Infectious necrosis is one of severe local complications caused by acute pancreatitis,and the mortality rate was reported to be up to 10％ ～ 20％.Traditional open surgical debridement used to be the sole option for this disease.Nevertheless,this approach is associated with poor outcome.Currently,conservative treatment and minimally invasive procedures are more favorable.The treatment for infectious necrosis caused by acute pancreatitis can be summarized as 3D,representing delay,drain,debride.The patients usually receive initial treatment in ICU division,and surgical intervention is then delayed.Percutaneous drainage can be firstly performed in the early course of the disease,followed by necrotic tissue debridement with laparoscopic or video-assisted retroperitoneal procedures.Open surgical debridement is now rarely used,which is merely performed for certain refractory cases.The management of acute pancreatitis infected necrosis therefore is a clinical question that requires a multiple disciplinary team rather than a simply surgical disease.This paper reviewed the relevant issues.

In recent years,postoperative mortality rate of pancreatic resection has dropped below 5％,while the complication rate still remains as high as 30％ ～ 50％.Postoperative pancreatic fistula and abdominal abscess are two serious complications after pancreatic resection,with the incidence of 10％ ～28％.Deep understanding of the physiological functions of the pancreas together with the research and development of new medications has improved the prognosis of patients with pancreatic fistula.This article gave a brief overview on the progress in this regard.

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis(CAPD).Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.

Pancreatic cancer is the fourth most common cause of cancer death,with a 5- year survival rate of less than 5％.The management and prognosis of the patients have remained dismal due to higher resistance of cancer cells to conventional approaches including surgery,radiation and chemotherapy.Therefore,there is a need for development of specific and sensitive tumor marker for pancreatic cancer.Caveolin- 1 is an essential constituent of caveolae and interacts with a variety of cellular proteins and regulates cell- signaling events.In this review,we survey the functional roles of caveolin- 1 in pancreatic cancer and argue that caveolin-1 regulates multiple cancer-associated processes including tumor growth,cell invasion,metastasis,cell apeptosis.However,Caveolin-1 has been reported to impact both positively and negatively on various aspects of pancreatic cancer progression.The function of caveolin- 1 is interdependent on tumor stage and the expression of some signaling pathways that impact on its role during tumor progression.

LI-cadherins are a new member of cadherin superfamily,which transmembrane glycoproteins mediate Ca2 + dependent cell-cell adhesion independent of cytoplasmic interactions.They play an pivotal role during tissue development and are critical for the maintenance of junctional complexes between cells and tissues,LI-cadherin high expression in hepatocellular carcinoma results in the decrease of intercellular adhesion effect,cause hepatocellular carcinoma metastasis.

Objective To investigate the tolerance of chemotherapy based on gemcitabine and cisplatin in elderly patients (> 70 years old) with advanced pancreatic cancer. Methods Retrospective analysis in 34 elderly patients with advanced pancreatic cancer between January 2004 and January 2009 was performed. Results 6 patients had partial remission (PR) and 16 patients had stable diaease (SD). The clinical benefit response (CBR) rate was 64.7%. 18 patients reduced their analgesics dose exceeding 50% , as well as pain intensity descended exceeding 35% , 22 patients had the weight increased more than 7% and had improved general well-being. The incidence rate of nausea and vomiting was 38. 2% (13/34) , 4 patients had worsened liver function and aggravated skin and sclera stained yellow. Incidence of Ⅲ- Ⅳ myelosuppressive was 34. 6% , and there were decrease in the number of white blood cell, hemoglobin, platelets to some extent, the rate of thrombocytopenia was 28. 3% (12/34) , blood routine normalized after using G-CSF. There was no occurrence of peripheral neurotoxicity or chemotherapy-related death. Conclusions Chemotherapy of gemcitabine in combination with cisplatin was tolerable for elderly patients with advanced pancreatic cancer who were in good condition of behavior.

Objective To investigate colonization of multidrug-resistant organisms (MDROs)in neonatal intensive care unit (NICU)newborns on admission.Methods From April to November 2013,293 newborns who admitted to NICU of a hospital were screened for methicillin-resistant Staphylococcus aureus (MRSA)by nasal and throat swabs and for extended-spectrumβ-lactamases (ESBLs)bacteria and vancomycin-resistant Enterococcus (VRE)by anal swabs.Results Of 293 newborns,61 were detected MDROs (20.82%).The positive rate of MDROs screening in newborns aged <3 days(5.92%)was lower than those aged <3-6 days(37.74%)and 7-28 days (43.66%), the difference was significant (P =0.000).The major colonized MDROs were ESBLs-producing bacteria(83.60%), the major colonized site was anus(88.52%).Conclusion Neonatal anus and stool are important sources of MDROs in NICU;more attention should be paid to colonization screening for MDROs by anal swabs in newborns aged >3 days,and appropriate isolation measures should be taken for positive screening patients to prevent the transmission of MDROs.

Objective To investigate MR imaging findings of hepatic focal nodular hyperplasia (FNH) on unenhanced and dynamic contrast enhanced scans and evaluate their diagnostic value. Methods The unenhanced and dynamic gadolinium enhanced MR images of 22 FNHs proved by pathology were retrospectively analyzed. Results Average size of FNH lesions was 4.05 cm. The typical MR isointensity signal with surrounded hepatic parenchyma on T 1 and T 2 weighted images was seen in only 4 lesions, while atypical signal was encountered in 18 lesions. A central scar was noted in 8 lesions on unenhanced images. After gadolinium administration, 21 lesions had vigorous enhancement on arterial phase and prolonged enhancement on portal vein and delayed phase. The ring enhancement of capsule was noted in 2 lesions on portal vein and delayed phase. 18 lesions showed a central scar on dynamic contrast enhanced images. 19 lesions were correctly diagosed by using the combination of unenhanced and dynamic contrast enhanced MR imaging. Conclusion The combination of unenhanced and dynamic contrast enhanced MR imaging can fully show the pathologic characteristics of FNH and improve to differeniate ability from other malignant hypervascular tumors.

Animals ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Wound Healing

Qi in TCM is the most essential substance that makes up the body and maintains life activities. All vital substances in the body are transformed by constant motion and changes of qi. Qi in TCM mainly means full of functions. What is the basic material attribute of qi? We don't have a systematic study on it. Therefore, we combined the achievement of modern medicine, and explored further from the origin, functions, pathogeneses, and therapies of mitochondria and qi. Surprisingly, we found out that the origin of mitochondria was similar to that of qi. They are tiny substance constituting the human body. Secondly, the function of mitochondria is similar to that of qi. When the disorder of qi and mitochondria occurs, similar vital signs occur or the same reactions occur. These results suggested that the basic material attribute of qi might be mitochondria.
Humans ; Medicine, Chinese Traditional ; methods ; Mitochondria ; physiology ; Qi