Objective To evaluate in vitro effects of propranolol and isoproterenol on proliferation of infantile hemangioma endothelial cells(IHECs)as well as expressions of vascular endothelial growth factors(VEGF and VEGF-2) and human basic fibroblast growth factor (bFGF). Methods The second - third passage endothelial cells derived from the proliferative phase of infantile hemangioma were divided into propranolol and isoproterenol groups. The propranolol group was further classified into 5 groups to be treated with propranolol solutions at concentrations of 10, 15, 20 mg/L, EGM-2 medium (blank control group 1), or EGM-2 medium containing 0.16% DMSO (DMSO group), while the isoproterenol group was classified into 4 groups to be treated with isoproterenol solutions at concentrations of 5, 10, 20 mg/L or EGM-2 medium(blank control group 2). Methyl thiazolyl tetrazolium(MTT)assay was performed to evaluate cellular proliferative activity in these propranolol groups at 24, 48, 72 and 96 hours separately, enzyme-linked immunosorbent assay (ELISA)to measure VEGF, VEGF-2 and bFGF lev els in culture supernatants of IHECs at 24 and 48 hours separately. Results The proliferative activity of IHECs showed no significant differences between 10-, 15- and 20-mg/L propranolol groups at either 24 or 48 hours (H = 1.152, 2.643, respectively, both P > 0.05), or between the blank control group 1, DMSO group, and 10- and 15-mg/L propranolol groups at either 72 or 96 hours, but significantly decreased in the 20-mg/L propranolol group compared with the blank control group 1 at 72 and 96 hours (both P < 0.05). The 24-hour treatments with propranolol or isoproterenol at the above concentrations all affected the expressions of VEGF, VEGF-2 and bFGF to different degrees. At 48 hours, there was a significant decrease in VEGF levels in 15- and 20-mg/L propranolol groups, as well as in VEGF-2 and bFGF levels in 10-, 15- and 20-mg/L propranolol groups compared with the blank control group 1 (all P < 0.05), but a significant increase in VEGF levels in 5-, 10- and 20-mg/L isoproterenol groups compared with the blank control group 2 (all P < 0.05), as well as in VEGF-2 and bFGF levels in the 20-mg/L isoproterenol group compared with the blank control group 2, 5- and 10-mg/L isoproterenol groups (all P < 0.05). Conclusions The treatment with propranolol at certain concentrations for certain durations can suppress the growth of, as well as expressions of VEGF, VEGF-2 and bFGF in, endothelial cells derived from the proliferative phase of infantile hemangioma, whereas that with isoproterenol has opposite effects. The therapeutic mechanism of propranolol in infantile hemangioma may be associated with expressions of β-adrenergic receptors and their downstream signal transduction-related cytokines.

Objective To investigate the expression of NOD2 and TLR9 in gastric carcinoma and precancerous lesions and their clinical significance. Methods The expression of NOD2 and TLR9 was measured by immunohistochemical staining (S-P method) in 84 patients with atrophic gastritis, 48 eases with gastric ulcer, 80 cases with gastric adenocarcinoma and 40 eases with superficial gastritis. Results NOD2 and TLR9 expression was up-regnlated in superficial gastritis, atrophic gastritis, gastric ulcer and gastric adenocarcinoma. The positive expression rate of NOD2 was 35% ,21% ,33% ,40% respectively, and the positive expression rate of TLR9 were 15%, 12% ,21% ,22% respectively. The expression of NOD2 and TLR9 in Hp complicated atrophic gastritis, gastric carcinoma was significantly higher than that of lip not complicated disease entities ( P < 0. 05 ). Conclusions The expression of NOD2 and TLR9 may be valuable index for predicting the development of gastric mucosal damage from superficial to atrophic gastritis, gastric ulcer and gastric carcinoma.

Objective To investigate the clinical efficacy of Bushen Tongdu Capsule for treating patients with rheumatoid arthritis (RA, TCM syndrome of kidney-deficiency with cold). Methods Totally 71 RA patients were randomly divided into treatment group (36 cases) that was treated with Bushen Tongdu Capsule and control group (35 cases) that was treated with tripterygium glycosides tablet. Both groups were treated for 12 weeks. The signs and symptoms, the state of illness, and laboratory index were observed before and after treatment. Results The total effective rate was 72.22% (26/36) in the treatment group, and 62.86% (22/35) in the control group, without statistical significance (P>0.05). After treatment, simplified disease activity index, TCM syndrome integrals, tender joint count, swollen joint count, overall evaluation from patients, overall disease evaluation from doctors, rest pain, morning stiffness time, average hands grip strength, 20 m walking time, healthy condition questionnaire score, and C-reactive protein were significantly improved in both groups (P<0.01, P<0.05). Compared with control group, TCM syndrome integrals changed more significantly, with statistical significance (P <0.05). Conclusion Bushen Tongdu Capsule can relieve symptoms and signs of RA patients (TCM syndrome of kidney-deficiency with cold) effectively.

Objective To study the use of ultrasound-guided percutaneous transhepatic cholecystostomy (PTGD) followed by selective minilaparotomy cholecystectomy (MC) for acute obstructive cholecystitis in the high-risk elderly.Method A retrospective study was conducted on 120 patients who received ultrasound-guided PTGD followed by selective MC from January 2008 to December 2010.Results PTGD+ MC were performed successfully on 120 patients with acute severe obstructive chole cystitis.In all the patients,the abdominal pain was relieved within 2-3 h of operation,and the temperature decreased to normal from 24- 48 h after operation.The average time of drainage was 10 days.In 97 patients MC was performed 1 week after PTGD,and in 23 patients 2 weeks after PTGD.Bleeding from gallbladder bed occurred in 1 patient.No patient suffered from bile leak.There was no major complication or death after PTGD+ MC.Conclusion PTGD followed by selective MC is a simple,efficacious and minimally invasive treatment for high-risk elderly patients with acute obstructive cholecystitis.

Objective To investigate the expression of hypoxia-inducible factor-1 alpha (HIF-1 α),vascular endothelial growth factor-A (VEGF-A) and vascular endothelial growth factor-D (VEGF-D)in hypoxic environment as well as the relationship between HIF-lα and VEGF-D.Methods Human esophageal cancer cell line EC9706 was cultured under hypoxia environment for 6,12 and 24 h,the cell radiosensitivity was evaluated by survival curve.HIF-1 α siRNA was constructed and transfected into human EC9706 cells.Protein expressions of HIF-1 α,VEGF-A and VEGF-D were analyzed by Western blot before and after RNA interference.Results EC9706 cells under hypoxia showed radioresistance with a SF2 of 0.62 higher than that of normoxic cells of 0.43.Moreover,the protein expressions of HIF-1α,VEGF-A and VEGF-D were all increased (F =205.24,227.88,130.55,P ＜0.05) due to hypoxia treatment.On the contrary,after HIF-1α siRNA transfer,the protein expressions of HIF-1α,VEGF-A and VEGF-D in EC9706 cells were not influenced by hypoxia treatment.Conclusions EC9706 cells in hypoxic environment was radioresistance,and the upexpressions of HIF1α,VEGF-A and VEGF-D may be involved.

Objective To investigate the alteration of serotonin-producing gastric enterochromaffin (EC)cell in patients with functional dyspepsia(FD).Methods Fifteen healthy volunteers and 33 patients with FD were enrolled.Proximal gastric mucosal EC cells were countered after immunohisto- chemistry staining.The ultrastructure of EC cell was observed by electromicroscope.Results The EC cells in proximal gastric mucosa in patients with FD were significant higher than that in controls(12.5?2.1 vs 8.3?1.4,t=2.353,P＜0.05),and the staining intensity of EC cell in patients with FD was also stronger than that in controls(3.72?0.42 vs 2.61?0.57,t=2.078,P＜0.05).The more sever the gastric mucosal inflammation was,the more number of EC cells and the stronger staining intensity were.Under the electromicroscopy,more Golgi apparatus,mitochondria and endoplasmic reticulum were found in EC cells.Special secreting particles were also found in cytoplasm.Conclusions EC cells may be involved in the pathogenesis of FD.The number of EC cell is related with the severity of gastric mucosal inflammation.

Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. However, due to its complex pathogenesis, there are no officially approved drugs for NAFLD treatment currently. Therefore, it is extremely urgent to find safe and effective anti-NAFLD drugs. Nowadays, lipid-lowering drugs are the main option for NAFLD therapy, but the clinical efficacy of chemical drugs is also very limited, as well as the frequent side effects or adverse reactions. Traditional Chinese medicine (TCM) has attracted more and more attention in the treatment of NAFLD due to its unique advantages through multiple targets and pathways with few side effects. In recent years, numerous studies have demonstrated that the imbalance of gut microbiota plays an important role in the occurrence and development of NAFLD. This review systematically summarizes the experimental and clinical evidences of TCM active compounds and TCM prescription involved in the regulation of intestinal flora in the treatment of NAFLD in recent years, so as to provide a reference for further exploring the pathogenesis of NAFLD and exploring TCM treatment methods.

Objective To describe the feasibility of biliary reconstruction methods and to explore the preventing and curing methods for biliary complications. Methods A total of 77 cases of living donor liver transplantation were included in our study for retrospective analysis. The operation types included right lobe contain middle hepatic vein (n=29), right lobe without middle hepatic vein (n=45), left lobe (n=1) and left lateral lobe transplantation (n=1). The biliary reconstruction was performed by duct-to-duct and Roux-en-Y epaticojejunostomy. Results Fifty-four grafts had 1 bile duct and 23 had multiple ones. The duct-to-duct biliary reconstruction was performed for 75 adult cases and T-tube drainage was used in 63 patients. Meanwhile, the conventional Roux-en-Y epaticojejunostomy was utilized for 2 pediatric patients. Total biliary complication incidence was 36.4% (28/77) and the complications included bile leakage (10.4%, 8/77) and biliary stricture (26.0%, 20/77).The rate of biliary complication was remarkably different between single hepatic duct group and multiple group (P<0.05). All the 8 patients suffering from bile leakage were cured by percutaneous bile drainage guided by ultrasound. By percutaneous balloon cholangioplasty and placing stent through the T-tube tract or endoscopic retrograde balloon cholangioplasty, the liver function of biliary stricture cases got better and most cases were cured. Conclusion Protecting the blood supply of bile duct at the cutting surface and harvesting one bile duct stump as much as possible can reduce biliary complication effectively. Radiate intervention treatment such as percutaneous balloon cholangioplasty and endoscope treatment etc. are effective for treatment of biliary complications.

Objective To observe the clinical effect of MC and LC in treatment of elderly patients with cholelithiasis and dise~s the best treatment in elderly patients with cholelithiasis.Methods Of 798 elderly patients with cholelithiasis,412 patients were divided into MC group with minilaparotomy cholecystectomy treatment,and 386 patients were divided into LC group with laparoseopic cholecystectomy treatment,then compare clinical effect and complications after operation.Results There was no significant differences in incision length,operative time,blood loss,bed time,hospital stay(all P＜0.05);There Was significant statistical significance in cost of treatment,complications after operation(all P＜0.05).Conclusion Minilaparotomy cholecystectomy was suitable for elderly patients with cholelithiasis,and it Was good at cost of treatment,complications after operation.