Objective To explore the clinical features of acute ischemic bowl disease in order to guide clinical treatment and avoid the severe complications.Methods 25 cases diagnosed as ischemic bowl disease were enrolled retrospectivly analysed the clinical features of symptoms,signs,laboratory test results,abbominal enhanced CT and CTA,enteroscopes of these patients.Results Among the 25 cases accorrding to first presentation of first contacts,the cardinal symptoms were spectively abdomial pain 20 (80％),abdomial distension 16 (64％),diarrhea 18 (72％),vomiting 13 (52％),hemafecia 6 (24％),bloody purulent stool 8 (32％),watery stool 7 (28％),fever 11 (44％) and physical signs were spectively local tenderness 12(48％),peritonitis sign 9(36％),active bowl sound 7 (28％),weak or disappeared bowl sound 5 (20％).22 of 25 cases were positive with ocult blood test of stool and 23 of 25 cases showed elevated D-dimer concentration(more than 500μg/L) within 24 hours after first contacts.All the 25 cases were dignosed with CTA and 1 case was performed with enteroscopy which showed that local mucosa of sigmoid colon was congestive,edema,submucosal extravasated blood and some part was bleeding.Conclusion The patient with high risk factors who suffered from the tetralogy of severe abdominal pain,intense evacuation symptoms,highly elevated D-dimer concentration and positive ocult blood test,is stongly suggested to be a ischemic bowl disease and should be performed the abdomial CTA or DSA examination in time to avoid missing the golden opportunity to cure.

Biliary tract malignant tumours do not have any special symptom or physical sign in early stages.It is easy to be delayed for diagnosis and it is often very serious when the disease was diagnosised.With the development of technology of molecular biology,the biliary tract malignant tumours' diagnosis in molecular biology has been made some progresses,and it is expected to be possible to diagnose and treat the diseases in early stages.

Accidents, Occupational ; Acute Disease ; Adult ; Humans ; Male ; Sulfuric Acid Esters ; poisoning

Objective:To observe the clinical efficacy and safety of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) combined with traditional medicine retention enema for treatment of chronic radiation proctitis.Methods:A total of 128 patients pathologically diagnosed as cervical cancer and endometrial cancer with grade 1-2 chronic radiation proctitis at Xiangyang Central Hospital from October 2017 to October 2019 were enrolled in a random, single-blind, control trial. The patients were divided into the control group and the experiment group according to the random number table, and the control group was given the treatment regimen of gentamicin + dexamethasone + Yunnan Baiyao retention enema, and the experimental group was given the treatment regimen of rhGM-CSF + gentamicin + dexamethasone + Yunnan Baiyao retention enema; both regimens treated twice daily for three weeks. The clinical symptom before and after enema treatment based on the subjective, objective, management and analytic (SOMA) scale was scored and the efficacy was evaluated by combining with stool routine and rectoscopy.Results:According to the SOMA scale, the scores of hematochezia, diarrhea, tenesmus, abdominal pain after enema were lower than those before enema, and the differences were statistically significant (all P<0.05); however, the scores of all symptoms before treatment of both groups were not statistically significant different (all P>0.05). The score of hematochezia in the experimental group after enema was lower than that in the control group [(0.33±0.15) scores vs. (0.48±0.32) scores, t=2.045, P=0.022], and the scores of other symptoms in both groups were not statistically significant different (all P>0.05). The overall effective rate was 79.69% (51/64) in the control group and 90.63% (58/64) in the experimental group, and difference was statistically significant (χ 2=6.485, P=0.026). All patients had no obvious adverse reactions. Conclusions:rhGM-CSF combined with traditional medicine retention enema for treatment of chronic radiation proctitis in patients with cervical cancer and endometrial cancer is highly effective and easy to operate, and patients are well tolerated, which is worthy of clinical promotion.

Objective To analyze the prognostic value of baseline serum free light chain (sFLC) in light-chain (AL) cardiac amyloidosis.Methods Twenty-seven patients with AL cardiac amyloidosis were retrospectively reviewed from January 2014 to January 2015.sFLC was measured by immuoturbidimetric assay.Baseline characteristics,echocardiographic parameters and electrocardiogram data were analyzed.According to the median baseline dFLC (involved sFLC minus uninvolved sFLC),patients were categorized into either the low dFLC(≤307mg/L) or the high dFLC group (＞307mg/L).Results More subjects in the high dFLC group with early/late diastolic mitral velocity ratio (E/A ratio) over 2 (71.4％ vs 30.8％,P =0.035),and subjects in this group had a shorter median survival time than those in the low dFLC group (3 months vs 17 months,P =0.004).A similar phenomenon for median survival time was observed when the subjects were redivided either by a new cut-off value of 180mg/L for dFLC (low dFLC group:17 months;high dFLC group:4 months,P =0.014) or a κ/λ ratio,in which subjects with κ type sFLC-ratio ≤ 19.6 and λ type sFLC-ratio ＞0.065 were in the low sFLC-ratio group (17 months) and those with κ type sFLC-ratio ＞ 19.6 and λ type sFLC-ratio ≤0.065 were in the high sFLC-ratio group (4 months,P=0.023).In multivariate analysis,dFLC and New York Heart Association (NYHA) classification of cardiac function were two risk factors associated with all-cause mortality in patients,among which the hazard ratio for higher dFLC was 4.28 (95％ CI 1.55-11.8,P =0.005).Conclusion The level of sFLC could be a marker for the prognosis of AL cardiac amyloidosis.

Objective To retrospectively evaluate effects of early dynamization of interlocking intramedullary nail on union of tibial shaft fractures.Methods From January 2002 to Septemher 2004,75 patients with tibial shaft fractures were treated in our department with internal fixation using static interlocking iutramedullary nails.Early dy- namization(6 to 10 weeks postoperative)was adopted in 32 patients (the dynamic group) according to the fracture con- ditions,while the other 43 patients were treated without early dynamization (the non-dynamic group).The healing time of fractures and the rate of delayed union in both groups were documented.Results All the cases were followed up for a mean duration of 6.5 months (range,4 to 13 months).The mean healing time was 115.6 days (range,105 to 126 days) in the dynamic group and 124.5 days (range,119 to 133 days) in the non-dynamic group.The difference was statistically significant between the two groups (P＜0.05).There were two cases (6.2%) of delayed union in the dynamic group and four (9.4%) in the non-dynamic group.The difference was not significant (P＞0.05). Conclusion Early dynamization of interlocking intramedullary nail can promote union of tibial shaft fractures.

Objective To investigate the regulation of parathyroid hormone(1-34) on mRNA expression of osteoclast inhibitory lectin (OCIL) gene in UMR106 osteoblastic-like cells and involved signaling pathway.Methods Rat UMR106 osteoblastic-like cells were cultured and treated with various concentration of PTH(1-34) and specific agonists or inhibitors of PKA,PKC,Ca2+/calmodulin-dependent protein kinase (CaMK) and mitogen-activated protein kinase (MAPK) signal pathways for indicated time intervals.Then the cells were gathered at indicated time points and total RNA were extracted.OCIL mRNA expression was analyzed using real-time PCR technique.Results PTH(1-34) stimulated OCIL mRNA expression in a time-and dose-dependentmanner.A dose of 10 nmol/L PTH(1-34) started to induce OCIL mRNA from 6 h,with a highest increase of about 2.8-fold vs.control group (without PTH treatment) at 24 h.The up-regulation of OCIL mRNA began and reached maximum later than RANKL induction and OPG suppression effected by PTH(1-34).Protein Kinase A (PKA) signaling activators forskolin(FSK) and dibutyryl cAMP (db-cAMP),as well as calcium ionophore A23187 all up-regulated OCIL mRNA with the maximal induction of about 4.2-fold,4.5-fold and 5.1-fold.Protein Kinase C (PKC) activator phorbol-12-myristate-13-acetate(PMA) reduced OCIL mRNA expression at the early stage(2-6 h),with the highest down-regulation of 50％ at 6 h.However,the inhibitory effect on OCIL mRNA turned into slightly stimulatory effect later (24 h).PKA inhibitor KT5720,calmodulin antagonist W-7,CaMK Ⅱ inhibitor KN-62 and mitogen-activated protein kinase (MAPK) inhibitor PD98059 all blocked PTH(1-34)-induced OCIL mRNA expression by the maximal reduction of 56％,61％,63％ and 50％ respectively.There also exist cross-talks between different signal pathways.MAPK inhibitor PD98059 blocked the expression of OCIL mRNA which was stimulated by PKA activators FSK or db-cAMP,with the reduction of 98％ and 63％ respectively,while the OCIL mRNA expression stimulated by A23187 remained unaffected.Conclusion PTH(1-34) increased OCIL mRNA expression in vitro through cAMP/PKA,Ca2+/CaMK and MAPK signaling pathways.