Objective To evaluate the diagnosis and treatment of chronic pancreatitis complicated by stricture and dilation of the pancreatic duct. Methods The clinical data of 27 patients of chronic pancreatitis with stricture and dilation of the pancreatic duct undergoing operation in our hospital from 1990 to 1999 were analyzed retrospectively. Results Of the 27 patients, the positive diagnosis rate was 89% by B-US, 100% by CT, 100% by MRCP, 100% by ERCP. All patients received surgical operation, 12 patients received Partington procedure, 3 distal pancreatectomy, 4 pylorus preserving pancreaticoduodenectomy, 4 Beger procedure, 2 Frey procedure, 2 pancreatic cystojejunostmy. The complication rate was 11%. Postoperatively 89%(24/27) patients achieved pain relief,78%(18/23) gained in body weight, and diabetes significantly relieved in 5 cases(33%). Conclusion Appropriate diagnosis and treatment are very important for improving the patients′ life quality and natural history of chronic pancreatitis with stricture and dilation of the pancreatic duct.

Objective To investigate the localization of human herpesvirus (HHV-8) in lesions of Kaposi′s Sarcoma (KS) and explore the role of HHV-8 in the pathogenesis of KS in Xinjiang. Methods HHV-8 DNA was detected by fluorescence in situ polymerase chain reaction. A total of 40 paraffin-embeded specimens were studied, including 20 KS lesions (12 nodular, 6 plaque and 2 patch lesions) and 20 non-KS lesions (18 dermatofibroma and 2 hemangioma). Results HHV-8 DNA was detected in 17 (85%) of 20 KS lesions and none in non-KS lesions (P

Objective To understand websites of public hospitals in China.Methods Website search and appraisal were called into play to analyze the percentage and present conditions of websites built by public hospitals in Shanghai,Hubei Province and Gansu Province.Rusults The study found websites in less than 55％ of the public hospitals in these three areas.Those websites in operation provide instant information on hospitals and medical services,yet their online service functions are less satisfactory and website levels vary sharply.Conclusion The authors recommend the Chinese government encourage public hospitals to build websites and enhance their online services.

Glomerulonephritis and rheumatic heart disease are usually inferred as immune complex disease caused by infections, but the pathogenesis of rheumatic heart disease is still not clear. In this experiment, we infected 38 rabbits with cercariae of S. japonicum and de-monstrated the histopathological changes of endocarditis, myocarditis and perivasculitis in the heart tissues of 33(86.8%) infected rabbits. Thrombosis was also found in heare vessels, but adult schistosomes or eggs were not found in the heart tissues. Direct and ndirect immune enzyme staining studies showed the presence of schistosome-specific antigenst and host antibodies in the heart tissues, suggesting that the histopathological changes in ithe infected rabbit hearts were resulted from the deposition of immune complexes and th secondary events pf host autoimmune reactions. In this paper, correlative clinical cases were reviewed and the possibility of heart disease in human schistosomiasis caused by immune mechanism was discussed. We hope that the above findings might broaden our understanding of the pathogenesis of rheumatic heart disease, myocardiopathy and cardio-vascular diseases (Plates 1-3).

Bacillus megaterium strains are commonly used in microbial fertilizer(MF) . MF products are often contaminated by other B. cereus group members,which have similar phenotype such as Bacillus cereus,B. thuringiensis,B. mycoide. For quality control and safety of MF,a rapid and accurate method is needed to distinguish the strains of Bacillus megaterium from B. cereus group. Based on specific nucleotide sequences of the spoOA genes,2 pairs of species-specific primers were designed and a multiplex-PCR(mPCR) was developed for this purpose. When the optimized mPCR was used to detect the DNAs of 24 reference strains from three genera of Bacillus,Paenibacillus,and Brevibacillus,all B. megaterium strains showed singlefragment of 443 bp and Bacillus cereus group showed a fragment of 411 bp. However,no any amplified product was from the other bacteria. The sensitivity of mPCR was 105 CFU/mL. The mPCR results of 10 isolates of B. megaterium/B. cereus group and 8 products of MF coincided with the biochemical assay. Taken together,our newly developed mPCR assay was species-specific and effective in application. It can be used to detect and identify the strains of B. megaterium and B. cereus group from microbial fertilizer products.

Objective To determine the advantages of laparoscopic cholecystectomy (LC) by establishing pneumoperitoneum under direct vision. Methods A 1cm incision was made just below the umbilicus; lifting and cutting out of the peritoneum at the line alba abdominis with direct vision; then a 10mm trocar was inserted into the pneumoperitoneum cavity.Results There were 107 patients underwent LC.Of them, 93 patients suffered from chronic cholecystitis with gallstone, 6 from acute cholecystitis with gallstone, and 8 from cystopolyps. Among them, 16 patients had previous abdominal operations. Two patients with atrophic cholecystitis converted to open cholecystectomy(OC) owing to the unclear bile duct anatomy. The average operation time was 45min. Postoperative complications included pulmonary infection in 3 patients, bile leakage in 1( due to the titanic clip falling off),but no bile duct injury or other severe complications occurred;and no mortality in this series. Conclusions Establishing pneumoperitoneum under direct vision has following advantages:rapid and safe,and favorable to avoid the severe trocar-related complications.

AIM To investigate the hypoglycemic effect of buccally delivered insulin solution (INS SOL) in normal rats. METHODS The hypoglycemic response was examined after buccal delivery of INS SOL co administered with various absorption enhancers. The pharmacological bioavailability (PA) was used to evaluate the absorption enhancement of INS SOL from the buccal cavity under various conditions compared with subcutaneous injection. RESULTS In the absence of enhancers, the PA was low(6 8%) after buccal delivery of INS SOL. However, the concomitant administration of sodium lauryl phosphate, sodium deoxycholate, Brij78 as well as lecithin appeared to be more effective in increasing the hypoglycemic effects of insulin. INS SOL (5 ??kg -1 ) containing 5% Brij 78 had the highest PA of 33%. CONCLUSION The use of proper absorption enhancers is useful for improving the buccal absorption of insulin.

Objective To determine any relationship among detrusor wall thickness (DWT),bladder capacity (BC) and neurogenic lower urinary tract dysfunction (NLUTD),and to study the clinical implications of using DWT to predict the risk of renal injury after spinal cord injury (SCI).Methods Forty-eight adults with NLUTD due to SCI were recruited for the SCI group,and another 41 healthy adults formed a control group.Both groups underwent urodynamic evaluation and maximum bladder capacity (MBC) detection.The DWT of all subjects was measured by ultrasound imaging of the anterior bladder wall.Thereafter,the SCI group was divided into low and high risk subgroups based on the results of the urodynamic tests.Patients with detrusor leak point pressure ＜40 cmH2O were classified as low risk.Results At MBC,the average DWT in the SCI group was (0.97 ± 0.31)mm and (0.59 ± 0.08)mm in the control group,demonstrating a significant difference in DWT between patients with NLUTD and normal adults.The average DWT among the patients with type A detrusor sphincter dyssynergia was (1.10 ± 0.34)mm,which was significantly higher than among the patients with external urethral sphincter contraction without detrusor contraction (type C).DWT was significantly correlated with detrusor leak point pressure.A DWT of 0.87 mm (sensitivity 89.5％,specificity 58.6％) could be used as a critical point for predicting risk of renal injury in patients with NLUTD.Conclusions DWT is significantly greater among SCI patients with NLUTD and it correlates positively with detrusor leak point pressure.DWT could be used as a risk predictor for renal injury in patients with NLUTD due to SCI.

OBJECTIVETo study the application of VSD in the treatment of severe necrotizing fasciitis in extremities of patients.

METHODSEight patients, suffering from severe necrotizing fasciitis, who had been traditionally treated with iodophor-soaked gauze for 21 to 365 days in other hospitals, were transferred to our institute because of the nonhealing wounds and systemic toxic symptoms induced by infection, from January 2011 to August 2013. After admission, surgical debridement was performed timely, and the necrotic tissue was collected during the operation for pathological observation after HE staining. After the operation, VSD was started with negative pressure ranging from -100 to -80 kPa, and the furacilin solution (0.2 g/L) and oxygen (2 L/min) were continuously infused into the wound during the treatment. Surgical debridement was performed repeatedly according to the wound condition followed by change of VSD dressings to continue VSD treatment. The wounds were closed by suturing or with autologous skin grafts after being covered by fresh granulation tissue. The times of surgical debridement, times of change of VSD materials, wound healing status, and length of stay in our institute were recorded. All patients were followed up for a long time. Results HE staining showed that there were diffuse necrotic adipose and fibrous connective tissues in the necrotic tissue, and the normal tissue structure disappeared accompanied by significant infiltration of inflammatory cells. The number of surgical debridement was 2 to 10 (3.9 +/- 2.8) times. The number of VSD materials change was 2 to 10 (4.0 +/- 2.9) times. Wounds were closed by suturing and healed in two patients; wounds in the other six patients were partially sutured, their residual wounds were healed by autologous skin grafting. The length of stay in our institute was 20 to 49 (33 +/- 10) days. All patients were discharged after recovery. Patients were followed up for 2 to 24 months, and their wounds were found to be in good condition without ulceration or recurrence.

CONCLUSIONSVSD can effectively remove the necrotic tissues and exudates from the fascial spaces and promote proliferation of granulation tissue. Therefore it serves as an effective approach to the treatment of severe necrotizing fasciitis in extremities.

Debridement ; Drainage ; Extremities ; surgery ; Fasciitis, Necrotizing ; surgery ; Granulation Tissue ; Humans ; Negative-Pressure Wound Therapy ; Oxygen ; Pressure ; Skin ; Skin Transplantation ; Ulcer ; Vacuum

Objective To investigate the mRNA expression of IKB kinase (IKK-α) and interferon-α (IFN-α) in the peripheral blood leukocytes of patients with systemic lupus erythematosus (SLE), and to explore the role of IKK-α in the production of IFN-α in SLE patients. Methods SYBR green dye I based real-time quantitative PCR was used to detect the mRNA expression levels of IKK-α and IFN-α in the peripheral blood leucocytes of SLE patients and healthy controls. Serum levels of IFN-α were measured with ELISA method. Results IKK-α mRNA expression levels in SLE patients were significantly higher than those of normal controls (P<0.05). IKK-α mRNA expression levels in SLE patients with active disease were significantly higher than patients with stable disease (P<0.01). IFN-α mRNA expression level in SLE patients was significantly lower than that of the normal controls (P<0.01). IFN-α mRNA expression levels in SLE patients with active disease were significantly higher than patients with stable disease (P<0.01). Serum levels of IFN-α in SLE patients with active disease was significantly higher than that of the normal controls and patients with stable disease (P<0.05). The anti-dsDNA antibody correlated positively, and complement C3 correlated negatively with serum concentration of IFN-α. IKK-α mRNA expression levels in SLE patients correlated positively with serum concentration of IFN-α. Conclusion IKK-α correlates positively with serum concentration of IFN-α. The IFN-α level is significantly correlated with disease activity, This suggests that IKK-α may play an important role in the pathogenesis of SLE.