The treatment strategy for infected acute necrotizing pancreatitis is that enables recovery but at the same time limits the morbidity and mortality.The current gold standard remains open necrosectomy.Recent literature contains scattered reports of percutaneous drainage,endoscopic,and laparoscopic approaches to managing patients with this condition.This review addresses the role of minimally invasive approaches and treatment strategy in patients with infected acute necrotizing pancreatitis.

目的探讨高水平篮球运动员创伤性前交叉韧带损伤关节镜术后的疗效。方法1991～1998年,国家级篮球运动员前交叉韧带损伤患者9例9膝,其中男4例,女5例;年龄20～27岁,平均25岁;从受伤到手术时间为1～21d,平均11d。均为训练和比赛过程中发生膝关节扭伤,其中合并半月板损伤5例,骨软骨损伤1例。所有患者均行X线、MRI检查,行关节镜下检查并同时实施手术。结果所有患者均在关节镜下行前交叉韧带重建术。术后Lysholm评分优6例、良2例、可1例。全部患者获得随访,随访时间10～18年,平均13年。无感染和再断裂病例。现有5名仍参加全国职业篮球联赛,其他4名从事教练工作。结论篮球运动员膝关节前交叉韧带损伤多为急性撕裂,关节镜下修复具有创伤小、恢复快等优点。远期随访疗效满意。

ObjectiveTo observe the effect of early rehabilitation on patients with acute severe brain injury.Methods180 cases with acute severe brain injury were tr eated with early rehabilitation measurements consisted of breath rehabilitation,passive activity of joints in range of joint motion, body posture change,preve ntion of the lower urinary tract infection, and rehabilitation with Traditional Chinese Medicine,etc.Results18 patients (8.3%) co mplicated infection of lungs during the acute stage, no patient died of complica tions.Conclusions The early rehabilitation can pre vent patients with severe brain injury from complications and improve the effica cy of the treatment.

Background and purpose:With the development of the three-dimensional (3D) science, minimally invasive technology is going into the 3D period. While 3D laparoscope system has been widely accepted by surgeons because of its better visual effect and safer operations compared to traditional laparoscope system, this study aimed to evaluate the feasibility of 3D thoracoscope system in minimally invasive surgery for the treatment of thoracic diseases. Methods: A total of 96 cases of thoracic diseases were accomplished with KARL STORZ 3D thoracoscope during Mar. 2014 to Oct. 2014, including 33 cases of lobectomy, 2 cases of segmentectomy, and 10 cases of wedge resection of pulmonary tumor, 27 cases of mediastinal tumor, 20 cases of esophageal tumor and 4 case of esophageal achalasia. The data of operative time, bleeding volume, postoperative chest tube drainage and hospital time and postoperative complications were counted. Results: All the operations were completed successfully, without conversion to open surgery. All the operations cost 30 to 237 min. The operation of local resection lasted 30 to 120 min, with an average of 52 min, the operation of pulmonary lobectomy lasted 63 to 122 min, with an average of 75 min;the operation of mediastinal tumor resection lasted 35 to 125 min, with an average of 77 min;and the operation of esophageal diseases lasted 57 to 237 min, with an average of 189 min. The bleeding volumes were 2 to 85 mL, 15 to 72 mL, 30 to 186 mL and with the average of 50 mL, 47 mL, 118 mL in pulmonary, mediastinal and esophageal operations respectively. The time of postoperative chest tube drainage of each surgery was 1 to 5 days after pulmonary operations, 1 to 3 days after mediastinal operations, and 2 to 6 days after esophageal operations. The postoperative hospital time of pulmonary operation was 2 to 10 days, with an average of 6.3 days;the time of mediastinal operation was 3 to 6 days, with an average of 4.2 days;and the time of esophageal operation was 4 to 19 days, with an average of 13.3 days. No complications and tumor recurrence or metastasis were observed during the followed 3 months. Conclusion: 3D thoracoscope system not only preserves the minimally invasive advantage of video-assisted thoracoscopic surgery (VATS), it can also provide high-definition and stereoscopic vision and better sense of depth which facilitate the operation more precise and safer, thus operation time becomes shorter. Besides, 3D system possesses the advantage of natural vision similar to open surgery, thus it has an easier and shorter learning curve.

Objective To explore the clinical effect of IFN combined with adefovir dipivoxil in the treatment of patients with the hepatitis B and hepatitis C overlapping infection.Methods 90 cases of hepatitis B overlapping infection of hepatitis C were divided into control group(n =43) and treatment group(n =47).The control group was treated with IFN,the treatment group was treated with IFN and adefovir dipivoxil.Results The treatment group was better than the control group in the liver function,HBV DNA,HCV RNA.At the 24th weeks,the negative rates of HBV DNA and HCV RNA in the control group were 14 (32.6%) and 18 (41.9%),while there were were 38 (80.9%) and 34(72.3%) in the treatment group.There was significant differences between the two groups(x2 =6.43,5.28,all P ＜ 0.05).Conclusion The clinical efficacy of IFN combined with adefovir dipivoxil for the hepatitis B and hepatitis C overlapping infection patients was significant better than IFN,which is worthy of clinical application.

BACKGROUND: Autologous bone graft was always applied to repair bony cavity defect produced by benign bone tumor.OBJECTIVE: Taking autogenous bone graft for repairing bony cavity defect caused by bone tumor or tumor-like pathological change as control standard, to observe transplantation of deproteined bovine cancellous bone combined with autogenous red marrow in occluding the residual cavity and the density of newly formed bone.DESIGN: A randomized grouping design, controlled observation SETTING: Department of Orthopaedics, the 175 Hospital of Chinese PLA PARTICIPANTS:We recruited 175 cases of bony cavity defect who received treatment in the Department of Orthopaedics, the 175 Hospital of Chinese PLA from July 1993 to July 1998. They were randomly assigned into two groups: experimental group and control group. There were 63 cases treated in the experimental group. The average disease-suffering time was (6.2±2.1) months and bone defect was (136±30) mm3. There were 62 cases treated in the control group. The average disease-suffering time was (6.1±2.3)months, and bone defect was (133±37) mm3.METHODS: Deproteined bovine cancellous bone combined with autogenous red marrow was transplanted in the experimental group and autologous bone graft was applied in the control group. We curetted tumor completely, cauterized the wound with alcohol of 0.95 volume fraction, then curetted the area of cauterization to make it bled. Bone graft was applied.The quantity of implanted bone should be abundant, and disposed compactly. The X-ray films of the first week after operation were used as a standard for density of new bone growth. X-ray films were taken at the 3rd,6th and 8th months postoperatively, and the X-ray films of the eighth months after operation were used as a standard.MAIN OUTCOME MEASURES: To compare the bone union in two groups with a standard of residual cavity occluding and density of bone growth.RESULTS: All patients were followed up for an average of 20 months.One case was lost six months after operation. And two cases were lost eighteen months after operation respectively in the experimental group and control group. After 8 months of operation, residual cavities of bone defect of 44 cases in experimental group and 46 cases in control group were disappeared. Palingenetic bone fused with left bone organization. Its density was the same as or higher than normal bone organization. Residual cavities of 12 cases in experimental group and 10 cases in control group were disappeared basically. The density of palingenetic bone was approximate to normal bone organization. To compare with autologous bone graft, deproteined bovine cancellous bone and an autogenous red marrow had an identical effect for repairing bony cavity defect.CONCLUSION: Bony cavity defect produced by benign bone tumor is often repaired by bone transplantation. To explore the substitutable grafting materials of autogenous bone in this study, a composite material composed of deproteined bovine cancellous bone and an autogenous red marrow (DBCAM) is applied to repair the bony cavity defect.

Objective To explore the effects of zinc finger E-box binding protein (ZEB)2 3′UTR gene transfection on proliferation, invasion and migration in human gastric epithelial cell line GES-1. Methods The synthetic ZEB2 3′UTR and miR-200b micmics were transfected into GES-1 cell line by lipofectamine 2000. We set up control grop, the mutation group and ZEB2 3′UTR group. Real-time quantitative PCR was performed to evaluate the expression levels of miR-200a/b/c and ZEB1/ZEB2 mRNAs after transfection.And then we set up control group, ZEB2 3′UTR group, ZEB2 3′UTR+negative control group and ZEB2 3′UTR+miR-200b micmics group. The protein expression levels of ZEB1, ZEB2, matrix metallopro-teinases (MMP) 2/9 and proliferating cell nuclear antigen (PCNA) were detected by Western blot assay. The invasion and mi-gration capability were analyzed by transwell assay and wound healing test. MTT assay was used to detect the proliferation ability. Results Compared with control group and mutation group, the expressions of miR-200a/b/c were significantly de-creased, especially for miR-200b. And the expressions of ZEB1/ZEB2 were significantly increased at both mRNA and pro-tein levels after transfected with the ZEB2 3′UTR, enhancing the capability of migration,invasion,and proliferation (P <0.05). Compared with ZEB2 3′UTR group, the capabilities of proliferation,invasion and migration were significantly lower in combined group. Conclusion ZEB2 3′UTR can increase the ability of cell proliferation, invasion and metastasis through regulating the levels of miR-200a/b/c, and then influence the regulation of transcription of the target gene, which could lead to malignant transformation of GES-1 cells.

Objective:To explore the effect and mechanism of miRNA sponge on the epithelial-mesenchymal transition (EMT) of gastric carcinoma cell lines SGC7901. Methods:Synthetic ZEB2 3'UTR plasmid and siRNA targeting ZEB2 were transfected into the SGC7901 cell line by Lipofectamine 2000. Real-time quantitative polymerase chain reaction was performed to evaluate the expres-sion levels of miR-200a/b/c. Finally, the migratory, invasive, and proliferative activities of the gastric carcinoma cells in vitro were ana-lyzed by the scratch test, the Transwell cell invasion, and the cell cloning assay. The expression of the target protein was detected by Western blot. Results:Compared with the control group, the expressions of miR-200a/b/c significantly decreased, and their migration, invasion, and proliferation capabilities were considerably higher after they were transfected with ZEB2 3'UTR. Although the expres-sions of miR-200a/b/c significantly increased, the migratory, invasive, and proliferative activities of SGC7901 cells also degraded after they were transfected with siRNA targeting ZEB2. The expression of ZEB2 increased, and that of E-cadherin decreased at the protein level after they were transfected with ZEB2 3'UTR. The protein expression of Vimentin in SGC7901 cells significantly increased. The indicators show the opposite trend when cells were transfected with siZEB2, and the differences between the control and mutation groups were insignificant. Conclusion:ZEB2 3'UTR can regulate EMT course by regulating the miR-200a/b/c expression in gastric car-cinoma, consequently regulating the invasion and migration of carcinoma cells.

【Objective】 To establish preliminary diagnostic criteria of spleen-stomach damp-heat syndrome (SDS) in chronic superficial gastritis (CSG) by disease-syndrome combined differentiation method and modern epidemiological method. 【Methods】 A clinical questionnaire of SDS in CSG was drafted out based on literatures study and experts' survey. Questionnaire investigation was performed in 146 cases of CSG, which consisted of 81 SDS cases and 65 nonSDS cases. Mter the investigation, discriminant analysis was adopted to set up the discriminant functional equations and to perform frequency analysis. According to the results, the diagnostic criteria and the simplified diagnostic criteria of SDS in CSG were established. 【Results】 The preliminary diagnostic criteria of SDS in CSG were as follows: (1) the major symptoms were characterized as yellow and greasy tongue fur, fullness or distension or pain in the stomach, loose stool and poor appetite; (2) the secondary symptoms were characterized as bitter taste and sticky mouth, chest depression, thirst but unwilling to drink, fatigue and nausea; (3) diagnosis could be confirmed by the existence of yellow and greasy tongue fur accompanied by either 2 of the other major symptoms, or by either 1 of the other major and 2 of the secondary symptoms, or by more than 3 of the secondary symptoms. The simplified diagnostic criteria were characterized the co-existence of yellow and greasy tongue fur and fullness or distension or pain in the stomach. 【Conclusion】 The preliminary diagnostic criteria of SDS in CSG are scientific, objective and practicable to some extent.

Objective To study the inlfuence of the allicin on abnormal crypt focus(ACF). in Wister rat model. Methods 60 Wister rats were subcutaneous injected by dimethylhydrazine (DMH), according to 20 mg/kg weight, once a week, feeding 18 weeks continuously. All of the rats were randomly divided into allicin group and non-allicin group, each group was divided into three groups evenly, and put to death at 8, 16 and 24 weeks after medication separately. Large intestines were observed after dyeing. Results Large intestines were divided into ten equally, and all pieces were observed. ACF were almostly distributed in the middle and distal of the large intestines, about in 50%-80%.The basic situation of non-allicin group was as follows:ACF at 8 weeks was 63.97±1.22 on average per each, 16 weeks was 83.97±1.13, 24 weeks was 69.33±2.01. The basic situation of allicin group:ACF at 8 weeks was 9.4±1.12 on average per each , 16 weeks was 7.17±1.33, 24 weeks was 4.97±1.23.The occurrence of ACF in non-allicin group was higher than allicin group, the differences of incidence rate and number of ACF between two groups was significant (χ2=15.88,P<0.01).Conclusion Allicin can significantly reduce the number of ACF in Wister rats, lower the incidence of colorectal cancer, has prevention effect.