Clinical Characteristics of Patients with Drug-induced Liver Injury.

BACKGROUND: Drug is an important cause of liver injury and accounts for up to 40% of instances of fulminant hepatic failure. Drug-induced liver injury (DILI) is increasing while the diagnosis becomes more difficult. Though many drugs may cause DILI, Chinese herbal medicines have recently emerged as a major cause due to their extensive use in China. We aimed to provide drug safety information to patients and health carers by analyzing the clinical and pathological characteristics of the DILI and the associated drug types. METHODS: A retrospective analysis was conducted in 287 patients diagnosed with DILI enrolled in our hospital from January 2011 to December 2015. The categories of causative drugs, clinical and pathological characteristics were reviewed. RESULTS: Western medicines ranked as the top cause of DILI, accounting for 163 out of the 287 DILI patients (56.79%) in our study. Among the Western medicine, antituberculosis drugs were the highest cause (18.47%, 53 patients) of DILI.   Antibiotics (18 patients, 6.27%) and antithyroid (18 patients, 6.27%) drugs also ranked among the major causes of DILI. Chinese herbal medicines are another major cause of DILI, accounting for 36.59% of cases (105 patients). Most of the causative Chinese herbal medicines were those used to treat osteopathy, arthropathy, dermatosis, gastropathy, leukotrichia, alopecia, and gynecologic diseases. Hepatocellular hepatitis was prevalent in DILI, regardless of Chinese herbal medicine or Western medicine-induced DILI. CONCLUSIONS: Risks and the rational use of medicines should be made clear to reduce the occurrence of DILI. For patients with liver injury of unknown origin, liver tissue pathological examination is recommended for further diagnosis.

Research progress on the mechanism of single-Chinese medicinal herbs in treating diabetes mellitus.

Treating diabetes mellitus (DM) with Chinese medicine (CM) has had a few thousands years of history. Past Chinese medical texts had already recorded numerous medicinal herbs as well as recipes for treating DM and accumulated much clinical experience. In the following article, the prevention of DM using CM in the past 5 years is retrospectively studied, and mainly focuses on the usage of simple Chinese herbal extracts or monomers in terms of cellular as well as molecular biology.

Antidiabetic effects of Tangnaikang on obese Zucker rats and the mechanism.

OBJECTIVE: To observe the effects of Tangnaikang (TNK), a compound traditional Chinese herbal medicine, on glucose metabolism and insulin resistance in obese Zucker rats. METHODS: Twelve male obese Zucker rats, 6 weeks old, were randomly divided into control group and TNK group (3.24 g/kg) after being fed for 2 weeks. All rats received high-fat diet and 4-week treatment. Body weight and blood glucose were tested every week. Oral glucose tolerance test (OGTT) was performed and fasting insulin level was tested on days 0, 14 and 28. Triglyceride, cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and free fatty acids (FFA) were tested on day 28. Glucose infusion rate (GIR) was tested by hyperinsulinemic-euglycemic clamp from day 29. The protein expressions of protein kinase B (Akt), phospho-Akt (p-Akt) (Thr308) and glucose transporter protein 4 (GLUT4) in skeletal muscle and GLUT4 in adipose tissue were measured after hyperinsulinemic-euglycemic clamp test. RESULTS: Compared with the control group, the fed blood glucose level and glucose level of OGTT at 120 min had a significant decline in TNK group on day 28, and TNK caused no alteration of the fasting serum insulin, and the GIR increased significantly in hyperinsulinemic-euglycemic clamp study. Furthermore, TNK increased Akt and p-Akt (Thr308) protein expressions in skeletal muscle and decreased the protein expression of GLUT4 in white adipose tissue. Body weight, and triglyceride, cholesterol, LDL-C and FFA contents were slightly decreased in the TNK group, but there were no statistically significant effects. CONCLUSION: TNK increases the protein expressions of Akt and p-Akt (Thr308) of the signal transduction pathway to influence the translocation of GLUT4 in skeletal muscle and improves glucose metabolism by reducing insulin resistance.

[Characteristics of soil phosphorus runoff under different rainfall intensities in the typical vegetable plot of Taihu Basin].

Experiments of field runoff plots, which were conducted at vegetable plots in Hongsheng town of Wuxi city--the typical region of Taihu Basin, were designed to assess the effects of different rainfall intensities on soil phosphorus runoff loss from vegetable plots by artificial rainfall simulations. Results showed that there was a relationship of power function between initial runoff-generation time and rainfall intensity. Runoff amount slowly increased under small rainfall intensity, but rapidly increased with rainfall intensity increase. The concentrations of total phosphorus (TP) and particulate phosphorus (PP) were higher at the early stage, then gradually decreased with time and finally reached a comparative steady stage under 0.83, 1.17 and 1.67 mm x min(-1). However they indicated no obvious trend except wavy undulation under 2.50 mm x min(-1). In the course of rainfall-runoff, dissolved phosphorus (DP) gently varied and accounted for 20% - 32% of TP. PP was 68% - 80% of TP and its change trend was consistent with TP. Therefore, PP was main loss form of soil phosphorus runoff. Comparison of different phosphorous loss rate under different rainfall intensities suggested that loss rate of TP and DP under 2.50 mm x min(-1) was 20 times and 33 times higher than that under 0.83 mm x min(-1), which showed that loss rate of PP and DP increased with the increase of rainfall intensities. Results indicated that lots of inorganic dissolved phosphorus (DIP) of phosphorous fertilizer was discharged into water environment by using fertilizer in soil surface before rainfall, which increased loss of DP and greatly aggravated degree of water eutrophication.

[Meta-analysis on acupoint sticking therapy for facial paralysis].

OBJECTIVE: To evaluate the therapeutic effect and safety of acupoint sticking therapy for facial paralysis. METHODS: Search the literatures in the whole paper databank of China figure medical library (Jan. 1994-Dec. 2004) and China Biomedical Literature Disk Databank (Jan. 1995-Dec. 2004). Meta-analysis was conducted with RevMan 4. 2. 5 software. RESULTS: Sixteen controlled trials involving 2 157 patients were included. Meta-analysis indicated that there was high statistically difference between the acupoint sticking therapy and simple acupuncture therapy or Western medicine therapy. CONCLUSION: The acupoint sticking therapy is effective and safe for facial paralysis.

Histidine enhances carbamazepine action against seizures and improves spatial memory deficits induced by chronic transauricular kindling in rats.

AIM: To investigate whether histidine can enhance the anticonvulsant efficacy of carbamazepine (CBZ) and simultaneously improve the spatial memory impairment induced by transauricular kindled seizures in Sprague-Dawley rats. METHODS: Chronic transauricular kindling was induced by repeated application of initially subconvulsive electrical stimulation through ear-clip electrodes once every 24 h until the occurrence of 3 consecutive clonic-tonic seizures. An 8-arm radial maze (4 arms baited) was used to measure spatial memory, and histamine and gamma-amino-butyric acid levels were measured by high performance liquid chromatography (HPLC). RESULTS: Chronic transauricular kindling produced a significant impairment of spatial memory and a marked decrease in histamine content in the hypothalamus, the brainstem, and the hippocampus. Injection of histidine (1000 mg/kg or 1500 mg/kg, ip) significantly inhibited transauricular kindled seizures. Injection of histidine at lower doses (200 mg/kg or 500 mg/kg, ip) had no appreciable anticonvulsant effect when administered alone, whereas it significantly potentiated the protective effects of CBZ against kindled seizures. CBZ had no ameliorative effect on memory deficit, but, in contrast, histidine (200 mg/kg or 500 mg/kg, ip) alone or co-administered with CBZ significantly ameliorated the memory deficits induced by the seizures. CONCLUSION: Chronic transauricular kindling is a very useful animal model for evaluating memory deficits associated with epilepsy, and histidine has both a potentiate effect on the anticonvulsant efficacy of CBZ and an ameliorative effect on the spatial memory deficits induced in this model. Histidine at a specific dosage range might serve as a beneficial adjuvant for the clinical treatment of epilepsy, especially when accompanied by impaired spatial memory.

[Drug screening model acting on out-membrane protein OprM in pseudomonas aeruginosa efflux pump system].

OBJECTIVE: To establish an efflux pump inhibitor screening model with the out-membrane protein OprM in Pseudomonas aeruginosa efflux pump system as the target point. METHODS: Efflux pump out-membrane protein gene oprM was obtained from standard Pseudomonas aeruginosa PA01 strain. Expression of OprM protein was induced in E. coli strain HS151 with T-easy vector as the cloning vector, and pMMB67EH as the expression vector. In order to evaluate the function of OprM protein, we measured intracellular tetracycline concentrations with liquid scintillation counter, measured the diameters of bacteriostatic circles with paper disc, and then established a screening model accordingly. RESULTS: OprM protein was highly expressed. Using Pseudomonas aeruginosa as the main detecting bacteria, we established a drug screening model acting on OprM. A total of 1 600 microbial fermentation samples were screened with this model, among which 56 positive strains were found, with a positive rate of 3.5%. CONCLUSION: OprM plays an important role in drug efflux. The established model has good specificity and maneuverability.