Objective To observe the antitumor action of Wei Yi Ting granules (WYTG) and to explore its possible mechanism.Methods The inhibitory effect of WYTG and its different WYTG ingredient combinations on the growth of S180 tumor in mice was observed.Meanwhile,the effect of WYTG and its different ingredient combinations on the expression of P53 and PCAN during tumor development was studied by immunohistochemical method.Results WYTG had an obvious inhibitory effect on tumor growth and could reduce the positive cell number of P53 and PCAN,the difference being significant as compared with the blank control group(P 0.05).Conclusion WYTG,which has the actions of strengthening Qi,activating blood and removing toxicity,exerts an obvious inhibitory effect on tumor as compared with its ingredient combination of strengthening Qi and with that of strengthening Qi and removing toxicity.Its therapeutic mechanism may be related to the inhibition of the expression of P53 and PCAN and the influence on tumor-associated gene during the growth of tumor.

Objective To determine the pathological mechanism of gastrolithiasis formation in vitro and the effects of pectinase on gastrolithiasis. Methods The test in vitro was divided randomly into two groups:(1) Haws and persimmons(25g respectively) were chewed and put into two clean containers filled with fresh gastric juice.(2) Wine containing 30% alcohol(50ml) was added to the container. Each group included 4 collections.All two groups were placed in 37℃ calorstat box to observe the course and time of gastrolith formation. After gastrolith formation, 2g pectinase was added to the container and observed the decomposition of pectinase to gastrolith and the time was recorded. The effects of pectinase on 54 patients with gastrolithiasis were also investigated. Results The mean time of haws juice coagulation and persimmons was 23 minutes and 25 minutes respectively in the group without wine; but in the group with wine, the mean time of haws juice coagulation and persimmons was 14 minutes and 19 minutes respectively. After adding pectinase, the mean time of clot initiated decomposition was about 17 minutes in both groups, but complete decomposition needed 34 minutes. All the 54 patients with gastrolithiasis who received pectinase were cured.The gastrolith disappeared 6 hours after taking pectinase confirmed by barium meal examination. Conclusions Haws and/or persimmons mixed with gastric juice could induce gastrolith formation. The effects of pectinase on patients with haws or persimmons gastrolithiasis are good, this therapeutic procedure is simple, and the gastrolith resolves quickly.Pectinase may be widely used in the treatment of gastrolithiasis.

Objective: To observe the effects of early enteral nutrition(EEN) on incidence of postoperative complication in gastric cancer patients. Methods: 150 patients with gastric cancer were randomly divided into early enteral nutrition group (n=82) and non-early enteral nutrition (N-EEN) group (n=68). The patients in group EEN were given enteral nutrition after operation, and the patients in group N-EEN were given total parenteral nutrition support. The postoperative complications were recorded. The serum albumin, prealbumin and transferrin were measured on postoperative day 1, 5 and 9. The serum level of alanine aminotransferase(ALT), bilirubin, blood urea nitrogen(BUN), creatinine, glucose, cholesteroland triglyceridewere monitored. Results: The complications occurred in 21patients. 5 of these patients belonged to EEN group and the other belonged to N-EEN group. In EEN group, the serum albumin, prealbumin and transferrin were significantly higher than in N-EEN group on postoperative day 9 (P

Objective:To elucidate the role of ERK1/2 MAPKs signal transduction in the protective effects of ischemic preconditioning during liver transplantation. Methods: Twenty-four rats were equally randomized into 4 groups: sham control (group A); liver transplantation (group B); ischemic preconditioning+liver transplantation (group C), and MEK inhibitor intervention+ischemic preconditioning+liver transplantation (group D). Serum AST and ALT were detected after operation and cellular ultrastructures were observed by transmission electron microscopy. Liver tissue ERK1/2 MAPKs phosphorylation activities were evaluated through determining ERK-1 protein phosphorylation by Western blotting. Results: Serum ALT and AST activity in group B and group D was significantly higher than those in group A, and remained normal in group C. Liver tissue ERK1/2 MAPKs phosphorylation activity increased significantly in group C, and the activation effect was inhibited in group B and D. Cellular ultrastructure was obviously damaged in group B and group D, and the damage was prevented in group C.Conclusion: Ischemic preconditioning has a protective effect on transplanted liver cells in which ERK1/2 MAPKs pathway plays a pivotal role.

Objective To observe the effects of Wu-Yao,Da-Huang combination on severe acute pancreatitis gut barrier protection,and on the clinical treatment of severe acute pancreatitis.Methods In the past 10 months,45 casea of severe pancreatitis those treated in our department were randomly divided into 3 groups.group A:on the basis of conventional treatment of inhibiting trypsin secretion and anti-infection,50%magnesium sulfate 50 mL were insected via stomach tube,twice a day;group B:on the basis of conventional treatment,Da-Huang decoction 100 mL high retention enema,twice a day;group C:on the basis of conventional treatment were given by Wu-Yao decoction 50 mL.as well as 100 mL Da-Huang decoction enema,twice a day.Three groups were observed the release of abdominal distension,abdominal(bladder pressure measurement),ACAPHE-Ⅱ score,indicators of neutrophils(N),C-reactive protein(CRP),and the blood levels of D-lactic acid in 1,3,5,7,9 days etc.Results The abdomenal circumference,abdominal pressure,APACHE-Ⅱ score,N and other indicators of the three groups after treatment had the significantly different(P<0.05),with group C the most significant decrease,while no significant difference in CRP.Endotoxin content in three groups was significantly different(P<0.05),and each diminished with time(P<0.05).Conclusion Wu-Yao,Da-Huang combination on gut barrier dysfunction in severe acute pancreatitis showed synergistic protective effect.

To study the effects of Xuesaitong Injection, an extract from a Chinese herbal medicine, on coagulation function of gastric cancer patients undergoing laparoscopic surgery.

Objective To study the anatomy of the caudate lobe and to apply the knowledge in caudate lobe resection and piggyback liver transplantation. Methods Dissection of the caudate lobe was carried out in 35 fresh adult livers. Before dissection, the portal venous system was injected with barium sulfate emulsion to show the portal branches of the caudate lobe. Results The caudate lobe was shown to consiste of 3 portions: (1) the Spigelian lobe, the paracaval portion and the caudate process. The Spigelian lobe was pyramidal in shape with 3 faces, a peak and a base; (2) the paracaval portion was situated to the right and to the front of the vena cava; (3) the caudal process was the liver parenchyma between the hepatic hilum and the anterior aspect of the vena cava. Conclusions The entire caudate lobe is situated at the posterior part of the liver and it surrounds the vena cava. The key point in resecting the entire caudate lobe or in performing a piggyback liver transplantation is adequate mobilization and division of all the outflowing veins of the caudate lobe.

Objective To investigate the effect of small intestine exclusion surgery on blood glucose and oral glucose tolerance test (OGTT) in Goto-Kakizaki (GK) rat with type Ⅱ diabetes mellitus.Methods 40 GK rats were randomly divided into 5 groups:duodenal bypass (Group A,n = 8),duodenaljejunal bypass (Group B,n = 8),duodenum and total jejunum exclusion (Group C,n = 8),sub-total small intestine exclusion (Group D,n = 8),and sham-operation (Group SO,n=8).All rats were observed for 24 weeks after surgery.Fasting blood glucose was tested at 0,1,3,6,12,and 24 wk.OGTT was performed at 0,1,and 24 wk.After the administration of 3 g/kg glucose by oral gavage,blood glucose was measured in conscious rats before (baseline) and after 30,60,120,and 180 minutes.Areas under curves (AUC) were calculated by trapezoidal integration.Results Rats in group A,B,C and D had lower fasting blood glucose levels and better oral glucose tolerance as shown by lower peak and area-under-thecurve (AUC) glucose values through the entire follow-up period[group B (fasting blood glucose:(9.0±2.4) mmol/L vs.(4.4±1.0) mmol/L;OGTT peak:(20.8±3.1) mmol/L vs.(10.3±2.0) mmol/L;AUC:(2658±417) mmol·min/L vs.(1324±317) mmo·min/L,P ＜0.05 or P ＜0.01].Fasting blood glucose had no differences before 12 wk and significantly increased at 12 (9.1±2.4) mmol/L and 24 wk (10.0±2.3) mmol/L in group SO (preoperative values were (8.1±1.9) mmol/L,P ＜ 0.01.There was no differences in oral glucose tolerance as shown by lower peak and area-under-the-curve (AUC) glucose values between 0 and 1 wk (P＞0.05),while the oral glucose tolerance become worse as shown by the delay of peak,higher peak (25.6±2.0) mmoL/L vs.(21.4±2.7) mmoL/l,and AUC (3422±360) mmol·min/L vs.(2667±377) mmol·min/L.Glucose values in group SO at 24 wk compared to preoperatively (P＜0.01).Rats in group A,B,C,and D had lower fasting blood-glucose and better oral glucose tolerance compared with sham-operated group through the entire follow-up period (P＜0.05 or P＜0.01).Rats in group B had lower fasting blood-glucose and better oral glucose tolerance compared to those in group A while the effect on diabetes control in group B,C and D were similar to one another (P＞0.05).Conclusion Small intestinal exclusion containing proximal gut was effective for glucose control and improving gucose tolerance,duodeno-jejunal bypass may be applicable for diabetes control in clinical setting.

Objective To evaluate the efficacy,safety and the possible mechanism of shenfu injection (SFI)in the treatment of severe acute pancreatitis(SAP).Methods A total of fifty-eiSht patients with SAP admitted to Research Institute of General Surgery of Nanjing Military Command from June 2006 to September 2008 were randomized into the conventional group(n=28)and SFI group(n=30).Patients in SFI group were treated by plus SFI(50 ml per day for 7 days)on routine treatment.The time to pain ease,bowel sound recovery times,body temperature recovery time were observed;APACHE Ⅱ score,Binder point was calculated;serum amylase,TNF-α and IL-1β were measured.The complication rate,operation rate,mortality were analyzed.Results The duration of abdominal pain,recovery of bowel sound,body temperature,and mean hospital stay days in SFI group were 95.3±2.8)d,(5.1±1.7)d,(7.1±2.4)d and(32.4±6.4)d;7 days later the APACHE Ⅱ score,Binder point was 8.63±1.33 and 6.50±1.66.respectively;the serum levels of amylase,TNF-α,and IL-1β were(1152±576)U/L,(48.7±16.4)ns/na and(199.3±53.3)ng/ml,respectively.12 episodes of severe complication occurred,operation rate was 3.33%(4/30)and the mortality rate was 0%.All the parameters were statistically significantly lower than those in the conventional group(P＜0.05 or P＜0.01).There was no adverse event related to SFI.Conclusions SFI was safe and effective for SAP,and the mechanism may be related to inhibit over-release of inflammatory medium and cytokines,and improve microcirculation.

Objective To observe therapeutical effects of gastric bypass on non-obese type 2 diabetes patients.Methods From June 2008 to April 2010,data of 47 patients with both gastric lesions and non-obese type 2 diabetes mellitus undergoing gastric bypass in the Institute of General Surgery were studied.The patients were divided into 3 groups according to the operation type:total stomach resection plus Roux-en-Y anastomosis ( n =20),partial stomach resection plus Roux-en-Y anastomosis(n =13)and Billroth Ⅱ gastrectomy(n =14).They were followed for 6 months after surgery.Level of body mass index (BMI),fasting blood glucose (FBG) and GLP-1 was measured before operation and on the 1 st week,2nd week,1 st month,3rd month,and 6th month after operation.The level of glycosylated hemoglobin was measured before operation and on the 3rd and 6th month after operation.The prognosis of the patients on the 6th month after surgery was evaluated.Results Compared with preoperative level,FBG level in all the 3 groups significantly decreased on the 1 st week after surgery and maintained a similar level during the follow-up period (P ＜ 0.01 ).GLP-1 level was elevated after operation (P ＜0.01 or P ＜ 0.05).On the 3rd and 6th month after operation,glycosylated hemoglobin level in all the 3 groups significantly decreased (P ＜ 0.01 or P ＜ 0.05 ).The change of the above parameters was greater in groups undergoing Roux-en-Y anastomosis than in Billroth Ⅱ group(P ＜ 0.05 ).The control rate of T2DM for Billroth Ⅱ,partial stomach resection plus Roux-en-Y anastomosis and total stomach resection plus Roux-en-Y anastomosis was 78.5％(11/14),100％ (13/13) and 100％ (20/20)respectively on the 6th month after surgery,indicating Roux-en-Y gastric bypass had better effect of blood glucose control than Billroth Ⅱ (P ＜ 0.05 ).Postoperative BMI decreased significantly in all groups (P ＜ 0.05) and there was no statistical difference between all the groups (P ＞ 0.05 ).Conclusions All groups of gastric bypass are effective in terms of glucose control.Roux-en-Y gastric bypass is more effective than Billroth Ⅱ on diabetes control and its therapeutic effect is independent of weight loss.