Objective To investigate the efficacy of laparoscopic cholecystectomy(LC)for patients with acute cholecystitis.Methods From May 2003 to November 2007,238 patients with acute cholecystitis underwent LC in our hospital.Four trocars were used in the operation.During the procedure,intraperitoneal pressure was controlled at 11 to 13 mm Hg(10 mm Hg for elderly patients).Retrograde cholecystectomy was performed on the patients with difficult anatomy caused by edema of the cystic triangle.For cases with calculi incarcerated in the cystic duct,the LC was performed after the stones were removed into the cyst(cholangiography was performed to exclude bile duct calculi).Results Of the 238 cases,LC was completed successfully in 220 patients,the other 18 cases were converted into open surgery because of massive hemorrhage and difficult anatomy(12 cases)or bile duct calculi(6 cases).After the LC,two patients received a second surgery because of postoperative hemorrhage;six patients developed bile leakage(occurred at 2-4 days after the LC with 50-80 ml of drainage)and were cured by conservative therapy including fasting,intravenous nutrition and anti-biotic therapy.This series were followed up for 1 to 12 months(mean,6 months).No post-operative complications were noticed during the period.Conclusions LC is a safe and effective for patients with acute cholecystitis or acute episode of chronic cholecystitis.Controlling the operation opportunity properly and dissecting the Calot's triangle area carefully to expose the cystic duct are the key steps during the operation.Convertion to open surgery is necessary in some difficult situations.

Objective To study the protective effects of fucoidan from Laminaria japonica on CCl_4-induced acute liver injury in mice.Methods Fifty mice were allocated into control group,model group,bifendate group,low and high dosage of fucoidan group randomly.The mice were treat with bifendate(100mg?kg~(-1)) or fucoidan(200,100mg?kg~(-1)) for 10 days. Then 10%CCl_4(10mL?kg~(-1)) was given to mice by intraperitoneal injection.The activities of serum ALT,AST,ALP and BIL were determined,the body weight and liver weight were measured,as well as the pathological changes of the liver were observed in all groups.Results fucoidan(200mg?kg~(-1)) could significantly lower the ALT,AST BIL in serum and the liver index of mice,improve the liver histology.Conclution fucoidan can protect the liver against damage induced by CCl_4 in mice.

Objective To explore the effect of patients with acute cerebral infarction and complication of acute gastric mucosal lesions (AGML) on their short-term prognoses.Methods Two hundred and sixteen patients with acute cerebral infarction admitted to the Department of Neurology in Tianjin Nankai Hospital from January to December 2014 were enrolled, and they were divided into the control group without AGML (167 cases) and observation group with AGML (49 cases) according to whether AGML occurred or not. The digestive tract was monitored in the two groups, and the relationships between the incidence of AGML and the location of infarction, stroke classification, as well as the anti-thrombosis treatments like thrombolysis, anti-coagulation and anti-platelet, etc. were analyzed; the changes in scores of the National Institutes of Health Stroke Scale (NIHSS) on admission, 7 days and 14 days after onset and 14-day mortality of two groups were compared.Results AGML occurred in 49 of 216 patients (22.69%); the 14-day mortality of the observation group was obviously higher than that of the control group [6.12% (3/48) vs. 1.80% (3/167),P < 0.05], the incidence of infarction located in cerebellum, brainstem, multiple cerebral lobes, etc. (low density shadow > 1/3 hemispheres) in the observation group was higher than that in the control group [cerebellum: 18.37% (9/49) vs. 4.19% (7/167); brainstem: 24.49% (12/49) vs. 8.98% (15/167), multiple lobes: 16.33% (8/49) vs. 2.99% (5/167), all P < 0.05]; the incidence of cardiac cerebral embolism (CE) was significantly higher than that in the control group [55.10% (27/49) vs. 12.57% (21/167),P < 0.05]. With the extension of disease course, the NIHSS score of the observation group was increased, while the score of the control group was gradually reduced, and the NIHSS scores of the observation group were obviously higher than those of control group on the 7th and 14th day after onset (7 days: 18.12±4.20 vs. 10.93±6.73, 14 days: 19.33±3.11 vs. 9.66±9.15, bothP < 0.05). The thrombolysis, argatroban anti-coagulation and anti-platelet incidence between the two groups after treatments was of no statistically significant difference (the incidence in control group was 4.79%, 47.31%, 47.90%, and it was 4.08%, 44.90%, and 48.98% in observation group, allP < 0.05). Conclusion The occurrence of AGML complication in patients with acute cerebral infarction is closely related to their short-term prognoses, and when the cerebral embolus is cardiac in origin or the infarction is located at multiple cerebral lobes, brain stem or cerebellum, the probability of the occurrence of AGML is relatively high, suggesting a poor outcome.

OBJECTIVE:To utilize computer to give better service to clinical practice METHODS:About 4 000 prescriptions of Chinese patent medicines,derived from phamacon criteria:the Chinese traditional patent medicine volume 1～20 published by Ministry Health P R China,were logged into computer and corresponding database was established by using Microsoft Access database By searching the

Objective To study the effects of Buyang Huangwu decoction(BHD) on serum matrix metalloproteinase-9(MMP-9),high sensitivity C-reactive protein(hs-CRP)levels and inflammatory reaction of patients with ischemic stroke accompanied by Qi deficiency and blood stasis syndrome. Methods Thirty-nine patients with acute ischemic stroke onset for 24-48 hours accompanied by Qi deficiency and blood stasis syndrome were admitted into Nankai Hospital of Tianjin City,and in accordance with the random number table,they were divided into BHD treatment group(21 cases)and conventional western treatment control group(18 cases). The patients in both groups were given conventional western medicine,such as anti-platelet,descent of blood lipid and protection of brain. In the BDH group,the patients were additionally given BHD oral administration. Before and after treatment for 72 hours and 7 days,the changes of serum levels of MMP-9 and hs-CRP were observed in both groups. In the mean time,20 subjects having taken physical healthy examinations in outpatient clinics were assigned in the healthy control group. Results Compared to the healthy control group,before treatment the levels of MMP-9 and hs-CRP in western treatment control and BHD groups were significantly higher than those in the healthy control group〔MMP-9 (μg/L):403.3±32.9,417.9±45.3 vs. 86.5±6.1;hs-CRP(mg/L):7.4±0.7,6.9±0.6 vs. 2.2±0.4,all P<0.05〕. After treatment for 72 hours,the levels of MMP-9 and hs-CRP achieved their peaks,after treatment for 7 days, the levels of MMP-9 and hs-CRP were significantly lower than those at 72 hours in both groups〔the control group:MMP-9(μg/L):190.4±58.0 vs. 528.9±65.1,hs-CRP(mg/L):5.8±0.7 vs. 11.1±0.8;the BDH group:MMP-9 (μg/L):89.5±11.4 vs. 437.6±55.2,hs-CRP(mg/L):3.1±0.9 vs. 7.3±0.6,all P<0.05〕. Conclusions In patients with acute cerebral infarction,the serum levels of MMP-9 and hs-CRP are significantly increased. After conventional treatment,the levels gradually decline,and the descent in the group with addition of BHD is more remarkable,suggesting that BHD have prominent effect for treatment of patients with acute cerebral infarction accompanied by Qi deficiency and blood stasis syndrome.

BACKGROUND:Studies have found that Wudi Dan can suppress local inflammatory response of the lesioned joints to protect the articular cartilage. OBJECTIVE:To verify the effect of Wudi Dan on chondrocyte viability and apoptosis as wel as the therapeutic effect on osteoarthritis. METHODS:Rat chondrocytes were cultured in serum medium containing Wudi Dan, and the effects of Wudi Dan on cel viability and apoptosis were observed by comparison with the control group. Rabbit model of knee osteoarthritis was constructed using modified Hulth method. Rabbit models were divided into two groups:Wudi Dan group treated with Wudi Dan and control group treated with normal saline, twice a day, consecutively for 4 weeks. Therapeutic effect of Wudi Dan on knee osteoarthritis was observed;cel viability and apoptosis were observed under microscope;the levels of interleukin-1 and matrix metal oproteinase-3 were determined using immunohistochemical method. RESULTS AND CONCLUSION:The apoptotic rate of chondrocytes was significantly lower in the Wudi Dan group than the control group. Pathological findings of the rabbit knee joints showed that the control group had more severe damage to the articular cartilage than the Wudi Dan group. Immunohistochemical staining revealed that in the Wudi Dan group, the cytoplasm and extracel ular matrix were colored light and there were a smal number of positive cel s as wel as low expression of interleukin-1 and matrix metal oproteinase-3. The results suggest that Wudi Dan can effectively protect against articular cartilage lesions, reduce inflammation, and have a good therapeutic effect on osteoarthritis. Its mechanism may be related to inhibition of chondrocyte apoptosis, reduction of cytokine production and inhibition of protein expression of matrix metal oproteinase.

Objective To study the clinical outcomes of 28 pancreatic cancer patients who underwent total pancreaticoduodenectomy.Method The clinical data of 28 patients with pancreatic cancer who underwent total pancreaticoduodenectomy from January 2009 to March 2015 were retrospectively analyzed.Results Among the 28 patients,complications occurred in 11 (39.2％) after the operation.There were 7 patient having Grade Ⅱ,4 Grade] complications.No patient died within 30 days after the operation.Fol low-up of 25 patients showed a median survival of 13.5 months.There were 24 patients with pancreatic ductal adenocarcinoma,and the median survival was 13 months.Conclusions Total pancreaticoduodenectomy could not improve long-term survival but it decreased postoperative complications and improved postoperative quality of life.In selected patients,total pancreaticoduodenectomy could be a rational option.

Objective To analyze the clinical value of X ray examination, CT examination and MRI examination in the diagnosis of giant cell tumor of bone.Methods 50 patients with giant cell tumor of bone confirmed by postoperative pathology were selected.The patients' X ray, CT scan and MRI imaging examination data were retrospectively analyzed, and the imaging features of giant cell tumor of bone were discussed and summarized.Results The rate of CT examination and MRI examination in the diagnosis of bone destruction was higher than X ray examination, but the difference was not statistically significant (x2=4.181,P>0.05).CT examination and MRI examination in the soap bubble sign, bone crest, liquid plane and soft tissue mass in the diagnostic rate compared with X ray examination was significantly higher, the difference was statistically significant (x2=5.333,22.941,30.000,38.400,64.000,14.166,6.102,all P<0.05).Conclusion The diagnostic accuracy of CT and MRI in giant cell tumor of bone is higher than X ray, but the value of MRI examination in the diagnosis of edema near the tumor is better.

Objective To investigate the traditional Chinese medicine ( TCM) syndromes of rheumatoid arthritis ( RA) by studying the Chinese medical patterns,and analyze the correlations of different indicators and related syndromes. Methods The questionnaires were designed according to clinical epidemiological theories. The data were collected and analyzed by multivariate statistical methods. Results The TCM symptoms of the 401 cases of RA were concluded into 3 common factors,that is,cold,heat and deficient. Their syndromes were sub-classified as 6 groups: cold syndrome,heat syndrome,deficiency,cold heat complex,deficient cold and asthenic fever. Statistical analysis showed that there were significant differences in health assessment questionnaire ( HAQ) ,platelet ( PLT) ,rheumatoid factor ( RF) ,anti-keratin antibody ( AKA) among these 6 TCM syndromes ( P

Objective To observe the effect of sinomenine(SN) in vitro on nuclear factor-?B(NF-?B) DNA binding activity and nuclear translocation of synoviocytes in collagen-induced arthritis(CIA) rats and explore its antiinflammatory mechanisms.Methods The experimental model of CIA rats was used and synoviocytes were collected.Cells were divided into five groups:normal control,CIA,CIA+10 ?mol/L methotrexate(MTX),CIA+50 ?mol/L SN,CIA+500 ?mol/L SN.Nuclear translocation of NF-?B p65 subunit and NF-?B DNA binding activity of synoviocytes were investigated by fluorescence labelling laser confocal scanning microscopy and electrophoretic mobility shift assay(EMSA) respectively.Results Compared to normal control,significant nuclear translocation of NF-?B p65 subunit was observed and NF-?B DNA binding activity was increased in synoviocytes of CIA rats(P