ObjectiveTo observe the clinical efficacy and safety of Yuyin Lidan granules （YYLD） in preventing the recurrence of common bile duct stones （CBDS） in patients with liver and gallbladder dampness-heat syndrome following endoscopic retrograde cholangiopancreatography （ERCP）. MethodsThis randomized， parallel， controlled trial enrolled postoperative CBDS-ERCP patients who met the inclusion and exclusion criteria. Sixty-four patients were randomly assigned to an observation group or a control group， with 32 cases in each. Both groups received conventional Western medical treatment after ERCP， while the observation group additionally received YYLD for 8 weeks. The follow-up period lasted for 1 year. The efficacy indicators included bile bilirubin levels， traditional Chinese medicine （TCM） syndrome scores， clinical efficacy rate， pancreatitis and inflammation markers， postoperative liver function， and CBDS recurrence rate at 1-year follow-up， which were used to jointly evaluate the clinical efficacy and safety of both groups. ResultsA total of 56 patients completed the study and were included in the final analysis， i.e.， 29 in the observation group and 27 in the control group. Baseline characteristics were comparable between the two groups. Compared with pre-treatment and with the control group after treatment， the bile bilirubin level in the observation group significantly decreased （P<0.05）. After treatment， the clinical cure and marked improvement rates were higher in the observation group than in the control group， showing a statistically significant difference in overall clinical efficacy （P<0.05）. Compared with pre-treatment， the primary and secondary symptoms in the observation group， as well as the primary symptom and the secondary symptom of nausea and vomiting in the control group （weeks 4 and 8）， were significantly reduced （P<0.05）. Compared with the control group after treatment， the observation group showed significant reductions in the primary symptom of loose stools/constipation （day 5 and week 4） and in three secondary symptoms， i.e.， bitter taste and sticky dry mouth， abdominal distension and poor appetite （throughout the treatment period）， and general heaviness and fatigue （day 5 and week 4）， with statistical differences （P<0.05）. Compared with pre-treatment， both groups showed decreased lipase and urinary amylase levels （P<0.05）. However， no significant between-group differences were observed in pancreatitis or inflammation-related indices after treatment. Compared with pre-treatment， all liver function indicators in the observation group and alanine aminotransferase （ ALT ）， γ-glutamyl transferase （ γ-GT ）， alkaline phosphatase （ALP）， and conjugated bilirubin in the control group significantly decreased at weeks 4 and 8 （P<0.05）. Compared with the control group after treatment， only serum total bilirubin and unconjugated bilirubin were significantly reduced in the observation group during the treatment period （P<0.05）. ConclusionYYLD combined with conventional Western medical treatment can effectively regulate bilirubin metabolism （in bile and serum）， improve TCM clinical symptoms， and prevent CBDS recurrence after ERCP in patients with liver and gallbladder dampness-heat syndrome. This regimen is safe and effective and is worthy of further clinical research and promotion.

Objective To investigate the anti-inflammatory effect and molecular mechanism of Chrysanthemum indicum decoction(C.indicum decoction,CID)through NF-κB signaling pathway based on RAW264.7 macrophages model induced by lipopolysaccharide(LPS).Methods MTT was used to select the appropriate concentration of CID on the activity of RAW 264.7 macrophages;Griess method and enzyme-linked immunosorbent assay(ELISA)were used to measure the release of nitric oxide(NO),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in cells treated with 50,100 and 200 μg·mL-1 CID,respectively;and the relative contents expression levels of cyclooxygenase-2(COX-2)and inducible nitric oxide synthase(iNOS)in each group were analyzed by real-time fluorescent quantitative polymerase chain reaction(Real-time PCR);the relative production of nuclear factor-kappa B p65(NF-κB p65),inhibitor kappa B(IκB-α)and phosphorylated IκB-α(p-IκB-α)in each group was observed by Western blotting(WB).Results 50-200 μg·mL-1 CID significantly decreased the relative production of NO,TNF-α,and IL-6 in RAW264.7 macrophages induced by LPS(P<0.01),down-regulated the expression of COX-2 and iNOX mRNA(P<0.01),down-regulated the relative contents of p-IκB-α,total NF-κB p65 and nuclear NF-κB p65(P<0.01),and up-regulated the relative contents of IκB-α and cytoplasmic NF-κB p65(P<0.01).Conclusion CID could effectively inhibit the release of inflammatory factors from RAW 264.7 macrophages induced by LPS,and the mechanism may be related to the inhibition of inflammation by reducing the expression of TNF-α and other key proteins and regulating the inflammatory signaling pathway such as NF-κB.

Objective:To evaluate the preventive effect of indwelling pancreatic duct guide wire through nasobiliary drainage catheter for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in cholelithiasis patients with small-caliber pancreatic duct.Methods:The clinical data of 127 patients with gall bladder and common bile duct stones undergoing ERCP and elective laparoscopic cholecystectomy in the Cholelithiasis Center of Shanghai East Hospital Affiliated to Tongji University from January 2019 to June 2023 were analyzed retrospectively, including 55 males and 72 females, aged (56.95±10.86) years old. According to the preventive methods of PEP, patients were divided into the guide wire group (indwelling pancreatic duct guide wire through nasobiliary drainage catheter), stenting group (nasobiliary catheter with 5Fr 5 cm single pigtail pancreatic duct stent) and conventional group (nasobiliary catheter). The incidence of post-ERCP hyperamylasemia (PEH) and PEP were compared.Results:The incidence of PEH in the guide wire group was lower than that in the conventional group [17.8% (8/45) vs. 43.5% (10/23), P=0.023], and also lower than that in the stenting group [17.8% (8/45) vs. 32.2% (19/59)], despite no statistical significance ( P=0.337). The incidences of PEH were comparable in the stenting group and conventional group [32.2% (19/59) vs. 43.5% (10/23), P=0.096)]. The incidence of PEP in the guide wire group was lower than that in both the stenting group [6.7% (3/45) vs. 23.7% (14/59), P=0.030]. and conventional group [6.7% (3/45) vs. 30.4% (7/23), P=0.025]. The incidences of PEP were comparable in the stenting and conventional group [23.7% (14/59) vs. 30.4% (7/23), P=0.532]. Conclusion:Compared to the preventive pancreatic duct stenting, indwelling pancreatic duct guide wire through nasobiliary drainage catheter can effectively prevent the PEH and PEP in high-risk patients with a small-caliber pancreatic duct.

Objective:To study the feasibility and safety of percutaneous jejunal drainage in treatment of hepatolithiasis after choledochojejunostomy.Methods:The clinical data of 24 patients with hepatolithiasis after choledochojejunostomy treated by percutaneous jejunal drainage at the Cholelithiasis Center, Shanghai East Hospital Affiliated to Tongji University from May 2021 to May 2022 were retrospectively analyzed. There were 16 males and 8 females, aged (50.46±10.89) years old. Ultrasound and X ray guided percutaneous jejunography was performed under local anesthesia for patients with hepatolithiasis after choledochojejunostomy. Then the fistula was directly dilated to 16.0Fr, and percutaneous jejunal choledochoscopy was performed 3 days later. The success rate, complication rate and stone removal rate were analysed.Results:Twenty-four patients were treated with percutaneous jejunography, with a success rate of 79.2%(19/24), including 19 patients after anterior colonic cholangiojejunostomy with a success rate of 94.7%(18/19), and 5 patients after retrocolonic cholangiojejunostomy with a success rate of 20.0%(1/5). There was no complication including bleeding, intestinal leakage and bile leakage. In 19 patients with successful percutaneous jejunography, the success rate of fistula dilation was 100%(19/19), and there was no complication. Five patients with failed percutaneous jejunography underwent open choledocholithotomy through the jejunal output-loop, and bile leakage occurred in one patient. Thirteen patients with anastomotic stenosis, 5 with intrahepatic biliary strictures, and 6 with anastomotic and intrahepatic biliary strictures were diagnosed by choledochoscopy and selective cholangiography in these 24 patients. After choledochoscopic electrotomy, cylindrical balloon dilation, stone removal, stenting and other treatments, the stenosis relief rate was 100%(24/24), and the clearance rate of intrahepatic bile duct stones was 91.7%(22/24).Conclusion:Percutaneous jejunal drainage was a feasible, safe and minimally invasive method for treatment of hepatolithiasis after choledochojejunostomy. The procedure was especially suitable for patients with anterior colonic cholangiojejunostomy.

OBJECTIVETo investigate the effects of baicalin against Candida albicans germ tube formation, and adherence to buccal epitherial and vaginal epitherial cells.

METHODVarious concentrations of baicalin (100, 50, 10 mg x L(-1)) were incubated with C. albicans suspension, the mixed suspension of C. albicans and human buccal epitherial cells, the mixed suspension of C. albicans and vaginal epitherial cells, respectively. The effects of baicalin on C. albicans germ tube formation, and adherence to buccal epitherial and vaginal epitherial cells were then assessed microscopically.

RESULTAll concentrations of baicalin could inhibit C. albicans germ tube formation, and adherent to buccal epitherial and vaginal epitherial cells,while there was no significant difference between standard and clinical strains.

CONCLUSIONBaicalin could inhibit C. albicans germ tube formation, and adherence to buccal epitherial and vaginal epitherial cells.

Adult ; Anti-Infective Agents ; pharmacology ; Candida albicans ; drug effects ; growth & development ; physiology ; Candidiasis ; drug therapy ; microbiology ; Cheek ; microbiology ; Epithelial Cells ; microbiology ; Female ; Flavonoids ; pharmacology ; Humans ; Mouth Mucosa ; microbiology ; Vagina ; microbiology ; Young Adult