Objective To review the clinical presentation of patients with hepatobiliary stones (HS).Method 2 359 patients with HS were divided into group A and B according to the presentation of these patients before or after 2002.Their clinical data were retrospectively analyzed.Results The age,the percentage of patients with a case history ＞ 10 years,the admission rate for relapse,the intrahepatic to extrahepatic stone ratio,the number of patients complicated with liver cirrhosis/portal hypertension,the elective operation rate,the ratio of biliary drainage operation,or the ratio of biliary drainage combined with hepatic resection in group B were 54.02 ± 13.54 years,68.99％,53.07％,73.18％,13.41％,80.80％,83.81％,44.74％,respectively.The corresponding figures for group A were 48.65 ± 14.47 years,46.25％,32.0％,62.02％,4.63％,63.92％,41.45％,19.05％,all P ＜0.01.However,the rates of biliary ascariasis,acute cholangitis of severe type (ACST),hepatic abscess,bleeding or perforation of the biliary tract,non-operative mortality,emergency operation rate and stone residual rate in group B were 6.56％,6.15％,0.84％,0,0,1.71％,5.18％,18.70％,respectively.All these were significantly lower than those in group A (12.11％,33.72％,1.95％,0.37％,0.67％,25.62％,respectively,all P ＜ 0.01).Conclusions The popularization of medical insurance and the increase in hospital admission rate,but not the actual increase in HS,led to the increase in hospitalization of patients.There was a tendency of less patients presenting with severe disease due to delay in treatment.Routine choledochoscopic stone extraction intraoperatively or postoperatively and the increased liver resection rate had decreased the residual stone rate.There should be a strict restriction on the use of choledochojejunostomy.

Objective To study the changes and significance of sCD14 in inflammatory response of patients with gouty arthritis.Methods CD14 mRNA was measured using quantitative real-time PCR in peripheral blood mononuclear cells (PBMCs).The expression of CD14 mRNA in PBMCs was compared between patients with acute gouty arthritis (AGA)(n =31)and non-acute gouty arthritis (NAGA)(n =23)and healthy controls (HC)(n =20).β-actin was selected as the internal control.The protein expressions of sCD14,IL-1βand TNF-αwere measured using enzyme linked immunosorbent assay (ELISA) in patients’ plasma.The protein expression of CRP was measured using immunoturbidimetry in patients’ plasma. Routine blood and blood biochemistry indexes were measured by routine blood analyzer and blood biochemistry analyzer of patients with AGA,NAGA and HC.We analyzed the correlation between CD14 mRNA,sCD14 protein expression and each clinical indicator.Results When compared with that in AGA group,the mRNA expression of CD14 increased significantly in PBMCs of HC patients (P < 0.05 ).When compared with that in HC and NAGA patients,the protein expression of sCD14 increased significantly in the plasma of AGA patients (P <0.01).The protein expression of sCD14 was significantly lower in the plasma of NAGA than in HC (P <0.05).The protein expression of sCD14 increased significantly in the plasma of AGA compared with HC and NAGA (P < 0.01 ).When compared with those in HC,the protein expressions of IL-1β and TNF-α increased significantly in the plasma of AGA and NAGA (P < 0.01 ).When compared with that in NAGA,the protein expression of IL-1βincreased significantly in plasma of AGA (P <0.01). The indexes of WBC increased significantly in AGA compared with HC (P <0.01),and WBC increased significantly in NAGA compared with HC (P <0.05).The indexes of GR and MO increased significantly in AGA compared with HC (P <0.05),and MO increased significantly in AGA compared with NAGA (P < 0.05 ).The indexes of UA increased significantly in AGA and NAGA compared with HC (P <0.01).There was a positive correlation between CD14 mRNA expression and IL-1β in PBMCs in AGA group (r s =0.362,P =0.045).A positive correlation was found between GR and the protein expression of sCD14 in NAGA patients’plasma (r s = 0.397,P = 0.030 ). Conclusion The dysregulated expressions of CD14 mRNA in PBMCs and sCD14 protein in GA show that sCD14 may play a significantly regulatory role in inflammatory reaction.

Objective To understand epidemic data and provide evidence for prevention and control of infectious diseases in Yongchuan area .Methods We collected the clinical materials of patients hospitalized during January 2008 to December 2012 ,and retrospectively analyzed the spectrum ,classification and epidemic tendency of infectious diseases in a hospital .Results A total of 4 632 patients were admitted to the department of infectious disease .The top two diseases were always hepatitis B virus infection related diseases and tuberculosis .Fatality mainly also appeared in end-stage liver diseases and tuberculosis .Morbidity of measles and mumps increased obviously in recent years .Hand-foot-mouth disease and influenza A(H1N1) were epidemic in this area .Conclusion The main infectious diseases in Yongchuan area are hepatitis B virus infection related diseases and tuberculosis ,which still are the important points for control and prevention .Also we should strengthen prevention of other infectious diseases such as hand-foot-mouth disease ,H1N1 and the mumps in order to decrease the occurrence of these infectious diseases .

Objective To provide evidence for control and prevention of hand-foot-mouth disease(HFMD) ,we analyzed the epi-demiological and viral characteristics of HFMD in Yongchuan district from 2009 to 2012 .Methods We collected the clinical dates of HFMD cases from Diseases Infectious Department of the Yongchuan Affiliated Hospital of Chongqing Medical University during 2009 to 2012 ,and analyzed the epidemiological characteristics .Results There were 509 HFMD cases in recruitment ,including 2 se-vere cases(one was dead) .The peak incidence of HFMD occurred from May to July annually .Between 2011 and 2012 ,there was an-other peak incidence ,which occurred from November to December .Most of the patients were under 5 years-old .The number of male cases was larger than that of the female .The number of scattered children cases was larger than that of the nursery children .More cases were reported in rural area than in urban area .Coxsackie virus A16(Cox A16) and other enteroviruses were the predominant strains of HFMD ,however enterovirus 71(EV71) infected cases increased sharply between 2011and 2012 .Enterovirus 71(EV71) inflection is the main cause of severe and death of HFMD .Conclusion The prevalence of HFMD in Yongchuan district had signifi-cant seasonal ,sex and age-specific ,regional differences and etiological characteristics .It was very important to make practical man-agements to prevent occurrence of HFMD according to these epidemiological characteristics .

Objective To study treatment of massive variceal bleeding secondary to localized pancreatitis-associated portal hypertension (MVBPAPH).Methods A retrospective study on the clinical data of patients with MVBPAPH was carried out.Of 24 patients with MVBPAPH,20 had pancreatic pseudocysts.12 were operated after failure of treatment with endovascular intervention for variceal bleeding (including 10 patients with splenectomy and gastric fundus-body peripheral vessels amputation and 2 patients with pancreatic pseudocystogastrostomy).8 patients underwent partial splenic embolization and left gastroepiploic artery embolization.4 patients directly underwent splenectomy and gastric fundus-body peripheral vessels amputation for variceal bleeding.Results Left pleural effusion developed in 5 patients who underwent arterial embolization.Left pleural effusion and lung infection occurred in 2 patients who underwent operation.All patients recovered well and were discharged home.During the follow-up period of 2 to 72 months,no rebleeding occurred in these patients (including 2 patients had passed little interval melena).Gastroscopy re-examination showed that variceal veins were not found in 18 patients.Variceal veins which were detected in the remaining 6 patients were obviously less severe.Conclusion Individualized treatment should be given to patients with MVBPAPH and according to the specific type of pancreatitis and the onset time of any accompanying pseudocyst.

OBJECTIVETo compare the differences in clinical efficacy on peripheral facial paralysis at acute stage between the opposing needling technique and routine acupuncture at the affected side so as to provide the evidence on the acupuncture treatment for peripheral facial paralysis at acute stage.

METHODSForty patients were rando- mized into an opposing needling technique group (19 cases) and an affected side needling technique group (21 cases). The basic medication was same in the two groups. The acupoints were Fengchi (GB 20), Yangbai (GB 14) to Yuyao (EX-HN 4) (penetrating needling method), Jingming (BL 1), Chengqi (ST 1), Xiaguan (ST 7), Jiache (ST 6) to Dicang (ST 4), Hegu (LI 4) and Zusanli (ST 36). In supplementation, in the opposing needling technique group, the acupoints were stimulated on the face of healthy side. In the affected side needling technique group, the acupoints were stimulated on the face of the affected side. The treatment was given three times a week, for 4 weeks. House-Brackmann (H-B) facial nerve function assessment was used to evaluate facial nerve function before and after treatment in the patients of the two groups. The efficacy was compared between the two groups.

RESULTSThe facial nerve function was recovered in the two groups and the total effective rate was 100.0% in the two groups (P>0.05). The curative rate was 68.4% (13/19) in the opposing needling technique group and better than 47.6% (10/21) in the affected side needling technique group (P<0.05). On the 7th and 14th day, scores of H-B in the opposing needling technique group were better than those in the affected side needling technique group (both P<0.05). The curative time in the opposing needling technique group was apparently shorter than that in the affected side needling technique group ((23.95 +/- 4.30) days vs. (29.14 +/- 5.43) days, P<0.01).

CONCLUSIONThe opposing needling technique accelerates the recovery of facial nerve function in peripheral facial paralysis at acute stage and apparently shortens the curative time. The efficacy is better than that in acupuncture on the affect- ed side of the face.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adolescent ; Adult ; Child ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

ObjectiveTo observe the effects of moxibustion in treating knee osteoarthritis (KOA).MethodTotally105 patients with KOA were randomly divided intoamoxibustion group (n=39), anelectroacupuncture group(n=44) andaCelebrex group (n=22).The three groups were treatedsuccessively for 4 weeks.The visual analogue scale (VAS) score of knee-joint pain and knee-joint function score were observed.ResultSeven days,fourteen days and twenty-eight daysrespectivelyafterthe treatment,theVAS scores of knee-joint pain and knee-joint function scoresweresignificantlydecreased in the three groups (P<0.001). Fourteen days and twenty-eight days afterthe intervention,the knee-joint function scores ofthemoxibustion group and electroacupuncture group weresignificantlyhigherthan those oftheCelebrex group (P<0.05).ConclusionMoxibustion therapy can improve the clinical symptoms and the knee-joint function in patients with KOA,similar to the electroacupuncture group and Celebrex group, and the moxibustion group has better effect in improving theknee-joint functioncompared to the Celebrex group.

OBJECTIVETo develop an HPLC method for the determination of pseudoprodioscin in Dioscorea panthaica and provide scientific basis for quality control of it and its preparation.

METHODThe analysis was carried out on a Merck Purospher STAR RP-18e column eluted with acetonitrile and water as mobile phases in gradient mode. The detection wavelength was 203 nm, and the flow rate was 1.0 mL min(-1).

RESULTThe pseudoprodioscin in D. panthaica extract was well separated. The linear range is between 0.0800-4.00 microg, r =0.9999. The average recovery and RSD are 99.9% and 2.3%, respectively.

CONCLUSIONThis method for quantitation of pseudoprodioscin in D. panthaica is simple, accurate and reliable and can be used for the quality control of D. panthaica and its preparations.

Chromatography, High Pressure Liquid ; methods ; Dioscorea ; chemistry ; Diosgenin ; analogs & derivatives ; analysis ; Drugs, Chinese Herbal ; analysis

Objective To investigate the single nucleotide polymorphisms(SNPs) rs3733591(C>T) of SLC2A9 gene in Chinese Han population, and to explore the association of this gene polymorphisms with gout susceptibility, tophi, serum uric acid levels, other clinical and laboratory data and the levels of SLC2A9 mRNA of peripheral blood mononuclear cells(PBMCs). Methods ① A total of 297 primary gout arthritis patients(GA) and 211 normal controls(NC) were enrolled into this study. The clinical and laboratory data of patients were collected. The genotypes and alleles frequencies were measured by using TaqMan ?SNP Geno-typing Assays and the possible association between gene polymorphism of SLC2A9 and gout was investigated by Chi-square test. The odds ratios(OR) and 95% confidence intervals(95%CI) were calculated. ② The lev-els of SLC2A9 mRNA on PBMCs of 86 gout patients(46 patients in remission) and controls were measured by real-time quantitative polymerase chain reaction (RT-qPCR). The nonparametric test was used to analyze the expression in different groups. Results The frequencies of genotypes and alleles of rs3733591(C>T) in gout patients were different from controls(P<0.05). The frequency of TT genotype was significantly lower than that in controls (P<0.05) and the relative risk of this genotype to develop gout was 0.647 (95%CI: 0.452-0.925). Moreover, the frequency of T allele in cases was much lower than in controls (60.9% vs 69.2%, χ2=7.324, P=0.007, OR=0.695), but the frequency of C allele was much higher(39.1% vs 30.8%, χ2=1.440, P=0.007, OR=1.440). Interestingly, the levels of SLC2A9 mRNA on PBMCs in gout patients who carried TC genotype of rs3733591 was higher than those who carried TT genotype(P<0.05). There was no difference in the expression of SLC2A9 mRNA on PBMCs among different genotype carriers of rs3733591 in controls (P>0.05). However, there was no significant difference in the distribution of genotypes and alleles between 30 tophaceous gout patients and 190 non-tophaceous gout patients(P>0.05). Conclusion Results of present study suggest the rs3733591(C>T) polymorphism of the SLC2A9 gene might be associated with gout development, but not with tophaceous gout. The C allele predisposes to gout, and TT genotype and T allele might protect Chinese Han population from developing gout. The rs3733591(C>T) polymorphism probably affects the susceptibility to gout by influencing the f expression of SLC2A9 mRNA susceptibility.

OBJECTIVETo establish the reference extraction method for determining five components contained in Pueraria labta decoction and detecting the applicability and feasibility of the application of reference extracts according to the quality standard of traditional Chinese medicine.

METHODZorbax C18 chromatographic column (4.6 mm x 250 mm, 5 microm) was used, with methanol-0.02% phosphoric acid (25:75) as the mobile phase and the detection wavelength was set at 250 nm. Self-prepared reference extracts of P. labta was used for determining the content of 3'-hydroxy puerarin, puerarin, 3'-methoxy puerarin, isoflavoues aglycone-8-C-apiose-(1--> 6) glucoside and daidzin and compare with the experimental results obtained with the single reference substance determination method.

RESULTThe reference extraction determination method showed high precision, stability and reproducibility, with coincident determination results with the results obtained with the single reference substance determination method.

CONCLUSIONThe reference extraction determination method of P. labta can be used for quality control of P. labta herbs. The study preliminarily proves the feasibility of the application of P. labta in traditional Chinese medicine.

Chemical Fractionation ; methods ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Glucosides ; analysis ; isolation & purification ; Isoflavones ; analysis ; isolation & purification ; Pueraria ; chemistry