RESUMO
Gegen Qinliantang， a classic traditional Chinese medicine（TCM） compound， has been verified in modern research to possess various pharmacological effects such as anti-inflammation，anti-oxidative stress，protecting intestinal mucosal barrier， and regulating intestinal flora and immune response. Ulcerative colitis （UC） is a chronic idiopathic inflammatory disease involving the colorectal mucosa， which mainly results from genetic susceptibility， intestinal mucosal barrier damage， abnormal immune response， intestinal flora disturbance， and bile acid metabolism disorders. By reviewing the literature published in recent years， this paper sorted out the relevant pathways and mechanisms involved in the treatment of UC by Gegen Qinliantang to provide ideas for further clinical and basic research. This literature review uncovered that Gegen Qinliantang exerted the therapeutic effects against UC mainly via interleukin-6（IL-6）/Janus tyrosine kinase 2（JAK2）/signal transducer and activator of transcription 3（STAT3） signaling pathway， Toll like receptor 4（TLR4）/nuclear transcription factor-κB（NF-κB） signaling pathway，Notch signaling pathway， and matrix metalloproteinase-9（MMP-9）/p38 mitogen-activated protein kinase（p38 MAPK） signaling pathway. Gegen Qinliantang regulates the intercellular molecular transmission in multiple pathways to protect the intestinal mucosal barrier， adjust the immune response and anti-oxidative stress， and relieve UC， demonstrating the multi-target， multi-mechanism， and multi-pathway advantages of TCM compounds.
RESUMO
<p><b>OBJECTIVE</b>To study the feasibility of binding pancreatic duct to mucosa anastomosis (BDM)-a complementary procedure to both binding pancreaticojejunostomy and binding pancreaticogastrostomy.</p><p><b>METHODS</b>(1) Animal experimental study:gastrostomy and jejunostomy were performed on six adult New Zealand rabbits. The gastrostomy and jejunostomy shared a same stent (rubber urethral catheter, silicone tube or plastic infusion tube). Both ends of the stent were placed in gastric and enteric cavity. Purse-string suture was performed around the stent before the jejunum and the stomach were brought together for fixation by few stitches. And to observe whether the purse-string suture around a plastic tube, rubber tube or silicon tube inserted into jejunum and/or stomach can prevent leaking out of the jejunal or gastric content to cause peritonitis. (2) Clinically 7 patients were performed with BDM anastomosis. The procedure was consisted of five steps: preparation of the pancreatic stump;preparation of the jejunum; preparation of the fixing sutures between the pancreatic stump and the jejunum; implementation of the anastomosis; lastly, fixation of the jejunum beside the pancreas stump. Post-operative periodic examination of the blood amylase and the amylase in the abdominal drainage. Pancreatic fistula was classified in to two categories: parenchymal fistula (pancreatic cut surface fistula) and anastomotic leakage.</p><p><b>RESULTS</b>Animal experiment did not show any leakage around the plastic tube or silicon tube inserted into jejunum and(or) stomach. There was no anastomotic leak in all the patients. There was transient increase of amylase in two cases, but the volume of drainage did not exceed 50 ml/d and the recovery of the patients was not affected.</p><p><b>CONCLUSIONS</b>BDM is a simple, safe and easy procedure to perform. It provides to the surgeons with a new option in different situations to achieve the most ideal surgical result.</p>