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ObjectiveTo investigate the influencing factors for the clinical outcome of patients with drug-induced liver injury （DILI）， and to establish a nomogram prediction model for validation. MethodsA retrospective analysis was performed for the general information and laboratory data of 188 patients with DILI who were admitted to Heilongjiang Provincial Hospital Affiliated to Harbin Institute of Technology from January 2017 to December 2022， and according to their clinical outcome， they were divided into good outcome group with 146 patients and poor outcome group with 42 patients. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Logistic regression analyses were used to investigate the independent influencing factors for the clinical outcome of DILI patients. R Studio 4.1.2 software was used to establish a nomogram model， and calibration curve， receiver operating characteristic （ROC） curve， and decision curve analysis （DCA） were used to perform internal validation. ResultsThe univariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI， platelet count， cholinesterase， albumin， prothrombin time activity， IgM， and IgG were associated with adverse outcomes in patients with DILI. The multivariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI （odds ratio ［OR］=0.072， 95% confidence interval ［CI］： 0.022 — 0.213， P<0.001）， clinical classification （OR=0.463， 95%CI： 0.213 — 0.926， P=0.039）， alanine aminotransferase （OR=0.999， 95%CI： 0.998 — 1.000， P=0.025）， prothrombin time activity （OR=0.973， 95%CI： 0.952 — 0.993， P=0.011）， and IgM （OR=1.456， 95%CI： 1.082 — 2.021， P=0.015） were independent influencing factors for clinical outcome in patients with DILI. The nomogram prediction model was established， and after validation， the calibration curve was close to the reference curve. The area under the ROC curve was 0.829， and the DCA curve showed that the model had good net clinical benefit. ConclusionThe nomogram prediction model established in this study has good clinical calibration， discriminative ability， and application value in evaluating the clinical outcome of patients with DILI.
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The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.
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Portal vein thrombosis is one of the common complications of liver cirrhosis, and anticoagulation is currently the main treatment method for this disease. Since low-molecular-weight heparin must be injected and vitamin K antagonists require regular monitoring of international normalized ratio (INR), direct oral anticoagulants have become a research hotspot in replacement therapy with the advantages of convenient oral administration, no need for INR monitoring, and high recanalization rate. This article summarizes the advances in direct oral anticoagulants in the treatment of cirrhosis-associated portal vein thrombosis, in order to lay a foundation for further clinical studies.
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Recent studies have shown that some long non-coding RNAs (lncRNAs) are expressed abnormally in hepatocellular carcinoma (HCC) tissue, and the expression of H19 gene in lncRNAs in HCC tissue is significantly higher than that in normal tissue. After the knockout of H19 gene, the proliferative and invasive abilities of HCC are significantly reduced. This article briefly introduces lncRNAs and H19 gene, the detection method for lncRNAs, and the value of H19 in the diagnosis of HCC and points out that H19 may be used in a method for the diagnosis of HCC. Further studies on the expression of H19 in HCC and rapid, simple, and economic detection of lncRNAs including H19 play important roles in the diagnosis of HCC.
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Turn-over of messenger ribonucleic acid ( mRNA) is a major control point in gene expres-sion.In mammals,many mRNAs encode inflammatory cytokines ,oncoproteins,and G-protein-coupled receptors are destabilized by the presence of AU -rich elements ( AREs ) in their 3′-untranslated regions .Association of ARE-binding proteins(AUBPs)with these mRNAs promotes rapid mRNA degradation .ARE/poly(U)-binding factor 1(AUF1),one of the best-characterized AUBPs,binds to many ARE-mRNAs and assembles other fac-tors to recruit the mRNA degradation machinery .Most studies support an mRNA -destabilizing role for AUF1,al-though other findings suggest additional functions for this factor .However,several lines of evidence also support a role for AUF1 in the initiation and/or development of cancer .Many AUF1-targeted transcripts encode products that control pro-or anti-oncogenic processes .Numerous signaling pathways alter the composition of this AUF 1 complex of proteins to affect changes in ARE -mRNA degradation rates .This review briefly describes the roles of mRNA decay in gene expression in general and ARE -mediated decay ( AMD) in particular ,with a focus on AUF1 and the different modes of regulation that govern AUF 1 involvement in AMD.In the end,we discuss how changes in AUF1 isoform distribution,subcellular localization,and post-translational protein modifications can influence the metabolism of targeted mRNAs .
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ObjectiveTo observe the dose of methadone and the compliance of patients to the methadone maintenance treatment(MMT).MethodsWe analyzed the status of 69 patients who were addicted to opiate medication and 44 patients who dropped out in our clinic until July 31,2010.ResultsThere was no significant relationship between patients' urine test and the dose.Crime caused the patients who dropped out.The percentage of positive urine did not decline as the dose increased,but the rate of patients who dropped and the number of positive urine test showed a significant correlation( r =0.523 P =0.000).Crime was the main reason that affected the compliance to MMT and caused dropping out.ConclusionThe use of MMT dose should be individualized.
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Objective To explore the effect of psychotherapy in patients with methadone maintenance treatment.Methods 60 patients accepted drug and 69 patients accepted drug with psychotherapy treatment were evaluated with Self-Rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) in the beginning of psychotherapy therapy and 3 months later.All of them were assessed for heroin use at 3 months after the end of a 3-month treatment period.Results SAS、SDS did not show any significant differences between the two groups in the beginning(P ＞0.05).After 3 months of psychotherapy,the differences in SDS and SAS between the two groups showed statistically significant(t =- 2.858,- 2.465,all P ＜0.05).After 2 months of psychotherapy,the number of relapsing again patients of group psychotherapy treatment was significantly lower than control group(x2 =6.906,5.054,5.100,4.247,all P ＜0.05).Conclusion The mental healthy status of patients with heroin dependence is poor.Psychological treatment plays an important role in short-term prevent hernoin addicts from relapse again.
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Mental health has emerged an outstanding problem in public health and a social problem as welL Early warning and intervention mechanism for mental health of community residents serves an effective mechanism to combat mental problems for such a population. Recommendation: Emphasize and build mental health service institutions in communities, and improve their functionality, establish an effective early warning and intervention mechanism for community mental health services in communities, enhance health education, health promotion and mental health knowledge education, and carry out the tertiary prevention and tertiary functionality principles for mental health. These measures can prevent community residents from mental illness, improve their mental health, and promote the development of mental health services in Chinas communities.
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Streptomyces hygroscopicus NND-52 producing Azalomycin B was treated with UV, UV -- LiC1, acridine orange ,the best treatment dose was determined. The yields of several strains which were obtained were more than three times thaat of CK, and the yield of strain A13 was 1100mg/L,they were stable. Through comparing the treating methods, it was shown that the later two methods were more effective
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Objective:To study the effects of osteoid hydroxyapatite(OHA)in repair of bone defect.Methods:Bone defect in the size of 9 mm?5 mm?4 mm was made in bilateral thigh-bone entocondyle in 12 rabbits,OHA was implanted in the defects on one side and hydroxyapatite(HA)on another side.2,4,8 and 12 weeks after operation 4 rabbits were killed respectively,bone samples with the implants were prepared and examined by roentgenography,histology and SEM.New bone formation was determined by measuring the area of new bone in the samples.Results:Gross imspection and roentgenography observation showed that the defects were repaired in both groups 12 weeks after operation.Histological examination showed that new bone was increasing,absorption and disintegration of the implants were progressing from 2 to 12 weeks after operation.4,8 and 12 weeks after operation larger new bone area was found in OHA implanted defects than that in HA implanted(P
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Streptomyces hygroscopicus NND 52 producing Azalomycin B was treated with UV,UV+LiCl,acridine orange,the best treatment dose was determined. The yields of several strains which were obtained were more than three times thaat ofCK, and the yield of strain A13 was 1100mg/L,they were stable.Through comparing the treating methods, it was shown that the later two methods were more effective