Clinical characteristics of choledocholithiasis combined with periampullary diverticulum and influencing factor analysis for difficult cannulation of endoscopic retrograde cholangiopan-creatography: a report of 1 920 cases / 中华消化外科杂志

Objective:To investigate the clinical characteristics of choledocholithiasis com-bined with periampullary diverticulum and influencing factor for difficult cannulation of endoscopic retrograde cholangiopancreatography (ERCP).Methods:The retrospective case-control study was conducted. The clinical data of 1 920 patients who underwent ERCP for choledocholithiasis in 15 medical centers, including the First Hospital of Lanzhou University, et al, from July 2015 to December 2017 were collected. There were 915 males and 1 005 females, aged (63±16)years. Of 1 920 patients, there were 228 cases with periampullary diverticulum and 1 692 cases without periampullary diverticulum. Observation indicators: (1) clinical characteristics of patients with choledocholithiasis; (2) intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis; (3) influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Clinical characteristics of patients with choledocholithiasis. Age, body mass index, cases with complications as chronic obstructive pulmonary disease, diameter of common bile duct, cases with diameter of common bile duct as <8 mm, 8?12 mm, >12 mm, diameter of stone, cases with number of stones as single and multiple were (69±12)years, (23.3±3.0)kg/m 2, 16, (14±4)mm, 11, 95, 122, (12±4)mm, 89, 139 in patients with choledocholithiasis combined with periampullary diverticulum, versus (62±16)years, (23.8±2.8)kg/m 2, 67, (12±4)mm, 159, 892, 641, (10±4)mm, 817, 875 in patients with choledocholithiasis not combined with periampullary diver-ticulum, showing significant differences in the above indicators between the two groups ( t=?7.55, 2.45, χ2=4.54, t=?4.92, Z=4.66, t=?7.31, χ2=6.90, P<0.05). (2) Intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis. The balloon expansion diameter, cases with intraoperative bleeding, cases with hemorrhage management of submucosal injection, hemostatic clip, spray hemostasis, electrocoagulation hemostasis and other treatment, cases with endoscopic plastic stent placement, cases with endoscopic nasal bile duct drainage, cases with mechanical lithotripsy, cases with stone complete clearing, cases with difficult cannulation, cases with delayed intubation, cases undergoing >5 times of cannulation attempts, cannulation time, X-ray exposure time, operation time were 10.0(range, 8.5?12.0)mm, 56, 6, 5, 43, 1, 1, 52, 177, 67, 201, 74, 38, 74, (7.4±3.1)minutes, (6±3)minutes, (46±19)minutes in patients with choledocholithiasis combined with periampullary diverticulum, versus 9.0(range, 8.0?11.0)mm, 243, 35, 14, 109, 73, 12, 230, 1 457, 167, 1 565, 395, 171, 395, (6.6±2.9)minutes, (6±5)minutes, (41±17)minutes in patients with choledocholithiasis not combined with periampullary diverticulum, showing significant differences in the above indicators between the two groups ( Z=6.31, χ2=15.90, 26.02, 13.61, 11.40, 71.51, 5.12, 9.04, 8.92, 9.04, t=?3.89, 2.67, ?3.61, P<0.05). (3) Influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Results of multivariate analysis showed total bilirubin >30 umol/L, number of stones >1, combined with periampullary diverticulum were indepen-dent risk factors for difficult cannulation in patients with periampullary diverticulum who underwent ERCP for choledocholithiasis ( odds ratio=1.31, 1.48, 1.44, 95% confidence interval as 1.06?1.61, 1.20?1.84, 1.06?1.95, P<0.05). Results of further analysis showed that, of 1 920 patients undergoing ERCP for choledocholithiasis, the incidence of postoperative pancreatitis was 17.271%(81/469) and 8.132%(118/1 451) in the 469 cases with difficult cannulation and 1 451 cases without difficult cannula-tion, respectively, showing a significant difference between them ( χ2=31.86, P<0.05). In the 1 692 patients with choledocholithiasis not combined with periampullary diverticulum, the incidence of postopera-tive pancreatitis was 17.722%(70/395) and 8.250%(107/1 297) in 395 cases with difficult cannula-tion and 1 297 cases without difficult cannulation, respectively, showing a significant difference between them ( χ2=29.00, P<0.05). In the 228 patients with choledocholithiasis combined with peri-ampullary diverticulum, the incidence of postoperative pancreatitis was 14.865%(11/74) and 7.143%(11/154) in 74 cases with difficult cannulation and 154 cases without difficult cannulation, respectively, showing no significant difference between them ( χ2=3.42, P>0.05). Conclusions:Compared with patients with choledocholithiasis not combined with periampullary divertioulum, periampullary divertioulum often occurs in choledocholithiasis patients of elderly and low body mass index. The proportion of chronic obstructive pulmonary disease is high in choledocholithiasis patients with periampullary diverticulum, and the diameter of stone is large, the number of stone is more in these patients. Combined with periampullary diverticulum will increase the difficult of cannulation and the ratio of patient with mechanical lithotripsy, and reduce the ratio of patient with stone complete clearing without increasing postoperative complications of choledocholithiasis patients undergoing ERCP. Total bilirubin >30 μmol/L, number of stones >1, combined with periampullary diverticulum are independent risk factors for difficult cannulation in patients of periampullary diverticulum who underwent ERCP for choledocholithiasis.

Clinical efficacy of short-term deep sedation after decompressive craniectomy with hematoma removal in patients with hypertensive intracerebral hemorrhage / 中国基层医药

Objective:To investigate the efficacy and safety of short-term deep sedation after conventional decompressive craniotomy with hematoma removal in patients with hypertensive intracerebral hemorrhage.Methods:Sixty patients with hypertensive intracerebral hemorrhage who underwent conventional decompressive craniotomy with hematoma removal in the People′s Hospital of Yueqing, China between March 2018 and May 2019 were included in this study. They were randomly divided into deep sedation and light sedation groups ( n = 30/group). The deep sedation group was administered propofol (0.6-1.2 mg/kg/h) combined with sedate fentanyl to achieve the level of sedation to Richmond Agitation-Sedation Scale (RASS) -3 to -4 points and to the level of pain to Critical Care Pain Observation Tool (CPOT) 0-1 point. The duration of sedation and analgesia was for 48 hours. The light sedation group was administered propofol (0.2-0.5 mg/kg/h) combined with sedate fentanyl to achieve the level of sedation to RASS -1 to -2 points and to the level of pain to CPOT 0-1 point. The duration of sedation and analgesia was rehemorrhage for 48 hours. Patients in the two groups were intravenously administered Urapidil to control blood pressure to be 120-160/60-90 mmHg. In addition, all patients were subjected to mechanical ventilation, dehydration, reduction of intracranial pressure, anti-infection and symptomatic treatment. At 0, 6, 12, 24 and 48 hours after surgery, heart rate, mean arterial pressure, intracranial pressure, recurrence of hemorrhage, ventilator-associated pneumonia, lower extremity deep venous thrombosis, and gastrointestinal bleeding were monitored. Results:At 6, 12, 24 and 48 hours after surgery, the heart rate, mean arterial pressure, and intracranial pressure in the deep sedation group were significantly lower than those in the light sedation group ( P < 0.05 or P < 0.01). The recurrence of rehemorrhage and the incidence of gastrointestinal bleeding in the deep sedation group were 3.33% (1/30) and 6.67% (2/30), respectively, which were significantly lower than those in the light sedation group [10.00% (3/30), 20.00% (6/30), χ2 = 1.071, 2.307, both P < 0.05). There were no significant incidences in ventilator-associated pneumonia [30.00% (9/30) vs. 23.30% (7/30), χ2 = 0.340, P > 0.05] and lower extremity deep venous thrombosis [10.00% (3/30) vs. 6.67% (2/30), χ2 = 0.340, P > 0.05]. Conclusion:Short-term deep sedation after conventional decompressive craniotomy with hematoma removal can lower the heart beat, mean arterial pressure, intracranial pressure, the postoperative recurrence of hemorrhage, and the incidence of gastrointestinal bleeding in patients with hypertensive cerebral hemorrhage.

Clinical observation of Danzhi Sangqin decoction in the treatment of premenstrual acne with liver and lung stagnation / 中国基层医药

Objective:To observe the clinical efficacy of Danzhi Sangqin decoction in the treatment of premenstrual acne with liver and lung stagnation.Methods:Sixty patients with liver and lung stagnation premenstrual acne diagnosed and treated in the Department of Dermatology of Shaoxing Central Hospital from July 2016 to November 2018 were selected in the research.They were divided into the control group( n=28) and treatment group( n=32) by random number table method.The treatment group was treated with self-made Danzhi Sangqin decoction, and the control group was orally treated with isotretinoin capsules and vitamin B6.The two groups were treated for 1 week.The clinical efficacy and the incidence of adverse reactions were compared between the two groups. Results:In the treatment group, 18 cases were markedly effective, 11 cases were effective, and 3 cases were ineffective, and the total effective rate was 90.6%(29/32). In the control group, 16 cases were significantly effective, 10 cases were effective, and 2 cases were ineffective, and the total effective rate was 92.9%(26/28). There was no statistically significant difference in the total effective rate between the two groups( P>0.05). The incidence of adverse reactions in the treatment group was 3.1%(1/32), which was significantly lower than that in the control group [21.4%(6/28)], the difference was statistically significant(χ 2=6.281, P<0.05). Conclusion:The clinical efficacy of Danzhi Sangqin decoction in the treatment of premenstrual acne with liver and lung stagnation is similar to that of isotretinoin capsules, but the incidence of adverse reactions is low.

Problem exploration and measures on the investigator initiated trial from the perspective of scientific research supervision / 中华医学科研管理杂志

Objective By analyzing the problems existed in the Investigator Initiated Trial (IIT),this article put forward the corresponding countermeasures and therefore provides reference for the standardization of clinical research project management.Methods Four types of problems identified in the supervision of hospital IIT projects are analyzed according to literature review,data analysis of clinical research project,comparative study and summary.Identified problems are existed in the following aspects:scientific research supervision function,research method guidelines,technical specification of the diagnosis and treatment,scientific research design and project approval review,research funds,medical ethics committee,construction of Biobank and Regulation Conflicts.Results This article put forward 6 countermeasures for improvement:establishing and perfect IIT project scientific research supervision entity,bring in the IIT project steering group to strengthen the scientific review;Strengthen risk management to ensure medical safety,carry out IIT training,establish IIT management database information system,build a comprehensive integrated development multi-point application model of hospital BioBank.Conclusions The establishment of the hospital's IIT scientific research supervision system,management mode and technical standard system is of great importance to standardize clinical research,ensure research quality and guide the clinical research work of the hospital effectively.

Safety and effectiveness of ERCP for patients with decompensated cirrhosis combined with choledocholithiasis / 中华消化内镜杂志

Objective To evaluate safety and effectiveness of endoscopic retrograde cholangiopancreatography ( ERCP ) for patients with decompensated cirrhosis combined with choledocholithiasis. Methods A retrospective analysis was performed on data of 79 patients with decompensated cirrhosis combined with choledocholithiasis, 92 patients with chronic viral hepatitis, and 114 patients without liver disease who underwent ERCP at the First Hospital of Lanzhou University from December 2012 to December 2016. Intraoperative operating conditions, postoperative improvement of liver function indices, and complications among the three groups were compared and analyzed. Results The level of serum prothrombin time before ERCP in patients with cirrhosis (12. 9±2. 2) s was higher than that in patients with chronic viral hepatitis (12. 1±1. 9) s and those without liver disease (11. 7±1. 4) s, the difference was statistically significant ( F=21. 530, P<0. 001) . Operating time in patients with cirrhosis was longer than that of two other groups ( 58. 58 ± 19. 40 min VS 52. 53 ± 16. 74 min VS 49. 81 ± 14. 82 min, F=6. 444, P = 0. 002 ) . In patients with cirrhosis, postoperative liver function indices of aspartate aminotransferase ( 66. 0 IU/L VS 53. 0 IU/L) , alanine aminotransferase ( 61. 0 IU/L VS 52. 0 IU/L) ,γ-glutamyltransferase ( 318. 0 IU/L VS 231. 0 IU/L ) , alkaline phosphatase ( 232. 0 μmol/L VS 210. 0 μmol/L) , and total bilirubin ( 65. 7 μmol/L VS 56. 3 μmol/L ) were all lower compared with preoperative ones ( all P<0. 05) . No perforation or death occurred in the three groups. There were 3 cases ( 3. 8％) of mild bleeding at duodenal papilla after endoscopic sphincteropapillotomy in cirrhosis patients, i.e., 2 cases of Child-Pugh C and 1 case of Child-Pugh B. Errhysis occurred in one case ( 1. 27％) of Child-Pugh C patient at lower esophagus varices. There were no statistical differences on incidences of complications among the three groups ( P>0. 05) . Conclusion ERCP is safe and effective for Child-Pugh A and B patients with decompensated cirrhosis combined with choledocholithiasis. Liver function and blood coagulation function should be improved in Child-Pugh C patients before ERCP.

Treatment progress of approach in thyroidectomy / 中国基层医药

The study is aim to explore the value of surgical approach and related treatment in thyroid nodule.We searched Pubmed and CNKI by setting keywords "thyroid operation" from January 2006 to date,a total of 90 literatures were retrieved.Inclusion criteria were as follows:variety surgical treatment of thyroid nodule;methods and effects of integrative medicine of thyroid disease.39 studies met the inclusion criteria.Different surgical treatments of thyroid nodule had advantages and disadvantages and should be selected according to the specific condition of the patients.Priority should be given more effective,less invasive,less painful,more beautiful and low-cost surgery.The depth study of features of surgical treatment of thyroid nodule will help provide a better reference for clinical treatment.

Early endoscopic pancreatic and (or) biliary stents combined with Qingyi granules in treatment of acute biliary pancreatitis / 中华内分泌外科杂志

Objective To investigate the early (within 72 hours) application and effect of endoscopic pancreatic and (or) biliary stents combined with Qingyi granules in treatment of acute biliary pancreatitis (ABP) patients.Methods A retrospective analysis was done to the 245 patients admitted for ABP from Jan.2012 to Jan.2016 in the First Hospital of Lanzhou University.133 patients (group A) were treated within 72 hours by endoscopic pancreatic and (or) biliary stents combined with Qingyi granules through feeding tube.112 patients (group B) were treated by endoscopic pancreatic and (or) biliary stents and feeding tube without Qingyi granules.Then the study was done to compare the difference of recover days of abdominal distension,abdominal pain,normalization time of amylase and WBC,length of stay,decrease level of PCT,and the incidence of ABP complications.Results Group A was superior to group B in terms of the recover days of abdominal distension (3.8±3.2)d vs (5.2± 2.4)d,abdominal pain (2.6±2.1)d vs (4.9±2.7)d,normalization time of amylase(2.8±1.6)d vs (4.4±3.7)d,WBC (2.6±1.3)d vs (4.1± 2.7)d,length of stay(9.4±2.1)d vs (12.6±3.3)d and postoperative PCT level(2.59±2.33)ng/ml vs (3.98±3.03)ng/ml,and the difference had statistical significance (P＜0.05),while there was no significant difference between the two groups in the incidence of ABP complications.Conclusions For ABP patients,early placement of endoscopic pancreatic and (or) biliary duct stents combined with Qingyi granules through feeding tube can remove the etiology,and block the disease from further progress.Early enteral nutrition can contribute to the recovery of intestinal mucosa and the maintenance of internal environment.Combined with Qingyi granules,it can relief the symptoms,decrease the laboratory index and shorten the hospitalization time.

Efficacy of endoscopy for the treatment of benign biliary stricture after biliary surgery / 中华消化外科杂志

Objective To investigate the efficacy of endoscopy for the treatment of benign biliary stricture after biliary surgery.Methods The clinical data of 127 patients with benign biliary stricture after biliary surgery at the First Hospital of Lanzhou University from January 2007 to December 2011 were retrospectively analyzed.According to the Bismuth classification,there were 60 patients with type Ⅰ,35 with type Ⅱ,21 with type Ⅲ and 11 with type Ⅳ.The efficacies of endoscopy for the treatment of biliary stricture with different Bismuth subtypes were analyzed.Results The location and severity of biliary stricture were confirmed by endoscopic retrograde cholangiopancreatography (ERCP) + cholangiography.Sixteen patients ( including 7 with type Ⅲ and 9 with type Ⅳ) were transferred to surgical treatment due to severe biliary stricture.A total of 111 patients underwent endoscopic treatment successfully,with the success rate of 87.4％ (111/127).The success rates of endoscopy for the treatment of patients with Bismuth Ⅰ,Ⅱ,Ⅲ and Ⅳ biliary strictures were 95％ (57/60),86％ (30/35),9/14and 1/2,respectively.Twenty-nine patients were implanted with retrievable metallic biliary stent,and 82 were implantated with plastic biliary stent.Of the 111 patients,only 6 patients were complicated by acute pancreatitis,and they were cured by conservative treatment.The alleviative rates of yellow skin and icteric sclera,tenderness and distending pain of right upper quadrant,fever were 73％ (81/111 ),83％ (74/89),90％ (73/81 ) and 89％(68/76) at 1 week after treatment,and they were 88％ (98/111),91％ (81/89),94％ (76/81) and 92％(70/76) at 8 weeks after treatment.The efficacy of endoscopy was good in 97 patients and poor in 14 patients,and the 14 patients were converted to open surgery.The symptoms including yellow skin and icteric sclera,tenderness and distending pain of right upper quadrant,fever were completely alleviated at postoperative month 6.Conclusion Endoscopic treatment for benign biliary stricture is safe and effective.

The histological changes of diabetic rats' skin and the effects on the percutaneous absorption of glucocorticoid / 药学学报

To examine the histological changes of diabetic rats' skin and the effects on the percutaneous absorption of hydrocortisone (HC, a glucocorticoid), male Wistar rats were randomly divided into five groups: control group, diabetes one-week group (W1), two-week group (W2), three-week group (W3), and four-week group (W4), while each group contained 6 rats. Diabetes mellitus (DM) rat model was prepared with the method of streptozocin (STZ, 40 mg x kg(-1)) intraperitoneal injection. Abdominal skin was cut to carry out an in-vitro penetration experiment on an improved Franz diffusion cells, and phosphate buffer (PBS, pH 7.4) was used as receptor solution. The solution was analyzed with HPLC, and then the penetrating rate can be calculated. Meanwhile, rats' abdominal skins of different DM periods were HE stained and made into tissue slices to find if any histological changes occurred. The penetrating rate of control, W1, W2, W3, and W4 groups were 2.39 +/- 1.25, 3.22 +/- 1.72, 3.02 +/- 1.89, 3.63 +/- 2.02 and 5.00 +/- 3.36 microg x h(-1) x cm(-2), respectively. There was significant difference between the control and the W4 group (P 0.05). The tissue slices showed that compared to the normal rats' skin, little change was observed in one-week DM rats' skin, but the skin of one-month DM rats' skin was observed thinner, and it became much thinner than that of rats with two-month diabetes, especially the epidermis. After making a rat into diabetic, the rats' skin goes through a pathological change, and this change is closely interrelated with the increase of the permeation of HC. Therefore, it is necessary to adjust the dose while some drug was applied on the skin in case of diabetes mellitus.

Effects of cyclooxygenase-2 in ischemia reperfusion injury in liver transplantation in rat / 中华消化外科杂志

Objective To investigate the expression and role of cyclooxygenase-2(COX-2)in the ischemia reperfusion in"ury in liver transplantation in rat.Methods Fifty-four male Wistar rats were divided into control group(n=6),liver transplantation group(n=24)and NS398 treated group(n=24)according to random number table.The expression of COX-2 mRNA was detected by RT-PCR,the distribution of COX-2 positive cells by immunohistochemistry.and the content of serum TNF-αand IL-10 by enzyme-linked immunosorbent assay.All the data were processed by one-way ANOVA.Results The serum indexes and changes of TNF-α.expression were in accordance with the histological injury of liver graft.The expression of COX-2 mRNA was essential to the ischemia reperfusion injury of the liver graft.Inhibition of the expression of COX-2 mRNA would aggravate the isehemia reperfusion injury of the liver graft.Conclusions COX-2 plays an important role in the ischemia reperfusion injury in liver transplantation.COX-2 may decrease the isehemia repertusion injury of liver graft.

Effects of cyclooxygenase-2 on immunologic function of rats with sepsis / 中华消化外科杂志

Objective To study the expression of cyclooxygenase-2(COX-2)in hepatic inflammatory reaction and the effects of COX-2 on immunologic function of rats with sepsis.Methods Fifty-four Wistar rats were divided into sham group(n=6),sepsis group(n=24),and NS-398 intervention group(n=24).All rats were subjected to cecal ligation and puncture or sham operation.The expression of COX-2 mRNA in rat hepatic tissue was determined by RT-PCR,serum levels of IL-6,IL-10 and TNF-α were detected by ELISA,and percentage changes of CD4+,CD8+ cells by flow eytometry.The pathological changes of liver were observed at the same time.Results (1)Severe pathologic injuries of liver were observed in sepsis group,while not in NS-398 intervention group.(2)The expression of COX-2 mRNA was up-regulated in sepsis group and NS-398 intervention group,and the expression value was higher in sepsis group than that in NS-398 intervention group.The expression of COX-2 mRNA was the lowest in sham group.(3)The level of IL-6 was higher in sepsis group than that in sham group and NS-398 intervention group(F=125.582,134.712,54.760,121.441,P＜0.05).(4)The level of IL-10 was higher in NS-398 intervention group than that in sham group and sepsis group(F=39.064,34.382,51.115,8.174,P＜0.05).(5)The levels of TNF-α in sepsis group and NS-398 intervention group were increased,and the difference between the 2 groups had no statistical significance(x2=5.600,6.162,7.136,7.200,P＞0.05).(6)The ratio of CD4+to CD8+ was higher in NS-398 group than that in sepsis group(F=17.448,15.055,30.068,64.210,P＜0.05).Conclusions COX-2 plays an important role in the development of sepsis by changing the dynamic equilibrium between pro-inflammatory and anti-inflammatory cytokine and that between CD4+and CD8+.

Influence of Stratum Corneum on the Percutaneous Absorption of Fluorescein Sodium Liposome in Rat Skin / 中华皮肤科杂志

Objective To study the effects of stratum corneum on the percutaneous absorption of fluorescein sodium (NaFl) liposome in rat skin. Methods Stratum corneum was stripped off by Scotch adhesive tape, and the NaFl content in the stratum corneum and the skin with no stratum corneum were detected by spectrofluorimetry at regular intervals. The dynamic permeated amount of different preparations of NaFl in the skin at different intervals in Franz diffuse cell was determined and the distribution of NaFl at 4 h after stripping off the stratum corneum was observed by fluorescence microscope. Results The concentrations of NaFl in the stratum corneum and the skin with no stratum corneum after applying liposome NaFl preparation were significantly higher than those of NaFl solution and gel preparations (P 0.05). Conclusions It is suggested that liposome can increase and change the penetration of NaFl into the stratum corneum and the skin with no stratum corneum in vitro. Hair follicular structure may not play an important role in the drug diffusion when stratum corneum is removed.

Selection of the Formula of the 0.5% Liposome Podophyllotoxin Chitosan Film / 中国医师杂志

Objective To explore the best formula of the 0 5% liposome podophyllotoxin chitosan film. Methods Chitosan,acetic acid and gelatin were selected as three factors to prepare film, each factor including three levels, and 0 5% liposome podophyllotoxin served as blank factor. The films of different formula were prepared according to orthogonal design. The evaluation was made on the basis of the characteristics of conglutination and dissolution, then the best formula was determined finally. Results The results showed that the conglutination and dissolution of the film which was made of 2% chitosan, 1%acetic acid, 2% gelatin and 0 5% liposome podophyllotoxin chitosan was the most perfect. Conclusion The film designed according to orthogonal experiment was coincidenced with the requirements in aspect of conglutination and dissolution, and its appearance was perfect.

Epidermal and Dermal Distribution After Topical Application of Liposome Podophyllotoxin Suspen-sion in Rats / 中华皮肤科杂志

Objective To study the distribution pattern of liposome podophyllotoxin(LP)in rat skin.Methods The rats were divided into two groups:0.5%liposome podophyllotoxin suspension was ap-plied to LP group,0.5%podophyllotoxin tincture was applied to control group.The skin specimens were ob-tained1?2?4?6?12and24h after drug application,the amount of fluorescent stain was observed under con-focal laser scanning microscope and converted to the values of area under the curve(AUC).Results The epidermal AUC of fluorescent amount in LP group was1.5-fold than that in control group,dermal AUC was2.3-fold higher.The unit area fluorescent amount in both epidermis and dermis was highest2hours after topical medication in control group(1585.52/?m 2 and2005.66?m 2 ),and quickly reduced after4hours.But the epidermal and dermal unit area fluorescent amount in LP group was rather low in4hours after topi-cal medication,and gradually increased after6hours,and peaked after12hours(750.28/?m 2 and1073.08/?m 2 ).Conclusion Liposome preparation of podophyllotoxin can be slowly released and lasts longer in the skin.