OBJECTIVETo observe the efficacy of Xingnaojing Injection (XI) in treatment of sepsis-associated encephalopathy (SAE).

METHODSTotally 65 SAE patients were retrospectively analyzed at EICU from September 2010 to September 2013. They were assigned to the control group (32 cases) and the treatment group (33 cases) according to whether they received XI. Patients in the control group received anti-infection and symptomatic support, while those in the treatment group were intravenously injected with XI at 20 mL per day for additional 7-10 days. The fever clearance time, Glasgow coma scale (GCS), C-reactive protein (CRP), neuron-specific enolase (NSE), and improvement of electroen-cephalogram (EEG) were observed in the two groups.

RESULTSCompared with the control group, the fever clearance time was shortened, CRP levels decreased, GCS score and efficacy of EEG was alleviated in the treatment group after treatment with statistical difference (P < 0.05). No adverse reaction occurred during medication.

CONCLUSIONX1 was safe and effective in treatment of SAE.

C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Injections ; Phosphopyruvate Hydratase ; metabolism ; Sepsis-Associated Encephalopathy ; drug therapy ; Treatment Outcome

Objective To evaluate the effect of colonoscopy with a transparent hood on the adenoma detection rate.Methods A prospective randomized controlled trial was performed.A total of 376 patients,who underwent colonoscopy for screening colorectal polyps,were randomly allocated to 2 groups:transparent hood group (TH group,n =190) and conventional colonoscopy group (CC group,n =186).Only one endoscopist performed all the colonoscopy examinations,recorded the withdrawal time,bowel preparation status,the number,shape,location,size of adenoma when withdrawing the endoscope.All the adenoma were removed under the colonoscopy.The pathological results were recorded,and the data and relative factors were analysed.Results A total of 317 adenomas were detected in 175 patients:172 adenomas in 99 patients of TH group,145 adenomas in 76 patients of CC group.Total ADR was 46.54％.ADR of TH group was 52.11％ and ADR of CC group was 40.86％ (P =0.029).A total of 40 adenomas were found behind the fold,32 in TH group and 8 in CC group(P ＜ 0.01).In cecum and transverse colon,there were more adenomas in TH group than in CC group.In cecum,there were 23 adenomas found in TH group,6 adenomas in CC group(P ＜0.05).In transverse colon,there were 46 adenomas in TH group,25 adenomas in CC group (P ＜ 0.05).In descending colon and rectum,there were more adenomas in CC group than in TH group.In descending colon,there were 16 adenomas TH group,and 30 adenomas in CC group.In rectum,there were 14 adenomas in TH group,24 adenomas in CC group(P ＜0.05).There was no significant difference in size or shape of adenomas found between two groups.Conclusion Colonoscopy with transparent hood for screening can increase the adenoma detection rate,especially the adenoma behind the fold.

Objective To explore the relationship between the inflammatory reaction and insulin function in children with critically ill.Me-thods Ninty-six children with critical disease in Oct.2003 to Oct.2006 were enrolled in the study.Blood sugar,plasma insulin,C-peptide,tumor necrosis factor(TNF)-?,C reactive protein(CRP)were measured in the peak period and convalescence.Results Blood sugar and plasma levels of insulin,C-peptide,TNF-?,CRP were significantly higher in the peak period than those in the convalescence(Pa

Background:Colonoscopy is considered as a standard method for detecting various kinds of colorectal polyps. However,conventional colonoscopy( CC)still has the chance to miss some lesions. Literatures have already reported that transparent hood assisted colonoscopy( THAC)can improve the detection of colorectal polyps. However,the effect of black hood assisted colonoscopy( BHAC)on detection of colorectal polyps is still unclear. Aims:To evaluate the effect of BHAC on detection of colorectal polyps. Methods:A total of 1 076 patients underwent CC and BHAC from Sept. 2014 to April 2015 at Huadong Hospital Affiliated to Fudan University were enrolled in this prospective randomized controlled study. Baseline characteristics,cecal intubation time,withdrawal time,number of polyps,detection rate of polyps,location, size,morphology and pathological diagnosis of polyps between two groups were compared. Results:Compared with CC group,cecal intubation time was significantly shorter in BHAC group than in CC group[(6. 31 ± 3. 51)min vs.(7. 05 ± 4. 15)min,P=0. 002]. No significant differences in withdrawal time and rate of cecal intubation were found between two groups(P>0. 05). Detection rate of polyps was significantly higher in BHAC group than in CC group(65. 4% vs. 48. 7%,P=0. 004). No significant differences in size,morphology of polyps were found between two groups(P>0. 05). Conclusions:Compared with CC,BHAC could significantly improve the detection of colorectal polyps,and shorten cecal intubation time.

Objective To improve the knowledge of intestinal Behcet's disease.Methods From October 2012 to January 2014,36 patients with intestinal Behcet's disease were collected.The general information of the patients,manifestation of Behcet's disease,digestive symptoms,lab findings,imaging findings,endoscopic examination results,treatment and prognosis of Behcet's disease were analyzed.Chi square test and Fisher exact probability test were performed for count data analysis.Single factor and multi factors of efficacy were analyzed by Logistic regression analysis.Results Among 36 patients with Behcet's disease (male 19 and female 17),the mean onset age was 26.5 years old and the average course of disease was (8.2±6.8) years.Symptoms of digestive system of 91.7％ (33/36) patients showed up later than system manifestations of Behcet's disease appeared.All 36 patients had oral ulcer.The rates of genital ulcers,skin diseases,inflammation and joint disease were 63.9％ (23/36),58.3％ (21/36),25.0％ (9/36) and 25.0％ (9/36),respectively.The main symptoms of digestive system were abdominal pain,diarrhea,bloating and hemafecia,of which abdominal pain was the predominant symptom and the incidence rate was 75.0％ (27/36).Gastrointestinal bleeding,intestinal perforation,intestinal obstruction and arteriovenous fistula were the common complications of Behcet's disease and the incidence rates were 36.1％ (13/36),2.8％ (1/36),2.8％ (1/36) and 2.8％ (1/36),respectively.Among patients with ocular lesions,male patients were more than female patients (male six and female three),and the difference was statistically significant (x2 =0.111,P＜0.05).Erythrocyte sedimentation rate increased in 55.6％ (20/36) patients.C-reactive protein was positive in 27.8％ (10/36) patients.Nine patients received computed tomography (CT) examination,there were five cases with thickened bowel wall and one case with proliferative lesions at ileocecal valve.Ileocecum was the predilection site,and accounted for 36.1％ of the disease (13/36).Endoscopic appearance was mainly ulcers.Pathological examination indicated non-specific acute and chronic gastrointestinal mucosal inflammation and the formation of inflammatory granulation tissue.Twerty-two patients received sulfasalazine (SASP) treatment and 24 patients accepted glucocorticoid therapy.After Behcet's disease recurrence,five patients received combined immunosuppressive therapy,five patients received immunosuppressive therapy and tumor necrosis factor (TNF) antagonist treatment,and nine patients received TNF antagonist treatment.All the patients treated together with proton pump inhibitor (PPI).Twelve patients without glucocorticoid treatment took thalidomide and immunosuppressive therapy.The efficacy was good in patients with immunosuppressive therapy or TNF antagonist treatment and the recurrence rate was low (r=3.984,P ＜ 0.05).Conclusions Most patients with intestinal Behcet' s disease are young adults.Symptoms of digestive system show up later than system manifestations of Behcet's disease appeared.Ileocecum is the predilection site of digestive system.The common endoscopic appearance is ulcers.Corticosteroids and sulfasalazine are the main therapy,which could be much more effective when combined with tumor necrosis factor antagonists or immunosuppressive therapy.

Aim The effects of midazolam on the whole-cell sodium currents in rat sympathetic neurons were studied to explore the mechanisms where by midazolam mediates hypotension. Methods Whole-cell patch-clamp recordings were performed on enzymatically isolated rat superior cervical sympathetic neurons. Results Midazolam dose-dependently blocked the whole-cell sodium currents evoked by a voltage step to 0 mV from a holding potential of -80 mV with a mean drug concentration required to produce 50% current inhibition (IC50) values of 18.35 ?mol?L-1; Clinically relevant concentration of midazolam(0.3 ?mol?L-1) reduced sodium peak currents by 19.98%(P

Guanylate binding protein-1(GBP-1) is an interferon-induced protein. To observe its antiviral effect against Hepatitis B virus (HBV) and Coxsackie virus B3 (CVB3), we constructed an eukaryotic expression vector of human GBP-1(hGBP-1). Full-length encoding sequence of hGBP-1 was amplified by long chain RT-PCR and inserted into a pCR2.1 vector, then subcloned into a pCDNA3.1(-) vector. Recombinant hGBP-1 plasmids and pHBV1.3 carrying 1.3-fold genome of HBV were contransfected into HepG2 cells, and inhibition effect of hGBP-1 against HBV replication was observed. Hela cells transfected with recombinant hGBP-1 plasmids were challenged with CVB3, and viral yield in cultures were detected. The results indicated that recombinant eukaryotic expression plasmid of hGBP-1 was constructed successfully and the hGBP-1 gene carried in this plasmid could be efficiently expressed in HepG2 cells and Hela cells. hGBP-1 inhibit CVB3 but not HBV replication in vitro. These results demonstrate that hGBP-1 mediates an antiviral effect against CVB3 but not HBV and perhaps plays an important role in the interferon-mediated antiviral response against CVB3.

To establish a replication cellular model of hepatitis B virus (HBV) and determine its application in antiviral drug evaluation,we constructed an expression plasmid which contained 1.3 copies of the HBV genome,and measured the level of viral replication after transient transfection in Huh7 cells.We then observed the effect of antiviral drug administration.1.3 fold of the HBV(ayw) gene fragment was cloned into pCR2.1 by PCR and restriction endonuclease digestion.The recombinant plasmid was trans ient transfected into Huh7 cells,HBsAg,HBeAg and HBV DNA in supernatant of Huh7 cells were measured by ELISA and real-time PCR respectively; intracellular HBV replicative intermediates and intracellular HBV transcripts were detected by Southern blot and Northern blot respectively.The antiviral effect of adefovir,a novel anti-HBV nucleotide analogue,was evaluated in this cellular model system.The results indicated that a recombinant plasmid of HBV replicon was constructed successfully; the HBV genome carried in plasmid pHBV1.3 could efficiently replicate and be expressed in Huh 7 cells,adefovir could inhibit HBV replication in this cellular model,and the inhibition was dosage-dependent.The conclusion is HBV replicon,which can initiate viral replication efficiently in hepatoma cells,may be a useful tool in the study of HBV replication and antiviral drug.

BACKGROUND: Chinese traditional osteopathy is long in history, unique in manipulation and miraculous in therapeutic effect. But people understand it more m perception rather than in theory, more in application rather than in development. There is little research truly on the bioseience.OBJECTIVE: To probe into the macro-idea of Chinese traditional osteopathy, micro-mechanisms on characters and mathematics-physics models, aiming to provide new principles and approaches of treatment for the daily increased bone trauma, fracture and sport injury.SETTING: Physics and machine-electron college of a university, and its affiliated hospital.METHODS: Based on the natural concept of "integration between heaven and human being" and new concept of holistic medicine in Chinese traditional osteopathy, the macro-idea and characters of reduction and union of fracture are generalized from the characters of natural therapy and the biomechanical mechanisms and characters of reduction and union of fracture are summarized from the micro-reaction of bone repair and union so as to discover biomechanical mechanisms and characters of reduction and union of fracture and further to set up biomechanical models and mathematics-physics expressions during the treatment.RESULTS: Chinese traditional osteopathy envelopes macro-idea of "initiative reduction-functional union" in fracture and micro-mechanism on "stress adaptability-functional adaptability" of bone repair and union.CONCLUSION: Chinese traditional osteopathy compiles with the natural,green and non-traumatic therapy in bio-natural law of bone repair and union and supports the theme of "high thought and high skill".

OBJECTIVESTo compare the outcomes after liver resection for a single small hepatocellular carcinoma (HCC) (≤ 5 cm) between non-cirrhotic patients and cirrhotic patients, and to explore the influence of liver cirrhosis on recurrence and overall survival after liver resection in patients with a single small HCC.

METHODSA consecutive series of 256 patients with a single small HCC undergoing liver resection from April 2001 to October 2009 was retrospectively reviewed. Among the 256 patients, 227 patients were male, and 29 were female. The medium age was 49 years (ranged, 14 - 79 years); 224 (87.5%) patients were positive for hepatitis B surface antigen, 241 (94.1%) patients were with preoperative liver function of Child-Pugh grade A. The entire cohort were divided into non-cirrhosis group (n = 44) and cirrhosis group (n = 212). Univariate analysis and then multivariate analysis were performed to determine the prognostic factors of recurrence and overall survival after liver resection for all patients.

RESULTSThe 1-, 3-, 5-year recurrence-free survival rates after liver resection were 93.0%, 85.3%, and 68.5%, respectively, in non-cirrhosis group, while 81.1%, 58.6%, and 45.0%, respectively, in cirrhosis group. The 1-, 3-, 5-year overall survival rates after liver resection were 100%, 92.5%, and 92.5%, respectively, in non-cirrhosis group, while 93.8%, 78.7%, and 67.8%, respectively, in cirrhosis group. Both the recurrence-free survival and overall survival of non-cirrhosis group were significantly better than those of cirrhosis group (χ(2) = 8.756, P = 0.003; χ(2) = 8.603, P = 0.003). Cirrhosis, absence of tumor capsule, presence of microvascular invasion and moderate/poor tumor differentiation were the independent adverse prognostic factors for recurrence-free survival and overall survival in patients with a single small HCC after liver resection.

CONCLUSIONSCirrhosis is an important adverse prognostic factor for long-term survival in patients with a single small HCC after liver resection. Liver resection resulted in much worse survival for cirrhotic patients compared to non-cirrhotic patients.

Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular ; complications ; mortality ; pathology ; Female ; Hepatectomy ; Humans ; Liver Cirrhosis ; complications ; mortality ; pathology ; Liver Neoplasms ; complications ; mortality ; pathology ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult