Objective To observe the clinical efficacy of deep needling at Tianshu (ST25) with electroacupuncture in treating post-stroke constipation. Method Forty-eight patients with post-stroke constipation were randomized into an electroacupuncture (EA) group and a medication group, 24 cases in each group. The EA group was intervened by deep needling at Tianshu with EA, while the medication group was by Cong Rong Tong Bian oral liquid. After 1 treatment course, the constipation symptom score was observed and the clinical efficacy was calculated. Result After 1 treatment course, the symptom score, total effective rate, recovery plus markedly-effective rate of the EA group were superior to that of the control group, and the inter-group differences were statistically significant (P<0.05). Conclusion Deep needling at Tianshu with EA can significantly enhance the clinical efficacy in treating post-stroke constipation and improve the quality of life.

Objective To study the effects and mechanisms of myocardial injury in schistosome-infected mice.To investigate the effects and mechanisms of quercetin on myocardial injury due to the development of hepatic fibrosis after being treated by Praziquantel.Methods Eighty mice were divided into four groups:group A,group B,group C,and group D.Group A,group B,and group C were infected with Schistosoma japonicum cercariae.After 8 weeks,group A was treated with Praziquantel 500 mg/kg for 2 d,group B was treated with quercetin 30 mg/(kg?d) for 8 weeks after being treated with Praziquantel 500 mg/kg for 2 d.Group C was taken as experimental control without any treatment.Group D was taken as normal control.At the week 16,all mice were sacrificed and a part of liver tissue and myocardium tissue were preserved.HE Staining,electric microscope,RT-PCR,and immunohistochemical technique were applied to observing the changes of hepatic and cardiac histopathology,myocardial ultramicrostructure,the expression of myocardial c-fos,c-jun mRNA,and the contents of myocardial transforming growth factor-?1 (TGF-?1),typeⅠand typeⅢcollagen in mice infected with S.japonicum before and after treatments. Results There was different degree of myocardial injury among three groups of experimental control, Praziquantel treatment,Praziquantel combined with quercetin treatment.Praziquantel treatment relieved the degree of hepatic fibrosis and myocardial injury.The content of myocardial c-fos mRNA,c-jun mRNA,TGF-?1,typeⅠand typeⅢcollagen were obviously reduced compared to the experimental control. When Praziquantel treatment combined with quercetin,the degree of hepatic fibrosis and myocardial injury were further relieved.Although the content of myocardial c-fos mRNA,c-jun mRNA,TGF-?1, typeⅠand thypeⅢcollagen were still higher than those in normal control,those were reduced significantly compared to the group treated with Praziquantel.Conclusion Hepatic cirrhosis due to advanced schistosomiasis may lead to cardiac remodeling by stimulating the expression of immediate early gene and promoting the overexpression of TGF-?in myocardium.Anti-fibrosis therapy can reduce the degree of cardiac remodeling.Quercetin may protect myocardium through reducing the degree of hepatic fibrosis and inhibiting the expression of immediate early gene,which could decrease the level of myocardial TGF-?1.

Objective To evaluate the safety and efficacy of the endoscopic resection of large nonampullary duodenal adenomas.Methods Twenty cases with large nonampullary duodenal adenomas(≥ 1.0 cm) were referred for EMR.After submucosal injection of the mixture of glycerin fructose solution and methylene blue,either en bloc or piecemeal snare polypectomy was performed.All resected specimens were retrieved for pathologic study.Follow-up gastroscopy was performed in patients after EMR.Results Among 20 lesions,six were found located in the 1st part(30％),13 were in the 2nd part(65％),and one in the 3rd part(5％)of the duodenum.The mean diameter of the lesions was 1.9 ± 1.1 cm.Endoscopic ultrasonography (EUS) was performed in 12 patients,and all lesions were originated from the mucosa.EMR was performed successfully in 20 patients.The en bloc resection rate was 75％ (15/20),and the mean time for EMR was 33.8 ± 16.7 min.The perioperative complication rate was 20％ (4/20).Bleeding occurred within 24 hours after EMR in 4 cases.There were no perforations.The complete resection rate was 100％.Of these 20 adenomas,14 adenomas were tubulous and 6 was tubulovillous.During the follow-up period (2-39 months),1 patient showed recurrence within 6 months after EMR.Conclusion Endoscopic resection of large nonampullary duodenal adenomas is safe and effective treatment.

Objective To explore the safety and efficacy of endoscopic retrograde cholangiopancreatography(ERCP)by using carbon dioxide for malignant biliary obstruction.Methods A total of 60 patients with malignant biliary obstruction, hospitalized from September 2008 to February 2010, were randomly divided into 3 groups to receive ERCP by using carbon dioxide, contrast agent or magnetic resonance cholangiopancreatography(MRCP)without any agent.The safety and efficacy of 3 contrast methods were compared.Results Successful stent or drainage tube insertion was achieved in all patients.Carbon dioxide was superior to contrast agent in terms of lowering postoperative infection rate(P ＜ 0.05), and it was also superior to MRCP for more effective drainage(P ＜ 0.05).There was no significant difference in occurrence of postoperative pancreatitis and hyperamylasemia between 3 groups.Conclusion Using carbon dioxide during ERCP, safe and effective, is superior to use of contrast agent in less leukocyte increase, and to MRCP in more adequate drainage in patients with malignant biliary obstruction.Furthermore, there is no more risk of pancreatitis and hyperamylasemia.

Objective To investigate the proliferation,apoptosis and cell cycle and possible mechanisms of different breast cell lines by difluoromethylorithine (DMFO).Methods The growth of breast cancer MDA-435 (ODC GG) cell lines and SK-br3 (ODC AA) cell lines treated with DFMO were observed.The apoptosis and cell cycle were detected by flow cytometry.PCR was applied to detect the changes of A and G alleles of ODC G316A in MCF-7 cells treated with DFMO.Results The growth inhibition rates of MDA-435 and SK-br3 cells treated with 10 mmol/L and 20 mmol/L DFMO after 48 h were 24.1％ and 33.6 ％,46.3 ％ and 53.5 ％,respectively,and there was statistical significance (t =2.134,P =0.021,t =2.213,P =0.019).The growth inhibition rates of MDA-435 and SK-br3 treated with 10 mmol/L and 20 mmol/L DFMO after 72 h were 28.9 ％ and 35.7 ％,54.3 ％ and 65.4 ％,respectively,and there was statistical significance (t =2.434,P =0.015,t =2.489,P =0.013).The apoptosis rates of MDA-435 (ODC GG) and SK-br3 (ODC AA) cells both dealt with 20 mmol/L of DFMO after 24 h,48 h and 72 h were (7.58± 2.06) ％ and (13.88±3.45) ％ (t =2.047,P =0.041),(43.28±14.28) ％ and (59.96±16.42) ％ (t =3.680,P =0.000),(77.87±30.25) ％ and (93.08±32.15) ％ (t =3.293,P =0.000 1),respectively.The proportions of S stage cells MDA-435 (ODC GG) and SK-br3 (ODC AA) cells under the same condition after 24 h,48 h and 72 h were (13.25±2.38) ％ and (12.89±2.21) ％ (P ＞ 0.05),(21.43±3.12) ％ and (12.24±3.55) ％ (t =2.638,P =0.012),(16.32±3.23) ％ and (15.24±3.01) ％ (P ＞ 0.05),respectively.After the treatment by DFMO,the expression of ODC G316A allele A in breast cancer cell line MCF-7 (ODC AG) was reduced (t =3.708,P =0.000),and the expression of G had no significant changes.Conclusion The proliferation inhibition and apoptosis in breast cancer cells treated by DFMO is different in breast cancer cells with different genetic type of ODC G316A.DFMO can inhibit the activity of ODC,and the mechanism may be that DFMO could selectively bind to ODC G316A allele A.

Objective: To investigate the factors influencing the therapeutic effect in acupuncture treatment of apoplectic pseudobulbar palsy (PBP). Methods: Sixty patients with apoplectic pseudobulbar palsy in pattern of obstruction of wind and phlegm in the meridians were randomly divided into the treatment group and control group, to observe the therapeutic effect. Results and Conclusion: The therapeutic effect was significantly better in the treatment group than in the control group (P＜0.05). It has been found in the study that with increase in the occurrence of cerebral apoplexy, the incidence rate of severe dysphagia increased and dysphagia took place progressively earlier, indicating the importance of early treatment and prevention of cerebral apoplexy.

Objective To evaluate the clinical utility of SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system for the diagnosis and treatment of bile duct disorders.Methods A total of 9 patients with biliary diseases were treated with SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system.Four patients with large bile duct stones accepted laser lithotripsy,and stones were removed by ERCP.Five patients with indeterminate bile duct stricture accepted cholangioscopy-guided sampling.All patients underwent ENBD,routine blood test,blood amylase test,oral food and water restriction,acid suppression and prophylactic antibiotics.Results SpyGlass was successful in all patients with a manipulating time of 21.2min and total procedure time of 46.2min.Complete stone clearance was achieved in all 4 patients with large biliary stones.Sample quality was adequate in all patients with bile duct stricture with 2 patients diagnosed as having malignant biliary tumor and 3 as inflammatory bile duct stenosis.Post-ERCP complications including mild pancreatitis in 2 patients,and the patients recovered gradually after corresponding treatment.Conclusion ERCP-guided cholangiopancreatoscopy with the SpyGlass system is technically feasible and can be successfully and safely performed in patients with biliary disorders.

OBJECTIVE:To establish a HPLC method for the determination of levofloxacin hydrochloride in the levoflo_ xacin hydrochloride ointment.METHODS:The chromatographic column was C 18 ,the mobile phase was consisted of0.05mol/L citric acid-acetonitrile(85∶15)with detection wavelength at293nm and flow speed at1.0ml/min,the column temperature was40℃and the sample size was10?l.RESULTS:Good linear relation was achieved when the levofloxacin hydrochloride concen-tration was at the range of3.88～37.88ug/ml(r=0.9998);The average recovery was99.4%(n=9).CONCLUSION:This determination method is accurate,reliable and it can act as an effective quality control for levofloxacin hydrochloride ointment.

Objective To evaluate a method named “one-step procedure”,i.e.,combined duode-noscopy,laparoscopy and choledochoscopy for choledocholithiasis accompanied with cholecystolithiasis.Meth-ods Fifty-three cases with gallbladder stones combined with common bile duct stones diagnosed from February 2012 to February 2014 were assigned to two groups,29 cases in “one-step procedure”group,who underwent duodenoscopy,laparoscopy and choledochoscopy in one operation,and 24 cases in the control group,who first-ly underwent endoscopic sphincterotomy to remove common bile duct stones,and then LC was performed after several days.The rate of complications related to the procedure,success rate of complete stone removal,length of hospital stay and hospitalization expenses were compared between the two groups.Results All 53 patients underwent the surgery and ERCP procedure successfully.There were no significant differences between the“one-step procedure”group and the control group in complication rates[3.4%(1 /29)VS 12.5%(3 /24),P =0.21],complete stone removal rates[96.6%(28 /29)VS 100.0%(24/24),P =0.37].Differences were sig-nificant in length of hospital stay (6.7 ±1.3d VS 10.9 ±1.6d,P <0.01 )and hospitalization expenses (15 724 ±1 613 yuan VS 19 829 ±2 433 yuan,P <0.05)between the “one-step procedure”group and the control group.Conclusion The “one-step procedure”,the combined duodenoscopy,laparoscopy and chole-dochoscopy,is safe,effective,and has smaller length of hospital stay and lower hospitalization expenses.

Objective To evaluate the efficacy and safety of Spyglass single-operator cholangioscopy-guided laser lithotripsy for removing difficult bile duct stones.Methods A total of 39 patients with difficult bile duct stones were divided into Spyglass single-operator cholangioscopy-guided group (n =20) and fluoroscopy guided group (n =19) to receive corresponding treatments.The success rates of complete stone removal and the complication rates related to the procedure were compared between the two groups.Results There was no significant difference in success rate of complete stone removal between Spyglass single-operator cholangioscopy-guided group(17/20, 85.0％) and the fluoroscopy guided group(16/19, 84.2％ ,P =0.661) or in rates of procedure related complication (acute pancreatitis P =0.695, infection of bile duct P =1.000).Conclusion Both Spyglass single-operator cholangioscopy-guided laser lithotripsy and fluoroscopy are safe and effective.