Objective To investigate the effects of Shugan Huoxue Huatan Decoction (SHHD) on non-alcoholic steatohepatitis (NASH) of rats. Methods 32 SD male rats were randomly allocated into 4 groups:normal group, model group, Dongbao Gantai (DBG) group, SHHD group. NASH model was induced by hyperlipid diet. General condition and pathological changes of liver tissues were observed. Liver function, blood lipids, liver tissue Hyp and serum LEP were dectected. Fasting insulin resistance index (FIRI) was evaluated according to the levels of fasting blood glucose (FBG) and fasting serum insulin (FINS). Results Compared with model group, SHHD had the effects of improving liver function and blood lipids, decreasing liver tissue Hyp, LEP and FIRI siginificantly. Conclusion Inhibiting leptin and insulin resistances, enhancing the lipid metabolism are probably the main mechanisms of SHHD in preventing and treating NASH.

Objective To investigate the effect of advanced glycation end products(AGEs)on expression of vascular endothelial growth factor(VEGF)in rabbit retinal M?ller cells in vitro.Methods We successfully cultured rabbit retinal M?ller cells and made AGEs-BSA as well as its control in vitro.Study with M?ller cells were divided into AGEs-BSA group,AGEs-BSA control group and blank control group.AGEs-BSA group and AGEs-BSA control group were respectively treated with 5 different concentration series of AGEs-BSA and AGEs-BSA control and cultured for 3,6 and 9 days,while blank control group was incubated without any intervention.Then VEGF expression in M?ller cells was observed by immunocytochemistry(ICC).Results Compared with control group,VEGF expression in cultured retinal M?ller cells was significantly enhanced in AGEs-BSA group.And the effects were in the time-and concentration-dependent manners.Conclusions AGEs increases VEGF expression in rabbit retinal M?ller cells in vitro,which indicates that AGEs may promote the progression of diabetic retinopathy(DR)through the induction of VEGF expression.

Objective To verify the safety and advantages of total transperitoneal laparoscopic nephroureterectomy (ttLNU) in the treatment of upper urinary tract urothelial carcinoma (UTUC).Methods From Jun.2013 to Jun.2014,there were 13 UTUC patients treated with ttLNU,including 7 males and 6 females.The mean age was 70.4 ± 8.3 yrs,and BMI was 23.3±4.1.Of them,11 cases were diagnosed with renal pelvis carcinoma,6 in the left and 5 in the right.2 cases were diagnosed with left ureteral carcinoma.TNM stages were T1-T3N0M0.Patients were put on lateral position and the position was not changed during the operation.A ttLNU was performed,and the specimen was removed from the middle extended inferior umbilical incision.Results The mean operative time was 188±33 (150-240) min,the intraoperative blood loss was 150.5±60.1 (50-700) ml,and the time of out-of-bed activity was between 1 and 4 d.The mean postoperative drainage time was 6.8±4.6 (3-6) d.The mean postoperative bowel function recovery time was 1.5± 1.0 (2-4) d and postoperative hospital stay was 12.8±7.0 (3-27) d.The ttLNU procedures were successfully performed in all cases without conversion to open surgery.Pathological results showed urothelial carcinoma in all cases,including 8 high grade and 5 low grade.All the surgical margins were negative.The followed up was from 2 to 12 mon,and there was no tumor recurrence and metastasis found.Conclusions Total transperitoneal laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma is characterized by short operative time,low blood loss,decreased trauma and quick recovery.This is a safe and effective treatment option for the treatment of upper urinary tract urothelial carcinoma.

Objective To summarize the existing animal models of cholelithiasis,and to explore a pathological model that can better reflect the characteristics of clinical syndromes of traditional Chinese and western medicine and meet the needs of the development of clinical and basic research of traditional Chinese medicine. Methods The animal models for experimental research on cholelithiasis at home and abroad were collected and sorted out by searching CNKI,Wanfang,VIP,SinoMed,PubMed and other databases. The animal types,modeling methods,modeling cycles,detection indicators and positive drugs of the models were statistically analyzed. Results Among the 128 articles included,the animal types of cholelithiasis models were mainly guinea pigs,rabbits and C57BL/6J mice. The most used modeling method is high-fat diet,and the feeding cycle takes eight weeks to complete. High-frequency detection indicators were stone formation rate,total cholesterol,phospholipids,total bilirubin,total bile acid,etc. The commonly used intervention methods are traditional Chinese medicine compound,western medicine and single Chinese medicine or extract. Ursodeoxycholic acid (UDCA) is mainly used for western medicine intervention,whereas the intervention of traditional Chinese medicine mainly includes traditional Chinese medicine compound,acupuncture,exercise,diet and other methods. The positive control drug in the experiment was mostly UDCA. Conclusion With the continuous improvement and development of cholelithiasis animal model,there are many kinds of modeling methods to simulate the clinical manifestations of cholelithiasis in Chinese and western medicine,but there are also some limitations. This paper aims to provide reference for the selection,application and improvement of cholelithiasis model through data mining and characteristic analysis.

OBJECTIVETo evaluate the relationship between CT findings and immunohistochemical types of gastrointestinal stromal tumors (GIST).

METHODSCT imaging and clinicopathological data of 85 patients with GIST were analyzed retrospectively. The CT findings of GIST including lesion location, size, contour, boundary, tumor growth pattern, degree of enhancement, necrosis and calcification, were summarized and compared with the immunohistochemical types of the GIST.

RESULTSOf the 85 patients, smooth muscle differentiation was in 26 cases (30.6%), neural differentiation in 20 (23.5%) , both smooth muscle and neural differentiation in 10 (11.8%) and no obvious differentiation in 29 (34.1%) cases. GISTs occurred in the duodenum were more frequently seen in muscle type than in any other types, GIST with smooth muscle differentiation had higher prevalence of huge mass (larger than 10 cm), distinctive enhancement and extensive necrosis than other types (P < 0.05). There was no significant difference in the relationships of immunohistochemical types with tumor contour, boundary, growth pattern and calcification among the four groups of GIST (P > 0.05).

CONCLUSIONSCT scan is the most important and effective method for diagnosis of GIST. Analyzing CT signs has some potential value in judgmet of immunohistochemical types of GIST.

Objective To investigate the clinical efficacy of intraoperative fluorouracil implant combined with raltitrexed chemotherapy in advanced gastric cancer. Methods The clinical data of patients with advanced gastric cancer from November 2013 to November 2014 were retrospectively analyzed. The patients were divided into 2 groups according to intraoperative treatment method. Sixty-two cases (observation group) received intraoperative fluorouracil implant combined with raltitrexed regional chemotherapy, and 54 cases (control group) were not given the intraoperative chemotherapy drugs. The postoperative ventilation time, incidence of complications, peripheral blood white blood cell and platelets 1st, 3rd, 5th and 7th day after operation, cumulative recurrence rate and cumulative survival rate 3 years after operation were compared between 2 groups. Results There were no significant differences in postoperative ventilation time and incidence of complications between 2 groups (P > 0.05). The white blood cell 1st and 3rd day after operation in observation group was significantly lower than that in control group: (5.21 ± 1.03)×109/L vs. (6.52 ± 1.08)×109/L and (5.29 ± 1.11)×109/L vs. (6.37 ± 1.06)×109/L, the platelet 1st, 3rd and 5th day after operation in observation group was significantly lower than that in control group: (172.64 ± 31.48) × 109/L vs. (188.34 ± 30.05) × 109/L, (175.81 ± 31.77) × 109/L vs. (190.36 ± 31.12) ×109/L and (178.46 ± 32.04) ×109/L vs. (191.18 ± 31.29) ×109/L, and there were statistical differences (P＜0.05); but the white blood cell and platelets in 2 groups were in the normal range at all time points. The 3-year cumulative recurrence rate in the observation group was significantly lower than that in control group: 75.8% (47/62) vs. 83.3% (45/54), the 3-year cumulative survival rate was significantly higher than that in control group: 71.0% (44/62) vs. 51.9% (28/54), and there were statistical differences (P＜0.05). Further analysis of patients with recurrent 3 years after operation, the incidence of local recurrence and extensive peritoneal metastasis in observation group was significantly lower than that in control group: 40.4% (19/47) vs. 68.9% (31/45), and there was statistical difference (P＜0.01). Conclusions It is a safe and effective treatment for intraoperative fluorouracil implant combined with raltitrexed regional chemotherapy to inhibit local recurrence and peritoneal metastasis in patients with advanced gastric cancer.

Cholestatic liver disease is a common disease of the hepatobiliary system. Its etiology and pathogenesis are complex. The establishment of an appropriate animal model of cholestatic liver disease is the basis for further study of its pathogenesis and prevention. This study summarized the existing modeling methods， mechanisms， and characteristics of this model， and analyzed its alignment with the clinical disease and syndrome characteristics of integrated traditional Chinese and Western medicine based on the modern clinical diagnostic criteria and traditional Chinese medicine syndrome characteristics of cholestatic liver disease， so as to provide a reference for establishing standard animal models and evaluation methods for cholestatic liver disease that accord better with the clinical practice of integrated traditional Chinese and Western medicine.

Metabolic-associated fatty liver disease （MAFLD） is a manifestation of multi-system metabolic dysfunction that affects the liver. Its disease spectrum not only includes fatty liver hepatitis， liver fibrosis， cirrhosis， liver malignancies， and other liver diseases but also includes extrahepatic diseases such as type 2 diabetes， atherosclerosis diseases， and chronic kidney disease. It is the most common chronic liver disease worldwide， with a complex pathogenesis and a lack of effective pharmacological treatments. With the improvement of people's living standards and the acceleration of the aging process， the incidence of MAFLD may continue to increase in the future， and its occurrence， development， prevention， and treatment have received widespread attention. Recent studies have shown that abnormal composition and proportion of gut microbiota can affect the changes in gut microbiota-derived metabolites. Metabolic disorders of bile acids and choline can further exacerbate gut microbiota imbalance， leading to a vicious cycle that destroys intestinal barrier function， increases intestinal permeability， and allows lipopolysaccharides， bacteria， viruses， and other substances to enter the liver through the ''gut-liver axis''. This process promotes liver inflammation and lipid deposition. Factors such as gut microbiota shift， regulation of host energy absorption， glucose and lipid metabolism， and inflammatory response interact to participate in the occurrence and development of MAFLD. Traditional Chinese medicine regulates the structure and function of gut microbiota through multiple targets， promoting the growth of beneficial bacteria， inhibiting the formation of harmful bacteria， restoring the balance of gut microbiota， improving intestinal mucosal barrier function， inhibiting liver inflammation and lipid degeneration， and influencing liver metabolism and immune response. This ultimately contributes to the prevention and treatment of MAFLD. This article systematically reviewed the mechanism of traditional Chinese medicine （TCM） treatment of MAFLD targeting gut microbiota through a literature search， aiming to provide ideas and references for TCM treatment of MAFLD.

Saponins are widely found in various Chinese medicines such as Ginseng Radix et Rhizoma， Notoginseng Radix et Rhizoma， and Bupleuri Radix. They possess multiple biological activities， including anti-inflammatory， antioxidant， antitumor， hepatoprotective， lipid-lowering， and hypoglycemic effects. They play an important role in the prevention and treatment of diseases such as acute lung injury， hyperlipidemia， and diabetic cardiovascular complications， and hold significant research potential and value. Metabolism-related fatty liver disease is a prevalent chronic liver disease characterized by excessive lipid accumulation in hepatocytes. According to the "multiple hit" theory， its occurrence is the result of systemic homeostasis disorder， influenced by abnormal lipid metabolism， oxidative stress， inflammation， insulin resistance， mitochondrial dysfunction， and intestinal microbiota. However， there is currently no effective treatment available in clinical practice. Recent studies have found that Chinese herbal saponins can alleviate metabolism-related fatty liver disease through various pathways， including regulating abnormal lipid metabolism， inhibiting inflammatory responses， alleviating oxidative stress， reducing insulin resistance， improving mitochondrial dysfunction， modulating intestinal flora， inhibiting hepatocyte programmed death， regulating liver autophagy， and correcting immune imbalances. Therefore， this review summarized the pharmacological effects and related mechanisms of Chinese herbal saponins in improving metabolism-related fatty liver disease in recent years， aiming to provide a theoretical reference for the clinical application and experimental research of Chinese herbal saponins in the prevention and treatment of metabolism-related fatty liver disease.

The liver is closely associated with inflammation and the redox response， and inflammation is the body's innate defense system for clearing away harmful stimuli and participating in the liver's wound-healing response.Oxidative stress is associated with the activation of inflammatory pathways， and sustained inflammation and the corresponding regenerative wound healing response can induce fibrosis， cirrhosis， progression to end-stage liver disease or hepatocellular carcinoma， and ultimately death.Some "medicine and food homology" traditional Chinese medicine has been used in clinical effect， showing the ability to protect the liver.This paper reviewed the relationship between liver and oxidative stress response and inflammation response， and sorted out 110 "medicine and food same origin" traditional Chinese medicines based on the Chinese Pharmacopoeia（2020 edition） and the Chinese materia medica.The results showed that common floweringqince fruit， licorice root， cassia seed， emblic，seabuckthorn fruit，Chinese date， honeysuckle， ginger， cape jasmine fruit， platycodon root， lotus leaf， dandelion， reed root， honey， mountain honeysuckle， milkvetch root， glossy ganoderma， Gastrodia gastrodia and eucommia leaf were recorded to have liver protection effects.The liver protection mechanism is mainly anti-inflammatory， antioxidant and lipid peroxidation inhibition. Some Chinese herbs can also play a liver protection role by inhibiting the growth of hepatitis virus and liver cancer cells and regulating bile acid metabolism.In addition， the biological mechanism of its liver protection effect through antioxidant and anti-inflammatory effects in animal experiments was analyzed， and it was found that it plays a role through multiple pathways and multiple targets， providing new ideas for the role of "medicine and food homology" traditional Chinese medicine in the treatment strategy of liver diseases.