Objective To study the effect of endoscopic treatment in acute severe pancreafitis. Methods EST(endoscopic sphincterepapiilotomy) and ENBD ( endoscopic naso-billary dralnage) or ENPD ( endoscopic naso-pancreatic drainage) were used to treat the acute severe pancreatitis(ASP). Results The recover time of blood dia-stase of the endoscopic therapy group and the contrast group was (3.2±1.5) days, (6.6±1.2) days, respectively (P<0.01) ; the incidence of needing to be operated was 0.7% (1/140), 6.5% (8/124), respectively (P<0.05) ;mortality rate was 0:7% (1/140) ,7. 3% (9/124) ,respectively(P <0. 01 ) ;the incidence of complication was 3.6% (5/140) ,41.9% (52/124), respecfivly(P<0.01). Conclusion EST + ENBD(or ENPD) in treating ASP has cer-tain effect and is the primary therapy to the ASP.

Digestive System Neoplasms ; classification ; pathology ; surgery ; Lymphoma ; classification ; pathology ; surgery ; Neoplasm Staging ; Pathology ; trends ; Pathology, Surgical ; trends ; Urogenital Neoplasms ; classification ; pathology ; surgery ; World Health Organization

Animals ; Colorectal Neoplasms ; blood ; etiology ; Humans ; Hyperinsulinism ; blood ; complications ; Insulin ; blood ; Insulin Resistance ; Insulin-Like Growth Factor Binding Proteins ; blood ; Insulin-Like Growth Factor I ; metabolism ; Metabolic Syndrome ; blood ; complications ; Receptor, IGF Type 1 ; blood ; Receptor, Insulin ; blood

Adenomatous Polyposis Coli ; genetics ; metabolism ; pathology ; Bone Morphogenetic Protein Receptors, Type I ; genetics ; metabolism ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; metabolism ; pathology ; Genes, APC ; Genetic Predisposition to Disease ; Hamartoma Syndrome, Multiple ; genetics ; metabolism ; pathology ; Humans ; Microsatellite Instability ; Mutation ; PTEN Phosphohydrolase ; genetics ; metabolism ; Peutz-Jeghers Syndrome ; genetics ; metabolism ; pathology ; Protein-Serine-Threonine Kinases ; genetics ; metabolism ; Proto-Oncogene Proteins B-raf ; genetics ; metabolism

Aging ; psychology ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Learning ; drug effects ; Male ; Memory ; drug effects ; Rats ; Rats, Wistar

The Nipah virus outbreak in Malaysia (September 1998 to May 1999) resulted in 265 cases of acute encephalitis with 105 deaths, and near collapse of the billion-dollar pig-farming industry. Because it was initially attributed to Japanese encephalitis, early control measures were ineffective, and the outbreak spread to other parts of Malaysia and nearby Singapore. The isolation of the novel aetiological agent, the Nipah virus (NiV), from the cerebrospinal fluid of an outbreak victim was the turning point which led to outbreak control 2 months later. Together with the Hendra virus, NiV is now recognised as a new genus, Henipavirus (Hendra + Nipah), in the Paramyxoviridae family. Efforts of the local and international scientific community have since elucidated the epidemiology, clinico-pathophysiology and pathogenesis of this new disease. Humans contracted the infection from close contact with infected pigs, and formed the basis for pig-culling that eventually stopped the outbreak. NiV targeted medium-sized and small blood vessels resulting in endothelial multinucleated syncytia and fibrinoid necrosis. Autopsies revealed disseminated cerebral microinfarctions resulting from vasculitis-induced thrombosis and direct neuronal involvement. The discovery of NiV in the urine and saliva of Malaysian Island flying foxes (Pteropus hypomelanus and Petropus vampyrus) implicated these as natural reservoir hosts of NiV. It is probable that initial transmission of NiV from bats to pigs occurred in late 1997/early 1998 through contamination of pig swill by bat excretions, as a result of migration of these forest fruitbats to cultivated orchards and pig-farms, driven by fruiting failure of forest trees during the El Nino-related drought and anthropogenic fires in Indonesia in 1997-1998. This outbreak emphasizes the need for sharing information of any unusual illnesses in animals and humans, an open-minded approach and close collaboration and co-ordination between the medical profession, veterinarians and wildlife specialists in the investigation of such illnesses. Environmental mismanagement (such as deforestation and haze) has far-reaching effects, including encroachment of wildlife into human habitats and the introduction of zoonotic infections into domestic animals and humans.
Swine ; Virus ; Malaysia ; seconds ; control

Objective To evaluate the diagnostic value of the early rheumatoid arthritis (RA) classification criteria for early RA and to assess the clinical efficacy of knee arthroscopic synovectomy for RA.Methods A total of 62 patients who had arthritic complaints with disease duration less than one year were treated with knee arthroscopic synovectomy.Patients were diagnosed as RA confirmed by changes of synoviomorphous under arthroscopy,synovial biopsy,immunological biochemical laboratory and MRI,and compared with the preoperative ERA diagnosis.The efficacy was assessed at the third months and more than 12 months after operation,including Health Assessment Questionnaire (HAQ),Lysholm score,laboratory parameters of erythrocyte sedi-mentation rate (ESR) and C-reactive protein (CRP).Results The sensitivity and specificity in the early RA classification criteria for RA diagnosis were 81.58％ and 91.67％.38 patients diagnosed as RA and the remaining 24 patients were significantly improved of HAQ,Lysholm score,ESR,CRP compared with preoperation,showed statistical difference (P ＜ 0.01).There were still statistical differences between the follow-up results of the group of patients with RA in different period after operation (P ＜ 0.01).Conclusion The early RA classification criteria is worthy of clinical application,because it has the advantages of simple,practical,and is beneficial to early diagnosis of RA.The early RA patients should be treated with knee arthroscopic synovectomy as far as possible.It can improve not only the knee function,but also the general symptoms,and it can interrupt the RA pathological process,effective maintain curative effect after operation.

Left ventricular pseudoaneurysm is a rare complication of myocardial infarction or cardiac trauma. We report a case of sudden death from rupture of such a lesion. Clinically, these lesions need to be distinguished from the other ventricular out-pouching lesions (true aneurysms and diverticula) because of their greater likelihood for rupture. Pathologically, apart from often being infarct-related, they are characterized by a narrow connection with the ventricular cavity and a fibrous outer wall that is devoid of myocardial tissue.
Lesion, NOS ; Left ; seconds ; Traumatic Rupture ; Case Report

Objective To evaluate the treatment of lateral tibial plateau fractures involving the posterolateral condyle with double plate fixation via the combined anterolateral and posterolateral approaches.Methods From January 2013 to August 2015,12 patients with lateral tibial plateau fracture involving the posterolateral condyle were treated by double plate fixation via the combined anterolateral and posterolateral approaches.They were 8 males and 4 females,with an average age of 36.9 years (range,from 23 to 58 years).According to the Schatzker classification,we had 8 ones of type Ⅱ,3 ones of type Ⅴ and one of type Ⅵ.Firstly,the posterolateral condylar fractures were stabilized temporarily by the Kirschner wire after reduction through the posterolateral approach.Secondly,the lateral tibial plateau fractures were dealt with via the anterolateral approach,and fixated with a proximal tibial locking plate.Finally,a T-shaped plate for the distal radius was used to support the posterolateral condyle.The clinical and radiographic results were evaluated using the Hospital for Special Surgery (HSS) knee score and the Rasmussen Score,respectively.Results The average operative time was 143.3 min (range,from 110 to 210 min);the average intraoperative blood loss was 190.0 mL (range,from 100 to 300 mL).The follow-ups for the 12 cases ranged from 12 to 24 months (average,16.6 months).All the cases obtained clinical healing after 12 to 24 weeks (average,16 weeks).At the last follow-up,the HSS knee-scores ranged from 65 to 98 points (average,84.6 points),giving 7 excellent cases,3 good ones and 2 fair ones.The Rasmussen radiological scores ranged from 13 to 18 points (average,17.1 points),giving 8 excellent and 4 good cases.Conclusions The combined anterolateral and posterolateral approaches can offer excellent exposure for articular reduction and fixation with double plates,achieving satisfactory radiological and functional results in lateral tibial plateau fractures involving the posterolateral condyle.First reduction of the posterior lateral condylar fractures,followed by reduction and fixation of the anterolateral plateau fractures and finally fixation of the lateral condylar fractures,can lead to effectively improved knee function for the patients.