Recent advances in understanding the biochemical and molecular mechanism of diabetic cardiomyopathy.

Cardiovascular complications account for significant morbidity and mortality in the diabetic population. Diabetic cardiomyopathy (DCM), a prominent cardiovascular complication, has been recognized as a microvascular disease that may lead to heart failure. During the past few decades, research progress has been made in investigating the pathophysiology of the disease; however, the exact molecular mechanism has not been elucidated, making therapeutic a difficult task. In this review article, we have discussed a number of diabetes-induced metabolites such as glucose, advanced glycation end products, protein kinase C, free fatty acid and oxidative stress and other related factors that are implicated in the pathophysiology of the DCM. An understanding of the biochemical and molecular changes especially early in the DCM may lead to new and effective therapies toward prevention and amelioration of DCM, which is important for the millions of individuals who already have or are likely to develop the disease before a cure becomes available.

Role of the Na(+)/Ca(2+) exchanger on the development of diabetes mellitus and its chronic complications.

Diabetes mellitus (DM) is a serious metabolic disorder with micro- and macrovascular complications that results in significant morbidity and mortality. It is well established that cytosolic Ca(2+) play an important role in controlling insulin secretion in pancreatic ß-cells. The Na(+)/Ca(2+) exchanger (NCX), an ion transport protein, is expressed in the plasma membrane of virtually all animal cells. NCX is a reversible carrier that can mediate the transport of Ca(2+) across the plasma membrane in both directions. Therefore, great efforts have been made to identify NCX associated with DM. NCX is expressed in several tissues, and acts in the protection against intracellular calcium overload; in the regulation of insulin secretion by beta cells, and in improving vascular endothelium-dependent relaxation. All these mechanisms are associated with DM pathogenesis and its chronic complications. Therefore, NCX is a candidate protein for the development of these disorders. Only a few studies investigated NCX in relation to chronic complications of diabetes, with inconclusive results.

Measures for increasing the safety of donors in living donor liver transplantation using right lobe grafts.

BACKGROUND: The safety of donors in living donor liver transplantation (LDLT) should be the primary consideration. The aim of this study was to report our experience in increasing the safety of donors in LDLTs using right lobe grafts. METHODS: We retrospectively studied 37 living donors of right lobe grafts from January 2002 to March 2006. The measures for increasing the safety of donors in LDLT included carefully selected donors, preoperative evaluation by ultrasonography, angiography and computed tomography; and necessary intraoperative cholangiography and ultrasonography. Right lobe grafts were obtained using an ultrasonic dissector without inflow vascular occlusion on the right side of the middle hepatic vein. The standard liver volume and the ratio of left lobe volume to standard liver volume were calculated. RESULTS: There was no donor mortality in our group. Postoperative complications only included bile leakage (1 donor), biliary stricture (1) and portal vein thrombosis (1). All donors recovered well and resumed their previous occupations. In recipients, complications included acute rejection (2 patients), hepatic artery thrombosis (1), bile leakage (1), intestinal bleeding (1), left subphrenic abscess (1) and pulmonary infection (1). The mortality rate of recipients was 5.4% (2/37); one recipient with pulmonary infection died from multiple organ failure and another from occurrence of primary disease. CONCLUSIONS: The first consideration in adult-to-adult LDLT is the safety of donors. The donation of a right lobe graft is safe for adults if the remnant hepatic vasculature and bile duct are ensured, and the volume of the remnant liver exceeds 35% of the total liver volume.

Clinical study on safety of adult-to-adult living donor liver transplantation in both donors and recipients.

AIM: To investigate the safety of adult-to-adult living donor liver transplantation (A-A LDLT) in both donors and recipients. METHODS: From January 2002 to July 2006, 50 cases of A-A LDLT were performed at West China Hospital, Sichuan University, consisting of 47 cases using right lobe graft without middle hepatic vein (MHV), and 3 cases using dual grafts (one case using two left lobe, 2 using one right lobe and one left lobe). The most common diagnoses were hepatitis B liver cirrosis, 30 (60%) cases; and hepatocellular carcinoma, 15 (30%) cases in adult recipients. Among them, 10 cases had the model of end-stage liver disease (MELD) with a score of more than 25. Donor screening consisted of reconstruction of the hepatic blood vessels and biliary system with 3-dimension computed tomography and volumetry of whole liver and right liver volume. Various improved surgical techniques were adopted in the procedures for both donors and recipients. RESULTS: Forty-nine right lobes and 3 left lobes (2 left lobe grafts for 1 recipient, 1 left lobe graft for 1 recipient who had received right lobe graft donated by relative living donor) were obtained from 52 living donors. The 49 right lobe grafts, without MHV, weighed 400 g-850 g (media 550 g), and the ratio of graft volume to recipient standard liver volume (GV/SLV) ranged from 31.74% to 71.68% (mean 45.35%). All donors' remnant liver volume was over 35% of the whole liver volume. There was no donor mortality. With a follow-up of 2-52 mo (media 9 mo), among 50 adult recipients, complications occurred in 13 (26%) cases and 4 (8%) died postoperatively within 3 mo. Their 1-year actual survival rate was 92%. CONCLUSION: When preoperative CT volumetry shows volume of remnant liver is more than 35%, the ratio of right lobe graft to recipients standard liver volume exceeding 40%, A-A LDLT using right lobe graft without MHV should be a very safe procedure for both donors and recipients, otherwise dual grafts liver transplantation should be considered.

Clinicopathological characteristics of 15 patients with combined hepatocellular carcinoma and cholangiocarcinoma.

BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is a rare subtype of primary liver cancer, and clinicopathological features of cHCC-CC have seldom been reported in detail. This study was undertaken to explore the diagnosis and clinicopathological characteristics of cHCC-CC in comparison with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC), respectively. METHODS: The clinical data from 15 patients with cHCC-CC, 132 patients with HCC and 44 patients with CC who had undergone hepatic resection were analyzed retrospectively. Clinicopathological characteristics of cHCC-CC, HCC and CC such as hepatitis B viral infection, serum hepatitis C virus (HCV) antibody, serum alpha-fetoprotein (AFP) level, cirrhosis, vascular invasion, lymph node metastasis, surgical procedure and adjuvant treatment were also analyzed. Follow up was carried out in the patients, and their 1-, 3-, and 5-year survival rates were calculated. RESULTS: Two patients with cHCC-CC were correctly diagnosed by enhanced CT before operation, the other 13 patients were diagnosed by histology and immunohistochemistry after operation. Radical (8/15) and conservative hepatectomy (7/15) for cHCC-CC was similar to that for HCC and CC (P>0.05). Pathologically cHCC-CC showed more significantly vascular invasion and lymph node metastasis than HCC (P<0.05), and a similarity to CC (P>0.05). Hepatitis B viral infection, serum HCV antibody, cirrhosis, and serum AFP level of cHCC-CC patients were similar to those of HCC patients (P>0.05) but different from CC patients (P<0.05). The cumulative 1-, 3-, and 5-year survival rates in patients with cHCC-CC were poorer than in patients with HCC or CC (P<0.05). CONCLUSIONS: Patients with cHCC-CC are seldom diagnosed before operation. The progression of cHCC-CC is more rapid than that of HCC or CC. Survival rate of patients with cHCC-CC after hepatic resection is poorer than that of patients with HCC or CC.

Purity evaluation of carbon nanotube materials by thermogravimetric, TEM, and SEM methods.

Raw and purified samples of carbon nanotubes are considered as multicomponent systems with a distribution of carbonaceous, amorphous, multishell graphitic particles and nanotubes, together with the particles of metal compounds from the catalyst. With respect to the carbon nanotube fractions, a distribution of size, defect concentrations, and functionalities needs to be taken into account. In order to address the problem of quantitative evaluation of purity it is necessary to measure the quality and distribution of the carbon nanotubes. In this research conventional and high resolution thermogravimetry are applied to quantify different fractions of carbonaceous and metallic materials in raw and moderately purified single walled and multiwalled carbon nanotubes. For each oxidized fraction, defined by careful line shape analysis of the derivative thermogravimetric curves (DTG), the temperature of maximum rate of oxidation, the temperature range for this oxidation, related to the degree of homogeneity, and the amount of associated material is specified. The attribution of carbonaceous materials to each fraction in the distribution was based on SEM and TEM measurements and the literature. The MWNT purified sample with 1.6 wt% metal oxide was investigated by high resolution thermogravimetry (HRTG). The quantitative assessment for the carbonaceous fractions was 25 wt% of amorphous and high defect carbonaceous materials including nanotubes, 54 wt% MWNT and 20 wt% multishell graphitic particles. A qualitative evaluation of these fractions was obtained from the SEM and TEM images and supports these results. The accuracy of the values, taking into account other measurements performed on the same batch of material, should be more sensible than +/-4 wt%.

Caudate lobectomy by the third porta hepatis anatomical method: a study of 16 cases.

BACKGROUND: The treatment for primary tumor in the caudate lobe of the liver is difficult because of its unique anatomical location. This study was undertaken to improve operative techniques and results by a new anatomical method of caudate lobectomy. METHODS: Clinical data of 16 patients who had had caudate lobectomy for the liver from January 1996 to November 2004 were retrospectively analyzed. The third porta hepatis anatomical method was performed in all 16 patients. Operative time, intraoperative blood loss, postoperative complications were recorded. The 1-, 3-, and 5-year survival rates of 13 patients with caudate lobe carcinoma were followed up. Anatomical status, operative routes, operative procedures, liver blood supply were evaluated. RESULTS: The operation was successful in the 16 patients. The operative time was 255+/-70 minutes and blood loss 740+/-402 ml. None of the patients died from massive bleeding during the operation, nor did complications such as biliary fistula and liver failure occurred. In 13 patients with malignant tumor, 7 died from recurrence and metastasis of the tumor and the other 6 are still alive at the end of follow-up. One patient has survived for 6 years. The 1-, 3-, and 5-year survival rates in the 13 patients were 83.9%, 58.7% and 39.2%, respectively. CONCLUSION: Caudate lobectomy by the third porta hepatis anatomical method can improve operative effect and increase the resection probability for solitary tumor in the caudate lobe.

[Recombinant adenovirus vectors carrying antisense matrix metalloproteinase-2 inhibits hepatocellular carcinoma growth in vivo].

OBJECTIVE: To investigate the inhibitory effect of a recombinant adenoviral vector carrying antisense matrix metalloproteinase-2(MMP2) on the growth of hepatocellular carcinoma(HCC) in vivo. METHODS: The recombinant adenoviral vector carrying antisense MMP2(Ad-MMP2(AS))which had been constructed by us in readiness was used to infect the human HCC cell line (Bel-7402). Then the invasiveness of the Bel-7402 cells was assayed in Matrigel, and the production of MMP2 in the Bel-7402 cells was detected with Western blot analysis and Gelatin zymography. After the Ad-MMP2(AS)-infected Bel-7402 cells being subcutaneously inoculated in nude mice, the production of tumors was under observation, and then Ad-MMP2(AS) was injected intratumorally into the pre-existing tumors. RESULTS: Compared with PBS or Ad-CMV-infected cells, infection of Bel-7402 cells with Ad-MMP2(AS) significantly reduced MMP2 enzyme activity, the invasiveness resulted in 52% reduction in Matrigel assays, and the tumor volume displayed a 4.3-fold reduction in nude mice. In addition, direct intratumoral injection of Ad-MMP2(AS) into pre-existing tumors significantly impaired the further expansion of the tumor mass and resulted in a 63% reduction in tumor cell growth. CONCLUSION: The recombinant adenovirus with antisense MMP2 can effectively inhibit the invasiveness and growth of Bel-7402 cells in vitro and in vivo, and has a therapeutic potential for HCC.

[Introduction of microvascular surgery to biliary reconstruction in living donor liver transplantation].

OBJECTIVE: To explore the feasibility of introduction of microvascular surgery into biliary reconstruction in living donor liver transplantation (LDLT) so as to reduce the incidence of postoperative biliary complications. METHODS: The experience in the microvascular surgery performed on 32 patients undergoing LDLT, 8 children and 24 adults, including duct-to-duct anastomosis in 21 case, hepato-jejunostomy under surgical loupe in 13 cases, and hepato-jejunostomy under operative microscopy in 9 cases, totally 43 cases of biliary reconstruction manipulations. RESULTS: Post-operative biliary complications occurred in 2 patients. One male patient who underwent hepato-jejunostomy under surgical loupe suffered from leakage from a bilioenteric anastomotic stoma 3 days after operation and laparotomy was performed to repair the leakage and carry out drainage. Mild stricture of the anastomotic stoma occurred in the other patient 3 months after operation and conservative treatment was given. Both patients recovered. CONCLUSION: Introduction of microvascular surgery to biliary reconstruction in LDLT, especially the use of operative microscopy for hepato-jejunostomy on very small hepatic ducts,

[Modifications of surgical technique in adult-to-adult living donor liver transplantation].

OBJECTIVE: To report the authors' experience with adult-to-adult living donor liver transplantation using right lobe liver grafts performed by a modified technique. METHODS: From March to June 2005, 13 patients underwent living donor liver transplantation using right lobe grafts. Among these, one patient received two left lobes from his two elder sisters, one received a right lobe from his mother and a left lobe from a cadaveric donor. All patient underwent a modification designed to improve the reconstruction of right hepatic vein, the reconstruction the tributaries of the middle hepatic vein by interpositioning a vein grafts, and the anastomosis of the hepatic arteries and bile ducts. RESULTS: There were no severe complications and deaths found in donors. Four complications occurred in recipients including hepatic artery thrombosis (n = 1), bile leakage (n = 1), left subphrenic abscess (n = 1) and pulmonary infection (n = 1). The patient with pulmonary infection died of multiple organ failure (MOF). All patients underwent direct anastomosis of right hepatic vein and inferior vena cava (IVC), 5 cases plus the reconstructions of right inferior hepatic vein, and the other 5 cases plus the reconstruction of the tributaries of the middle hepatic vein by interpositioning a vein graft to provide sufficient venous outflow. The graft and recipient weight ratio (GRWR) were between 0.72% and 1.24%, among these, 9 cases < 1.0% and 2 cases < 0.8%, and there was no "small-for-size syndrome" occurred. CONCLUSIONS: With modifications of surgical technique, especially the reconstruction of hepatic vein to provide sufficient venous outflow, living donor liver transplantation in adults using right lobe liver grafts can become a relatively safe procedure and prevent the "small-for-size syndrome".

Modified techniques for adult-to-adult living donor liver transplantation.

BACKGROUND: Because of critical organ shortage, transplant professionals have utilized living donor liver transplantation (LDLT) in recent years. We summarized our experience in adult-to- adult LDLT with grafts of right liver lobe by a modified technique. METHODS: From January 2002 to August 2005, 24 adult patients underwent living donor liver transplantation with grafts of the right liver lobe at West China Hospital, Sichuan University, China. Twenty-two patients underwent modified procedures designed to improve the reconstruction of the right hepatic vein and the tributaries of the middle hepatic vein by interposing a great saphenous vein (GSV) graft and the anastomosis of the hepatic arteries and bile ducts. RESULTS: No severe complications and death occurred in all donors. In the first 2 patients, (patients 1 and 2), operative procedure was not modified. One patient suffered from "small-for-size syndrome" and the other died of sepsis with progressive deterioration of graft function. In the rest 22 patients (patients 3 to 24), however, the procedure of venous reconstruction was modified, and better results were obtained. Complications occurred in 7 recipients including acute rejection (2 patients), hepatic artery thrombosis (1), bile leakage (1), intestinal bleeding (1), left subphrenic abscess (1), and pulmonary infection (1). One patient with pulmonary infection died of multiple organ failure (MOF). The 22 patients underwent direct anastomosis of the right hepatic vein to the inferior vena cava (IVC), 9 direct anastomosis plus the reconstruction of the right inferior hepatic vein, and 10 direct anastomosis plus the reconstruction of the tributaries of the middle hepatic vein by interposing a GSV graft to provide sufficient venous outflow. Trifurcation of the portal vein was met in 3 patients. Venoplasty or separate anastomosis was performed. The ratio of graft to recipient body weight ranged from 0.72% to 1.17%. Among these patients, 19 had the ratio <1.0% and 4 <0.8%, and the ratio of graft weight to recipient standard liver volume was between 31.86% and 62.48%. Among these patients, 10 had the ratio <50% and 2 <40%. No "small-for-size syndrome" occurred in the 22 recipients who were subjected to modified procedures. CONCLUSIONS: With the modified surgical techniques for the reconstruction of the hepatic vein to obtain an adequate outflow and provide a sufficient functioning liver mass, living donor liver graft in adults using the right lobe can be safe to prevent the "small-for-size syndrome".

[Adult-to-adult living donor liver transplantation using right lobe graft: report of 24 cases].

OBJECTIVE: To investigate the safety and feasibility of adult-to-adult living donor liver transplantation (A-A LDLT) using right lobe graft. METHODS: From January 2005 to December 2005, 24 patients, 22 males and 2 females, aged 20 - 53, with the underlying diseases of liver cirrhosis, hepatocellular carcinoma, and Budd-Chiari syndrome, underwent A-A LDLT using right lobe graft. During the second period, including 22 cases, modified techniques were adopted, e.g. direct anastomosis of the right hepatic vein (RHV) and inferior vena cava was performed in all 22 cases, reconstruction of inferior right hepatic vein was performed on 9 cases, and reconstruction of tributaries of middle hepatic vein by interposing a vein graft on 10 cases so as to provide sufficient venous outflow. RESULTS: No sever complication and death was found in the donors. The graft and recipient weight ratio was 0.72% - 1.17%, being < 1.0% among 19 cases and being < 0.8% among 4 cases. During the first period one of the 2 patients suffered from stenosis at the anastomotic stoma of the right hepatic vein, and the other patient suffered from small-for-size syndrome and died. During the second period modified techniques were adopted and no more small-for-size syndrome occurred. CONCLUSION: With the modified techniques, A-A LDLT has become a relative safe procedure.

[Safety of donor of right lobe graft in living donor liver transplantation].

OBJECTIVE: To evaluate the safety of donors of right lobe graft. METHODS: We retrospectively studied 13 living donors of right lobe graft from January 2002 to June 2005. The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein. Liver transection was done by using an ultrasonic dissector without inflow vascular occlusion. The standard liver volume and the ratio of left lobe volume to the standard liver volume were calculated. RESULTS: The mean blood loss was 490 ml. The mean blood transfusion was 440 ml. In the perioperative period the mean albumin administered was 85 g. One donor had portal vein trifurcation, two had a right posterior bile duct and a right anterior bile duct draining into the left bile duct, respectively. One had bile ducts from left lateral and left internal segment and right duct draining into common hepatic duct. On postoperative day 1 the donors' liver functions were found impaired to some extent, but all the indices rapidly returned to the normal level at the end of the first week. Postoperative complications included 1 case of abdominal bleeding, 2 wound steatosis and 1 chyle leak. There was no donor mortality. All donors are well and have returned to their previous occupations. CONCLUSIONS: The donation of right lobe graft for adult living donor liver transplantation is safe provided that the patency of the remnant hepatic vasculature and bile duct is ensured, the volume of the remnant liver exceeds 30% of the total liver volume, and there is no injury to the remnant liver.

Effect of peroxisome proliferator-activated receptor-gamma ligand on inflammation of human gallbladder epithelial cells.

AIM: To investigate the effect of peroxisome proliferator-activated receptor gamma (PPAR-gamma) and its ligand, ciglitazone, on inflammatory regulation of human gallbladder epithelial cells (HGBECs) and to assess the effect of human epithelial growth factor (hEGF) on growth of HGBECs. METHODS: HGBECs were cultured in media containing hEGF or hEGF-free media. HGBECs were divided into normal control group, inflammatory control group and ciglitazone group (test group). Inflammatory control group and ciglitazone group were treated with 5 microg/L of human interleukin-1beta (hIL-1beta) to make inflammatory model of HGBECs. The ciglitazone group was treated with various concentrations of ciglitazone, a potent ligand of PPAR-gamma. Subsequently, interleukin-8 (IL-8), IL-6, and tumor necrosis factor-alpha (TNF-alpha) concentrations in all groups were measured. The data were analyzed statistically. RESULTS: HGBECs were cultured in medium successfully. The longevity of HGBECs in groups containing hEGF was longer than that in hEGF-free groups. So was the number of HGBECs. The longest survival time of HGBEC was 25 d. The inflammatory model of HGBECs was obtained by treating with hIL-1beta. The concentrations of IL-6 and IL-8 in ciglitazone group were lower than those in inflammatory control group (P<0.05). The secretion of IL-6 in inflammatory control group was higher (350.31+/-37.05 microg/L) than that in normal control group (50.0+/-0.00 microg/L, P<0.001). Compared to normal control group, IL-8 concentration in inflammatory control was higher (P<0.05). CONCLUSION: hEGF improves the growth of HGBECs in vitro. Ciglitazone inhibits the inflammation of HGBECs in vitro and has potential therapeutic effect on cholecystitis in vivo.

[Inhibition of adenovirus-mediated gene transfer of antisense matrix metalloproteinase-2 on hepatocellular carcinoma growth in vivo].

OBJECTIVE: To investigate if a recombinant adenoviral vector carrying antisense matrix metalloproteinase-2 (MMP2) gene would inhibit the growth of hepatocellular carcinoma (HCC) in vivo. METHODS: Using the recombinant adenoviral vector carrying antisense MMP2 gene (Ad-MMP2AS) which was constructed by us previously, to infect the human HCC cell line (Bel-7402). Then the invasiveness of the Bel-7402 cells was assayed in Matrigel, and the production of MMP2 in the Bel-7402 cells was detected with Western blotting analysis and Gelatin zymography. Then the Ad-MMP2AS-infected cells were subcutaneously inoculated in nude mice. After tumors developed, Ad-MMP2AS was injected intratumorally into pre-existing tumors. The tumors were removed, sectioned, and stained with H E. RESULTS: Compared with PBS or Ad-CMV-infected cells, the infected Bel-7402 cells with Ad-MMP2AS injections significantly reduced their MMP2 enzyme activity and invasiveness about 52.05% in Matrigel assays, and the tumor volumes in nude mice resulted in a 3.3-fold reduction. In addition, direct intratumoral injection of Ad-MMP2AS into pre-existing tumors significantly prevented further expansion of the tumor masses and resulted in a 63.06% reduction in tumor cell growth. CONCLUSION: The recombinant adenovirus with antisense MMP2 can effectively inhibit the invasiveness and growth of Bel-7402 cells in vitro and in vivo, and it has a therapeutic potential for HCC.

[An experimental study on the gastroantrium-cholecystostomy using pylorus sphincter to replace Oddi sphincter for preventing reflux].

OBJECTIVE: This experimental study of gastroantrium-cholecystostomy was designed to identify the possible use of pylorus sphincter as a substitute for Oddi sphincter. METHODS: Fifteen prairie dogs were randomized to three groups. The dogs in the control group underwent sham operation. The dogs in the first experiment group were subjected to gastroantrium-cholecystostomy and gastrojejunostomy. Meanwhile, two thin tubes were placed in stomach antrium and duodenum separately for post-operative photography. One week after operation, 20% cyctografin (10 ml) was injected into the duodenum through the relevant tube so as to check whether any backflow came out from duodenum to the bile duct. Then, 20% cyctografin (5 ml) was injected into the stomach antrium so as to demonstrate how it went from stomach antrium into duodenum. The samples of liver, stomach, stomach antrium, gallbladder and extra hepatic duct were collected for pathological examinations. The dogs of the second experiment group underwent the same operations, but the samples for pathological examination were collected four weeks after operation. RESULTS: Roentgenography showed that there was no contrast medium backflowing into the stomach antrium, and the contrast medium could flow from stomach antrium into duodenum smoothly. The results of histo-pathological examination showed that there were no obvious changes in the liver, stomach antrium and bile duct. Under light microscope, a few inflammatory cells could be seen in the gallbladder wall, and the mucosa of stomach was slightly atrophic. CONCLUSION: The gastroantrium-cholecystostomy which uses pylorus sphincter to take over the functions of Oddi sphincter can effectively prevent intestinal juice from flowing back into the bile duct.

[A study on inflammatory regulation of human gallbladder epithelial cells by PPAR-gamma ligand].

OBJECTIVE: To investigate the inflammatory regulation of human gallbladder epithelial cells (HGBEC) by peroxisome proliferator activated receptor gamma (PPAR-gamma) ligand ciglitazone. METHODS: HGBEC were cultured in medium containing human epidermal growth factor (hEGF). HIL-1beta were added into the ciglitazone groups and inflammatory control groups to make inflammatory model . IL-6 and TNF-alpha concentration in ciglitazone groups and all control groups were measured. RESULTS: HGBEC were cultured in medium successfully. The inflammatory model was made. The longest duration is 25 d. In inflammatory control groups, cells were edema with unclear cellular membrane and plasmid. In ciglitazone groups, the inflammatory edema of cells were less evident than that in inflammatory control groups, especially in 50 micromol/ml group. The IL-6 concentration in ciglitazone groups is lower than that in control group (P<0.01). The relation between the inhibitory effect and the concentration of ciglitazone is positive correlation. CONCLUSION: Ciglitazone that can inhibit the inflammation of HGBEC maybe an effective treatment for acute and chronic cholecystitis.