Type I Mirizzi syndrome treated by electrohydraulic lithotripsy under the direct view of SpyGlass: A case report.

BACKGROUND: Mirizzi syndrome is an uncommon clinical complication for which the available treatment options mainly include open surgery, laparoscopic surgery, endoscopic retrograde cholangiopancreatography (ERCP), electrohydraulic lithotripsy, and laser lithotripsy. Here, a patient diagnosed with type I Mirizzi syndrome was treated with electrohydraulic lithotripsy under SpyGlass direct visualization, which may provide a reference to explore new treatments for Mirizzi syndrome. CASE SUMMARY: This paper describes a middle-aged female patient with suspected choledocholithiasis who complained for over 1 mo of intermittent abdominal pain, dark yellow urine, jaundice, and was proposed to undergo ERCP lithotomy. Mirizzi syndrome was found during the operation and confirmed by SpyGlass. Electrohydraulic lithotripsy was performed under the direct vision of SpyGlass. After the lithotripsy, the stones were extracted using the stone extraction basket and balloon. After the operation, the patient developed transient hyperamylasemia. Through a series of symptomatic treatments (such as fasting, fluids and anti-inflammation medications), the symptoms of the patient improved. Finally, laparoscopic cholecystectomy or open cholecystectomy was performed after a half-year post-operatively. CONCLUSION: Direct visualization-guided laser or electrohydraulic lithotripsy with SpyGlass is feasible and minimally invasive for type I Mirizzi syndrome without apparent unsafe outcomes.

Combined probiotic bacteria promotes intestinal epithelial barrier function in interleukin-10-gene-deficient mice.

AIM: To investigate the protective effects of combinations of probiotic (Bifico) on interleukin (IL)-10-gene-deficient (IL-10 KO) mice and Caco-2 cell monolayers. METHODS: IL-10 KO mice were used to assess the benefits of Bifico in vivo. IL-10 KO and control mice received approximately 1.5 × 10(8) cfu/d of Bifico for 4 wk. Colons were then removed and analyzed for epithelial barrier function by Ussing Chamber, while an ELISA was used to evaluate proinflammatory cytokines. The colon epithelial cell line, Caco-2, was used to test the benefit of Bifico in vitro. Enteroinvasive Escherichia coli (EIEC) and the probiotic mixture Bifico, or single probiotic strains, were applied to cultured Caco-2 monolayers. Barrier function was determined by measuring transepithelial electrical resistance and tight junction protein expression. RESULTS: Treatment of IL-10 KO mice with Bifico partially restored body weight, colon length, and epithelial barrier integrity to wild-type levels. In addition, IL-10 KO mice receiving Bifico treatment had reduced mucosal secretion of tumor necrosis factor-α and interferon-γ, and attenuated colonic disease. Moreover, treatment of Caco-2 monolayers with Bifico or single-strain probiotics in vitro inhibited EIEC invasion and reduced the secretion of proinflammatory cytokines. CONCLUSION: Bifico reduced colon inflammation in IL-10 KO mice, and promoted and improved epithelial-barrier function, enhanced resistance to EIEC invasion, and decreased proinflammatory cytokine secretion.

[Effect of Astragalus polysaccharides and berberine on carbohydrate metabolism and cell differentiation in 3T3-L1 adipocytes].

OBJECTIVE: To compare the effects of Astragalus polysaccharides (AP) and berberine (BB) on the adipocyte's carbohydrate metabolism and cell differentiation, for assessing the possible mechanism of them in improving carbohydrate metabolism. METHODS: Adipocytes were treated with AP or BE, the 3H-glucose up-take rate in them was investigated, those of differentiation phase were stained by oil red O to analyze the degree of cell differentiation by spectrophotography quantitatively. The adipocyte differentiation related expression of PPARgamma mRNA and C/EBPalpha mRNA were determined by RT-PCR. RESULTS: The 3H-glucose up-take rate in the AP group and BE group were 109.3% and 182.7% of that in the blank control group respectively. AP obviously promoted the cell differentiation and up-regulated expression of PPARgamma mRNA, while BE suppressed the differentiation and expression of PPARgamma and C/EBPalpha mRNA distinctly, all showing significant difference as compared with that in the blank control (P<0.01). CONCLUSION: AP could promote glucose up-take, cell differentiation and PPARgamma mRNA expression, BB also promote glucose up-take, but suppress the cell differentiation, and inhibit expressions of PPARgamma and C/EBPalpha mRNA in 3T3-L1 adipocytes.

[Effects of salidroside on carbohydrate metabolism and differentiation of 3T3-L1 adipocytes].

OBJECTIVE: To observe the effects of salidroside on carbohydrate metabolism and differentiation of 3T3-L1 adipocytes. METHODS: 3H-glucose uptaking rate in adipocytes treated by salidroside was detected. Adipocytes treated by salidroside in differentiation were stained by oil red O and analyzed by spectrophotography quantitatively. The expression of PPAR-gamma and C/EBP-alpha mRNA relating to differentiation of adipocytes was detected by reverse transcription PCR. RESULTS: 3H-glucose uptaking rate in the salidroside group was 110.4%, higher than that in the blank control group (P < 0.01). Salidroside suppressed the differentiation of 3T3-L1 pre-adipocytes and down-regulated the expression of PPAR-gamma and C/EBP-alpha mRNA (P < 0.01, vs control group). CONCLUSION: Salidroside promotes the 3H-glucose uptaking, suppresses the differentiation and down-regulates the expression of PPAR-gamma and C/EBP-alpha mRNA in 3T3-L1 adipocytes.

[Pathogenesis of insulin resistance and prevention and treatment strategy of integrated traditional Chinese and western medicine].

Insulin resistance is the common pathophysiologic basis of multiple metabolic diseases, but the exact mechanism of insulin resistance is still unclear presently. In the past few years, studies on the pathogenesis of insulin resistance, in which the endocrine function of adipocyte and inflammation reaction participate, as well as the insulin-sensitizing drugs have become the new hotspot. The exploration on pathogenesis and treatment of insulin resistance in traditional Chinese medicine has established a foundation for the prevention and treatment of insulin resistance in integrated traditional Chinese and western medicine.