Objective To investigate the efficacy of intravenous antioxidants therapy in treating moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP).Methods Pubmed,Embase,Cochrane library and CNKI databases for all randomized control trials published before March 18st,2016 manually was searched by computer.Data on AP associated mortality and length of stay (LOS) were collected.The quality of the trials included was assessed by the Cochrane systematic review method.Results Fifteen trials with data of 620 patients were eligible for final inclusion.Among the 15 trials,detailed randomization for grouping was clearly described in 5 studies and obvious bias was observed in 1 study.Three studies had obvious biases considering whether outcome assessment was blinded,outcome data was incomplete and outcome report was selective.No other apparent bias was found.Statistical analysis showed that compared with control group,intravenous antioxidants administration did not significantly reduce mortality (12.1 vs 9.7,RD=-0.02,95％ CI-0.08～-0.03,P=0.44;RR=0.83.95％ CI0.51～ 1.34,P=0.44),but could shorten LOS (MD=-2.02;95％ CI-4.00～-0.05;P=0.04).Conclusions Intravenous antioxidants could greatly shorten LOS of patients with MSAP and SAP.

ObjectiveTo investigate the capacity and diagnostic value of various MRI seguences in patients with trigeminal neuralgia.Methods MR images of 60 patients with trigeminal neuralgia were analyzed retrospectively.The sensitivity,specificity and diagnostic value of various MRI sequences were evaluated comparing with clinical data and operation results.All patients were scanned with conventional sequences including SE-T1WI,T2WI,FLAIR of head.Among them,9 cases were injected with contrast agent,49 cases were scanned with 3D-TOF and 3D-TSE sequences on cerebellopontine angle additinally.The sensitivity,specificity and accuracy of the 3D-TOF and 3D-TSE sequences were analyzed by using the x2 test.Results Six cases with tumor,3 cases with radiculitis and meningitis,1 case with multiple sclerosis and 1 case with pons infarction were diagnosed by conventional MR sequences.MRI of 49 cases with 3D-TOF and 3D-TSE showed neurovascular compress proved by operation.The sensitivity,specificity and accuracy of 3D-TOF and 3D-TSE were 95.3％ (41/43)vs.95.6％ (43/45),66.7％ (4/6)vs.50.0％(2/4) and 91.8％ (45/49)vs.91.8％ (45/49),and no significantly difference was found between the two sequences (x2 =0.13,0.19 and 0.17,P ＞0.5).ConclusionsMRI plays an important role in displaying the causes and diagnosis of trigeminal neuralgia.The conventional head MR sequences should be recommended for diagnosis of secondary TN caused by tumor and inflammation et al,and further 3D-TOF and 3D-TSE with high sensitivity and accuracy should be applied in patients with primary TN to display the neurovascular relationship.

Objective To explore the therapeutic effect of dual perfusion embolization and chemotherapy via hepatic artery and portal vein(combmation treatment) in the treatment of unresectable PHC.Methods Eighty-one cases of unresectable PHC were randomly divided into two gronps: (1) Combination treatment group.Forty-one cases,These cases received embolization and chemotherapy via hepatic artery and portal vein through a drug delivery system intraoperatively,and then embolization and chemotherapy via the drug pump were given periodically. (2) TACE group.Forty cases.These cases were treated with Seldinger's technique, the dosage of drugs were the same as used in the former group during laparotomy. After 3 times of treatment, AFP, the size of tumor, liver function, body weight, abdominal perimeter, survival time of the two groups were compared.Results The weight, AFP, decrease of tumour size in combination group were much better than those in TACE group( P 0.05). The median survival time in the two groups were 18.0 months and 11.1 months ( P =0.0001). The accumulating survival rate of 6, 9, 12, 24 months were 87.8%, 78.0% , 68.2%,31.7% in combination group, and 70.0%, 52.5%, 30.0%, 5.0% in TACE group, respectively . The factors affecting survival were therapeutic method, liver function, size of tumour.Conclusions Combination treatment is simple, convenient with less complications, and the effect is better than TACE. So it is an effective method for the unresectable hepatic carcinoma.

Objective To investigate the expression variation of aquaporin in colon tissues in acute necrotizing pancreatitis (ANP).Methods ANP rat model was induced by the retrograde injection of sodium taurocholate into the biliopancreatic duct.The rats were killed at 4 h, 8 h, 12 h and 24 h after modeling with 6 rats for each time point.The pancreas and colon tissues were harvested for pathological examination.The levels of IL-6, TNF-α mRNA expression and AQR (aquaporin-3, aquaporin-4, aquaporin-8) mRNA expression in proximal and distant colon were detected by RT-PCR.The levels of aquaporin protein in colon were examined by immunohistochemistry.Results After the establishment of ANP SD rat model, the integrity of colonic mucosa was continuously damaged, the structure of epithelial cells was unclear and the colonic villus were broken and destroyed, and inflammatory cell infiltration in submucosa was observed.The pathological score increased with the time of modeling.In 4 h, except that the mRNA levels of AQP-4 in distal colon was not obviously changed, mRNA levels of IL-6 and TNF-α, mRNA and protein expression of AQP-3 and AQP-8 in the proximal and distal colon of ANP rats were significantly elevated compared with shame group (P<0.05).AQP-3 and AQP-8 mRNA in proximal colon of ANP rats reached its peak in 8 h after the establishment and AQP-4 mRNA peaked at 24 h.AQP-3 and AQP-4 mRNA in distant colon of ANP rats reached its peak in 8 h after the establishment and AQP-8 mRNA peaked at 24 h.Protein expression of AQP-3, AQP-4 and AQP-8 in proximal and distant colon was strongest in 12 h and 24 h after the establishment.Conclusions With the progression of the ANP, the expression levels of AQP-3, AQP-4 and AQP-8 in both proximal and distal colons were elevated in various degrees, indicating that the aquaporins may participate in water metabolism of colon during ANP.

In order to remove the endotoxin from the blood of endotoxemia patients, we prepared a new adsorbent with heparin space arm and polymyxin B (PMB) ligand. The carrier of chloromethyl polystyrene resin was activated and heparin space arm was grafted, and then PMB ligand was immobilized onto adsorbent with glutaraldehyde. We employed in vitro FITC-lipopolysaccharide (FITC-LPS) static adsorption to characterize the adsorption properties on the adsorbent, and conducted in vitro lipopolysaccharide (LPS) static adsorption to measure quantitavely the adsorption capacity and rate, and then evaluated the blood compatibility. The in vitro static adsorption indicated that the adsorbent had the removal rate of LPS above 70% with the adsorption equilibrium time for 2 hours. Blood compatibility experiment showed that the adsorbent had little negative effects on blood cells and plasma protein, and their adsorption rates were less than 10% for hemocytes and 20% for plasma protein respectively. This adsorbent exhibited high selectivity, high adsorption capacity and good biocompatibility, and presented a promising clinical application in the treatment of endotoxemia.
Adsorption ; Endotoxemia ; therapy ; Endotoxins ; isolation & purification ; Hemofiltration ; instrumentation ; methods ; Heparin ; chemistry ; Humans ; Ion Exchange Resins ; chemistry ; Ligands ; Polymyxin B ; chemistry ; Sorption Detoxification ; methods

Objective To explore the clinical efficacy and safety of hyper-early embolotherapy in treatment of intracranial ruptured aneurysm.Methods A retrospective analysis was made on 33 patients with intracranial ruptured aneurysm.Preoperative Hunt-Hess grade:grade Ⅰ-Ⅱ in 16 patients,gradeⅢin 5 patients,grade Ⅳ in 9 patients,grade Ⅴ in 3 patients.All patients were confirmed with subarachnoid hemorrhage (SAH) by angiography and then underwent embolization under general anesthesia by detachable coils within 6 h from onset.Results After operation,25 patients (75.8％) recovered well,4 patients (12.1％) were with mild disability with paralysis and aphasia,4 patients (12.1％) were dead (1 patient for intraoperative aneurysm rupture,1 patient for postoperative pneumonia,1 patient for infection of hematoma at puncture site and 1 patient for postoperative gastrointestinal bleeding).Followed up 1-6 months,no rebleeding occurred.Conclusions Hyper-early embolotherapy could avoid rebleeding of the aneurysm,and relieve the vasespasm,without increasing the intra-operative rebleeding rate.Moreover hyper-early embolotherapy could greatly decrease the mortality of poor-grade SAH patients.

Objective:To assess the feasibility of free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection in patients with supratentorial intracerebral hemorrhage (sICH), and to evaluate the accuracy of catheter placement.Methods:Fifty-two sICH patients received free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection in our hospital from January 2018 to December 2019 were chosen (free-handed conical craniotomy group); 30 sICH patients received frameless stereotactic puncture and drainage at the same time period were selected (stereotactic puncture group). The clinical data of these patients were retrospectively analyzed. The CT results were analyzed, and differences of relative error (RE) as the indicator of catheter placement accuracy were compared between the two groups.Results:Mobile CT was successfully performed in all patients from free-handed conical craniotomy group, and sufficient information was provided for surface projection in all patients. The percentages of patients with satisfactory results of catheter placement (RE<1) in the free-handed conical craniotomy group and stereotactic puncture group were 92.3% and 90.0%; one patients from the free-handed conical craniotomy group had repeated puncture. There was no significant difference in postoperative RE between the two groups (0.52±0.33 vs. 0.53±0.29, P>0.05). Subgroup analysis of different hematoma locations and volumes also showed no statistically significant difference in postoperative RE ( P>0.05). Conclusion:Free-handed conical craniotomy and drainage guided by novel 16-slice mobile CT-assisted surface projection is feasible in sICH patients, and the accuracy of catheter placement is similar with frameless stereotactic puncture and drainage.

Objective:To evaluate the effectiveness and safety of ultrasound-guided hydrostatic reduction for pediatric acute intussusception.Methods:One thousand eight hundred and thirty patients with acute intussusception diagnosed by ultrasound in Shenzhen Children′s Hospital from September 2017 to July 2020 were treated with ultrasound-guided hydrostatic reduction method. The therapeutic effects, complications and ultrasonic features were observed.Results:Among 1 830 cases, 1 791 cases were diagnosed as primary intussusception, and 39 cases were secondary intussusception. The overall rate of successful ultrasound enema reduction were 1 780/1 830(93.7%) patients. All 50/1 830(2.7%) patients underwent surgery after unsuccessful enema reduction, including 42 cases of primary intussusception, and 8 cases of secondary intussusception. The complication of intestinal perforation occurred in 3 cases (0.16%), and there were no deaths.Conclusions:Ultrasound-guided enema reduction for pediatric acute intussusception is an effective and safe method without radiation exposure, and can be used as the preferred method for non-operative treatment of intussusception.