Objective]To research the regulation of L-type calcium channels by Xuanfu Daizhe soup in the lower esophageal sphincter(LES) smooth muscle of rabbit reflux esophagitis model induced by mixed perfusion of hydrochloric acid and bile. [Methods]Established the rabbit model of mixed reflux esophagitis, nifedipine was used to block L-type calcium channel.The muscle tension of L-type calcium channel were compared among groups in the experiments. [Results]The calcium releasing and flowing phase of LES in the model group was higher than that in the normal group, the whole recipe group, sweet-scending group, the getting rid of bitter-reducing group and the getting rid of lifting and declining group( P<0.01). There was no significant difference between the model group and bitter-reducing group, the lifting and declining group and the getting rid of sweet-ascending group( P>0.05). There was no significant difference between the normal group and the whole recipe group in calcium releasing and flowing phase of LES( P>0.05). [Conclusion]The decreasing of reflux esophagitis model LES tension was relevant with the L-type calcium channel dysfunction;Xuanfu Daizhe soup could improve the LES tension by regulating L-type calcium channels. The sweet-ascending group had a remarkable effect among those dismantle prescription groups.

This article was aimed to discuss the mechanism of lactulose enema therapy to improve efficiency among maintenance hemodialysis (MHD) patients with uremic pruritus (UP) from the intervention of parathyroid hormone (PTH) and micro-inflammation state. A total of 60 cases of chronic kidney disease (CKD) stage 5, MHD patients with UP were randomly divided into 3 groups according to different intervention methods, which were the control group, loratadine and lactulose group. The integration of kidney disease treatment was adopted in the control group. In the loratadine group, on the basis of the control group medication, oral administration of loratadine, 10 mg/time, once a day, was combined. In the lactulose group, on the basis of the control group medication, lactulose enema, 30 mg/time, twice a day, was combined for 30 days. The pretreatment and posttreatment clinical curative effects were e-valuated among patients from 3 groups. Observation was also made on their itchy visual analogue scale (VAS) and serum PTH, high-sensitivity c-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) lev-el, respectively. The results showed that there were significant improvements on VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) before and after treatment (P< 0.05 or P< 0.01). Compared to the control group, the posttreatment clinical total curative effects were significantly increased in both the loratadine group and lactulose group (P< 0.05); VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) were significantly decreased (P< 0.05). There was no statistical difference of indexes mentioned above in the loratadine group and lactulose group. It was concluded that lactulose enema therapy improve PTH and micro-inflammation state among MHD patients with UP. It is one of the mechanisms to relieve skin itching.

Objective To observe the intervention effect of different compatibility of aconite and peony in Zhenwu Decoction on experimental nephritis in rats, and explore the connotation of suitable fire and evil fire. Methods Sixty experimental rats were randomly divided into blank group, model group, valsartan group, high aconite and low peony group, aconite and peony equivalent group, low aconite and high peony group. All rats except the blank group were made glomerulonephritis model by tail vein injection of monoclonal antibody 1-22-3. Rats were gived continuous gavage administration (blank group and model group were lavaged with NS) after modeling, and killed 2 weeks later. The morphological change of kidney tissues and serum hs-CRP, TNF-α, IL-6 levels were observed. Results The valsartan group, aconite and peony equivalent group, low aconite and high peony group inhibited the rats mesangial cell proliferation and extracellular matrix expansion significantly, so as the level of hs-CRP, TNF-αand IL-6. The effect of aconite and peony equivalent group was better than low aconite and high peony group, but inferior to valsartan group, while high aconite and low peony group accelerated the progress of the disease. Conclusion The different compatibility of aconite and peony in Zhenwu Decoction has resistance and proinflammatory effect on renal inflammation.

Tumor metastasis, the main characteristic and important indication of malignant tumor, is also the primary cause of death for most cancer patients. The tumor metastasis is a multistep process involving various factors, multiple interactions of many genes as well as the microenvironment. To investigate the mechanism of tumor metastasis will help us understand the essences of metastasis process, therefore exploring molecular targets for clinical diagnosis and treatment of cancer.

Objective To study the indication and the feasibility of laparoscopic cholecystectomy (LC) combined with laparoscopic appendectomy (LA). Methods Following routine LC under general anasthesia,a dissecting forceps was introduced from the 10 mm trocar on the right McBurney point.The appendix was excised outside the abdomen,or removed by using an electrotome after the mesoappendix and the appendix root were dipped. Results The operation time was 29～76 min (mean, 48 min) and the length of hospital stay was 2～7 days(mean,3 days).Complications occurred in 3 cases: 1 case of transection of the common bile duct, 1 case of appendicular artery bleeding, and 1 case of right lower abdominal pain with unknown causes. Conclusions LC combined with LA is feasible and applicable to cholecystic benign diseases accompanying simple or suppurative appendicitis.

Objective To evaluate intra-arterial catheter directed thrombolysis in combination with artery angioplasty for chronic long superficial femoral artery occlusion.Methods Clinical data were reviewed on patients of chronic long superficial femoral artery occlusion treated by endovascular therapy from September 2010 to September 2012.In 19 patients,catheter-directed thrombolysis was initially carried out,which was followed by endovascular angioplasty balloon dilatation or stent placement.The other 37 patients were treated by upfront endovascular angioplasty balloon dilatation or stent placement.Results In the thrombolysis group,the occluded length of the artery before and after thrombolysis was (16 ± 5) mm and (10 ± 6) mm(t =3.598,P ＜ 0.05).The length and the number of stents used in thrombolysis group was lower than stent group [(10±5) cm、(1.6±0.8) vs.(12±4) cm、(2.1 ±0.7),t=2.102,P＜0.05].There were no significant difference in primary patency rate assisted,primary patency rate and secondary patency rate between thrombolysis group and stent group.Conclusions For patients of chronic long superficial femoral artery occlusion,a successful catheter directed thrombolysis with artery angioplasty reduces the number of stents for angioplasty.

Objective To compare the effect between computer assisted navigation total knee replacement and conventional total knee replacement on rotation alignment,mechanical axes,comPOnent position and clinical outcomes.Methods Eighty-two patients were recruited into this pmspoctive study according to entry criteria and were randomly selected into either control group which treated with standard knee replacements or navigation assisted group which operated with navigation assisted total knee replacements.To analyze the rotation of the femoral component and the tibial component in the transverse plane.the combined rotation of both components and mismatch between two components,the mechanical axes,which were measured from postoperative radiographs and computed tomography images.To compare the functional outcomes at 6 weeks and 6 months.Results There were significant diffefences(P＜0.05)in following parameters between control group and navigation assisted group:average rotation of femoral component were 1.51°±3.55°in control group and-0.63°±3.04°in navigation assisted group,the combined rotation of both components were 2.85°±4.07°in control group and 0.28°±3.43°in navigation assisted group,mismatch between components were 1.44°±4.55°in conlrol group and-0.43°±2.86°in navigation assisted group.There were no significant differences between two groups in rotation of tibial component.In addition,analysis showed that patients in navigation assisted group had significantly better mechanical axes and functional outcomes at 6 weeks.Conclusion The use of navigation can help avoid malrotation and errors in axial rotation,and provides improved alignment accuracy as well as better functional outcomes at 6 weeks.

Objective To evaluate the current methods for psychiatry clinical internship and needs for innovation from the perspectives of medical undergradutes.Methods Independent interview on patients and their relatives as well as social psychological interview were conducted for five-year psychiatry majors in clinical internship (n =72).Self-made questionnaire was used to investigate the teaching feedback concerning the practice effect and teaching method tendency.Data were analyzed by t test and P ＜ 0.05 signifies statistically significant differences.Results Medical students considered the clinical internship as the main source of psychiatry knowledge (rising from 29.4 ％ (20/69) to 36.2％ (25/69),t =4.67,P ＜0.01).Respective interviewing with patients and their families and then doing focus-group discussion was the most acceptable method for medical undergraduates:82.6％(57/69) of medical undergraduates thought this method helped expose defects of clinical skills and prejudice against psychiatry; 54.3％ (37/69) of medical undergraduates thought this method was more beneficial to acquire psychiatry knowledge.The second acceptable method was the demonstration of a typical case by teacher:27.3％ (19/69) thought this method helped expose defects of clinical skills and prejudice against psychiatry; 27.2％ (19/69) thought this method was more beneficial to acquire psychiatry knowledge.62.0％ (43/69) of medical undergraduates ranked the characteristics of the symptomatology and core symptoms differentiation as the first place.49.0％ (34/69) considered the training of interviewing skills with patients as the second important in the clinical training.91.3％ (63/69) expected to see more kinds of mental disorders.65.2 ％ (45/69) expected to learn more about the interviewing skills.Conclusions It is necessary to pay more attention to the method of doing respective interviewing with patients and their families and then making focus-group discussion.Meanwhile training of interviewing skills in the clinical internship of psychiatry should be enhanced.

Objective:To observe the clinical efficacy and safety of compound hypoglycemic Yuye oral liquor combined with metfo-ma and glimepiride in the treatment of type 2 diabetes mellitus ( deficiency of both Qi and Yin) . Methods:Totally 80 type 2 diabetes mellitus patients were randomly divided into the treatment group and the control group with 40 each, both groups were treated with met-formin hydrochloride tablets and glimepiride tablets, the treatment group was given compound hypoglycemic Yuye oral liquor additional-ly, and the treatment duration was 12 weeks. At the end of the treatment, fasting plasma glucose( FPG) , postprandial 2 hours plasma glucose(2hPG), hemoglobin A1c(HbA1c)and traditional Chinese medicine (TCM ) syndrome in the two groups were compared. Re-sults:In both groups, FPG, 2hPG and HbAlc were decreased after the treatment, and the decrease in the treatment group was more notable than that in the control group with statistically significant difference (P<0. 05 or P<0. 01). As for TCM syndrome, the score in the treatment group was lower than that in the control group with statistically significant difference (P<0. 01). The clinical efficien-cy in the treatment group was 47. 5%, that was 22. 5% in the control group, and the difference between the two groups was statistically significant (P<0. 05). Conclusion:Compound hypoglycemic Yuyeoral liquor can reduce the blood glucose in type 2 diabetes mellitus patients( deficiency of Qi and Yin) , and the improvement of clinical symptom is striking with good safety and clinical application value.

Objective To observe and investigate the influence degree of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation.Methods 76 patients with gastric and duodenal ulcer perforation were selected as study subjects,and they were divided into control group(conventional open operation group)and observation group(laparoscopic operation group)according to the random number table,38 cases in each group.The serum body stress hormones and antiinflammatory,proinflammatory related indexes of the two groups at first day before operation and at first,third,seventh day after operation were respectively detected and compared.Results The serum IL -2 levels of the observation group at first,third and seventh day after operation were (3.53 ±0.24)μg/mL,(3.25 ±0.22)μg/mL and (4.37 ±0.33)μg/mL,which were higher than those of the control group(F =5.876,P <0.05),while other serum body stress hormones and antiin-flammatory,proinflammatory related indexes were all obviously lower than those of the control group (all P <0.05), there were significant differences between those postoperative evaluation results of the two groups.Conclusion The influence of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation is relatively small,and it shows that the bad body stress degree caused by the operation is relatively smaller.