Objective To compare the incidence of pancreatic fistula after hand and stapler suture in preventing pancreatic fistula after distal pancreatectomy.Methods The literatures published before December 2011 were retrieved from SinoMed and electronic database.Prospective controlled trials and retrospective reports were screened out for Meta analysis.The diagnostic criteria of pancreatic fistula were based on the criteria formulated by the International Study group of Pancreatic Fistula.The heterogeneity of the studies was analyzed using the Ⅰ2 test.The data were integrated using the fixed or random effect model.The results of the Meta analysis were presented with odds ratio (OR) and 95％ confidence interval (95％ CI).Results According to the selection criteria,lO literatures were selected which included 1 prospective randomized controlled study,3 prospective nonrandomized controlled studies and 6 retrospective studies.There were 1 441 cases in the hand suture group and 612 cases in the stapler suture group.There was no significant difference in the incidences of the pancreatic fistula between the hand suture group and the stapler suture group (OR =1.10,95％ CI:0.86-1.40,P ＞0.05).Six studies compared the incidences of severe pancreatic fistula (grade B or C) between the hand suture group and the stapler suture group.There were 1 182 cases in the hand suture group and 383 cases in the stapler suture group.There was no significant difference in the incidence of severe pancreatic fistula between the hand suture group and the stapler suture group (OR=1.33,95％CI:0.94-1.88,P＞0.05).Conclusion The efficacies of hand suture and stapler suture in preventing pancreatic fistula after distal pancreatectomy are comparable.Stapler suture provides an another option in distal pancreatectomy.

Objective To explore effective treatment of uremic hemodialysis patients with chronic helicobacter pylori-negative erosive gastritis.Methods Fourty-eight cases of uremic hemodialysis patients with helicobacter pylori-negative chronic erosive gastritis were diagnosed by detection of helicobacter pylori and endoscopic examination.Fourty-eight patients were randomly divided into two groups,treatment group (24 patients) with oral pantoprazole 40 mg,once a day,combinding with oral Marzulene-S particles,each 0.67 g,three times a day,the control group (24 cases ) only with the dose of pantoprazole treatment.Effect of treatment was compared in these two groups after treatment for 21 days.Results Twenty-one days after treatment,the clinical symptoms of uremic hemodialysis patients with upper gastrointestinal improved in treatment group,and the performance of endoscopic and histopathological has varying degree of improvement.It shows that pantoprazole combined with Marzulene-S treatment group has a significant effect than that single treatment with pantoprazole group.In the treatment group,the total effective rate was 95.83％,however it was 83.33％ in the control group( U =2.716,P ＜ 0.01 ).Repair of mucosal lesions were significantly different between the two groups ( total effective rate 83.33％ vs 45.83％,U =2.349,P ＜ 0.05 ).Conclusion Pantoprazole combined with Marzulene-S therapy has a significant effect on uremic hemodialysis patients with chronic Helicobacter pylori-negative erosive gastritis.

Objective To evaluate the method of hemodialysis patients with the diagnosis and treatment of herpes zoster.Methods Diagnosis and treatment of 27 cases of hemodialysis patients with varicella-zoster virus (VZV) infection in patients with clinical data.Results All patients in addition to continuing the line hemodialysis treatment,use the ganciclovir,topical recombinant human interferon α -1b cream,vitamin Bl,Methycobal,antibiotics to prevent bacterial infection,oral medicine,comprehensive treatment of pain.The total effective rate of treatment group is 92.59％.Conclusion VZV was a common disease in hemodialysis patients,easy diagnosis,rational drug treatment is very important,need comprehensive treatment can achieve good results.

Objective: To observe the dynamic changes of plasma level thymosinβ4 (Tβ4) in acute myocardial infarction (AMI) patients with intervening therapy within 15 days of onset and to explore the relationship between Tβ4 and clinical prognosis in AMI patients.
Methods: Our research included 2 groups:AMI group, n=69 and Control group, the patients with suspected chest pain while CAG excluded coronary artery stenosis, n=32. Plasma levels of Tβ4 were examined in all AMI patients on admission day and every day until 15 days of onset;AMI patients were followed-up for 18 months and the endpoint was defined as major adverse cardiovascular event (MACE) occurrence.
Results: ①Compared with Control group, AMI group had increased plasma level of Tβ4 on admission day and on day-15 of onset, P<0.01. ② With intervening therapy, AMI group had elevated Tβ4 level upon immediate onset, it was decreased on day-1, reached low level on day-3 and elevated to peak on day-6, then reduced followed by slightly raising on day-11.③During follow-up period, the AMI patients without MACE had the higher mean in-hospital maximum Tβ4 value than those with MACE occurrence, P<0.01. Logistic regression analysis indicated that the mean in-hospital maximum Tβ4 value was related to MACE occurrence during follow-up period (OR=0.999, 95%CI 0.999-1.000).
Conclusion: AMI may induce up-regulated expression of plasma Tβ4;with intervening therapy, Tβ4 showed a trend of“elevation-reduction-elevation-reduction”at the early stage of AMI. High expression of Tβ4 was helpful for improving clinical prognosis in AMI patients which may provide a theoretical basis for exogenous use of Tβ4 in AMI treatment.

[ Abstrct] Back in the 1980s, β?blockers was widely used because of decreased myocardial infarction mortality and protected heart function. In recent years, with the rapid development of percutaneous coronary intervention ( PCI) technology, the mortality of pa?tients with acute myocardial infarction ( AMI) significantly decreased. The issue of whether patients with AMI continue to benefit fromβ?blockers treatment is disputed. This review is aim to retrospect the researches about the effects ofβ?blockers on patients with AMI in aspects of myocardial infarct size, heart failure and mortality after AMI, meanwhile summarizing the rational use ofβ?blocker therapy in the PCI era.

Objective:To investigate the clinical features of neonatal testicular torsion and to evaluate the effect and necessity of early intervention.Methods:A retrospective analysis was performed on 11 neonates admitted to the Second Hospital of Shandong University with neonatal testicular torsion from June 2017 to June 2022. Clinical data of these cases including clinical manifestations, ultrasonography findings, surgical management and outcomes were reviewed and analyzed with descriptive statistical methods.Results:The median age of the 11 patients on admission was 2.6 d (1-5 d). The median time from finding abnormal scrotum to admission was 12 h (1-120 h). Various degrees of scrotal swelling or scleroma were found in the patients. Among them, seven patients presented with acute inflammatory signs of cyano sis or skin redness, and testis-like tissue induration could be touched. Ultrasound scan showed abnormal blood flow in the affected testicle in all cases. Emergency scrotal exploration under general anesthesia was performed successfully in all cases and ten of them underwent orchiectomy of the affected testicle plus contralateral orchiopexy. The rest one who was admitted within 1 h after birth only underwent orchiopexy of the affected testicle as the parents refused contralateral testicular exploration. During the operation, 12 twisted testis were observed, including seven with extravaginal torsion, three with intravaginal torsion and two adhering to the surrounding tissue without normal testicular tissue or distinguishable torsion direction or degree. In this study, ten patients had unilateral testicular torsion, which affected the left side in seven cases and the right side in three cases, and one had bilateral testicular torsion, which was diagnosed as left testicle torsion before surgery. During scrotal exploration, the left testicle of this bilateral case was resected due to necrosis, while the right testicle twisted about 180 degrees with good blood flow and was subjected to orchidopexy after reduction. In one case, the unaffected testicle was unfixed and dysplastic during contralateral exploration, which was also subjected to orchidopexy. In the 12 testis with torsion, one testicle of the patient admitted within 1 h after birth and the right testicle of the bilateral case were preserved with a salvage rate of 2/12. Pathological examination showed necrosis in the ten excised testis, and fibrosis and calcification foci in two of them. None of the patients had any perioperative complications and the scrotal incision healed well in all neonates. The patients were followed up for 6-12 months with regular ultrasound. The two preserved testis and the contralateral testis subjected to orchidopexy were located in the scrotum with good blood supply, and no torsion, atrophy or other abnormalities occurred.Conclusions:Neonatal testicular torsion is rarely seen in clinical practice and has no specific manifestations. It has a high excision rate due to testicular necrosis. Early diagnosis and bilateral scrotal exploration are crucial to the prognosis and the keys to save the affected testis and avoid anorchidism.

Bacterial biofilm refers to a tunicate-like biological group composed of polysaccharide, protein and nucleic acid secreted by bacteria on the surface of the mucous membrane or biological material. The biofilm formation is a major cause of chronic infections. Bacteria could produce some secondary metabolites during the growth and reproduction. Some of them act as signaling molecules allowing bacteria to communicate and regulate many important physiological behaviors at multiple-cell level, such as bioluminescence, biofilm formation, motility and lifestyles. Usually, these signal molecules play an important role in the formation of bacterial biofilm. We review here the effects of related signal molecules of Quorum Sensing, cyclic diguanylate, Two-Component Systems and sRNA on the biofilm formation. Focusing on these regulation mechanism of signal molecules in the process of biofilm formation is necessary for the prevention and treatment of some chronic diseases.
Bacterial Proteins ; Biofilms ; Cyclic GMP ; Gene Expression Regulation, Bacterial ; Protein Binding ; Quorum Sensing