Endoscopic retrograde cholangiopancreatography (ERCP)has become an important method for the diagnosis and treatment of cholangio -pancreatic duct diseases.Post -ERCP pancreatitis (PEP)is the most common complication and its incidence has increased up to 40% in recent years.The prevention of PEP has always been a hot topic in clinical research.This article reviews the research advances in the pharmacological prevention of PEP and points out that controlled clinical trials with a large sample size are still needed to investigate the effect of preventive drugs,and further studies should focus on optimal medication time,route of administration,and dose.In addition,de-mographic features of populations from different countries and different age groups should be taken into consideration.

Objective To elevate the efficacy and safety of low molecular weiGht heparins on severe acute pancreatitis. Methods Random or controlled clinical trials literatures( CRT,CTT ) which met the inclusion criteria were collected by computer retrieval combined with manual screeninG,and the data were analyzed by Meta-analysis. Results There were 6 randomized controlled study,includinG 626 cases severe acute pancreatitis which divided into low molecular weiGht heparin Group(n=3l2)and control Group(n=3l4). There were statistical siGnificant differences between Groups in terms of the mortality rate cure rate,complication rate, operation rate,averaGe hospitalization time( P<0. 05). while the parameters of coaGulation showed no siGnificant difference between two Groups. Conclusion Conventional treatment of SAP with LMWH is superior to conventional therapy in improvinG patients'outcome and decreasinG the mortality. Initial subcutaneous therapy with the LMWH appeared to be effective and safe,which cannot lead to bleedinG tendency.

ObjectiveTo find out the risk factors and the incidence of lithiasis. MethodsA questionnaire was formulated by the National Biliary Surgical Group. It was sent to the medical staff of all levels of hospitals in the Zunyi Region, Guizhou to fill in on surgically proven cases of cholelithiasis. The clinical data were collected and analyzed using SPSS 13.0. ResultFor lithiasis, the gender ratio was 1∶ 1.78; the peak age was 41-year and 51-year respectively. The proportion of cholecystolithiasis (n =4456 ; 86.76 ％) and choledocholithiasis (n =554;10.79 ％ ) was comparatively higher than in other regions in China. ConclusionsThe commonest type of lithiasis in Zunyi was cholecystolithiasis. There was an increasing tendency for lithiasis to develop in young people. Lithiasis was closely associated with factors such as gender, food and occupation.

Objective To investigate the changes of cholesterol efflux,the scavenger receptor class B type Ⅰ(SR-BI) protein expression in THP-1 maerophage derived foam cells treated with Lippolysaecharide (LPS), and to discover the role of NF-κB pathway in this process.Methods The foam cells were treated with LPS along or treated with N-p-Tosyl-L-phenylalanine chloromethyl ketone(TPCK) for 24 h.The protein levels of SR-BI and intranuclear NF-κB p65 were measured by Western blotting.Cellular lipid accumulation was determined by high performance liquid ehromatograpby analysis.Cholesterol efflux was determined by FJ-2107P type liquid scintillator.Results The expression of SR-BI was decreased after treated with LPS,while the intranuclear NF-κB p65 protein level was increased by LPS.The results also showed that cellular lipid accumulation was increased ,while the cellular cholesterol efflux was decreased in THP-1 maerophage derived foam cells after exposed to LPS for 24 h and these changes can be reversed partly by pretreatment with TPCK.Conclusion LPS could down-regulate the expression of SR-BI, promote the accumulation of lipid and decrease cellular cholesterol efflux in THP-1 maerophage derived foam cells ,which should be related to the TLR4/NF-κB dependent pathway.

AIM: To observe if there is a synergistical effect on induction of apoptosis when arsenic trioxide alone or combination with bortezomib in KM3 cells. METHODS: KM3 cells were treated with arsenic trioxide alone or combined with bortezomib, the numbers of viable cells were determined by trypan blue exclusion. Cell growth inhibition was examined by MTT method. The cells were simultaneously stained with annexin V-FITC and PI and apoptosis was determined by bivariate flow cytometry using a FACScan. Reverse trascriptional-PCR (RT-PCR) method was used to examine the change of p65 mRNA and Western blotting to measure the expression of protein p65, p-p65, caspase-3, -8, -9, and poly ADP-ribose polymerase (PARP). RESULTS: Arsenic trioxide inhibited the cell growth and induced apoptosis. The mechanism was responsible for the activation of caspase-mediated induction of apoptosis. A synergistic effect of combination with bortezomib on apoptosis was observed. CONCLUSION: Arsenic trioxide inhibits KM3 cell growth and induces apoptosis with a synergistical effect when cotreated with bortezomib.

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Objective:To purify and characterize the major antigenic components of sand swimming crab,and provide theoretical evidences for the research of standardization of allergenic vaccine.Methods:The crude extract of Linnaeus was prepared using classical method, and electrophoresis of SDS-PAGE was used to separate the proteins of each group. The allergen proteins of 26 crab were identified using Western blot. To distinguish between the primary allergen proteins and secondary allergen proteins, FPLC(Gel Chromatography and ion exchange chromatography) was used to filtrate and identify the allergen protein.Results:SDS-PAGE analysis revealed that sand swimming crab proteins were composed of at lease 9 discrete protein bands, which molecular weight ranging from 13 000 to 90 000. Major bands were of 20 900, 24 200, 27 100, 29 200, 33 700, 38 900, 48 700, 74 700, 89 100 respectively. Western blot assay indicated that the crude extract reacted with sera obtained from 26 crab allergenic subjects and contained 5 allergen bands altogether, and the bands of 74 400 and 48 700 were the major allergenic components. The positive rates of the two major allergen proteins were both 100%, indicating the allergenic components maintained the immunocompetence after yielding from chromatography.Conclusion:The 74 400 and 48 700 bands are the major allergens of sand swimming crab. The major allergen proteins can be purified by chromatography.

OBJECTIVE:To systematically review the efficacy and safety of Moxifloxacin(MFX)in the treatment of acute ex-acerbation of chronic bronchitis (AECB),and provide evidence-based reference for Tational use of MFX. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,Medline,CBM,CJFD,VIP and Wanfang Database,the relevant conference proceed-ings and grey literature were also hand-searched,randomized controlled trials(RCT)about MFX(test group)versus other antibiot-ics (control group) in the treatment of AECB were collected. Meta-analysis was performed by using Rev Man 5.2 software with ITT analysis and PP analysis after literature selection,data extraction and quality evaluation. RESULTS:Totally 14 RCTs were in-cluded,involving 6 058 patients. Results of PP analysis showed,the clinical effective rate in test group was similar to that of con-trol group [RR=1.02,95%CI(1.00,1.04),P=0.06],while bacteria clearance rate was significantly higher than control group [RR=1.07,95%CI(1.04,1.11),P<0.001]. Results of ITT analysis showed,the clinical effective rate in test group was significantly high-er than control group [RR=1.03,95%CI(1.00,1.06),P=0.03],while there was no significant difference in the bacteria clearance rate [RR=1.02,95%CI(0.92,1.12),P=0.73] and the incidence of adverse reactions [RR=0.97,95%CI(0.87,1.08),P=0.52] be-tween 2 groups. CONCLUSIONS:The efficacy of MFX is not inferior to other antibiotics in the treatment of AECB,safety is simi-lar to other antibiotics.

OBJECTIVE:To explore the feasibility of using international index of rational drug use for the intervention and evaluation of rational use of antimicrobial agents during perioperative period in patients undergoing thyreoidectiomy.METHODS:The patients in the common surgical department were divided into intervention group and non-intervention group.An intervention control study was performed before intervention(from Mar.to Aug.in 2007)vs.after intervention(from Mar.to Aug.in 2008)on the synchronously discharged thyreoidectomy patients with the international index of rational drug use as references.RESULTS:After prophylactic use of antibiotics in the intervention group,the average antimicrobial application time was decreased from 6.83 days to 2.50 days,the average hospital stay of patients was decreased from 8.24 days to 7.15 days,the average hospitalization fee decreased from 1 895.99 yuan to 1 375.26 yuan,the cost of antibacterials decreased from 852.11 yuan to 538.53 yuan,and the proportion of the cost of antibacterials in the total hospitalization cost reduced slightly.However,all the indexes in the non-intervention group showed little change.CONCLUSION:It is effective and feasible to adopt the international index of rational drug use in the intervention and evaluation of rational use of antimicrobial agents during perioperative period.

Objective To investigate the diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones.Methods The retrospective cohort study was conducted.The clinical data of 460 patients with gallbladder stones who were admitted to the Affiliated Hospital of Zunyi Medical College from June 2012 to June 2016 were collected.Of 460 patients,106 combined with asymptomatic secondary common bile duct stones and 354 with gallbladder stones were allocated into the common bile duct stone group and gallbladder stone group,respectively.The serum liver function test was applied to the 2 groups,including alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil),direct bilirubin (DBil),glutamyltransferase (GGT) and alkaline phosphatase (ALP).The receiver operating characteristic (ROC) curve was built using significant statistical indicators,and correspondent cut-off value,sensitivity and specificity were calculated according to ROC curve.Observation indicators:(1) comparison of serum liver function indicators (ALT,AST,TBil,DBil,GGT,ALP) between the 2 groups;(2) analysis result of ROC curve.Measurement data with normal distribution was represented as x±s.The comparison between groups was evaluated with the independent-sample t test.The comparison of count data were analyzed using the chi-square test.The ROC curve analysis was done for significant statistical indicators.Results (1) Comparison of serum liver function indicators between the 2 groups,the levels of ALT,AST,TBil and DBil were (32±8)U/L,(35±8)U/L,(12.8±2.5)μmol/L,(2.6±0.4)μmol/L in the common bile duct stone group and (30±7)U/L,(32±7)U/L,(12.2± 2.4)μmol/L,(2.5 ±0.4)μmol/L in the gallbladder stone group,respectively,with no statistically significant difference (t=0.891,0.786,0.924,1.026,P＞0.05).The levels of GGT and ALP were (162±43) U/L and (145±37) U/L in the common bile duct stone group and (36± 10)U/L and (128±23) U/L in the gallbladder stone group,respectively,with significantly statistical differences (t =20.859,2.483,P＜0.05).(2) Result of ROC curve showed that areas under the curve of GGT and ALP were respectively 0.963 [95％ confidence interval (CI):0.938-0.988] and 0.621 (95％CI:0.561-0.684).The correspondent cut-off value of diagnostic accuracy,sensitivity and specificity of GGT and ALP were 92.5 U/L and 139.5 U/L,91.6％ and 50.7％,95.7％ and 76.5％,respectively.Conclusion The abnormally elevated levels of serum GGT have major diagnostic value for patients with gallbladder stones combined with asymptomatic secondary common bile duct stones,with an advantage of convenient and fast operation,and it is worth to be applied and popularized.