Objective To observe the changes of inflammation cytokines in pancreas tissues of experimental acute necrotizing pancreatitis (ANP) rats treated with rhubarb.MethodsThirty-three rats were randomly divided into sham operation group,ANP group and rhubarb treatment group with 11 rats in each group.ANP model was induced by retrograde injection of 3％ sodium taurocholate into the biliopancreatic duct,and jejunostomy was performed.Rats in rhubarb treatment group were fed with 1 g/ml rhubarb at the dose of 1 ml/kg body weight via jejunum route.Thirty-six hours later the rats were sacrificed.The serum level of amylase was measured; part of the pancreatic tissue was harvested for routine pathologic examination; total RNA was extracted from pancreatic tissue.The expression of IL-6,IL-8,and TNF-α mRNA was measured by real-time PCR.ResultsAfter ANP induction,the serum level of amylase was significantly increased,and pancreatic tissue necrosis,bleeding and inflammatory cell infiltration were observed,which was consistent with changes of ANP.The expressions of IL-6,IL-8,and TNF-α mRNA were 0.29 ±0.13,0.35 ±0.15,1.09 ±0.32 in sham operation group,while they were 2.23 ±0.49,2.26 ±0.51,5.24 ±0.59 in ANP group,which were significantly higher than those in sham operation group ( P ＜ 0.05 ).The corresponding values were 0.97 ±0.30,1.02 ±0.34,2.59 ±0.36 in rhubarb treatment group,which were significantly lower than those in ANP group,but they were still significantly higher than those in sham operation group ( P ＜ 0.05 ).ConclusionsRhubarb lavage via jejunum route can decrease the expressions of IL-6,IL-8,and TNF-α,therefore attenuate the pancreatic pathologic injuries.

Objective To investigate the effects of ω-3 fish oil lipid emulsion via vein on the inflammatory response,immune and organ function in patients with severe acute pancreatitis.Methods A total of 53 patients with severe acute pancreatitis were randomized into conventional therapy plus fish oil group (FO group) and conventional therapy group (CON group).The patients in FO group were treat with ω-3 fish oil lipid emulsion (0.2 g · kg-1 · d-1,10％) based on conventional therapy for 14 days.The level of C-reactive protein (CRP),TG and TC were detected before treatment and at day 7 and day 14 after treatment.CD4+,CD4+/CD8+ and C3,C4 were also detected at day 1 and day 14 after treatment.At the same time,acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ score),intra-abdominal pressure,negative fluid balance time,enteral nutrition start-time and ICU stay time were observed and recorded.Results Forty-five out of 53 patients were finally recruited into results statistics.The level of CD4+,CD4+/CD8+ and C3 at day 14 after treatment in FO groups improved significantly than that in the CON group (P ＜0.05).The levels of CRP,intra-abdominal pressure and APACHE Ⅱ score at day 7 and day 14in FO group descended more obviously than that in the CON group (P ＜ 0.05).The negative liquid balance time in FO group (3.55 ±0.86) days was obvious shorter than that in CON group (4.61 ± 1.12) days,while enteral nutrition start-time (3.86 ± 1.17) days was significantly earlier compared with CON group (5.30 ± 1.61) days (P ＜ 0.05),however ICU stay time and 28 days mortality rate had no significant difference between the two groups.Conclusions ω-3 fish oil lipid emulsion can decrease the inflammatory response and the negative liquid balance time,improve the immune function and restore bowel function in severe acute pancreatitis patients.Therefore,it maybe provide a new and effective means for severe acute pancreatitis.

Objective To analyze the clinical results and prognostic factors of patients with early-stage primary gastric mucosa-associated lymphoid tissue(MALT) lymphoma. Methods Seventy-seven pa-tients with primary gastric MALT lymphoma treated from 1985 to 2006 were retrospectively analyzed. All pa-tients were pathologically confirmed as MALT lymphoma in stage Ⅰ ,Ⅱ and ⅡE (by modified Blackedge staging system). Thirty-seven patients had stage Ⅰ disease,23 stage Ⅱ and 17 stage ⅡE. Sixty patients un-derwent surgical resection and 17 received non-surgical treatment. Survival rates were calculated by the Kap-lan-Meier analysis with the Logrank test. Results With a median follow up of 57 months for the surviving patients(ranging from 1 to 198 months for all patients), the 5-year overall survival rate, disease-free survival rate,loco-regional control rate and distant metastasis free survival rate were 74% ,70% ,76% and 87% ,re-spectively. In univariate analysis, clinical stage was significantly associated with overall survival. Patients with stage Ⅰ or Ⅱ disease had a better overall survival than those with stage ⅡE (P = 0.01). Tumor size and surgical resection were significantly associated with disease-free survival. Patients with primary tumor 8 cm or less in diameter had better disease-free survival than those with primary tumor more than 8 cm in diameter(P =0.03). Patients who underwent complete resection had better disease-free survival than those who under-went incomplete resection or no surgery (P =0.02). Clinical stage, tumor size and surgical resection were significantly associated with loco-regional control. Patients with stage Ⅰ or Ⅱ disease had better loco-regional control than those with stage ⅡE (P = 0. 03). Patients with primary tumor 8 cm or less in diameter had better loco-regional control than those with primary tumor more than 8 cm in diameter(P =0.01). Patients who un-derwent complete resection had better loco-regional control than those who underwent incomplete resection or no surgery(P=0.03). Patients with stage Ⅰ and Ⅱ disease treated with surgery had more local recurrence, and patients treated without surgery tended to recur systematically. Patients with stage ⅡE disease tended to recur locally in spite of surgery or not. Conclusions The efficacy of surgical and non-surgical treatment for primary gastric MALT lymphoma are similar. Surgical resection is no longer a necessary approach in the primary treatment. Clinical stage is an important prognostic factor for primary gastric MALT lymphoma.

Objective To study the effect of electroacupuncture on the behavior of APP/PS1 transgenic mice of different age, and to explore the optimal intervention time of electroacupuncture in treating Alzheimer's disease (AD). Method APP/PS1 double-transgenic mice of 4 months, 6 months and 9 months old, 20 in each age group, were randomized into a model group and an electroacupuncture group, and ten C57BL/6 wild-type mice were taken as a control group; after 6-week electroacupuncture treatment, the Morris water maze was adopted for spatial memory and behavioral test, and the changes of behavior in each group were observed.Result Of the 5-month-old mice, there were no significant between-group differences (P>0.05), while the time factor (day) produced a statistical significance (P<0.01); of the 7-month-old mice, there were significant differences considering the different groups, time factor and interaction (P<0.01); of the 10-month-old mice, there were significant differences considering the different groups, time factor and interaction (P<0.05). The spatial probe test showed that there were significant between-group differences in comparing the platform crossings and swimming distance in platform quadrant in each age group (P<0.05).Conclusion Electroacupuncture can improve the learning and memory of APP/PS1 double-transgenic mice, the age of 6-7 months old is possibly the optimal intervention time of electroacupuncture for AD, but there still requires further mechanism studies.

OBJECTIVEThe combination of oxaliplatin and S-1 is effective in patients with advanced gastric cancer. The purpose of this study was to analyze the safety and compliance of this combination regimen as adjuvant chemotherapy in patients with gastric cancer.

METHODSClinical data of 71 patients with gastric cancer treated with oxaliplatin plus S-1 as adjuvant chemotherapy in the Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) from Jan 1(st), 2010 to Jan 1(st), 2012 were retrospectively reviewed. The types and incidence rate of adverse events related to chemotherapy and the results of follow up of the patients were analyzed.

RESULTSAmong the 71 cases, 17 were treated with oxaliplatin biweekly, while 54 with oxaliplatin triweekly. The most common adverse events were neutropenia (n = 49, 69.0%), nausea/vomiting (n = 51, 71.8%), and anorexia (n = 49, 69.0%). The most frequent grade 3-4 toxicities were neutropenia (n = 13, 18.3%), thrombocytopenia (n = 10, 14.1%), anorexia (n = 5, 7.0%) and nausea/vomiting (n = 4, 5.6%). Seven (87.5%) of the 8 patients previously treated with neoadjuvant chemotherapy experienced thrombocytopenia in the postoperative adjuvant chemotherapy, and four (50%) of the 8 patients experienced grade 3-4 thrombocytopenia. The rates of grade 3-4 adverse events in patients aged 65-years or older were similar to that in younger patients.

CONCLUSIONSThe combination of oxaliplatin and S-1 used as adjuvant chemotherapy is well tolerated by patients with gastric cancer. Neutropenia, thrombocytopenia, nausea/vomiting and anorexia are the major treatment-related adverse events. Patients who received neoadjuvant chemotherapy do not well tolerate this regimen as postoperative adjuvant chemotherapy. This combination regimen has a manageable tolerability profile in adjuvant setting in patients ≥ 65 years old.

Adenocarcinoma ; drug therapy ; pathology ; surgery ; Adult ; Aged ; Anorexia ; chemically induced ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Chemotherapy, Adjuvant ; Drug Combinations ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nausea ; chemically induced ; Neoadjuvant Therapy ; Neoplasm Staging ; Neutropenia ; chemically induced ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; Oxonic Acid ; administration & dosage ; adverse effects ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; pathology ; surgery ; Survival Rate ; Tegafur ; administration & dosage ; adverse effects ; Thrombocytopenia ; chemically induced

OBJECTIVETo examine the significance of individual risk on diabetes to subjects who underwent diabetes screening.

METHODS2003 asymptomatic diabetes subjects with high-risk factors of diabetes as family history, obesity, hypertension, and/or dyslipidemia, fetal giant history were screened. 5362 subjects having no risk factors but from the same community were allocated as controls.

RESULTSThere were 131 (6.54%) diabetes identified in the screening group and 1547 (77.23%) subjects having 1 risk factor, 387 (19.27%) having 2 risk factors, 70 (3.49%) having 3 or more risk factors. There were 96 (1.79%) diabetes identified in the control group. Compared with control group, the OR (95% CI) value was 2.68 (2.20-3.25) after adjusted on age among the high risk group. The OR value of those having 1 risk factor was 2.89, but these having 3 or more risk factors increased to 4.68.

CONCLUSIONThe relation between the risk of high-risk group with diabetes and the number of risk factors of diabetes presented positive correlation. Early and regular screening for diabetes was essential in these individuals with high-risk factors.

Adult ; Aged ; China ; epidemiology ; Diabetes Mellitus, Type 2 ; epidemiology ; etiology ; genetics ; Family Health ; Female ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; epidemiology ; Hypertension ; epidemiology ; Male ; Mass Screening ; Middle Aged ; Obesity ; epidemiology ; Odds Ratio ; Prevalence ; Risk Factors ; Smoking

OBJECTIVETo investigate the value of spiral CT examination for diagnosis occult fracture of the patients with negative result of X-ray examination and with high suspicion of fractures,so as to reduce misdiagnosis.

METHODSFrom January 2007 to June 2010, 31 patients with ankle trauma performed spiral CT examination, including 18 males and 13 females, ranging in age from 21 to 67 years, with a mean of 35 years. The main symptoms of the patients included ankle pain, local swelling, obvious tenderness and activity limitation. All the patients had negative results of X-ray examination.

RESULTSThe spiral CT examination revealed 11 patients with fractures, involving a total of 17 points. Single fracture were found in 6 cases,and multiple fractures were found in 5 cases. Among single fractures, the lateral malleolus fracture was found in 1 case, talus fracture was found in 1 case, scaphoid fracture was found in 1 case, the fracture of the base of 5th metatarsal base was found in 1 case and calcaneal fractures were found in 2 cases. Within multiple fractures,internal and lateral malleolus fracture were found in 1 case; medial malleolus, calcaneus and talus fractures were found in 1 case; talus and scaphoid fractures were found in 1 case; the fractures of 1st and 2nd cuneiform bone were found in 1 case; the 2nd and 3rd metatarsal base fracture was found in 1 case.

CONCLUSIONFor the patients with negative X-ray examination and high suspicion of fractures,the spiral CT examination is needed, which could significantly improve the detection rate of occult fractures, and provide imaging basis for clinical treatment and judicial identify.

Adult ; Aged ; Ankle Injuries ; diagnostic imaging ; Female ; Foot Injuries ; diagnostic imaging ; Fractures, Closed ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods

OBJECTIVE: To explore the efficiency of the cervical pedicle screws in the posterior reconstructive operation of the lower cervical diseases. METHODS: From November 2001 to July 2003, 31 patients suffering from the lower cervical diseases were treated with the posterior pedicle screws fixation. We put the screws in the inferior articular process of the upper centrum, the lateral of the intervertebral facet center (3 - 5 mm the medial edge of lateral mass). The angles of toe-in sagittal plane varied from 30 degrees to 45 degrees, and the screws were from 18 to 26 mm (22.3 mm) in average. RESULTS: There were 193 pedicle screws in this group, and no one had spinal cord injury or vertebral artery injury. The improvement rate was 84.5%. Follow-up was from 9 to 28 months (17 months in average). The screws were fixed properly without being loose and broken, and the bone graft fusions within 9 to 12 months in the X-ray and CT scan examination were satisfactory. The Japanese orthopaedics association score (JOA) was 9.7 preoperatively, but it was raised to 16.3 postoperatively. CONCLUSION The posterior reconstructive operation with cervical pedicle screws is a good choice for patients with lower cervical diseases.
Adult ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo study the morphological features of secundum atrial septal defect (ASD) in adult and the implications for transcatheter closure.

METHODSTranscatheter closure using Amplatzer duct occluder was performed in 272 adult patients with ASD from September 1997 to December 2005. The morphological features were evaluated by transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). The size, length and thickness of rims, occluder diameter, the complete closure rate, residual shunt rate and complications were compared in patients with deficient and/or thin rims (Group A, n = 135) and patients with well-developed rims (Group B, n = 137).

RESULTSThe complete closure rate was 97.8% (132/135) in group A and 99.3% (136/137) in group B. There were 74 cases with deficient rims, 39 cases with thin rims and 22 cases with both deficient and thin rims in group A. Gender distribution, age, operation successful rate, residual shunt rate and complication rate were similar between the 2 groups. The defect diameters measured by TTE (18.9 +/- 5.5 mm vs. 16.5 +/- 4.8 mm, P < 0.01), TEE (22.7 +/- 5.0 mm vs. 20.0 +/- 5.5 mm, P < 0.01) and occluder diameters used (29.1 +/- 5.7 mm vs. 26.0 +/- 5.9 mm, P < 0.01) were significantly larger in groups A than that in group B. The systolic pulmonary artery pressure was also significantly higher in groups A than that in groups B (36.9 +/- 11.9 mm Hg vs. 32.6 +/- 9.1 mm Hg, P < 0.01). There are significant correlations between occluder diameters and defects measured by either TTE or TEE in both groups (group A, TTE: r = 0.709, TEE: r = 0.850; group B, TTE: r = 0.716, TEE: r = 0.915, P all < 0.01).

CONCLUSIONSPoor residual rims were found in around 50% of adult patients with ASD. Transcatheter closure of these defects could be successfully performed with larger occluders. The defect diameters measured by TTE and TEE, especially the latter, could guide the occluder selection.

Adult ; Cardiac Catheterization ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial ; etiology ; pathology ; therapy ; Humans ; Male ; Middle Aged

This study is to investigate the effects of phenytoin sodium, lidocaine (sodium channel blockers), propranolol (beta-adrenergic receptor antagonist), amiodarone (drugs prolonging the action potential duration) and verapamil (calcium channel blockers) on arrhythmia of mice induced by Bufonis Venenum (Chansu) and isolated mouse hearts lethal dose of Chansu. Arrhythmia of mice were induced by Chansu and then electrocardiograms (ECGs) were recorded. The changes of P-R interval, QRS complex, Q-T interval, T wave amplitude, heart rate (HR) were observed. Moreover, arrhythmia rate, survival rate and arrhythmia score were counted. Isolated mouse hearts were prefused, and the lethal dose of Chansu was recorded. Compared with control group, after pretreatment with phenytoin sodium, broadening of QRS complex and HR were inhibited, and the incidence of ventricular arrhythmia was reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with lidocaine, the prolongation of P-R interval and broadening of QRS complex were inhibited, and the incidences of ventricular arrhythmia were reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with propranolol, prolongation of P-R interval, broadening of QRS complex, prolongation of Q-T interval and HR were inhibited, and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically, while survival rate was improved. After pretreatment with amiodarone, HR was inhibited, the incidences of ventricular tachycardia were reduced dramatically. Lastly, after pretreatment with verapamil, the prolongation of P-R interval and Q-T interval were inhibited and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically; the isolated mouse hearts lethal dose of Chansu was reduced significantly. In in vivo experiments, phenytoin sodium was most effective against the mice arrhythmias induced by Chansu while cautious use of verapamil for Chansu inducing arrhythmia should be noted. It is also concluded that mice ventricular arrhythmias induced by Chansu might be most closely related to sodium channel, supraventricular arrhythmias might be related to beta-adrenergic receptor, and calcium channel plays an important role in conduction block. In in vitro experiments, phenytoin sodium was most effective, followed by lidocaine and propranolol, and amiodarone had no obvious effect and verapamil reduced the lethal dose of Chansu.
Amiodarone ; pharmacology ; Animals ; Anti-Arrhythmia Agents ; pharmacology ; Arrhythmias, Cardiac ; chemically induced ; physiopathology ; Bufanolides ; toxicity ; Electrocardiography ; drug effects ; Female ; Heart Rate ; drug effects ; In Vitro Techniques ; Lethal Dose 50 ; Lidocaine ; pharmacology ; Male ; Mice ; Phenytoin ; pharmacology ; Propranolol ; pharmacology ; Verapamil ; pharmacology