Objective To investigate clinical features and treatment strategy for pancreatic duct stent displacement complicated with acute pancreatitis.Methods Ten cases of pancreatic duct stent displacement complicated with acute pancreatitis were retrospectively analyzed.All the cases were confirmed by lab examination,X-ray examination,endoscopy and computed tomography (CT) examination.After operation,the clinical symptoms of patients were observed.Time consumed for stent removing and blood amylase level before endoscopic retrograde cholargio-pancreatography (ERCP) and 1st,4th,7th day after ERCP were recorded.Clinical features,the time of stent displacement,time of clinical cure and therapeutic strategy were summarized.Results The average age of the ten cases (four male and six female) was 55.9 years.All the displaced pancreatic duct stents were pancreatic duct stent with side wing,length five to seven cm.Obstruction was observed in one case.The end of the pancreatic duct stent of two cases dislocated at the neck of pancreats,seven cases at the head of pancreas and one at the body of pancreas.Ten cases presented with abdominal pain,seven with nausea and vomiting and one with fever.The average time of the occurrence of pancreatic duct stent displacement was 2.9 months.All the stents were successfully taken out,which of two cases were removed with balloon,seven cases with forcep and one with snare,and the average time duration was 17.7 min.After the stents taken out,pancreatic duct stent was replaced in one case and the left nine cases received nasal-pancreatic drainage treatment.After the operation,no severe complications such as pseudocyst of pancreas,pancreatic abscesses,pancreatic necrosis and gastrointestinal bleeding were observed in all the patients.Average blood amylase level at 1st,4th and 7th day after ERCP was 508 U/L,137 U/L and 86 U/L,respectively.The average time of recovery was 6.7 days,and the average time of keeping the nasal-pancreatic tube was 8.6 days.Conclusions For patients with pancreatic duct stent displacement complicated with acute pancreatitis,it is safe and effective to take out the stent and perform pancreatic duct drainage by ERCP as soon as possible,which could improve the symptoms in a short time.

Objective To investigate the diagnostic value of the shear-wave elasticity (SWE) imaging technology on the quantitative diagnosis of chronic nephrosis stage.Methods Sixty patients with nephrosis (nephrosis group) were evaluated with SWE and the renal function test.The Young's modulus value and the renal function were measured,and the results were compared with those of twenty healthy subjects (control group).Results Twenty cases of healthy control group were definited as R0.Sixty patients of nephrosis group were divided into four groups according to renal function:R1-R4.The Young's modulus of the nephrosis group was significantly higher than the control group (P ＜0.01).There were also statistically significant differences among each stage of the nephrosis group (except R1 and R2 of nephrosis group)(P ＜ 0.01).According the ROC curve,the cut-off value of the Young's modulus was 5.53 kPa when maximum area under the curve equal to 0.886,the sensitivity and specificity were 81.70％ and 80.40％.The Young's modulus value and renal function were positively correlated with the stage of nephrosis.The areas under the ROC curves for the Young's modulus,urea nitrogen and csytatin C were 0.965,0.950,0.965 for ≥R3,0.978,0.912,0.961 for =R4,respectively.Conclusions SWE imaging technology provided a new quantitative index for the stage of nephrosis through quantizing the elasticity of the tissue.

Objective To explore the value of shear wave elastography (SWE) in diffuse thyroid disease.Methods The elastic modulus were detected by SWE in 41cases of diffuse thyroid disease [including 16 cases of Graves' disease (GD),16 cases of Hashimoto' s thyroiditis (HT) and 9 cases of subacute thyroiditis(SAT)] and 30 cases of healthy volunteers.The elastic modulus,including Emean,Emin and Emax,were measured and compared.Results Compared with the normal group[Emean(15.7-± 2.5)kPa,Emin(11.6 ± 2.4)kPa and Emax (20.2 ± 3.0)kPa],the Emean[(20.4 ± 4.7)kPa],Emin[(14.4-± 3.8)kPa] and Emax [(27.8 ± 7.3)kPa] of GD,the Emean [(18.4-± 5.0)kPa] and Emax [(25.2 ± 5.8)kPa] of HT,and the Emean[(11.0 ± 2.9)kPa] and Emin [(6.0 ± 2.7)kPa] of the SAT were different significantly(P =0.001,0.007,0.001 ; P =0.045,0.001 ; P =0.000,0.000).There were significant differences between the SAT and the other two groups,namely GD and HT (P ＜0.05).Such differences,however,were not found between GD and HT (P ＞0.05).Conclusions SWE can be used to measure the elastic modulus of the thyroid tissue quantitatively and objectively,serving as a useful technique to predict the diffuse thyroid disease.

OBJECTIVETo explore the preparation technology of beta-cyclodextrin inclusion compound for chuanxiong volatile oil.

METHODOrthogonal test was used to evaluate the influence of the 4 factors, including the proportion of volatile oil to beta-cyclodextrin, the mode of mixing, inclusion temperature and mixing time.

RESULTThe best inclusion condition is the proportion of volatile oil to beta-cyclodextrin 1:9, the mode of mixing grinding, inclusion temperature 60 degrees C and inclusion time 90 min.

CONCLUSIONThe best inclusion technology of chuanxiong volatile oil is confirmed.

Carbon Dioxide ; Chromatography, Supercritical Fluid ; Drug Carriers ; Ligusticum ; chemistry ; Oils, Volatile ; administration & dosage ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Technology, Pharmaceutical ; methods ; Temperature ; Time Factors ; beta-Cyclodextrins

Objective To explore the effect of Zhengu Pills ( a kidney-tonifying and blood-activating Chinese medicine) and Guci Fengshi Pills ( a dampness-dispelling and blood-activating Chinese medicine) on bone remodeling of cell model in vitro. Methods MC3T3-E1 and RAW264.7 cells were differentiated into osteoblasts ( OB) and osteoclasts ( OC) after stimulated by different inductive agents respectively, and then OB and OC were co-cultured. Immunocytochemical staining was applied to identify the construction of co-cultured OB and OC system. The serum containing corresponding medicine was prepared after the rats were given intragastric administration of Diacerein, Zhengu Pills and Guci Fengshi Pills. And then the obtained serum was used for treatment of co-cultured cells separately. At the end of experiment, Western blotting and real-time polymerase chain reaction (PCR) tests were carried out. Results The osteoprotegerin (OPG) expression was increased and gene expression of glycoprotein 130 (gp130) was decreased in co-cultured cells after treatment with the serum containing Zhengu Pills and Guci Fengshi Pills ( P<0.05) . Conclusion Zhengu Pills and Guci Fengshi Pills have therapeutic effects on osteoarthritis ( OA) by inhibiting the bone resorption function of OC by the down-regulation of gp130 and by enhancing bone formation and increasing the bone density through recombinant murine’s RANK ligand (RANKL) -RANK-OPG system.

Objective To observe and evaluate the predictive value of electroencephalogram (EEG) abnormalities of the EEG monitoring of patients with brain dysfunction in the intensive care unit (ICU).Methods Total of 58 cases with brain dysfunction under EEG were collected from the ICU of the XiangYa Hospital,Central South University from January 2014 to December 2015.EEG was performed to monitor those patients and data was collected,analyzed and classified according to both Synek and Young EEG scales to evaluate its predictive value.The statistical analysis was performed with SPSS 23.0 software (MAC,USA) and statistical significant was considered as P ＜0.05.Numerical values were given as means ± SD and t-test was performed to compare data of different groups.Kaplan-Meier survival estimator was used to draw the survival curve,and the survival analysis was postulated by COX regression analysis.Results Data from 58 patients were collected and classified according to both Synek and Young EEG scales,positive waveforms as periodic discharge or delta-predominant background were found among 50 patients,electrographic seizures were found in 7 patients,patients with EEG abnormality possessed a high level of SI00β and showed statistical differences.The 28-day mortahty was independently associated with Acute Physiology and Chronic Health Evaluation (APACHE]] score) (OR:1.08;95％ CI [1.03 to 1.14])、Synek Grade ＞2 (OR:0.17;95％ CI [0.03 to 0.80])、electrographic seizures (OR:23.70;95％ CI [2.02 to 277.73]) and slow rhythm (OR:8.54;95％ CI [1.72 to 42.32]).Conclusions The 28-day mortality of patients under EEG with brain dysfunction was independently associated with Synek Grade ＞ 2,electrographic seizures and slow EEG rhythm.

Objective We aimed to perform a meta-analysis of clinical trials on the efficacy of autologous bone marrow-derived cells ( BMCs ) transfer for patients with chronic ischemic heart disease. Methods We searched MEDLINE, EMBASE, and Cochrane database through September 2009. Eligible studies were randomized controlled trials of autologous BMCs infusion in patients with chronic ischemic heart disease. We gathered information about left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV) , left ventricular end-systolic volume ( LVESV) and death, and did a randomeffect meta-analysis to obtain summary effect estimates for outcomes. The pooled analyses were performed and forest plots were generated with RevMan 5. 0 software. Heterogeneity was assessed by meta-regression with STATA 10. 0 software. Additionally, subgroup analysis was performed to compare the effect of intracoronary BMCs transfer with intramyocardial cell injection on LVEF. Results Eleven trials with 490 participants were identified. There were 268 patients in BMCs group, and 222 in control group. In control group, the patients received saline injection or autologous plasma injection or no injection. BMCs transfer was performed via intracoronary transfer or intramyocardiac injection. Compared with controls, BMCs transfer significantly improved LVEF by 4. 63% (95% CI 2. 42 to 6. 84; P < 0.01 ) . BMCs transfer was also associated with significant reductions in LVEDV (standardized mean difference -0. 55,95% CI -0.94 to -0. 17,P = 0. 005 ) and LVESV ( standardized mean difference -0. 45,95% CI - 0. 73 to - 0. 17, P = 0. 002). In addition, BMCs treatment was associated with a significant effect on death ( OR 0.42,95% CI 0. 18 to 1.01 ,P =0. 05). Subgroup analysis indicated that intramyocardial cell injection was preferred due to its more significant improvement of LVEF than intracoronary cell therapy. Meta-regression suggested the existence of a negative association between baseline LVEF and LVEF change. Conclusion BMCs infusion is associated with a significant improvement in LVEF, and an attenuation of left ventricular remodeling.

Objective To evaluate the role of combining relative alpha variability and electroencephalogram (EEG) reactivity to predict the prognosis of hypoxic?ischemic encephalopathy(HIE) in adult patients. Methods A total of 28 adult patients with HIE admitted to general intensive care unit at Xiangya Hospital in Central South University were enrolled in this observational study from January2016 to April 2017. These patients with body temperature over 35℃after 72?hour admission could be continuously monitored at least 12 hours byEEG.At the same time,each patient was assessed for EEG reactivity.Then we analyzed the correlation between EEG reactivity, relative alpha variability and clinical prognosis. Results EEG reactivity was elicited in 15/28 patients, among whom 12 patients had a good outcome. While in the other 13 patients, EEG reactivity was not elicited, among whom only 3 patients had a good outcome. As to the results ofrelative alpha variability,11/13 patients with degree 3?4were of good prognosis; while only 3/15 patients with degree 1?2 were of good prognosis. Glasgow coma scale(GCS), EEG reactivity, and relative alpha variability were correlated with clinical outcome(χ2=5.073,9.073,-3.626, respectively,all P<0.05). The sensitivity of GCS, EEG reactivity,and relative alpha variability to predict the poor prognosis were 69.2%, 76.9%, 84.6%, respectively. The specificity were 73.3%, 80.0%, 73.3%, respectively. The consistency rates were 71.4%, 78.6%, 78.6%, respectively. The positive predictive values were 69.2%, 76.9%, 73.3%, respectively. The negative predictive values were 73.3%, 80.0%, 84.6%, respectively. More importantly, the accuracy of the relative alpha variability combined with EEG reactivity for the prediction of poor prognosis was much higher with the positive predictive value of 90.0%,the specificity of 93.3%,the sensitivity of 69.2%, the consistency rate of 82.1%,and the negative predictive values of 77.8%. Conclusions The combination of relative alpha variability and EEG reactivityis reliable to predict clinical outcome of patients with HIE.

OBJECTIVE: To compare several noninvasive indices of fibrosis in chronic viral hepatitis B, including liver shear-wave velocity (SWV), hyaluronic acid (HA), collagen type IV (CIV), procollagen type III (PCIII), and laminin (LN). MATERIALS AND METHODS: Acoustic radiation force impulse (ARFI) was performed in 157 patients with chronic viral hepatitis B and in 30 healthy volunteers to measure hepatic SWV (m/s) in a prospective study. Serum markers were acquired on the morning of the same day of the ARFI evaluation. Receiver operating characteristic (ROC) analysis was performed to evaluate and compare the accuracies of SWV and serum markers using METAVIR scoring from liver biopsy as a reference standard. RESULTS: The most accurate test for diagnosing fibrosis F ≥ 1 was SWV with the area under the ROC curve (AUC) of 0.913, followed by LN (0.744), HA (0.701), CIV (0.690), and PCIII (0.524). The best test for diagnosing F ≥ 2 was SWV (AUC of 0.851), followed by CIV (0.671), HA (0.668), LN (0.562), and PCIII (0.550). The best test for diagnosing F ≥ 3 was SWV (0.854), followed by CIV (0.693), HA (0.675), PCIII (0.591), and LN (0.548). The best test for diagnosing F = 4 was SWV (0.965), followed by CIV (0.804), PCIII (0.752), HA (0.744), and LN (0.662). SWV combined with HA and CIV did not improve diagnostic accuracy (AUC = 0.931 for F ≥ 1, 0.863 for F ≥ 2, 0.855 for F ≥ 3, 0.960 for F = 4). CONCLUSION: The performance of SWV in diagnosing liver fibrosis is superior to that of serum markers. However, the combination of SWV, HA, and CIV does not increase the accuracy of diagnosing liver fibrosis and cirrhosis.
Acoustics ; Biological Markers ; Biopsy ; Collagen Type III ; Collagen Type IV ; Elasticity Imaging Techniques ; Fibrosis* ; Healthy Volunteers ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hyaluronic Acid ; Laminin ; Liver Cirrhosis ; Liver* ; Prospective Studies ; ROC Curve

OBJECTIVETo investigate the therapeutic effect of L-arginine (L-Arg) administration on fetus growth retardation (FGR) due to pregnancy-induced hypertension and explore its mechanism.

METHODSSixty-eight pregnant women with pregnancy-induced hypertension and FGR were enrolled in this study, and 25 of them were given L-Arg in addition to routine therapy. Umbilical artery flow parameters and serum NO concentrations in maternal and umbilical blood were measured, and the therapeutic effects were evaluated according to neonatal birth weight.

RESULTSL-Arg therapy markedly decreased the systolic/diastolic value, pulse index and resistant index (P=0.000,0), while increased the fast blood velocity rate(P=0.000,0). NO contents in maternal and umbilical blood were 60.45-/+22.68 and 28.45-/+11.35 micromol/L in L-Arg group, respectively, significantly higher than those in routine treatment group (P=0.000,0 and 0.001,7, respectively) but lower than those in the control group (P=0.000,8 and 0.000,0, respectively). The neonatal birth weights were 2.9-/+0.3 kg in L-Arg group, significantly higher than that in routine treatment group (2.7-/+0.3 kg, P=0.006,8) and similar with that of the control group (3012.9-/+295.9 g, P=0.176,2).

CONCLUSIONL-Arg promote intrauterine growth of the fetus by increasing NO production and improving the umbilical artery flow in pregnant women with pregnancy-induced hypertension and FGR.

Adult ; Arginine ; therapeutic use ; Blood Flow Velocity ; drug effects ; Female ; Fetal Growth Retardation ; physiopathology ; prevention & control ; Humans ; Hypertension, Pregnancy-Induced ; blood ; drug therapy ; physiopathology ; Nitric Oxide ; blood ; Pregnancy ; Umbilical Arteries ; physiopathology