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Intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) is a special type of tumor occurring in the biliary system, with no specific clinical manifestations and imaging findings, and thus it is difficult to diagnose before surgery. It is often considered when a large amount of mucus is found in the bile duct during surgery and then it is forced to change the surgical plan. Clinicians lack an understanding of this disease due to its low incidence rate. This article reviews the recent research advances in the etiology and classification, clinical features, differential diagnosis, treatment, and prognosis of IPMN-B, so as to improve the clinical diagnosis and treatment of IPMN-B among clinicians.
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" Day surgery hospital-community joint follow-up model " results newly from the deepening implementation of the hierarchical medical system policy. It is designed to follow up the patients discharged from hospital but not fully recovered in time to ensure the prevention of adverse events after surgery. It can also improve the quality and efficiency of follow-up, and ensure the safety and integrity of the whole day operation management. In this context, through a comparative study of 720 patients discharged from daytime surgery in the region, patients in the combined follow-up group were followed up by telephone on the 3rd day after the operation by nurses from the day surgery ward. On the 10th and 20th days after the operation, the family doctor from the community health service center will visit the patient at home and follow up the patient by telephone. One month later, the patient returned to the hospital for follow-up consultation. Follow-up results show day surgery hospital-community joint mode as a helpful aid in keeping track of the patients postoperative rehabilitation, reducing complications and handling in time, while improving the ambulatory surgery perioperative safety.
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The colorectal cancer screening program was implemented in Pujiang community health service center of Minhang District of Shanghai in 2015 (before optimization) and 2016(after optimization).The screening results were compared between 2015 and 2016.In 2015 the positive rate of FOBT was 20% (4 564/22 819),and 707 subjects received further screening colonoscopy with a compliance rate of 15.49% (707/4 564).Colonoscopy detected 4 cases of colorectal cancer,30 cases of intraepithelial neoplasia,240 cases of colorectal polyps (including 167 cases of colorectal adenoma) and 6 cases of colorectal inflammatory lesions.In 2016 the positive rate of FOBT was 12.58% (2 947/23 424),817 subjects received screening colonoscopy with a compliance rate of 27.72% (817/2 947).Colonoscopy detected 5 cases of colorectal cancer,101 cases of intraepithelial neoplasia,430 cases of polyps (including 330 cases of colorectal adenoma) and 9 cases of inflammation lesions.There were no significant differences in the detection rates of colorectal cancer,inflammatory and other lesions between 2015 and 2016 (P > 0.05),the colonoscopy compliance,detection rate of intraepithelial neoplasia and polyps in 2016 were significantly higher than those in 2015 (P < 0.05).The results suggest that through various measures to optimize the implementation of the colorectal cancer screening,community health service center can improve the colonoscopy compliance in FOBT-positive subjects,the early detection rate of precancerous lesions and polyps in the community.
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Objective To investigate the clinical effects of peroral endoscopic myotomy (POEM) in the treatment of achalasia of cardia. Methods Clinical data of 27 cases who were diagnosed with achalasia of cardia recived POEM from May 2014 to March 2016 were collected retrospectively. The surgical results, before and after POEM, parameters measured by esophageal manometry and complications after POEM and during follow-up were analyzed. Results POEM were successful 100.0% in the 27 patients. There was 1 case of subcutaneous emphysema, 1 case of aeropleura symptoms were significantly improved in all patients who had successful POEM; parameters measured by esophageal manometry were also improved obviously (P < 0.05). Conclusion POEM has appreciable short-term effects in the treatment for achalasia of cardia, and it can be relieve dysphagia and other adverse symptoms in postoperation, but the long-term efficacy and complications need further follow-up observations.
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Objective To investigate the protective effect of aloe polysaccharide on experimental colitis mucosal. Methods The TNBS-induced experimental rat colitis model was successfully established and were treated by aloe polysaccharide, and enteric-coated tablets with sulfasalazine (SASP). Results DAI score, gross morphology score , histopathologic score and MPO in the model group were significantly higher than that in the normal group (P < 0.01), while those indicators were significantly lower after treatment (P < 0.01), IL-12 and IFN-γ mRNA and protein expressions in the model group were significantly higher than that in the normal group (P < 0.01), and IL-12 and IFN-γ expression levels in treatment group were significantly lower than that in the model group (P < 0.01), IL-4 and IL-13 mRNA and protein expression levels in the model group were significantly lower than that in the normal group (P < 0.01), and IL-4 and IL-13 expression in treatment group was significantly higher than that in the model group (P < 0.01). Conclusion Aloe polysaccharide on experimental colitis in rats has a good protective effect , of which mechanism may be reduced by IFN-γ and IL-12 levels, increased IL-4, IL-13 levels, and correct the imbalance of Thl/Th2.
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Traditional Tibetan medicine nature theory was the core of Tibetan medicine. This study was aimed to understand the scientific values of Tibetan medicine correctly and catch its unique advantages accurately. The history origin, nature and taste, target, effect, the relationship between diseases and Tibetan medicine and other aspects of traditional Tibetan medicine nature theory were discussed in this paper. Several points were put forward, which included the research of Tibetan medicine nature theory was the premise to maintain and develop Tibetan medicine; it was necessary to carry out literature research, definite and improve the nature theory; the data mining technology and systems biology should be applied to the theory research to elucidate the rules and scientific connotation of Tibetan medicine nature; building the model of experimental study with clinical research to determine its clinical values forward during the development of Tibetan medicine nature theory research.
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<p><b>OBJECTIVE</b>To study the characteristics of intestinal absorption of icariin and epimedin C of Xianlinggubao capsules, and compare the absorption of Xianlinggubao capsules prepared by different processes.</p><p><b>METHOD</b>Non everted gut sac method was applied to investigate the influence of absorption sites and concentration on icariin and epimedin C, which were determined by HPLC.</p><p><b>RESULT</b>The absorption rate constants of epimedin C in duodenum were absolutely more than that in jejunum and ileum (P < 0.05). The absorption rate constants of icariin in jejunum were absolutely less than that in duodenum and ileum (P < 0.05). The absorption rate constants of epimedin C and icariin kept at the same level when the concentrations of drug solution were at high, middle and low level. The Ka of epimedin C at three levels were 0.040, 0.058, 0.061 h(-1) , respectively, and the Ka of icariin at three levels were 0.002, 0.007, 0.003 h(-1), respectively.</p><p><b>CONCLUSION</b>Intestinal absorption of icariin and epimedin C is not effected by concentrations. The absorption rate constants of icariin and epimedin C in new Xianlinggubao capsules are higher.</p>
Sujets)
Animaux , Humains , Mâle , Rats , Capsules , Médicaments issus de plantes chinoises , Pharmacocinétique , Epimedium , Chimie , Flavonoïdes , Pharmacocinétique , Absorption intestinale , Intestins , Métabolisme , Modèles animaux , Rat Sprague-DawleyRésumé
<p><b>OBJECTIVE</b>To study the characteristics of intestinal absorption of psoralen and isopsoralen of Xianlinggubao capsule, and compare the absorption of Xianlinggubao capsule prepared by different technologies.</p><p><b>METHOD</b>Non everted gut sac method was applied to investigate the influence of absorption sites and drug concentration on psoralen and isopsoralen absorption, which were determined by HPLC.</p><p><b>RESULT</b>Although the absorption rate constants of psoralen and isopsoralen in duodenum were more than that in jejunum and ileum, there was no significance difference between them. The absorption rate constants of psoralen kept at the same level when the concentrations of drug solution were at middle and low level, while the absorption rate constant at high level was absolutely lower than them (P < 0.05). The results of isopsoralen were the same as psoralen's.</p><p><b>CONCLUSION</b>Intestinal absorption of psoralen and isopsoralen may be affected by the dissolution. The absorption rate constants of psoralen and isopsoralen in new Xianlinggubao capsules are higher. The absorptions of active components absorption has significant difference in different preparation processes of Xianlinggubao capsule.</p>
Sujets)
Animaux , Rats , Capsules , Pharmacocinétique , Préparation de médicament , Médicaments issus de plantes chinoises , Pharmacocinétique , Duodénum , Métabolisme , Psoralène , Pharmacocinétique , Furocoumarines , Pharmacocinétique , Iléum , Métabolisme , Absorption intestinale , Intestins , Métabolisme , Jéjunum , MétabolismeRésumé
<p><b>OBJECTIVE</b>To study the dissolution characteristics of seven active components of Xianlinggubao capsules in vitro, and compare the dissolution of Xianlinggubao capsules prepared by different processes.</p><p><b>METHOD</b>The dissolution of Xianlinggubao capsules was determined by small cup method with the rotating speed of 100 r x min(-1) and phosphate buffer (pH 6.8) as dissolution medium. The different dissolution rates in vitro of seven kinds of active components (icariin, epimedin C, asperosaponin VI, psoralen, isopsoralen, salvianolic acid B and tanshinone IIA) of Xianlinggubao capsules were investigated. The contents of active components were determined by HPLC. The accumulative dissolution percentages were calculated, and the resemblance of release curves were compared by similarity factors (f2).</p><p><b>RESULT</b>The results of determination showed that the similarity factor values (f2) of the dissolution curves of seven active components after different preparation processes were all less than 50.</p><p><b>CONCLUSION</b>There is significant difference in dissolution of active components between Xianlinggubao capsules of different preparation processes. The accumulative dissolution percentages of the active components in new Xianlinggubao capsules are higher than that of Xianlinggubao capsules.</p>
Sujets)
Capsules , Préparation de médicament , Méthodes , Médicaments issus de plantes chinoises , Chimie , SolubilitéRésumé
<p><b>OBJECTIVE</b>To establish a method to determine the dissolution of Tanshinone IIA in xianling gubao capsules, and compare the dissolution of Xianling Gubao capsules prepared by different processes.</p><p><b>METHOD</b>The small cup method was used at a rotary speed of 100 r x min(-1), the dissolubility was inspected in the following 6 mediums: (1) water; (2) 0.1 mol x L(-1) hydrochloric acid solution; (3) pH 6.8 phosphate buffer; (4) pH 6.8 phosphate buffer solution + 0.5% cholic acid; (5) pH 6.8 phosphate buffer solution + 1.0% cholic acid; (6) pH 7.6 phosphate buffer solution + 4. 0% cholic acid. A HPLC method was used to determine the dissolution samples of tanshione IIA in different dissolution mediums. The accumulative dissolution percentages were calculated, and the resemblance of release curves were compared by similarity factors (f2).</p><p><b>RESULT</b>The accumulative dissolution percentage was the highest while pH 7.6 phosphate buffer solution + 4.0% cholic acid was used as medium. The similarity factor values (f2) of tanshinone IIA dissolution curves of different preparation processes of Xianling Gubao capsules were all less than 50.</p><p><b>CONCLUSION</b>There is significant difference in tanshinone IIA dissolution between Xianling Gubao capsules of different preparation processes. The accumulative dissolution percentages of the tanshinone IIA in new Xianling Gubao capsules is higher than that in the capsules prepared by other preparation processes.</p>