ， authors，journals and keywords involved in the literatures using CiteSpace software ，to obtain the spatial and temporal distribution of ursolic acid and research frontiers. The research status and development frontier of ursolic acid were further analyzed by analyzing keywords co-occurrence ，keyword emergence ，keyword clustering ，etc. RESULTS & CONCLUSIONS Totally 3 528 valid papers were included in this study ，and the top three countries were China ，India and the United States. Analysis of publishing institutions showed that Chinese Academy of Sciences ，Univisity of Karachi and China Medical University were the top 3 research institutions in the list of publication amount. Analysis of published journals showed that Molecules （127 articles），Journal of Ethnopharmacology（90 articles），Journal of Agricultural and Food Chemistry （75 articles）had high number of literatures on ursolic acid. The analysis of keyword analysis showed that pharmacological effects ，such as antitumor activity of ursolic acid ， antioxidant activity ，antibacterial activity and anti-inflammatory activity ，are always the focus of the research ；the mechanism ursolic acid induced apoptosis ，oxidative stress and autophagy ，the research on ursolic acid signaling pathway ，drug delivery of ursolic acid nanoparticles were the research direction in the future.
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Objective To quantify operation characteristics of the ankle rotating-traction-poking manipulation (RTPM) for treating acute lateral ankle sprain by using motion capture technology, so as to provide objective references for standardized operation of RTPM and its education inheritance. Methods A professional physiotherapist performed the RTPM on 60 volunteers with acute lateral ankle sprain. Motion capture system was used to acquire effective kinematic data during the RTPM, so as to make analysis and summarize rules. Results The average time of ankle rotating for six circles was 11.36 s and the average time of ankle traction and poking was 3.42 s. The average displacement of ankle traction was 36.94 mm and the average displacement of ankle poking was 22.44 mm. The average angle of ankle traction was 23.27°, and the average angle of ankle poking was 22.76°. During the RTPM for treating acute lateral ankle sprain, the average linear velocity of ankle rotating was 58.28 mm/s, and the average linear velocity of ankle traction and poking was 23.81 mm/s. The linear acceleration of ankle rotating was 0.43 mm/s2, and the linear acceleration of ankle traction and poking was 0.54 mm/s2. Conclusions The RTPM can be applied in clinical practice. During the RTMP, the principle of gentleness, rhythmicity and continuity should be followed. Under the premise of following physiological characteristics of ankle joint, treatment of the sprained ankle should be carried out with slow and uniform speed continuously.
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Objective:To explore the effect of nutritional status on pulmonary infection in patients with severe stroke, and to identify the nutrition-related risk factors of pulmonary infection, so as to provide reference for the prevention and treatment of pulmonary infection from the perspective of nutrition.Methods:The clinical data of 122 patients admitted to the neuro-intensive care unit (NICU) of the First Affiliated Hospital of Chongqing Medical University from August 2019 to February 2020 were retrospectively analyzed. Patients with severe stroke were divided into two groups according to whether they had pulmonary infection during hospitalization in NICU, and there were 25 patients in case group and 97 patients in control group. Nutritional Risk Screening (NRS2002), Nutrition Risk in the Critically ill (NUTRIC) score and malnutrition criteria, combined with anthropometry, clinical comprehensively history and laboratory data were used to evaluate the nutritional status of patients. Logistic regression was used to identify nutrition-related risk factors for pulmonary infection in patients with severe stroke.Results:The incidence of pulmonary infection in severe stroke patients was 20.5% (25/122). Univariate analysis showed that the difference of chronic obstructive pulmonary disease, endotracheal intubation, nasogastric tube use, NUTRIC ≥ 5, the Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Sequential Organ Failure Assessment (SOFA), Glasgow Coma Scale (GCS), and creatinine levels, duration of enteral nutrition, length NICU stay, and length of hospital stay between the two groups were statistically significant ( χ2 value was 7.542-34.403, t value was 2.207, Z value was -3.511, 3.083 and 3.115, P<0.05 or 0.01). Multivariate Logistic regression analysis showed that NUTRIC≥5 ( OR= 12.202, 95% CI 2.342-63.568) and nasogastric tube use ( OR=16.990, 95% CI5.343-54.024) were independent risk factors of pulmonary infection in patients with severe stroke ( P<0.01). Conclusions:NUTRIC score≥ 5, high nutritional risk and nasogastric tube use were independent risk factors of pulmonary infection in patients with severe stroke, which should be given early nutritional assessment and individualized care.
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OBJECTIVE：To explo re the potential molecular mechanism of ursolic acid in the treatment of osteoporosis （OP）. METHODS：TCMSP，PubMed database and UniProt database were used to screen potential targets of monomer compound ursolic acid. OP related target genes were searched with GeneCards database. The common target genes of component-disease were obtained by Venny 2.1 online mapping tool. The protein-protein interaction （PPI）network of component-disease common target genes was constructed by using STRING database ，and topological analysis was carried out ；the core target genes ，whose degree value was greater than the average degree value ，were screened. GO functional annotation and KEGG pathway enrichment analysis of component-disease common target genes were carried out by DAVID database. AutoDock Vina 1.1.2 software was used for molecular docking ，using protein encoded by the core target gene as receptor and ursolic acid as ligand. RESULTS ：A total of 55 ursolic acid related target genes and 4 273 OP related target genes were excavated ，with a total of 44 common target genes. PPI network with above common target genes included 44 nodes and 513 edges，with an average node degree of 23.3. There were 24 core target genes ，including VEGFA，TP53，IL6，CASP3. There were 340 GO functional items were enriched （corrected P＜ 0.05），including 263 biological processes （negative regulation of apoptosis ，etc.），25 molecular functions （protein binding ，etc.） and 52 cell components （cytosol，etc.）. There were 90 KEGG signaling pathways （corrected P＜0.05），such as tumor pathway ， hepatitis B pathway ，TNF signaling pathway ，viral carcinogenesis and phosphatidylinositol 3 kinase/protein kinase B （PI3K-Akt） signaling pathway. The binding energy between ursolic acid and 6 proteins encoded by core target genes such as TP53 was lower than －5 kcal/mol，which had strong binding activity. CONCLUSIONS ：The therapeutic effect of ursolic acid on OP may be achieved by regulating VEGFA，TP53，IL6，CASP3，JUN and other core target genes and acting on multiple key pathways such as cancer pathway ， hepatitis B and TNF signaling
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The treatment of lower extremity chronic refractory ulcers requires a long time but with poor prognosis. Thus, many patients end up with amputations. The treatment of lower extremity chronic and recalcitrant ulcers and limb salvage has been a challenge worldwide. The Ilizarov technique based on the law of "tension-stress" brings a new hope in treating lower limb chronic and recalcitrant ulcers. The Ilizarov technique and distraction osteogenesis not only induce bone formation but also lead to angiogenesis and improved microcirculation. The Ilizarov technique consists of longitudinal distraction of long bone and tibia trans-verse transport (TTT) (proximal tibial corticotomy followed by transverse distraction). These two techniques have their own advantages and disadvantages with different indications in clinical application. Longitudinal distraction of long bone is mainly used for bone formation, such as large bone defects, osteonecrosis or bone infection (with or without soft tissue loss or ulcers). Because of only a partial osteotomy in TTT, the trauma is minor and their effects on limb instability are limited. Moreover, the procedure is simple with only a few minor complications. Thus, it is ideal in treating lower limb ischemic ulcers, such as diabetic foot ulcers, thromboangiitis obliterans (Buerger's disease), ulcers caused by atherosclerotic occlusion, arterial or venous ulcers, and trauma wounds. Several studies reported that TTT achieved high healing and limb salvage rates in treating severe diabetic foot ulcer. However, TTT could achieve lower recurrent rate. Thus, it is the most successful application in treatment of chronic ulcers. TTT also improves healing and limb salvage in treatment of thromboangiitis obliterans. However, the overall effects are limited than those in treating diabetic foot ulcer. For lower limb atherosclerosis occlusion, TTT induces regeneration of microvessles and consequently leads to ulcer healing. The effects are better than other conventional treatments. A combination therapy with vascularization is emphasized to attain the optimal long-term effects. The effects of TTT on lower limb recalcitrant ulcers still need to be validated in randomized control trial with larger sample size. Further, the mechanism of treatment needs to be explored by pilot studies which could show that this may be related to the formation of pro-angiogenetic factors and a rebalance of the inflammatory microenvironment during TTT.
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Autophagy is a process of self-defense and self-repair of cells and tissues and plays an important role in regulating the body's immune inflammatory response and maintaining the homeostasis of liver cells. This article summarizes the mechanism of autophagy in the development and progression of autoimmune hepatitis (AIH) from the aspects of the role of autophagy in regulating immune inflammatory response, regulating immune signal transduction, and preventing overactivated innate immune response. It is believed that autophagy may reveal the mechanism of AIH and provide new ideas and methods for the research on AIH.
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The influence of circadian rhythm disorder on nonalcoholic fatty liver disease (NAFLD) has attracted more and more attention in recent years, and studies in China and globally have shown that individuals who work in shifts at night or often stay up late have a higher incidence rate of NAFLD-related hepatocellular carcinoma (NAFLD-HCC) than those with regular work and rest. This article summarizes the research advances in the effect of circadian rhythm system on the pathogenesis of NAFLD-HCC by regulating lipid metabolism, glucose metabolism, and intestinal flora, and it is pointed out that restoration of normal circadian rhythm has potential clinical significance in delaying the development and progression of disease.
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The influence of circadian rhythm disorder on nonalcoholic fatty liver disease (NAFLD) has attracted more and more attention in recent years, and studies in China and globally have shown that individuals who work in shifts at night or often stay up late have a higher incidence rate of NAFLD-related hepatocellular carcinoma (NAFLD-HCC) than those with regular work and rest. This article summarizes the research advances in the effect of circadian rhythm system on the pathogenesis of NAFLD-HCC by regulating lipid metabolism, glucose metabolism, and intestinal flora, and it is pointed out that restoration of normal circadian rhythm has potential clinical significance in delaying the development and progression of disease.
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Objective@#To examine the value and clinical application of convolutional neural network in pathological diagnosis of metastatic lymph nodes of gastric cancer.@*Methods@#Totally 124 patients with advanced gastric cancer who underwent radical gastrectomy plus D2 lymphadenectomy at Affiliated Hospital of Qingdao University from July 2016 to December 2018 were selected in the study. According to the chronological order, the first 80 cases were served as learning group. The remaining 44 cases were served as verification group. There were 45 males and 35 females in the study group, with average age of 57.6 years. There were 29 males and 15 females in the validation group, with average age of 9.2 years. The pre-training convolutional neural network architecture Resnet50 was trained and fine-tuned by 21 352 patches with cancer areas and 14 997 patches without cancer areas in the training group. A total of 78 whole-slide image served as a test dataset including positive (n=38) and negative (n=40) lymph nodes. The convolutional neural network computer-aided detection (CNN-CAD) system was used to analyze the ability of convolutional neural network system to screen metastatic lymph nodes at the level of slice by setting threshold, and evaluate the system′s classification accuracy by calculating its sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic curve (AUC).@*Results@#The classification accuracy of CNN-CAD system at slice level was 100%.The AUC for the CNN-CAD system was 0.89. The sensitivity was 0.778, specificity was 0.995, overall accuracy was 0.989. Positive and negative predictive values were 0.822 and 0.994, respectively. The CNN-CAD system achieved the same classification results as pathologists.@*Conclusions@#The CNN-CAD system has been constructed to distinguished benign and malignant lymph node slides with high accuracy and specificity. It could achieve the similar classification results as pathologists.
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Objective To investigate the feasibility of manual reduction with inverse shift for pronation-extorsion trimalleolar fracture by applying the finite element method combined with clinical experience. Methods Based on CT images and anatomical features of bone, ligaments and other tissues as well as material parameters, a normal ankle model with completed muscles and bones for a Chinese young male was established. According to the related characteristics of the pronation-extorsion trimalleolar fractures, fracture was simulated in the proper position to make osteotomy model. The finite element model of pronation-extorsion trimalleolar fractures was thus established and then applied with mechanical loading to simulate manual reduction with inverse shift. Results The established finite element model of pronation-extorsion trimalleolar fractures was effectively restored by the displacement loading. Conclusions The finite element analysis on pronation-extorsion trimalleolar fractures by inverse shift maneuver could further prove the feasibility, effectiveness and scientificity of manual reduction with inverse shift based on clinical experience.
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Objective To observe the effect of Hp infection on the expression of Foxp3 and ROR in peripheral blood of patients with hepatitis C cirrhosis ,and to explore the effect of Hp infection on the regulation of Treg cells. Methods Totally 42 hepatitis C cirrhosis patients with Hp infection were chosen as observation group and 30 patients without as control group. Gene expressions were determined by RE-PCR and relative cell factors were detected by ELISA in two groups. Results Expression of FoxP3 and RORγt in observation group was significantly higher than that in control group;the expression level of IL-10,IL-6,IL-17,TGF-β1 and IFN-γin observation group was significantly higher than that in control group but IL-2 expression level was lower than that in control group and expression of IL-10 and TGF-βwas positively correlated with Foxp3 expression and was negatively correlated with IL-2. Conclusion Through inducing the high expression of Treg cells ,Hp may promote the expres-sion of IL-10,TGF-β1,IL-6 and IL-17,inhibit the expression of IL-2 and IFN-γ,imbalance of Treg/Th17 and Th1/Th2 balance in the body and promote the liver inflammation and fibrosis in patients with hepatitis C liver cirrhosis.
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Objective Meta-analysis the efficacy and safety of Exenatide and insulin therapy oral hypoglycemic drugs effect of obesity with type 2 diabetes .Methods According to the research purpose to set up the screening of related literature and exclusion criteria; formulatethe searching strategy, through PubMed、the Chinese Biological Medicine Datebase(CBM)、 CNKI、Wanfang Data Knowledge Service Platform, VIP to retrieve all theliterature selection of efficacy and safety by Exenatide oral hypoglycemic drugs and insulin therapy of obese type 2 diabetes mellitus.Choose met inclusion exclusion criteria, the complete data information randomized controlled trial (RCT) as the research object; Apply to the international commonly used Jadad score method to evaluate quality included in the test; To process the relevant data in the test ; Apply the ReviewManager 5.1 software to analysis the extracted research data.Analysis the results and put forward conclusions.Results Participants included 11 RCT , meta analysis results showed that compared with the Exenatide, in terms of reducing fasting glucose ,insulin effect more apparent [MD = 0.35, 95％CI: (0.11, 0.59), P = 0.004)]. In control effect of glycosylated hemoglobin, there was no statistically significant difference[MD=-0.04 ,95％CI:(-0.20,0.11), P=0.58],between Exenatide and insulin. Compared with the insulin, Exenatide reduce BMI more apparent[MD=-2.77,(95％CI: -3.34,-2.20),P<0.00001]; Compared with the insulin, Exenatide reduce insulin resistance index, the effect is more obvious[MD=-1.67,95％CI:(-1.93,-1.41), P<0.00001]; Adverse reaction in the process of treatment, the insulin is more likely to lead to hypoglycemia, [OR = 0.32, 95％ CI: 0.19, 0.54), P<0.0001]; While Exenatide are more likely to lead to gastrointestinal adverse reaction [OR = 4.04, 95％ CI: 2.35, 6.93), P<0.00001).Conclusion According to the Meta-analysis: Exenatide can be used in the treatment of oral hypoglycemic drugs of adult obesity with type 2 diabetes, and obvious effects of treatment of insulin resistance, long-term results still needs a large number of samples of high quality RCT to verify.
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Objective To observe the effect of Hp infection on the expression of Foxp3 and ROR in peripheral blood of patients with hepatitis C cirrhosis ,and to explore the effect of Hp infection on the regulation of Treg cells. Methods Totally 42 hepatitis C cirrhosis patients with Hp infection were chosen as observation group and 30 patients without as control group. Gene expressions were determined by RE-PCR and relative cell factors were detected by ELISA in two groups. Results Expression of FoxP3 and RORγt in observation group was significantly higher than that in control group;the expression level of IL-10,IL-6,IL-17,TGF-β1 and IFN-γin observation group was significantly higher than that in control group but IL-2 expression level was lower than that in control group and expression of IL-10 and TGF-βwas positively correlated with Foxp3 expression and was negatively correlated with IL-2. Conclusion Through inducing the high expression of Treg cells ,Hp may promote the expres-sion of IL-10,TGF-β1,IL-6 and IL-17,inhibit the expression of IL-2 and IFN-γ,imbalance of Treg/Th17 and Th1/Th2 balance in the body and promote the liver inflammation and fibrosis in patients with hepatitis C liver cirrhosis.
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Comparing the definition,classification,quantity,core capacity construction and the supervision mode of Chinese and the United States specialist nurses,there was a gap between them.The training for the specialist nurses in China was at the initial stage.The advanced experience should be learned from America to provide the reference for building the core capacity and supervision mode of the specialist nurses.
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The electroencephalography (EEG) has a wide range of content, complex graphics and abstract theory. Meanwhile, there are differences in professional level, learning ability and subjective initia-tive among refresher doctors. In order to improve the quality of teaching, and to better serve the refresher doctors, the following strategies have been applied in the teaching process. We not only make the training target according to the actual condition of every refresher doctors, but also make them take a correct atti-tude towards study and follow the teaching arrangement. Besides, we not only orient at the operational skills training, including electrode installation, EEG evoked test, Point-of-Care test to eliminate the interference, but also promote the refresher doctors to seek the law of the diagram in the actual interpretation process with longitudinal development view and horizontal comparison perspective. Furthermore, we not only stan-dardize their report, but also broaden their view.
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<p><b>OBJECTIVE</b>To explore the accuracy of endoscopic ultrasound (EUS) in preoperative staging of rectal cancer and to guide the treatment of transanal endoscopic microsurgery (TEM) in early rectal cancer.</p><p><b>METHODS</b>Clinical data of 80 patients with rectal cancer receiving EUS examination for preoperative staging in our department between June and December 2012 were retrospectively analyzed. Consistence comparison of EUS preoperative staging and pathological staging was performed to identify the accuracy of EUS preoperative staging. All the patients underwent operation within 1 week after EUS examination. According to preoperative staging, early rectal cancer(Tis or T1N0M0) patients with lesions less 20 cm to anus underwent TEM.</p><p><b>RESULTS</b>The overall accuracy of EUS for preoperative T stage was 68.8%(55/80), and for T1, T2, T3, T4 was 91.3%(73/80), 83.8%(68/80), 77.5%(62/80), 85.0%(67/80), which had a good consistence with postoperative pathological T staging(Kappa=0.562). The overall accuracy of EUS for preoperative N stage was 52.7%(39/74), and for N0, N1, N2 stage was 64.9%(48/74), 55.4%(41/74), 85.1%(63/74), which had a poor consistence with postoperative pathological N staging(Kappa=0.235). Six patients underwent TEM successfully, with mean operation time 99(65 to 123) min, without intraoperative and postoperative complication, and were discharged 2-3 days after operation. Enteroscope showed good recovery 1 month later. Pathology confirmed that all the lesions were early rectal cancer. During postoperative follow-up of 14.8 (11 to 19) months, there was no local recurrence and distant metastasis.</p><p><b>CONCLUSION</b>Preoperative EUS has a good accuracy with pathologic T stage, and can guide TEM in early rectal cancer.</p>
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Humans , Anal Canal , Endosonography , Neoplasm Recurrence, Local , Neoplasm Staging , Postoperative Complications , Rectal Neoplasms , Retrospective Studies , Transanal Endoscopic MicrosurgeryABSTRACT
Objective To assess the risk factors of pulmonary infection in patients with cerebral hemorrhage,and then to provide references for policy-making.Methods Relative literature of crosssectional or case-control studies about risk factors of pulmonary infection in patients with cerebral hemorrhage was searched by computer in data bases such as CNKI,VIP,CBM,WanFang Data and PubMed from January of 1994 to October 2014.Resluts A total of 22 studies (2 case-control studies and 20 crosssectional studies) were brought into the study.The risk factors' OR and its 95％CI was 2.64(2.10-3.33) for over 60 years of age,2.05(1.56-2.69) for smoking history,3.07(2.24-4.19)for those who have diabetes,3.36 (2.40-4.70) for those who have chronic pulmonary diseases,1.54 (1.16-2.05) for those who have heart diseases,2.38 (1.83-3.08) for those who have a history of stroke,5.07 (3.15-8.16) for disorder of consciousness,2.78(2.36-3.27) for amount of bleeding over 30ml,2.85(2.22-3.66) for deviated from midline,2.58 (1.60-4.17) for breaking into ventricle,2.05(1.67-2.51) for high level of fasting blood sugar respectively,and so on.Conclusions Prophylactic measures can be carried out according to the risk factors of pulmonary infection in patients with cerebral hemorrhage,and then to reduce the incidence rate of pulmonary infection.
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Background:Dexamethasone can protect mice against the acute inflammatory liver injury by inhibiting innate immune cell function. However,the roles of T cell in this protective effect remain unknown. Aims:To investigate the regulatory effect of dexamethasone on T cell immune response in acute inflammatory liver injury. Methods:Six male C57BL/ 6J mice were randomly divided into 2 groups. One hour before induction of acute inflammatory liver injury by lipopolysaccharide, dexamethasone 5 mg/ kg and PBS were given intraperitoneally in experimental group and model group,respectively. All the mice were sacrificed 12 hours after model construction. The clinical score and liver function parameters were assessed;splenic mononuclear cells were isolated for measurements of T cell activation,as well as cytokine expression,secretion, and transcriptional factor expression for different T-cell subsets. Results:Clinical score and serum levels of transaminase were significantly lower in experimental group when compared with the model group. Meanwhile,percentage of CD44 +CD62L - T cells(i. e. activated or memory T cells)from spleen was significantly decreased in experimental group. Among splenic T cell population,expression and secretion of IFN-γ,a Th1-type cytokine,was decreased;expression and secretion of IL-4,a Th2-type cytokine,percentage of regulatory T cells(Treg cells),and ratios of Th2 / Th1 and Treg/ Th1 were increased;transcriptional factor specific for Th1 cells was down-regulated,and those for Th2 and Treg cells were up-regulated. Conclusions:Dexamethasone inhibits T cell activation and directs the reciprocal T cell lineage differentiation (repressing Th1 cell differentiation,promoting Th2 and Treg cell differentiation),which may contribute to the protection against acute inflammatory liver injury.