OBJECTIVE： To screen active fractions of Xiaozhong zhitong lotion that are able to reduce swelling， promote ulcer healing and analgesia， and to provide reference for it’s secondary development of ointment preparation. METHODS： Water elution fraction and 20％， 40％， 60％， 95％ ethanol elution parts were separated by D101 macroporous resin from Xiaozhong zhitong lotion. 120 SD rats were randomly divided into normal group （n＝8） and modeling group （n＝112）. Rats in the normal group were not treated. Hemorrhoids model was established in the model group by injecting 75％ glacial acetic acid into the perianal skin to induce perianal ulcer. 96 model rats were randomly divided into model group [blank ointment matrix 0.51 g/（kg·d）]， positive group [Mayinglong ointment， 0.51 g/（kg·d）]， high-dose and low-dose groups of Xiaozhong zhitong lotion and it’s water elution fraction and 20％， 40％， 60％ ethanol elution parts [8.34， 2.78 g/（kg·d） by crude drug， all make into containing drug ointment]， with 8 rats in each group. The periphery of the anus was smeared with relevant medicine， twice a day， for consecutive 7 d. The local symptoms around the anus of rats 3 and 7 days after administration and the pathological morphology of the local mucosa around the anus of rats 7 days after administration were observed and scored respectively. The effects of each elution part for reducing swelling and promoting ulcer healing were investigated. 120 ICR mice were randomly divided into model group [blank ointment matrix 1.03 g/（kg·d）]， positive group [Mayinglong ointment 1.03 g/（kg·d）]， high-dose and low-dose groups of Xiaozhong zhitong lotion and it’s each elution part [16.65， 5.55 g/（kg·d） by crude drug， all make into containing drug ointment]， with 10 mice in each group. Transdermal administration， twice a day， for consecutive 7 d. After 30 min of last administration， the latency time and 15 min writhing times of mice were detected by designing acetic acid writhing test； pain threshold of mice was determined by hot-plate pain test so as to investigate systemic and local analgesic effects of each elution part. RESULTS： In the detumescence and ulcer healing test， compared with normal group， the score of local symptoms around anus at 3rd and 7th day of administration as well as pathological score of hemorrhoids local mucosa were increased significantly in model group （P＜0.01）. Compared with model group， above scores of positive group， 40％ ethanol elution high-dose and low-dose groups were decreased significantly （P＜0.05 or P＜0.01）. The scores of local symptoms around anus in 20％ ethanol elution part high-dose group at 3rd and 7th day after medication as well as 60％ ethanol elution part group at 7th day after medication were decreased significantly （P＜0.05）. In analgesia test， compared with model group， writhing latency time was shortened significantly and 15 min writhing times was decreased significantly in positive group， 40％ ethanol elution part high-dose and low-dose groups as weel as 60％ ethanol elution part high-dose group （P＜0.05 or P＜0.01）； writhing latency time of 20％ ethanol elution part high-dose group was shortened significantly （P＜0.05）. Pain threshold of mice was increased significantly in positive group， 40％ ethanol elution part high-dose and low-dose groups after medication （P＜0.05 or P＜0.01）. CONCLUSIONS： The 40％ ethanol elution part from Xiaozhong zhitong lotion is the effective part that can reduce swelling， promote ulcer healing and analgesia.

Objective: To explore the clinical application value of enhanced recovery after surgery (ERAS) in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis. Methods: The prospective study was conducted. The clinicopathological data of 52 patients with cholecystolithiasis comorbid with choledocholithiasis who were admitted to the Third Affiliated Hospital of Zunyi Medical University from September 2016 to September 2018 were collected. Patients were divided into 2 groups by random number table: patients in observation group received laparoscopic cholecystectomy + choledocholithotomy + choledochoscopic exploration + T-tube drainage (or primary suture of common bile duct) and perioperative management guided by the concept of enhanced recovery after surgery (ERAS), and patients in control group received traditional perioperative management. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) postoperative complications; (4) postoperative pain scores; (5) changes in hepatic function and blood routine during perioperative period. Follow-up using outpatient examination and telephone interview was performed to detect complications during the postoperative 6 months up to March 2019. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the paired t test or repeated ANOVA. Count data were described as absolute numbers and percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results: Fifty-two patients were screened for eligibility, including 20 males and 32 females, aged 25-68 years, with an average age of 53 years. There were 30 patients in the observation group and 22 in the control group. (1) Surgical situations: the operation time and volume of intraoperative blood loss were (133±19)minutes and (47±21)mL in the observation group, and (136±22)minutes and (49±23)mL in the control group, respectively, showing no significant difference between the two groups (t=-0.386, -0.211, P>0.05). (2) Postoperative situations: time to out-of-bed activity, time to initial food intake, time to first anal flatus, duration of postoperative hospital stay, and hospital expenses were (18±4)hours, (19±5)hours, (28±2)hours, (4.0±1.0)days, and (1.82±0.22)×10⁴ yuan in the observation group, and (29±7)hours, (46±9)hours, (37±4)hours, (6.6±1.6)days, and (2.25±0.29)×10⁴ yuan in the control group, respectively, showing significant differences between the two groups (t=-7.054, -14.169, -9.426, -6.582, -5.809, P<0.05). (3) Postoperative complications: 1 of 30 patients in the observation group had postoperative biliary leakage, with a postoperative complication rate of 3.3%, and was cured after symptomatic support treatment. Six of 22 patients in the control group had postoperative complication, with a postoperative complication rate of 27.3%, including 2 of biliary leakage, 1 of hemorrhage, 1 of abdominal infection, 1 of pulmonary infection, 1 of urinary infection, and they were cured after symptomatic support treatment. There was a significant difference between the two groups (χ²=4.358, P<0.05). (4) Postoperative pain scores: from postoperative 6 hours to 48 hours, the postoperative pain score changed from 2.4±0.7 to 1.9±0.9 in the observation group, and from 4.1±0.7 to 2.9±0.9 in the control group, respectively, showing a significant difference in the changing trend between the two groups (F=78.053, P<0.05). (5) Changes in hepatic function and blood routine during perioperative period: from preoperation to postoperative 3 days, levels of alamine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT), total bilirubin (TBil), and count of white blood cells in the observation group changed from (77±20)U/L to (53±12)U/L, from (85±22)U/L to (61±17)U/L, from (166±39)U/L to (55±24)U/L, from (40±13)μmol/L to (29±12)μmol/L, from (7.0±2.0)×10⁹/L to (6.8±1.9)×10⁹/L, and changed from (79±23)U/L to (62±14)U/L, from (88±24)U/L to (64±17)U/L, from (179±34)U/L to (74±29)U/L, from (45±13)μmol/L to (35±12)μmol/L, from (7.9±2.4)×10⁹/L to (7.5±1.9)×10⁹/L in the control group, respectively. The levels of ALT, AST, GGT, TBiL, and count of WBC showed increasing at postoperative 1 day, and decreasing at postoperative 3 days. There was no significant difference in the changing trend between the two groups (F=0.058, 0.471, 3.021, 1.593, 2.172, P>0.05). Conclusion ERAS is safe and effective in the laparoscopic surgery for choledocholithiasis comorbid with cholecystolithiasis.

Objective To analyze of the efficacy of minimally invasive surgery combined with medication in the treatment of ureteral calculi.Methods From June 2013 to June 2015,124 patients with ureteral calculi which confirmed by X-ray in our hospital were collected as subjects.According to the treatment method,they were divided into control group and observation group,patients in the control group were treated with simple medication,while the observation group were treated with minimally invasive surgery combined with drug therapy.The effects of treatment and the levels of MCP-1,TFF1 and HMGB1 in urine between two groups were compared.Results The stone expulsion rate and the net rate of the observation group was higher than those of the control group,the differences were significant(P<0.05).The stone expulsion time of observation group was shorter than that of the control group,the formation rate of the observation group was lower than that of the control group,the differences were significant(P<0.05).Adverse reactions occurred in 11 cases of the observation group,in 29 cases of the control group,the incidence of adverse reactions in the observation group was lower than that in the control group,the difference was significant(P<0.05).After the treatment,17 cases of adverse drug reactions occurred in the observation group,which was more than 5 cases of adverse drug reactions in the control group,the difference was significant(P<0.05).After treatment,the levels of MCP-1 and HMGB1 in urine of two groups were decreased compared with those before treatment,the level of TFF1 was increased,the differences were significant(P<0.05);while the levels of MCP-1 and HMGB1 of the observation group after treatment were lower than those of the control group,the level of TFF1 was higher than that of the control group,the difference was significant(P<0.05).The effective rate of the observation group was 88.71％,which higher than 69.35％ of the control group,the difference was significant(P<0.05).Conclusion On the basis of medication,combined with extracorporeal shock wave lithotripsy for ureteral calculi can not only improve the therapeutic effect,but also reduce the risk of adverse reactions.

OBJECTIVETo investigate the effect of formaldehyde exposure on the expression of inflammatory cytokines in human bronchial epithelial cells (16HBE cells).

METHODS16HBE cells were treated with formaldehyde with a concentration of 0, 0.04, 0.08, 0.16, 0.32, or 0.64 mmol/L for 24 hours, and MTT assay was applied to measure proliferative activity and calculate median lethal dose; 16HBE cells were exposed to formaldehyde with a concentration of 0, 0.04, 0.16, 0.64, or 1.20 mmol/L for 4 hours, MTT assay was applied to measure proliferative activity, and enzyme-linked immunosorbent assay was applied to measure the levels of Th1, Th2, and Th17 cytokines and tumor necrosis factor α(TNF-α) in cell supernatant.

RESULTSCompared with the control group, the 0.32-and 0.64-mmol/L exposure groups had significant decreases in cell viability (P<0.05); all exposure groups had reductions in interleukin(IL)-2 and IL-12, but no significant changes in interferon-γ and IL-10. In the 1.20-mmol/L exposure group, there was an increase in IL-4, with the increasing exposure dose, IL-5 and IL-6 tended to increase first and then decrease, and there was no significant change in IL-13; with the increasing exposure dose, IL-8 tended to increase first and then decrease, and there was no significant change in IL-17. In all the exposure groups, TNF-α increased and tended to increase significantly with the increasing exposure dose(P<0.05).

CONCLUSIONFormaldehyde exposure can cause imbalance between Th1 and Th2 cytokines secreted by 16HBE cells, as well as increased expression of IL-8 and TNF-α.

Cells, Cultured ; Cytokines ; metabolism ; Epithelial Cells ; drug effects ; metabolism ; Formaldehyde ; adverse effects ; Humans ; Interferon-gamma ; metabolism ; Interleukins ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To evaluate the value of CT and MRIin diagnosis of littoral cell angioma(LCA) of spleen.Methods CT and MRI findings the data of 6 patients with LCA were rospectively analyzed,and all patients were proved LCA of spleen by pathology.Then enhanced CT (n =4 cases) and MRI (n =2 cases) were performed.The imaging performance of LCA was observed,and its imaging features was summarized.Results None of patients showed obvious signs and symptoms of hypersplenism,4 cases were with splenomegaly.5 patients had a single lesion,only one had few lesions.There were not any calcification or envelopement of all the lesions.On CT,all lesions demonstrated distinct borders.The enhanced scan for low-density nodules demonstrated slow progressive enhancement.On MRI,all the LAC had well circumscribed borders,and demonstrated T1 · hypointense and T2-equal,hyperintense signals,and progressive enhancement on the post contrast images.Conclusion CT and MRI imaging of littoral cell angioma of spleen have special imaging characteristics,those particular findings is helpful in the diagnosis.

To propose an equipment and technology package for oxygen preparation and supply under hypoxia conditions in order to meet the requirements of populations on the plateau .Different populations were analyzed in terms of their oxygen supply requirements, and the modes, schemes and equipment for oxygen supply were explored accordingly and then applied.Efforts in the past 20 years have resulted in the advances in the equipment for centralized, mobile and portable oxygen preparation and supply, though the equipment for individual use hads to be improved and the diffused oxygen supply scheme also needs to be further evaluated .

Objective To investigate the application of three stages enhanced scan of multi-slice spiral CT for the characteristic analysis on the wall and lumen of colorectal mucous adenocarcinoma.Methods 51 patients with colorectal mucinous adenocarcinoma who had complete pathologic diagnosis were studied.GE Discovery CT 750HD scanner was used for line scan,arterial and portal venous phase scan,and delayed scan.The lesions of intestinal wall,enteric cavity and proximal normal lumen were observed by line scan and enhanced scan,and the related quantitative value and CT value were observed.Results The intestinal wall was uneven annular thickening or hemispherical thickening.The thickening intestinal wall showed lobular changes around the inner margin,outer margin,or without lobular changes.The hierarchical sign and cystoids sign were observed with three layers or two layers structure after enhanced scan.Metastases of the larger lymph node,liver,ovaries were characterized similar to cyst.According to the form,the stenosis was divided into natural streamlined,irregular fixed,and irregular constrictive types.The proximal normal intestinal canal of the lesion showed occlusion,mild expansion or severe expansion.Conclusions Walls of colorectal mucous adenocarcinoma was uneven annular thickening or hemispherical thickening,in which calcification was found,and there was features of similar to layer and cyst after enhancement.The stiff intestinal wall appeared less,and the proximal bowel obstruction was rare.Therefore,depend on these characteristics,the diagnosis of colorectal mucous adenocarcinoma can be achieved.

The cross-disciplinary form-function joint teaching of nervous system centered on organ was carried out in the Second Military Medical University for medical students of the eight-year system according to its actual situation.The nervous system was selected as the teaching content and problem-based learning was used,with the fusion of three aspects of knowledge of histology and embryology,physiology and human anatomy and the integration of teachers from different disciplinarians.The effect was good.

Objective To evaluate the diagnosis value of spiral CT in leiomyosarcoma of abdomen.Methods Both plain and enhanced CT fingdings in 12 cases with pathologic-proved leiomyosarcoma of abdomen were respectively analyzed.Results In all of 12 cases,1 case occurred in colon,1 case in rectum,1 case in small intestine,5 cases in mesentery,4 cases in retroperitoneum,CT positioning accuracy rate was 91.7 ％ (11/12).The volume was comparatively large,the average diameter was 6 cm.The density were uneven,nodosity or lamellar necrosis were found.Delay enhacement were occurred in lower density part in most part of cases (9/12).Conclusion The localization of spiral CT is comparatively accurate to the leiomyosarcoma of abdomen,some characteristics are found in CT image,but the final diagnosis depends on immunohistochemistry.

Objective To investigate CT feature after contrast-enhanced and anatomic distribute of the whole body lymph nodes involved by lymphoma. Methods The whole body CT findings in 89 cases (HL 12 cases, NHL 77 cases) of malignant lymphoma were retrospectively analyzed. The contrast-enhanced CT features (size, density and the digree of contrast enhancement) and anatomic distribution of the whole body lymph nodes involved by lymphoma were clarified. Results In the HL group, Diffuse and homogeneous enhancement of the enlarged lymph nodes was found in 9 cases (75.0 %), while homogeneous enhancement of the enlarged lymph nodes with some little necrosis was found in 3 cases (25.0 %). In the NHL group, diffuse and homogeneous enhancement of the enlarged lymph nodes was found in 64 cases (83.1 %), while homogeneous enhancement of the enlarged lymph nodes with some little necrosis was found in 13 cases (16.9 %). There was not statistically significant (Fisher exact probability, P = 0.4461) between the two groups. In the HL group, the enlarged lymph nodes were mixed together in 6 cases (50.0 %), while the enlarged lymph nodes were separate in 6 cases (50.0 %). In the NHL group, the enlarged lymph nodes were mixed together in 8 cases (10.4 %), while the enlarged lymph nodes were separate in 69 cases (89.6 %), there was statistically significant (Fisher exact probability, P = 0.0028). The dominant anatomic distributions of the lymph nodes involved by HL group were neck and mediastinum. The dominant anatomic distributions of the lymph nodes involved by NHL group were neck, mediastinum and abdomen, there was not statistically significant between the anatomic distributions (Fisher exact probability, P =0.110). Conclusion CT can easily demonstrate the involvement and extension of malignant involving the whole body, but CT can not differentiate HL and NHL except for the confluence state.