Clinical data of 14 patients with iatrogenic duodenal injuries treated in hospital from January 2000 and January 2010 were retrospectively reviewed.Iatrogenic duodenal injuries were found intraoperatively in 9 cases,in whom repair or additional jejunostomy was performed and all were cured and discharged.In 2 patients the duodenal injuries were found within 24 hours postoperatively,1 was cured,another had low flow duodenal fistula and cured with conservative treatment.Duodenal bypass and extraoral drainage were performed in 2 patients whose duodenal injuries was found 72 hours after surgery and died from severe infection of retroperitoneal space and multiple organ failure respectively.One patient whose duodenal injury was found 7 d postoperatively suffered from septic shock and died in 4 h after admission.The results suggest that early detection and early management would result in satisfied outcome for patients with iatrogenic duodenal injuries,the first 24 hours are crucial.

Objective To explore the feasibility of using portable γ spectrometer to rapidly identify the low activity of depleted uranium and the underlying conditions.Methods Firstly,high purity germanium (Ge) γ spectrometer was used to analyze energy spectrum of DU samples (5 g) and calculate nuclide percentage of 235U in an attempt to ascertain the properties of these DU samples.The portable γ spectrometer was used to provide the evidences for identification of DU samples.Secondly,portable γ spectrometer was also used to identify DU samples of same group.These samples contain 1 g DU powder and 0-5 g environmental clay powder,which were sealed with double layer pocket,and then detected with a distance of 1-5 cm during the longest detection time of 10 min.According to the detection of nuclide activity of 238U and 235U in the samples and the subsequent calculation of specific activity,the nuclide percentage composition was calculated and the existence of DU was confirmed if this value of 235U was less than 0.718％.Results The activity of 238U was detected using portable γ spectrometer under all test conditions,while the activity of 235U was detectable only under certain test conditions (MA ≥ 1 g,DN ≤ 1 cm).Under the condition that the 238U and 235U was both detected,the nuclide percentage of 235U was all less than 0.718％,which suggested that the DU was confirmed.Conclusions The energy spectrum of low activity of DU and the type of nuclide could rapidly be identified and evaluated by using portable γ spectrometer.This is same as the conclusions obtained with high purity Ge γ spectrometer,α spectrometer and ICP-MS.

Objective To explore the hemorheological changes in children with essential hyepertension,and explore their clinical significance.Methods The hemorheological parameters,blood lipid,blood glucose in 37 children with essential hyepertension [19 boys and 18 girls,median age(12.49?3.20) years] were measured and analyzed.The parameters in 30 healthy children were measured as controls.SPSS 11.5 software was used to analyze the data.Results The whole blood viscosity under high,middle and low shear rate,plasma viscosity,hematocrit,rigidity index of erythrocyte,platelet aggregation M were significantly higher in hypertension group than those in healthy control group(Pa0.05).Conclusions There have been developed significant hemorheological changs in children with essential hypertension.The hemorheological changes might play an important role in pathogenesis of childhood hypertension.

ObjectiveTo observe the effect of succus entericus reinfusion with continuous enteral nutrition on the barrier function of intestinal mucosa and nutritional status in patients with stomal type fistulas. Methods Sixteen patients with stomal type fistula from July 1995 to May 2008 were enrolled in the study. A]l patients met the following conditions: gut function returned normal; abdominal infection was controlled; total enteral nutrition was provided ; and the length of small intestine for succus entericus reinfusion was more than 50 cm. Intestinal mucosa was taken at 25 to 30 cm away from stoma of fistula by endoscope 0, 7, and 14 days after reinfusior. Hematoxylineosin staining was performed to count the number of intestinal intraepithelial lymphocytes (IIELS). In addition,proliferating cell nuclear antigen (PCNA) was measured with immunohistochemical staining. Serum protein levels were determined by immunonephelometry. ResultsThe percentage of IIELS in intestinal mucosa ( 19.06％ ±4.81％ vs. 12.81％ ±2.95％, P=0.000) and the percentage of PCNA positive cells ( 12.13％ ±4.33％ vs.6.44％ ± 2.34％, P =0.000) 14 days after succus entericus reinfusion were significantly higher than those on the day of reinfusion. Serum fibronectin level increased from ( 152.80 ± 16.50 ) to ( 227.05 ± 45.36 ) mg/L ( P =0.000), and transferring protein level increased from ( 2.16 ± 0.52 ) to ( 2.62 ± 0.41 ) g/L ( P =0.017 ) 14days after succus entericus reinfusion. ConclusionSuccus entericus reinfusion is effective in protecting the intestinal mucosa in patients with stomal type fistulas.

Objective:To analyze risk factors for the rupture of basilar tip aneurysms (BTA) using morphological parameters assessed on CTA.Methods:The clinical data and CTA imaging characteristics of 62 patients with BTA from March 2016 to November 2020 in Huanhu Hospital of Tianjin were analyzed retrospectively. The patients were divided into un-rupture ( n=44) and rupture ( n=18) groups according to whether the BTA ruptured. The morphological parameters of aneurysms were measured and recorded. The number, shape and orientation of aneurysms were analyzed by χ 2 test between the two groups. The length (H max), height (H p), neck width (N D), aspect ratio (AR), size ratio (SR), angle of aneurysms (AA), flow angle (FA), basilar vessel angle (BVA), the angle between the proximal long axis of bilateral posterior cerebral artery P1 segment (P1-P1 angle), the angle between the proximal long axis of bilateral superior cerebellar arteries and bifurcation angle (the sum of the angle between the basilar artery and the bilateral posterior cerebral arteries) were analyzed by independent-sample t test between the two groups. On the basis of univariate analysis, logistic regression was used to identify the independent risk factors for BTA rupture. ROC curve analysis was further performed. Results:BTA with irregular shape was more likely to break (χ 2=5.412, P<0.05). The H max[(4.18±2.11)mm], N D [(3.06±1.75)mm], P1-P1 angle (148°±18°) in the rupture group were smaller than those in the un-rupture group [(6.38±2.21)mm, (5.20±1.59)mm, 178°±25°], with statistically significant difference ( P<0.05). While AR (1.19±0.13), BVA (82°±11°), and bifurcation angle (212°±18°) in the rupture group were larger than those in the un-rupture group (1.05±0.18, 70°±10°, 181°±27°), with statistically significant difference ( P<0.05). The logistic regression analysis showed that the shape of aneurysms (β=4.878, OR=11.418, P=0.019), BVA (β=0.165, OR=1.177, P=0.043), and P1-P1 angle (β=-0.223, OR=1.080, P=0.029) were independent risk factors for BTA rupture. The ROC curve analysis showed that the cut-off value of BVA and P1-P1 angle to predict the BTA rupture were 76.7° and 158.5°, and area under curve (AUC) were 0.79 and 0.86, respectively. The AUC of combined BVA with P1-P1 angle was 0.89. Conclusion:The shape of aneurysms, BVA and P1-P1 angle are independent risk factors for BTA rupture. BTA are prone to rupture when the shape of aneurysm is irregular, BVA>76.7 ° and P1-P1 angle<158.5 °.

OBJECTIVETo analyze the current status of clinical studies of TCM in preventing and treating angina pectoris of coronary heart disease.

METHODSA statistical analysis of articles regarding the use of TCM in preventing and treating angina pectoris, published in TCM core journals or journals of TCM university (college) from January 2001 to June 2002 was conducted, the items analyzed included the differentiation of stable angina (SA) and unstable angina (UA), the grading or stratifying, standard for therapeutic efficacy evaluation, standardized drug therapy of UA (according to the "Suggestion on the diagnosis and treatment of UA" formulated by Society of Cardiovascular Disease, Chinese Medical Association, etc.

RESULTSFrom the 44 articles that retrieved, UA and SA was not differed in 29 articles (65.9%), among which 11 articles came from provincial, national TCM institute or hospital affiliated to TCM university (college). In the 34 articles dealing with UA, only 3 articles mentioned the standardized drug therapy. Standard of therapeutic efficacy evaluation announced in 1979 was used in 35 articles (79.5%).

CONCLUSIONMost articles dealing with clinical study on TCM prevention and treatment of angina pectoris, UA and SA, have the flaws of un-standardized, lacking in compact and insufficient science. Improvement of related standard for clinical therapeutic efficacy evaluation needs to be further perfected.

Angina Pectoris ; drug therapy ; prevention & control ; Angina, Unstable ; drug therapy ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Phytotherapy ; Reference Standards ; Research Design

Objective To explore the effects of secreted apoptosis-related protein 1 (SARP1) on apoptosis of the hyperstrophic scar fibroblasts (HSFB) and its regulating mechnisms.Methods The recombinant vector was identified by enzyme digestion analysis.And the virus supernatant of the recombinant vector was extracted from packaged 293 cells,then it infected the skin fibroblasts from hypertrophic scar patients,which aimed to promote its expression of SARP1 protein.After adenovirus infection,the expression of SARP1 in the fibroblasts was confirmed by RT-PCR and Western blot.The effect of SARP1 on proliferation of HSFB was detected by MTT assay,and the effect of SARP1 on apoptosis of HSFB was detected and change of the cells functions were analyzed by FACS.Results Recombinants were confirmed.After adenovirus infection,both protein and mRNA of SARP1 were detected in HSFB.And the mRNA value of SARPlwas detected to increase significantly by RT-PCR and the protein expression was detected to increase significantly by Western blot (P＜0.05).The proliferation in the groups of the adenovirus infection and HSFB was positively regulated by SARP1 (P＜0.01) and the apoptosis of them was inhibited by the expression of SARP1 as compared to the control groups of HSFB and Ad-EGFP.It showed that the apoptosis index decreased as compared the group of infected fibroblasts to the control group by flow cytometry.Conclusions SARP1 could be highly expressed in HSFB by adenovirus infection,exhibiting the proliferation-enhancing and apoptosis-inhibiting effects on HSFB.

Phospholipase D(PLD) is ubiquitous in bacteria,fungi,and mammal.In pathogenic microorganisms,PLD can be pathogenic determinant and play a role in spore generation.In mammalian cells,PLD functions in several signal transduction pathways,such as membrane transportation,mitosis regulation,and actin cytoskeleton regulation.In the process of pathogens invasion host cells,both of the pathogen and host cells’ PLD will be activated and a series of cascade reaction will be generated.During this process,pathogen’s PLD can regulate the polymerization and reorganization of its own actin filaments and induce the polymerization or reorganization of the host cell actin filaments near the foci,thus to promote the phagocytosis of the pathogen by host cell.Investigating the role of PLD activation in the infection will be significance for further understanding the molecular mechanism of pathogen-host cell interaction.

Objective To investigate the influence of tissue-specific growth hormone receptor (GHR)deficiency in type 1 diabetes in the mice at the gene level using pancreaticβcells combined with streptozotocin (STZ)-induced type 1 diabetes model.Methods The experiment was divided into four groups:knockout mice group (LLc knockout group), using the homozygotes (LLc:LL+Cre) producted by pancreaticβ cell-specific expressed recombinant enzyme mice (RIP-Cre)and Cre-LoxP system modified GHR mice (Floxed,LL);LL control group, containing Floxed GHR allele homozygous mice (LL);LLc STZ group and LL STZ group (STZ was used for inducing type 1 diabetes model mice). The mice with feeding glucose≥25 mmol · L-1 were considered to be successful models.The Glucose Tolerance Test (GTT),pancreas tissue HE staining and immunohistochemistry were performed in the mice.Results The blood glucose of the mice in LL STZ group and LLc STZ group and LLc STZ group were increased after inj ection of STZ and the models achieved the diagnostic criteria for diabetes 1 6 d later.The results of GTT showed that compared with LLc control group and LLc knockout group, the blood glucose levels of the mice in LL STZ and LLc STZ groups were increased (P<0.05).There was no significant change of morphology and structure of islets between LL control group and LLc knockout group detected by HE staining. The immunohistochemistry results showed that the insulin level of the mice in LL STZ group was significantly reduced compared with LL control group;the insulin level of the mice in LLc STZ group was reduced compared with LLc control group.Conclusion Pancreaticβcell GHR gene knockout has no effect on the blood glucose and the function ofβcells in the mice with STZ-induced type 1 diabetes.

Objective To evaluate the effectiveness and safety of partial splenic embolization using polyvinyl alcohol versus gelfoam to treat hypersplenism in cirrhotic patients.Methods A literature search was performed in databases which included PubMed,Embase,Cochrane library,Sinomed,CNKI,Wangfang data and VIP for trials on partial splenic embolism using PVA or gelfoam to treat hypersplenism in cirrhotic patients.The study was censored in May 2016.After data extraction and assessment of quality,a meta-analysis was performed using the RevMan 5.3 software.Results Five studies which involved 197 patients were selected in this study.Included into the PVA group were 92 patients and the gelfoam group 105 patients.On Meta-analysis,the PVA group had a higher value of WBC a month after PSE (WMD =0.4,95％ CI:0.05 ～ 0.75,P ＜ 0.05),higher values of WBC (WMD =0.39,95％ CI:0.06 ～ 0.71,P ＜0.05) and PLT (WMD =8.08,95％ CI:1.65 ～ 14.51,P ＜ 0.05) on month 6 post-embolization.The degree of post-embolization pain was more severe (RR =1.32,95％ CI:1.14 ～ 1.54,P ＜ 0.05) and the length of painful time was longer (RR =2.01,95％ CI:1.36 ～ 2.66,P ＜0.05) in the PVA group.There were no significant differences in the values of PLT,fever and complications (all P ＞ 0.05).Conclusions PSE using PVA achieved better short-term and long-term results in hematological indicators than gelfoam.However,the degree and extent of duration of pain were significantly longer.