Objective To explore the effects of warm water insufflation applied in difficult colonoscopy on its success rate, insertion time, operation difficulty level and tolerance of patients. Method 200 cases of the difficult defecation of non-narcotic colonoscopy, IBS and always has a history of pelvic/abdominal surgery patients, were randomly divided into warm water infusion group (experimental group) and traditional method of air insufflation group (control group), then compare the differences of the success rate of the two groups of patients, the insertion time and degree of tolerance in patients. Results All the patients completed the investigation in this study, neither bowel perforation nor other complications occurred. Experimental group success rate of the whole colon examination, the insertion time, the operator satisfaction and check again wishes were significantly higher than that of control group (P < 0.05). In abdominal pressure and utilization, abdominal pain scoring position transformation, the former was significantly lower than the latter (P < 0.05). In abdominal pressure and utilization, abdominal pain scoring position transformation, the former was significantly lower than the latter (P < 0.05). There is no significant difference (P > 0.05) in Polyp detection rate. Conclusion Warm water insufflation colonoscopy can effectively improve the tolerance and accelerating the colonoscopy in patients with difficult insertion process, improve work efficiency, and is an ideal method, which is worth of promoting.

To investigate the hypolipidemic effects of gypenosides granules and its combination with lipitor, a model of hyperlipidaemia C57BL/6J mice was established by high-fat diet feeding for 4 weeks. The mice were randomly divided into blank group, model group, lipitor group(10 mg/kg of lipitor), low dose group(90 mg/kg of gypenosides granules), medium dose group(120 mg/kg of gypenosides granules), high dose group(180 mg/kg of gypenosides granules)and the combination group(180 mg/kg of gypenosides granules and 10 mg/kg of lipitor). After 4 weeks of continuous administration, the contents of serum lipid indexes, serum ALT, AST and apolipoprotein B(ApoB)were measured. The liver tissues of mice were observed by H&E staining. The expression levels of key factors involved in hepatic cholesterol metabolism were observed by RT-PCR and Western blot methods, such as adenosine triphosphate combined box transporter A1(ABCA1), liver X receptor(LXRα), cholesterol 7 alpha hydroxylase(CYP7A1)and type BΙ scavenger receptor(SR-BΙ). The results revealed that gypenosides granules significantly decreased the mice body weight, total abdominal fat area and the level of serum total cholesterol(TC). The combination group showed a more significant reduction in TC level than the other administration groups. Moreover, gypenosides granules treatment remarkably increased the protein expression of ABCA1 and up-regulated the mRNA expression of ABCA1, CYP7A1 and SR-BI. The above results suggest that gypenosides granules can significantly reduce blood lipid contents, and the combination therapy with lipitor show better the lipid-lowering effect. Meanwhile, gypenosides granules can decrease the level of serum transaminase. Preliminary exploration suggests the lipid-lowering mechanism of gypenosides granules may be involved in cholesterol reversal to regulate the level of TC.