Objective To evaluate the effect of endoscopic variceal ligation(EVL) combined with splenectomy for the patients with portal hypertension. Methods Thirty two cases of portal hypertension underwent EVL plus splenectomy from May 1999 to May 2002 in our department. The patients were registered and followed up in the third, sixth and twelfth months after operation respectively. Re ligations were performed in case of relapsed varices. Results Thirty one patients were followed up for ≥2 years.Of them,esophageal varices recrrented in 6.4% of patients during following-up period,but no reblecding, and no death caused by hepatic encehpalopathy or other complications.Conclusions EVL combined with splenectomy has less trauma , less postoperative complications and high eradication rate of esophageal varices, so it can be used safely in the treatment of patients with ruptured esophageal varices.

Objective To Study the effect of splenectomy plus endoscopic varices ligation (SEVL) in the treatment of portal hypertension. Methods SEVL was carried out in 38 patients with portal hypertension from January 2000 to June 2002. The authors compared hemodynamic parameters and gastric emptying time before and after the operation. The incidence of upper gastrointestinal bleeding, the disappearance rate of esophageal varicosis, the outcomes of portal hypertensive gastropathy (PHG) and the incidence of complications were recorded at postoperative 3 weeks, 6 months, 12 and 18 months, respectively. Results Postoperatively, the free portal pressure, portal flow volume and velocity were significantly reduced in all the cases ( P 0.05). Portal thrombosis was seen in 6 cases (6/38, 15.8%). Conclusions SEVL has little influence on gastric emptying and PHG, offering a high disappearance rate of varicosis and a low incidence of complications.

Objective To investigate protective effects of schisandra lignans on doxorubicin-induced liver injury in rats. Methods SD rats were randomly divided into six groups: normal control, model control, vitamin C and schisandra lignans at small, middle, and high doses. The liver injury model was established by intraperitoneal injection of doxorubicin. Normal controls were intragastrically administrated with 0. 9%sodium chloride solution,while other groups were administrated with different medications,respectively. Interleukin-10 (IL-10) in serum,nitric oxide (NO) and aspartate aminotransferase (AST) in liver tissue homogenate were measured. Histopathological changes in hepatic tissues were also observed. Results Serum IL-10 and tissue NO were obviously lower in the model control group than those in other groups,while those in all schisandra lignans treated groups were significantly improved (P<0. 05, P<0. 01). The AST level in schisandra lignans middle- and high dose groups was (372. 58±105. 80) and (327. 92±42. 80) U·g-1 ,respectively,significantly lower than (565. 07±22. 13) U·g-1 in the model control group (P<0. 05,P<0. 01). Histopathological analysis showed that degeneration and necrosis of hepatocytes were remarkably alleviated in all schisandra lignans treated groups. Conclusion Schisandra lignans protect rats against doxorubicin-induced liver injury.

Objective To analyze the clinical manifestations of early cerebral ischemic lesions after stenting with WingSpan system for symptomatic intracranial artery stenosis, and to evaluate the early effects and safety of the stenting therapy. Methods Twenty-nine consecutive patients with symptomatic intracranial stenosis underwent diffusion weighted imaging (DWI) before and after stenting (within 72 hours). The clinical data, including patients' general condition, stenting procedures and newly-developed cerebral ischemic lesions, were recorded. Neurological defect was estimated with NIHSS, the safety and early outcome of stenting were evaluated. Results The degree of stenosis was reduced from a mean baseline of (72.3 ± 10.7)% to (31.9 ± 13.6)% immediately after stenting. The technical success rate was 100%. The total eomplicatiom nate was 17.2%. And among them, z were symptomatic (6.9%). Sixty-three ischemic lesions were demonstrated on DWI in 13 patients (44.8%). Among them, 11 (84.6%) were asymptomatic. Fifty-five newly-developed lesions on DWI (87.3%) were located in the region of stented vessels and 3.2% were situated in the region of branch vessels of stented artery. Conclusion DWI is of great value in assessing the safety of intracranial stenting procedures. The treatment of symptomatic intracranial artery stenosis by using WingSpan system is safe and effective. Newly-developed ischemic lesions can be well detected on DWI and should receive physician's attention, although most ischemic lesions are asymptomatic. Long-term outcome of this treatment needs to be further observed.

Cholangiopancreatography, Endoscopic Retrograde ; Duodenum ; surgery ; Humans ; Retrospective Studies

Objective To explore the apphcation of the integrated teaching method of PBL and TBL based on cases in pharmacology teaching.Method Ninety-two students majored in Pharmaceutical Preparations were selected into the control group,and 184 students majored in pharmacy were enrolled into the experimental group.The teaching effect was comprehensively evaluated by using the combination of theoretical examination and student feedback.Results In the experimental group,the average score of students in Pharmacology (73.68 ± 9.40) was significantly higher than that of the control group (67.34 ± 7.18),and the feedback of the students in the experimental group was significantly better than that in the control group.Conclusion Compared with the traditional teaching method,the integrated teaching method can significantly improve the students' theoretical examination results and students' learning interest.

OBJECTIVE:To explore the protective effect and its mechanisms of Sinomenium acutum polysaccharide on mice with acute alcoholic liver injury. METHODS:60 mice were randomly divided into blank control group (normal saline),model group (normal saline),bifendate group (positive control,150 mg/kg) and S. acutum polysaccharide low-dose,medium-dose, high-dose groups(100,200,400 mg/kg),10 in each group,intragastrically administrated,once a day,for continual 7 d. 1 h af-ter last administration,mice received 50% ethanol (0.1 mL/10 g) intragastrically to induce acute alcoholic liver injury model ex-cept for those in blank control group. After 12 h,alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels in se-rum,malondialdehyde(MDA),superoxide dismutase(SOD),glutathione(GSH),glutathione peroxidase(GSH-Px)levels in liv-er tissue of mice were determined;hematoxylin-eosin staining was conducted to observe the pathological changes in liver tissue;flow cytometry was used to detect the cell apoptosis rate. RESULTS:Compared with blank control group,mice in model group showed pathological changes in edema,disordered cell arrangement and local necrosis;ALT and AST levels in serum,MDA level in liver tissue and hepatocyte apoptotic rate were significantly increased,while the SOD,GSH and GSH-Px levels in liver tissue were significantly decreased,with statistical significances (P<0.01). Compared with model group,cell degeneration and necrosis degree of mice were improved in S. acutum polysaccharide medium-dose and high-dose groups;except for cell apoptosis rate of liver in S. acutum polysaccharide low-dose group was not decreased significantly,the above-mentioned indicators in other treatment groups were significantly improved(P<0.05 or P<0.01). CONCLUSIONS:S. acutum polysaccharide shows obvious protective effect on mice with acute alcoholic liver injury,its mechanism might re-late to anti-oxidation stress and inhibiting hepatocyte apoptosis.

Objective To study the influence of total flavonoids of hemerocallis fulva(TFHF) on hepatocyte apoptosis and related protein expression in mice with alcoholic hepatic injury.Methods A total of 40 mice were randomly divided into four groups:blank control,model control andsmall and high dose TFHF groups,10 cases in each group.The mice were given the continuous gavage administration for 7 d.Then the model group was given once gavage by 50％ ethanol 12.0 mL/kg after 1 h of the last administration.The blank control group was given the equal volume of distilled water.The activity levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum as well as the superoxide dismutase(SOD) activity and malondialdehyde (MDA) content in liver tissue hemogenate were detected.Hematoxylin and Eosin(HE) staining was performed for observing the pathological changes of the liver tissue.The flow cytometer was used to test the apoptosis ratio in hepatocyte suspension.The expressions of caspase-3,Bcl-2 and Bax protein were detected by Western blot.Results The various TFHF groups could decrease the activities of ALT and AST in serum (P＜0.05),while could decrease the MDA content in liver tissue hemogenate (P＜0.01) and increased the SOD activity;the liver tissue pathological examination showed that the high dose TFHF group could make the liver cell degeneration,alleviated the necrosis degree and relieved the pathological change of hepatic tissue;compared with the model group,the hepatocyte apoptosis rate in each TFHF group was decreased significantly;Western blotting results showed that the caspase-3 protein level in each TFHF group was decreased,expression of Bcl-2 protein was increased,whereas which of Bax protein was decreased and Bax/Bcl-2 ratio was reduced.Conclnsion TFHF has obvious protective effect on mice acute hepatic injury induced by ethanol,and can inhibit the hepatocyte apptosis,its action mechanism may be related to its antioxidation and regulation of caspase-3,Bcl-2 and Bax expression.

Objective:To evaluate the clinical efficacy of SKy bone expander system in percutaneous kyphoplasty for treat- ment of osteoporotie verterbral compression fracture.Methods:Twenty-two patients(aged 62-90 years,32 vertebrae)under- went percutaneous kyphoplasty using SKy bone expander system.The bone cement was injected into the collapsed vertebrae. The vasual analogue scale(VAS)and complications were recorded during follow up.Results:The operations were successful in all patients via unilateral or bilateral approach.The operation time ranged from 30 to 120 min.The mean volume of cement in- jected into each vertebra body was(4.8?1.1)ml,ranged from 3.1 to 6.8 ml.Extravertebral leakage of bone cement was ob- served in two vertebrae with no symptoms.All patients had their pain relieved;the VAS was 7.6?0.8 before operation,3.5?0.5 one day after operation,2.8?0.6 one week after operation,and 2.4?0.6 one month after operation,with significant difference found between preoperation and postoperation(P

Objective:To investigate the effects of oxymatrine(OM)on the apoptosis of human hepatoma HepG2 cells and its possible mechanisms.Methods:HepG2 cells were treated with different concentrations of OM.The proliferation inhibition was measured by MTT assay and the apoptosis of HepG2 cells were examined by Hochest staining method.Flow cytometry was used to analyze the cell cycle distribution and apoptosis rate.The expression of caspase-3,Bcl-2,Bcl-x_L and Bax proteins was assayed by Western blotting assay.Results:OM inhibited HepG2 cells growth in a time-and dose-dependent manner.After treatment with OM for 24 hours,some cells appeared typical apoptotic characteristics and the apoptosis rate was increased. Treatment with OM also increased caspase-3 activity and Bax expression in HepG2 cells,and decreased the expression levels of Bcl-2 and Bcl-x_L.Conclusion:OM can induce HepG2 cell apoptosis,which may be related to the down-regulation of PI3K/Akt signal pathway,suppression of Bcl-2 and Bcl-x_L activity,and activation of caspase-3.