Efficacy and safety of endoscopic retrograde cholangiopancreatography during pregnancy and puerperium： A comparative analysis / 临床肝胆病杂志

ObjectiveTo investigate the efficacy and safety of endoscopic retrograde cholangiopancreatography （ERCP） during pregnancy and puerperium through a comparative analysis. MethodsA retrospective analysis was performed for the clinical data of 22 patients in pregnancy and 39 patients in puerperium who received ERCP in Digestive Endoscopy Center of The First Affiliated Hospital of Nanchang University from January 2007 to August 2022. The two groups of patients were compared in terms of baseline data， diagnosis during ERCP， interventions， laboratory results before and after ERCP， post-ERCP complications， and delivery and fetal outcomes. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsThere were no significant differences between the patients in pregnancy and those in puerperium in all baseline data （all P>0.05） except the rate of CT examination （22.73% vs 58.97%， χ2=7.44， P=0.006）. During the ERCP procedure， compared with the patients in puerperium， the patients in pregnancy had a significantly lower proportion of the patients who underwent biliary stone extraction or endoscopic papillary balloon dilation （χ2=4.007 and 4.315， both P<0.05） and a significantly higher proportion of the patients who did not receive X-ray fluoroscopy （χ2=12.103， P=0.001）. After ERCP， both groups had significant improvements in white blood cell count， total bilirubin， direct bilirubin， alanine aminotransferase， and aspartate aminotransferase （all P<0.05）. The overall incidence rate of post-ERCP complications was 7.04% （5/71） for all patients， with post-ERCP biliary infection as the most common complication （3/71，4.23%）， and there was no significant difference in the incidence rate of post-ERCP complications between the two groups （P>0.05）. As for delivery and fetal outcomes， compared with the patients in puerperium， the patients in pregnancy had a significantly higher proportion of patients with early termination of pregnancy （50.00% vs 0，χ2=20.528， P<0.001） and a significantly lower proportion of patients with cesarean section （36.36% vs 76.92%， χ2=4.756， P=0.029）. There were no significant differences in the incidence rates of adverse events such as abnormal fetal development and stillbirth between the two groups （P>0.05）. ConclusionWith strict control of ERCP indications and timing， ERCP is effective and relatively safe in both pregnancy and puerperium and has a comparable incidence rate of post-ERCP complications to that in the general population， with relatively good delivery and fetal outcomes.

Experimental Study on Hypoglycemic Effect ofMori Cortex Aqueous Extracts and Chemical Split Fractions / 世界科学技术-中医药现代化

This article was aimed to study effects of aqueous extracts and all chemical split fractions ofMori Cortex on hypoglycemic effect of diabetic mice model. Intra-peritoneal injection of 170 mg·kg-1 streptozocin (STZ) was given to male Kunming mice to establish type I diabetes mode. Continuous administration of medication was given for 4 weeks. And then, indicators such as body weight, water intake, food intake, fasting plasma glucose (FBG), insulin, C-peptide, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), and low density lipoprotein cholesterol (LDL-c) were detected. Pathological morphology of the liver and pancreas were observed by light microscopy. The results showed that high-dose group ofM. Cortex aqueous extracts can improve weight loss of type I diabetic mice, significantly reduce water intake and food intake, reduce FBG, TC, TG and LDL-c levels in different degrees (P<0.05 orP<0.01), and increase C-peptide and HDL-c levels (P<0.05 orP<0.01). When dosages of 30% ethanol fraction and fatty oil fraction were only about 1/2 and 1/4 ofM.Cortex aqueous extracts, we found that it can improve lipid disorder status,repair liver cells, and improve liver tissue damage. Its effect was superior to M. Cortex aqueous extracts. It was concluded thatM. Cortexaqueous extracts showed a better hypoglycemic effect. The effective component parts were 30% ethanol fraction and fatty oil fraction. Its hypoglycemic mechanism may be related to the promotion of insulin secretion, regulation of blood lipid disorders, as well as the protection of liver structure and function.

Study on Diuretic Effect ofMori Cortex Aqueous Extracts and Chemical Split Fractions / 世界科学技术-中医药现代化

This study was aimed to investigate the diuretic effect ofMori Cortex and to identify effective fractions inM. Cortex. Metabolic cages were used to firstly observe the diuretic effect ofM. Cortex aqueous extracts on rats. Medications were continuously given for 5 days to screen for the best dosage of diuretic effect. Picric acid assays were used to detect creatinine levels in serum and urine after 5-day medication. Then, the diuretic effect of each chemical split fraction inM. Cortex was studied in order to indentify the effective parts. The results showed that after administration ofM. Cortex aqueous extracts for 3 to 5 days, compared with the control group, there was a significant diuretic effect on rats (P<0.05 orP<0.01). And the medium-dose ofM. Cortex aqueous extracts showed the best effect (P<0.01). However,M. Cortex aqueous extracts had no significant effect on creatinine levels in serum and urine. Assays of diuretic effect of chemical split fractions ofM.Cortex indicated that compared with the control group, 30% ethanol fraction and fatty oil fraction had the best diuretic effect (P<0.01). It was concluded thatM.Cortex aqueous extracts had a significant diuretic effect. And the chemical fractions contributed mostly to this effect were mainly existed in the 30% ethanol fraction and fatty oil fraction.

Study on Antitussive, Expectorant and Antiasthmatic Effect of Aqueous Extracts and Chemical Split Fractions ofMori Cortex / 世界科学技术-中医药现代化

This study was aimed to investigate the antitussive, expectorant and antiasthmatic effects of aqueous extracts and the chemical split fractions ofMori Cortex. Cough mice models induced by ammonia water were used to observe the effect on arresting cough. The phenol red expectoration method in mice was used to observe the effect on expelling phlegm. Histamine and acetylcholine mixture induced asthma model was used to observe the effect on relieving asthma. Isolated trachea model was used to observe the effect on relieving spasm. Compared with the control group, the low, medium and high doses of aqueous extracts ofM. Cortex can obviously decrease the frequency of cough, increase phenol red output of trachea in mice, prolong the latent period of asthma in guinea pigs, and increase the antispasmodic rate. The medium dose had the best effect. The comparison between different chemical split fractions ofM. Cortex and the control group showed that the 30% and 50% ethanol fraction ofM. Cortex can obviously decrease the frequency of cough and prolong the latent period of cough induced by ammonia water in mice, increase phenol red output of trachea in mice (P<0.05 orP<0.01); and 30% ethanol fraction and fatty oil fraction can prolong the latent period of asthma in guinea pigs (P< 0.05 orP<0.01). In addition, 30% ethanol fraction can obviously reduce the degree of tracheal contraction. It had certain effect of relieving spasm. It was concluded that aqueous extracts ofM. Cortex had better effects on relieving cough, expectorant and antiasthma. The effective part was the 30% ethanol fraction, which was the dose equivalent of 1/3 of the medium dose. It had significant effect on relieving cough, expectorant and antiasthma. The effect was equivalent to the medium dose of aqueous extracts of M. Cortex.

Study on Immunomodulatory Effect of Chemical Split Fractions ofMori Cortex / 世界科学技术-中医药现代化

This article was aimed to study immunomodulatory effect of chemical split fractions ofMori Cortex, in order to initially explain effective parts that played a role in immunomodulatory effect ofMori Cortex. The carbon clearance test, serum hemolysin test, E-rosette test, and lymphocyte transformation test were carried out to explore influence of these chemical split fractions ofMori Cortex on immune organs, nonspecific immunity, humoral immunity and cellular immunity. The results showed that in the carbon clearance test, 50% ethanol fraction markedly reduced the thymus index (P<0.01) and the correction indexα (P<0.05). In hemolysin test, the half value hemolysis (HC50) was improved by 30% ethanol fraction and fatty oil fraction (P<0.05). Besides, in the E-rosette test, the E-rosette ration was increased in the 30% ethanol fraction group (P<0.05). In the lymphocyte transformation test, the 30% ethanol fraction can promote the thymus and spleen lymphocytes proliferation (P<0.05 orP<0.01), while the 50% ethanol fraction inhibited the proliferation (P<0.05 orP<0.01). It was concluded that the 30% ethanol fraction can boost both the humoral immunity and cellular immunity; the 50% ethanol fraction can induce the growth of thymus with a suppressive effect on nonspecific immunity and cellular immunity; the fatty oil fraction can improve humoral immunity.

Evaluation of Estrogenic Effects ofCoicis Semen Aqueous Extracts / 世界科学技术-中医药现代化

This study was aimed to investigate the estrogenic effects ofCoicis Semen in order to preliminarily discuss the mechanism. Mouse uterine weight test and MCF-7 cell proliferation assay were used to evaluate the estrogenic effects ofC. Semen. Reporter gene assays were adopted to explore the action mechanism ofC. Semen. In reporter gene assay, HEK293 cells were co-transfected with pERE-TAL-luc, pβgal-Control, pCXN2-hERα, or pCXN2-hERβ. And the expression of reporter gene luc was controlled by ERE. Mouse uterine weight test showed that compared with the control group, the aqueous extracts ofC. Semen can increase the uterus index of premature female mice (P<0.01). It can significantly promote the proliferation of MCF-7 cells in the medium without estrogen (P<0.01). The reporter gene controlled by ERE technology showed thatwhen mediated by ERα or ERβ respectively, the normalized luciferase activity of aqueous extracts ofC. Semen was significantly higher than activity of the control group (P< 0.05 orP< 0.01). It was concluded that the aqueous extracts ofC.Semen can increase the uterus index of premature female mice and promote the proliferation of MCF-7 cells in the medium without estrogen. We found the estrogenic effects ofC. Semen for the first time. And the estrogenic effects ofC. Semen were mainly mediated by ERβ.