Objective To determine the feasibility and management of the laparoscopic cholecystectomy (LC)for acute cholecystitis. Methods The clinical data of 106 patients with acute cholecystitis underwent LC were reviewed retrospectively. Results Six cases were converted into laparotomy and LC were successfully performed in other 100 cases. No complications occurred in this series. Conclusions LC is feasible for acute cholecystitis;the skill and experience of the operator is the key to the success of the operation.

Objective To discuss the effects of Deming cycle on reducing adverse drug reactions (ADR) induced by injections of traditional Chinese medicine (TCM).Methods The TCM injections which induced much more ADRs in 2013 were selected. The usage of these TCM injections and characteristics of the ADRs were analyzed. Strategies for controlling ADRs were developed according to Deming cycle and put into the recycle implementation in 2014. Results The ADRs induced by TCM injections were all reduced; the number of total cases was reduced by 41.3% compared to 2013, among which Tanshinone IIA Sulfonate injection,Xinmailong injection, Mylabris injection,Shenqi Fuzheng injection andShengmai injection were reduced significantly, and their reduction rates were all more than 50%. The clinical manifestations of ADRs, including rash, itching, chills, fever, phlebitis, chest distress and palpitation, were all reduced in 2014 compared to 2013, among which especially the allergic reactions, including phlebitis, rash and itching, were reduced by 14.9% and 13.4%.Conclusion Application of Deming cycle in the practice of TCM injections for clinical rational medication can effectively reduce the occurrence of ADRs and better ensure the safety of clinical use of TCM injections.

Objective:To explore the relationship between loneliness and attachment in college students and the mediating effect of rumination.Methods:Totally 545 students [239 males,306 females;average age (20 ± 3) years] were assessed with the Russell UCLA Loneliness Scale (UCLA),Experiences in Close Relationships Inventory (ECR,including attachment avoidance and attachment anxiety) and Nolen-Hoeksema Ruminative Response Scale (RRS).The structural equation model was used to research the mediating effect of rumination on relationship between loneliness and attachment.Results:The scores of UCLA,ECR and RRS were positively correlated each other (r =0.30,0.20,0.44,Ps ＜ 0.01) in college students.The inspection of the mediating effect found fit indices for hypothetical model were acceptable (x2 =16.69,df=5,NFI =0.98,IFI =0.99,TLI =0.96,CFI =0.99,AGFI =0.96,RMSEA =0.07).Path analysis revealed that attachment avoidance and attachment anxiety predicted directly loneliness (β =0.10,0.06) and rumination (β =0.05,0.16),and predicted loneliness by rumination (β =0.18).Conclusion:The rumination may be associated with loneliness and individual attachment and play a partial mediating effect between loneliness and attachment in college students.

Objective:To observe the effect of Xinfeng Capsule (XFC) on synovial membrane PI3K/AKT/mTOR pathway in adjuvant arthritis (AA) rats.Methods:Rats were randomly divided into normal control group,model control group,methotrexate group,tripterygium glycoside group and XFC group.The expressions of IL-6,IL-10,HIF-1α and VEGF-A were detected by immunohistochemical method,and the expressions of PI3K,AKT1 and p-AKT1 were detected by immunoblotting.Results:Expression of AKT1,mTOR and ES proteins in synovial blood vessels.The expression of IL-6,VEGF,HIF-1α and synovial membrane PI3K,AKT1,p-AKT1,mTOR,ES in the model group were significantly higher than those in the control group The expression of PI3K,p-AKT1,mTOR,ES in synovial membrane decreased,and IL-10 in serum increased in XFC group,and the expression of HIF-1α,IL-6 and VEGF-A were decreased.Conclusion:XFC can improve angiogenesis in AA synovium by regulating PI3K/AKT/mTOR signaling pathway,HIF-1α and ES expression.

Objective To evaluate the clinical efficacy and outcomes of percutaneous cholecystostomy(PC) under type-B ultrasonic guide as an alternative treatment option for critically ill patients of acute cholecystitis.Methods The clinical data of 53 high-risk patients of acute cholecystitis were retrospectively analyzed,who received PC from January 1999 to August 2005.Results All cases were successfully punctured and intubated,and 4 received reoperation because of blocked tube or fall-off.Fifty-two(97.3%) gained bile drainage effectively.No complications occurred due to the procedures in the cholecystostomy and intubation.One patient required emergency cholecystectomy on day 1 after the procedures because of deteriorating conditions.Forty-one accepted selective cholecystectomy in 2 weeks to 3 months after cholecystostomy.The follow-up period was 6 months to 3 years.Conclusion PC is an effective,convenient and safe method in managing acute cholecystitis in high-risk patients,with high achievement ratio and less complications.

ObjectiveTo investigate the effects of moxa smoke versus tobaccosmoke on autonomous behaviors and hippocampal expression of glial fibrillary acidic protein (GFAP) in apolipoprotein E gene knockout (ApoE-/-) mice.Method Thirteen 8-week-old C57BL/6 mice constituted a blank control group. Twenty-seven ApoE-/-mice of the same age were randomized into ApoE-/-model, moxa smoke and tobacco smoke groups. The tobacco smoke and moxa smoke groups of mice were exposed to smoke 5-15 mg/m3circumstances. Every group of mice was intervened in 20 min. daily, six days a week, for atotal of 12 weeks. A behavioral test was conducted in week 13. The animals were then sacrificed to take the materials. Hippocampal GFAP in the brain was measured by an immunohistochemical method.ResultAutonomous activities were significantly more in theblank group than in the model group (P<0.05) and significantly fewer in the tobacco smoke group than in the blank group (P<0.05). There was no statistically significant difference in autonomous activities between the tobacco smoke group and the model or moxa smoke group (P>0.05). Moving distance was longer in the moxa smoke group than in the model group (P<0.05). Standing-up number was smaller in the moxa smoke group than in the blank group (P<0.05). Integral optical density of GFAP immune reaction products in the hippocampus was significantlyhigher in the model group of mice than in the blank and moxa smoke groups (P<0.05). Hippocampal GFAP expression was significantly higher in the group of mice than in the moxa smoke and blank groups (P<0.05).Conclusion Moxa smoke can increase the excitability of central nervous system in mice and reduce hippocampal GFAP expression in a mice model of Alzheimer disease.

Objective To evaluate the effect of a bone transport method using unilateral external fixator in treatment of partial bone defect.Methods Three patients with partial bone defect were reviewed,including 2 males and 1 female,and whose ages were 50,50,and 24 years,respectively.The defects were at medial part of the left proximal tibia in 2 cases.In the first case,the defect was 5 cm in length,1/3-2/3 of transverse diameter in width,with a 5 cm×3 cm skin loss.In the second case,the defect was 6 cm in length and 3 cm in width.For the remaining patient,the bone defect was located in lateral part of the right femur,which was 13 cm in length,1/3-2/3 of transverse diameter in width,with a 15 cm×7 cm scar on it.After debridement of the wound,the Orthofix's limb reconstruction external fixation system was mounted medially,initially with 2-3 HA coated screws in the middle clamp to anchor the near cortex of the segment to be transferred.A partial corticotomy was performed with multiple drill hole technique.The gradual segment transport was started 2 weeks after the operation at a rate of 1 mm/d,4 times/d.Results The follow-up time was 14,28 and 24 months,respectively.The external fixator was removed 8 and 6 months after the osteotomy in 2 patients,when radiographs demonstrated bony union of the docking site as well as mature consolidation of the generated callus.The range of motion of hip,knee,ankle on the injured side was similar to the uninjured side.The segment was unable to be transported successfully in the femur,because the compressiondistraction device was misused.Two months after the first operation,the osteotomy was performed at the same site for the second time.The frame was removed at 10 months after the second osteotomy when the new bone formed well and the fracture healed at the docking site.The patient was able to stand independently and walk with a stick at 17 months after the osteotomy.At the latest follow-up,there was no sign of osteomyelitis.Conclusion Bone transport method using unilateral external fixator is a practical option to treat partial bone defect.In addition to shorten the period with fixator,it can avoid malunion and donor injury.

Objective To investigate the effect and mechanism of anti-tumor necrosis factor (TNF)-α on the intestinal mucosal permeability in dextran sulfate sodium (DSS) induced colitis mice.Methods Eighteen C57BL/6J mice were evenly divided into healthy control group,model group and anti-TNF-α treated group.The mice of model group and anti-TNF-α treated group were fed with 5％DSS solution for 7 days.The mice of anti-TNF-α treated group were injected anti-TNF-α (5 mg/kg)intraperitoneally on the first and fourth day; control group and model group were substituted with equal volume saline injection.The mice were sacrificed at 7 days after modeling.The disease activity index (DAI) score was evaluated everyday.The intestinal permeability was examined by Evan′s blue (EB) method and FITC-dextran (FITC-D) method.The colon tissue was collected for observation under microscope and histological index (HI).The small intestinal tissues were examined under electron microscope.The 10％ homogenate of colon and intestinal mucosa was prepared,the activity of myeloperoxidase (MPO),the content of TNF-α and epithelial myosin light chain kinase (MLCK) concentration were determined with kits respectively.The expression of MLCK in intestinal mucosa was tested by Western blot assay.Single factor of variance between groups were analyzed.Results Compared with control group,the DAI of model group increased daily.Compared with model group,the DAI of anti-TNF-α treated group improved.In model group,mice intestinal epithelial cells junctional complex shortened and widened and the cell gap expanded.In anti-TNF-α treated group,the connection structure of mice intestinal epithelial cells was tighter.The activity of HI and MPO and the content of TNF-α of model group were higher than those of control group (P ＝ 0.008,0.006 and 0.001,respectively),all of those of anti-TNF-α treated group were lower than those of model group (P=0.004,0.008 and 0.005,respectively).The F value of three groups was 131.98,218.28 and 58.93,respectively.The contents of EB in mice intestinal wall and serum FITC-D of model group were higher than those of control group (P=0.003 and 0.010),and those of anti-TNF-α treated group were lower model group (P＝0.001 and 0.009).The F value of three groups was 69.36 and 17.96.The MLCK concentration in mice intestinal mucosa of model group [(71.10± 7.52) ng/g] was higher than that of control group [(18.56±9.92) ng/g,P＜0.01],that of anti-TNF-α treated group [(37.56±15.84) ng/g] was lower than model group (P=0.008),and the difference among these three groups was statistically significant (F＝ 17.23).The Western blot results indicated the expression of MLCK in intestinal mucosa of model group was higher than that of control group,and that of anti-TNF-α treated group was lower than model group.Conclusions Anti-TNF-α play an important role in improving colitis,and the intestinal mucosal permeability.The mechanism may be related with the regulation of MLCK expression.

Rheumatoid arthritis (RA), as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA.

Primary retroperitoneal liposarcoma is a rare low-grade malignant tumor and accounts for approximately 1% of all adult malignancies. Complete gross resection is the most important and maybe only method to cure retroperitoneal liposarcoma. The addition of advanced- modality radiotherapy to surgery for primary retroperitoneal liposarcoma is associated with improved local recurrence-free survival, and the toxic effect is tolerable. Several new drugs, especially targeted drugs, have achieved good efficacy. The aim of this article is to improve the understanding of treatment of primary retroperitoneal liposarcoma. The multidisciplinary therapy model, including surgery, radiotherapy, chemotherapy and targeted therapy, is recommended for patients with retroperitoneal liposarcoma.