Bile duct stone is the common and frequently-occurring disease, its incidence upwards trend. In recent years, people realize that Oddi sphincter movement disorders play an important role in the inci-dence of bile duct stones. NO, CCK, VIP and theie interactian have effects on sphincter function and dis-charged from the regulation of bile. These factors are necessary to conduct an in-depth study to investigate the cause of bile duct stone and its treatment.

Objective To investigate the changes and significance of the contents of cholecystokinin (CCK) acceptors and nitric oxide synthase (NOS) in sphincter of Oddi and the contents of CCK and nitric oxide (NO) in the blood of the patients with calculus of bile duct. Methods The contents of CCK acceptors and NOS in sphincter of Oddi and the contents of CCK and NO in the blood were determined in 41 patients with gallstone and 6 controls. Results The contents of CCK and NO in the blood of patients with gallstone were significantly higher than that in control [ ( 38.91±4.85 ) pmol/L vs ( 30.67±1.81 ) pmol/L; (40.84±4.74 ) pmol/L vs ( 32.81±1.11) pmol/L] ;The contents of CCK acceptors and NOS in sphincter of Oddi in the patients with gallstone were signifi-cantly lower than in the controls [ (67.59±5.87 ) ng/L vs ( 78.99±1.71 ) ng/L; ( 457.52±45.40 ) ng/L vs ( 519.61±11.38 ) ng/L] ;The contents of CCK and NO in the blood in the different groups with calculus of bile duct were significantly different from those in the controls. Conieusion The degree of the decrease of the contents CCK acceptors and NOS in sphincter of Oddi leads to the decrease of Oddi sphincter function,resuting in cholestasis and promoting the formation of bile duct stone.

Objective To explore the effect of medicated serum of Sangleng and Eshu on the expression of vascular endothelial growth factor and vascular endothelial cell proliferation induced by VEGF in vitro. Methods Medicated serum of Sangleng and Eshu was used to culture human umbilical vein endothelial cell (HUVEC-1) induced by VEGF. The morphologic changes of HUVEC-1 were observed with phase contrast microscope, and cell proliferation was detected by MTT method, and the expression of vascular endothelial growth factor protein and mRNA in endothelial cells was detected by Western blotting and RT-PCR. Results The medicated serum of 5.0, 2.5 g?kg~ -1 ?d~ -1 Sangleng and Eshu could cause arrangement disorder in the normal umbilical vein endothelial cells. The medicated serum of 5.0 g?kg~ -1 ?d~ -1 Sangleng and Eshu (10%, 5%, 2.5%) and medicated serum of 2.5 g?kg~ -1 ?d~ -1 (10%) could inhibit vascular endothelial cell proliferation remarkably (P

This article explained that the evidence grading system occupied an important position in the evidence-based clinical practice guidelines. Through the comparative analysis on characteristics of clinical evidences between traditional Chinese medicine (TCM) and modern medicine, different possible establishment ideas of evidence grading system in TCM evidence-based clinical practice guidelines were proposed . The design for evidence grading standard of Chinese medical literature which reflected the academic characteristics of TCM was suggested.

Objective To explore the relationship between cholelithiasis and the function of sphincter of Oddi (SO). Methods To identify the existence of calculi, choledochoscopy was performed in patients 6 weeks after exploration of the common bile duct (CBD) and T tube drainage, in which 71 were patients with stones in gall bladder, CBD or intra-hepatic bile duct, and 9 with trauma of pancreas or liver.Biliary manometry was performed after choledochoscopy, and an additional manometry was applied after calculus removal if calculi were detected. The indices measured included SO basal pressure ( SOBP), amplitude of SO contractions (SOCA), frequency of SO contractions (SOF) and CBD pressure (CBDP). The patients with cholelithiasis were classified into cholecystolithiasis group, choledocholithiasis group, and hepatolithiasis group according to the position of calculi. Patients with trauma were assigned as the control group.Results All variables in 50 patients with choledocholithiasis were similar before and after the procedure.The variables in patients with cholecystolithiasis and choledocholithiasis had no difference from those of the control (P ＞ 0. 05 ). The SOBP and SOCA of patients in hepatolithiasis group were lower than those of the control group ( P ＜ 0. 05 ), while no difference in SOF was detected (P ＞ 0. 05 ). Conclusion The function of SO in patients with hepatolithiasis is abnormal ( decrease in SOBP and SOCA). Biliary manometry cannot be the reliable evidence for the existence of calculi in bile duct.

Objective To establish the canine model of esophageal variees caused by portal hyper-tension. Methods The model was established in 12 dogs with a side-to-side portacaval shunt, an ameroid constrictor around the portal vein and double ligation and cross suture of the cephalic part of the inferior vena cava (IVC), and the development of esophageal varices was confirmed 6 weeks later by endoscopy and portal vein angiography. Results The mean pre- and postoperative portal pressure were (11.0 ± 1.1) mm Hg and (22. 9 ± 1.2) nun Hg, respectively (P =0. 010). Endoscopy detected mild to moderate esophageal varices in all dogs, which was confirmed by portal vein angiography, and varices was also seen in abdominal wall. Conclusion Canine model of esophageal varices induced by portal hypertension can be established with the procedure.

Purpose:To determine the independent prognostic factors of survival for extrahepatic cholangiocarcinoma after operation. Methods:The clinical data of 52 patients with cholangiocarcinom a treated by operation in our hospital from 1992 to 2002 were retrospectively an alyzed and 10 possible factors influencing survival were selected . A multivaria te analysis was performed in these patients by the computer′s Cox proportional hazard model. Results:The over-all cumulative survival rate was 44.2% in a y ear,23.1% in three years and 9.6% in five years.The univariate analysis showed t he major significant prognostic factors influencing survival of these patients w ere mass of tumor of TNM stage,invasion and metastasis , method of operation , e xpression of E-cd and MMP-9 (P

BACKGROUND:There are stil some controversies about lateral compression rotational y unstable pelvic ring injuries and fixed mode. OBJECTIVE:To evaluate the pelvic stability of locking plate fixation pelvic reconstruction repairing lateral compression rotational y unstable pelvic ring injuries. METHODS:We retrospectively analyzed 15 patients with unstable lateral compression rotational y unstable pelvic ring injuries treated with reconstruction locking plates fixation at Suzhou Xiangcheng People’s Hospital between November 2011 and November 2014. The Matta standard was used to evaluate the quality of fracture reduction. Clinical efficacy was evaluated by Majeed score. RESULTS AND CONCLUSION:Fifteen patients were fol owed up for 12-44 months (mean 24 months). According to the standard of Matta, 11 cases were excel ent, 2 cases were good, 2 cases were average, 0 case poor, and the excel ent and good rate was 87%. According to Majeed functional assessment, clinical function outcomes were graded as 9 cases excel ent, 3 cases good, 1 case average, 1 case poor;excel ent and good rate was 80%. There were no patient loss of reduction and internal fixation failure among these 15 patients in the final fol ow-up. No iatrogenic neurovascular injury occurred. Incision superficial infection was detected in 2 patients with a Morel-Laval ee lesion after subjecting to double-tube continuous negative pressure drainage, and healed after wound management. A large area of infection and skin necrosis did not occur. These results confirm that pelvic universal reconstruction locking plates in repair of lateral compression rotational y unstable pelvic ring injuries can maintain a strong and effective fixation. We should pay much attention to the cases of pelvic fractures combined with soft tissue injury around the pelvis.

Objective To report one case with congenital ichthyosiform eruption, neurosensory deafness and vascularizing keratitis. Methods The overall clinical and laboratory examinations were conducted to confirm the diagnosis of keratitis, ichthyosis and deafness (KID) syndrome. Results The case presented with the typical hypotrichosis features of the eye lashes and eyebrows, alopecia of the scalp, and ophtalmological lesions. The keratotic plaques over the face, nose, ears, and the extremities were characterstic, and the skin of the trunk was leather-like, dry and hyperkeratotic. Dysplasia of cerebellum, and cystic enlargement of the fourth ventricle of cerebrum, and Dandy Walker syndrome were observed on MRI scanning. Treatment with oral acitretin for 3 weeks cleared the hyperkeratotic ichthyotic lesions on her posterior scalp and also improved other lesions on the extremities and the trunk. Conclusion Acitretin seems to be promising in the treatment of keratotic skin lesions in KID syndrome.

OBJECTIVETo study the effects of a Gold Belt (GB, a traditional Chinese herbal medicine) combined with methyl-prednisolone (MP) on the motor function and brain-derived neurotrophic factor (BDNF) expression in rats with contusive spinal cord injury (SCI).

METHODSThirty adult female SD rats were randomly divided into 5 equal groups, namely the sham-operated group, SCI group, SCI with MP treatment group (MP group, with intramuscular injection of 50 mg/kg MP within 8 hours after SCI and then dosage reduced 10 mg/kg daily), SCI with GB treatment group (GB group, with intragastric gavage of GB 50 mg/kg once daily for 7 days), and combined GB and MP treatment group. The Basso, Beattie and Bresnahan (BBB) locomotor scale was used to evaluate the hindlimb motor function of the rats on days 1, 3, 7, 14, 21 and 28 after the injury. After the last evaluation the rats were sacrificed for immunohistochemistry to observe the localization of BDNF in the ventral and dorsal horn of spinal cord.

RESULTSBDNF were distributed mainly in neurons in the spinal cord grey matter ventral horn and dorsal horn of the rats. The number of BDNF-positive neurons and BBB scores in the combined treatment group were significantly higher than those in the other 4 groups (P<0.05).

CONCLUSIONGB combined with MP produces better therapeutic effects for treating SCI than GB or MP used alone, and such effects are probably related with enhanced BDNF expression in the spinal cord.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Female ; Immunohistochemistry ; Methylprednisolone ; pharmacology ; Neurons ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; drug therapy ; metabolism