Objective To explore the effect of neostigmine in treatment of severe acute pancreatitis (SAP) combined with intra-abdominal hypertension (IAH).Methods 42 patients diagnosed as SAP combined with IAH and meeting standard were collected from Aug.2012 to Jul.2016 in our hospital.They were randomly divided into two groups:observation group and the control group.General information of the two groups was comparable.Patients of the control group received conventional treatment methods such as fasting,gastrointestinal decompression,nutritional support,antispasmodic,analgesia,intravenous infusion of omeprazole and octreotide.Patients of the observation group received intramuscular injection of neostigmine methylsulfate on the basis of the control group for seven days.The intra-abdominal pressure,recovery time of bowel sounds,the first exhaust and defecation time,remission time of abdominal distention,modified Marshall score,APACHE-Ⅱ score,SIRS score,total hospitalization time and total hospitalization expenses,MODS rate,operation rate and mortality of the two groups were recorded during the treatment.Results The intra-abdominal pressure of the observation group was (14.25±1.03) mmHg,(13.52 ±1.23) mmHg,(12.73±1.14)mmHg respectively,lower than that of the control group (15.14± 1.12) mmHg,(14.60± 1.11) mmHg,(13.84±1.08) mmHg at the 3rd,4th,and 5th day after treat ment (P＜0.05).For the observation group,the recovery time of bowel sounds was (7.24±1.35) d,the first exhaust and defecation time was (11.33±1.51) d,(8.36±1.63) d,remission time of abdominal distention was (13.62±2.26) d,lower than those of the control group ((9.56±1.17)d,(13.42±1.26)d,(10.45±1.54)d,(16.75±3.05)d) (P＜0.05).The recovery time of bowel sounds,the first exhaust and defecation time,remission time of abdominal distention of the observation group were lower than those of the control group (P＜0.05).The modified Marshall score,APACHE-]Ⅱ score,SIRS score of the two groups had no significant difference (P＞0.05).The total hospitalizationtime and total hospitalization expenses of the two groups had no significant difference (P＞0.05).MODS rate,operation rate and mortality of the two groups had no significant difference (P＞0.05).Conclusions Neostigmine can significantly reduce intra-abdominal pressure of patients suffering from SAP combined with IAH,improve the symptoms of paralytic ileus,promoting exhaust and defecation.However,it has limited effects on prognosis of patients suffering from SAP combined with IAH.

OBJECTIVE To explore the role and mechanism of dental pulp stem cells(DPSCs)in repairing hypoxic injury to rats pulmonary microvascular endothelial cells(PMVECs).METHODS ①PMVECs were treated with cobalt chloride at 0,10,25,50 and 100 μmol·L-1 for 72 h.CCK-8 was used to detect the cell viability,and the protein levels of hypoxia-inducible factor 1α(HIF-1α),zona occludens small-band protein 1(ZO-1),and occludin(OCLN)were detected by Western blotting.②There was a cell control group,model group,and model+DPSCs group,and the levels of reactive oxygen species(ROS)was detected by immunofluorescence staining after at 24 and 48 h of action.The levels of ZO-1 and OCLN proteins were detected by Western blotting.③ A cell control group,model group,model+DPSC group and model+DPSC cell knockdown superoxide dismutase 1(SOD1)group were set up.The mRNA level of SOD1 was detected by real-time fluorescence quantitative PCR 24 and 48 h later,while the protein levels of ZO-1 and OCLN were detected by Western blotting.RESULTS ① Com-pared with the cell control group,72 h of cobalt chloride 100 μmol·L-1 treatment of PMVECs resulted in a cell survival rate above 80%,a significant increase in the level of HIF-1α protein(P<0.05),a signifi-cant decrease in the levels of ZO-1 and OCLN proteins(P<0.01),and establishment of a model of hypoxic injury in PMVECs.② Compared with the cell control group,the ROS level was significantly higher in the model group(P<0.01).Compared with the model group,the ROS level was significantly lower in the model+DPSCs group(P<0.01),while the levels of ZO-1 and OCLN proteins were signifi-cantly higher in the model+DPSCs group(P<0.05).③ Compared with the DPSC group,ZO-1 and OCLN expressions were significantly decreased after knockdown of SOD1 in DPSCs(P<0.05,P<0.01).CONCLUSIONS DPSCs can repair hypoxic injury to PMVECs,and the anti-oxidative stress capacity of DPSCs plays an important role in hypoxic injury repair of PMVECs.

Objective    To compare the ascending aortic diameter and postoperative outcomes of patients with simple ascending aortic dissection or simple ascending aortic dilatation and to study the reliability of the surgical indication in present guideline for Chinese patients with ascending aortic dilatation. Methods    The clinical data of patients with aortic aneurysm and aortic dissection who underwent surgery at Beijing Anzhen Hospital, Capital Medical University from 2010 to 2017 were retrospectively reviewed. After exclusion of patients with Marfan syndrome, heart valve and other diseases, 139 patients were divided into two groups: a simple ascending aorta dilatation group (56 patients) and a simple ascending aortic dissection group (83 patients). The ascending aortic diameter and postoperative outcomes of two groups were compared.  Results    The inner ascending aortic diameter (57.30±9.41 mm vs. 50.72±9.53 mm, P <0.001) and the inner ascending aortic diameter index (31.12±5.38 vs. 27.22±6.40, P<0.001) in the simple ascending aorta dilatation group were significantly greater than those in the simple ascending aortic dissection group. For male patients, the results were similar (60.28±10.80 mm vs. 47.40±6.53 mm; 30.00±6.33 vs. 23.60±3.72, both P<0.001). But for the female patients, there was no significant difference between the two groups (54.90±7.47 mm vs. 53.81±10.84 mm; 32.03±4.37 vs. 30.58±6.56, both P>0.05). The mortality, the incidence of tracheotomy and postoperative reopen rate in the simple ascending aortic dissection group were higher. Conclusion    In this study, the inner diameter of the ascending aorta in the group of ascending aorta is mostly < 5.5 cm. In our opinion, the present surgical indication for Chinese patients with ascending aortic dilatation is not enough. In the future clinical studies, we also need to find more reasonable surgical indications.