Objective To investigate an effective method for the treatment of biliary ascariasis.Methods A retrospective analysis was performed for the clinical data of 32 patients with biliary ascariasis who were treated in The People's Hospital of Huangmei County from January 1994 to January 2014.All the patients were given spasmolysis,pain management,anti-infective therapy,traditional Chinese medicine syndrome differentiation-based treatment,Chinese materia medica for regulating qi and relieving pain,and ascariasis-relieving and parasite -expelling treatment.Patients were given surgical treatment due to poor response.Results Of all the 32 patients,5 (15.6％) had no response to the ascariasis-relieving treatment with Fructus Pruni Mume decoction and were given surgical treatment,and 27 (84.4％) were cured by Western medicine combined with Fructus Pruni Mume decoction.There were no complications such as acute pancreatitis,perfora tion of the gallbladder,and liver abscess.All the patients were treated with Fructus Pruni Mume decoction regularly after discharge and no patient experienced recurrence.Conclusion Integrated traditional Chinese and Western medicine therapy is effective,safe,and reliable in the treatment of biliary ascariasis and holds promise for clinical application.

Objective To explore the role of adjustable and close persistent peritoneal drain in large ascites and acute renal insufficiency(ARI)in patients with primary nephrotic syndrome(PNS).Methods The adjustable and close persistent peritoneal drain tube were planted in 6 cases with PNS accompanied by large ascites and ARI during December 2005 and August 2006.On the basis of drain,they were treated by prednisone,anticoagulative agent,hypolipidic agent,antibiotics,antioxidant,microcirculation-improving agent and aweto preparation.Results After the treatment,ascites disappeared or decreased.ARI was cured in 5 cases.Among these patients,partial remission(PR)and no respone(NR)to treatment were present in 3 cases respectively during hospitalization.After the follow-up of 3~12 months,the complete remisson(CR)of PNS was found in 2 cases,PR in 3 cases and NR in 1 case respectively.Conclusion The adjustable and close persistent peritoneal drain may be applicable for PNS patients with large ascites and ARI and slight glomerular lesion.It can clear away the superabundant water,mitigate the renal interstitial edema and accelerate the recovery of ARI.It also makes the patients have the opportunity of the treatment which includes predenisone,anticoagulative agent and hypolipidic agent.

Objective To observe the relationship between blood stasis syndrome and clinical pathology in patients with IgA nephropathy (IgAN). Methods Clinical and pathological materials of 42 patients with blood stasis syndrome,and 73 patients with non blood stasis syndrome were analyzed. Result Patients with blood stasis syndrome are often female and accompanied with renal dysfunction. Compared with patients of non blood stasis syndrome,Lee’s grades were obviously higher,degrees of fibrinogen-related antigen (FRA) deposited in renal were stronger,and scores or ratio of tubular atrophy significantly were higher. Conclusion Blood stasis syndrome of IgAN is correlated with certain renal pathological changes. Blood stasis is the main etiological factor.

Objective To evaluate the antihypertensive effect and safety of domestic produced amlodipine(Lan Di) in the treatment of chronic renal insufficiency with mild-mnderate hypertension and to compare with the effect of imported amledipine.Methods Sixty-onc patients with chronic renal insufficiency(Scr:265～442 μmol/L,seated DBP 90 ～105mmHg and seated SBP≤170mmHg) were enrolled in this study.Patients were randomly assigned to receive Lan Di 5mg or novasc 5mg once daily for 4 weeks.Doses were titrating to 10mg/d for another 4 weeks in patients hating seated DBP≥80mmHg or SBP≥130mmHg at the end of 4 weeks.Blood pressure,heart rate,laboratory examinations were performed at baseline and the end of the trial,and side effects were assessed pre and post Lan Di or novasc treatment.Results Lan Di group(31 cases) and novasc group(30 cases) finished a 8 week clinical trial.At the end of 4,8 weeks,seated SBP and DBP were significantly lowered compared with those at baseline(P＜0.01 ).There was no significant difference in the reduction of seated DBP or SBP between the two groups at the end of 4,8 weeks(P＞0.05).At the end of 8 weeks ,the response rate was 87% in Lan Di group and 90% in novasc group.If the target value of blood pressure is below 130/80mmHg,the response rate was 36% in Lan Di group and 30% in novasc group.At the end of 8 weeks,no difference was found in laboratory findings compared with those at baseline in two groups(P＞0.05).Side effects were comparable during the period of treatment.Condusion Domestic produced amlodipine 5mg or 10mg daily is as effective and safe as imported amolodipine in chronic renal insufficiency patients with mild to moderate hypertension.

Objective To investigate the effects of the zinc finger protein A20 on LPS-TLR4 signaling pathways in severe acute pancreatitis(SAP) rats.Methods 24 SD rats were randomly divided into 3 groups:group A(the sham operation group),group B (the SAP group),group C (the SAP group treated with LPS).SAP model was induced by retro-injection of intraductal 5％ sodium taurocholate into the biliary-pancreatic duct as previously described.The protein expression of A20,TLR4,NF-κBp65 and p38MAPK in pancreatic tissues was evaluated by immunohistochemistry.Results The positive area of A20 in pancreatic tissues was decreased in group B and group C compared with that in group A (t =17.234,19.698,all P ＜ 0.05).On the contrary,the expression of TLR4,NF-κBp65 and p38MAPK in pancreatic tissues were up-regulated(t =15.909,20.432,16.543,18.629,22.105,19.006,all P ＜ 0.05).A20 was decreased in group C than that in group B (t =14.894,P ＜ 0.05),while TLR4、NF-κBp65 and p38MAPK were increased in group C than those in group B (t =14.047,15.582,17.070,all P ＜0.05).Conclusion The expression of A20 reduced and TLR4,NF-κBp65 and p38MAPK enhanced in the pancreas of rats with SAP,which indicated that A20 inhibited LPS-TLR4 signaling pathways which play important roles in the pathogenesis of SAP.

AIM:To observe the clinical effects of Huangkui Capsule (Abelmoschus manihot (Linn)Medic.)on the treatment of IgA nephropathy of damp-heat syndrome.METHODS: Sixty-four patients were assigned randomly into two groups: treatment group in which 32 cases were treated with Huangkui Capsule,and control group,in which 32 cases were treated with fosinopril.The therapeutic course for both groups was 12 weeks.The indexes of efficacy ,including damp-heat syndrome scores,24 h urinary protein,serum creatinine,urea nitrogen and the indexes of safety,including liver function,electrolyte and occurrence of adverse events were observed.RESULTS :There was no significant statistical difference between the two groups in aspects of baseline clinical figures,after 12 weeks of treatment,the content of 24h urinary protein significantly decreased by (0.49±0.78 )g/24 h and (0.4±0.76 ) g/24 h respectively in the two groups,showing significant difference in comparing with baseline,but insignificant difference between the two groups ( P ＞ 0.05 ),the scores of damp-heat syndrome in the two groups decreased by (0.88±1.43 ) scores and (1.94±1.63 ) scores respectively with significant difference as compared with baseline (P ＜0.05 ),and in comparison between groups(P ＜0.05 ).The total effective rate of 24 h urinary protein was 53.1% in the treatment group and 65.6% in the control group (P ＞ 0.05 ),The total effective rate of dampheat syndrome scores was 84.4% in the treatment group and 50% in the control group ( P ＞ 0.05 ).No significant change in levels of serum creatinine,urea nitrogen in the two groups was found (P ＞0.05 ).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION: Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.

0.05).No severe adverse event occurred during the treatment,and the occurrence in the two groups was similar.CONCLUSION:Huangkui Capsule can effectively decrease the proteinuria just like fosinopril and improve clinical syndrome of patients of IgA nephropathy with damp-heat syndrome type,and shows no serious adverse reaction.

ObjectiveTo investigate the method and efficacy of cholelithotomy by laparoscopy and cholangioscopy, a controversial therapy for cholecystolithiasis. MethodsForty-eight patients with cholecystolithiasis who were admitted to our hospital and treated with gallbladder-preserving cholelithotomy by laparoscopy and cholangioscopy from March 2012 to June 2013 were enrolled as subjects. ResultsAfter surgery, all patients recovered without complications. One patient had relapse of cholecystolithiasis at six months after surgery. One patient had gallbladder atrophy at one year after surgery. ConclusionGallbladder-preserving cholelithotomy by laparoscopy and cholangioscopy is a feasible and safe therapy for cholecystolithiasis. The therapy achieves satisfactory short-term outcomes. However, the long-term efficacy of this therapy needs further investigation.

Objective:To identify the epitope of mAb15A11 which is specific against RA associated autoantigen cartilage oligomeric matrix protein ( COMP ).Methods: A filamentous phage library displaying random linear dodecapeptides was used to mapping the epitope of mAb15A11.After three rounds of screenings,40 phage clones were selected at random and sequenced.The specificity of phages was confirmed by enzyme immunoassays.Homology search by ClustalW2 and structure analysis by PyMol to identified the epitope amino acid sequence.Western blot analysis of COMP and ELISA analysis of COMP-derived peptides were used to confirm epitope′s characterization.Results: After repeated screenings using bio-panning method, 2 clones were identified, which interacted specifically with mAb 15A11.Homology search did not find succession consensus sequence within COMP molecular,which indicated that the epitope was not linear.PyMol Structure analysis identified the rationality of conformational epitope.Western blot analysis and ELISA of EDTA-treated COMP further prove an conformational structure of the epitope recognized by mAb 15A11.ELISA analysis of COMP-derived peptides demonstrated both disulfide bonds between 229 C-243 C and 237 C-253 C and every epitope amino acid of 232 G,238 H,240 H,241 A,244 V,247 R and 251 R were essential to the binding of mAb 15A11 with COMP.Conclusion: In this study, the potential B cell antigentic epitopes of mAb 15A11 was identified by phage display library.The epitope amino acids sequence and char-acterization were also recognized.It may have important theoretical value for the study of reaction mechanism of COMP antibody and antigen and may also show application significance in the detection of rheumatoid arthritis.

Objective To investigate the effect of berberine on endoplasmic reticulum stress PERK apoptosis pathway in HK-2 cells by high fructose.Methods HK-2 cells were grown in DMEM/F12, containing 10% fetal bovine serum (FBS) and divided randomly into four groups: normal control group (Group C); Fructose group (Group F): it contains 25mmol/L fructose culture; Berberine group (Group B): 25mmol/L fructose + 10μmol/L berberine treatment group; TUDCA group (Group T):25mmol/L fructose +2μmol/L TUDCA culture group; Cells were collected after culturing 24h. The expression of glucose-regulated protein 78 (GRP78), CHOP protein and the phosphorylation levels of PERK, eIF2α were tested by Western blotting. The cell cycles were detected by flow cytometry and the apoptosis of cells were detected by TUNEL staining.ResultsWestern blotting showed that the expression of GRP78 and CHOP protein in group F was significantly higher than that in group C, and the levels of p-PERK and p-eIF2α in group F were significantly higher than those in group F. Compared with group F, GRP78, CHOP, p-PERK and p-eIF2α in group B and T were significantly lower (P<0.05). The expression of GRP78, CHOP, p-PERK and p-eIF2α in group B had no significant difference. Flow cytometry and TUNEL staining showed that the cell viability of fructose group was significantly lower than that of C group, and the apoptotic index was significantly higher than that of group C (P<0.05). Compared with group F, the activity of HK-2 cells in group B and T significantly increased, otherwise the apoptosis index significantly decreased, and the difference was statistically significant (P<0.05). Compared with group T, the viability index and apoptosis rate of group B had no significant difference (P>0.05).Conclusion Persistent high fructose can activate the intracellular PERK pathway in HK-2 cells, causing endoplasmic reticulum stress. Berberine can inhibit the fructose-induced PERK and eIF2α phosphorylation, down-regulated the expression of GRP78, CHOP protein, thus by regulating PERK Pathways to alleviate cell cycle arrest and reduce cell apoptosis.