Objective To evaluate the treatment effect of sustained low-efficiency diafiltration( SLEDF) on patients with severe acute pancreatitis( SAP). Methods Forty-two patients with SAP were randomly divided into continuous veno-venous hemofiltration( CVVH)group with 22 patients and SLEDF group with 20 patients. In addition to routine treatment,patients in CVVH and SLEDF were administrated to patients respectively in two groups. Mortality,incidence of complication,clinical symptoms,sign and laboratory examination and recovery time were recorded and measured. The scores of acute physiology and chronic health evaluation( APACHE)II and multiple organ dysfunction syndrome( MODS ) were performed. The level of C-reactive protein( CRP ),tumor necrosis factor-α( TNF-α),interleukin( IL )-6 and IL-8 were measured. Results There were no significant differences in terms of the mortality(90. 91% vs. 90. 00%;χ2 =0. 010,P=0. 920),incidence of complication (18. 18% vs. 20. 00%;χ2 =0. 023,P =0. 881)and recovery time of clinical symptoms,sign and laboratory examination in CVVH group and SLEDF( P﹥0. 05 ). There were also no significant differences between CVVH and SLEDF group in terms of scores of APACHE II((12. 1 ± 6. 1)vs.(11. 9 ± 7. 2);t=0. 097,P=0. 920), MODS((4. 3 ± 1. 7)vs.(4. 4 ± 1. 8);t=0. 185,P=0. 850),CRP((161. 7 ± 22. 9)mg/L vs.(157. 6 ± 21. 8) mg/L;t=0. 594,P=0. 550),TNF-α((5. 8 ± 1. 9)ng/L vs.(5. 7 ± 1. 8)ng/L;t=0. 175,P=0. 860),IL-6 ((4. 1 ±1. 2)pg/L vs.(4. 2 ± 1. 1)pg/L;t =0. 282,P =0. 780)and IL-8((3. 3 ± 1. 4)pg/L vs.(3. 2 ± 1. 0)pg/L;t=0. 268,P=0. 790)at 72 h post-treatment. However,the above test indices were decreased at 72 h post-treatment than those at admission(P﹥0. 05). Conclusion SLEDF and CVVH are proved with same treatment effect based on the levels of inflammatory cytokine,alleviating pathogenetic condition and improving prognosis in patients with severe acute pancreatitis.

Objective To investigate the protective effect and its mechanism of edaravone against rat renal tubular epithelial cell injury induced by cisplatin. Methods The rat renal tubular epithelial cells (NRK-52E) were divided into the control, model control (50μmol·mL-1 cisplatin), group A (50μmol·mL-1 cisplatin plus 10μmol·mL-1 edaravone), B (50μmol·mL-1 cisplatin plus 20 μmol·mL-1 edaravone), and C (50 μmol·mL-1 cisplatin plus 40 μmol·mL-1 edaravone). The cell proliferation ability, content of malondialdehyde, activity of superoxide dismutase(SOD), level of reactive oxygen species ( ROS) , rate of apoptosis, express of protein and mRNA of Bax, Bcl-2 and Caspase-3 activation of cell were detected. Results The proliferation and SOD activity in NRK-52E cells declined, malondialdehyde and ROS were elevated upon being co-cultured with cisplatin. Moreover, the rate of apoptosis, express of protein and mRNA of Bax and Bcl-2, and Caspase-3 activation of cells were upregulated compared to the control group. However, edaravone stimulated cell proliferation, SOD activity and protein and mRNA of Bcl-2 and lowered content of malondialdehyde, level of ROS, rate of apoptosis, express of Bax protein and mRNA and Caspase-3 activation of cell(P<0. 05). Conclusion Edaravone can alleviate rat renal tubular epithelial cell injury induced by cisplatin, via inhibiting oxidative stress and down-regulating cell apoptosis.

Objective CRT has gained acceptance as a useful form of device therapy for patients with refractory congestive heart failure. Despite recent technical advances, some problem still remained unsolved. The study highlighted some of these issues and try to provide possible solutions. Methods Since February 1999, about 50 patients underwent CRT. The CS lead was implanted with PTCA wire for dislodgment of lead in 3 patients. Injury of CS was present in 5 patients. Elevation in left ventricular pacing threshold was found in 2 patients who received early CRT. Results The patients who implanted the CS lead with PTCA wire acquired satisfactory capture threshold without any complication. Pace makers were implanted successfully in all 5 patients with CS injury The CS leads were extracted successfully from the 2 patients with elevated ventricular pacing threstold. Conclusion Implantation of the CS lead is a main step in the operation of CRT and prompt management to its related problems can enhance the operation success rate.

Objective To explore the clinicopathological and immunohistochemical features, diagnosis and treatment,prognosis of hepatoid adenocarcinoma of the stomach with neuroendocrine tumor.AFP, Syn, CgA, Ki-67, P53 were stained by immunohistochemistry and follow-up was conducted by telephone.Methods Hepatoid adenocarcinoma of the stomach with coexisting neuroendocrine tumor was identified in 13 cases from June 2004 to June 2014 in Ren Ji Hospital.Results Among the 13 cases of hepatoid adenocarcinoma of the stomach coexisting with neuroendocrine tumor patients, there were 7 males and 6 females, with an median age of 62 years.Tumors located in the gastric cardia in 2 cases, in the gastric antrum in 8 cases and in the gastric body in 3 cases.Tumor ranged from 1-19 cm.The follow-up rate was 100％.The median overall survival rate was 12 months, two patients died of liver metastasis and one patient died of anastomotic recurrence.Serum AFP increased in 10 patients with hepatoid adenocarcinoma of the stomach coexisted with neuroendocrine tumor.The structure consisted of hepatoid cell differentiation and adenocarcinoma differentiation and neuroendocrine differentiation area by histological microscope examination.Immunohistochemical staining showed that tumor regional AFP, Syn, CgA, Ki-67, P53 were positive.Conclusions Hepatoid adenocarcinoma of the stomach coexisting with neuroendocrine tumor is very rare, it is made up of three structures : hepatoid cell differentiation, adenocarcinoma differentiation and neuroendocrine differentiation area.Diagnosis relies on immunohistochemical and histological examination.

OBJECTIVE: To review the current research of tissue engineered venous valve at home and abroad, to analyze the developing trend of tissue engineered venous valve in the clinical application.METHODS: A computer retrieve was performed among PubMed, ProQuest Health & Medical Complete database, Springer English Academic Journal Full-text database, Elsevier Full-text database between January 2000 and August 2009, with the key words of "tissue engineering venous valve", and the language was limited to English. At the same time, Chongqing VIP database, Qinghua Academic Journals Database, Chinese Biomedical Literature database were also screened on computer by using the

BACKGROUND:It is controversial to treat sacroiliac joint fracture.Some scholars advocated expectant treatment,and some others advocated surgery therapy.Pelvic stability was responsible for the scheme selection.Sacroiliac joint fracture-dislocation destroys pelvic stability,which easily induces instability and bone nonunion,resulting in sacroiliac joint pain,unequal size of lower limbs,sitting pain and dysfunction.Thus,prognosis of mental implant is significantly better than expectant treatment in treatment of unstable pelvic fracture.OBJECTIVE:To summarize the treatment of unstable pelvic fractures and their clinical application using various internal and external fixation of metal implants.METHODS:The computer-based research was done in Pubmed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) for articles published from January 1991 to December 2009 with the key words of "Pelvic fractures,instability,surgical treatment" by the first author.A total of 115 articles were retrieved,and those concerning characteristics and clinical application of implants in the treatment of unstable pelvic fracture.Articles addressing old and repetitive contents were excluded.Literatures of the same fields published in recent years or in authorized journals were selected.Finally,30 articles were included.RESULTS AND CONCLUSION:Sacroiliac joint fracture-dislocation is a severe,high-energy trauma,has been paid great attention in the therapy,particularly in unstable sacroiliac joint fracture-dislocation.A stable type of fracture and dislocation of the sacroiliac joint received a conservative treatment of unstable sacroiliac joint fracture-dislocation appropriate line of external fixation,internal fixation for reconstruction of pelvic stability and internal fixation treatment varied,but the therapeutic effect of internal fixation needs to be improved.What are bio-mechanical characteristics of various internal fixation methods,and how the timing of weight-bearing activities following various internal fixations require further basic and clinical studies.An unstable sacroiliac joint fracture-dislocation fixation has many ways,including the anterior and posterior fixed-fixed.Minim ally invasive therapy such as posterior CT guided sacroiliac joint lag screw is the developmental trend.

BACKGROUND: Using low-intensity pulsed ultrasound (LIPU) to promote the repair of articular cartilage injury is very common,and we also have more options to choose the cytoskeleton, but the application conditions of LIPU and the appropriate cytoskeleton have not reached any consensus yet.OBJECTIVE: To investigate the feasibility of establishing tissue-engineered cartilage by cell-free allograft demineralized bone matrix (CFDBM) co-cultured with rabbit cartilage cells and bone marrow mesenchymal stem cells (BMSCs) in vitro, and to investigate the effect of LIPU on the cells in CFDBM.DESIGN, TIME AND SETTING: Multiple sample observation was performed at the Institute of Biomedical Engineering, Second Military Medical University of Chinese PLAfrom May to August 2009.MATERIALS: The CFDBM was prepared as modified Urist's method; the cartilage cells were obtained using mechanical disintegration and enzyme digestion; the BMSCs were separated using whole bone marrow rinsing method, purified, and amplified layer by layer.METHODS: As CFDBM With a composite of different cellular components, and whether applying LIPU stimulation, the samples were divided into four groups: chondrocyte group, BMSCs group, compound group (CFDBM was compounded with chondrocytes,BMSCs, and chondrocytes/BMSCs, respectively, without LIPU stimulation), and LIPU group (CFDBM was compounded with chondrocytes/BMSCs, and then the samples were stimulated with LIPU on the second day, 1.0 MHz frequency, 10 mW/cm~2 transient spatial intension, 20 min/d).MAIN OUTCOME MEASURES: ① the 2~(nd)-generation of cartilage cells and BMSCs were examined by immunohistochemical method; ② The CFDBM prepared as modified Urist's method was examined as HE staining; ③ The samples of four groups were examined by collagen II immunohistochemical staining on the 21~(st) day.RESULTS: ① The collagen II immunohistochemical staining of the second generation of the articular cartilage cells showed that the morphostructure was polygon, star or round, and pseudopodia extended, and the cells were rich in cytoplasm; the cytoplasm was brownish yellow, and the cell nuclear was round. ② The result of immunohistochemical staining of BMSCs showed that,CD34 was negative, CD44 and CD105 were positive. ③ In the center of CFDBM prepared as modified Urist's method, there was no obvious cell-like structure and the gap size was uniform. ④ On the 21~(st) day after combining CFDBM with cells, collagen II immunohistochemical staining demonstrated that BMSCs group was negative, chondrocyte group was weak positive, compoundgroup was positive, and the LIPU group was strongly positive.CONCLUSION: ① Biological property of the 1~(st)-3~(rd)-passage chondrocytes and BMSCs was similar to primary-cultured cells. ②Both chondrocytes and BMSCs had a highly proliferative ability in CFDBM. ③ 10 mW/cm~2 LIPU could not affect activity of BMSCs but could promote differentiation Into articular cartilage cells, and it also could not promote celt proliferation.

Objective:To compare the efficacy and safety of ropivacaine and bupivacaine in combined spinal epidural anesthesia in abdominal operation. Methods:Totally 86 abdominal operation patients with combined spinal epidural anesthesia were randomly divid-ed into group A and group B with 43 ones in each. Group A was with ropivacaine anesthesia, while group B was with levobupivacaine anesthesia. The anesthesia effect, hemodynamic changes at different time points and adverse drug reactions were compared between the two groups. Results:The duration of sensory block in the two groups was not statistically different (P>0. 05), while the patients in group A had shorter motor nerve recovery time than those in group B (P<0. 05), and Bromege score of group A was significantly lower than that of group B (P<0. 05). After the onset of anesthesia block, all hemodynamic parameters (SBP, DBP and HR) in the two groups were lower than those before the anesthesia (P<0. 05), while at the end of anesthesia, the parameters showed no statistically significant difference from those before the anesthesia (P>0. 05). During the operation, the parameters at different time points in group A had no significant difference from those in group B (P>0. 05). The incidence of adverse drug reaction was not statistically significant between the two groups as well (P>0. 05). Conclusion:Ropivacaine and levobupivacaine show similar blocking effect on the sensory nerve with the same effects on hemodynamics and adverse reactions, however, the blocking effect of ropivacaine on motor nerve is weaker, which is more beneficial to the early exercise of the patients after operation.

Objective To quantitatively evaluate the influence of fluid attenuated inversion prepared recovery (FLAIR) on apparent diffusion coefficient (ADC) and its clinical application value. Methods The data of DWI and FLAIR-DWI of 139 stroke were retrospectively reviewed. Paired t-test was used to analyze DWI (ADCCON ) and FLAIR-DWI (ADCFLAIR) values at varying time points from hyperacute to chronic stage. All of the lesions were further divided into cortex involved infarction and subcortical infarction. The ADCCON and ADCFLAIR values in the lesion sides and the contralateral sides were compared separately. Results The mean ADCCON values for lesions less than 6 hours, 7--12 hours, 13--24 hours, within 2 days, 3-4 days, 5-7 days and 8--14 days were not significantly different from those of the ADCFLAIR values(P >0.05) [ADCCON were (0.55±0.07), (0.50±0.09), (0.50±0. 13), (0.50 ± 0. 13), (0.62 ± 0. 14), ( 0. 60 ± 0. 12), (0. 72 ± 0. 20) × 10-3 mm2/s; ADCFLAIR were ( 0. 53 ± 0. 09 ), (0.49±0.06),(0.49±0.10),(0.48±0.08),(0.58±0. 14), (0.60±0.09),(0.73±0.15) × 10-3 mm2/s]. Lesions of 15 to 30 days [ (0. 95±0. 21 ) × 10-3 mm2/s and ( 1.02±0. 27) × 10-3 mm2/s for ADCFLAIR and ADCCON ] and the chronic stage ( >31 days) [ ADCFLAIR and ADCCON were (1.10 ± 0. 30) × 10-3 mm2/s and (1.36±0. 41 ) × 10-3 mm2/s respectively], had a significantly lower ADCFLAIR than those of the ADCCON (P <0. 01 ). For patients with a symptom duration of less than 14 days, the mean ADCFLAIR values of the cortex involved and subcortical lesions were all not significantly different from the mean ADCCON (P > 0. 05 ) [ ADCCON were ( 0. 55 ± 0. 16 ), ( 0. 61 ± 0. 14 ) × 10-3 mm2/s ; ADCFLAIR were (0.53±0. 14), (0.60±0. 13) × 10-3 mm2/s]. For patients with a symptom duration of longer than 14 days, the mean ADCFLAIR values of the cortex involved and subeortical lesions were all significantly lower than those of the mean ADCCON values [ ( 1.16±0. 36) × 10-3 mm2/s vs. ( 1.35±0. 48) × 10-3 mm2/s for cortex involved lesions and (0. 97±0. 19) × 10-3 mm2/s vs. ( 1.15±0. 33) × 10-3 mm2/s for subcortical lesions ] (P < 0. 01 ). The ADC values of the normal contralateral sides were significantly decreased after the fluid inversion prepared pulse was conducted [ ADCFLAIR, ( 0. 76 ± 0. 05 ) × 10-3 mm2/s and ADCCON, (0. 82 ± 0. 11 ) × 10-3 mm2/s ] ( p < 0. 01 ). Conclusions The FLAIR significantly decrease the absolute ADC values of the ischemic lesions 14 days later after the stroke onset, which may be helpful in determining individual lesion age. Meanwhile, the application of FLAIR can have a more accurate relative ADC value by reducing the free fluid partial volume effect of the normal contralateral side, and hence enhance the ability of detecting the subtle ischemic pathophysiological changes.

OBJECTIVE To investigate the qacE△1-sul1 genes in multidrug-resistant Gram-negative bacilli and their significance.METHODS A total of 225 strains of multidrug-resistant Gram-negative bacilli were clinically isolated.The genes of qacE△1-sul1 were analyzed using polymerase chain reaction(PCR).RESULTS From them 120 strains of multidrug-resistant Gram-negative bacilli were found the qacE△1-sul1 genes.The positive rate of qacE△1-sul1 was 53.3%.CONCLUSIONS There are high percentages of qacE△1-sul1 genes in multidrug-resistant Gram-negative bacilli.