Objective To investigate the role of endoscopic nasobiliary drainage ( ENBD) of bile duct instead of T tube drainage during laparoscopic common bile duct exploration (LCBDE). Methods All the patients accepted ENBD before LCBDE / laparoscopic cholecystectomy (LC) + LCBDE. During the operation the stones were extracted by choledochoscopy or crashed with electrohydraulic lithotripsy. After removing all of the biliary stones, the nasobiliary tube still remained in the common bile duct, then primary closure of the exploration wound on the duct wall was made, and with routine abdominal drainage. After operation , radiography of the nasobiliary tube was taken to investigate if there were any residual stones or leakage in the bile duct remained. Subsequently the drainage tube and nasobiliary tube were respectively removed as indicated. Results Totally 43 cases accepted ENBD preoperatively, after 6. 1 days LCBDE was performed, in 36 cases (83. 7% ) the operation was successfully using nasobiliary drainage and primary closure of the duct wound. Postoperative radiography of the duct system through the nasobiliary tube showed only in one case (2. 6% ) a small stone left which was then extracted under ERCP. There were no bile duct stricture and bile leakage, so the nasobiliary tube was removed smoothly. Seven cases ( 18. 6% ) were transferred to open abdominal exploration, 2 of them still kept the nasobiliary tube and the choledochal incisions were primary closed. Totally 38 patients (88.4% ) were successfully drained by ENBD. The abdominal drainage and nasobiliary tubes were removed in average of 3.2 and 6.7 days respectively without complications. Conclusion ENBD is an effective and safe procedure for bile duct drainage in LCBDE. It has the advantage of minimal trauma, short drainage period and rare complications. It suggested that this procedure should be a new satisfied way in treatment of bile duct stones.

Objective To study the risk factors of white matter lesions (WMLs), especially on the correlation of WMLs incidence with those well known risk factors for cerebrovascular disease (hypertension, hyperglycemia, hyperlipemia and smoking). Methods Four hundred and seventeen consecutive inpatients in Neurology Department of our hospital were enrolled who had undergone brain MRI. Detailed clinical history, relevant data and the Fazekas scores of WMLs were collected. Logistic regression was used to analyze the independent risk factors. Results Age (P=0.000), homocysteine level (P=0.010), grade of hypertension (P=0.007), patients with diabetes for less than 10 years (P=0.033) and smoking more than 40 years (P=0.003) were correlated with WMLs. In the group of patients with ischemic cerebrovascular disease, the independent risk factors of WMLs are Age (P=0.006), smoking (P=0.000) and grade of hypertension (P=0.028). Conclusions Age, homocysteine level and grade of hypertension are independently correlated with WMLs. Age, smoking and grade of hypertension are the independent risk factors for the patients with WMLs and ischemic cerebrovascular disease.

AIM: To observe the therapy effect of standard prescription on ametrop amblyopia in hyperopic children.
METHODS: This study included 270 cases ( 54 eyes ) with complete data, and followed up 24mo. All the amblyopic children were given standard prescription and were divided into progressive addition glass group, under corrected group and full corrected group. And all were observed for their therapy effect and the average healing time in low hyperopic, moderate hyperopic and high hyperopic children with ametropic amblyopia respectively.
RESULTS: In low hyperopic children, the difference of the therapy effect of the three corrected methods were insignificant in two years. The meam cure time of the three corrected methods were ( 7. 33 ± 2. 11 ) mo in progressive addition glass group;(9. 0±3. 71)mo in under corrected grope;(12. 5±5. 17) mo in full corrected group. Three groups of independent samples by paired t-test showed: the difference between progressive addition glass group and under corrected grope (t=1. 66, P>0. 05) was statistically insignificant; the difference between progressive addition glass group and full corrected grope ( t = 3. 92, P < 0. 01 ) was statistically significant; the difference between under corrected grope and full corrected grope ( t = 2. 33, P < 0. 05 ) was statistically significant. In moderate hyperopic chileren, the differences of the therapy effect of the three corrected methods were significant in two years (χ2=6. 75;P<0. 05). The difference between progressive addition glass group and under corrected grope (χ2 = 6. 3; P < 0. 01 ) was statistically significant; the difference between progressive addition glass group and full corrected grope (χ2=8. 1;P<0. 005) was statistically significant. The mean cure time of the three corrected methods were ( 14. 0±4-87) mo in progressive addition glass group; ( 16. 93±4-58)mo in under corrected grope; (17. 93±4. 42) mo in full corrected group. Three groups of independent samples by paired t-test showed: the difference between progressive addition glass group and under corrected grope (t=2. 88, P<0. 01) was statistically significant; the difference between progressive addition glass group and full corrected grope ( t= 3. 9, P<0. 01 ) was statistically significant;the difference between under corrected grope and full corrected grope ( t = 1. 01, P > 0. 05 ) was statistically insignificant. In high hyperopic amblyopic children, the difference of the therapy effect and the healing time of the three corrected methods were insignificant in two years. (χ2=2. 43, P>0. 05. t=1. 49, P>0. 05;t=1. 46,P>0. 05;t=1. 11, P>0. 05).
CONCLUSION:Under standard prescription, application of progressive multifocal glasses provides a new effective treatment for ametropic amblyopia in hyperopic children, and makes up the deficiency of the whole straightening and under correction in clinical treatment.

Objective To evaluate the therapeutic effect of acupoint catgut embedding on gastrointestinal dysfunction after surgery in patients with severe traumatic brain injury.Methods Sixty-eight consecutively hospitalized patients with gastrointestinal dysfunction after surgery in patients with severe traumatic brain injury admitted to the Department of Intensive Care Unit (ICU) in the First Affiliated Hospital of Zhejiang University of Chinese Medicine from January 2015 to December 2015 were enrolled.Six of those patients were withdrawn from the course of observation,and actually only 62 patients entered the study.They were divided into an observation group (32 cases) and a control group (30 cases) by random number table.All the patients of two groups were given conventional treatment of western medicine for consecutive 7 days.The observation group was additionally treated with acupoint catgut embedding.The control group took mosapride tablets via a nasogastric tube 5 mg,3 times a day.Intra-abdominal pressure (IAP),gastric residual volume (GRV),time for reaching standard enteral nutrition,serum diamine oxidase(DAO),D-Lactate activity,incidence of hospital-acquired pneumonia (HAP),hospitalization days in ICU,28-day mortality and adverse reactions of acupoint catgut embedding were observed in the two groups.Results After treatment,the levels of IAP,DAO,D-lactic acid were lower than those before treatment,GRV was less than that before treatment in the two groups,and after treatment for 7 days the changes were more significant in the observation group [IAP (cmH2O,1 cmH2O =0.098 kPa):12.42±3.11 vs.17.70 ± 2.98,GRV (mL):129.54 ± 57.54 vs.242.91 ± 99.29,DAO (U/L):9.06± 2.84 vs.13.60 ± 7.16,D-Lactate (mg/L):16.47 ± 5.39 vs.26.29 ± 9.62,all P ＜ 0.01].Days of mechanical ventilation (days:6.97 ± 4.13 vs.9.23 ± 4.61),time for reaching standard enteral nutrition (days:4.25 ± 3.15 vs.5.50 ± 3.12) and hospitalization days in ICU (days:9.50± 4.03 vs.12.20 ± 6.38) in observation group were significantly shorter than those in control group (all P ＜ 0.05).The incidence of HAP [15.6％ (5/32) vs.40.0％ (12/30)] and 28-day mortality [3.1％ (1/32) vs.6.7％ (2/30)] in observation group were obviously lower than those in control group.The patients in observation group had no significant adverse reactions of acupoint catgut embedding.Conclusions Acupoint catgut embedding therapy is not only easy to operate,but also can effectively improve gastrointestinal motility and intestinal barrier function in patients with gastrointestinal dysfunction after surgery of severe head injury,thus it is beneficial to reaching the enteral nutritional goal in less time,reducing the incidence of HAP,shortening the hospitalization time in ICU and promoting the recovery of the patients.

Objective To study the endoscopic manifestations of moderate or severe chronic atrophic gastritis (CAG) related to their pathologic diagnosis.Methods The correlation analysis was done between gastroscopic manifestations and pathologic diagnosis of 49 patients with moderate to severe atrophic gastritis.Results Pathologic diagnosis of moderate to severe CAG and mild CAG were conducted in 33 and 10 cases respectively, among them, 27 cases with intestinal metaplasia (IM) and 30 cases with atypical hyperplasia. For moderate to severe CAG under gastroscopy compared with their pathologic diagnosis, the coincidence rate was 67 35%; 20 cases out of them, stained in vivo with methylene blue under gastroscopy, the coincidence rate of diagnosis was 80%. Compared with pathologic diagnosis, the gastroscopic manifestations of gastric mucosa have positive prediction rate more than 80%, when several alterations coexisted, positive prediction rate raised to more than 90%, but for every individual alteration, incidence of positive prediction was not significant. Both sensitivity and specificity of each manifestation under endoscopy were more than 95%. Other manifestations such as gastric mucosa thinning, their positive prediction rates of IM and atypical hyperplasia were less than 70%; their sensitivity and specificity were less than 30%. In using coarse and uneven lumped mucosa as the criteria in diagnosing IM and atypical hyperplasia, the sensitivity was 92 85% and 83 33% respectively, and the specificity was the same (about 70%).Conclusion Coincidence rate of diagnosis under gastroscopy and pathology is quite low in moderate to severe CAG, but the knowledge of gastroscopic manifestation and the staining technique might raise this coincidence rate.

Aim To study the effect of the total flavonoids of turpinia arguta seen (TFS) on immune function of rats with adjuvant arthritis. Methods Adjuvant arthritis (AA) was induced on d0 by intradermal injection of Complete Freund′s Adjuvant (FCA), containing 10 mg heat-inactive BCG in 1ml paraffin oil. On d 28 after immunization, AA rats were killed by cervical decollation. Immune cells (splenocytes and peritoneal macrophages) were obtained, then cultured in vitro with TFS. Some immune indexes were detected respectively such as the splenocytes proliferation and the productions of IL-1 and IL-2 were measured by the method of cell proliferation, the production of prostaglandin E2 was determined by radioimmunoassay. Results Compared with normal groups, the response of splenocytes to ConA and LPS was lowered, IL-2 syn-thesis was decreased, and IL-1 and PGE_2 released from PM? were elevated. TFS (10~ -8 ~10~ -4 mg?L~ -1 ) not only increased splenocytes proliferation, which induced by ConA and LPS, and IL-2 production of splenocytes, but also reduced the elevated productions of IL-1 and PGE_2 released from peritoned macrophate in AA rats in vitro. Conculsion TFS could adjust abnormal immune function in AA rats.

The pharmacological mechaisms of Panax notoginseng saponins on nervous system diseases (Alzheimer's disease, Parkinson's disease, ischermic cerebral apoplexy and depressive disorder) , including panax notoginseng saponins, protoparaxotriol saponins, panasadiol saponins, ginsenoside Rg1, ginsenoside Rb1, ginsenoside Re and notoginsenoside R1 were summarized to analyze the study hotspots and potential advantages (such as estrogen-like effect) of notoginsenoside's pharmacological actions, provide reference for further pharmacological studies and new ideas for clinical treatment of nervous system diseases and drug studies and development.
Animals ; Drugs, Chinese Herbal ; administration & dosage ; Gene Expression ; drug effects ; Humans ; Nervous System Diseases ; drug therapy ; genetics ; metabolism ; Panax notoginseng ; chemistry ; Saponins ; administration & dosage

ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Nucleus ; metabolism ; Cytoplasm ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Proliferating Cell Nuclear Antigen ; metabolism ; Y-Box-Binding Protein 1 ; metabolism ; Young Adult

The chemical consitituents from cytotoxic fraction of the Callicarpa nudiflora extract were isolated and purified by a combination of HP-20 macroporous resin, silica gel and Sephadex LH-20 column chromatographies. The structures were elucidated on the basis of the spectroscopic data and comparison of their spectroscopic data with reported data. The cytotoxicity was evaluated by the MTT assay. The 50% and 70% EtOH elutions of EtOH-extract showed significant cytotoxic activities, leading to the isolation of twelve compounds, which were identified as luteoloside(1), lutedin-4'-O-β-D-glucoside(2), 6-hydroxyluteolin-7-O-β-glucoside(3), lutedin-7-O-neohesperidoside(4), rhoifolin (5), luteolin-7, 4'-di-O-glucoside (6), forsythoside B (7), acteoside (8), alyssonoside (9), catalpol(10), nudifloside(11), and leonuride(12). Compounds 3-6, 10 and 12 were isolated from this genus for the first time, and compound 9 was isolated from this plant for the first time. The cytotoxicity assay demonstrated that flavonoids 1-6, in various concentrations, showed monolithic proliferation inhibitory activities against Hela, A549 and MCF-7 cell lines. Compounds 3, 5 and iridoid glycoside 11 possessed higher cytotoxicacivities. In short, flavonoids are the main components of cytotoxic extract from C. nudiflora, while phenylethanoid glycosides are the predominant ingredient but inactive to cancer cell lines. In addition, the minor iridoid glycoside expressed weak cytotoxic activity.
Callicarpa ; chemistry ; Cell Proliferation ; drug effects ; Cytotoxins ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; MCF-7 Cells ; Molecular Structure

Objective To compare of the effect of intravenous zoledronic acid and calcitonin on the elderly with osteoporotic intertrochanteric fractures.Methods From June 2009 to November 2012,610 patients with osteoporotic intertrochanteric fractures were treated with closed reduction and internal fixation.543 consecutive patients were grouped sequentially according to the admission time.From June 2009 to April 2011,control group (n=325)received calcitonin for osteoporosis (male 107,female 218,mean age 75.02±5.65 years).The number of Evans-Jensen type Ⅰ,Ⅱ,and Ⅲ type patients were 87,136,and 102,respectively.Average lumbar bone mineral density (BMD) and hip BMD were 0.737±0.08 g/cm2 and 0.725±0.05 g/cm2,respectively.From May 2011 to November 2012,218 patients (male 82,female 136,mean age 74.71±5.32 years) received zoledronic acid for osteoporosis.The number of Evans-Jensen type Ⅰ,Ⅱ,and Ⅲ type patient were 62,91 and 65,respectively.Average lumbar BMD and hip BMD were 0.738±0.05 g/cm2 and 0.722±0.06 g/cm2,respectively.All patients received once-yearly intravenous zoledronic acid in one week after operation.The BMD during hospitalization and one year after operation were compared between the two groups.Harris score and VAS score were applied to evaluate the function and pain degree of the operated hip joint.Results The average follow-up time were 12.8 months (range,5 to 22 months) in control group and 12.5 months (range,4 to 19 months) in treatment group.The average fracture union time,Harris score,VAS score were 14.25±1.38 weeks,68.88±5.71 points,and 0.36±0.55 points respectively in treatment group and 14.39± 1.12 weeks,69.47±4.60 points,and 0.33±0.48 points respectively in control group.There were no statistical differences between two groups in fracture union time,Harris score and VAS score.The average lumbar BMD and hip BMD were 0.76±0.06 g/cm2 and 0.75±0.04 g/cm2 in treatment group,which were 0.75±0.07 g/cm2 and 0.74± 0.07 g/cm2 in control group one year after operation,respectively.Compared with the baseline,the BMD of lumbar spine and hip one year after operation slightly increased without statistically significant difference in control group.The BMD increased significantly in treatment group.Conclusion Early administration of intravenous zoledronic acid does not influence bone healing and it could increase BMD one year after closed reduction and internal fixation.