Objective Analysis of early risk predict markers within 24h after admission of prognosis in severe acute pancreatitis (SAP). Methods Medical records of 127 patients with sever acute pancreatitis admitted to our hospital within 72h after onset from February 2006 to July 2009 were retrospectively analyzed. These inpatients were grouped into survival group (102 cases) and death group (25 cases). The clinical and laboratory data within 24h after admission were compared between two groups. Results Compared with survival group, patients in death group had significantly difference in heart rate, respiratory, PaO2, pH value, serum calcium, serum kalium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱscores (P<0.05). Higher APCHE Ⅱ scores after admission was an independent early high risk predicator of death. Conclusions Death group was characterized as severe multiple organ dysfunction and severe internal disturbance. Heart rate, respiratory, PaO2, pH value, serum calcium, serum potassium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱ scores were early risk predict markers of death in patients with sever acute pancreatitis.

Objective To study the effect of different warm-ischemia time on islet structure, yield and function. Methods Adult pigs were studied, and according to warm ischemic time (WIT, 0, 10, 20, 30, 45 min), the porcine pancreata were divided into 5 groups (A, B, C, D, and E group). The isolation of adult porcine pancreas was carried out by injection of Hanks into pancreatic duct and digestion with collagenase Ⅴ and Ⅰ. A discontinuous Ficoll 400 solution was applied for purifying islets. The structure, purity and viability of islets were determined by dithizone staining and AO/PI staining, and the function of islets was evaluated by the glucose stimulating insulin release test. Results There were little islets debris in group A, B and C. But it was very difficult to obtain integrate islets in group E. There was no significant difference between the groups of 0, 10 and 20 min in islet number before and after islet purification ( P ＞ 0.05 ), while the difference was significant when warm ischemic time was prolonged to 30 min and 45 min ( P ＜ 0. 01 ). In respect of islet function, the similar results were found in different groups. Conclusions When WIT is within 20 min, there is no deleterious effects on islet morphology and yield as well as function. However, when WIT is prolonged to 30 min, the loss in islet yield is severe, and the islet function is significantly impacted.

Objective To evaluate the effect of anti-rejection of glucocorticoid-free immunosuppressive regimen on allogenic islet transplantation.Methods Tacrolimus (FK506)+ mycophenolate mofetil (MMF) and FK506+MMF+prednisone (Pred) were administered respectively for two weeks to inhibit rejection after allogenic islet transplantation in rats,which were compared with control group. The concentrations of blood glucose,insulin and C-peptide were determined dynamically in recipients and the sites of transplantation were observed morphologically.Results As compared with control group without immunosuppressive agents,FK506+MMF and FK506+MMF+Pred could prolong the survival time of grafts significantly. There were many morphologically intact islets in liver of recipients two months after transplantation. Group FK506+MMF kept normal blood glucose,insulin and C-peptide beyond 60 days after transplantation,but compared with the former,group FK506+MMF+Pred secreted less C-peptide ( P

BACKGROUND: To synthetically analyze the correlation between cytokeratin 19 and pancreas stem cells.DATA SOURCES:References about the correlation between cytokeratin 19 and pancreas stem cells were retrieved in Medline and Ovid database with the key words of "cytokeratin, pancreas, stem cells, marker, differentiation" in English from January 2000 to May 2006.STUDY SELECTION:Literatures about the correlation between cytokeratin 19 and pancreas stem cells were retrieved and those characterized by strong pertinency, published in the near future and selected from authoritative journals were selected in this paper.DATA EXTRACTION: Among 86 articles, 35 of them met the inclusion criteria and 51 were excluded.DATA SYNTHESIS:Pancreas stem cells are characterized by multi-directional differentiation.Cytokeratin 19 has a positive expression in pancreas stem cells and a molecular sign of pancreas stem cells. This provides a new way to further understand bionomics of pancreas stem cells,study separation,purification,transconformation and direction differentiation to islet cells, and treat diabetes mellitus with transplantation of pancreas stem cells.CONCLUSION: Expression of cytokeratin 19 is observed during the differentiation of pancreas stem cells and cytokeratin19 is a sign of pancreas stem cells.

Early portal vein thrombosis is a rare but serious complication after liver transplantation,also is one of the main causes which lead to graft loss and receptor death. We collected domestic and foreign relevant data,and summarized and discussed the causes, clinical manifestation, imaging diagnosis of early portal vein thrombosis after liver transplantation. Early portal vein thrombosis after liver transplantation caused by multiple risk factors synergy. It was reported incidence of 1% to 2%. Clinical manifestations were concealment and lacked of specificity. Abdominal ultrasound and computed tomography angiography ( CTA) imaging methods of combi?ning could help early clinical findings,When necessary magnetic resonance angiography( MRA) . If each check negative,portal vein angiography could make a definitive diagnosis. Intravascular interventional therapy with small trauma, less complications and high success rate for advantages gradually became first?line treat?ments. Surgical treatment is not only as traditional effective treatments,but also an effective remedial measures after interventional treatment failure.

Objectives: To investigate the feasibility, safety, indication, and clinical effect of real-time ultrasound-guided percutaneous radiofrequency ablation and surgical resection for adult hepatic haemangioma. Methods: The clinical data of real-time ultrasound- guided percutaneous radiofrequency ablation and partial hepatectomy for 79 patients with adult hepatic haemangioma between July, 2005 and June 2008 were retrospectively analyzed. Results: The real-time ultra-sound-guided percutaneous radiofrequency ablation was safely carried out in 18 lesions of 11 patients with hepatic haemangioma. The Surgical resections were done for 68 patients. The surgical procedures were safely carried out in all 79 cases of adult hepatic haemangioma. No one died after operations. The average operation time were(67.2?23.2)min and(108.4?26.3)min in percutaneous radiofrequency ablation group(PRFA)and surgical resection group(SR)respectively(P

Objective To analyze etiopathogenisis, diagnosis and treatment of the aged with bowel obstruction. Methods The clinical data of 168 cases with bowel obstruction, whose age were more than 60 years,in our hospital from 1998 to 2007 were reviewed retrospectivly. Results In all the cases,32 patients' original disease were abdomenal hernia,6 patients were mesenteric vascular thrombus,75 patients were bowel tumor, 12 patients were feces,18 patients were false colonic obstruction and 25 patients were ankylenteron. 114 cases (67.68%) received operation,43 patients (25.59%) received expectant treatment and 11cases received colonofiberscope therapy. 138 cases (81.55%) were cured without any complication. 25 cases(14. 88%) had this or that kind of complication. 5 cases (2. 98%) were dead. Conclusion Firstly, the regular original disease of the aged with bowel obstruction were bowel tumor. Secondly,most elderly patients with bowie obstruct should be cured after operations. Thirdly,the aged with bowel obstruction would have higher complication rate,which should attract our enough attention.

Objective To investigate early diagnosis, clinical effect of surgical treatment and prognosis of a-cute appendicitis in elderly. Methods The clinical data of acute appendicitis in elderly undergoing surgical therapy between January 1994 and November 2008 was analyzed retrospectively, and predisposing factors, diagnostic meth-ods, therapeutic effect of operation and prognosis were studied. Results Acute appendicitis in elderly was diagnosed in 276 cases(114 female/162 male). There were 7 cases of deaths. MoRality was 2.5% (7/276). Stitches were taken out from 6 to 8 days after operation. Average stay was 8 days. 196 cases(71.0%) of wound healing at grade A, 43 cases(15.6%) at grade B ,37 cases(13.4%) at grade C. 86 cases(31.2%) with perforated acute appendici-tis, and 7 cases(2.5%) with periappendiceal abscess were confirmed after operation. 76 cases auompanied with con-comitant diseases, 87 cases auompanied with postoperative early complications, and 39 cases(14.1%) with postop-erative wound or intra-abdominal septic complications. Conclusion Key point of improvement of operative therapeu-tic effect and prognosis of acute appendicitis in elderly are early diagnosis, operation in time, and effective treatment of associated diseases and complications.

BACKGROUND: Pancreatic stem cells can be differentiated into endocrine functioning cells under a suitable cultivation condition, suggesting that pancreatic stem cells can be used as a new source of islet in treating diabetes mellitus.OBJECTIVE: To discuss the expression of stem cell in different purities of pancreatic islets.DESING: A controlled observation based on cells.SETTING: Third People's Hospital of Mianyang City.MATERIALS: The experiment was conducted in the Center Laboratory (Key Laboratory of Chongqing City), the First Affiliated Hospital of Chongqing Medical University from March 2005 to March 2006. Thirty healthy male SD rats, of clean grade, aged 50 days were used in this study. During the experiment, the disposal of animals corresponded to Animal Ethical Standard. Cytokeratin (CK)-19 and β-actin were designed by Shanghai Invitrogen Biological Co., Ltd.Brdu reagent, mouse anti-rat Brdu monoclonal antibody, rabbit anti-mouse (RAM) CK-19 polyclonal antibody and Brdu immunohistochemical kit were from Boster Co., Ltd. (Wuhan); HistostainTM -DS double immunohistochemical staining kit was purchased from Beijing Zhongshan Company.METHODS: Rats were intraperitoneally injected with Brdu for labeling, and subjected to perfusion with Ⅴ-type collagenase via pancreatic ducts, with pancreas being excised, ripped, beaten up, digested and centrifuged to obtain pancreatic islet sediments. After being precipitated, the sediments were divided into 3 groups. Group A: The isolated sediments of islets were not purified; Group B: The sediments were added slowly with 25% Ficoll-400 and Hanks solution for purification; Group C: The sediments were slowly added with 25% Ficoll-400, 11% Ficoll-400 for purification in order.MAIN OUTCOME MEASURES: Expressions of Brdu and CK-19-positive cells in the islet samples were detected by immunohistochemical method, and mRNA expression of CK-19 in the different purities of islets was detected by reverse transcription-polymerase chain reaction.RESULTS: ① The purity of islets in the group A was the lowest. The purity of islets obtained by different purification techniques showed significances among the three groups (F =89.42, P ＜ 0.05). ②Positive expressions of Brdu and CK-19 in the group A were significantly higher than those in the group B and group C (F =18.64, 22.12, 38.61. P ＜0.01). ③Expression of CK-19 mRNA in the group A was significantly higher than that in other groups, with group C showing the lowest.CONCLUSION: Expressions of Brdu and CK-19-positive cells exist in different purities of islets, suggesting the existence of more stem cells in the low purify of islets.

Retmperitoneal ganglioneuroma is a rare neurogenic benign tumor.The prognosis of patients was good when the tumor was completely resected,while the surgical procedure is complicated.In March of 2013,a male patient with complex retroperitoneal ganglioneuroma was treated at the First Affiliated Hospital of Chongqing Medical University.A hypoechoic solid lesion (size,6.5 cm ×4.5 cm) adjacent to the head of the pancreas was detected by color Doppler ultra-sonography 9 months ago,and no any other clinical symptoms were detected.Perioperative abdominal computed tomography and the surgery confirmed that the tumor (size,8.5 cm × 7.5 cm × 4.5 cm) was located beneath the pancreas,encompassing thc ccliac artery,hepatic artery,splenic artery and superior mesenteric artery,surrounding the head and uncinate process of the pancreas,making it impossible to be separated.The tumor was closely connected with the portal vein,superior mesenteric vein,splenic vein and left renal vein.The tumor was separated from the major blood vessels,the body and tail of the pancreas,while the tumor could not be resected from the pancreatic head,and thus tumor resection and pancreaticoduodenectomy were performed.The surgery was extremely diffcult,but the complete removal of tumor was successfully achieved without excision of the major blood vessels and the patient recovered well.