Objective To investigate the characteristics of high-risk cholecystolithiasis and summarize the experience of laparoscopic chol-ecystectomy for this disease.Methods A retrospective analysis was performed on the clinical data of 1 15 patients with high-risk cholecys-tolithiasis who underwent laparoscopic cholecystectomy in our hospital from October 2008 to March 2012.Results Of the 1 15 patients,47 had stones filling the gallbladder as well as atrophy of the gallbladder and porcelain gallbladder,42 had acute suppurative and gangrenous cholecystitis,20 had stone incarceration in the gallbladder neck,3 had cystic duct stones,2 had cholecystoduodenal fistula,and 1 had Mi-rizzi syndrome;all patients were cured and discharged.Conclusion For patients with high-risk cholecystolithiasis,laparoscopic cholecys-tectomy is feasible,given active preoperative preparation,strengthened perioperative management,and accurate,standard,and skilled sur-gical operation.

OBJECTIVE:To study the pharmacokinetics of emodin(an active component of Qingyi-Ⅱgranula) in rats after i.g administration of Qingyi-Ⅱgranula.METHODS:Rats were i.g administered with Qingyi -Ⅱgranula(2.5 g?kg~(-1) and 5.0 g?kg~(-1)).Serum concentrations of emodin were determined at different time points by HPLC,and the pharmacokinetic parameters were computed.RESULTS:The pharmacokinetic parameters of emodin in rats after administration of Qingyi-Ⅱgranula(2.5g?kg~(-1) and5.0g?kg~(-1)) were asfollows:t_(1/2?):(9.468?8.46) hand(21.68?17.867) h;t_(1/2?):(15.388?5.46) h and.(39.63?24.39) h;t_(max):(2.500?3.479) h and(5.333?3.266) h;C_(max):(0.058?0.004) mg?L~(-1)and(0.101?0.007) mg?L~(-1);CL:(33.027?9.365) L?h~(-1)?kg~(-1) and(9.405?5.846) L?h~(-1)?kg~(-1);AUC_(0-∞):(0.652?0.201) mg?h~(-1)?L~(-1)and (1.364?0.267) mg?h~(-1)?L~(-1).The pharmacokinetic process was in line with two-compartment model.CONCLUSION:The method for the detection of serum concentration of emodin in rats and the related pharmacokinetic parameters had been established in our study,which serves as a theoretic basis for the pharmacokinetic study of Qingyi-Ⅱgranula.

[ ABSTRACT ] AIM: To investigate the protect effect of Chinese herbal preparation, Qing Yi TangⅡgranule (QYT), on acute pancreatitis (AP) mice and its mechanism.METHODS:Adult male and female C57BL/6 mice (n=24) were randomly divided into control group, AP group and AP+QYT group.Severe AP was induced by combined intra-peritoneal injection of caerulein (50μg/kg) and lipopolysaccharide (LPS;10 mg/kg).Drinking water or 24%QYT solu-tion was given to the mice in AP group or AP+QYT group by oral gavage.The mice in control group were intraperitoneally injected with equivalent volume of normal saline and gavaged with water.The mice were sacrificed 3 h after the last injec-tion.Severity of AP was assessed by biochemical markers and histology.The plasma level of IL-6 and MCP-1, and lung myeloperoxidase ( MPO) levels were determined for assessing the extent of systemic inflammatory response.The intestinal microflora, T lymphocytes and T-lymphocyte subgroups were examined for assessing the function of the intestinal barrier. RESULTS:Compared with control group, the mice in AP group presented significant increases in pathological histological scores, plasma amylase activity and IL-6 and MCP-1 levels, as well as the MPO activity in the lung and pancreatic tissues. QYT attenuated these changes to some extent.Furthermore, the increased intestinal microflora was significantly reversed by QYT.No difference of the numbers of Peyer’ s patches in small intestine in the 3 groups was observed, but the percentage of CD3 +T lymphocytes decreased significantly in AP group, and increased percentage of CD4 +and CD4 +/CD8 +ratio were found in AP group and AP+QYT group.CONCLUSION: QYT protects against cearulein and LPS-induced acute pancreatitis in mice.The mechanisms may be related to the suppression of the inflammatory response, promoting intestinal bacteria removal, and regulating the functions of T lymphocytes in the intestinal barrier.

Objective To investigate the mechanism of intestinal barrier functional disturbance in rats with severe acute pancreatitis (SAP). Methods Forty-eight Sprague-Dawley (SD) rats were randomly divided into SAP model group (SAP group, n=24) and sham operation group (SO group, n=24) according to the random number table method. SAP model was established in SAP group by retrograde injection of 3%sodium taurocholate in pancreatic duct. The intestinal canals of rats in SO group were only lfipped after laparotomy. At the time points of 6, 12, 24 h after operation, the seroperitoneum volume of 8 rats in each group was measured after laparotomy and the inferior vena cava blood was collected to measure the levels of blood amylase, tumor necrosis factor (TNF)- α, D-lactic acid, diamine oxidase (DAO) . The tissues of pancreas and terminal ileum were pathologically examined after the rats were sacriifced. The experimental data of two groups were compared using t test. Results SAP model was established successfully in SAP group and seroperitoneum, increasing blood amylase, pathological damage of pancreatic tissues were observed in the rats. At the time points of 6, 12 and 24 h after operation, the average blood TNF- α levels in SAP group [(262±17), (320±18), (382±33)μg/L] were signiifcantly higher than that in SO group [(201±16)μg/L] (t=10.066, 7.387, 7.720; P<0.05). Increasing intestinal permeability and alteration of intestinal flora were observed in SAP group. The blood D-lactic acid levels were (168±14), (200±15), (255±24)μg/L accordingly in SAP group and were signiifcantly higher than that in SO group [(125±9)μg/L] (t=13.211, 25.191, 36.888;P<0.05). The blood DAO levels were (156±12), (196±11), (220±14)μg/L accordingly in SAP group and were significantly higher than that in SO group [(119±6) μg/L] (t=23.811, 43.561, 48.069; P<0.05). The ileum mucosa damage and local focal necrosis or piecemeal intestinal necrosis were observed in SAP group. The intact structure of ileum mucosa tissues were observed in SO group. Conclusion The activated TNF-α, alteration of intestinal lfora and increasing intestinal permeability may play important roles in the intestinal barrier functional disturbance of rats with SAP.