Objective To investigate the prevention and treatment strategy of bile duct injury (BDI) in laparoscopic cholecystectomy (LC). Methods Latest progress was reviewed based on recent documents and the experience on BDI in LC in our department. Results With the popularity of LC, BDI in LC is increasing. The reasons include illegibility and variability of local anatomy in gallbladder trigone,injury caused by galvanothermy, as well as operator’s over confidence. In order to prevent BDI, we should apply more blunt dissection, not to use electrocogulation if possible and to study local anatomy and its variance clearly. The common bile duct and common hepatic duct should be clearly identified. Intraoperative cholangiography, laparoscopic ultrasonography and hepatobiliary scintigraphy are selections as necessary.The treatment of BDI depends on the type of BDI and its site and local condition.The treatment includes end to end anastomosis, repairing the defect, choledochoduodenostomy, Roux en Y choledochojejunostomy and so on. T tube should be maintained in place for more than half a year after operation.Conclusion The key to improve the prognosis of BDI is prevention and treatment in proper time and in correct way.

Objective To explore the therapeutic effect of liver transplantation on hepatic alveolar echinococcosis (HAE) in late stage.Methods Five HAE cases in late stage failed to be treated by hepatic lobectomy underwent liver transplantation, in which 4 cases were performed under veno-venous bypass and 1 without bypass. Three cases were subjected to veno-venous bypass prior to mobilization of the liver. The end-to-end anastomosis was made between the hepatic artery and hepatic artery, and between the bile duct and bile duct. Two cases received placement of T tube in the bile duct. The mean duration of surgery was 8.3 h. Results One patient was reoperated because of the T tube falling off on the postoperative day 10, and one because of the bile leakage. Four patients recovered completely in the postoperative period, one died of multiple organ failure (MOF) and septi-caemia caused by pneumonia, acute rejection and embolism of the liver artery. Four patients were followed up for 21 months to 37 months, showing a good quality of their life. Conclusion Liver transplantation can be applied in treatment of hepatic alveolar echinococcosis in end stage, and can ensure a better clinical result.

OBJECTIVE: To establish the characteristic chromatogram of Baphicacanthis Cusiae Rhizoma et Radix and its decoction pieces by HPLC for the identification of authentic and counterfeit products. METHODS: High performance liquid chromatography (HPLC) was used with Agilent Zorbax C18(4.6 mm×250 mm, 5 μm). The mobile phase was acetonitrile-water with gradient elution. The detector was a secondary tube array (DAD). The column temperature was maintained at 35 ℃, the flow rate was 1.0 mL•min-1, and the injection volume was 10 μL. RESULTS: Fifteen batches of genuine crude drug and twelve batches of genuine decoction pieces were determined. Five common peaks were found, among which three peaks were 2-benzoxazolinone, indigo and indirubin. CONCLUSION: The established characteristic chromatogram of Baphicacanthis Cusiae Rhizoma et Radix can effectively distinguish the authentic from the counterfeit. The methodological demonstration shows that the method is accurate, stable and reproducible.

Objective To study the regulatory ability of peroxisome proliferator-activated receptor ?(PPAR?) ligands to the inflammatory response in human gallbladder epithelial cells. Methods Culture human gallbladder epithelial cells and identify them . Cells were treated for 24 hours with 0, 10 ?mol/L, 20 ?mol/L, 30 ?mol/L, 50 ?mol/L and 100 ?mol/L of Ciglitazone during cellular growth peak(5th day), then stimulated them with hIL-1? 5 ng/ml for 2 hours and measured the concentration of IL-6、IL-8 and TNF-? in cellular supernatants by riadioimmunoassay. Results Contrasted with control group, the expression of IL-6 and IL-8 in each test group were inhibited ((P

Objective: To analyze the main chemical constituents of traditional Chinese medicine compound Chenxiang Huaqi Pills by using UPLC-Q-TOF/MS technology. Methods: The separation was performed on Phenomenex Kinetex C18 column (100 mm×4.6 mm, 2.7 μm), and the gradient elution of acetonitrile-0.1% formic acid was used as mobile phase at a flow rate of 0.8 mL/min. The data was collected by the positive and negative ion modes using Q-TOF/MS and ESI source. The main chemical constituents of Chenxiang Huaqi Pills were identified according to the exact molecular mass, the cleavage fragments of MS/MS, the literature data, and the reference control. Results: A total of 73 chemical components were separated and identified in Chenxiang Huaqi Pills, including 36 flavonoids, 16 2-(2-phenylethyl) chromones, 7 triterpenoid saponins, 2 sesquiterpene lactones, and 12 other components. Conclusion: This study showed that UPLC-Q-TOF/MS technology provided a simple, rapid, and accurate method for the identification of chemical constituents in Chenxiang Huaqi Pills, which provided a new technology method for the pharmacological basis and quality control of Chenxiang Huaqi Pills.

OBJECTIVETo compare the therapeutic effect and toxicity of chemotherapy, used alone or in combined with Shenqi Fuzheng Injection (SFI), for the treatment of advanced colorectal carcinoma (ACRC).

METHODSOne hundred and fifty-two patients with ACRC were equally randomized by digital table, to the treated group, treated by chemotherapy of FOLFOX regimen combined with SFI, and the control group treated by FOLFOX regimen alone. The therapeutic effect and adverse reaction of the treatment in patients were assessed.

RESULTSThe effective rate (CR +PR) was 63.2% (48/76) in the treated group and 46.1% (35/76) in the control group, showing significant difference between the two groups (P < 0.05). The median survival time in the two groups was 31 weeks and 28 weeks respectively. CD4/CD8 ratio was significantly increased in the treated group (1.56 +/- 0.21, 1.64 +/- 0.28, P < 0.05), but significantly decreased in the control group (1.58 +/- 0.22, 1.46 +/- 0.33, P < 0.01). Quality of life in the former group was higher than that in the latter group (P < 0.05). Times/case of nausea, vomiting, leukopenia occurring in the control group was more than those in the treated group A (P < 0.05).

CONCLUSIONBy combining with SFI, some adverse reactions of chemotherapy (such as nausea, vomiting, leukopenia) and its influence on patients' immunity could be alleviated in treating ACRC, which might enhance the efficacy of chemotherapy, and improve the quality of life and prolong the median survival time in patients.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Fluorouracil ; therapeutic use ; Humans ; Leucovorin ; therapeutic use ; Organoplatinum Compounds ; therapeutic use ; Quality of Life ; Survival Rate

OBJECTIVE：To esta blish a UPLC fingerprint of Pyrrosia petiolosa from southwest China ，and to determine the contents of 4 kinds of phenolic acids （neochlorogenic acid ，caffeic acid ，chlorogenic acid and cryptochlorogenic acid ）. METHODS：The determination was performed on Waters Cortecs T 3 C18 column（100 mm×2.1 mm，1.6 μm）with mobile phase consisted of methanol- 0.1％ phosphoric acid （gradient elution ）at the flow rate of 0.35 mL/min. The detection wavelength was set at 326 nm. The column temperature was 30 ℃，and injection volume was 1 μL. UPLC method was used to establish the UPLC fingerprint of P. petiolosa in combination with the Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition）. Cluster analysis and principle component analysis （PCA）were performed by using SPSS 20.0 software. The contents of 4 kinds of phenolic acids in 20 batches of P. petiolosa were determined by external standard method. RESULTS ：There were 9 common peaks for the UPLC fingerprint of P. petiolosa . Peaks 1，3，4，5 and 9 were identified as neochlorogenic acid ，caffeic acid，chlorogenic acid ，cryptochlorogenic acid and isochlorogenic acid C ，respectively. RSDs of the relative retention time of each peak in different batches of P. petiolosa were 0-0.68％，and the RSDs of the relative peak area were 0-62.35％. The similarities between the fingerprint of 20 batches of medicinal materials and the control chromatogram were not less than 0.990. The result of cluster analysis showed that P. petiolosa from different regions could be sorted into three species. Results of PCA showed the differences among P. petiolosa from different regions. The linear range of neochlorogenic acid ，caffeic acid ，chlorogenic acid and cryptochlorogenic acid were 0.61-61.41，0.18-17.60，2.00-200.11，0.62-61.51 μ g/mL （R2＞0.999 9）. RSDs of precision ， reproducibility and stability tests were all lower than 2.00％. The recoveries were 96.23％-98.17％（RSD＝0.96％-2.28％， n＝6）. Among 20 batches of samples ，the contents of above 4 kinds of phenolic acids were 0.385 3-1.891 9，0.018 0-0.129 5，2.569 5-10.676 0，0.563.5-1.860 5 mg/g. CONCLUSIONS ： The established UPL C fingerprint could reflect the main chemical constituents of P. pedunculata . Phenolic acids could be used as the main evaluation indexes for the quality of P. petiolosa . The quality order of P. petiolosa from southwest China was Chongqing product＞Sichuan product ＞Guizhou product.

OBJECTIVE: To observe the early adverse effect index caused by short-term-repeated exposure to cadmium chloride via oral perfusion in male rats. METHODS: Forty specific pathogen free healthy male SD rats were randomly divided into four groups: control group,low-,middle-and high-dose groups. The rats of low-,middle-and high-dose groups were treated with cadmium chloride 1. 11,3. 51 and 11. 06 mg/kg body weight,respectively,and the control group rats was treated with the same volume of ultra pure water,by gavage once a day for four weeks. During the experimental duration,the body weights of the rats were taken and activity status of the rats was observed. After the experiment,the rats were executed,and some indicators of main organ coefficients,blood routine,serum biochemical indexes,urine related effect indexes and bone mineral density were measured. RESULTS: During the experimental duration,rats of high-dose group showed the symptoms such as decreased activity,increase repose,move slowly and skin duller. Comparing with control group at the same time points,the body masses of the high-dose group of the 1-4 weeks were lower(P < 0. 05).After the experiment,comparing with control group,the weights of kidney and spleen of the high-dose group decreased significantly(P < 0. 05) and the liver coefficient increased significantly(P < 0. 05). The cadmium levels in blood,urine,liver,kidney and thighbone of the middle-and high-dose groups were higher than those of the control group(P < 0. 05).The red blood cell counts of the low-and middle-dose groups increased significantly(P < 0. 05). The level of hemoglobin of middle-and high-dose groups decreased(P < 0. 05),and the activity of alanine aminotransferase in high-dose groups increased significantly(P < 0. 05). Comparing with control group,the levels of urine α_1-microglobulin and urine β_2-microglobulin in urine of the middle-dose group were decreased(P < 0. 05) and the level of urine urea nitrogen increased(P < 0. 05),but there were no significantly changes of the above three indexes in the high-dose group(P >0. 05). There were no significant difference of the levels of N-acetyl-beta-D glucosaminidase in urine between control and treatment groups(P > 0. 05). Simultaneously,in high-dose group,the weight of thighbone,the bone calcium content and bone mineral density reduced significantly than those of the control group(P < 0. 05). CONCLUSION: Skeletal effects can be used as an early toxic effect sensitive index of short-term-repeated experiments exposure to cadmium chloride via oral perfusion in male rats.

OBJECTIVE：To establish UPLC fingerpri nt of Ligusticum sinense ，Ligusticum jeholense and Conioselinum vaginatium，and to conduct their chemometrics analysis so as to provide reference for the identification of Rhizoma Ligustici from different origins. METHODS ：UPLC method combined with Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition） were used to establish the fingerprints of Rhizoma Ligustici from different origins. Chromatographic peak identification and similarity evaluation were carried out. Cluster analysis （CA），principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA）were performed to analyze Rhizoma Ligustici from different origins，and screen differential components. RESULTS ：Totally 13，11，11 characteristic peaks were identified in UPLC fingerprints of L. sinense ，L. jeholense and C. vaginatium ，respectively. Similarity evaluation showed that the similarity between C. vaginatium and L. jeholense were 0.312-0.541；that between C. vaginatium and L. sinense were 0.324-0.682；that between L. sinense and L. jeholense were 0.312-0.671，indicating there was great difference among Rhizoma Ligustici from different origins. CA，PCA and OPLS-DA showed that Rhizoma Ligustici from different origins were clustered into each category respectively ； chemical components represented by peak 10，peak 13，peak 12，peak 7 and peak 6 were differential components for Rhizoma Ligustici from 3 origins. CONCLUSIONS ：The study establishes UPLC fingerprint of Rhizoma Ligustici from different origins ， and screens 5 differential components ，which can be used to identify Rhizoma Ligustici from different origins.