Objective To observe the effect of total glucosides of peony on hypergammaglobulinemia of undifferentiated connective tissue disease(UCTD). Methods Fifty patients with UCTD were randomly divided into the treat-ment group (total glucosides of peony and hydroxychloroquine and thymosin) (n=30) and the control group (hydroxychloroquine and thymosin) (n=20). The changes between the two groups on hypergammaglobulinemia after treated for 3 months were compared. Results The two groups all had the IgG and IgA decreased, but the treatment group decreased more significantly. In addition, the treatment group had decreased RF. Conclusion Total glucosides of peony can improve the hypergammaglobulinemia of UCTD.

AIM: To observe the effect of phagotrophic ability of macrophage on pseudomonas aeruginosa which was cocultured with low concentration of erythromycin. METHODS: The pseudomonas aeruginosa ATCC 27853 was cultured in LB both with low concentration of erythromycin (Group A) and without erythromycin (Group B) for 18 h separately, then incubated with macrophage from murine abdominal cavity for 2 h. The ratio of phagocytosis of macrophage was determined by microscope detection. RESULTS: The ratio of phagocytosis of group A in which erythromycin was added was higher than the group B, and the pseudopodia of macrophage were increased in the group A under electron microscope. CONCLUSION: Low concentration of erythromycin may enhance the phagocytosis ability of macrophage in vitro by influencing the virulent factors of PA.

Objective To report the modified surgical technique currently used for the construction of an orthotopic ileal neobladder.So as to improve the vesical function of urinary storage and urination after total cystectomy. Methods Radical cystectomy and ileal neobladder with double “U” shape were performed in 20 patients with transitional cell carcinoma. After the detubularized ileal segment approximately 40 cm in length was arranged in a U configuration,the two medial borders of the U-shaped open segment were oversewn with a single layer seromuscular continuous 2-0 polyglycolic acid suture.The bottom of the U was folded over between the two ends of the U.Thus a spherical pouch, the neobladder, was fashioned. During that period, the neobladder anastomosed to the urethra.The ureters were implanted according to the improved stitching method. Results The operative time to form a neobladder was (90?15)min.Follow-up turned out that no perioperative or early postoperative mortality was observed, and no severe early complications occurred. The mean postoperative follow-up time was 25 (range,6 to 48) months.All the 20 cases achieved excellent continence except for 6 cases with temporary incontinence at night.Dysuria occurred in 1 case,and hydronephrosis on the left was found in 1 case.Six months later, the mean bladder capacity was 340 ml (range,250 to 450 ml). Conclusions The construction of an ileal neobladder using a smaller part of ileum that has been completely detubularized and fashioned by double U shape is easy and agreeable to perform.This mode of operation has low complication rates, achieves adequate capacity at low pressure, and provides satisfactory continence rates.

Objective To investigate the role of individualized psychological intervention in gastroscopy.Methods 286 patients first underwent gastroscopy were randomly divided into the intervention and control groups,143 patients in each group. Individualized psychological intervention were provided for intervention group,and the patients of control group were just given routine nursing care. All the patients were measured by self rating anxiety scale (SAS) ,which were as measuring standards before and after intervention. At the same time,the blood pressure and heart rate were compared before and after intervention. Visual analogue scale (VAS) was observed to investigate the satisfaction of patients after operation. Results Compared with control group,anxiety rate and degree,blood pressure and heart rate in intervention group were lower( P ＜ 0. 05 ). The test of VAS revealed that the satisfaction of patients in intervention group was significantly higher than that in control group ( P ＜ 0. 05). Conclusion Individualized psychological intervention could improve negative emotion and relieve anxiety and affliction of patients underwent gastroscopy, and the satisfaction degree for gastroscopy was improved.

Objective To investigate the role of N-methyl-D-aspartate receptor one(NMDA-R1 )in visceral hypersensitivity forming of Sprague-Dawley rat model induced by transient Trichinella spiralis intestinal infection.Methods Forty male Sprague-Dawley rats were divided into healthy control group,visceral hypersensitivity group,0.9％ NaCl group and MK-801 group.The rats in visceral hypersensitivity group,0.9％NaCl group and MK-801 group were given Trichinella spiralis to establish infection model.After eight weeks,the rats in 0.9％NaCl group and MK-801 group were given 0.9 ％ NaCl and MK-801 respectively.The abdominal muscular electrical activity of each group was observed under 20,40,60 and 80 mm Hg (1 mm Hg=0.133 kPa) colorectal distension pressure.After abdominal muscular electrical activity recorded,rats were sacrificed and the colon specimens were collected.The expression of NMDA-R1 at protein level was detected by Western blot.The data were analyzed by LSD test and Bivariate correlation.Results There was significant correlation between areas under curve (AUC) of abdominal muscular electrical activity electromyography and distension pressure in healthy control group,visceral hypersensitivity group,0.9％ NaCl group and MK-801 group (r=0.823,0.618,0.913,0.889 respectively,all P＜0.01).Under 20,40,60,80 mm Hg distension pressure,there was significant difference in AUC between MK-801 group and visceral hypersensitivity group (LSD test,all P＜0.05).The AUC of MK-801 group was lower than that of healthy control group,but there was significant difference (LSD test,P =0.029) only when distension pressure was at 80 mm Hg.The integral optical density value of NMDA-R1 protein of MK-801 group (1.238 ±0.210) was significantly lower than that of visceral hypersensitivity group (2.231±0.450) and 0.9％NaCl group (2.104±0.220) (LSD teat,P=0.025,0.046).The JA value of NMDA-R1 protein of visceral hypersensitivity group and 0.9％NaCl group was significantly higher than that of healthy control group (LSD test,P =0.007,0.014).Conclusion The visceral hypersensitivity forming was correlated with the high expression of NMDA-R1,and it could be adjusted by inhibiting NMDA-R1 expression in enteric nervous system.

Objective To investigate the effects of cannabinoid 1 receptor (CB1R) on regulating visceral sensitivity in rats with acute partial restraint stress. Methods Thirty Sprague-Dawley rats were divided into blank control (sham stress), acute stress and CB1R groups with 10 each. The frequency of discharge of electromyogram (EMG) was recorded at the 1st, 2nd, 5th and 8th day to evaluate the visceral sensitivity to colorectal distension (CRD) in rats. The expression of the CB1R mRNA was determined by means of RT-PCR at day 8. Results There was no significant difference in baseline discharge frequency among three groups at the 1st day. But the discharge frequencies corresponding to CRD at 40,60,80 mm Hg at the 2nd day were significantly lower in CB1R group [(22.37±1.49)/min, (42.24±3.03)/min and (69.09±5.54)/min, respectively] than in acute stress group [(39.71±1.84)/min, (84.45±8.85)/min and (112.56±11.66)/min, respectively, P<0.05)]. The discharge frequencies corresponding to CRD at 40, 60,80 mm Hg in acute stress group [(104.12±6.77)/min, (158.07±18.68)/min, (193.58±25.69)/min,respectively] showed a significant elevation at the 5th day in comparison with blank control group[(36.33±5.42)/min, (74.07±8.25)/min, (102.94±7.95)/min, respectively, P<0.05] or CB1R group [(74.66±6.44)/min,(140.10±4.68)/min and (160.39±5.60)/min,respectively, P<0.05]. However, at the 8th day after stress, there was no significant difference in discharge frequency among three groups. The expressions of CB1R mRNA in ileocecal junction, proximal colonic and distal colonic tissues were significantly higher in acute stress group (2.53±0.52, 2.29±0.42, 2.54±0.29 respectively) than in blank control group(0.56±0.15, 0. 73±0.12, 0.82±0.09, respectively, P<0.05). There was no effect of CB1R agonist on CB1R mRNA expression in rats. Conclusion The visceral sensitivity in rats induced by stress can trigger the accommodation of endogenous cannabinoid system that plays an important role in modulation of visceral sensitivity.

To investigate the clinical efficacy of distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg for the treatment of traumatic chronic osteomyelitis of lower leg. A total of 25 patients with traumatic chronic osteomyelitis of lower legs were from Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2002 to June 2008. All the patients were treated with distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg after thoroughly debridement. Among them, 6 patients were treated with myocutaneous flap with nutrient vessel of saphenous nerve, and 19 patients were treated with myocutaneous flap with nutrient vessel of sural nerve. The sizes of the flaps were 5 cm×3 cm-18 cm× 12 cm, with attached muscles were 3 cm×3 cm-8 cm×5 cm. The lengths of the pedicles were 5-12 cm. All transplanted myocutaneous flaps survived well. A 6-24 months follow-up of all patients was obtained. The shape and texture of the myocutaneous flaps were good. And there was no recurrence of osteomyelitis. Results suggested that the distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg had reliable blood supply and satisfied efficacy, which was a good method for repairing traumatic chronic osteomyelitis of lower leg.

Background: Integrative traditional Chinese and western medicine may be a new approach to improve the eradication rate of Helicobacter pylori (Hp).Aims: To compare the efficacy and safety of Weifuchun tablet versus bismuth combined with standard triple regimen as the first-line therapy of Hp infection.Methods: A total of 141 patients with Hp infection and na(i)ve to treatment were randomly assigned into 3 groups receiving a 14-day eradication therapy.In standard triple therapy group, esomeprazole, amoxicillin and clarithromycin were given twice a day;while in Weifuchun group and bismuth group, Weifuchun tablet and bismuth potassium citrate were added, respectively, to the standard triple therapy.Hp eradication was assessed by 13C-urea breath test at least 6 weeks after the end of treatment.Hp isolates were tested for resistance to antibiotics.Results: One hundred and twenty-eight patients completed the study.Hp eradication rates in Weifuchun group, bismuth group and standard triple therapy group were 83.7%, 91.8% and 79.1%, respectively by ITT analysis and 88.4%, 97.8% and 84.6%, respectively by PP analysis.The eradication rate of Weifuchun group was lower than that of bismuth group and higher than that of standard triple therapy group, but the differences were not statistically significant (P>0.05).Only PP eradication rate of bismuth group was significantly higher than that of standard triple therapy group (P<0.05).The resistant rates of Hp to clarithromycin, amoxicillin and metronidazole were 33.3%, 2.9% and 70.5%, respectively.For eradication of clarithromycin resistant strains, bismuth group was superior to Weifuchun group and standard triple therapy group (100% vs.60.0% and 66.7%, P all <0.05).All three eradication regimens showed good compliance, and no significant difference in incidence of adverse events was found between the three regimens (P>0.05).Conclusions: Weifuchun tablet combined with standard triple regimen is safe and effective for use as first-line treatment for Hp infection, however, the eradication rate is relatively low in cases infected with clarithromycin resistant strains.Bismuth combined with standard triple regimen is a good alternative in areas with high clarithromycin resistance and regions where tetracycline is unavailable.

Purpose To investigate the clinical outcome of induced membrane technique for treatment of post-traumatic tibial osteomyelitis.Methods A retrospective analysis was made on 17 cases of post-traumatic tibial osteomyelitis admitted from August 2011 to October 2012.There were 13 males and 4 females aged 19-67 years (mean,40.9 years).Mean length of bone defect was 6.7 cm (range,2.0-18.5 cm).Surgical treatments were performed including phase Ⅰ surgical debridement and antibiotics-loaded bone cement impregnation to induce a membrane and phase Ⅱ bone defect reconstruction by intramembranous bone grafting.Clinical effect of the treatment was evaluated.Results Bone healing was detected at the 27-month follow-up (range,24-32 months).Radiographic healing was obtained 4-6 months after operation.Two cases of recurrent infection were noted after phase Ⅰ surgery and had another debridement.External fixator proximal pin track infection occurred in one case and infection was controlled by hardware removal and dressing change.There was one case of metal rejection,two function disorders,one clubfoot,and one ankle stiffness.Conclusion Induced membrane technique is effective in the treatment of post-traumatic tibial osteomyelitis,especially in lone bone defect reconstruction,but limb functional complications are worth consideration during treatment.

OBJECTIVE:To optimize the purification process of the extract from Yiqi guben granules. METHODS:The purifi-cation effect of the process was investigated with transfer rate of polysaccharide,calycosin glucoside and dry paste as evaluation in-dexes,using ZTC1+1 type Ⅱ,and shell poly sugar and 95% ethanol as clarifying agents. The purification process of the extract from Yiqi guben granules was optimized by orthogonal test using the ratio of material to liquid,the amount of clarifying agent and standing time as factor. The validation test was conducted. RESULTS:Selecting ZTC1+1 type Ⅱ as a clarifying agent,the best trans-fer rate of effective component had been obtained;optimal purification process was as follows as the ratio of material to liquid 1:2, the ratio of ZTC1+1 type Ⅱ A liquid 5%,the ratio of B liquid 10%,standing time of 5 h. The results of verification test showed transfer rates of dry paste in 3 tests were 71.54%,70.98%,69.21%,respectively;those of polysaccharide were 82.55%, 81.78%,82.15%,respectively;those of calycosin glucoside were 91.92%,92.34%,91.58%,respectively (all RSD≤1.72%, n=3). CONCLUSIONS:The optimized purification process is effective,stable and practical,and can be used for the purification of the extract from Yiqi guben granules.