Objective To investigate the role of the spleen in the pathogenesis of acute pancreatitis(AP). Methods The studied rats were divided randomly into four groups:Sham operation group, splenectomy group, AP group and AP with splenectomy group.The rats were sacrificed at 3h,6h and 12h after operation, and spleen and pancreas were removed for examination. Light microscopy was used to examine pancreatic tissues for pathologic change and to assess pathology score. Immunohistochemical method was used to observe the activity of splenic NF-?B(p65) in the rats with AP.Results The pancreas pathology score in the AP with splenectomy group was significantly lower than that in AP group at 6h(7.83?0.753vs 9.67?1.211) and 12 h (9.67?0.816 vs13?0.894) after operation (P

Objective To study the results of splenectomy for patients with idiopathic thrombocytopenic purpura(ITP), which refractory to medical therapy or with repeat recurrence of symptoms. Methods 58 ITP (patients) who failed to respond to conservative management were treated with splenectomy and the clinical (outcome) was observed. Postoperatively, 52 cases were followed up for 6 months to 12 years, and in 48 of these cases the followup was more than 1 year. Results Platelet count recovered to normal(≥100?10~9/L ) two weeks after operation in 47 cases(81.03%). The total effective rate was 79.31% when (followed-up) for 2 months, 78.85% when followed-up for 6 months and 11 cases had recurrence. (Conclusions) Splenectomy is a safe and effective therapy for patients with ITP who failed to respond to (conservative) management or have relapse of ITP. Patients who showed temporary response to preoperative (steroid) therapy and those who had an early or a high amplitude of increase of platelet count after operation have better prognosis.

Objective To study the risk factors of early complications and methods of treatment after pancreaticoduodenectomy(PD).Methods There were 79 patients who undercoent PD at our hospital between January 1998 and December 2007.All of the patients were divided into complication group and non-complication group according to the outcomes.Their clinical features,preoperative tests,and surgical factors were retrospectively analyzed.Results The postoperative complication rate was 58.2%,and the hospital mortality was13.9%.Logistic regression showed that the level of total bilirubin and liver function classification were the independent risk factors(P0.05).Conclusions The early complications after PD are closely related to the preoperative level of serum bilirubin and liver function.Proper periopertive management can effectively decrease the occurrence of pancreatic leakage and other postoperative compliccations.

Objective To investigate the value of Helicobacter pylori (HP),blood carcinoembryonic antigen (CEA),carbohydrate antigens 72-4 (CA72-4) and CA24-2 in the screening of gastric cancer.Methods The contents of HP,blood CEA,CA72-4 and CA24-2 in 50 healthy controls,45 patients with benign gastric lesions mnd 70 patients with gastric cancer were detected.According to the number of positive cases,the positive rate of single detection and the positive rate of combined detection were calculated.Sensitivity,specificity,and accuracy of serum tumor markers were calculated according to HP single and combined detection.Results The positive rate of each individual detection and 4 joint detection in gastric cancer group was significantly different from that in the benign lesion group and the normal control group (P ＜0.01).The positive rate of 4 joint detection in gastric cancer group was 89.25％,and the difference was statistically significant (P ＜0.01).There was no significant difference in the positive rate of the single test and the 4 joint detection in benign stomach group and normal control group (P ＞ 0.05).The sensitivity,specificity and accuracy of HP,blood CEA,CA72-4,CA24-2 joint detection were significantly higher than single detection (P ＜ 0.05).Conclusions Joint detection was significandy better than single detection,and can significantly improve the detection rate of gastric cancer.

Objective To investigate the clinical and pathological features of colonic polyp canceration and related risk factors of colon polyps,and explore clinicopathologic features and major risk factors of the canceration of polyps of colon polyps.Methods Totally 80 patients with colon polyps including 6 cases of cancerations and 20 patients with colon cancers were selected from Xuzhou Tumor Hospital Admissions.Those patients were divided into 74 cases of non cancer group and 26 cases of cancer group.The clinical data,the detection index and the statistical analysis were performed.Results The clinical features of patients included 51 cases of multiple polyps,30 cases of fatty liver,13 cases of fecal occult blood positive,and 30 patients with colonoscopy.There were 218 polyps,191 data intact,and 6 cases showed cancer (3.14％).Inflammatory polyps mainly occurred in rectum,cecum,and significant risk other than the colon.Tubular adenoma occurred mainly in the transverse colon.Sigmoid colon cancer colon polyps of the highest risk showed OR =2.30 (P ＜ 0.05).The cancer risk from high to low was from tubular villous adenoma to villous adenoma hair (P ＜0.01),and no difference in tubular adenoma cancer risk (P ＞0.05).There was no difference between the indexes of the canceration group and the non cancerous group (P ＞ 0.05).The single factor analysis showed pathological type,and the lesion were the main risk factors of malignant colonic polyps (P ＜ 0.05).Multi-factor regression analysis showed WBC,pathological type,and the lesion were the main risk factors of malignant colonic polyps (P ＜ 0.05).Conclusions The colonic polyps in male have higher incidence with fatty liver,hypertension and other pathological features,and are mainly tubular adenomas,inflammatory and hyperplastic polyps,with different lesions,pathological types occur and different cancer risk.

Objective To compare the efficiency difference of 3 serological methods in syphilis blood SCreening,and then select the most proper method to prevent the transmission of syphilis via blood.Methods The samples of 2 000 blood donors were tested by TP-ELISA,TRUSlT and TPPA.Those positive samples detected by TP-ELISA and TRUST were confirmed by TPPA again.Results Of the 2 000 samples,11 samples were-TP-ELISA positive in which 8 samples were confirmed positivewith TPPA;2 samples were TRUSlT positive and both the two samples were confirmed positive withTPPA;and 8 cases were TPPA positive.There was obvious difference in detection rate between TRUST and TP-ELISA method(P

Objective In order to recognize the high risk of acute abdomen caused by mesenteric vascular lesions and to improve the treatment.Method 8 cases have been followed and analyzed in clinic features,curative methods and effects.Results 6 patients were operated on and the diagnosis was confirmed pathologically.Most of patients suffered the acute abdominal,pain and signs were in the disorder.5 patients misdiagnosed, 1 diagnosed preoperatively, 2 cases with mesenteric vascular insufficiency were diagnosed by CT, celiac arteriography and cured with drugs,7 cured, 1 died.Conclusions Mesenteric vascular diseases are uncommon,accurate diagnosis should not rely on symptoms and signs which were nonspecific.Ultrasonography,CT were the sensitive examinations and benefitted to diagnosis.Early operation for the resection of bowel gangrene involving their mesentery,early application of anticoagulant therapy is essential to reduce the mortality and recurrence.

Aim To investigate the effect of zacopride ( Zac) on cardiac arrhythmia in isoproterenol ( ISO)-in-duced myocardial hypertrophic rats and the underlying electrophysiological mechanisms .Methods ① Fifty-one rats were randomly divided into control group ( n=17 ) , ISO group ( n=17 ) and ISO +Zac group ( n =17 ) .Rat model with cardiac arrhythmia and hypertro-phy was established by intraperitoneal ISO ( 5 mg?kg -1 ) injection.②ECGs were recorded to observe the effects of Zac on arrhythmia in model rats .③ Whole-cell patch clamp was applied to record inwardly rectifi-er potassium current(IK1), resting membrane potential ( RMP ) and amplicated delayed afterdepolarizations (DADs).Results ① Echocardiographic examination showed that , left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) significantly decreased in rats in ISO group compared with control group , whereas left ventricular posterior wall end-diastolic thickness ( LVPWd) and in-terventricular septum end-diastolic thickness ( IVSd ) increased ( P<0.05 ) , suggesting rat model of isoprot-erenol-induced myocardial hypertrophy was successfully established .② ECGs showed that 88.89% of rats in ISO group had ventricular premature beats ( VPBs ) , which significantly decreased to 11.11% after the ap-plication of Zac ( P <0.05 ) .③ Values of RMP de-creased from ( -71.05 ±1.27 ) mV in control group to (-69.38 ±1.21 ) mV in ISO group ( P<0.05 ) . After Zac administration , RMP significantly increased to ( -73.86 ±1.33 ) mV compared with control and ISO group(P<0.05).④DADs and TA incidence sig-nificantly decreased from 88.24% in ISO group to 11.76%in ISO+Zac group ( P<0.05 ) .⑤ Compared with control group , IK1 density was markedly reduced in ISO group, whereas Zac could effectively rescue IK1 suppression to normal level .Conclusions Zac, as a selective IK1 channel agonist , can significantly inhibit cardiac arrhythmia in isoproterenol-induced myocardial hypertrophic rats , which is mainly attributed to in-creased RMP by enhancing IK1 and subsequent suppres-sion of DADs.

Aim To investigate the inhibitory effects of zacopride(Zac) on arrhythmia induced by isoproterenol ( ISO) and the underlying mechanisms in rats. Meth-ods ①ECGs were recorded in anesthetized rats in vi-vo to observe the effects of zacopride on arrhythmia in-duced by ISO. ② Intracellular microelectrode tech-nique was used to investigate the effects of zacopride on resting membrane potential, delayed afterdepolariza-tions ( DADs) and triggered activity ( TA) induced by ISO combined with 3. 6 mmol·L-1 CaCl2 in right ven-tricular papillary muscle of rats. Results ① In ISO group rats, ventricular premature beats ( VPB ) oc-curred frequently with ST-segment depression. Com-pared with ISO group, the incidence of VPB in ISO+Zac group decreased from 100% to 50% ( n=6 , P<0. 05 ) and the total number of VPB recorded in 1 hour significantly reduced from 1 574 ± 521 to 33 ± 40 ( n=6,P<0. 05). ② Zacopride at 1 μmol·L-1 could hy-perpolarize the resting membrane potential of right ven-tricular papillary muscle in normal rat from ( -74. 42 ± 1. 95 ) mV to ( -78. 50 ± 2. 07 ) mV ( n =6 , P <0. 05). ③ Zacopride at 1 μmol·L-1 significantly de-pressed the DADs and TA induced by ISO combined with 3. 6 mmol·L-1 CaCl2 in right ventricular papilla-ry muscle. The incidence of DADs decreased from 93. 75% in rats in ISO group to 25% in ISO +Zac group ( n =16 , P <0. 05 ) , and this antiarrhythmic effect could be reversed by 1 μmol·L-1 BaCl2 . Conclusions Zacopride, a selective IK1 channel ago-nist , can significantly inhibit cardiac arrthymia induced by ISO in rats, the mechanism of which is mainly at-tributed to zacopride-induced hyperpolarization of the resting membrane potential and subsequent suppression of DADs and TA via enhancing IK1 . These results pro-vide further evidence that to enhance IK1 moderately may be a feasible pathway for antiarrthymic therapy.

Objective To study the effect of early enteral nutrition(EN) and total parenteral nutrition(TPN) in patients with severe acute pancreatitis by a mata analysis.Methods Randomized controlled trials of TPN and early EN in patients with severe acute pancreatitis were searched in Medline,Pubmed and Embase from Jan 1970 to June 2009,and Cochrane Library(Issue 2,2009).Seven studies were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed by two independent authors and analysed by using Revman 5.0.18 software.Results Compared with TPN,early EN was associated with a significantly lower incidence of pancreatic infections(OR =0.38,95% CI :0.18～0.82,P =0.01),organ failure(OR =0.43,95% CI :0.23～0.79,P =0.007),fewer surgical interventions(OR =0.34,95% CI :0.18～0.63,P =0.0006) and mortaily(OR =0.41,95% CI :0.19～0.88,P =0.02).However,there was no significant difference in total infections [ OR =0.43,95% CI(0.17,1.10),P =0.08]between patients with TPN and early EN.Conclusions Early EN could be the preferred nutrition feeding method for patients with severe acute pancreatitis.