Objective To discuss the prevention and treatment for complications following laparoscopic cholecystectomy (LC). Methods A total of 902 cases were summarized retrospectively with regard to causes, prevention and treatment of complications following LC. Results Out of the 902 cases, there were 2 cases of bile duct injury, 2 cases of residual calculi of common bile duct, and 4 cases of scrotum emphysema. The bile duct injury and residual calculi were all cured by re-operation, while the scrotum emphysema dissolved of itself without medical treatment. A conversion to open surgery was required in 31 cases. All the cases in the study were cured. Conclusions Emphasis should be laid on the prevention of complications after LC. A prompt conversion to open cholecystectomy is the key to the lowering of complication rate.

Objective To observe the expression of FAS/FASL in brain of autism model rats induced by sodium valproate,and study the role of FAS/FASL in pathogenesis of autism.Methods Female wistar rats were given a single intraperitoneal injection of sodium valproate(VPA,600 mg/kg) on 12.5 d after pregnancy,and their offspring were used as the experimental group;while the other pregnancy rats were given the same dose of normal saline,and their offspring were used as the control group.The growth,social and non-social behaviors,repetitive stereotyped movements of both groups were observed and tested.The expressions of FAS/FASL in brain of both groups on 1 d,7 d,l4 d,28 d,56 d and 90 d after birth were observed and compared by means of immunohistochemistry and image analysis.Results Compared with the control group,the rats in experimental group had stunted growth,a decrease in social behavior,an increase in non-social behavior,with repetitive stereotyped movements increased,and there were significant differences (all P ＜0.05) ;FAS/FASL expression was less on 1 d after birth,and it was growing gradually with age in days,and expression reached the peak on 28 d and then began to decrease.Compared with the control group,all day-old rats' FAS and FASL expression in the experimental group were significantly raised (all P ＜ 0.05).In experimental group,the brain FAS/FASL IOD values on 28 d after the birth reached the maximum,and 90 d after the birth reached the minimum.In the control group brain FAS/FASL IOD values on 14 d after the birth reached the maximum,and 1 d after the birth reached the minimum.Conclusions The apoptotic cell of autism model rats' brain neure is increasing firstly and then decreasing by FAS/FASL apoptotic pathway,and reach apoptosis peak on 28d.

Objective To observe the effects of the compatibility of Radix Astragali and Radix Angelicae Sinensis in different proportion on hemodynamic and balance of Th1/Th2 cells of Qi deficiency and blood stasis rat model. Methods Qi deficiency and blood stasis rats were caused by restricted diet, forced swimming and norepinephrine subcutaneous injecting, and treated by compatibility of Radix Astragali and Radix Angelicae Sinensis in different proportion of 5∶1, 3∶1, 1∶1 and 1∶2 for 21 days. The indexes of hemorheology were detected with hemorheological analyser, and the level of IFN-γand IL-4 in serum were tested by ELISA. Results Compared with model group, the compatibility of Radix Astragali and Radix Angelicae Sinensis in proportion of 1∶1, 3∶1 and 5∶1 groups reduced the low shear blood viscosity. The spleen index of model group decreased, and compatibility of Radix Astragali and Radix Angelicae Sinensis in 5∶1 proportion group increased spleen index. The level of IL-4 increased and IFN-γ decreased in the serum of model group, the compatibility of Radix Astragali and Radix Angelicae Sinensis in proportion of 3∶1 group increased the level of IFN-γ. Astragalus angelica 5∶1 group decreased the level of IL-4 and increased the level of IFN-γ. Conclusion The compatibility of Radix Astragali and Radix Angelicae Sinensis can improve hemorheology, adjust the balance of Th1/Th2 cells of Qi deficiency and blood stasis rats. The effects were better when Radix Astragali’s dosage greater than that of Radix Angelicae Sinensis, and the group of 5∶1 proportion was the best.

Background and Objective Large randomized controlled trials have demonstrated that percutaneous coronary intervention (PCI) with the routine use ofdrug-eluting stents is safe and effective, however, the patients older than 75 years undergoing PCI are at increased risk for major adverse cardiac events, so that the patients are usually excluded from this trial. The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary PCI. Methods We analyzed the outcome after stenting in 136 patients older than 60 years in our coronary care unit with acute STEMI, and the patients were further classified in 2 age groups: patients≥75 years and <75 years. Results Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than those of the younger, the procedural success had no difference between two groups. The main adverse clinical events (MACE) for the old group was a little higher comparing with the younger in 12-month following up. Conclusions Our study suggest that drug-eluting stent implantation in elderly patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time form symptom onset to PC1 and improve final TIMI flow strategy may decrease MACE among old patients following PCI.

The incompatibility of traditional Chinese medicines is related to the clinical medication safety, so has attracted wide attentions from the public. With the deepening of studies on the incompatibility of traditional Chinese medicines represented by 18 incompatible herbs, the incompatibility of theory traditional Chinese medicines has raised to new heights. From the origin of incompatibility theory of traditional Chinese medicines, relationship of herbs, harms of incompatible herbs and principle of prevention to toxic effects of specific incompatible medicines, the innovation and development of the traditional Chinese medicine incompatibility theory was explored. Structurally, the incompatibility of traditional Chinese medicines refers to the opposition of two herbs based on seven emotions and clinical experience. The combination of incompatible herbs may lead to human harms, especially latent harm and inefficacy of intervention medicines. The avoidance of the combination of incompatible herbs and the consideration of both symptoms and drug efficacy are the basic method to prevent adverse reactions. The recent studies have revealed five characteristics of incompatible herbs. Toxicity potentiation, toxication, efficacy reduction and inefficacy are the four manifestations of the incompatible relations. The material changes can reflect the effects of toxicity potentiation and toxication of opposite herbs. The accumulation of toxicity and metabolic changes are the basis for latent harms. The antagonistic effect of main efficacies and the coexistence of positive and negative effects are the distinctive part of the incompatibility. The connotation of incompatible herbs plays an important role in the innovation of the traditional Chinese medicine incompatibility theory.
Drug Incompatibility ; Drug Therapy ; history ; Drugs, Chinese Herbal ; chemistry ; history ; pharmacology ; History, Ancient ; Humans ; Medicine in Literature ; Medicine, Chinese Traditional

Objective To observe the effects of static pressure on the number of cultured retinal M?ller glial cells(RMGC)and expression of glial fibrillary acidic protein(GFAP)and heat shock protein(HSP)70 by these cells.Design Experimental study. Participants Cultured rat RMGC.Methods Rat RMGCs were cultured and identified according to previous method described by Reichenbach.These cells were treated with different static pressures and divided into 4 groups:A(1.33kPa),B(2.67kPa),C(5.33kPa)and D(10.67 kPa)while the cells without treatment was as control group(NC).The morphologies of RMGC in these groups were observed under inverted phased contrast microscope,the number of RMGC counted with conservative method and the viability were studied with trypan blue staining.The expressions of GFAP and HSP70 in RMGCs were detected with the method of western blot.Main Outcome Measures The morphologies of RMGC,cell number,cell viability.Results There were pressure-dependent changes of RMGC number. The cell number of group C and D was less than that of group NC,A and B(P＜0.01).High static pressure resulted directly in the decreased ratio of unstained RMGCs(P＜0.01).The ratio of unstained RMGCs in group C and D was less than that in group NC,A and B(P＜0.01).Many cells in group C and D were injured and the higher the pressure elevated,the more the degree of injury became.The expressions of GFAP and HSP70 in group NC were less than other pressure treated groups and the expression of GFAP in group C and D was higher than that in group A and B.There was no obvious difference between these pressure treated groups.Conclusions High static pressure could cause the injuries of RMGCs.The increased expression of GFAP and HSP70 in RMGC might be regarded as a sign of retinal injury response to high intraocular pressure.

Background The pathogenesis and development of cataract is associated with oxidative stress-induced apoptosis of human lens epithelial cells(LECs).BH3-only protein is a factor that can initiate apoptosis,and thus the apoptotic process is probably related to the activation of the c-Jun N-terminal kinase(JNK).However,the relationship between oxidative stress-induced apoptosis of human LECs and the JNK pathway remains to be illuminated.Objective This study was to investigate the effects of the JNK/c-Jun pathway and its target gene,Bim (Bcl-2 interacting mediator of cell death)and PU M A(p53 up-regulated modulator of apoptosis),on oxidative stressinduced apoptosis of human LECs.Methods The human LECs cell line(HLEC-B3)was cultured and passaged in DMEM with 10％ fetal bovine serum in vitro.Confluent cells were incubated in 24 well plates and divided into 4 groups.Hydrogen peroxide(H2O2)(50 μmol/L)was used to treat the cells for 4,8 or 12 hours,and cells without H2O2 treatment served as the control group.Apoptosis was detected using Hoechst 33258 staining and quantified by counting the number of cells with pyknotic nuclei.In addition,confluent cells were seeded in 6 well plates,and Western blot and RT-PCR were used to detect the expression of the caspase-3,c-Jun,Bim and PUMA proteins and their mRNA in HLEC-B3,respectively.The JNK/c-Jun pathway inhibitors,CEP11004 or SP600125,were added into cultured media with H2O2,and cells treated with DMSO or H2O2 only served as negative and positive control groups.The expression of the p-JNK,JNK,p-c-Jun,c-Jun,Bim,PUMA proteins was detected by Western blot and apoptosis was assayed using Hoechst 33258 staining.200 pmoL/L of Bim or PUMA small interference RNA(siBim or siPUMA)fragments were transfected into the cells for 24 hours,respectively,and H2O2 was then used to treat the cells for 8 hours.The expression of the Bim and PUMA protein and their mRNA in the cells was detected by Western blot and RT-PCR,respectively.Results After H2O2 treatment in HLEC-B3 cells for 4,8,or 12 hours,the rates of apoptosis were 4.30％±1.15％,27.08％±0.74％ and 46.59％±0.91％,showing a significant difference among them (F=1909.433,P=0.000),and those of the 4,8,12 hour groups were significantly increased in comparison to the control group(P =0.049,0.000,0.000).Compared to untreated cells,the levels of expression of the JNK,Bim,PUMA proteins and their mRNA in HLEC-B3 cells were significantly elevated.After the addition of CEP11004 or SP600125,the expression of these protein and mRNA in HLEC-B3 cells in the presence of H2O2 was significantly weaker than that in the DMSO control group(P =0.000,0.000).After the tranfection of siBim or siPUMA,the apoptosis rates of the H2O2 treated groups were significantly higher than those in the Bim-/-or PIMA-/-group (P＜0.05).Conclusions H2O2 can activate the JNK/c-Jun pathway and up-regulate the expression of its target genes Bim and PUMA in human LECs in a time-dependent manner.Inhibiting the JNK/c-Jun pathway and interfering with the expression of Bim and PUMA can protect human LECs against oxidative stress-induced apoptosis.

Aim To study the mechanism of DXM and NAC inhibiting the expression of IL-8 and ICAM-1 in A549 cells. Methods The expression of IL-8 and ICAM-1 was detected by ELISA and flow cytometry re-spectively; the expression of GR,HDAC,AP-1,NF-κB was detected by Western blot, while the activity of HDAC was detected by spectrophotometry. ResultsThe increasing expression of IL-8 and ICAM-1 induced by TNF-α could be inhibited by DXM and NAC in A549 cells. DXM could inhibit the transcribed activa-tion of AP-1,NF-κB, and the expression of HDAC and its activity induced by TNF-α and LPS; NAC only in-hibited the transcribed activation of NF-κB, while it had no affection on the transcribed activation of AP-1 and the expression of HDAC and its activity. Conclu-sions DXM and NAC both have the anti-inflammatory effect. DXM plays the role of anti-inflammation through increasing the expression and activation of HDAC, in-hibiting the transcribed activation of AP-1 and NF-κB, while NAC has no effect on the expression and activa-tion of HDAC, which shows that NAC does not exert anti-inflammatory effect through acetylation signal.

ObjectiveTo assess the cause of tadalafil failure and the feasibility of successfully rechallenging nonresponding patients.Methods A total of 80 consecutive erectile dysfunction ( ED ) patients who claimed poor response to tadalafil were enrolled into the study.A self-administered tadalafil-use questionnaire composed of eight questions was applied to assess how they had used tadalafil.Subjects were given thorough instruction based on individual answers and four doses of tadalafil 20mg.After a 2-week follow-up,end point efficacy of rechallenge was evaluated using the sexual encounter profile (SEP),which was recommended by international advisory panel in 2004.ResultsA total of 45 subjects had one or more areas of major suboptimal use of tadalafil:21.2％ did not know that sexual stimulation was necessary for tadalafil to work,87.5％ attempted to use tadalafil less than four times,57.5％ took a maximal dose less than 20 mg,and 84％ felt nervous or anxious.Of the 65 patients undergoing tadalafil rechallenge,30 patients answered “yes” to SEP2 and SEP3.The response rate to rechallenge was 46.2％ ( 30/65 ).ConclusionsInappropriate use of tadalafil was major cause of tadalafil non-pesponse.The efficacy of tadalafil could be improved to a better extent by education of patients.

Objective To assess the causes of sildenafil failure and the feasibility of successfully rechallenging non-responding patients. Methods A total of 126 consecutive erectile dysfunction (ED) patients from Jan 2009 to Dec 2009 who claimed poor response to sildenafil (sildenafil 100 mg on demand, at lease 4 epiodes) were enrolled into the study. All patients received sexual reeducation and were treated with sildenafil, taken on a daily dose of 50 mg for 4 weeks. The International Index of Erectile Function-5 (IIEF-5), Rigiscan, serum testosterone or penile Doppler were used to evaluate ED and the cause of on-demand sildenafil failure. End point efficacy of rechallenging was evaluated using the IIEF-5 and the sexual encounter profile (SEP) 'Were you able to insert your penis into your partner's vagina?' and 'Did your erection last long enough to achieve successful intercourse?'. Results The recruited patients comprised of 41 cases with psychological ED, 39 cases with hypogonadism ED, 28 cases with diabetes mellitus ED and 18 cases with vascular ED. Compared with pretreatment and on-demand sildenafil baseline, daily administration of sildenafil significantly enhanced all efficacy outcome variables. The IIEF-5 was significantly improved after daily sildenafil (12.3 ± 2.9 vs18. 8±4.4, P＜0.01), 78 patients responded to daily sildenafil. The overall salvage rate was 61.9%(78/126). Conclusions Sexual reeducation and daily administration of sildenafil may be able to salvage many patients with ED who were sildenafil non-responders.