Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; drug therapy ; Humans ; Phytotherapy

Objective To investigate the timing of cholecystectomy in patients with mild biliary acute pancreatitis.Methods 80 patients with mild acute biliary pancreatitis were prospectively collected.According to the principle of random digital table, the patients were randomly divided into the study group and control group,40 cases in each group.The study group underwent early cholecystectomy, while the control group received delayed cholecystectomy.Main indicators included biliary tract complications, perioperative complications, conversion to open surgery, operation time and total hospital stay were observed.Results Compared with the control group, the total hospitalization time of the study group was significantly shorter[(9.39±2.48)d vs.(11.48±3.28)d,t=3.582,P=0.000].There were no statistically significant differences in the rate of conversion to open surgery, operation time, perioperative complications and mortality between the two groups (P>0.05).The incidence rates of acute cholecystitis, biliary colic and total biliary complications of the study group were 0.00%,0.00% and 0.00%, which were significantly lower than those in the control group (15.00%,22.50% and 47.50%) (x2=4.505,8.013 and 22.364,P=0.034,0.005 and 0.000).Conclusion Early laparoscopic cholecystectomy is helpful to reduce the incidence of adverse events in the biliary system.

Hormone therapy is a major treatment option for hormone-receptor-positive (HR+) breast cancer. Resistance to hormone therapy is the major reason for disease recurrence and progression. Recent studies have identified several resistance mechanisms that lead to the estrogen-independent growth of HR+breast cancer and were exploited to develop novel target drugs, including cyclin-de-pendent kinases 4 and 6 (CDK4/6) inhibitor, mammalian target of rapamycin (mTOR) inhibitor, epidermal growth factor receptor family inhibitor, vascular endothelial growth factor inhibitor, histone deacetylase inhibitor, fibroblast growth factor receptor inhibitor, insulin-like growth factor receptor inhibitor, and checkpoint inhibitor. These inhibitors are being developed to block resistance pathways and improve the efficacy of hormonal therapy. Among these drugs, the mTOR inhibitor everolimus and the CDK4/6 inhibitor palbociclib are currently approved in the United States to treat metastatic HR+breast cancer. In this study, we summarize the frontier advances in the combination of hormone and target therapies.

In the past, treatment of acupuncture and moxibustion always were emphasized on improving the strength of muscle. In fact, spasticity is the key point. This paper summarized recent studies on therapeutic effect of acupuncture and moxibustion on spastic paralysis after stroke.

Objective To investigate the quality of life (QOL) of maintenance hemodialysis (MHD) patients and its influencing factors.Methods A total of 257 MHD patients in our hospital were recruited in this study.Clinical data of the patients were collected,and the QOL was assessed by MOS 36 item short form health survey(SF-36).Nutritional status of patients was evaluated by modified quantitative subjective global assessment (MQSGA).Univariate analysis of variance,pearson correlation analysis and multiple linear stepwise regression analysis were performed to determine the effect of related factors on QOL scores.Results The scores of all scales of SF-36 evaluation in MHD patients were relatively lower than that of general population as reported before.Their physiological component summary (PCS) score decreased gradually as age grew,nevertheless,the mental component summary (MCS) score was highest in the group aged 41-60.The score was lower in patients with moderate to severe malnutrition or diabetic nephropathy when compared with other patients.Univariate analysis of variance also revealed that high SF-36 scores associated with higher education or income.Multivariate analysis indicated that PCS score and total SF-36 score of MHD patients were positively correlated with body mass index (BMI) and cholesterol,but negatively correlated with diabetic nephropathy,pulmonary artery systolic pressure and MQSGA score (all P ＜ 0.05).There was positive correlation between MCS score and income,yet negative correlation between MCS score and MQSGA score (all P ＜ 0.05).Conclusion MHD patients had relatively poor QOL.Primary diseases and nutritional status were probably the main influencing factors.Age,educated level,family income and pulmonary artery systolic pressure might also have effects on their QOL.

Objective: To establish Xiaochaihu Granules multi-wavelength fingerprints and conduct Bupleuri Radix-preparations peaks matching studies for further limitation validation of a single wavelength fingerprint quality evaluation. Methods: RP-HPLC was adopted to estimate the similarity on three batches of Xiaochaihu Granules from three manufacturers and three batches of Xiaochaihu Granules by laboratory-made (total 12 batches), and make peaks match raw herbs under the same conditions; the contents of indicator ingredients in different batches of Xiaochaihu Granules were determined by RP-HPLC method. Results: There was few differences of the fingerprint similarities among the three batches of Xiaochaihu Granules both from the same manufacture and laboratory-made at the wavelength of 210, 254, 280, and 323 nm. Among the fingerprints of Xiaochaihu Granules from different manufactures, the similarities of Xiaochaihu Granules only from manufacture A and of the three batches of Xiaochaihu Granules from the laboratory-made were over 0.9 under the four wavelengths. The similarities from the other two manufacturers were over 0.9 except 280 nm, but less than 0.9 at the wavelength of 210, 254, and 323 nm. At 210, 254, 280, and 323 nm wavelengths, peak pattern matching showed that Xiaochaihu Granules had 5, 5, 2, and 18 matching peaks with Bupleuri Radix, Glycyrrhizae Radix et Rhizoma, Codonopsis Radix, and Scutellariae Radix, respectively. The contents of glycyrrhizic acid and baicalin in Xiaochaihu Granules from different manufactures were significantly different. Saikosaponins a and d, ferulic acid, atractylenoide III, and lobetyolin were not detected in the formulations. Conclusion: There are great limitations to estimate quality of Xiaochaihu Granules with the fingerprint similarity at 280 nm. Multi-wavelength similarity evaluation combined with the peak matching of fingerprint for medicinal materials and preparations and quantitative determination of active components could provide a reference for the comprehensive quality evaluation of preparations for Chinese materia medica.

Objective: To investigate the expression of metastatic suppressor Kangai 1 (KAI1) expression in the primary gallbladder carcinoma and its clinical significance. Methods: The clinical stages of 35 primary gallbladder carcinoma patients were determined according to the TNM criteria of International Union Against Cancer (UICC). Histopathologic changes and the expressions of KAI1 were detected by H-E and immunohistochemical methods, respectively. All the patients were followed up for 3 years. Results: It was found that 1 patient had carcinoma in situ (0 stage), 13 had early carcinoma (I-II stage), and 21 had intermediate or advanced carcinoma (III-IV stage). Histopathologic grading showed that 14 patients had well-differentiated carcinomas, 10 had moderately differentiated ones, and 11 had poorly differentiated ones. Immunohistochemical results revealed that 60.00% (21/35) of the patients were positive of KAI1, with the positive rate being 92.31% (12/13) in early carcinoma (I-II stage) and 42.86% (9/21) in intermediate and advanced carcinoma (III-IV stage), and the former was significantly higher than the latter (Pexact=0.00 476). The positive rate of KAI1 protein was negatively correlated with the clinical staging of patients (Ptrend=0.004) and positively correlated with histopathologic grading (Ptrend=0.001). The positive rate of KAI1 protein in well differentiated carcinoma was 92.86% (13/14), in moderately differentiated carcinoma was 60.00% (6/10), and in poorly differentiated carcinoma was 18.18% (2/11)(Pexact=0.000 475 between the 3 groups). The positive rate of KAI1 protein was 89.47% (17/ 19) in 19 survival patients and 25.00% (4/16) in 16 death cases. Obvious significance of the expression of KAI1 protein was found between the 2 groups (P=0.001). Conclusion: The positive rate of KAI1 is negatively correlated with the clinical staging but positively correlated with the histopathologic grading in patients with primary gallbladder carcinoma. The high expression of KAI1 genes may indicate a better prognosis of gallbladder carcinoma.

Adolescent ; Diagnosis, Differential ; Diverticulum, Stomach ; complications ; diagnosis ; pathology ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Gastroscopy ; Humans ; Male

AIM: To discuss the establishment of immediate diabetic keratopathy animal model of C57BL/6 mouse induced by ahigh-fat and high-glucose diet.
METHODS: Diabetes mellitus was induced by a high-fat and high-glucose diet in C57BL/6 mouse. 1% rose bengal was stained on the cornea to examine the integrality of the corneal epithelium at 2 ~ 12mo after completion of the model. Corneal epithelial wound healing was observed using a vivo epithelial debridement model which was dyed by sodium fluorescein. Corneal morphology histology was examined by pathological methods.
RESULTS: The high-fat and high-glucose diet C57BL/6 mouse in 2mo had showed general symptoms of diabetes: polydipsia, polyphagia, polyuria, weight loss etc. The model had a steady-state high glucose (≥18mmol/L), also the weight was lower compared with normal control mouse. 1% rose bengal corneal staining had dot coloring at 2mo after completion of the model, the stained area and extent were gradually increased with the extension of the duration of diabetes, almost all the cornea was stained at 12mo after completion of the
model. With the passage of time into a mold, the cornea epithelial healing time become longer: 2mo was about 40h;3mo was about 120h; 4, 6, 12mo was about 144h;the coloboma were gradually increased at 12mo after completion of the model, then the area was reduced gradually until complete healing, the time was 96~120h, showed repeating phenomenon.
CONCLUSION: The mouse were induced by high-fat and high-glucose diet can be used as animal models of diabetic keratopathy: the damage of epithelium for corneal and delay healing on epithelium and other symptoms.