Sphincter of Oddi dysfunction (SOD) refers to a series of clinical syndromes that occurs because of structural or functional disorders involving the biliary and/or pancreatic sphincters.It remains controversial whether endoscopic sphincter manometry (SOM) or sphincterotomy is needed in patients with type Ⅲ SOD.An important problem is that ERCP (with or without SOM) carries significant risks, especially the post-ERCP pancreatitis.The EPISOD trial has updated our knowledge on type Ⅲ SOD.The latest Rome Ⅳ consensus suggested that the classification term type Ⅲ biliary SOD should be abandoned and a new classification of biliary SOD was proposed;also, manometry and sphincterotomy were not recommended for patients with this type of SOD.The goal of this paper is to review recent literatures and elucidate the selected important questions regarding type Ⅲ SOD.

Objective: To investigate the expression level of FOXC2 in adipose tissues and its correlation with obesity and insulin resistance Methods: Abdominal visceral and subcutaneous adipose tissue biopsies were obtained from 15 non-diabetic obesity patients(BMI≥35) and 8 non-diabetic controls(BMI

IL-17,as a pro-inflammatory cytokine,is one of the early initiation factors of the inflammato-ry response induced by T cells.It can induce and regulate multiple immune responses.Recent studies have re-vealed that myeloid neutrophils,macrophage,mast cell and other innate immune cells all can secrete large a-mount of early responding IL-17 in organs suffering ischemia/hypoxia,and in turn can activate,amplify and re-cruit neutrophils to the reperfusion-damaged tissue to release large amount of free radicals and lysozyme that cause IRI.Researchers have also provided evidence that appropriate administration of anti-IL-17 mono-antibody to neutralize IL-17 during early reperfusion stage would reduce the tissue damage.The purpose of this review is to summarize the research progress of the effects of IL-17 produced by innate immunocyte on organ reperfusion injury.

OBJECTIVE: To investigate the role of TREM-1 in tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) secretion from lipopolysaccharide-induced mice macrophage cell lines RAW264.7. METHODS: Designing and synthesizing small interfering RNA (siRNA) with high intangerference ratio, then constructing pLKO1.1-puro-TREM-1 The mice macrophage cell lines RAW264.7 were divided into four groups: control group (control); lipopolysaccharide group (LPS); empty plasmid group (pLKO1.1) - just transfected with pLKO1.1; interference group (siRNA) - transfected with pLKO1.1-puro-TREM1.24 h after stimulation with LPS, real-time PCR was used to detect the mRNA levels of TREM-1, TNF-α and IL-1β respectively. The concentrations of TNF-α and IL-1β were assayed by ELISA. RESULTS: In siRNA group, the mRNA levels of TREM-1, TNF-α and IL-1β were decreased significantly (P<0.01): moreover, the concentrations of TNF-α and IL-1β were lower than other groups significantly (P<0.01). CONCLUSION: Small interfering RNA may reduce TNF-α, IL-1β secretion in LPS-induced macrophage 264.7 through inhibiting the expression of TREM-1 gene.

BACKGROUNO:Some experiments have proved that some traditional Chinese medicines (TCM) have good biocompatibility when they touch and interact with human body tissues, body fluid or blood.Therefore,the physicochemical properties and functions of biomaterials can be improved by compounding it with some TCM.OBJECTIVE:To evaluate the biocompatibility of gelatin-bletilla porous material carrying TCM.DESIGN:Single sample experiment.SETTING:Department of Acupuncture & Moxibustion and Orthopaedics.Hubei College of Traditional Chinese Medicine. MATERIALS:This experiment was carried out in the Department of Orthopaedics,Tongji Medical College,Huazhong University of Science and Technology between February and April 2005.Twelve mice,male and female in half,weighing 18-24 g, and 6 Japanese big-eared rabbits,weighing 2.8 to 3.0 kg,were chosen for this experiment.They were raised at (18±1)℃ in separate cages.METHODS: Spongy gelatin-bletilla porous materials carrying extract of Coptidis and Radix Salviac Militiorrhizae was prepared by freeze-drying method.The acute systemic toxicity test:The 12 mice were divided into experimental group and control group. Mice in the two groups were intraperitoneally injected with leaching liquor and normal saline,respectively (the dose was 50 mL/Kg),then the general state and body mass of mice were recorded at the 4th,24th,48th and 72nd hours after injection, respectively.The porous materials were implanted in dorsal muscle of rabbits.Two rabbits were sacrificed at the 1st, 2nd and 6th weeks after operation seperately,and tissue reaction of biomaterial in vivo was assessed by gross observation and histological examination. MAIN OUTCOME MEASURES: Gross observation and histological examination of tissue reaction of biomaterials in vivo.RESULTS: Twelve mice and six big-eared rabbits were involved in final analysis.The acute systemic toxicity test:Mice of two groups had good status,normal activity and appetite,stable respiration:and no abdominal irritation,exhaustion, cyanosis or death was found.Body mass of mice of two groups presented tendency of increase at the 24th,48th and 72nd hours after injection,and there were no significant differences between two groups (P＞0.05).The implantation test:①Gross observation:The samples were tightly bounded with muscular fibrous tissues at postoperative 1 week.They were connected with muscular fibrous tissues and could not be easily separated at postoperative 4 weeks.Gelatin-bletilla porous materials carrying TCM could hardly been seen at postoperative 8 weeks.②Histological observation:There were a lot of infiammatory cells and mesenchymal stem cells around the samples at 1 week after the implantation of gelatin-bletilla porous materials carrying TCM; Some materials were degraded and infiammatory cell infiltration was reduced around the implanted materials at 4 weeks; The inflammatory cells were further reduced and the materials were absorbed and replaced by muscular tissues at 12 weeks.CONCLUSION:Gelatin-bletilla porous materials carrying TCM is safe and reliable for application in wound healing,skin and muscle tendon tissue engineering.

Objective To evaluate the efficacy and adverse events of irinotecan (CPT-11) combined with 5-FU in treatment of patients with advanced rectal cancer. Methods 86 patients were randomly divided into FOLFIRI treatment group and IFL treatment group. The efficacy and adverse events were observed. Results There was no statistically significant difference between FOLFIRI treatment group and IFL treatment group in CR、PR、SD and RR(all P ＞ 0. 05). There was also no statistically significant difference between FOLFIRI treatment group and IFL treatment group in adverse events(all P ＞ 0.05). Conclusion Irinotecan in combination with 5-FU was effective and had some tolerable adverse events in treating patients with advanced rectal cancer in both FOLFIRI treatment group and IFL treatment group.

Objective Hyperglycemia was common during acute myocardiai infarction (AMI). This study investigated the impact of stress hyperglycemia on in-hospital outcomes in patients without diabetes hospitalized with AMI. Methods The study included 107 patients with AMI without diabetes, who were admitted to 81 hospital of PLA of Nanjing, China from January 2000 to May 2010. The in-hospital mortality and in-hospital complications were analyzed retrospectively. The exclusion criteria were: (1 ) patients < 18 years old; (2) patients with history of diabetes; (3) patients who initiated anti-hyperglycemic therapy during their hospital stay though without previously diagnosed diabetes; (4) patients with non-cardiovascular causes for AMI; (5) patients with hepatic failure, kidney failure, serious lung illnesses and end stage of malignant tumour; (6) patients administrated with steroid treatment recently and those with some diseases which had dramatic effect on glucose metabolism such as hyperthyroidism and cushing syndrome. Patients were categorized according to FBG levels into4 mutually exclusive groups; <7.0 mmol/L, ≥7.0 but <8.0 mmol/L, 8.0 to< 11. 1 mmol/L and ≥11.1 mmol/L. The Statistical Package for Stata, version 9.2 was used for statistical analysis. According to corresponding data analysis of /-test, ANOVA, rank test and exact propability were used respectively. Univariate logistics regression analysis was conducted followed by multivariate logistics regression analysis on significant variables. Results The incidence rate of stress hyperglycemia in patients with AMI without diabetes was 43. 9% (n =47). In non-diabetic patients, the mortality of the group of FBG≥7. 0 mmol/L was significantly higher than the group of FBG < 7. 0 mmol/L, which are 27.66% and 6.67%(P=0.0063)respectively,OR=5.35(95%CI 1.61 - 17.75,P = 0.0061). In-hospital complications for example lung infection, congestive heart failure, serious arrhythmias and acute cerebrovas-cular events were increased significantly in AMI patients with stress hyperglycemia. Multivariate logistic regression analysis for mortality were performed adjusting for risk factors which demonstrated FBG was a independent risk factors of in-hospital death , OR = 1.56(95%CIl.09 -2.23). Conclusions In-hospital mortality and in-hospital complications were significantly increased in patients with AMI without diabetes which developed stress hyperglycemia. Stress hyperglycemia was of great prognostic value for short-outcomes of AMI.

Acupuncture Therapy ; Enteritis ; diagnosis ; therapy ; Eosinophilia ; diagnosis ; therapy ; Gastritis ; diagnosis ; therapy ; Humans ; Male ; Middle Aged

Objective To study the growth inhibitory effect of chemotherapeutic drugs on the pancreatic cancer cell line Aspc-1 and Bxpc-3, and the relations to the varied concentration and exposere time of chemotherapeutic drugs administrated in single or in combination. Methods Four chemotherapeutic drugs included 5-fluorouracil (5-FU), epirubicin (E-ADM), mitomycin(MMC) or cisplatin (DDP) administrating in single or in combination and using varied concentrations(d1、d2、d3 and d4) and exposure times(24、28 and 72 hours); and then the growth inhibitory effect on the two cell lines. resulted from these drugs were assayed by MTT colorimetry and analysed by “ t ” test. Results The growth inhibitory rate of two cell lines was increased, with the increment of drug concentration and/or the prolongation of exposure time ( P

Case based teaching was applied in order to enhance the teaching efficacy and clinical safety for resident doctors in anesthesia training centers and to arouse their learning incentives and improve their clinical performance.Case based discussions on basic cardiopulmonary resuscitation and multiple traumas were conducted.Process consciousness was enhanced and theoretical knowledge analysis was combined with practical clinical skill training for residents in department of anesthesiology to improve the quality of training.