Objective To evaluate the effect of Ji Tang Zhi on glucose metabolism in insulin resistance (IR) HepG 2 cell line,and to explore the related mechanism.Methods The HepG2 cells were incubated in culture medium addition of 10-7 mol/L insulin for 24 h to establish the IR cell model.Effect of Ji Tang Zhi on rate of glucose absorption in HepG2 cell was detected by the method of glucose oxidase-peroxidase (GOD-POD).We performed an MTT assay to determine cytotoxicity effects of Ji Tang Zhi on HepG2 cell line.The expression of p-IRS-1 Ser307,PI3K and GLUT-4 were detected by Western blotting.Results Incubated with 10-7 mol/L insulin for 24 h,the insulin resistance cell model had been built.Compared with model group,the rate of glucose absorption of cell treated with JTZ (30 ～ 120 μg/mL) was significantly improved.According to model cells,the expression of GLUT-4 and PI3K decreased significantly compared to control cells.While the expression of p-IRS-1 Ser 307 was inhibited and GLUT-4 and PI3K expression were increased in IR cells after treated with JTZ (30 ～ 120 μtg/mL).Conclusion JTZ exert beneficial effects on hyperglycosemia in IR cell line possibly through regulating the levels of GLUT-4,p-IRS-1 Ser307 and PI3K in HepG2 cell.

Gastrointestinal benign stricture is a common disease with symptoms of dysphagia,abdominal pain and difficult defecation,which severely impair the quality of life for patients.Endoscopic intervention is the first-line treatment,and the available methods include balloon dilation,local drug injection and stent insertion,etc.Endoscopic incision was first used for the treatment of Schatzki's rings,and later it was used for the treatment of other gastrointestinal benign strictures,and the promising results were achieved.

Objective To evaluate the efficacy and safety of peroral endoscopic full-thickness myotomy for patients with severe esophageal achalasia.Methods A total of 64 patients with severe achalasia,whose Eckardt's score ≥6,esophageal diameter ≥6 cm or with S-type esophagus,were treated by peroral endoscopic full-thickness myotomy.Data of Eckardt's score,complications,recurrence,gastroscopy and esophageal barium radiography were collected before and during periodical follow-up.Results All the 64 patients underwent peroral endoscopic myotomy (POEM) successfully,mean operation time was 55 minutes,average length of tunnel and myotomy were 14.1 cm and 10.6 cm respectively,and full-thickness myotomy was performed beyond 6 cm near esophagogastric junction.Symptoms remitted in all patients.Eckardt's score decreased significantly [pre-treatment VS post-treatment,(7.4 ± 1.5) VS (0.6 ± 0.8),P ＜ 0.001],the diameter of esophageal lumen reduced[pre-treatment VS post-treatment,(59.7 ± 13.0) mm VS (31.4 ±3.3) mm,P ＜ 0.001),and the diameter of cardia increased [pre-treatment VS post-treatment,(15.6 ± 10.1) mm VS (33.4 ± 8.9) mm,P ＜ 0.001].Complications occurred in 9.4％ (6/64) of the cases,gas-related complications was 6.3％ (4/64).Treatment success was achieved in 98.4％ cases (63/64) with a follow-up of 6 ～20 months (median 12.3 months),with no recurrence cases.Conclusion Peroral endoscopic full-thickness myotomy is an effective and safe method for severe achalasia.Long-term efficacy and complications need further assessment.

Objective To investigate the risk factors and incidence of gas-related complications in peroral endoscopic myotomy for easophageal achalasia.Methods Clinical data of 216 patients with achalasia treated by peroral endoscopic myotomy from August 2011 to November 2013 were collected.Potential risk factors for gas-related complications were analyzed by univariate and multivariate analysis.Results The incidence of gas-related complications was 10.2％ (22/216).Univariate analysis showed risk factors for complications were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,tunnel width ≤3 cm,degree of myotomy,and operation time (P ＜ 0.05),while multivariate analysis showed the risk factors were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,and tunnel width ≤3 cm(P ＜ 0.05).Conclusion Simple longitudinal incision for tunnel entry,tunnel width≤3 cm and sigmoid type esophagus are risk factors of gas-related complications in POEM,while myotomy depth is not.

Background:There have been several studies about peroral endoscopic myotomy( POEM)for treating esophageal achalasia( EA). Although the feasibility,safety and effectiveness of POEM have been demonstrated,comparative studies of full-thickness and circular muscle myotomy were rare. Aims:To evaluate the efficacy and safety of POEM for treating patients with EA. Methods:A total of 216 patients with EA admitted from Aug. 2011 to Nov. 2013 at the Second Xiangya Hospital of Central South University were treated with POEM,of whom 133 received full-thickness myotomy and 83 received circular muscle myotomy. Data about Eckardt ’s score, diameter of esophageal lumen, intra- and post-operative complications and recurrence before and/or during periodical follow-up were collected,and the efficacy of full-thickness and circular muscle myotomy was compared. Results:All the 216 patients successfully underwent POEM with an average operation time of 59. 1 minutes. Average length of tunnel and myotomy were 13. 3 cm and 10. 1 cm,respectively. Symptoms remitted in all of the 216 patients,Eckardt’s score decreased significantly,diameter of esophageal lumen was reduced(pre-treatment vs. 6 months after treatment,53. 7 mm vs. 30. 8 mm,P<0. 001),and complications occurred in 13. 0%(28/216)of the cases. Success treatment was achieved in 99. 1%(214/216)of the cases with a follow-up of 3-30 months( mean 13. 8 months),no recurrence was noted. The operation time,efficacy and complications were comparable between full-thickness and circular muscle myotomy(P>0. 05). Conclusions:POEM is an effective and safe method for treating EA. Full-thickness myotomy did not increase the operation time and procedure-related complications, however,its long-term efficacy and complications need to be further assessed.

OBJECTIVETo compare steroidal saponins-main active ingredients of Paris polyphylla from different areas in Guizhou province, in order to provided basis for further proving Guizhou province to be the planting base of P. polyphylla.

METHODThe contents of nine steroidal saponins, namely paris-VII, (25R)-5-en-spirost-3beta,17alpha-diol-3-O-alpha-L-rhamnopyranosyl-(1-->2) [alpha-L-rhamnopyranosyl(1-->4)]-beta-D-glycopyanoside (PGRR), paris-H, paris-VI, paris-II , paris-III, gracillin, paris-I and paris-V of P. polyphylla from eight areas of Guizhou province were determined by HPLC-UV.

RESULTFive steroidal saponins-paris-VII, PGRR, paris-H, paris-VI and gracillin were detected in all the drugs, which provided basis for distinguishing P. polyphylla. P. polyphylla from Dushan showed the highest content of steroidal saponins (9.62%), followed by Tongren (6.39%), and the lowest was Zunyi (0.99%).

CONCLUSIONSaponins from different areas of Guizhou province show significant difference in variety and content, therefore Dushan is suitable for planting P. polyphylla.

China ; Chromatography, High Pressure Liquid ; methods ; Liliaceae ; chemistry ; Phytosterols ; analysis ; isolation & purification ; Plant Extracts ; analysis ; isolation & purification ; Rhizome ; chemistry ; Saponins ; analysis ; isolation & purification

Objective To study the characteristics of measurement points in auricle and to make a method of individual identification by auricle. To make an accurate, simple and reliable individual identification recognition to forensic anthropology by the auricle in the videos and pictures. Methods To select measurement points by the auricle pictures of the 148 adults of Han nationality -from 19 to 22 years old- beyond one month and to analysis the data by SPSS statistical software, analyzing the various factors that influence on the measurement result, then to calculate the ability of recognition, and to confirm the each index difference and the reference value range between the two batch of photos in the end. Results The 6 measurement points were retained by statistical test from the 10 measurement points. The result is stable, and the variation coefficient of each index is not quite different. Conclusion To confirm reference range of the 6 observation points so that to determine whether the two auricle pictures belong to the same individual is accurate and feasible method.

Objective To evaluate the clinical efficacy of submucosal tunnel endoscopic resection (STER) for upper gastrointestinal muscularis propria submucosal tumors (SMTs) with diameter ≥3.5 cm.Methods The clinical data of 14 patients with SMTs≥3.5 cm who were admitted to the Second Xiangya Hospital of Central South University between October 2011 and July 2014 were retrospectively analyzed, including 13 patients with tumor at esophagus and 1 patient with tumor at cardia.All patients underwent STER and the observed indexes included operation tine, tumor location and diameter, results of pathological examination and occurrence of postoperative complications.All patients were followed up regularly at the out-patient department including reexamination of gastroscopy, endoscopic ultrasonography (EUS) and computed tomography (CT) till August 2014.Measurement data with normal distribution were presented as average (range).Results All the 14 patients underwent STER successfully with mean operation time of 83 minutes (range, 60-160 minutes).Fourteen tumors were exited, with 13 located at esophagus and 1 at gastric cardia.En bloc resection was achieved in 13 patients and the tumors were extracted through the tunnel.The tumor in the remaining 1 patient was large with a diameter of 5.3 cm and close to trachea, it was extracted by 2 pieces.The average diameter of 14 tumors extracted was 4.1 cm and postoperative pathological examination confirmed the tumors as leiomyomas.Three patients had postoperative complications, subcutaneous emphysema occurred in 1 patient and retrosternal pain in 1 patient.One patient suffered mucosal laceration and recovered after a metal stent was inserted for 2 weeks.The average duration of postoperative hospital stay was 6.4 days (range, 4.0-8.0 days).All patients were followed up for a median time of 11.5 months (range, 1.0-24.0 months) with no recurrence.Conclusion STER is a safe and effective method for SMTs with diameter≥3.5 cm.

Objective To compare the efficacy and safety of full-thickness peroral endoscopic myotomy (POEM) and circular myotomy for patients with severe achalasia.Methods The clinical data of 123 patients with severe achalasia who were admitted to the Second Xiangya Hospital of Central South University from August 2011 to May 2013 were retrospectively analyzed.Seventy patients who received full-thickness POEM were in the full-thickness myotomy group,and the other 53 patieuts who received circular myotomy were in the circular myotomy group.The clinical efficacies and incidences of complications of the 2 groups were compared.Patients in the 2 groups were followed up at the out-patient department till May 2014.The consecutive measurement data were presented by (x) ± s and analyzed using thc t test; the non-consecutive data were presented by M (range) and analyzed using the Wilcoxon rank test.Data before and after operation were compared using the repeated measure of analysis of variance.The count data were analyzed using the chi-square test.Results All the patients successfully received POEM.The operation time of the full-thickness myotomy group and the circular myotomy group were (57 ± 8)minutes and (63 ± 12)minutes,with significant difference between the 2 groups (t =3.421,P ＜0.05).The incidences of complications of the full-thickness myotomy group and the circular myotomy group were 14.3％ (10/70) and 11.3％ (6/53),with no significant difference between the 2 groups (x2=0.234,P ＞0.05).Atotal of 119 patients were followed up,with the median time of 18 months (range,12-24 months).The Eckardt scores at postoperative month 6 and 12 were 0 (range,0-3) and 0 (range,0-3) in the full-thickness myotomy group,and 0 (range,0-2) and 0 (range,0-3) in the circular myotomy group,with no significant difference between the 2 groups (Z =0.525,1.476,P ＞ 0.05).The sussess rates of the full-thickness myotomy group and the circular myotomy group were 98.6％ (69/70) and 98.1％ (52/53),with no significant difference between the 2 groups (x2=0.040,P ＞ 0.05).The diameters of the esophagus at postoperative month 6 of the full-thickness myotomy group and the circular myotomy group were (3.2 ± 0.3) cm and (3.4 ± 0.4) cm,with no significant difference between the 2 groups (t =1.927,P ＞ 0.05).The diameters of the esophagus at postoperative month 6 and 12 were significantly lesser than (5.9 ± 1.0) cm and (5.9 ± 1.0) cm before operation (F =780.923,493.018,P ＜ 0.05).No recurrence was detected in the 2 groups during the follow-up.Conclusion The short-term efficacy and incidence of complications of full-thickness myotomy and circular myotomy are comparable,while the operation time of patients who received full-thickness myotomy is shorter.

Objective To identify the effect of glucose regulating protein 75 expression in PC12 cells under glucose deprivation.Methods MTT method was used to monitor the cell viability.The leakage of LDH was represented as the index of cell injury.Flow cytometry was applied for cell cycle analysis,apoptosis and necrosis.Using RT-PCR detected and quantified mRNA.Western blot to measure relative amounts of the protein.Results Cell viability decreased and the LDH leakage increased.While the treated PC12 cells had two main forms of apoptosis and necrosis.GRP75 mRNA and protein levels were upregulated.Conclusion GRP75 has protective function during glucose deprivation.