Objective To investigate the effect of Qingyi Decoction enema on the toll-like recep-tor(TLR)4/nuclear factor(NF)-κB signaling pathway in patients with acute pancreatitis(AP).Methods A total of 100 patients with mild AP were selected as the study objects,and randomly di-vided into control group(n=50)and observation group(n=50).The control group received con-ventional western medicine therapy combined with ulinastatin,while the observation group was treated with Qingyi Decoction retention enema on the basis of control group.Clinical efficacy,symptom re-lief,traditional Chinese medicine syndrome scores,pancreatic function indicators,inflammatory mark-ers as well as TLR4 mRNA and NF-κB mRNA expression levels were compared between the two groups.Results The clinical effective rate in the observation group was 92.00％which was significantly higher than 76.00％in the control group(P＜0.05).The observation group had significantly shorter times for abdominal distension pain relief,first bowel movement,recovery of bowel sounds and normalization of amylase(AMS)levels compared to the control group(P＜0.05).After 10 days of treatment,both groups showed significantly lower scores for abdominal pain,tenderness,fullness,dryness,nausea,vomiting and short red urine syndrome compared to before treatment,with the observation group showing significantly lower scores than the control group(P＜0.05).After 10 days of treat-ment,serum AMS and lipase(LPS)levels were significantly lower in both groups compared to be-fore treatment,with the observation group showing significantly lower levels than the control group(P＜0.05).After 10 days of treatment,serum tumor necrosis factor(TNF)-α,triggering receptor expressed on myeloid cells(TREM)-1,microtubule-associated protein 1 light chain 3(MAP1-LC3)and intercellular adhesion molecule(ICAM)-1 levels were significantly lower in both groups com-pared to before treatment,with the observation group showing significantly lower levels than the con-trol group(P＜0.05).After 10 days of treatment,TLR4 mRNA and NF-κB mRNA expression lev-els were significantly lower in both groups compared to before treatment,with the observation group showing significantly lower levels than the control group(P＜0.05).Conclusion Qingyi Decoc-tion can effectively improve the clinical symptoms of AP patients such as abdominal pain andabdomi-nal distension,inhibit inflammatory response,and promote the recovery of pancreatic function,which may be related to the inhibition of TLR4/NF-κB signaling pathway.

Objective To study the clinical course and clinicopathological features of para-aortic lymph node metastases in patients with gallbladder cancer.Methods Forty-two patients with gallbladder cancer who underwent radical resection combined with para-aortic lymphadenectomy at the Mianyang Hospital of Traditional Chinese Medicine from January 2001 to December 2013 were retrospectively studied.The survival rates of the para-aortic lymph node metastasis group were compared with the negative para-aortic lymph node group of patients.Para-aortic lymph node metastasis as well as clinical features were correlated with survival.Results No one died within the perioperative period.The total complication rate was 24.0％,and there was no significant difference between the positive para-aortic lymph node group and the negative group (P ＞0.05).The rate of para-aortic lymph node metastasis on histopathology was 21.4％ (9/42),which was positively correlated with tumor depth of invasion and negatively correlated with the degree of differentiation (P ＜ 0.01).The 1-,2-,and 3-year survival rates of the positive para-aortic lymph node group were significantly inferior to the negative group (P ＜ 0.05).Conclusions Dissection of para-aortic lymph nodes in patients with gallbladder cancer was safe and feasible.Lymphadenectomy did not improve the longterm survival rates of patients with para-aortic lymph node involvement metastases.The extent of lymph node dissection for gallbladder cancer should be decided by intraoperative biopsy.