Objective To observe the effect of Xingnaojing injection in myocardial mitochondrial oxidative stress injury in sepsis mice. Methods The septic model were set up by receiving endotoxin through interaperitoneal injection. After Xingnaojing injection by gastric tube , seventy mice were randomly divided into 7 groups in ten of each group including group LPS-6 h , group LPS-24 h , group LPS-48 h; group XNJ-6 h , group XNJ-24 h, group XNJ-48 h and control group. The myocardial mitochondrial changes , the semi-quantitative scores and the level of SOD、MDA、NO、iNOS in sepsis mice were observed. Results Xingnaojing injection could improve the myocardial mitochondrial changes , reduce the semi-quantitative scores , significantly reduce the level of MDA、NO、iNOS and elevate the level of SOD. Conclusion Xingnaojing injection could significantly reduce the myocardial mitochondrial oxidative stress level and improve the ability of clearing oxygen radicals , thereby protect the myocardial mitochondrion in sepsis mice.

Sepsis associated encephalopathy (SAE)is the most common form of encephalopathy in the pediatric intensive care units and might appear before other systemic features of sepsis.The pathogenesis of SAE is complex and not clear.SAE causes increased morbidity and mortality but has limited therapeutic options.SAE has become a hot issue in critical care medicine.

Objective To evaluate the clinical manifestation and operative treatment for the scolio-sis of Marfan syndrome, and analyze its clinical outcomes as well. Methods The retrospective study cov-ered 10 patients including 8 females and 2 males with an average age of 12.9 years (9 to 16 years), who had undergone operations from January 1990 to December 2002. The Cobb's angle in the coronal and sagittal plane, the trunk shift, the apex rotation and shift were evaluated both before and after operation respectively. In the group, there were four cases with family history. Of the 10 cases, the classification of scoliosis was single curve in two cases, double curves in six cases and three curves in two cases. Results All the pa-tients were followed up for a mean time of 15 months, ranged from 4 months to 3 years. The trunk shift changed from the mean distance of 2.17 cm to 1.41 cm. The apex rotation decreased about 1?. The apex shift changed from the mean distance of 4.57 cm to 2.14 cm. The mean Cobb's angle in the coronal plane changed from 88? to 42?. The correction rate was about 46.38% (18.18% to 81.54%). The Cobb's angle on the final follow-up was 46?( 11? to 96?), and the mean lost angle was 4?. The mean Cobb's angle of the thoracic kyphosis was 20?(-10? to 52?) preoperatively and 23?(0? to 35?)postoperatively, and 24?( 0? to 35?) on the final follow-up. The Cobb's angles of the thoracolumbar kyphosis of 5 cases improved from 85? to 10? after operations, and there was no angle loss on the follow-up. Conclusion The three dimensional corrective instrumentation can be used effectively for the correction of the scoliosis of Marfan syndrome. The critical points for the successful operation are the simultaneous correction of the coronal and sagittal plane deformities, prevention of the dural expansion in the lumbar or lumbosacral canal, rigid and multi-segmental internal fixation, extensive and ample bone fusion, and correct external fixation after operation.

Objective To analyze the value of three-dimensional computed tomography (CT) reconstruction imaging for the diagnosis and treatment of congenital scoliosis. Methods 76 patients with congenital scoliosis were examined with X-ray of total spine and three-dimensional CT reconstruction, and the results were analyzed. Compared with X-ray film, the findings with the CT imaging were classified into three groups: Group Ⅰ, no supplementary useful information was obtained; Group Ⅱ, further confirmation of findings which were unclear or ambiguous on X-ray film, with improved visualization and comprehension of the type of the deformity; Group Ⅲ, substantial new information was obtained. Results Group Ⅰ: 11 (14.5%) patients, without supplementary useful information obtained with three-dimensional CT reconstruction imaging. The patients aged from 2 to 16 years(11.00?10.09 years), and the Cobb angle ranged from 28? to 102?(55.60??21.06?). Group Ⅱ: 49 (64.5%) patients, with confirmatory finding or improved visualization and comprehension of the previously identified deformities obtained with CT imaging. The 49 patients aged from 4 to 28 years (13.53?4.47 years), and the Cobb angle ranged from 20? to 115? (55.41??23.44?). Group Ⅲ: 16 (21%) patients, with substantial new information obtained with CT reconstruction images which was unrecognized with X-ray film. The patients aged from 6 to 16 years (12.88?2.68 years),and the Cobb angle ranged from 37? to 145?(73.19??28.18?). The difference of age of patients between 3 groups was of no significance (P=0.052), but the difference of Cobb angle between 3 groups was significant statistically (P=0.039). Conclusion Three-dimensional and multiplanar reformatted CT imaging allows better visualization and understanding of the deformities of scoliosis, and supplementary useful information may be obtained which was obscure or unrecognized with X-ray film, especially for patients with severe deformities. Its application in clinical practice may contribute to the diagnosis of the type of deformity and the segments involved, as well as the individualized operative planning.

Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response due to infection, and it can further develop into septic shock.Currently, sepsis is still a leading cause of death in children all over the world.Therefore, early assessment of the severity and prognosis of sepsis is of great significance.However, there are no indexes with high sensitivity and specificity for evaluating the severity and prognosis of sepsis at present.In recent years, a large number of studies have revealed the essential role of platelets in sepsis.It has been reported that the platelet count is an independent factor affecting the severity and prognosis of sepsis patients.Up to now, the specific mechanism of sepsis-induced thrombocytopenia has not been fully clarified.In this review, the value of thrombocytopenia in predicting the severity and prognosis of sepsis patients was elaborated.

Prevention and treatment of tumor metastasis are important for the therapy of colon cancer. The discovery of stem cell markers provides a new approach for radical treatment of cancer. So far,the colon cancer stem cell markers discovered included several membrane protein molecules,transcription factors and related signal pathway. Exploration of colon cancer stem cell markers could contribute to the treatment of colon cancer and improve the survival rate and life quality of patients. This article reviewed the advances in study on colon cancer stem cell markers.

Objective To study the reasonable doses, efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration(CVVH) in children. Methods There were 66 patients hospi-ta-lized in Pediatric Intensive Care Unit of Zhujiang Hospital,Southern Medical University treated with RCA-CVVH that were recruited in the study from October 2012 to July 2014. The patients were divided into 4 groups according to their weight:≤10 kg( group Ⅰ) ,20 kg≥weight>10 kg( group Ⅱ) ,30 kg≥weight>20 kg( group Ⅲ) ,>30 kg( groupⅣ),and each group randomly received 2 different doses of anticoagulant acid citrate dextrose formula A(ACD-A):ACD-A(mL/h)=0. 75×blood flow rate(BFR)(mL/min)(A dose) and ACD-A=1. 5×BFR(B dose). Data of hemo-filter duration, activated partial thromboplastin time( APTT) ( systemic and circuit) , ionized calcium( Ca2+) ( systemic and circuit), blood urea nitrogen(BUN), serum creatinine(Cr), alanine aminotransferase(ALT), aspartate amin-otransferase(AST), blood pH, sodium ion(Na+), bicarbonate ion(HCO3-) were collected and analyzed. Results There was no significant difference in BUN,Cr,ALT,AST and APTT of 2 different doses of ACD-A among the groups (all P>0.05);pH of B dose of ACD-A in group Ⅰwas significantly higher than that in A dose(F=7.384,P=0. 015);pH of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 492,P=0. 046),HCO3-of B dose of ACD-A in groupⅠwas significantly higher than that in A dose(F=7. 735,P=0. 013);HCO3-of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 644,P=0. 042);hemofilter duration of B dose of ACD-A in group Ⅲ was significantly higher than that in A dose(t=-3. 147,P=0. 016);hemofilter duration of B dose of ACD-A in groupⅣwas significantly higher than that in A dose(t=-6. 342,P=0. 000). Conclusions RCA-CVVH is effective and safe for critical children,and different doses of ACD-A for children with different weight can re-duce metabolic alkalosis and enhance regional anticoagulation.

Objective To compare the effect of the different operation for mammary duct fistula (MDF). Method The clinical data of 85 cases of MDF were analysed retrospectively. Continuous section examinations between the multiple fistula was performed in 3 cases undergoing breastectomy.Results Among the 85 cases with 146 MDF, the opening located within 5cm around areola in 129 cases. MDF incision was performed on 38 cases, 34 cases cured, 4 cases recurred;MDF resection was performed in 44 cases, all the 44 cases were cured;simple mastectomy was performed on 3 cases of extensive breast inflammation,all the 3 cases cured. Conclusions Most of MDF occurs in main mammary duct. Most of the opening of MDF are around the areola. MDF incision or resection is the first choice of operation.

Objective To explore the changes of etiology and mortality of upper gastrointestinal bleeding (UGIB) in the last 20 years in Guangdong region. Methods A total of 3140 UGIB cases diagnosed in Guangdong General Hospital from January 1990 to October 2009 were analyzed with retrospective analysis. Groups were divided according to admission chronological order and age to analyze the causes of UGIB to get the trend of changes and influencing factors. Results UGIB occurred more in men than in women, the gender ratio was 2. 5∶1. There was no significant change in gender composition between the first and later 10 years. Peptic ulcer bleeding (PUB) was the main cause of UGIB in young and middle-age patients (age<60 years), especially duodenal ulcer (DU)bleeding (45. 0%) , and secondary was acute gastric mucosal lesion ( AGML) (16. 6%). While in elder patients group (age≥60 years), the main cause of UGIB was AGML (40. 5%), the frequency was significantly higher compared with the young and middle-age group (40. 5% vs 16. 6%,P<0. 01).Compared the first 10 years with the later 10 years, the occurrence rate of PUB was overall in downward trend (57. 4% vs 42. 8%, P<0.01), of which DU and compound ulcer(CU) bleeding reduced significantly (DU: 43.8% vs 27.7%, P<0. 01 and CU: 7.7% to 5.5%, P<0. 05). While the incidence of gastric ulcer (GU) (7.4% vs 8. 1% ,P>0. 05) and esophagogastric variceal bleeding (EVB) (11. 7% vs 12. 9%, P>0.05) remained stable. The occurrence of AGML bleeding significantly increased than before (32. 4% vs 18. 8%,P<0. 01), and became one of the most important causes of UGIB. Conclusions PUB is still the most important cause of UGIB in Guangdong region. AGML becomes another important cause of UGIB in elder patients, which may relate to the increasing use of non-steroidal anti-inflammatory drugs (NSAIDs), anti-platelet and antineoplastic medicine.

ObjectiveTo investigate the effects of autophagy on exocrine function of pancreas in rats with acute sepsis, and to determine whether the mitochondrial coenzyme Q (Mito Q) can prevent exocrine dysfunction of pancreas mediated by autophagy.Methods ExperimentⅠ: 30 Sprague-Dawley (SD) rats were randomly divided into three groups, with 10 rats in each group. All the rats were given lipopolysaccharide (LPS, 10 mg/kg) intraperitoneally, and Wortmannin (2 mg/kg), the specific inhibitor of autophagy (LPS+ Wortmannin group), Mito Q (6.5μmol/kg, LPS+Mito Q group), or the same volume of normal saline (LPS group) was respectively injected via the tail vein 1 hour later. Survival rate was assessed within 12 hours after LPS injection. ExperimentⅡ: another 100 male SD rats were randomly divided into ten groups with 10 rats in each group: namely control 4, 6 and 12 hours groups, LPS 4, 6 and 12 hours groups, and LPS+ Wortmannin 4 hours group, Wortmannin 4 hours group, LPS+ Mito Q 6 hours group, and Mito Q 6 hours group. The protocols of model reproduction and drug administration were the same as in the experimentⅠ. Blood samples were collected at each time point, and the amylase content was determined with the velocity method. The levels of reactive oxygen species (ROS) in the pancreases were measured with enzyme-linked immunosorbent assay (ELISA). The expression of the autophagy-related protein LC3 was determined with Western Blot. The pathological changes in the pancreas were observed with microscopy.Results① The survival time in the LPS+ Wortmannin group was significantly shorter than that in the LPS group (hours: 7.50±0.64 vs. 11.90±0.13,χ2= 19.847,P= 0.001). There was no significant difference in the survival time between LPS+ Mito Q and LPS groups (hours: 11.60±0.24 vs. 11.90±0.13,χ2= 1.055,P= 0.137).② The serum amylase in the LPS 6 hours, LPS+ Wortmannin 4 hours, and LPS+ Mito Q 6 hours groups were significantly higher than those in the control group at the same time points (U/L:2 881.00±550.12 vs. 2 099.20±249.57, 3 672.00±779.24 vs. 2 081.36±245.18, 2 975.20±687.03 vs. 2 099.20± 249.57, allP< 0.05), and were significantly lowered in LPS 12 hours group (U/L: 794.00±218.71 vs. 2 086.80±261.75, P< 0.01). The pancreatic ROS in the LPS 6 hours and 12 hours groups, LPS+ Wortmannin 4 hours group, and LPS+Mito Q 6 hours group were significantly higher than those of the control group at the same time points (kU/L: 3.18±1.06 vs. 1.78±0.37, 3.63±1.08 vs. 1.85±0.41, 3.14±0.98 vs. 1.65±0.34, 3.17±1.03 vs. 1.78±0.37, allP< 0.05). The serum amylase and pancreatic ROS in LPS+ Wortmannin 4 hours group were significantly higher than those of the LPS group at the same time points (U/L: 3 672.00±779.24 vs. 2 432.20±442.85, kU/L: 3.14±0.98 vs. 1.87±0.42, both P< 0.05), but there were no differences in above two parameters between LPS+ Mito Q 6 hours group and LPS group (U/L: 2 975.20±687.03 vs. 2 881.00±550.12, kU/L: 3.17±1.03 vs. 3.18±1.06, bothP> 0.05). Light microscopy showed that obvious pathological changes were found in the pancreas in the LPS 6 hours and 12 hours groups, LPS+Wortmannin 4 hours group, and LPS+ Mito Q 6 hours group. Electron microscopy showed that the number of autophagic vacuoles increased 6 hours after LPS administration. There was no difference at any time point in the number of autophagic vacuoles between LPS+ Mito Q 6 hours group and LPS 6 hours group, and the autophagic vacuoles were not found after Wortmannin intervention. It was demonstrated by Western Blot that the levels of LC3 protein in the LPS 6 hours and 12 hours groups, and LPS+ Mito Q 6 hours group were significantly higher than those of the control group at the same time points (A value: 0.34±0.02 vs. 0.17±0.02, 0.37±0.03 vs. 0.18±0.04, 0.36±0.02 vs. 0.17±0.02, allP< 0.05), but there were no differences between LPS 12 hours group or LPS+ Mito Q 6 hours group and LPS 6 hours group (bothP> 0.05).Conclusions Autophagy prevents exocrine dysfunction of pancreas in septic rats, and the autophagic capacity or autophagosome-formation rate may determine the development of exocrine pancreatic dysfunction. The mitochondria-targeted antioxidant Mito Q does not prevent exocrine dysfunction of pancreas.