Crohn’s disease( CD)is a gastrointestinal progressive granulomatous disease with unknown etiology. It is characterized as active stage alternating with remission stage,long-term course with many complications,sometimes needing surgery and having the tendency of relapse in patient ’s whole life. Therefore,it is important to define an effective therapeutic endpoint to ameliorate the natural course of CD. This article reviewed the progress in defining treatment endpoint of CD.

Objective To study the application of ESWL for ureteral stones in acute colic and with impairment of renal function. Methods From Mar.1987 to Sep.2000,emergent ESWL was performed for 168 cases of ureteral stone in acute colic and with impaired renal function on IVU (nonvisualization on IVU). Results All the patients got well after ESWL.104 patients less than 60 with a history of renal colic within 1 month have been followed up for 1 year.The renal function has reco vered and the urinary tract became visualized on IVU. Conclusions Ureteral stone may induce acute injury to the kidney but the harm is temporary and reversible when the ureteral stone is cured by ESWL on time.

Inflammatory bowel disease( IBD)includes ulcerative colitis( UC)and Crohn’s disease( CD),its incidence is increasing yearly in our country. With the progress of molecular biology,genetics,the understanding of IBD is deepen,however,the exact pathogenesis of IBD is still not fully clear,and it may be related to gene,environment, immunity,microorganism. Studies have shown that smoking,vitamin D,sex hormones,emotions,diet may be related with the occurrence of IBD. This article reviewed the role of environmental factors in IBD.

Objective To investigate the effects of transcutaneous electro acupuncture stimulation (TEA) on esophageal motility of patients with refractory gastroesophageal reflux disease (RGERD) by high resolution manometry (HRM),and to provide a new treatment option for RGERD.Methods From February 2014 to June 2015,a total of 45 patients with RGERD were enrolled.TEA instrument was used for electro acupuncture stimulation at the points of Zusanli and Neiguan.HRM was carried out before and after treatment.The changes of HRM parameters such as lower esophageal sphincter pressure (LESP),distal contractile integral (DCI),and amplitude of 3 cm,7 cm above lower esophageal sphincter (LES),esophageal body velocity and contractile front velocity (CFV) were also compared.The paired-samples t test was performed for statistical analysis.Results According to LESP value,45 patients were divided into low LESP group (10 patients) and normal LESP group (35 patients).According to parameter of esophageal motility function,patients were divided into esophageal dysmotility group (25 patients) and normal esophageal motility group (20 patients).After TEA treatment,the LESP of lower LESP group was (14.83± 4.17) mmHg (1 mmHg =0.133 kPa),which was higher than that before treatment ((9.54 ±2.42) mmHg),and the difference was statistically significant (t=4.92,P=0.001).LESP of esophageal dysmotility group was (19.04±5.91) mmHg,which was higher than that before treatment ((16.20±6.09) mmHg),and the difference was statistically significant (t=4.92,P=0.001).There was no statistically significant difference in LESP of normal LESP group and normal esophageal motility group before and after treatment (both P＞0.05).After treatment,DCI of esophageal dysmotility group was (530.76±215.53) mmHg· cm· s,which was higher than that before treatment ((363.92 ± 279.17) mmHg · cm · s),and the difference was statistically significant (t=2.86,P＜0.05).There was no statistically significant difference in esophageal body velocity,amplitude of 3 cm,7 cm above LES andCFV before and after treatment (all P＞0.05).There was no statistically significant difference in all of the esophageal motility parameters in normal esophageal motility group before and after treatment (all P＞0.05).Conclusion TEA can increase LESP and DCI in RGERD patients with esophageal motility dysfunction,improve contraction of entire esophagus and raise esophageal clearance capacity.

Objective To explore the clinical effect of extracorporeal shock wave lithotripsy (ESWL) for the treatment of horseshoe kidney stones.Methods A total of 42 cases of horseshoe kidney stones from March 1987 to January 2015 were enrolled.Among them,33 cases were male and 9 cases were female.Their age range was 19 to 71 years,average age was 42 years old.25 cases got left renal pelvis stone,17 cases were on the right renal pelvis side.The diameter range of stone was 0.4-3.7 cm,the average was 1.8cm.ESWL was applied to treat whole group.The prone position was used to removing calculus.The frequency of treatment was 2000-2700 times,with an average of 2500 times;the treatment voltage was 4-7KV.The gravel time of the treatment was 30-45min,the average was 35min.Results One time for ESWL was 29 cases,two times for ESWL was 8 cases,three times for ESWL was 3 cases,four times for ESWL was 2 cases.The first discharge stones time was 3 to 10 days.There was no special discomfort after operation.40 cases got hematuria after operation,which occurred in 1 to 3 days after ESWL Renal colic was in 7 cases which happened on 1-3 days after ESWL.Condusions Calculi in horseshoe kidney may be treated by ESWL.It is a safe and simple operation.The prone position may bring satisfactory effect.

Objective To evaluate clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) for treating patients with double J (DJ) stent extubation difficulties.Methods A retrospective analysis were conducted from July 1999 to December 2013,total 30 cases (18 male and 12 female) were accepted the ESWL therapy for treating the DJ extubation difficult due to the stone scales surface.The average age in those patients was 46 years (range 24 to 83 years).The average duration of DJ stents indwelling was 8.3 months (range 1.5 to 36.0 months).There were 10 cases with single stone and 20 cases with multiple stones.The distribution of stone location included left kidney in 14 cases,right kidney in 6 cases,left ureter in 3 cases and right ureter in 7 cases.The ureteral stone scales around the DJ stent showed tubular distribution.The distribution of imaging characteristic included kidney stones around the DJ stent joint in 20 cases and surface coarse in 10 cases.The diameter of the stone ranged from 0.7 to 3.2 cm (mean 1.8 cm).All the 30 cases were treated by ESWL with the 2 000-3 300 times frequency (mean 2 800 times).Treatment voltage was 4-8 KV.Results Gravel time ranged from 40 to 70 min (mean 45 min).No intraoperative and postoperative complications occurred.Their DJ stents were easily extubated immediately after ESWL.One week after ESWL,all the patients reported the flushing of the stone.Conclusion ESWL is a simple,convenient and efficacy way to solve the DJ stent extubation difficulties due to the scales surface.

AIM:To study the chemical constituents of leaves of Streblus asper Lour. METHODS:The constituents were isolated by column chromatography and their structures were elucidated through spectroscopic analysis. RESULTS:Seven compounds were isolated and identified as salicylic acid(1),?-sitosterol ( 2 ),?-daucosterol(3),oleanolic acid(4),magnolol(5),quercetin(6),taxifolin(7). CONCLUSION:The compounds are all obtained from the leaves of Streblus asper for the first time.

Objective To find new compound from gorgonian.Methods Three ceramides have been isolated from the South China Sea gorgonian Echinogorgia sp.by silica gel column chromatography.Results Their structures were established as(2S,3S,4R)-N-[2-(1,3,4-trihydroxyicosan-2-yl)]-hexadecanamide(1),(2S,3S,4R)-N-[2-(1,3,4-trihydroxyicosan-2-yl)]-heptadecanamide(2),and(2S,3S,4R)-N-[2-(1,3,4-trihydroxyicosan-2-yl]-octadecanamide(3) by spectroscopic methods and chemical conversion.Conclusion It is the first time to report the three chemical compounds from coral Echinogorgia sp.and compound 2 is a new compound.

Objective To investigate the predictable value of susceptibility weighted imaging (SWI)in hemorrhagic transforma-tion (HT)of ischemic stroke.Methods 48 patients with ischemic stroke were involved.The presence and features of HT on CT, T1 WI,DWI and SWI were observed,as well as the distribution and signal features of cerebral microbleeds (CMBs),abnormal visi-bility of venules on SWI sequence.The correlation between those imaging findings and HT were analyzed.Results HT was detected in 19 of 48 patients (39.6%).The sensibility of T1 WI,DWI,SWI in detecting HT were 68.4%,36.8%,100%,respectively.HT was significantly associated with abnormal visibility of venules within the infarction region.The incidence of HT greatly increased with the aggravation of CMBs.Conclusion SWI can be a sensitive predictor for HT,and it’s helpful in making clinical strategy for ischemic stroke.

A simple, sensitive, selective, and reproducible liquid chromatography-tandem mass spectrometric method was developed for the simultaneous determination of repaglinide and metformin in human plasma using d5-repaglinide and d6-metformin as internal standards (ISs). After a simple protein precipitation using acetonitrile as the precipitation solvent, both analytes and ISs were separated on a Venusil ASB C 18 (150 mm x 4.6 mm, 5 microm) via gradient elution using acetonitrile--10 mmol x L(-1) ammonium acetate as the mobile phase. A chromatographic total run time of 7.5 min was achieved. Mass spectrometric detection was conducted with atmospheric pressure chemical ionization under positive-ion and multiple-reaction monitoring modes. The method was linear over the 0.2 to 60.0 ng x mL(-1) concentration range for repaglinide and over the 4 to 1 000 ng x mL(-1) range for metformin. For both analytes, the intra- and inter-accuracies and precisions were within the +/- 15% acceptable limit across all concentrations. The validated method was successfully applied to a clinical bioequivalence study.