OBJECTIVE:To observe the clinical efficacy and safety of herbs-partitioned moxibustion combined with curcumin in the treatment of Crohn's disease. METHODS:80 patients with mild and middle Crohn's disease were randomly divided into ob-servation group and control group with 40 patients in each group. Both groups were given western medicine treatment,such as sul-fasalazine;control group was additionally given curcumin,and observation group were given curcumin combined with herbs-parti-tioned moxibustion. 2 months later,Therapeutic efficacy,ADR and complications of 2 groups were observed after treatment. RE-SULTS:The total effective rate of control group and observation group were 87.50% and 95.00%,respectively;that of observa-tion group was better than that of control group,with statistical significance(P<0.05). The incidence of ADR in control group and observation group were 22.50% and 7.50% respectively;that of observation group was significantly lower than that of control group,with statistical significance(P<0.01). The incidence of complications in control group and observation group were 22.50%and 7.50%,respectively;that of observation group was significantly lower than that of control group,with statistical significance (P<0.01). CONCLUSIONS:The clinical efficacy of herbs-partitioned moxibustion combined with ccurcumin is effective in the treatment of Crohn's disease,and can reduce the incidence of ADR and complications.

Objective:To observe the therapeutic efficacy of acupuncture plus heat-sensitive moxibustion in treating chronic pelvic inflammatory disease (CPID), for selecting an effective acupuncture-moxibustion method in treating chronic pelvic inflammation. Methods:Eighty CPID subjects were enrolled and divided into two groups by randomized single-blind method, 40 in each group. The observation group was intervened by acupuncture plus heat-sensitive moxibustion, while the control group was by acupuncture plus box-moxibustion, once every other day, 10 sessions as a treatment course, but the period time was skipped. The therapeutic efficacy was observed after 3 treatment courses. Results:The recovery rate was 45.0% and the total effective rate was 95.0% in the observation group, versus 20.0% and 80.0% in the control roup. There were significant differences in comparing the recovery rate and the total effective rate between the two groups (P<0.05). Conclusion:Acupuncture plus heat-sensitive moxibustion can produce a higher therapeutic efficacy in treating CPID than acupuncture plus box-moxibustion, and this is an easy-to-operate and safe method without adverse effect.

Objectives This study was designed to explore the function of ATP binding cassette transporter 1 ( ABCA1) and ApolipoproteinA-I (ApoA-I) in cholesterol reverse transportation ( RCT) , the influence of lovastatin and rosiglitazone on the concentration of cholesterol ( CHO) in THP-1 ( human monocytic leukemia cell line) derived foam cells.Methods LDL from healthy volunteers was obtained by density-gradient ultracentrifugation and was oxidized by incubation with Cu2+ and ox-LDL was identified.Macrophages were induced from THP-1 cell by phorbol ester (PMA).Models of foam cells were built by incubating macrophages with oxLDL.The effect of lovastatin and rosiglitazone on ABCA1 protein expression in THP-1 cell line derived macrophage were detected by western blot Foam cells were divided into 9 groups: control, ApoA-I, lovastatin, rosiglitazone lovastatin + ApoA-I, rosiglitazone + ApoA-I, ABCA1 monoclonal antibody pretreatment + ApoA-I, ABCA1 monoclonal antibody pretreatment + lovastatin + ApoA-I, ABCA1 monoclonal antibody pretreatment + rosiglitazone + ApoA-I.The concentration of intracellular CHO in each group was detected by using cholesterol kit Results As compared with control group, there are no big differences of CHO concentration within the cell of group lovastatin, rosiglitazone, and each ABCA1 monoclonal antibody pretreatment group (P >0.05), but the CHO concentration within the cells of group ApoA-I, lovastatin + ApoA-I, rosiglitazone + ApoA-I decreased obviously as compared with the control (P <0.05), and CHO concentration in group rosiglitazone + ApoA-I have a further decrease than the former two groups ( P < 0.05 ).Conclusions CHO concentration can be descreased in foam cells by cooperation of ABCA1 and ApoA-I mediate cholesterol efflux.Rosiglitazone can enhance this procedure in THP-1 macrophages derived foam cells which means that they can promote ABCA1 mediated cholesterol reverse transportation through improve ABCA1 protein expression.

Objective To explore the application value and clinical efficacy of the transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer.Methods The clinical data of 27 patients with ultra-low rectal cancer who underwent transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer at the Shengjing Hospital of China Medical University from July 2010 to July 2013 were analyzed retrospectively.The average operation time, average volume of intraoperative blood loss, average number of lymph nodes dissection, average distance to resection margin, average length of resected specimen, results of postoperative pathological examination, time for postoperative outoff-bed activity, time to anal exsufflation, gastric tube removal time and postoperative complications were recorded.The visual analogue scale (VSA) pain score and Wexner score for evaluating fecal incontinence were performed at postoperative week 1 and at postoperative month 1, respectively.The anal function was tested at postoperative month 3 and 12.The follow-up including tumor metastasis and recurrence, Wexner score and anorectal anometry was performed by outpatient examination and telephone interview once every 3 months for 2 years after operation and then once every year up to October 2014.Measurement data with normal distribution was presented as-x ± s and average (range).Repeated measures data were analyzed by the repeated measures ANOVA.Results All the patients received successful operations without procedure change or intraoperative accident.The average operating time, average volume of intraoperative blood loss, average number of lymph nodes dissection, average distance to distal resection margin and average length of resected specimen were 140 minutes (range, 115-173 mintues), 27 mL(range, 15-55 mL), 17(range, 14-20), 1.7 cm(range, 1.3-2.2 cm) and 18.5 cm(range, 14.7-22.4 cm), respectively.Postoperative TNM stages: T2N0M0 was detected in 19 patients, T2N1M0 in 3 patients,T3N0M0 in 4 patients and T3N1M0 in 1 patients.The time for postoperative out-off-bed activity and time to anal exsufflation were 8.8 hours (range, 7.0-13.0 hours) and 51 hours (range, 30-79 hours).Twenty-seven patients had the gastric tube removal after operation with fluid diet intake at postoperative hour 24 and semi-fluid diet intake at postoperative hour 48.One male patient was complicated with urinary retention at postoperative day 3 and 1 with anastomotic leakage at postoperative day 9, they were cured by symptomatic treatment.VSA pain scores in all patients from 1 day to 6 days postoperatively were 5.6, 4.6, 4.0, 3.2, 2.2 and 1.3.The average duration of hospital stay was 11.1 days (range, 7.0-19.0 days).Patients had good healing of abdominal incision at postoperative week 2.All the patients were followed up for a average time of 24.8 months (range, 15.0-32.0 months) without tumor metastasis and recurrence.Wexner score was 2.6 (range, 1.0-4.0) at postoperative month 1.The results of anorectal anometry: maximum anorectal resting pressure (MARP) and maximum anorectal systolic pressure were (267 ±23)mmHg (1 mmHg =0.133 kPa) and (305 ± 23)mmHg before operation, (266 ± 40)mmHg and (300 ± 38)mmHg at postoperative month 3, (267 ± 33)mmHg and (315 ± 30)mmHg at postoperative month 12, respectively, with no significant difference in the changing trend between pre-and post-operation (F =0.510, 1.390, P ＞ 0.05).Anorectal resting vector volume and anorectal systolic vector volume were (45 594 ± 1 981) cm (mmHg) 2 and (98 480 ± 8 165) cm (mmHg) 2 before operation, (40 310 ±3 465)cm(mmHg)2 and (78 461 ±6 777)cm(mmHg)2 at postoperative month 3, (40 385 ± 3 379) cm(mmHg) 2 and (82 082 ± 10 383) cm(mmHg) 2 at postoperative month 12, respectively, with significant differences in the changing trend between pre-and post-operation (F =26.845, 48.090, P ＜ 0.05).Conclusion Transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer is safe, aesthetic and minimally invasive compared with the traditional laparoscopic surgery, with the advantages of radical cure of tumor and protection of anal function.

Objective:To investigate the clinical security and feasibility of neoadjuvant chemotherapy with imatinib following lap-aroscopy-guided intersphincteric resection for patients with gastrointestinal stromal tumor of the low rectum (GSTLR). Methods:Clini-cal data of nine patients with GSTLR who were admitted to the Shengjing Hospital between January 2007 and January 2011 were re-viewed. These patients were treated with neoadjuvant imatinib chemotherapy after laparoscopic intersphincteric resection. Results:Pri-or to neoadjuvant chemotherapy, the tumor diameter ranged between from 5 cm to 9 cm (median=7.0 cm). After imatinib chemothera-py, the tumor diameter decreased to 2-4.5 cm (median=3.5 cm, P<0.001). Laparoscopic surgery through intersphincteric resection was performed after imatinib treatment for 3-24 months (median=7 months). All patients received a protective stoma, which was closed 3 months after the surgery. The Wexner scale scores ranged from 1 and 4 (median=2) prior to neoadjuvant imatinib chemotherapy and changed to 1-5 (median=2) after the chemotherapy (P=0.397). After stomal closure operation, the scores significantly increased to 4-9 (median=7, P<0.001) but were not statistically significantly different from those before the therapy. One year after laparoscopic surgery, the Wexner scale scores ranged from 1 to 5 (median=2, P=0.842). Six patients were treated with imatinib for 24 and 30 months after lap-aroscopic surgery. Recurrence in pelvis occurred in only one patient, who ceased imatinib administration at the 30th month after the sur-gery. Conclusions: Laparoscopic surgery through intersphincteric resection was secure and feasible and thus could be used for treat-ment of GSTLR.

ObjectiveTo establish an animal model of intracerebral hemorrhage (ICH) in rat and to observe the changes in behavior, brain edema and tissue structure during absorption of the hematoma.MethodsAn animal model of ICH was established by stereotactically infusing 100 μl (the first time 20 μl, the second time 40 μl, the third time 40 μl) of autologous caudal artery blood into caudate nucleus in the rats. The behavior of rats with ICH was assessed by Bederson score, beam-walking test, bilateral forepaws grasp and measurement of forelimb placing. The brain edema and the change in histology were observed.ResultsThe successful ratio of this model was 75%. There were significant behavioral changes and brain edema at 6 h after the ICH in rats of the experimental group compared to those of the control group. The worse behavioral changes and brain edema was at 48～72 h after hemorrhage. In the earlier period, the nerve cells were swelling. A lot of glial cells appeared around the hematoma in the late period.ConclusionThis ICH model is reproducible, and the obvious behavioral change and histological changes are similar to clinical patient with ICH.

Objective To explore the diagnostic sensitivity and specificity of echocardiography parameters ,and the diagnostic value of multiple parameters score . Methods Forty‐nine cases of the fetus checked by fetal echocardiography and were indicated aortic coarctation . According to the results of follow‐up ,the cases were divided into the positive and negative groups . Comprehensive analysis were performed in fetal echocardiography parameters ,such as diameter ratio and velocity ratio of ventricle ,aorta ,pulmonary artery ,ductus artery ,middle cerebral artery and umbilical artery . Results Diameter ratio of left ventricle/right ventricle ( LV/RV ) ,pulmonary artery/aorta ( PA/AO ) ,aortic isthmus/ductus artery ( AI/DA ) ,and velocity ratioof middle cerebral artery/inner umbilical artery ( MCA/inUA ) were calculated ,ROC curve showed their area under ROC were>0 .5 with a significant statistical significance ( P < 0 .05) . The Chi‐square test showed that the consistency of any single ratio was relatively low . When the number of the ratiois increased to 3-4 ,the Kappa value was 0 .687( P = 0 .000) and 0 .649( P = 0 .000) ,respectively , which had relatively high diagnostic value . Conclusions Ultrasonic diagnosis of fetal coarctation of aorta has certain difficulty ,and the value of single hemodynamic parameter of fetal echocardiography in diagnosis of fetal aortic coarctation is lower ,so that the comprehensive evaluation and combined multiple ultrasonic parameters can improve the sensitivity and specificity of ultrasound diagnosis .

OBJECTIVETo explore the correlation between the expressions of hypoxia inducible factor-1α (HIF-1α) and insulin in pancreatic cancer.

METHODSHIF-1α and insulin expression was detected by immunohistochemistry in the center and the edge of pancreatic adenocarcinoma specimens of 65 cases. Western blot was used to detect HIF-1α expression and insulin level in the center and the edge of pancreatic adenocarcinoma specimens of 28 cases. The relationship between HIF-1α expression and insulin level in the pancreatic cancer was analyzed.

RESULTSThe results of immunohistochemistry and Western blot showed that HIF-1α protein expression was high in both the center and the edge of pancreatic cancers (P > 0.05), and insulin level was significantly higher at the edge of specimen than that in the center (P < 0.05). HIF-1α protein and insulin levels were positively correlated at the edge of cancer tissue (r = 0.374, P < 0.05), but no significant correlation between them in the center of cancerous tissue (r = -0.145, P > 0.05).

CONCLUSIONInsulin may promote the local invasion and metastasis of pancreatic cancer by up-regulating HIF-1α.

Adenocarcinoma ; metabolism ; pathology ; Adult ; Aged ; Blotting, Western ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Immunohistochemistry ; Insulin ; metabolism ; Male ; Middle Aged ; Pancreatic Neoplasms ; metabolism ; pathology

OBJECTIVETo evaluate the therapeutic effect of compound salvia injection combined with ursodeoxycholic acid (UDCA) in treating pregnant women with intrahepatic cholestasis (ICP) and its influence on perinatal babies.

METHODSOne hundred and twenty-eight patients of ICP were assigned to two groups. The 72 patients in the treatment group were treated with salvia injection (20 mL in 10% glucose 500 mL for intravenous dripping once a day) and UDCA (15 mg, thrice daily by oral taken), and the 56 patients in the control group were treated with UDCA alone, all were treated for 14 days. Changes of itching symptom (estimated by scoring) and serum levels of biochemical indexes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin (TBil) and glycocholic acid (GCA), were determined before and after treatment, and conditions of the newborns were compared after delivery.

RESULTSCompared with before treatment, scores of itching were lowered from 3.6 scores to 1.4 scores in the treatment group, and from 3.4 scores to 1.6 scores in the control group, showing no significant difference between groups (P > 0.05), but the lowering was shown earlier in the former. Levels of biochemical indexes were improved significantly (P < 0.01) in both groups, but the improvements were more significant in the treatment group, the difference between groups was significant (P < 0.05). The difference between groups in the incidence of fetal distress, meconium-stained fluid and neonatal asphyxia were insignificant (P > 0.05). The birth weights of the newborns were higher in the treatment group than in the control group (3,108 +/- 236 g vs 2,681 +/- 269 g, P < 0.05).

CONCLUSIONThe combined therapy of compound salvia injection and UDCA shows better effect in treating ICP than that of UDCA alone.

Adult ; Cholestasis, Intrahepatic ; therapy ; Combined Modality Therapy ; Female ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Pregnancy ; Pregnancy Complications ; therapy ; Pregnancy Outcome ; Salvia miltiorrhiza ; chemistry ; Ursodeoxycholic Acid ; therapeutic use ; Young Adult