Objective To evaluate in a large open study if Jitongning capsule is potentially useful in the treatment of ankylosing spondylitis, and observe the safety of Jitongning capsule. Methods Sixty-five patients with ankylosing spondylitis were recruited. Jitongning capsule group were thirty-five patients, using Jitongning capsule at a dose of 4.2 g/d. The control group was using Sulfasalazine. There were thirty patients, using Sulfasalazine at a dose of 2.0 g/d. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), patient’s global assessment, total body pain, spinal pain and night pain, ESR and CRP were measured at 1, 3, 6 months. The primary end point in this study was the proportion of patients with a 20% improvement response according to the ASAS International Working Group criteria (ASAS20 responders) at month 1, 3, 6. Results The study was completed on 56 patients. The treatment group was completed on 33 patients. The control group was completed on 23 patients. Side effects of two groups were uncommon and well tolerated. The ASAS20 was achieved by 66.67% of patients in the treatment group and by 60.86% of patients in the control group at month 6. Conclusion Jitongning capsule can treat the patients of earlier and mid-half ankylosing spondylitis. That is safety and similar to Sulfasalazine.

Objective To establish a method for determining paraquat in the serum by ultraviolet spectrophotometry and present a quantitative index for paraquat poisoning salvage. Methods The sample was deproteinizated by 20% trichloracetic acid(TAC). 50 ?l microcell was used, the detection wavelength was 257 nm. Results The linearity was within 0.05～50 ?g/ml, r=0.999 9. The average recovery rates were 90.0%-102.4% and RSD=3.9%(n=4), the lowest detection limit was 0.01 ?g/ml. Conclusion The method is simple, rapid, precise and suitable for the determination of paraquat in the serum.

While Choledocholithiasis is concomitant with gallstones in approximately 9.2％ ～ 14.3％ of the patients,and its treatment methods are mainly by surgery,including:(1)Open cholecystectomy and open choledocholithotomy 、T-tube drainage (OC-OCHTD) ; (2) Endoscopic retrograde cholangiopancreatography (ERCP) and Endoscopic sphincterotomy (EST),and followed by Laparoscopic cholecystectomy (LC) second stage (ERCP/EST + LC) ; (3) Laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC +CBDE).These three methods all have their own characteristics.The last two methods are minimally invasive surgery treatment.Practice has proved that LCBDE and ERCP + EST + LC treatment methods are feasible and show certain advantages,compared with OC-OCHTD reflecting the development of minimally invasive surgery.Practice has proved that LCBDE and ERCP + EST + LC treatment methods are feasible and show certain advantages,compared with OCHTD reflecting the development of minimally invasive surgery.But the indications of operation are need to be summarized constantly in clinical practice,while operation skills are also need to be improved.At present,many reports of the two methods of minimally invasive treatment have been published because of the controversy,such as surgical indications,hospitalization expense,operation time,therapy danger,complications and the length of hospital stay.Both LCBDE and ERCP + EST + LC show some advantages and disadvantages compared with each other.On proper indications,LCBDE embodies the superiority of minimally invasive surgery technology as a one-stage operation,which is preferred for patients of choledocholithiasis with concomitant gallstones.For patients,no matter what kind of operation method,less invasion,lower risk and less complications is the key for best treatment choise.

Objective To compare the safety and efficiency of laparoscopic cholecystectomy (LC) + laparoscopic common bile duct exploration (LCBDE) with endoscopic retrograde cholangiopancreatography (ERCP) /endoscopic sphincterotomy (EST) +LC for patients with concomitant gallstones and common bile duct stones.Methods The Pubmed,EMBASE and CNKI were searched for randomized controlled trials published from 1990 to March,2012.Revman 5.1 was used to perform the meta-analysis.The main outcomes were stone clearance rate,treatment morbidity,operative time and length of hospital stay.Results 9 studies with 1021 patients were included into the final analysis.Meta-analysis demonstrated that LC+LCBDE was similar to ERCP/EST+LC in the stone clearance rate (OR 1.55,95％CI 0.95～2.52,P=0.08),treatment morbidity (OR 1.12,95％CI 0.75～1.67,P=0.58),operative time (WMD-54.44,95％CI-107.7～-1.17,P=0.05) and length of hospital stay (WMD-0.22,95％CI-2.6～2.16,P=0.86).The P value of the stone clearance rate was approaching 0.05 with increased number of studies in the analysis.There was no significant difference in the operative time,probably because of small sample size.Conclusions LC-LCBDE was equivalent to ERCP/EST+ LC in stone clearance rate,treatment morbidity,operative time and length of hospital stay.There is a possibility that LC+LCBDE can be superior to ERCP/EST+LC in the stone clearance rate and the operative time with increase in sample size.

Objective To investigate the effect of intrathecal nerve growth factor (NGF) on lidocaineinduced neurotoxicity to the spinal cord in rats.Methods Thirty healthy male Sprague-Dawley rats,aged 8-10 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =6 each) using a random number table:control group (group C),sham operation group (group S),lidocaine-induced neurotoxicity group (group L),normal saline group (group NS) and NGF group (group NGF).A catheter was inserted at L4.5 interspace into the epidural space in S,L,NS,and NGF groups.One day after surgery,20％ lidocaine 20 μl was injected intrathecally.At 24 h after lidocaine injection,normal saline 20 μl and NGF 10 μg (20 μd) were injected intrathecally in NS and NGF groups,respectively,once a day for 7 consecutive days.The tail flick latency (TFL) to a thermal nociceptive stimulus was measured on 1,3,5 and 7 days after lidocaine injection.The animals were sacrificed after the behavioral test was completed at 7 days after lidocaine injection,and the lumbar segments of the spinal cord were removed to detect the neuronal apoptosis (using flow cytometry) and caspase-3 mRNA expression (by RT-PCR).Results Compared with group C,the TFL was significantly prolonged at 1-7 days after lidocaine injection in L and NS groups and at 1-5 days after lidocaine injection in group NGF,the apoptosis rate was increased in L,NS and NGF groups,and caspase-3 mRNA expression was up-regulated in L and NS groups,and no significant change was found in the parameters mentioned above in group S.Compared with group L,the TFL was significantly shortened at 5 and 7 days after lidocaine injection,the apoptosis rate was decreased,and caspase3 mRNA expression was down-regulated in NGF group,and no significant change was found in the parameters mentioned above in group NS.Conclusion Intrathecal NGF can reduce lidocaine-induced neurotoxicity to the spinal cord in rats and inhibition of caspase-3 mRNA expression is involved in the mechanism.

Objective To observe the clinical effect of acupoint injection of salmon calcitonin in the treatment of senile osteoporosis. Methods From February 2016 to July 2017,136 elderly patients with osteoporosis admitted to Wenzhou Hospital of Traditional Chinese Medicine were included. The patients were randomly divided into two groups,with 68 cases in each group. The acupoint－injection group was given 50IU salmon calcitonin on day 1, day 2 100IU, one time per day, continuously used for 15 days for a course of treatment, and with an interval of 90 days,and repeat the course of treatment. The patients were given 0. 9% sodium chloride diluted to 2mL,inject 0. 5mL into bilateral Shenshu and Zusanli these two points. The intramuscular injection group was given the same dose of salmon calcitonin gluteus maximus injected intramuscularly. At the same time,both two groups were given calcium Erqi D tablets one tablet a day,alendronate once a week,each time 70mg fasting taken orally. The type Ⅰ collagen β－CTx,PINP,NBAP,femoral neck,femur trochanter,lumbar (L1 －L4) lumbar BMD and osteoporosis symptom score before and after treatment were compared. Results After treatment,the NBAP and BMD of the two groups were significantly higher than those before treatment (all P＜0. 05),and the β－CTx,PINP and symptoms scores were lower than before treatment (P＜0. 05). After treatment,NBAP in the acupoint injection group was (32. 36 ± 3. 03)μg/L, which was higher than (29. 66 ± 3. 20) μg/L in the intramuscular injection group(t =10. 477,P ＜0. 05). The β－CTx and PINP in the acupoint injection group were decreased to (0. 10 ± 0. 05)μg/L and (28. 78 ± 5. 23)μg/L, which were significantly lower than those in the intramuscular injection group[β－CTx(0. 20 ± 0. 05)μg/L,PINP (35.77 ±6. 49)μg/L(t =5. 983,2. 662,all P ＜0. 05)]. After treatment,the BMD of the femoral neck,femur trochanter and lumbar vertebra (L1 －L4) in the acupoint injection group were (0. 690 ± 0. 032)g/m2,(0. 620 ± 0. 010)g/m2and (0. 822 ± 0. 012)g/m2,respectively,which were higher than those in the intramuscular injection group[(0.652 ±0.012)g/m2,(0.572 ±0.022)g/m2and (0.801 ±0.011)g/m2(t=5.055,6.133,1.956,all P＜0. 05)]. After treatment,the improvements of TCM syndromes such as weakness in the waist and knees,tinnitus and deafness,loss of appetite,release of teeth,relaxation of two feet,weak tongue,weak pulse in the acupoint injection group were better than those in the intramuscular injection group (all P＜0. 05). Conclusion The acupoint injection of salmon calcitonin at Zusanli and Shenshu points is more effective than the intramuscular injection in the treatment of senile osteoporosis. It can significantly increase the serum NBAP,decrease the serum β－CTx,PINP,improve the BMD and improve the patients＇clinical symptoms,which means acupoint injection is a safe and effective way to treat senile osteoporosis.

Objective To compare the changes of 11 cytokines in ankylosing spondylitis(AS)before and after treatment with a loading regimen of infliximab and to evaluate the potential AS related discriminating cytokines and explore their value in diseases activity evaluation and possible association with therapeutic response.Methods This was an open-labeled,phase Ⅱ clinical trial conducted in 2 medical centers.All AS patients were infused with infliximab at week 0,2,6.The dosage was 5 mg/kg.Disease activity parameters were assessed at week 0,2,6 and 10.Eleven serum cytokines were detected using protein chip technique,then,serum IL-6 level wag measured by sandwich enzyme-linked immunosorbent assay(ELISA).Results IL-6 was detected by EHSA.Compared with healthy controls.IL-6 level incregsed markediy in AS(P<0.01).After treated with infliximab,IL-6 level decreased at week 2(P<0.01)and maintained at low level until week 10.Baseline serum IL-6 level was positively associated with AS disease activity index(night pain scores、ESRand CRP)(P<0.01).Conclusion Serum IL-6 level is associated with AS disease activity and may become a useful parameter for monitoring the clinical response of infliximab in AS patients.IL-6 is an important cytokine involved in the pathogenesis of AS.

Objective To explore the mechanism of multi-medicine drug resistance in human ovarian cancer cell line COC1/5-Fu. Methods The apoptosis and the tolerance of COC1/5-Fu cell induced by 5-Fu were analyzed by FACS. The expression of apoptosis related genes, such as p53, bcl-2, bcl-xl and bax, in COCI/5-Fu cell line were analyzed by RT-PCR. Results The COC1/5-Fu cell has some de-gree of drug resistance to 5-Fu and several other commonly used kind of chemotherapy medicine, among of which, drug resistance of 5-Fu reach 107.0 times and Paclitaxel reach 9.0 times compared with COC1. When COC1 was treated with the concentration of 5-Fu (0μmo/L, 30μmo/L or 150 μmol/L), the AI was (6.5±1.0) %, (14.0±4.0) % and (20.0±5.0) %, respectively. The rate of apoptosis increased 1.2 time and 2.1 time, compared with not treated with 5-Fu, which were significantly different (P<0.05). But when COC1/5-Fu was treated with the same concentration of 5-Fu (30 μmo/L or 150 μmoL/L), the AI was (6.7±0.7)%, (7.1±2.2)% and (6.5±2.0)%. When treated with the same concentration of 5-Fu (30 μmo/L or 150 μmol/L) , the proportion of apoptosis was significantly increased, G0/G1 phase was increased, and S and G2/ M phases were reduced in COC1 cells, but the proportion of apoptosis and cell cycle was not changed in COC1/5-Fu cells. The expression of bcl-xl , bcl-xs and bax mRNA were significantly increased and the expression of p53 and cpp32 mRNA were significantly decreased in resistant COC1/5-Fu cells , compared with COC1 cells. Conclusion wtp53 gene mutation is related with cell cycle change of ovary cancer cell and drug resistance, which is one of multi- medicine drug resistance mechanisms of COC1/5-Fu.

A method was proposed for the separation and determination of paraffin waxes in food by HPLC-evaporative light scattering detection (ELSD). A normal-phase column was used to separate nonparaffinic and paraffinic materials without resolving the latter into individual components. The t-test method was adopted for the evaluation of mean difference between response factors of n-alkanes in paraffin waxes on ELSD detector. No mean difference was obtained between response factors, which can be used for quantitative determination of paraffin waxes in food. The determination results obtained by HPLC-ELSD were compared with those by GC-MS. The linear range for the determination of paraffin waxes was in the range from 10 to 500 mg/L with a correlation coefficient of 0.9988, and the limit of detection was 1.0 mg/L. With the spiking level of 10, 50 and 100 mg/kg, the recovery ranged from 84.6% to 105.4% and the relative standard deviation ranging from 5.4% to 7.2%. The proposed method is simple, fast and sensitive.

Objective To clarify the association of pre-existing choledocholithiasis or cholecystolithiasis and the development of intrahepatic cholangiocarcinoma(ICC).Methods A computerized literature search was performed in Pubmed,EmBase and CBM.Cohort and case control studies on the risk of choledocholithiasis or cholecystolithiasis developing ICC was included.Meta-analysis was performed using STATA version 12.0.Either a fix or random effect model was used according to heterogeneity among studies.Egger's test was performed to assess publication bias.Results A total of 6 case control studies fulfilled our inclusion criteria including 123,713 patients,4,753 for ICC and 118,960 for tumor free controls.Bile duct stone contributed to the development of ICC (OR:15.64,95％ CI 9.33-26.23).Apart from hepatolithiasis,there was still a high risk of ICC development for choledocholithiasis (OR:11.05,95 ％ CI:4.02 ～ 30.37).Cholecystolithiasis is also a risk factor for ICC (OR:2.35,95 ％ CI:1.28 ～ 4.31).Conclusion Both choledocholithiasis and cholecystolithiasis are important prognostic factors for ICC.