ObjectiveTo review surgical management of the complications caused by iatrogenic endoscopic sphincterotomy(EST).MethodsEleven patients with complications of EST were surgically treated, including 4 patients with hemorrhage, 3 patients with perforation, 3 patients with perforation plus hemorrhage, and one patient with perforation plus severe pancreatitis. ResultsTwo patients with perforation plus hemorrhage and the patient with perforation plus severe pancreatitis died, other patients survived.ConclusionEarly diagnosis and surgical intervention was very important to lower the mortality. For patients suffering from perforation and hemorrhage or pancreatitis, it′s very important to make an unobstructed peritoneal drainage as well as other maneuvers.

OBJECTIVETo study the effects of Astragalus membranaceus (AM), Angelica sinensis (AS) and their combination on human umbilical vein endothelial cell (HUVEC) proliferation and cells cycle.

METHODSThe effects were observed and studied by means of taking the cultured HUVECs as model to determine the cell proliferation with MTT method, cell cycle was analyzed with cytometry, and vascular endothelial growth factor (VEGF) expression with SABC method. The regulatory effects of AM, AS and their combination on the HUVEC proliferation promoting were observed and studied.

RESULTSAM and AS, used singly or in combination, could promote the growth of endothelial cells, increase the cell population in S phase, the effects showed more significant when used in combination (P < 0.05 or P < 0.001). Meanwhile, VEGF expression in all the medicated group was up-regulated, but in the PBS control group, it showed only weak expression (P < 0.05 or P < 0.01).

CONCLUSIONAM and AS have effect in promoting vascular endothelial cell proliferation and DNA synthesis, and showed synergistic effect when they were used in combination, suggesting that these two Chinese herbs could have certain effect on the genesis and development of neogenetic vascularization in ischemic myocardium.

Angelica sinensis ; Astragalus membranaceus ; Cell Division ; drug effects ; Cells, Cultured ; DNA ; biosynthesis ; Drugs, Chinese Herbal ; pharmacology ; Endothelial Cells ; cytology ; Endothelial Growth Factors ; metabolism ; Humans ; Neovascularization, Physiologic ; Umbilical Veins ; cytology

OBJECTIVETo study the effects of extracts from Panax notoginseng (EPN) and Panax ginseng fruit (EPGF) on the proliferation and migration of human umbilical vein endothelial cells (HUVECs) in vitro.

METHODSCell proliferation was determined using an MTT method with a cultured HUVECs model cell cycle analyzed by cytometry. The effect on endothelial cell migration was investigated using an agarose scraping method. The content of vascular endothelial growth factor (VEGF) in the supernate was determined by enzyme-linked immunosorbent assay (ELISA). The VEGF mRNA expression of vascular endothelial cells (VECs) with different concentrations of EPN and EPGF was examined by reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTSEPN and EPGF can promote the proliferation of VECs and the secretion of VEGF from HUVECs. It can increase the cell population significantly in the S phase to (15.22+/-1.33) % in the 50 mg/L dose group (P<0.05 or P<0.01). They can promote the VEC migration in the 200 mg/L dose group and the migration rate was 93.75% (P<0.01). They could also increase VEGF mRNA expression in VEC and the effects in the 100 mg/L and 50 mg/L dose groups were significant with the proportion of VEGF mRNA expression of 0.1812+/-0.0413 and 0.2037+/-0.0399 respectively (P<0.01).

CONCLUSIONSEPN and EPGF can promote VEC proliferation, migration, DNA synthesis and VEGF mRNA expression. The results suggest that they have a certain effect on the genesis and development of new vessels in the ischemic myocardium.

Cell Cycle ; drug effects ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Endothelial Cells ; drug effects ; physiology ; Fruit ; Humans ; Panax ; Plant Extracts ; pharmacology ; RNA, Messenger ; analysis ; Vascular Endothelial Growth Factor A ; genetics ; secretion

OBJECTIVETo observe the effects of Shugan Jianpi Gusui Recipe (SJGR) on multiple sclerosis (MS).

METHODSA case cohort study was used. The MS patients were assigned to the test group (14 cases) and the control group (21 cases) according to whether they would combine with Chinese herbs. Corticosteroids or gamma globulin was administered to all patients in the acute phase. SJGR was administered to patients in the test group in the remission phase, while those in the control group were not treated or treated by azathioprine alone. They were followed-up for a long time after their first visits. The observation time ranged 10-131 successive months. The recurrence intervals and the yearly average recurrence times were calculated in the two groups.

RESULTSWhen compared with before treatment, the recurrence interval was obviously prolonged, and the yearly average recurrence times decreased in the test group after treatment with statistical difference (P < 0.05). There was statistical difference in the recurrence interval and the yearly average recurrence times between the test group and the control group (P < 0.05).

CONCLUSIONSSJGR showed better effects in prolonging the recurrence interval and reducing the yearly average recurrence times of MS patients. It is worth further researches.

Adrenal Cortex Hormones ; therapeutic use ; Adult ; Azathioprine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Middle Aged ; Multiple Sclerosis ; drug therapy ; Recurrence ; gamma-Globulins ; therapeutic use

BACKGROUND: Colorectal cancer (CRC) is the second most common cause of cancer-related deaths and has the third highest incidence in the world. Almost half of the patients with CRC have metastases at the time of diagnosis. However, the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial. Chinese medicine (CM) has unique characteristics and advantages in treating metastatic CRC. OBJECTIVE: To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy. METHODS: The study is a multicenter prospective cohort study. A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals among Beijing, Shanghai, Nanjing, and Guizhou, and assigned to three groups according to paitents' wishes: (1) integrated Chinese and Western medicine (ICM) group receiving CM herbal treatment combined with Western medicine (WM) anti-tumor therapy, (2) Chinese medicine (CM) group receiving only CM herbal treatment, and (3) WM group receiving only WM anti-tumor therapy. The primary endpoint is the overall survival (OS). Secondary endpoints include the progression free survival (PFS), quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, tumor control, and CM symptom score. DISCUSSION This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure. Patients in the ICM group will be compared with those in the WM group and CM group. If certified to be effective, national provision of CM treatment in metastatic CRC will probably be advised. (Registration No. NCT02923622 on ClinicalTrials.gov).

Calreticulin/genetics* ; DNA Methylation ; Female ; Humans ; Janus Kinase 2/genetics* ; Mutation ; Myeloproliferative Disorders/genetics* ; Polycythemia Vera/genetics*

The fragmentation pathways of the three ginkgolides (ginkgolides A, ginkgolides B, ginkgolides C) have been studied with high resolution and high mass accuracy using quadrupole time-of-flight mass spectrometry in negative ion mode in this paper. The results indicate that the three ginkgolides have similar fragmentation pathways, including four kinds of common cleavage pathways and one common characteristic ion. In high quality regions, the typical fragmentation pathways of the three ginkgolides are lactone ring opening with continuous loss of CO, CO₂,and loss of H₂O. In low quality regions, the common characteristic fragment ion of the three ginkgolides at 72.993 6 is formed by C rings cleavage. Also, the common fragment ions of ginkgolides A and ginkgolides B at 141.018 8, 125.023 8, 113.024 0, 97.029 1 are formed by A rings cleavage. The study of fragmentation pathways could be adopted for the structural identification of the ginkgolides and their metabolites.
Ginkgolides ; chemistry ; Mass Spectrometry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVE: To reveal the underlying relationships between Chinese medicine (CM) syndromes and ultrafiltration (UF) in the treatment of heart failure based on a metabonomic approach. METHODS: Seventeen acute decompensated heart failure (ADHF) patients were enrolled, and their CM syndromes before and after UF were collected. In addition, their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis. Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples. Partial least-squares to latent structure-discriminant analyses were used for data analysis. RESULTS: An obvious difference was observed pre- and post-treatment. A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine, 1-methylhistidine, phytosphingosine, O-decanoyl-R-carnitine, etc. were screened out, showing a significant change after UF. The major adjusted metabolic pathways were purine metabolism, histidine metabolism, leucine and isoleucine metabolism, arginine and proline metabolism, carnitine shuttle, sphingolipid metabolism and phospholipid metabolism. CONCLUSIONS Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.

DNA hypermethylation is an epigenetic modification that plays a critical role in the oncogenesis of myelodysplastic syndromes (MDS). Aberrant DNA methylation represses the transcription of promotors of tumor suppressor genes, inducing gene silencing. Realgar (α-As₄S₄) is a traditional medicine used for the treatment of various diseases in the ancient time. Realgar was reported to have efficacy for acute promyelocytic leukemia (APL). It has been demonstrated that realgar could efficiently reduce DNA hypermethylation of MDS. This review discusses the mechanisms of realgar on inhibiting DNA hypermethylation of MDS, as well as the species and metabolisms of arsenic in vivo.
Arsenicals/therapeutic use* ; DNA ; DNA Methylation/genetics* ; Humans ; Myelodysplastic Syndromes/genetics* ; Sulfides

OBJECTIVE: To investigate the relation of blood arsenic concentration (BAC) with clinical effect and safety of arsenic-containing Qinghuang Powder (, QHP) in patients with myelodysplastic syndrome (MDS). METHODS: Totally 163 patients with MDS were orally treated with QHP for 2 courses of treatment, 3 months as 1 course. The BACs of patients were detected by atomic fluorescence spectrophotometry at 1, 3, and 6 months during the treatment, and the effective rate, hematological improvement and safety in patients after treatment with QHP were analyzed. RESULTS: After 2 courses of treatment, the total effective rate was 89.6% (146/163), with 31.3% (51/163) of hematological improvement and 58.3% (95/163) of stable disease. The hemoglobin increased from 73.48 ± 19.30 g/L to 80.39 ± 26.56 g/L (P<0.05), the absolute neutrophil count increased from 0.81 ± 0.48 × 10/L to 1.08 ± 0.62 × 10/L (P<0.05), and no significant changes were observed in platelet counts (P>0.05). Among 46 patients previously depended on blood transfusion, 28.3% (13/46) completely got rid of blood transfusion and 21.7% (10/46) reduced the volume of blood transfusion by more than 50% after treatment. The BACs were significantly increased in patients treated for 1 month with 32.17 ± 18.04 μ g/L (P<0.05), 3 months with 33.56 ± 15.28 μ g/L (P<0.05), and 6 months with 36.78 ± 11.92 μ g/L (P<0.05), respectively, as compared with those before treatment (4.08 ± 2.11 μ g/L). There were no significant differences of BACs among the patients treated for 1, 3 and 6 months (P>0.05). The adverse reactions of digestive tract during the treatment were mild abdominal pain and diarrhea in 14 cases (8.6%), and no patients discontinued the treatment. The BACs of patients with gastrointestinal adverse reactions were significantly lower than those without gastrointestinal adverse reactions (22.39 ± 10.38 vs. 37.89 ± 11.84, μ g/L, P<0.05). The BACs of patients with clinical effect were significantly higher than those failed to treatment (40.41 ± 11.69 vs. 23.84 ± 12.03, μ g/L, P<0.05). CONCLUSION QHP was effective and safe in the treatment of patients with MDS and the effect was associated with BACs of patients.