Objective To investigate the role of staging nutrition(SN) in the treatment of severe acute pancreatitis(SAP). Methods One hundred patients with SAP treated in our hospital since 1997 were randomly divided into two groups: Total parenteral nutrition group(TPN group,50 cases) and staging nutrition group (SN group,50 cases). The curative effects and complications between two groups were analyzed and compared. Results The incidences of total complications,incubation complication,double infection,hepatic function injury,abdominal cavity infection and hospital stay in SN-group were significantly lower than those in TPN-group(all P

Objective:To investigate the imaging features of breast solid papillary carcinoma(SPC) by ultrasonography.Methods:The ultrasonic images of 218 breast SPC patients confirmed by pathology in Fudan University Cancer Center from December 2012 to January 2020 were retrospectively reviewed. The manifestations were preliminarily classified into 6 types, and the ultrasonic imaging features were summarized.Results:There were 22 cases with negative ultrasound findings. The cases of solid mass, nodular with ductal dilatation, cystic-solid mass, intraductal abnormal echo, simple ductal dilation and non-ductal flaky hypoechoic area or structural disorders were 79(36.2%), 33(15.1%), 29(13.3%), 30(13.8%), 20(9.2%) and 5(2.3%), respectively, and the diagnostic rates of ultrasound were 70.9%, 24.2%, 75.9%, 20%, 0 and 0, respectively.Conclusions:The ultrasonic manifestations of breast SPC are diverse, while cystic-solid findings can be seen as a clue of breast SPC.

Objective As the first robotic da Vinci S surgical system(Intuitive Surgical,Inc,CA) in China,atrial septal de- fect repair(ASD) were performed in 15 patients using the robotic da Vinci S surgical system.Prespectively,we evaluated safety and efficacy in performing both simple and complex ASD repairs.Methods Eligible patients had ASD with mild to moderate pulmonary hypertension.Operative techniques included peripheral cardiopulmanary perfusion,a 2 cm working port only in the forth intercostal space,transthoracic aortic occlusion,and antegrade blood cardioplegia.Transesophageal echocardiograms(TEE) were done intraoper- atively with three-dimensienal reconstructions.Successful repairs were defined.Results Enhanced three-dimensional visualization of ASD allowed safe,dexterous intracardiac tissue manipulation.All patients had successful repairs including direct suturing in 10 cases, as well as pericardial patching in 5 cases.There were no operative deaths,strokes,or device-related complications.One patient was reexplored for bleeding.There were no incisional conversions.The mean cardiopulmonary bypass times and aortic crossclamp times were (109.5?12.6) minutes and (41.2?11.7) minutes.Both robotic repair and total operating times decreased significantly re- spectively.Total ICU length of stay for patients was 1 to 2 days.Conclusion This study shows that the da Vinci S surgical system (intuitive Surgical,lnc) has no limitations in performing ASD repairs.Articulated wrist-like instruments and three-dimensional visual- ization enabled precise tissue telemanipulation.

To examine whether or not the regulatory sequence of chicken ovalbumin gene can drive transgene expression specifically in hen oviduct, the authors constructed an oviduct-specific expression vector (pOV), containing 3.0 kilobases (kb) of the 5'-flanking sequence and 3.0 kb of the 3'-flanking sequence of the chicken ovalbumin gene. Jellyfish green fluorescence protein (EGFP) reporter gene and bacterial LacZ reporter gene were respectively inserted into the downstream of the 5'-regulatory region.The recombinants were named as pOVEGFP and pOVLacZ. Two transfer systems, in vitro and in vivo, were used to verify the function of the vector. In vitro, the plasmid DNA pOVEGFP and pEGFP-N1 were transfected respectively by the polyethyleneimine procedure into the primary chicken oviduct epithelium (PCOE) and fibroblasts cells isolated from laying hens. In vivo, the recombinant vector pOVLacZ was injected into egg-laying hens via wing vein and the tissues were collected for RT-PCR analysis.The results showed that expression of pEGFP-N1 was achieved at low level in oviduct epithelial cells and at high level in fibroblasts, but that the recombinant vector was not expressed in both cells. RT-PCR analysis showed that the LacZ gene was transcribed in the oviduct, but not in the heart, liver, kidney and spleen of the injected hens. Accordingly, the ?-galactosidase activity was only detected in the oviduct magnum (116.7 mU/ml) and eggs (16.47 mU/ml). These results indicated that the cloned regulation regions of chicken ovalbumin gene could drive exogenous gene expression specifically in the oviducts of hens. In vivo gene injection via wing vein may serve as a rapid production system of recombinant proteins in chicken eggs. In addition, the cultured primary oviduct cells from laying hens were not efficient temporary expression systems for analyzing the function of regulating elements of ovalbumin gene.

BACKGROUNDThrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy. In this study we investigated the von Willebrand factor-cleaving protease (vWF-cp) activity deficiency in patients with TTP.

METHODSThe plasma or serum vWF-cp activity was measured using a sensitive enzyme-linked immunosorbent assay (ELISA) by detecting the residual collagen binding activity (R-CBA) of von Willebrand factor (vWF) before and after digestion by vWF-cp. Multimers of vWF in plasma of patients with TTP were also analyzed by SDS-agarose electrophoresis. Moreover, the serum vWF-cp activities were compared between the patients with TTP and those with tumors.

RESULTSThe coefficient of variation for intra-batch and inter-batch of the assay were 3.60% and 8.35%. The plasma and serum vWF-cp activity in healthy individuals were (78.79 +/- 9.17)% (n = 30) and (79.47 +/- 10.78)% (n = 53), respectively, while the plasma vWF-cp activity in 5 patients with TTP was markedly decreased [(21.83 +/- 19.98)%, P < 0.001]. The unusually large vWF multimers were observed in two plasma samples of the patients with TTP. Although the vWF-cp activities in patients with benign and malignant tumors were also decreased (P < 0.03 and P < 0.001, respectively), they were relatively high in comparison with that of TTP patients (P < 0.001).

CONCLUSIONMeasurement of the vWF-cp activity using R-CBA is a simple and rapid method for diagnosing TTP. The vWF-cp activity in patients with TTP was markedly lower than those of patients with tumors.

ADAM Proteins ; ADAMTS13 Protein ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Metalloendopeptidases ; blood ; deficiency ; Middle Aged ; Neoplasms ; enzymology ; Purpura, Thrombotic Thrombocytopenic ; enzymology

OBJECTIVEThe C1423T polymorphism in von Willebrand factor-cleaving protease (vWF-cp) gene affects its enzyme activity. The present study was to investigate the polymorphism frequency among Chinese Han population and its relevance to arterial thrombotic disorders.

METHODSAn amplified 366 bp fragment of human vWF-cp gene was analyzed by Rsa I restriction assay in 400 unrelated individuals including 150 with acute ischemic stroke (AIS), 103 with acute myocardial infarction (AMI) and 147 age- and gender-matched healthy controls. The resulting products were analyzed by 12% polyacrylamide gels electrophoresis and stained with ethidium bromide.

RESULTSTwelve cases were C1423T heterozygous, the C1423T frequencies were 98.5% and 1.5%, and the heterozygosity and allele frequency were 3% and 1.5%, respectively, which were remarkably lower than those reported in Japanese population. No 1423T/T homozygote was found. Besides, there was no significant difference between healthy controls and patients with thrombotic disorders.

CONCLUSIONC1423T polymorphism is low frequency in both controls and patients of Han population.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; ethnology ; genetics ; Brain Ischemia ; ethnology ; genetics ; Case-Control Studies ; China ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; ethnology ; genetics ; Polymorphism, Single Nucleotide ; von Willebrand Factor ; genetics

OBJECTIVETo compare the safety and efficacy of myocardial contrast enhancement (MCE)-guided and angio-pressure (AP)-guided transcoronary ablation of septal hypertrophy (TASH) for patients with hypertrophic obstructive cardiomyopathy (HOCM).

METHODSTASH was performed under MCE-guide (n = 47, group I) or AP-guide (n = 25, group II) for drug-refractory patients with HOCM. Myocardial perfusion imaging (MPI) data as well as other clinical data were compared.

RESULTSTASH both under MCE-guide or AP-guide resulted in similar and significant reduction of left ventricular outflow tract gradient (PG) and associated with significant symptom improvement (all P < 0.001). Dosage of ethanol use, peak-level of CK-MB and ablated myocardial area and incidence of arrhythmia were also similar between the two groups.Similar left ventricular/atrial dimension changes post TASH were observed in the 2 groups during follow-up. However, the first selected septal vessels were changed under MCE in 6 patients.

CONCLUSIONSOur data demonstrated that the MCE-guided TASH was not superior to AP-guided TASH in safety and efficacy. However, MCE-guided TASH can avoid the misplace of ethanol to avoid innocent myocardial ablation.

Adult ; Cardiac Catheterization ; methods ; Cardiomyopathy, Hypertrophic ; diagnostic imaging ; therapy ; Catheter Ablation ; methods ; Female ; Humans ; Male ; Middle Aged ; Myocardial Perfusion Imaging ; Ultrasonography

OBJECTIVETo investigate the effect of houttuyfonate sodium (HS) on eliminating adhesion of Psedomonas aeruginosa (Pa) and forming biofilms.

METHODPa biofilms were established in 96-hold plates. MTT assay was used to evaluate the changes in metabolism of biofilms and assess the minimum eliminating concentration and minimum biofilm inhibitory concentration for adherent Pa. The colony counting method was used to observe the effect of HS on Pa adhesion and biomass in biofilms. SEM was employed to examine the effect of HS on adhesion of tested Pa and morphology of biofilms.

RESULTMEC80 and MEC50 of HS for adherent Pa was 500 mg x L(-1) and 125 mg x L(-1), respectively. Meanwhile, its SMIC80 for either early or mature biofilms of Pa was 500 mg x L(-1), and SMIC50 for early and mature biofilms of Pa were 31.25, 1.95 mg x L(-1), respectively. At the concentration of 250 mg x L(-1), the number of viable bacteria in the state of adhesion and in initial and mature biofilms decreased significantly, compared with the control group (P < 0.05). The number of bacteria on adherent carriers notably reduced under SEM. Following the continuous administration, there were no visible biofilms on carriers in the mature biofilm phase, with the biomass remarkably shrinking and the bacterial morphology changing from bacillus into coccobacillus.

CONCLUSIONHS displayed powerful effect on eliminating adherent Pa, and can inhibit Pa biofilm from being formed through continuous administration.

Alkanes ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Bacterial Adhesion ; drug effects ; Biofilms ; drug effects ; Microbial Sensitivity Tests ; Pseudomonas aeruginosa ; drug effects ; Sulfites ; pharmacology

Objective To improve the diagnostic accuracy of pediatric mesenchymal hamartoma of liver(M HL)by analyzing and summarizing the CT findings.Methods Five pediatric patients with M HL confirmed by postoperative pathology were enrolled,all patients underwent contrast-enhanced CT before operation.Results All lesions were located in the right lobe of liver.The tumor size ranged from 98 mm to 139 mm(mean size was 122 mm)in diameter.Four cases showed cystic and solid mixed masses,and one solid masses.After contrast administration,the substantial part of the mass and its septa showed enhancement while no enhancement was observed in the cystic part.No calcification was observed in the tumor.Conclusion M HL has some special CT characters.Most of M HL can be diagnosed combined with clinical practice as well as CT.

Objective To understand the effect of hyaluronic acid (HA) on the proliferation and apoptosis of chondrocytes cultured in vitro with Kashin-Beck disease(KBD) to provide the experimental evidences for treating KBD diseases with HA. Methods The articular cartilage samples collected from KBD patients were selected according to Diagnosis for Kaschin-Beck Disease(GB 16003-1995). And the normal cartilage samples were collected from victims of incidence (control). Chandrocytes were separated and cultured in vitro. Then varying dosages of HA were administered to chondrocytes and individed into 0,100,500 mg/L group, according to HA doages. The effect of HA on the proliferation and apoptosis of chondrocytes cultured/n vitro both KBD and the controls were investigated by methyl thiazolyl tetrazolium(MTT), Annexin V/PI staining on 2~(nd), 4~(th), 6~(th) day. Results In the control group, 500 mg/L group(0.140 ± 0.049) promoted chondrocyte proliferation significantly than 0 mg/L group (0.116 ± 0.021 ) at the 4~(th) day(P < 0.05), similar phenomenon was observed in KBD group in the 6~(th) day between 500 and 0 mg/L group(0.179 ± 0.081,0.128 ± 0.017, P< 0.05). In the KBD group, compared with 0 mg/L (12.860 ± 2.159), both 100 and 500 mg/L( 10.458 ± 1.143,7.877 ± 1.346) inhibited chondrocyte apoptosis rate (P < 0.05). In control, apoptosis rate of 500 mg/L group(4.045 ± 1.204) descreased compared with 0 mg/L group (7.128 ± 1.244, P < 0.05). Conclusion HA can promote the proliferation and inhibit the apoptosis of KBD chondrocytes cultured in vitro, and 500 mg/L HA play more effective role than that of 100 mg/L in promoting proliferation and inhibiting poptosis.