Objective To report our clinical experience on laparoscopic common bile duct exploration and primary suture.Methods From March 1992 to December 2006,669 cases of laparoscopic common bile duct exploration and primary suture were carried out in our hospital.Cholangioscopic lithotomy,electrohydraulic lithotripsy,biliary dilation,bile duct drainage,or biliary stenting were performed on the patients.Results The surgeries were completed successfully in 643 of the 669 cases(96.1%).Biliary leakage was observed in 17(2.5%) cases after the operations,and was cured by nasobiliary and intra-abdominal drainage.2(0.3%) patients developed mild stenosis of the bile duct without showing any symptoms.4(0.5%) had residual stones and were cured by a second laparoscopic surgery.The fine duct fell off in 2 cases(0.3%),and was re-fixed by a re-operation.581 of the cases achieved a 6- to 48-month follow-up(mean,25.6 months),during the period,no patient developed biliary leak,and stenosis or hemorrhage of the common bile duct.Conclusion Laparoscopic common bile duct exploration and primary suture is safe and effective.

Objective To evaluate the clinieal significance of classification for intrahepatic cholestasis of pregnancy (ICP) on diagnosis and management of ICP. Methods A retrospective analysis was conducted on 1340 cases of ICP admitted to our hospitaI from January 2000 to December 2007.AIl subiects were divided to mild and severe ICP groups.AIl clinical data were retrieved,and clinical manifestations,biochemicsl indicators,mode of delivery,perinatal outcomes were analyzed between the two groups. Results These 1340 ICP cases occupied 8.58% of all the maternity inpatients during the study period.Among those delivered in the hospital(n=1058),including 52 twin pregnancies,the preterm birth rate was 11.72 oA(124/1058),the neonatal asphyxia rate was 2.07%(23/1110),and the perinatal mortality rate was 1.08%(12/1110).Skin pruritus was the main symptom in 75.97%(1018/1340) of all cases and no significant difference was found in theproportion of women with skin pruititus between mild and severe ICP cases [74.89%(522/697) vs 77.14%(496/643),X~2=0.94,P>0.05].The perinatal mortality rate(1.02%vs 1.46%),neonatal asphyxia rate(2.30% vs 1.82%)and preterrn birth rate(11.61 vs 12.04%)showed no difference between women with and without skin pruritus among those delivered in the hospital(all P>0.05).Comparisons between those women with CG≥64.43 μmol/L vs CG<64.43μmol/L,those with AST and/or ALT≥250 U/L vs both AST and ALT<250 U/L,those with TBA≥40 μmol/L vs DOI:10.3760/cma.j.issn.1007-9408.2010.02.005 TBA<40 μmol/L,the perinatal mortality rate,neonatal asphyxia rate and preterm birth rate were all lower in the former groups(all P<0.05).The average gestations at delivery was later in mild ICP women than in the severe ones[(38.3±1.9)weeks vs(36.1±1.7)weeks,P<0.05].And the cesarean section rate(73.73%va 97.33%),preterm birth rate(6.13 0A vs 18.28%),neonatal asphyxia rate(1.05%vs 3.49%) and perinatal mortality rate (0.18% vs 2.26%)in the mild ICP cases were all lower than in the severe ICP women(all P<0.05). Conclusions It ia helpful for the management of ICP by dividing ICP cases into mild or severe ones.Cesarean section ia recommended for severe ICP,and trial of labor may be possible for mild cases under close monitoring.

Objective:To summarize the evidence for the link between rheumatoid arthritis and risk of vertebral fractures or vertebral deformities with a meta-analysis, so as to provide objective proof for early preventing and the development of vertebral deformity and fractures.Methods:Wanfang,CNKI,VIP,PUBMED,Springlink and Elsevier were retrieved for all publications relating to rheumatoid arthritis and vertebral fractures in women.According to inclusion and exclusion criteria,two investigators collected their data individually,then statistical analysis was performed using Stata 12.0 software.Results: Eight case-control studies were enrolled, including 86 741 participants,2 258 of them with RA.The results of Meta-analysis showed that a higher incidence of vertebral fractures in RA,and Odds ratio was 3.70 with a 95%confidence interval(2.47-5.55,P<0.000 1).The publication bias analysis did not reveal any evidence of obvious asymmetry, and the sensitivity analysis showed that omission of any individual study made no significant difference for all comparison models,suggesting that our results were statistically robust.Conclusion:RA may be one of the risk factors for the vertebral fractures.

Objective To investigate the effects of interleukine-22 ( IL-22 ) on the expression of interleukin-6 (IL-6) by rheumatoid arthritis synovial fibroblasts (RASF), and to analyze their association with IL-17+CD4+T (Th17) cells differentiation.Methods RASF were isolated from six patients with rheu-matoid arthritis ( RA) and cultured in vitro.The expression of IL-6 at mRNA and protein levels by RASF were detected by qRT-PCR analysis and ELISA after treatment with different concentrations of IL -22 for dif-ferent periods of time.Anti-IL-22R1 blocking antibody and inhibitor assay were used to analyze the specific receptor and its downstream signaling pathways associated with IL-6 production.IL-22 pre-treated RASF and CD4+T cells were co-cultured for 3 days in the presence or absence of anti-IL-22R1 or anti-IL-6 to measure the percentage of Th 17 cells by flow cytometry .Results The expression of IL-6 by RASF was increased up-on IL-22 stimulation in a dose and time dependent manner (P<0.05), and that was closely related to IL-22R1 and its downstream signaling pathways of p38 and JAK2 (P<0.05).Co-culturing CD4+T cells with RASF and Transwell system indicated that the percentage of Th 17 cells was increased in IL-22 pre-treated group as compared with that in IL-22 untreated group , but it could be down-regulated by either blocking IL-22R1 or IL-6.Conclusion IL-22 promoted the expression of IL-6 by RASF and further enhanced Th 17 dif-ferentiation.Neutralizing IL-22 in synovium of patients with RA might be an effective therapeutic strategy for RA treatment.

Objective To explore the effects of matrine and oxymatrine on apoptosis in human hepatocarcinoma SMMC-7721 cells.Methods The MTT assay and double staining of annexin V-fluorescein isothiocyanate(annexin V-FITC)/propidium iodide(propidium iodide, PI)were used to detect proliferation and apoptosis of SMMC-7721 cells, respectively.Results When the concentrations of matrine and oxymatrine were 0.50 mg/ml, 1.00 mg/ml and 2.00 mg/ml, the proliferation inhibition rates in SMMC-7721 cells was gradually increased in a dose- and time-dependent manner,and the inhibition of matrine on proliferation were greater than that of oxymatrine in the same concentration(1.00 mg/ml)(24 h:42.39%±0.04%vs. 21.36%±0.02%;48 h: 51.69%±0.03%vs. 36.16%±0.02%;72 h: 78.98%±0.05%vs. 61.24%±0.13%;allP<0.05). When the concentrations of matrine and oxymatrine were 0.25 mg/ml, 0.50 mg/ml and 1.00 mg/ml, the apoptosis rates of SMMC-7721 cells were significantly increased;and induction of matrine in apoptosis in SMMC-7721 cells was greater than that of oxymatrine at the same time point(48 h)(apoptosis rates in 0.25 mg/ml, 4.08%±0.20%vs. 2.20%±0.18%;0.50 mg/ml: 4.32%±0.19%vs. 3.08%±0.26%;1.00 mg/ml: 9.93%±0.18%vs. 9.01%±0.20%;allP<0.05).Conclusion Matrine and oxymatrine can inhibit proliferation and promote apoptosis human hepatocarcinoma SMMC-7721 cells.

Objective:To investigate the expression profile variation of long non-coding RNA( lncRNA) in the peripheral blood mononuclear cells of rheumatoid arthritis ( RA ) and healthy controls, and explore the role of lncRNA in the pathogenesis of RA.Methods:A total of 12 RA patients and 11 age-matched healthy controls from University Hospital of Hubei University for Nationalities were recruited.Using lncRNA microarray technology to detect differently expressed lncRNAs in 3 cases of RA PBMCs and 3 cases of healthy controls.GO and Pathway analysis was performed.The coding-non-coding gene co-expression networks of lncRNA and mRNA was constructed based on the correlation analysis,and then searched lncRNA in pathogenesis of RA through the cis-analysis and trans-analysis.Results:A total of 1 615 deregulated lncRNAs and 878 deregulated mRNAs were detected in RA patients.GO analysis of different expressed mRNA may involve in metal ion binding,protein kinase binding,nucleotide binding,regulation of transcription,et al.Pathway analysis of different expressed mRNA may involve in TNF signaling pathway,B cell receptor signaling pathway,pancreatic cancer,system lupus erythematosus endometrial cancer,et al.REL,SMAD3 and ETS1 may play an important role in the pathogenesis and development of RA through cis-analysis and trans-analysis.As the NONHSAG027875,FR378506 and NONHSAT031501 also had the similar function,and they may be related to the pathogenesis and development of RA.Conclusion:Differentially expressed lncRNAs may exert a partial role in RA,and may provide potential targets for future treatment of RA.

Objective:To observe the effect of Yiqiyangyin Decoction( YQYY) on bleomycin-induced rats pulmonary fibrosis and the expression of Smad2 and Smad7.Methods:Sixty male SD rats were randomly divided into normal group,model group,YQYY group,hormone group,YQYY plus hormone group.The rats in the normal group injected saline via the trachea,the rest rats injected ble-omycin(5 mg/kg).From the second day of injection,YQYY group were treated with YQYY decoction(1 ml/100 g);hormone group were given 35%Prednisone acetate solution(1 ml/100 g);YQYY plus hormone group were treated with the mixture of YQYY decoction and hormone (1 ml/100 g);normal group and model group were given equivalent saline.After twenty-eight days,all the rats were killed,the rat lung histopathology was examined with HE staining and detect Smad2/Smad7 protein with immunohistochemical staining.Results:Compared with normal group, the model group rats alveolitis and pulmonary fibrosis scores were significantly increased;compared with model group,the hormone group,YQYY group,YQYY plus hormone group rats alveolitis and lung fibrosis scores were reduced,and the lung injury of YQYY group reduced obviously.The expression of Smad2 protein of model group in alveolar epithelial cells and the fibroblasts was significantly higher than normal group;compared with model group,the positive expression of Smad2 in hormone group,YQYY group,YQYY plus hormone group were reduced,the Smad2 of YQYY group was the lowest.Compared with normal group,the smad7 protein of model group decreased significantly;compared with model group,Smad7 protein expression in hormone group, YQYY group, YQYY plus hormone group were increased, the Smad7 expression of YQYY group was highest.Conclusion:Yiqiyangyin decoction has a good intervention and therapeutic effect on bleomycin-induced rats pulmonary fibrosis,its mechanism may be related to inhibiting the inflammatory reaction,reduce the formation and deposition of collagen and the intervention of Smad signal pathway.

Objective To clone human Sjogren's syndrome antigen A(SSA)for expressing of antigen SSA-52kD and establishing a new clinical detecting method.Methods According to the human SSA-52kD cDNA sequence reported in GenBank,primers of human SSA-52kD cDNA were designed and synthesized.Human SSA-52kD cDNA was amplified from RNA of cultured Hela cell by reverse transcriptase polymerase chain reaction(RT-PCR).The production of amplification was ligated to PET-30a vector and then transformed into the competent bacteria DH5?to construct the recombinant plasmid PET-30a-SSA-52kD.The recombinant plasmid was digested with Bgl Ⅱ and Hind Ⅲ,and positive clones were sequenced.Results The Human SSA-52kD cDNA fragment containing 1447bp was amplified by RT-PCR.Restriction endonuclease mapping using Bgl II and Hind III showed that the target gene was inserted into the recombinant plasmid.The complete coding sequence of Human SSA-52kD was consistent with that of GenBank through DNA sequencing.Conclusions The full length of human SSA-52kD cDNA was successfully cloned and the recombinant plasmid PET-30a-SSA-52kD was constructed.