Objective To explore the correlation between intestinal mucosal immune barrier and pathogenesis of pigment gallstone and its possible mechanism.Methods Eighty guinea pigs were randomly divided into control group(group CON),pigment gallstone group(group PS),and intestinal mucosal protection group(group GLN).The guinea pigs were fed with normal diet in group CON,pigment gallstonein during diet in group PS,and glutamine-supplemented diet in group GLN for 8 weeks.The guinea pig model of pigment gallstone was established.The incidence of pigment gallstone was detected.The morphology of intestinal mucosa was observed,and the numbers of CD3~+T cell,CD40~+B cell,and IgA~+ plasma cell were counted.Results The incidence of pigment gallstone was significantly higher in group PS than in groups GLN and CON(P＜0.05).Compared with group CON,the intestinal wall was significant thinner and represented obvious signs of inflammation in group PS,and the numbers of CD3~+ T cell,CD40~+ B cell,and IgA~+ plasma cell significantly decreased(CD3~+ T cell,21.8±2.5 vs 11.1±3.4,P＜0.01;CD 40~+B cell,12.9±2.0 vs 10.7±3.6,P＜0.01;IgA~+ plasma cell,12.4±3.4 vs 10.7±3.5,P＜0.01).The signs of inflammation were less severe in group GLN than in group PS.There were significant differences in the numbers of CD3~+ T cell,CD40~+ B cell,and IgA~+plasma cell between groups GLN and PS.Conclusion Intestinal barrier dysfunction,including mechanical barrier and immune barrier,is involved in the formation of pigment gallstone.Glutamine has proved to improve the function of intestinal mucosal barrier and decrease the incidence of pigment gallstone.

To observed the Clinical effect of ropivacaine (Rop) of different concentration used for analgesia of labor, and ex plore the ideal concentration and dosage. Methods: 45 case s of ASA Ⅰ-Ⅱ primiparae nearing labor were vandomly divided three groups rand omly (0.16% Rop group, 0.2% Rop group were assigned 15 cases). The analgesia, in which the cervical os had opened up to 2-3cm; the controlled group was not giv en the analgesia of labor. BP, SpO2, EKG, PETCO2, cerrical contraction , fetal cardiac sounds were monitored continuously in the perinatal analgesia pe riod. The analgesia effects were determined by giving a mark for pain by VAPS, motor nerve blockings were given amark by Bromage scale; Apgar scale were conduc ted 1-5 min after neonates were labored out. Results: The vital signs of three groups were stable in perinatal; the VAPS scale was lower s ignificantly in observed group than in controlled group; while the blocking freq uency and extent of motor nerve were highest from 0.2% Rop, which had light inhi bitory effect to cervical contraction, causing the dosage of oxytocin to increas e relatively; the NACS scale 24 h after labor was more increased significantly in observed group than controlled group. Conclusion: The un ique blockings to sense and motor were obviously separate, having no obvious eff ect to blood stream of uterus and placenta, being benificial to analgesia in per inatal. The 0.16% Rop was a more ideal local anaesthesia agent than 0.2% Rop .

Objective To explore the impact of juxtapapilary duodenal diverticulum on the formation of choledocholithiasis and biliary manometry after surgery.Methods The clinical data of 97 patients with common bile duct stones who successfully underwent ERCP and biliary manometry treatment from May 2011 to March 2014 were retrospectively analyzed.Ninty-seven common bile duct stone patients were divided to two groups,that is,52 cases of juxta-papilary duodenal diverticulum (experimental group) and 45 cases without juxta-papilary duodenal diverticulum (control group).The biliary manometric results before and after EST of both groups were compared.Results The basal pressure of sphincter Oddi of the experimental group before EST [(84.8 ± 26.1) mmHg] was higher than that of the control group before EST [(75.5 ± 14.6) mmHg] (P ＜ 0.05,1 mmHg =0.133 kPa);and that after EST was also higher than that of the control group after the operation[(19.8 ± 14.2)mmHg VS (15.9 ± 9.8)mmHg,P ＜ 0.05].The biliary pressure of common bile duct stone patients with JPD was higher than those without JPD before and after EST but with no significant difference(P ＞ 0.05).The biliary manometry was performed in 81 patients after one month and it was found that the basal pressure of sphincter Oddi of experimental group was still higher than that of the control group [(34.8 ± 17.1) mmHg VS (29.6 ± 15.3)mmHg,P ＜ 0.05].The biliary pressure of common bile of the experimental group was higher than that of the control group [(19.9 ± 11.2) mmHg VS (17.1 ± 13.1)mmHg,P ＜0.05].Conclusion The existence of juxtapapilary duodenal diverticulum increases the pressure of common bile duct and Oddi sphincter and leads to CBD stones.

Objective To determine and compare the contents of free total organic acids in Pinellia ternata and its processed products.Methods Back potentiometric titration was employed to determine the contents of free total organic acids in Pinellia ternata and its processed products.Results The contents of free total organic acids in three batches of Pinellia ternata and its processed products were determined.The contents of free total organic acids in prepared rhizoma pinelliae was higher than that of the crude drug.The recovery was 95.20% and RSD was 1.81%.Conclusion This method were simple,accurate and can be used to estimate the quality of Pinellia ternata and its processed products(prepared with potash alum and juice of rhizima zingiber or with just potash alum).

According to two kinds of acupoint combination methods for Huahe and Huhe in five-door and ten-change theory proposed by the deceased Taiwanese famous acupuncturist Mr. ZHOU Zuo-yu, the origin of the change theory proposed by the deceased Taiwanese famous acupuncturist Mr. ZHOU Zuo-yu, the origin of the acupoint combination method of five-door and ten-change is introduced. This method combines traditional philosophy of Yi with medicine, which is featured with casual timing, casual pattern, capacity to be combined with TCM syndrome differentiation, specific application scope and pertinence. Some clinical cases are additionally presented to verify this method. Huhe method is mostly used for Bi-syndrome while Huahe method has better effects on internal medicine diseases. They open the new thinking methods for clinical acupoint selection.
Acupuncture Points ; Acupuncture Therapy ; Aged ; Female ; Humans ; Meridians ; Middle Aged ; Osteoarthritis, Knee ; therapy ; Shoulder Pain ; therapy

AIM To investigate the chemical constituents from the leaves of Cucurbita moschata (Duch.ex Lam.) Duch.ex Poiret.METHODS The ethyl acetate and n-butanol fractions of 70％ ethanol extract from C.moschata leaves were isolated and purified by silica,Sephadex LH-20,ODS and preparative TLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Thirteen compounds were isolated and identified as β-amyrin (1),phytol (2),α-linolenic acid (3),α-methyl linolenate (4),palmitic acid (5),ethyl linoleate (6),ethyl palmitate (7),daucosterol (8),β-sitosterol (9),(6S,9R)-roseoside (10),soya-cerebroside Ⅰ (11),dibutyl phthalate (12),4,4'-diphenylmethane-bis (methyl) carbamates (13).CONCLUSION All the compounds are isolated from this plant for the first time.

This study was aimed to evaluate effects of traditional Chinese medicine ( TCM ) five elements music therapy on the quality of life for both senior and non-senior advanced cancer patients , and improve TCM com-prehensive treatment mode . A total of 170 patients were stratified according to 70-year-old in a randomized controlled trial ( RCT ) with a parallel single-blind design . The ratio of patients among three groups was 2:2:1 . In the experimental group , TCM five elements music was given in the treatment . In the positive control group , western music was used in the treatment . And in the negative control group , no music was given in the treat-ment . The treatment was given for 30 min , 5 times per week . And the observation duration was 3 weeks . The Hospice Quality of Life Index-Revised ( HQOLI-R ) , Karnofsky Performance Scale ( KPS ) and Symptom Diary Score recorded by patients were used in the evaluation . The results showed that when comparing HQOLI-R , KPS and Symptom Diary Score before and after treatment among all advanced cancer patients in each group , there was a significant difference before and after treatment in the TCM five elements music therapy group ( P< 0 . 05 ) . But there was no significant difference before and after treatment in the western music therapy group or the negative control group ( P > 0 . 05 ) . It was concluded that TCM five elements music therapy is effective in improving quality of life and subjective symptoms for both senior and non-senior advanced cancer patients . However , the sensitivity of using the Symptom Diary Score as an evaluation index among senior patients still needs to be further proved .

Objective To evaluate curative effects of treatment of malignant biliary and gastric outlet-duodenal obstruction with endoscopically placed self-expandable metal stents.Methods A retrospective analysis was performed in 17 patients who underwent enteral stenting after placement of the biliary stent.The success rate of insertion,the effective palliation of biliary and duodenal obstruction,the rate of complication,recurrent stent obstruction and the median patency were observed.Results In 17 patients,biliary stenting were all performed for obstructive jaundice and then enteral stents were inserted.The levels of tatal billirubin [from (263.4 ± 62.5) μmol/L to (157.6 ± 25.1) μmol/L],direct billirubin [from (1233.2 ±66.5) μmol/L to (130.9 ± 27.7) μmol/L] and alkaline phosphatase [from (233.2 ± 66.5) IU/L to (130.9 ±27.7)IU/L] decreased significantly (P ＜0.01),and the gastric outlet score increased significandy [from (0.9 ± 1.1) points to (2.1 ±0.7) points] (P ＜0.01).No serious complication in all patients.Lifetime of patients ranged from 70 days to 332 days,and the median survival time was 192 day.Conclusion Combined biliary and enteral stenting is an effective method for palliation of malignant biliary and gastric outlet-duodenal obstruction.

Objective To observe the effects of berberine on ICAM-1, VCAM-1 expression and inflammatory cells exudation in mice with viral pneumonia caused by influenza virus, and explore its anti-injury effect. Methods Totally 108 BALB/c mice were randomly divided into control group, model group, and berberine group. 25 μL 50 LD50 influenza virus, mouse lung-adapted strain, was intranasally inoculated to model group and berberine group. 1 h after infection, control and model group were intragastrically given 25 μL distilled water, berberine group was treated by intraperitoneal injection with berberine at a dose of 0.005 g/(kg·d) for 5 days, twice per day. On day 2, 4 and 6 after infection, immunocytochemical method was used to detect ICAM-1 and VCAM-1 expression, and sorting cell count of leukocytes in bronchoalveolar lavage fluid (BALF) were counted. Results The expression of ICAM-1 and VCAM-1 in model group increased obviously on day 2, 4, 6, and which in berberine group decreased compared with model group (P<0.01). WBC, mononuclear cell, eosinophile cell and neutrophil cell number in model group increased significantly. WBC and neutrophil cell number decreased in berberine group on day 6 (P<0.01), and the mononuclear cell number decreased on day 4 (P<0.01). Conclusion Berberine inhibited the expression of ICAM-1 and VCAM-1, and decreased the inflammatory cells exudation in lung of mice with viral pneumonia caused by influenza virus. Berberine has protective effect on inflammatory injury of lung tissue in mice with viral pneumonia caused by influenza virus.

Objective To explore the diagnostic value of alcohol fixation and liquid-based cytology method for malignant stricture of common bile duct and to study the interval time between sampling and fixation for procedure of alcohol fixation.Methods Data of 82 patients were retrospectively studied,who were suspected of having malignant stricture of common bile duct underwent brushing through endoscopic retrograde cholangiopancreatography (ERCP),and were confirmed by follow-up for 2 years or pathology after surgery from October 2008 to June 2013.These patients were randomly divided into alcohol fixation group (n =30),liquid-based cytology group (n =28) and conventional cytology group (n =24).The positive diagnostic rates of brush cytology in each group were compared.The alcohol fixation group were randomly divided into 2-minute group and 5-minute group according to the interval time between sampling and fixation.Positive diagnostic rates were also compared.Results The positive rates were 73.33％ (alcohol fixation group,22/30),75.00％ (liquid-based cytology group,21/28) and 20.83％ (conventional cytology group,5/24),respectively.The positive rate of conventional cytology group was obviously lower than alcohol fixation group (x2 =21.525,P=0.000) and liquid-based cytology group (x2 =22.208,P =0.000) with statistical significance.But the positive rate of alcohol fixation group was similar to the liquid-based cytology group (x2 =0.683,P =0.898).In alcohol fixation group,the positive rate of 2-min group (88.24％,15/17) was significantly higher than the 5-min group (53.85％,7/13) with statistical significance (x2 =4.535,P =0.033).Conclusion Compared with conventional fixation,alcohol fixation and liquid-based cytology can improve positive diagnostic rate of brushing during ERCP.The alcohol fixation is more simple in procedure and low in cost than liquid-based cytology.The interval time between sampling and fixation should be reduced to no more than 2 minutes.