Objective To study the glutamine combined with early enteral nutrition’s effects on severe acute pancreatitis’systemic inlfammation. Methods 150 Cases with severe acute pancreatitis were divided into total parenteral nutrtion group(TPN group), early enteral nutrition group(EEN group) and Glutamine and early enteral nutrition group(G+EEN group) according to their therapeutic methods. The curative effects, APACHEⅡscore and liver and kidney function were compared after treatment. Inlfammatory cytokines of hs-CRP, TNF-α, IL-1β, IL-6, IL-8 and IL-10 before and after treatment were detected and compared. Results The efifciency rate in G+EEN group was signiifcantly better than that in TPN and EEN group(P<0.05), with lower APACHEⅡscore and better liver and kidney function. The level of hs-CRP, TNF-α, IL-1β, II-6 and IL-8 after treatment in G+EEN group were signiifcantly lower than that in TPN and EEN group(P<0.05), except IL-10, which was signiifcantly higher than that in TPN and EEN group (P<0.05). Conclusion Glutamine combined with early enteral nutrition could signiifcantly ameliorate severe acute pancreatitis’systemic inlfammation, its curative effects is better than early enteral nutrition and total parenteral nutrition.

The objective of the study was to prepare and evaluate the quality of curcumin-piperinedual drug loaded self-microemulsifying drug delivery system(Cur-PIP-SMEDDS). Simplex lattice design was constructed using optimal oil phase, surfactant and co-surfactant concentration as independent variables, and the curcumin and piperine were used as model drugs to optimize Cur-PIP-SMEDDS formulation. In the present study, the drug loadings of curcumin and piperine, mean particle size of Cur-PIP-SMEDDS were made as indicators, and the experiment design, model building and response surface analysis were established using Design Expert 8. 06 software to optimize and verify the composition of SMEDDS formulation. The quality of Cur-PIP-SMEDDS was evaluated by observing the appearance status, transmission electron microscope micrographs and determining particle diameter, electric potential, drug entrapment efficiency and drug loading of it. As a result, the optimal formulation of SMEDDS was CapryoL 90-Cremophor RH40-TranscutoL HP (10:60:30). The appearance of Cur-PIP-SMEDDS remained clarified and transparent, and the microemulsion droplets appeared spherical without aggregation with uniform particle size distribution. The mean size of microemulsion droplet formed from Cur-PIP-SMEDDS was 15.33 nm, the drug loading of SMEDDS for Cur and PIP were 40.90 mg · g(-1) and 0.97 mg · g(-1), respectively, the drug entrapment efficiency were 94.98% and 90.96%, respectively. The results show that Cur-PIP-SMEDDS can increase the solubility and stability of curcumin significantly, in the expectation of enhancing the bioavailability of it. Taken together, these findings can provide the reference to a preferable choice of the Cur formulation and contribute to therapeutic application in clinical research.
Alkaloids ; chemistry ; Benzodioxoles ; chemistry ; Chemistry, Pharmaceutical ; methods ; Curcumin ; chemistry ; Drug Carriers ; chemistry ; Drug Combinations ; Drug Delivery Systems ; Drugs, Chinese Herbal ; chemistry ; Emulsions ; chemistry ; Methylmethacrylates ; chemistry ; Particle Size ; Piperidines ; chemistry ; Polystyrenes ; chemistry ; Polyunsaturated Alkamides ; chemistry

Based on the constructivism learning theory, we designed a new pharmaceutics of TCM experiment teaching course which focused on process of knowledge formation, including a self-designed experiments on the basis of primary experiment, a cooperative learning platform, and an formative evaluation system. The practice has showed that this new teaching method can arouse the participants' interest and initiative, help to enhance the teaching efficiency and performance.

Objective:To study the tonifying Qi and producing blood mechanism of Jianpi Shengxue tablets. Methods: SD rats were randomly divided into the normal group,FeSO4group, and low, medium and high dosage groups(0.65,1.3,2.6 g·kg-1). All the groups except the normal group received low iron diet,to induce anemia. After the two-week intragastric administration, real-time PCR was carried out to identify the changes of Hepcidin mRNA expression, while western blot was applied to test the changes of DMT-1 protein expression. Results:The medium and high dosage groups could significantly increase the DMT-1 expression compared with the normal group,while FeSO4 could reduced the DMT-1 expression. The Hepcidin expression in liver was increased along with the in-crease of the dosage. Conclusion:The Chinese medicine ingredients in Jianpi Shengxue tablets is beneficial to the expression of DMT-1 protein and the expression of Hepcidin mRNA in liver, which can finally improve the iron supply in the body.

Objective To investigate the epidemiological characteristics,clinical features,diagnosis,treatment and prognosis of benign tumor of the bile ducts.Methods The retrospective cross-sectional multicenter study was conducted.The clinical data of 136 patients with benign tumor of the bile ducts who were admitted to the eight hospitals between January 2007 and December 2016 were collected,including 70 in the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University,19 in the First Affiliated Hospital of Zhengzhou University,15 in the First Affiliated Hospital of Xi'an Jiaotong University,11 in the First Affiliated Hospital of Dalian Medical University,7 in the Affiliated Hospital of North Sichuan Medical College,6 in the Southwest Hospital of the Third Military Medical University,4 in the Cancer Center of Sun Yat-Sen University and 4 in the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.All the patients received laboratory and imaging examinations,and then underwent corresponding surgery when treatment planning was respectively determined by comprehensive hospitals according to clinical features and results of examinations.Surgical procedures were performed based on the results of intraoperative frozen section in rapid pathological diagnosis.Observation indicators:(1) epidemiological characteristics;(2) clinical features;(3) results of laboratory and imaging examinations;(4) treatment situations;(5) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients up to March 2017.Measurement data with normal distribution were represented as-x±s.Results (1) Epidemiological characteristics:Of 136 patients,the male to female ratio was 1.78 ∶ 1.The incidence of whole bile duct tumors was from high to low,including 52 patients with duodenal papilla adenoma,32 with extrahepatic bile duct adenoma,24 with intrahepatic biliary cystadenoma,11 with intrahepatic papillary adenoma,9 with intrahepatic bile duct epithelial tumor,7 with epithelial tumor of duodenal papilla and 1 with neuroendocrine tumor of duodenal papilla.Among 136 patients,adenomas (including cystadenoma) was detected in 108 patients,papillomas in 11 patients,intraepithelial neoplasias in 16 patients,neuroendocrine tumor in 1 patient;intrahepatic bile duct benign tumors in 44 patients and extrahepatic bile duct (including duodenal papilla) benign tumors in 92 patients.(2) Clinical features:of 44 patients with intrahepatic bile duct benign tumors,29 had abdominal pain,fever and abdominal masses,4 had jaundice,11 had no obvious clinical symptoms and were diagnosed by physical examination.Among 92 patients with extrahepatic bile duct benign tumors,76 developed obstructive jaundice,68 were accompanied by abdominal pain or colicky pain,8 were combined with pancreatitis and 2 deveIoped hemobilia,some patients were combined with multiple clinical symptoms.(3) Results of laboratory and imaging examinations:82 patients received CA19-9 test,results of 22 patients were abnormal,with a level of (148-± 126)U/mL.Ninety-seven patients received carcinoembryonic antigen (CEA) test,with a level of test of (2.7±2.0) μg/L,and a level of CEA in 1 patient was slight abnormal,with a level of 11.2 pμg/L.One hundred and thirty-six patients underwent preoperative ultrasound examinations,showing unqualified hepatic and bile duct space occupying lesions and bile duct dilatation.Ninetyfive patients underwent preoperative computed tomography (CT),80 underwent preoperative magnetic resonance imaging (MRI) or magnetic resonanced cholangio-pancreatography (MRCP),and 13 underwent preoperative endoscopic ultrasonography (EUS).Twenty-nine patients were considered for intrahepatic bile duct benign tumors;76 were diagnosed with obstructive jaundice,with uncertain benign or malignant tumors;other patients had bile duct space occupying,considering bile duct tumor (including cancer).Twelve patients with bile duct obstruction underwent ERCP,showing obstruction site and morphology.(4) Treatment situations:among 136 patients,65 underwent pancreaticoduodenectomy,17 underwent right hemihepatectomy + cholecystectomy,16 underwent cholecystectomy + hepatic left lateral lobectomy,11 underwent left hemihepatectomy + cholecystectomy,11 underwent duodenal papillary local excision+papilla reconstruction,11 underwent Roux-en-Y choledochojejunostomy anastomosis,4 underwent cholecystectomy + extrahepatic bile duct local excision + end-to-end bile duct anastomosis and 1 underwent endoscopic mucosal resection of duodenal papillary adenomna.Of 136 patients with postoperative complications,25 were complicated with pancreatic leakage,11 with bile leakage,2 with postoperative hemorrhage and 1 with hepatic failure.Two patients with pancreatic leakage died of massive hemorrhage caused by abdominal infection,1 died of hepatic failure and other patients were discharged from hospital after symptomatic treatment.(5) Follow-up situations:47 of 136 patients were followed up for 3-123 months,with a follow-up rate of 34.6％.During follow-up,2 patients undergoing duodenal papillary local excision + papilla reconstruction had canceration,and other patients had good survival.Conclusions There is a low clinical incidence of benign tumor of the bile ducts,which is more common in male than in female,and in adenomas (including cystadenoma) and papillomas.The preoperative imaging examinations or ERCP biopsy pathological examination can increase an accuracy of preoperative diagnosis.Benign tumors with high canceration rates need positive surgical treatment.

The 53rd annual meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago,United States between June 2 and 6,2017.The latest advances in biliary tract cancer research from this meeting were summarized and analyzed in this paper.The adjuvant therapy in biliary tract cancer made a breakthrough in this meeting,the findings could provide the basis for a new standard of changing the current management model in the disease.The precision medicine and targeted therapy will be the development direction in the future.Doctors should attach great importance to the adjuvant and comprehensive therapy in biliary tract cancer and initiate high level multi-center clinical trials to improve the overall the diagnostic and treatment levels of biliary tract cancer.

OBJECTIVETo analyze the relationship between pesticide exposure and adverse pregnancy outcomes in famers.

METHODSA search was conducted to collect the articles about the relationship between pesticide exposure and adverse pregnancy outcomes published worldwide from 1990 to February 2012. Meta-analysis was performed on the collected articles using RevMan 4.2 software.

RESULTSTwelve articles were collected. Compared with the controls, the pesticide-exposed famers showed a combined odds ratio (OR) for spontaneous abortion of 1.52 (95%CI: 1.04 ∼ 2.21; P = 0.03), a combined OR for premature birth of 1.33 (95%CI: 1.09 ∼ 1.61; P = 0.005), a combined OR for dead fetus of 1.22 (95%CI: 1.16 ∼ 1.29; P < 0.01), a combined OR for stillbirth of 1.90 (95%CI: 0.58 ∼ 6.28; P = 0.29), a combined OR for birth defect of 2.02 (95%CI: 0.84 - 4.69; P = 0.12), a combined OR for low birth weight of 1.62 (95%CI: 0.60 ∼ 4.39; P = 0.34), a combined OR for neonatal death of 2.18 (95%CI: 0.54 ∼ 8.88; P = 0.28), and a combined OR for delayed conception of 1.43 (95%CI: 0.93 ∼ 2.18; P = 0.1). Pesticide exposure increased the risks for spontaneous abortion, premature birth, and dead fetus, but was not significantly associated with stillbirth, birth defect, low birth weight, neonatal death, and delayed conception.

CONCLUSIONPesticide exposure can cause adverse pregnancy outcomes in farmers, increasing the risks of spontaneous abortion, premature birth, and dead fetus.

Agriculture ; Female ; Humans ; Maternal Exposure ; Pesticides ; adverse effects ; Pregnancy ; Pregnancy Outcome ; Rural Population

Guided by Chinese medicine culture,the strengthening of the cultural self-confidence of Chinese medicine is the cornerstone of the personnel training majoring in Chinese material medica.With the rapid development of modern medicine,the personnel training of the undergraduate students majoring in Chinese material medica in the universities of western medicine is facing several problems,such as lack of cultural identity,lack of professional confidence,unsteadiness of professional thinking,and changes of employment direction.For these problems,based on the main line "Solidify the cultural foundation of Chinese medicine,strengthen the self-confidence of Chinese material medica",our school selected the Chinese medicine cultural traveling,social practices and Chinese medicine employment guidance curriculum as the starting points,and carried out various of lively and vivid activities,which had positive impacts on the learning enthusiasm and professional love of the undergraduate students majoring in Chinese material medica.

OBJECTIVETo compare the expression of cell adhesion molecules (CAMs) among VLA-4 (CD49 d), VLA-5 (CD49e), LFA-1 (CD11a), L-selectin (CD62L), and PECAM-1 (CD31) which are more related to the homing of hematopoietic stem and progenitor cells (HSPC) on the ex vivo expanded CD34+ subset with that of fresh isolated AC133+ cells.

METHODSAC133+ cells selected from fresh cord blood (CB) samples were cultured in QBSF-60 serum-free media in the presence of Flt-3 ligand + SCF + TPO (FST), with initial addition of IL-3 for up to 2 week. Expansion potential and the expression of above CAMs were evaluated at day 0, day 7, day 10 and day 14.

RESULTS(1) Simultaneously numerical expansion of various HSPC was constantly observed during the culture, and the fold expansion of AC133+ cells and CD34+ cells on day 14 were 33.50 and 64.56 respectively; (2) The number of CD34+ subsets expressing the above adhesions were all increased at different degrees (from 20 fold to 160 fold). (3) The expressions of CD11a, CD49d, and CD49e on ex vivo expanded CD34+ cells were increased as compared to their baseline levels, but the percentage of CD62L+ and CD31+ subpopulations in CD34+ cells were decreased.

CONCLUSIONSOur short-term culture system can not merely support the simultaneous expansion of CB derived AC133+ cells, but the expanded hematopoietic progenitors may well sustained the expression of homing-related adhesion molecules.

AC133 Antigen ; Antigens, CD ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; biosynthesis ; genetics ; Cell Division ; drug effects ; Cells, Cultured ; Culture Media, Serum-Free ; Cytokines ; physiology ; Female ; Fetal Blood ; cytology ; metabolism ; Glycoproteins ; metabolism ; Hematopoietic Stem Cells ; cytology ; metabolism ; Humans ; Interleukin-3 ; pharmacology ; Lymphocyte Subsets ; Peptides ; metabolism ; Pregnancy ; Receptors, Lymphocyte Homing ; metabolism

Objective: To explore the prognosis of patients with T1b stage gallbladder carcinoma underwent different surgical procedure. Methods: The clinicopathological data of 97 patients with T1b stage gallbladder carcinoma came from 8 clinical centers from January 2010 to December 2016 and 794 patients who were admitted to the SEER database of USA from January 1973 to December 2014 were analyzed.There were 891 patients including 254 males and 637 females (1.0∶2.5) with age of (69.5±12.0)years. There were 380 patients who were less than 70 years old, 511 patients who were more than 70 years old. And there were 213 patients with the diameter of tumor less than 20 mm, 270 patients with the diameter of tumor more than 20 mm, 408 patients were unclear. There were 196 patients with well differentiation, 407 patients with moderately differentiation, 173 patients with poorly differentiation, 8 patients with undifferentiated, 107 patients were unclear. In the 891 patients with T1b stage gallbladder carcinoma, there were 562 cases accepted the simple cholecystectomy, 231 cases with simple cholecystectomy plus lymphadenectomy, and 98 cases with radical cholecystectomy. The time of follow-up were until June 2017. χ² test was used to analyze the enumeration data, rank-sum test was used to analyze the measurement data, the analyses of prognostic factors were used Cox proportional hazards model, the survival analysis was performed using Kaplan-Meier method. Results: The results of Cox proportional hazards model indicated, age, differentiation, surgical procedure were the risk factors of prognostic(1.929(1.594-2.336), P<0.01; 1.842(1.404-2.416), P<0.01; 1.216(0.962-1.538), P<0.01). The results of Kaplan Meier test indicated, the overall survival of T1b stage gallbladder carcinoma were (85.5±3.8)months, the overall survival of patients with simple cholecystectomy were (71.3±4.4)months, the overall survival of patients with cholecystectomy plus lymphadenectomy were(87.6±5.8)months, and the overall survival of patients with radical cholecystectomy were(101.7±9.3)months. The overall survival of patients with cholecystectomy plus lymphadenectomy and radical cholecystectomy were more than simple cholecystectomy(P<0.05). There were 329 patients with Lymph nodes examined in and after operations(231 patients with cholecystectomy plus lymphadenectomy, 98 patients with radical cholecystectomy). There were 265 patients with negative lymph node metastasis, the overall survival were(98.3±4.2)months. There were 64 patients with positive lymph node metastasis, the overall survival were(75.5±3.1)months. The overall survival of 38 patients with cholecystectomy plus lymphadenectomy were(62.7±2.6) months, and 26 patients with radical cholecystectomy were (82.2±3.7)months. The overall survival of patients with radical cholecystectomy were more than cholecystectomy plus lymphadenectomy(P<0.05). Conclusions The T1b stage gallbladder carcinoma patients with cholecystectomy plus lymphadenectomy or radical cholecystectomy has improved the prognosis comparing with simple cholecystectomy, significantly. When lymph node metastasis occurs, radical cholecystectomy has improved the prognosis comparing with cholecystectomy plus lymphadenectomy.