Objective To explore the significance of combining coagulation with bedside index for severity in acute pancreatitis (BISAP) scores in evaluation of severity of acute pancreatitis (AP).Methods One hundred and twenty-six patients with AP were diagnosed according to the AP:mild acute pancreatitis (MAP) group of 64 cases,severe acute pancreatitis (SAP) group of 62 cases,and selected 60 healthy persons as control group.AP patients BISAP scores were calculated in 24 h from admission,and the activity of partial thromboplastic time (AFTT),prothrombin time (PT),D-dimer and fibrinogen (FIB) were measured the next morning or after 8 h of fasting peripheral venous blood collected 3 ml.Results There was no significant difference in APTT,PT among three groups (P＞ 0.05).FIB and D-dimer in MAP group and SAP group were significantly higher than those in control group [(4.25 ± 1.01),(5.44 ± 2.19) g/L vs.(3.47 ± 0.49) g/L; (5.08 ± 3.20),(8.65 ± 6.43) mg/L vs.(3.41 ± 2.32) mg/L,P ＜ 0.05],SAP group was significantly higher than that in MAP group(P ＜ 0.05).The positive rate of D-dimer in MAP group was significantly lower than that in SAP group [26.6％(17/64) vs.85.5％ (53/62),P ＜0.01].BISAP scores and combining coagulation with BISAP scores predict the severity of AP AUC were 0.842(0.775-0.889),0.886 (0.839-0.925),there was no statistically significant difference (P ＞0.05).Conclusion The significance of combining coagulation with BISAP scores in the severity of AP is more accurate than only use BISAP scores,and will not increase the clinical application difficulty.

[Objective]To evaluate the effect of massive bioactive bone substitute in repairing large animals bone defect and to know its degrading rate.[Method]The massive Polylevolactic acid?collage calcium phosphate(PLLA?cTCP) carrieres by rapid forming technology was making,and then compounding rhBMP-2 and carrieres in a ratio of 3mg rhBMP-2 to one carrier was compounded to prepare the massive bioactive bone substitutes for dogs bone defect.Then the massive bone substitutes were implanted into 2.0cm dogss radius defects in the experiment group,and the massive carriers were implanted into in the control group.The repairing effect was evaluated by radiography,histology and biomechanics,and the degrading rate of the substitues was calculated in an image analysis apparatus.[Result]Radiographically,in the experiment group,the defects were connected by callus in all dogs in 12 weeks postoperatively;in 24 weeks,the callus rebuilt well.But in the control group,there was no callus formed in 24 weeks postoperatively,and the defects were not repaired.Histologically,in 12 weeks postoperatively,the outer layer of the callus in the experiment groups was lamellar bone and the center were trabecular bone,myeloid tissue and partial degrading carrier;in 24 weeks,the lamellar bone was more compact,trabecular bone decreased,myeloid tissue increased,and the carrier degraded more.In the control group,in 12 weeks postoperatively,the fibrous tissue wrapped and infiltrated into carrier,at the same time,part of the carrier degraded;in 24 weeks,the carrier was divided up by fibrous tissue and degraded more.The degrading rate of the carder in 12 weeks in the experiment group was 43.2%,in the control group was 35.7%,in 24 weeks 58.4% and 45.4%.Biomechanics,in 24 weeks after postoperation,the radius strength in the experiment group was superior to that in the normal bone.[Conclusion]The massive bioactive bone substitutes have satisfactory repairing effect on the radius bone defects of the large animal,but its degrading rate needs improving.

Aim To study the adaptive protection of H_2O_2 preconditioning against dopamine-induced damage in PC12 cells.Methods The apoptosis of PC12 cells was observed by electron microscope, PI stain flow cytometry (FCM) and Hoechst stain. The mitochondrial energy redox state was measured by MTT assay. The mitochondrial membrane potential(△?m) was investigated by the fluorescent probe of rhodamine 123.Results PC12 cells exposed to 50 ?mol?L -1 DA showed chromatin condensation and nucleus fragmentation observed by electron microscope. Exposure to DA (50 ?mol?L -1) for 24 h, the apoptosis of PC12 cells preconditioned by 10 ?mol?L -1 H_2O_2 for 90 min as measured by Hoechst stain was significantly decreased,compared with no-preconditioned cells. Exposure to 50,100,and 200 ?mol?L -1 H_2O_2 for 24 h, the proportion of apoptosis of PC12 cells was decreased from (20.9?1.8)%, (40.5?6.4)% and (88.1?3.9)% to (4.9?2.9)%, (12.0?1.4)%, (61.5?3.4)% after H_2O_2 preconditioning, respectively. By exposuring PC12 cells to 20,40,and 80 ?mol?L -1 DA for 24 h, the rates of MTT metabolism were reduced and the effect was prevented by H_2O_2 preconditioning. After 50 ?mol?L -1 DA exposure for 24 h,the mean fluorescence intensity of rhodamine 123 in no-preconditioned PC12 cells was decreased from (46.87?0.33) to (4.39?2.93),and that of preconditioned PC12 cells was decreased from (46.87?0.33) to (10.50?0.28). Conclusion H_2O_2 preconditioning possesses adaptive protection against dopamine-induced damage in PC12 cells.

Objective To develope a new method producing ventricular septal defect (VSD) model by transcatheter puncture and evaluate its feasibility and practicability. Methods Ten dogs underwent transcatheter ventricular septal puncture with Brockenbrough puncture needle via right jungular vein under fluoroscopy, and then dilated the defect with 6-8mm balloon catheter. Left ventricular (LV) angiography was performed with pigtail catheter by transaortic access after puncture. Right after the procedure and 1-4 months later, the dogs were sacrificed and the defects were inspected. Results VSDs were successfully made in 8 dogs, which were demonstrated by LV angiography with one defect at membranous part. The defects in other dogs were shown near membranous septum or muscular septum not far away from the membranous part. The distance from aortic valves to the rims of defect was 4-16mm, from tricuspid valves 4-10mm. Ⅲ?AVB was found in 1 dog which died 1 week later, with ruptured membranous part at autopsy. CRBBB was found in another dog. Conclusion Establishment of VSD animal by transcatheter puncture is feasible, practicable and of high successful rate and less complication.

Objective To explore the novel method to establish animal model of controllable sized atrial septal defect. Methods Fourteen dogs of both sexes were selected,with weight ranging from 15 to 20kg. Under guidance of fluoroscopy,ASD was established by using Brokenbrough needle and balloon dilatation. Results Tow dogs died of cardiac tamponade.Other twelve dogs had ASD created successfully without complication. Conclusion The method has the advantages of easy manipulation , size controllable and small amount of fluoroscopy exposure.

Objective To evaluate the methods of electrophysiological study (EPS) and radiofrequency catheter ablation (RFCA) for atrial tachycardia (AT) and the efficacy of RFCA. Methods Thirty-nine patients with AT were selected to undergo EPS and RFCA. The mean illness course was (4.5?1.6) years. Two patients had atrial septal defect, one had coronary artery disease, one dermatomyositis, and the other 35 patients had no structural heart disease. Identification of the earliest endocardial atrial activity (EAA) was based on the activation mapping recorded during AT. Results AT was induced spontaneously by atrial premature beats in 3 patients, and all other AT was inducible by atrial stimulation. Nine patients had other types of tachycardia combining with AT (including 5 patients with atrioventricular nodal reentrant tachycardia, 2 with atrial flutter and 2 accessory pathway). The site of AT was located by recording the EAA during AT and the region of successful FRCA. In 33 patients of successful ablation, the sites of AT were 9 near coronary sinus orifice, 5 near His bundle, 13 in right atrial lateral wall along crista terminalis, 2 in superior vena cava, 3 in atrial septum and 1 in right pulmonary vein. The successful rate was 81% (33/39) with all success of 9 other tachycardia. The mean fluoroscopic time was (16.4?2.1) minutes. None of patients had complications during and after ablation. Conclusions RFCA is an effective and safe treatment for AT. The activation mapping is the most effective method. Atrial septum and crista terminalis are the most common sites of AT.

Objective: To evaluate the biocompatibility of self made nitinol alloy ventricular septal defect occluder. Methods: Six nitinol alloy ventricular septal defect occluder were implanted in the ventricular septum by catheter in 6 normal anaesthetized open chest pigs, and the animals were observed for 45 to 120 d(2 animals). Results: One deaths resulted from hemorrhage and another from embolization of occluder in abdominal aorta during the placement procedure. Successful placement of the occluder was achieved in 4 animals. Four animals were killed at 45, 60 and 120 d. Postmortem gross and microscopic examination of 4 devices 45 to 120 d after placement showed that both the right and left ventricular discs of the occluder were completely covered by a smooth, shiny, glistening thin layer of neoendocardium, and the surface of neoendocardium was covered by a monolayer of endothelium like cells. The inflammatory infiltrate around the occluder was found at 45 d, and disappeared and fibrosis formed at 120 d. These appeared as a repair process of the injury. Embolization in lung,liver, spleen, kidney, intestinal and colon were not found. Conclusion: These suggest that the self made nitinol alloy ventricular septal defect occluder has good biocompatibility. [

AIM:To explore the roles of Akt ( also called protein kinase B ) and active caspase-3 in the leptin-mediated chronic morphine antinociceptive tolerance in rats .METHODS: A model of chronic morphine antinociceptive tolerance was established in the SD rats .The protein levels of spinal Akt and cleaved caspase-3 were tested by Western blotting.The technique of immunohistochemical staining was used to detect the immunoreactivity positive cells of phospho -rylated ( p)-Akt and cleaved caspase-3 in the spinal cord .Double staining of immunohistochemistry was used to examine the cellular location of the p-Akt and cleaved caspase-3 positive cells.RESULTS: The chronic intrathecal injection of morphine (15 μg) for 7 d markedly upregulated the spinal protein levels of p-Akt and cleaved caspase-3 in the rats.Thirty min before injection of morphine , intrathecal injection of leptin antagonist (3μg) for 7 d significantly attenuated the upreg-ulation of the protein levels of p-Akt and cleaved caspase-3 induced by chronic morphine treatment .The p-Akt was exclu-sively observed in the spinal neurons .The cleaved caspase-3 was only localized with the spinal astrocytes .Intrathecal injec-ting the inhibitors of leptin , Akt and caspase-3 ameliorated the chronic antinociceptive tolerance .CONCLUSION: The spinal Akt pathway and active caspase-3 are involved in the leptin-mediated chronic morphine antinociceptive tolerance in rats.

Objective: To investigate the findings of coronary artery angiography in coronary artery disease patients with diabetes mellitus. Methods: The angiographic fingings of 153 coronary artery disease patients from 1995 to 1997 were reviewed. Among them, 33 were diabetic,23 were impaired glucose tolerance(IGT) and 97 were nondiabetic patients. Results: The age, sex, hypertension, hypercholesterolemia, smoking and the rate of myocardial infarction were the same among 3 groups. But the 2 vessel and 3 vessel disease were more frequent in diabetic group(66.7% ,30.3%) than in nondiabetic group (26.8%,19 6%). Two vessel disease were more frequent in diabetic group(66.7%) than in IGT group (13.1%). Single vessel disease were less frequent in diabetic group(3.0%) than in IGT group(52.2%)and nondiabetic group(53.6%)( P

Objective To discuss the cause and means of prevention of postoperative acute renal failure(ARF) in patients with malignant tumors.Methods Clinical data of 32 patients with malignant tumors who suffered postoperative ARF were retrospectively studied.Results 13 patients(40.6%)suffered ARF because of hemorrhea or hypovolemia shock in or after operation, 10 patients(31.3%)suffered ARF because of fistula or sepsis after operation, 2 patients(6.3%)because of chemotherapy and other 7 patients(21.9%)with no evident causes. Conclusions ARF is a severe postoperative complication with high mortality. Maintaining adequate circulating volume before operation, carefully operating to decrease complication, avoiding nephrotoxins are key strategies to prevent the patients from ARF and improve prognosis.