【Objective】To observe the effect of Shenkang Pills(SP) on proliferation,extracellular matrix(ECM) secretion and cell cycle of in-vitro cultured rat mesangial cells(MC).【Methods】Sixteen Wistar male rats were randomized into 4 groups: normal serum group,Capoten(5 mg/kg) group,high-and low-dose SP(2.4 and 1.2 g/kg respectively) groups.Except the normal serum group,the rats in other groups received corresponding drugs according to the experimental design,and serum containing drug was isolated and prepared after treatment for 7 days.MC cultured with high glucose(30 mmol/L) in vitro were divided into 5 groups: A(cultured with high glucose 30 mmol/L),B(cultured with 5% normal serum),C(cultured with 5% serum containing Capoten),D and E(cultured with 5% serum containing high-and low-dose SP respectively).Another model group F(cultured with low glucose 10 mmol/L) was also established.After culturing for 72 hours,methyl thiazolyl tetrazolium(MTT) assay was used for the detection of MC proliferation,enzyme-linked immunosorbent assay(ELISA) for fibronectin(FN) content in the culture supernatant and flow cytometer for cell cycle.【Results】The proliferation of MC and FN content in supernatant were increased,and abnormal cell cycle was found in high-glucose group A.SP inhibited MC proliferation,increased the percentage of MC at G0/G1 phase,and decreased the percentage of MC at S phase and G2/M phase.【Conclusion】SP has an inhibition on MC proliferation and ECM secretion induced by high glucose,and its mechanism is probably related with the regulation of abnormal MC cell cycle.

BACKGROUND: Diabetic nephropathy is one of the most serious vascular complications of diabetes mellitus. Compound preparation of huangqi and dahuang, a traditional Chinese medicine, has been used to preventing or treating diabetic nephropathy for several years, and has a certain protective effect on the kidney of diabetes mellitus patients. But its exact mechanism remains unknown and needs to be studied more.OBJECTIVE: To investigate the effect of compound preparation shenkang wan on the proliferation and secretion of extracellular matrix in cultured rat mesangial cells induced by high glucose.DESIGN: Randomized and controlled study.SETTING: Center of Integrated Traditional and Western Nephrology of Zhujiang Hospital and Medicine Department of Nanfang Hospital, Southern Medical University.MATERIALS: The serum pharmacological experiment was performed in Animal Experimental Center of Southern Medical University in A pril 2005.The cell culture experiment was conducted in Cell culture room of Southern Medical University from April 2005 to July 2005. Totally 16 normal Wistar male rats, weighted varied from 190 g to 220 g, were used in the study.METHODS: Sixteen normal Wistar male rats were randomly divided into 4 groups: normal serum group, capoten group, shenkang wan group (high dose and low dose); shenkang wan was mainly constituted of huangqi,dahuang, leech, gordon guryale seed and corn stigma and made in Pharmacy Department of Zhujiang Hospital of Nanfang Medical University, agent number: 20031214). ① The rats in capoten group and high and low dose shenkang wan group were given the corresponding drugs respectively according to 5 mg/kg, 2.4 g/kg, 1.2 g/kg weight. The rats in normal serum group were given the same volume water. After treated 7 days, all rats were hocused and separated medication serum. ② Mesangial cell was cultured in vitro with different concentrations of glucose (10, 20, 30 and 40 mmol/L).The proliferation of mesangial cell was observed with the methyl-thiazoltelrazolium colorimetric assay at 24, 48, 72 hours and 96 hours. ③ Then the cultured mesangial cells were divided into six subgroups :Low glucose control group (10 mmol/L glucose), high glucose group (30 mmol/L glucose);normal serum group (30 mmol/L glucose); capoten group (30 mmol/L glucose); shenkang wan group (high dose and low dose, 30 mmol/L glucose).After cultured 72 hours, the proliferation of mesangial cell was detected with the methyl-thiazol-telrazolium colorimetric assay, the secretion and mRNA gene expression of fibronetin levels in mesangial cell were respectively detected by enzyme linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR) method.MAIN OUTCOME MEASURES: ①Proliferation of mesangial cell induced by different concentrations glucose. ② Proliferation and secretion and mRNA gene expression of fibronectin in every group.RUSULTS: ① Effect of different concentrations glucose on the prolifera-tion of mesangial cell: Compared with low concentrations glucose(10 mmol/L), 20 mmol/L glucose could accelerate the proliferation ofmesangial cell during 96 hours experiment period, but only had a statisti-cally significant difference at 72 and 96 hours (P ＜ 0.05). 30 mmol/L glu-cose could significantly accelerate the proliferation of mesangial cell thanthat of 10 mmol/L glucose from 24 hours to 96 hours (P ＜ 0.05 or P ＜ 0.01),and this effect was increasing with time in 72 hours and reduced after 72hours. 40 mmol/L glucose could significantly increase the proliferation ofmesangial cell than of low concentrations glucose in 48 hours (P ＜ 0.05),and this effect was reduced after 48 hours and even conversed to restraineffect. ② Effect of different medication serum on the proliferation ofmesangial cell: The optical density value in high glucose group is obviouslyhigher than that of low glucose control group (P ＜ 0.01). Compared withhigh glucose group, the optical density value in capoten, shenkang wangroup (high dose and low dose) was decreased markedly (P ＜ 0.01 or P＜ 0.05). While the optical density value in normal serum group was showedno difference with the high glucose group (P ＞ 0.05). ③ Effect of differentmedication serum on secretion of fibronectin in mesangial cell: Content offibronectin in high glucose group was increased more markedly than that oflow glucose group (P ＜ 0.01). Compared with high glucose group, contentof fibronectin in capoten and shenkang wan group (high dose and low dose)was showed a significantly decrease (P ＜ 0.01 or P ＜ 0.05), while contentof fibronectin in normal serum group was showed no difference with thehigh glucose group (P ＞ 0.05). ④ Effect of different medication serum onexpression of fibronectin mRNA in mesangial cell: The optical density val-ue of fibronectin strip in high glucose group was brighter than that in lowglucose group and the ratio of it and β-actin were increased markedly too(P ＜ 0.01). Compared with high glucose group, the optical density value offibronectin strip in capoten and shenkang wan group (high dose and lowdose) was showed a significantly decrease and the ratio of it and β-actinwas reduced distinctly too (P ＜ 0.01), while the ratio of it and β-actin innormal serum group was showed no difference (P ＞ 0.05).CONCLUSION: High glucose could accelerate proliferation, increase thesecretion and mRNA gene expression of fibronectin in mesangial cell,while shenkang wan could inhibit proliferation and secretion of the extra-cellular matrix in mesangial cell induced by high glucose.

Objective To investigate the effects of Yifuning soft gelatin capsules(YSGC)on immune function in ovariectomized (OVX) rats.Methods Fifty female mature Sprague-Dawley rats were randomized into 5 groups:normal control, model control, diethylstilbestrol tablets(DT)and YSGC(high-and low-dose). After 4-week treatment,the serum E2 and IL-2 levels were detected by radioimmunoassay. The estrogen receptor(ER)level in spleen were detected with method of radioligand receptor assay(RRA).The pathologic changes of thymus were observed under light microscope and the body weight,thymus index and spleen index were detected too.Results YSGC could obviously increase the serum levels of E2 and IL-2,increase spleen index and ER content in the spleen of OVX rats (P

Objective To evaluate the efficacy and safety of continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision. Methods From January 2015 to October 2015, 66 patients with gall bladder calculi combined with common bile duct stones who received laparoscopic gallbladder excision, common bile duct explo-ration, laparoscopy choledochotomy, suture choledoch immediately were randomly divided into two groups, experi-mental group using QuillTM SRS self-retaining suture for closing choledoch incision and control group using tradi-tional absorbable suture for closing choledoch incision. Then observe the operation time, the risk of bile leakage oc-curred in the operation and the risk of bile leakage after operation. Results All patients successfully completed in laparoscopic surgery without laparotomy. Operation time, the risk of bile leakage occurred during operation in exper-imental group has statistically significant difference compared with control group ( < 0.05). The operation time and incidence of intraoperative bile leakage of the experimental group was less and lower than control group, while the risk of bile leakage after operation show no statistically difference ( >0.05). Conclusion Compared with interrupted suture by normal sutures, continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision has the characteristics of shorter operation time and lower incidence of intraoperative and postoperative bile leakage. It is worthy of promoting.

Rheumatoid arthritis (RA) is a kind of chronic autoimmune disease and osteoporosis is one of its complications.

OBJECTIVE:To study the effect and thepossible mechanism of low molecular weight heparin(LMWH)on immunocytes' adhesion to fibroblast-like synovocytes(FLS)isolated from patients with rheumatoid arthritis(RA)and to study LMWH'S possible anti-inflammatory effect on RA.METHODS:LMWH's interference on the adhesion of peripheral blood monouclear cells(PBMC)isolated from healthy volunteers to FLS of RA patients was determined by quantitative counting using flow cytometry.The expression of CYR61 in the in vitro cultured FLS of RA patients was detected using real-time PCR technology.RESULTS:When FLS culture system was added with PBMC,PBMC were obviously found to adhere to FLS,but the number of adhered PBMC decreased after LMWH treatment,which manifested as increase of deciduous PBMC,increased more with the increase of LMWH dose.There was a high expression of CYR61 in synovium tissue in RA patients.CONCLUSION:LMWH inhibited the adheresion of PBMC to FLS from RA patients in a dose-dependent manner,which might be attributed to its competitive combination with heparin sulfate sites on CYR61.

Objective To investigate the clinical effect of laparoscopic reverse papillary intubation through cystic duct and laparoscope combined with duodenoscope in the treatment of cholecystolithiasis and thining choledocholithiasis.Methods The retrospective cohort study was adopted.The clinical data of 192 patients with cholecystolithiasis and thining choledocholithiasis who were admitted to Chengdu Second People's Hospital between May 2012 to August 2015 were collected.The 96 patients who underwent laparoscopic reverse papillary intubation through cystic duct were allocated into the case group,and the other 96 who received surgery by laparoscope combined with duodeuoscope were allocated into the control group.All the patients underwent laparoscopic cholecystectomy (LC) according to routine approaches.The 96 patients in the case group received the placement of 4 Fr ureter catheter via cystic duct and placement of common bile duct inserted through the duodenal papilla under laparoscope,and then the duodenal papilla was resected using needle knife along the ureter catheter and stones were removed by basket lithotriptor and ball lithotriptor.The 96 patients in the control group received the intubation using the bow knife with zebra guidewire,and stones were removed by basket lithotriptor and ball lithotriptor.During the operations,it was observed whether there were residual stones by nasobiliary radiograph.The comparison was made between the 2 groups concerning (1) surgical situation:intubation and operation time.(2) Postoperative alanine transaminase (ALT),postoperative aspartate transaminase (AST),postoperative total bilirubin (TBil),postoperative blood amylase,postoperative lipase,complications and extubation time.(3) Situation of follow-up:follow-up was done by outpatient examination or telephone interview up to November 2015.The stones recurrence was detected by retrograde cholangiography through nasal bile duct,magnetic resonance cholangiopancreatography (MRCP) or ultrasonic examination.Measurement data with normal distribution were represented as x ± s.Comparison between groups was done by the t test.Count data were analyzed by the chi-square test.Results (1) Surgical situation:2 groups both underwent successful LC.Ureteral catheter in the case group was successfully imbedded through cystic duct,including 8 patients with being difficult to intubate.Five patients in the control group were failed in endoscopic sphincterotomy (EST) due to periamullary diverticula or other causes,and then EST was performed again by the duodenal papilla through ureteral catheter which was intubated through cystic duct.Operation time of the case group and control group was (89 ± 17) minutes and (105 ± 26) minutes,respectively,with a statistically significant difference between the 2 groups (t =5.05,P ＜ 0.05).(2) Postoperative situation:ALT,AST,TBil of the case group and control group were (163 ±54)U/L,(87 ±38)U/L,(43 ± 18)tmol/L and (147 ±49) U/L,(101 ± 26) U/L,(37 ± 17) μmol/L,respectively,showing no statistically significant differences (t =0.97,1.21,0.84,P ＞ 0.05).Postoperative blood amylase and lipase of the case group and control group were (151 ± 41) U/L,(198 ± 72) U/L and (395 ± 142) U/L,(549 ± 217) U/L,respectively,showing statistically significant differences (t =16.18,15.05,P ＜ 0.05).No pancreatitis was found in the case group while 6 patients in the control group complicated with mild pancreatitis were improved by symptomatic treatment of fasting,somatostatin administration and acid suppression,with no severe pancreatitis.No complications such as intestinal perforation,bile duct perforation and massive hemorrhage were detected in both groups after operation.No death occurred.The nasal bile duct in the patients without pancreatitis was removed at postoperative day 3.The nasal bile duct in the patients with pancreatitis was removed after the remission of abdominal pain and diet intake.In the case group,it was difficult to remove the nasal bile duct of 1 patient.Nasal bile duct radiograph showed that the bending section of nasal bile duct was mistakenly sutured by the absorbable thread at the lower margin of incision of junction of cystic ducts,and yet there was unobstructed biliary drainage.The nasal bile duct was removed and the patient was discharged from hospital at postoperative day 19.The abdominal drainage tubes were removed at postoperative day 3 to5 in both groups.(3) Of 192 patients,151 were followed up for a median time of 10 months (range,3-12 months).Patients had good recovery without recurrence of abdominal pain,jaundice and stones.Conclusion Laparoscopic reverse papillary intubation through cystic duct for the treatment of cholecystolithiasis and thining choledocholithiasis is safe and feasible,and it can also reduce incidence of pancreatitis after nasobiliary drainage.

Fructus psoralea is a tonic traditional Chinese herb commonly used in clinic.The chemical constituents of Fructus psoralea are complicated,mainly containing coumarins,flavonoids and monoterpene phenols with various pharmacological effects.Since the increasing number of reports on the toxicity of Fructus psoralea in clinic,the side effects including toxicity on the liver and kidney,as well as skin allergies have gradually attracted attention.The toxicity of Fructus psoralea is produced from ADME (absorption,distribution,metabolism and excretion) in vivo.In this paper,we collected and clarified the studies of ADME of Fructus psoralea in vivo,and summarized recent adverse clinical events and research over its toxicity.We propose to make a thorough study on the toxic material basis of Fructus psoralea and the toxicological mechanism of its extraction,fractions and compounds.The review provided a possible reference and the direction of research for the safe clinical use of Fructus psoralea.

Objective To evaluate the outcome of primary total knee arthroplasty (TKA) in treatment of stiff knee, and discuss the key points of operative technique and rehabilitation. Methods From February 2005 to April 2009, 23 patients with 34 stiff knees were treated with primary TKA. The study included 3 males (4 knees) and 20 females (30 knees), with the mean age of 56.9 years. Primary disease of the patients included rheumatoid arthritis (26 knees in 15 cases) and osteoarthritis (8 knees in 8 cases). Varus deformity was found in 10 knees (5°-15°), and valgus was found in 5 knees (5°-10°). Evaluations included preoperative and postoperative range of motion (ROM) measurement, hospital for special surgery knee score (HSS), blood loss, operative time and assessment of postoperative complications. Results All patients were followed up. The mean follow-up time was 32.2 (range, 24 to 40) months. At the final follow-up visit, the HSS score increased from 42.9±5.2 preoperatively to 85.7±4.3, the range of motion increased from 42.6°±5.7° preoperatively to 89.2°±10.5°. Sixteen knees in 12 cases underwent manipulation at 3 to 8 weeks postoperatively for unsatisfied ROM, but ROM was still less than 90° in 8 knees at the last follow-up. The average blood loss were (632.4±180.2) ml in first 24 hours (450-850 ml) and the operative time were (98.1±18.6) min (80-150 min). Deep venous thrombosis was found in 3 patients. All the symptoms relieved after anticoagulant therapy. Postoperative varus deformity was seen in one patient, but the function of knee was good. No revision was needed. Conclusion Primary total knee arthroplasty is reliable method in treatment of stiff knees. Sufficient soft tissue release during the operation, postoperative muscle strength exercise and essential manipulation are key points for satisfactory outcomes.