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OBJECTIVE: To investigate the interventional effect of the Chinese herbal preparation Xi Fu Pai Chen(XFPC) on pulmonary inflammation and fibrosis in rats with silicosis. METHODS: A total of 144 adult specific pathogen free male SD rats were randomly divided into 6 groups: blank control group, silicosis model group, drug administration control group and groups of low-dose,medium-dose and high-dose XFPC, with 24 rats in each group. Lung silicosis model was established by single inhalation tracheal instillation method, which was treated with 50.0 g/L silica suspension, in groups except in the blank control group. On the 7 th day of modeling, the rats in the drug administration control group were orally given tetrandrine(5 mg/kg body weight), while those in the low-, medium-and high-dose groups were given 43, 86 and 192 g/L of XFPC by atomization inhalation once a day for 20 minutes, 5 days a week for 4 weeks. At the end of drug administration, the histopathological changes of the lung were observed. The number and classification of cells in bronchoalveolar lavage fluid(BALF)were examined, and the levels of malondialdehyde(MDA) and interferon-gamma(IFN-γ) in BALF were measured by enzyme-linked immunosorbent assay. RESULTS: On the 7 th day after modeling, the body weight in the drug administration control group and XFPC high-dose group decreased compared with the blank control group(P<0.05). On the 35 th day after modeling, the body weights of rats in the other 5 groups were lower than that in the blank control group(P<0.05). The pathological changes of lung tissue(infiltration of inflammatory cells, fibrosis and size of silicon nodule) in drug administration control group and XFPC low-dose group were better than those in silicosis model group by naked eyes and under light microscope. The lung coefficient, the proportion of neutrophils and the level of MDA and IFN-γ in BALF of the drug administration control group and XFPC low-dose group decreased(P<0.05), and the proportion of macrophages in BALF increased(P<0.05) compared with the silicosis model group. There was no significant difference in lung coefficients and the relevant indices of BALF between XFPC medium-, high-dose groups and silicosis model group(P>0.05). CONCLUSION: Low dosage XFPC can improve pulmonary fibrosis and inflammation in rats with silicosis, and its mechanism of action may be related to reducing the levels of IFN-γ and MDA in BALF.
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ObjectiveTo investigate the effect of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) on liver function and treatment outcome in patients with pancreaticobiliary diseases. MethodsA total of 397 patients with pancreaticobiliary diseases who underwent ERCP with an electronic duodenoscope in Beijing Chuiyangliu Hospital from January 2005 to July 2015, were enrolled. According to the type of disease, they were divided into benign obstruction group (109 patients), malignant obstruction group (47 patients), pancreatitis group (27 patients), foreign body obstruction group (127 patients), simple cholangitis group (19 patients), biliary fistula group (15 patients), juxta-ampullary duodenal diverticula group (29 patients), and liver transplantation group (24 patients). Liver function parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), and total bilirubin (TBil) were measured at 1 day before ERCP and at 4 weeks after ERCP. The therapeutic effect was evaluated at 1 month after ERCP. The paired t-test was used for comparison of continuous data before and after treatment within one group, an analysis of variance was used for comparison between multiple groups, and the chi-square test was used for comparison of categorical data between groups. ResultsAfter ERCP, all the patients showed significant improvements in ALT, AST, ALP, GGT, and TBil, suggesting that ERCP significantly improved the subjects′ liver function (all P＜0.05). The evaluation of therapeutic effect showed that after ERCP, all the groups showed significant remission of symptoms; all the patients in the simple cholangitis group were cured, while those in the liver transplantation group and malignant obstruction group only achieved certain improvements. ConclusionTherapeutic ERCP can significantly improve the patients′ liver function. However, as for patients with liver transplantation and pancreaticobiliary tumors, laparoscopic surgery should be performed in combination with ERCP.
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Objective To explore the technological and therapeutic value of endoscope for removal of hepatobiliary necrosis after liver transplantation.Methods Data of 36 patients with suspected hepatobiliary diseases,who underwent choledochoscopy or duodenoscopy to remove necrosis after liver transplantation,were reviewed.Liver function before and after the treatment were compared.Results Hepatobiliary necrosis located in common bile duct (n =6),intrahepatic bile duct (hilar bile duct included) (n =24) and intraand extra-hepatic duct (n =6).The total success rate was 72.2％ (26/36).Full clearance of bile duct necrosis was accomplished in 16 patients,partial clearance in 15 patients and the necrosis could not be removed in 5 others.The serum bilirubin and transaminase decreased significantly,compared with those before endoscopic treatment (P ＜ 0.05).No serious complications or death related to endoscopy occurred during the treatment.After 6-84 month follow-up,in 17 survivals,3 patients underwent a second liver transplantation with good prognosis.All the survivals had a life of good quality with no placed drainage tube except for one with drainage tube for four years with unstable serum bilirubin.Nineteen patients died from biliary tract related complications or other diseases during the long-term follow-up,among which eleven patients survived beyond four years.Conclusion Endoscopy for hepatobiliary necrosis removal,a minimally invasive method,is effective and safe.
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Objective To evaluate the feasibility, advantages and pitfalls of trans-gastric, trans-colonic and trans-umbilical peritoneoscopy, and to compare pure natural orifice transluminal endoscopic surgery (NOTES) with hybrid NOTES. Methods Two female pigs of 30kg were used in the study, one for pure NOTES, the other for hybrid NOTES. Each pig received trans-gastric, trans-colonic and trans-umbilical peritoneoscopy, respectively, followed by postmortem examination for organic lesions and closure of incisions.The two approaches were compared in terms of intra-operative situation and manipulation. Results The vital signs of the pigs were stable during the procedures, with no peri-incision organic lesions. There were blind areas in trans-gastric as well as in trans-colonic peritoneoscopy. It was easier to close the colonic incision than the gastric one. The situation in trans-umbilical peritoneoscopy was similar to laparoscopic surgery. Hybrid NOTES seemed superior to pure NOTES with regard to safe access, stable pneumo-peritoneum and adequate visualization. Conclusion Three routes for NOTES appear to be reasonable and feasible. Hybrid NOTES is more effective and safer than pure NOTES with current instruments.
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Objective To investigate the clinical value of argon plasma coagulation (APC)trans-choledochoscopy in biliary tract complications following liver transplantation. Methods All 27 patients underwent T-tube-choledochoscopy or percutaneous transhepatic cholangioscope (PTCS).APC was used to burn the hyperplasia of bile duct stenosis and then expended the stenosis with bougienage. The bile duct foreign bodies were burnt by APC and then eliminated. The granulation tissues of bile duct were burnt by APC after biopsied. The sutures of anastomoses were burnt by APC and then eliminated. Results In general, the therapeutic achievement ratio of stenosis of bile duct in 25 cases of 28 locations was 78. 6% (22/28). The clearance ratio of bile duct foreign bodies was 85. 7% (6/7). The elimination ratio of granulation tissues was 100% (5/5), the same as the elimination ratio of sutures of anastomoses. There were no treatment-related complications about APC. The recurrence ratio of bile duct stenosis was respectively 4.5% (1/22) and 13. 6% (3/22)after follow-up for 3 and 6 months respectively. All the recurrent stenosis was non-anastomotic. The recurrence ratio of bile duct foreign bodies was respectively 16. 7% (1/6) and 33.3% (2/6) after follow-up for 3 and 6 months respectively. Conclusion APC trans-choledochoscopy in treatment of biliary anastomotic stenosis, mural foreign bodies, mural biliary cast, granulation tissues of bile duct and sutures of anastomoses following liver transplantion has a high success ratio and a sure long-term efficacy without treatment-related complications.