Objective To explore the influence of gallbladder contraction function for gallbladderpreserving cholecystolithotomy by laparoscope combined with choledochoscope laparoscope.Methods Seventy-three patients with benign gallbladder diseases were selected.Patients treated with laparoscopic cholecystectomy were enrolled in LC group (31 patients),while those treated with endoscopic minimally invasive cholecystolithotomy (EMIC) were enrolled in EMIC group (42 patients).Operation situation,treatment outcome and postoperative complications were analyzed between two groups.At the same time,the level of cholecystokinin was detected with double antibody sandwich method in two groups,and the gallbladder contraction function of patients in EMIC group were detected with color Doppler.Results All patients were completed surgery without relapse cases.The operation time in EMIC group was longer than that in LC group:(84.6 ± 11.4) min vs.(72.1 ± 13.6) min,t =4.076,P ＜ 0.05.But the intraoperative bleed and postoperative complications in EMIC group were lower than those in LC group:(11.3 ± 4.8) ml vs.(19.6 ± 5.5) ml,t =3.715,P ＜0.05;2.38％ vs.16.14％,x2 =4.469,P ＜0.05.There were no recurrence.The levels of cholecystokinin in two groups before operation had no significant difference (P ＞ 0.05).After treatment for 1,6,12 months,the levels of cholecystokinin in EMIC group were (33.6 ± 10.6),(49.4 ± 12.7),(63.4 ± 14.6)ng/L,in LC group were (21.4 ± 9.1),(11.3 ± 7.4),(6.7 ± 2.7) ng/L,the levels of cholecystokinin in EMIC group were significantly higher than those in LC group (t =3.472,17.514,31.472,P ＜ 0.05 or ＜ 0.01).After treatment for 1 month,the rate of gallbladder contraction in EMIC group was significantly lower than that before treatment:(22.8 ± 4.5)％ vs.(39.2 ± 7.6)％,t =6.003,P ＜ 0.05).After treatment for 6 months,the rate of gallbladder contraction in EMIC group was recovered,after treatment for 12 months,the rate of gallbladder contraction in EMIC group was significantly higer than that before treatment:(48.8 ± 7.6)％ vs.(39.2 ± 7.6)％,t =3.054,P ＜ 0.01.Conclusions Gallbladder-preserving cholecystolithotomy by laparoscope combined with choledochoscope can get less iatrogenic trauma,which contribute to a protective effect on gallbladder contraction function on the base of high stone removal rate.It has promotive value in benign gallbladder diseases.

Objective To observe the expressions of Th1 cytokin [interleukin (IL)-12] and Th2 cytokin (IL-4) in gut of the mouse model of postinfcctious irritable bowel syndrome (PI-IBS). Methods Thirty mice were divided into control group (n=8) and model group (n=22,infected with Trichinella spiralis). The weight of the mouse was measured weekly after infection. Visceral sensitivity of colorectal distention in mouse was accessed by abdominal withdrawal reflex (AWR) at 0 and 8 weeks after infection. All mice were sacrificed at the 8th week, and tissues of jejunum, terminal ileum, proximal colon and distal colon were observed for inflammation with HE staining. The mRNA and protein expressions of IL-12 and IL-4 were examined by RT-PCR and Western blotting, respectively. Results Two weeks after infection, body weight was decreased in model group compared with control group ( -1.08%±1.08 % vs 3.09%±1.85%, P<0.05), but there was no significant difference at the 8th week between two groups (P>0.05). Severe inflammation was observed in the gut of mouse 2 weeks after infection, however it was recovered at the 8th week. The score of AWR was higher in model group at 30,45 and 60 mmHg in comparison with control group (P<0.05), whereas the perceptual threshold was lower in model group than in the control group (P<0.05). In comparison with control group, increased expressions of IL-12 mRNA and protein in ileocecum and proximal colon as well as decreased expressions of IL-4 mRNA and protein in all parts of gut were found in model group (P<0.05). Conclusion Th1/Th2 shift may involve in gut of PI-IBS mouse, which provides a new idea for treatment of PI-IBS.

We set up the characteristic medical psychology teaching mode based on the talent training objectives for three-year clinical medical majors and the requirements of the course qualification exam.The mode includes the basic psychological and clinical psychological teaching content system based on cases and tasks.Case-based teaching and Problem-based learning were used and research report and net exam were employed as main assessment methods.Online teaching resources were explored through establishing excellent course website,medlical psychology website and psychological test web

Objective To study the effects of the different concentrations of ethanol extracts of Smilax China on ear edema in mice and granuloma in rats,and to provide an evidence for optimizing the extraction process. Methods Effects of different concentrations of ethanol extracts of Smilax China on the xylene-induced ear edema in mice and the cotton ball-induced granuloma hyperplasia in rats were tested . Results Compared with the model controls,70% ethanol extracts of Smilax China at high,medium and low doses significantly inhibited ear edema in mice (t=2. 58,P<0. 05;t=2. 28,P<0. 05;t=2. 17,P<0. 05) and reduced the granuloma hyperplasia in rats(t=5. 28,P<0. 01;t=5. 24,P<0. 01;t=5. 17,P<0. 01). Conclusion The 70% ethanol extracts of Smilax China at three doses present the most active antiinflammatory effect,confirmed in both mice ear edema and rats granuloma models.

Trichinella spiralis infection in rodents is a well-known model of intestinal inflammation associated with hypermotility. The aim of the study was to use this experimental model to elucidate if Th17 cells are involved in the development of gastrointestinal hypermotility. Colonic smooth muscle contractility was investigated in response to acetylcholine. The levels of IL-17, IL-23 and TGF-beta1 in colon were measured by Western blotting. Flow cytometric detection of intracellular IFN-gamma/IL-4/IL-17 cytokine production was used to analyze the proportions of CD4+ T cells subsets in colon. Our results showed that colonic muscle contractility was increased 2 weeks post infection (PI) and stayed high 12 weeks PI when no discernible inflammation was present in the gut. The proportion of Th17 cells and the expression of IL-17 were up-regulated in colon 2 weeks PI and returned to normal 8 weeks PI. The content of IL-17 was correlated with the colonic smooth muscle hypercontracility 2 weeks PI. Meanwhile, TGF-beta1 was increased 2 weeks PI, while IL-23 was normal. Our results suggest that Th17 cells affect the colonic muscle contractility in mice infected with Trichinella spiralis at intestine stage but not at muscle stage and the effect of Th17 cells on muscle contractility might be induced by TGF-beta1. Other cytokines might be involved in the hypercontracility of colonic smooth muscle at muscle stage.

OBJECTIVETo study the mechanism that mediates the therapeutic effect of the bioactive fraction of Baqia (Smilax china) on chronic pelvic inflammatory disease (CPID).

METHODSSeventy rats were randomized into CPID model group, sham-operated group, normal control group, Jingangteng capsule group, and high-, medium-, and low-dose Baqia groups. Rat models of CPID were established by inducing chemical burns of the uterus and corresponding treatments were administered. After 14 days of treatment, the rat uterus was observed for swelling and inhibition rate, and the expressions of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) in the uterine tissues were determined using enzyme-linked immunosorbent assay.

RESULTSThe bioactive fraction of Baqia at the 3 doses obviously reduced the inflammatory cells in the endometrium, promoted epithelial cell proliferation, and ameliorated congestion and edema of the serosa. High and medium doses of Baqia bioactive fraction significantly decreased uterus swelling rate of the rats (P<0.01). All the 3 doses of the Baqia bioactive fraction obviously decreased uterine TNF-α content (P<0.01) and significantly increased uterine IL-4 expression level (P<0.05), and IL-4 up-regulation was especially obvious in high and medium dose groups (P<0.01).

CONCLUSIONBaqia bioactive fraction can ameliorate uterine swelling, lower uterine TNF-α and increase IL-4 expressions in rats with CPID, which may be a pharmacological mechanism underlying its therapeutic effect on CPID and cervical adhesion.

Animals ; Chronic Disease ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Interleukin-4 ; metabolism ; Pelvic Inflammatory Disease ; drug therapy ; metabolism ; Rats ; Rats, Sprague-Dawley ; Smilax ; chemistry ; Tumor Necrosis Factor-alpha ; metabolism ; Uterus ; drug effects ; metabolism

Objective To observe the expressions of serum insulin-like growth factor (IGF)- Ⅰ ,Ⅱ and IGF binding protein (IGFBP) 3, 5 and to explore the clinical significances in patients with clear cell carcinoma of kidney. Methods Enzyme-linked immunosorbent assay (ELISA) methods were adopted to examine serum expressions of IGF-Ⅰ , Ⅱ and IGFBP 3, 5 in 40 cases with clear cell carcinoma of kidney (renal carcinoma group) and 16 cases with hydronephrosis (control group) from May 2007 to December 2009. Results IGF- Ⅰ , Ⅱ and IGFBP 3,5 in renal carcinoma showed higher expressions before operation (985. 7 μg/L, 1154.0 μg/L,46.6 μg/L and 9.6 μg/L, respectively)than after operation (431.4 μg/L, 632.6 μg/L, 26.7 μg/L, and 6.7 μg/L, respectively, all P＜0. 05 ～0.01). There were no significant differences in those indexes between pre- and post- operation in control group (P＞ 0. 05). Conclusions There are high expressions of serum IGF-Ⅰ , Ⅱ and IGFBP 3, 5 in renal carcinoma patients, and IGF- Ⅱ has clinical significance in diagnosis.

OBJECTIVETo determine the effective fraction of Smilax for treatment of chronic pelvic inflammatory disease (CPID) by pharmacodynamic screening as the basis for further development of sarsaparilla preparations.

METHODSThe chemical fractions of Smilax were administered intragastrically in rat models of CPID induced by injecting phenol mucilage into the uterus to observe the therapeutic effects. The anti-inflammatory effects of different extract fractions from Smilax were tested in mice with xylene-induced ear edema and in rats with cotton-ball-induced granuloma.

RESULTSHigh-dose ethyl acetate extract of Smilax could obviously inhibit uterus inflammation in rats with CPID, showing also strong anti-inflammatory effects against ear edema in mice and granuloma in rats (P<0.01). The moderate dose of ethyl acetate extract also obviously ameliorated the inflammation. Both the ethyl acetate extract fraction and the total extract fraction of Smilax showed anti-inflammatory effects, while the former produced strong effects while the latter has only weak actions.

CONCLUSIONThe ethyl acetate extract fraction of Smilax is the effective fraction to produce anti-inflammatory and anti-CPID effects.

Animals ; Anti-Inflammatory Agents ; therapeutic use ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Mice ; Mice, Inbred Strains ; Pelvic Inflammatory Disease ; drug therapy ; Rats ; Rats, Sprague-Dawley ; Smilax

ility might be induced by TGF-β1. Other cytokines might be involved in the hypercontracility of colonic smooth muscle at muscle stage.

Objective To evaluate the curative effect and prognosis of endoscopic papillary large balloon dilatation ( EPLBD) in the treatment of choledocholithiasis. Methods A total of 153 patients with choledocholithiasis (>1. 0 cm in stone diameter) admitted and treated in Shanxi People's Hospital from August 2016 to November 2017 were randomly divided into two groups according to the random number table: the EPLBD group ( n=83) and the small endoscopic sphincterotomy plus large balloon dilatation ( ESLBD) group ( n=70) . The success rate of stone removal, the rate of lithotripsy, and the incidence of short-term and long-term complications were compared between the two groups. Results There were no statistical differences between the EPLBD group and the ESLBD group in total stone removal rate [ 95. 2％( 79/83) VS 97. 1％ ( 68/70) ,χ2=0. 388, P=0. 533] and one-time stone removal rate [ 92. 8％ ( 77/83) VS 90. 0％ ( 63/70) ,χ2=0. 375, P=0. 540] . The lithotripsy rate between the two groups had no statistical difference [ 25. 3％ ( 21/83 ) VS 35. 7％ ( 25/70 ) , χ2 = 1. 958, P= 0. 162 ] . There was no statistical difference in the incidence of recent complications between the two groups [ 43. 4％ ( 36/83 ) VS 40. 0％(28/70), χ2=0. 178, P=0. 673]. No postoperative perforation was found in either group. The follow-up time was 22. 7 ± 4. 3 months in the EPLBD group, and 20. 8 ± 6. 3 months in the ESLBD group. The cumulative recurrent rate of choledocholithiasis in the two groups were 2. 4％ ( 2/83) and 15. 7％ ( 11/70) , respectively, and the difference was significant ( P=0. 003) . Conclusion Simple EPLBD in the treatment of choledocholithiasis is equivalent to ESLBD in the success rate of stone removal, utilization rate of lithotripsy, and incidence of recent complications, but the long-term stone recurrence rate of EPLBD is lower than that of ESLBD. EPLBD is effective and safe on the treatment of choledocholithiasis.