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

Objective To explore the effects of postoperative compression cryotherapy at different durations on patients underwent shoulder joint arthroscopy. Methods Sixty patients underwent shoulder joint arthroscopy were divided into 3 study groups by random digits table method: group 1 (20 cases), group 2(20 cases),group 3(20 cases).The study populations with routine care were offered compression cryotherapy at different durations:group1 was managed with 30 mins postoperative cryotherapy every 8 h within 24 h, group2 with the same treatment within 48 h, group 3 within 72 h. Visual Analogue Scale (VAS)was used to assess preoperative as well as postoperative pains,and perimeters of three parts(20 cm and 25 cm above lateral epicondyle of humerus,and armpit)were measured to assess swelling at different durations-preoperatively and 24,48,72 h after operation. Results There was no significant difference in the scores of VAS at 24 h after operation among three groups(P>0.05).The score of VAS at 48 h after operation in group 1,group 2,group 3 was(3.65±1.23),(2.65±1.50),(1.80±1.11)points,and there was significant difference(F=6.838,P=0.002),a further comparison,there was significant difference between the two groups(P<0.05).The score of VAS at 72 h after operation in group 1,group 2,group 3 was(3.50± 1.10),(2.65±1.50),(2.05±1.10)points,and there was significant difference(F=10.366,P=0.000),a further comparison, there was significant difference between the two groups (P<0.05). There was no significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus, and armpit at 24 h after operation among three groups(F=1.208, 2.097, 0.427, P>0.05). There was significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus,and armpit at 48 h after operation among three groups(F=15.577, 17.128, 5.109, P<0.05), a further comparison, there was significant difference between group 1 and group 2, group 1 and group 3(P<0.05), but there was no significant difference between group 2 and group 3(P>0.05).There was significant difference in the swelling of 20 cm and 25 cm above lateral epicondyle of humerus,and armpit at 72 h after operation among three groups(F=24.159, 20.963, 8.496, P<0.05), a further comparison, there was significant difference between the two groups (P<0.05). Conclusions 72 h postoperative compression cryotherapy for patients underwent shoulder joint arthroscopy can be the most statistically significant factor to alleviate pain and swelling effectively,beneficial to early functional exercise and shoulder joint recovery.

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 observe the effect of Qingzao-Jiufei decoction and its composition on the levels of IL-10,TNF-α, CD4+cells, CD8+T cells and the change of CD4+/CD8+ratio in the serum to explore the mechanism of anti-MP infection. Methods The 144 SPF grade BALB/c mice were randomly divided into the normal group, the model, the whole decoction group, the composition Ⅰ group, the composition Ⅱgroup with the method of random digital table, and the azithromycin group and every group had 24 mice. The following five groups were treated with infection of MP model. After successful modeling, the rats in the whole decoction group were treated by gavage with 1 g/ml Qingzao-Jiufei decoction. The rats in the composition Ⅰ group were treated by gavage with 0.61 g/ml composition Ⅰ decoction. The rats in the composition Ⅱ group were treated by gavage with 0.39 g/ml composition Ⅱ decoction. And the three groups were administered for 14 days. The rats in the azithromycin group were treated by gavage with azithromycin suspension once a day. After three days, the drug was stopped. Each group was infected on 3,7,10,14 day. Then mice were sacrificed, with the method of taking the eye of the mice to take blood. The level of IL-10, TNF-α in the mice blood with the method of ELISA were detected. The level of CD4+, CD8+T in the rinsing solution of mice spleen with the method of FCM and the CD4+/CD8+ ratio were detected. Results Compared with the model group, the expressions of CD4+T cells (24.50 ± 1.41 vs. 22.08 ± 1.99) and IL-10 (18.15 ± 0.36 vs. 8.75 ± 0.16) in the whole decoction group significantly increased. The expressions of CD8+T cells (7.29 ± 1.23 vs. 9.13 ± 1.14) and TNF-α (28.32 ± 1.90 vs. 37.97 ± 1.71) significantly decreased (P<0.05), and the level of CD4+/CD8+ratio increased. In the composition Ⅰ group, the expressions of CD8+T cells (7.50 ± 1.45 vs. 9.13 ± 1.14) and TNF-α(33.48 ± 1.08 vs. 37.97 ± 1.71) significantly decreased (P<0.05). In the composition Ⅱ group, the expressions of CD4+T cells (23.63 ± 1.10 vs. 22.08 ± 1.99) and IL-10 (17.82 ± 0.63 vs. 8.75 ± 0.16) significantly increased (P<0.05). Conclusions The mechanism of Qingzao-Jiufei decoction on anti-MP infection may be related to the regulation of the cellular immune.

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.

OBJECTIVETo investigate the genetic association between schizophrenia and polymorphism of D-amino acid-oxidase (DAAO) gene.

METHODSA total of 112 parent/offspring trios in which the proband met the Amerecan Classification and Diagnostic Criteria for Mental Disorders (Fourth Revised Edition) were included in this study. Correlation analysis between schizophrenia and DAAO gene polymorphism and haplotype relative risk analysis were conducetd by using PCR and SNP typing in all the nuclear families.

RESULTSThe rs3918347 allele was correlated to schizophrenia (P = 0.014). Allele A was a protective factor (Z = -2.37) and allele G the hazard factor (Z = 2.37). The frequency of rs3918347 allele A was 0.41 and that of the allele G was 0.59. The rs3741775, rs3825251 and rs4964770 alleles were not associated with schizophrenia. Three haplotypes of C/G in the rs3825251-rs3918347, G/T in the rs3918347-rs4964770, C/G/T in the rs3825251-rs3918347-rs4964770 were associated with schizophrenia (P = 0.021, 0.036, and 0.028, with genotype frequencies of 0.33, 0.28, and 0.15, respectively).

CONCLUSIONThe nucleotide polymorphism of DAAO gene is associated with schizophrenia in Chinese population.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Carrier Proteins ; genetics ; Female ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Schizophrenia ; genetics ; Young Adult