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Objective: To investigate the therapeutic effect and possible mechanism of sinomenine(SIN) on type 2 diabetic(T2DM) mice with liver cancer(HCC). Methods: Eight-week-old male BALB/c mice(20-25 g) were divided into Control, T2DM+HCC,SIN-L, SIN-M and SIN-H group. Mice in the Control group were fed normally, and mice in other groups were injected intraperitoneally with streptozotocin(STZ) and inoculated with hepatocellular carcinoma cells(H22) in liver parenchyma to establish T2DM combined with HCC mice model. Mice in the SIN-L, SIN-M and SIN-H group were intraperitoneally injected with 10, 20 and 40 mg/kg/d of sinomenine, respectively. Mice in the Control group and T2DM+HCC group were intraperitoneally injected with 0.5 m L of normal saline respectively. All the mice were treated for 21 days. 24 hours after the last administration, the liver index was calculated and fasting blood glucose(FPG), fasting insulin(FINS), serum total cholesterol(TC), triglyceride(TG)], alanine aminotransferase(ALT), aspartate aminotransferase(AST) and lactate dehydrogenase(LDH), liver superoxide dismutase(SOD), catalase(CAT), Glutathione peroxidase(GSH-PX)and malondialdehyde(MDA) levels were detected. Liver morphology was observed by hematoxylin and eosin(HE) staining. The protein expression of BCL2, BAX, P53, signal transducer and activator of transcription 3(STAT3), cytokine signal inhibitor 3(SOCS3) and sterol regulatory element binding protein-1(SREBP-1) in liver tissue were detected by Western blot. Results: The median survival time of T2DM+HCC group, SIN-L group, SIN-M group and SIN-H group was 25, 32, 35 and 41 days respectively(P＜0.001), the median survival time of mice extended with the increase of sinomenine concentration. Compared with T2DM+HCC group, the levels of FPG, FINS, TC and TG in SIN-L, SIN-M and SIN-H group decreased, serum ALT, AST and LDH levels decreased, the basic rules of hepatic cell arrangement, edema, vacuolar degeneration, inflammatory cell infiltration and other lesions were significantly reduced, liver index decreased, liver SOD, CAT and GSH-PX levels increased, liver MDA level decreased, liver BCL2 protein expression decreased, liver BAX and P53 protein expression increased(P＜0.05). Compared with T2DM+HCC group, the expression of p-STAT3(Tyr705), SOCS3 and SREBP-1 protein in liver of SIN-L, SIN-M and SIN-H group decreased in a dose-dependent manner(P＜0.05). Conclusion: Sinomenine can effectively prolong the survival time of type 2 diabetic mice with liver cancer, improve the blood glucose and lipid levels as well as the live function, and inhibit the growth of cancer cells, which may be related to the inhibition of STAT3 signaling pathway. [ABSTRACT FROM AUTHOR]

Objective To study the skills and effects of endoscopic retrograde appendicitis therapy (ERAT) in treating patients with uncomplicated acute appendicitis. Methods We enrolled 21 patients with suspected acute appendicitis who then underwent emergent ERAT between October 2014 and January 2015. The data of treatment were collected and the operative skills and effects of ERAT were analyzed. Results ERAT was completed successfully in all the patients, resulting in a success rate of 100%. Mean operation time of ERAT was (49.7±18.2)min and mean hospital stay was (3.3±1.6)d. Cannulation of the appendix lumen was the most critical step of ERAT, and cannulation time [(5.7±4.9)min, P<0.05] was shortened significantly by the use of LoopTip guidewire. Fourteen patients with intraluminal appendicoliths (7 of massive appendicoliths, 4 of sand-like appendicoliths and 3 of sand-like appendicoliths with luminal stenosis) underwent endoscopic lithotomy successfully with balloon or basket, with the success rate of 100%. One patient who presented perforation after appendicolith removal by basket was cured with conservative treatment. Appendix stent was inserted, then pulled out after 1 week in 9 patients, while no complaint or complication of the stent was observed. Operation time of ERAT shortened with the increase of case number. Conclusion ERAT is an effective and safe therapy for treating patients with uncomplicated acute appendicitis. The high success rate and safety of ERAT will be achieved by selecting suitable instruments for cannulation and appendicolith removal, deciding suitable indications for stenting, and accumulating of operative cases. [ABSTRACT FROM AUTHOR]