Humans ; Myocardial Reperfusion Injury

Objective To compare the safety and effectiveness of duodenum-preserving pancreatic head resection (DPPHR) with pylorus-preserving pancreaticoduodenectomy (PPPD) in the treatment of chronic pancreatitis with a pancreatic head mass.Methods Medline,Biosis,Cochrane Library,Science Citation Index Database,CBM Database,Wan Fang and CNKI were searched systematically.The bias risk of the included trials was assessed according to the assessing tools as suggested by the Cochrane Handbook.Review Manage 5.2 was used to perform the statistical analysis.Results 7 RCTs with 226 patients were included in the meta-analysis which showed that there were no significant differences between PPPD and DPPHR in overall postoperative morbidity,postoperative hospital stay,complete pain relief,pancreatic fistula,exocrine insufficiency,symptom score at 5 to 7-year follow-up,and quality of life score at 14 to 15-year follow-up (P ＞ 0.05).While DPPHR had significant superiorities in operation time,blood replacement,delayed gastric emptying,occupational rehabilitation after the operations,weight gain,quality of life score at 1 to 2-year follow-up,symptom score at 5 to 7-year follow-up,and physical functioning score at 14 to 15-year follow-up.Conclusions DPPHR is more favourable than PPPD in reducing the use of blood replacement,shortening operation time,delayed gastric emptying,occupational rehabilitation after the operations,weight gain,physical functioning,and in improving quality of life of patients.

Objective To describe the status of the self-efficacy and coping styles of tuberculosis patients,analysis the relationship between self-efficacy and coping styles. Methods With the method of convenient sampling, used the general information questionnaire self-designed, General Self-Efficacy Scale (GSES) and Medical Coping Modes Questionnaire (MCMQ) to take questionnaire survey on 132 patients with pulmonary tuberculosis.Applicated SPSS19.0 software for the statistics, and analyzed the relationship between self-efficacy and coping styles on patients with pulmonary tuberculosis. Results The mean score of self-efficacy in 132 pulmonary tuberculosis patients was 24.90 ± 7.04,which was in the medium to low level. The proportion of mediun,lower,higher level of self-efficacy was 44.70% (59/132), 39.40%(52/132),15.90%(21/132).Scores of the coping styles on face,avoid, yield were 21.16±9.23,16.55± 2.83,9.68 ± 4.12.Patients self-efficacy level was positively correlated with face coping style (r=0.242, P<0.05), avoid coping style (r=0.150, P<0.05),and negatively correlated with the yield response (r=-0.008, P<0.05). Conclusions The general self-efficacy level of tuberculosis patients is at a lower level. Tuberculosis patients should have more choice to handle it.

Objective To investigate effect of carnosine on oxygen glucose deprivation/reperfusion ( OGD/RP) induced injury in rat brain slices. Methods Injury of brain slices was determined by TTC methods.The contents of ATP, ADP and AMP were determined by high performance liquid chromatography.Reactive Oxygen species ( ROS) were determined by fluorescence methods.Results Compared with control group, rat hippocampal slices were significantly damaged by OGD/RP, indicated by light color and decreased A490 nm value of TTC staining.Meanwhile the contents of ATP and ADP were significantly decreased, and the content of AMP and ROS were significantly increased, the difference between two group was significant ( P<0.01).Pre-incubation with Carnosine (1000, 200, 40 μg/mL) significantly inhibited the light color and decreased A490 nm value of TTC staining, increased the contents of ATP, ADP and AMP, and decreased the content of ROS, the difference between two group was significant ( P <0.01 ) . Conclusion Carnosine can protect rat hippocampal slices against injury induced by OGD/RP, which may relate to improve the energy metabolism and strengthen the ability of anti-oxidative stress.

Objective To explore the value of 64-row helical CT multi-phase enhancement scan combined with angiography (CTA)in the diagnosis of pulmonary mass.Methods Two hundred and sixty-five patients with pulmonary mass confirmed by pa-thology were checked,analyzed the CT sign of multi-phase enhancement scan and the blood supply of pulmonary mass displayed by CTA.Results Lung cancer was mainly supplied by bronchial arteries,some by body arteries,the feeding arteries display rate of lung cancer group was significantly higher than that of benign disease group(P <0.05).CT enhancement peak value of lung cancer group was significantly higher than that of tuberculoma group,inflammatory pseudotumor group and hamartoma group(P <0.05), but no significant difference between hemanginoma group(P >0.05).Enhancement dynamic curves of lung cancer group was differ-ent from benign lesion groups:Lung cancer without obvious enhancement in pulmonary artery phase,CT value increased rapidly in aorta phase,120 s reached peak,and declined slowly in delay phase;CT value of tuberculoma was increased slowly without obvious peak;CT value of inflammatory increased gradually in pulmonary artery phase,90 s reached the peak;hamartoma was no obvious enhancement;Hemangioma enhanced rapidly after strengthening in the pulmonary artery phase,reached the peak at about 15 s,and then decreased slowly.Conclusion 64-row helical CT multi-phase enhancement scan combined with angiography have important clinical value,which can differentiate malignant mass from benign ones.

The evaluation of undergraduate course teaching by the Ministry of Education is a challenge to all our teachers,but it is also a chance for us to improve the teaching quality of infectious disease class.In this article we summarized the experience of the infectious disease education reform of many years,and discussed the approach and means of improving the teaching quality of infectious disease class.

The interferon-γ testing and the comparative cervical skin test were compared with the simple cervical hypersensitivity test routinely used in our country in herds infected with Mycobacterium bovis, in which 167 infected cattle from 5 herds were tested with interferon-γ testing and the comparative cervical test (CCT) simultaneously and other 106 cattle were tested with other hypersensitivity tests used as control for comparison. In these 167 cattle tested with both tests, 89 cattle were proved to be positive both in interferon-γ testing and CCT using the bovine PPD of Netherland with a coincidence rate of 92.7% (89/96). In 106 cattle the coincidence rate of positive reactions detected by γ-interferon test and CCT was 93.41% (78/83.5), that detected by the routine skin of foreign country was 62.26%(66/106); and that between the hypersensitivity test of China and foreign country was 92.19% (59/64). It is obvious that the interferon-γ testing and CCT seem to have higher coincidence rate and the specificity of the skin tests used in our country was rather low. Consequently, the use of the comparative cervical skin test should be considered to replace the routinely used shin tests.

Objective To evaluate the postoperative complications and safety of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD).Methods Medline,EMBASE,Science Direct,Springer link,CBM,Cnki,Wan fang and VIP database were retrieved by computer search between 1st January 2004 and 31st March 2014 to collect all the RCT articles on pancreaticojejunostomy versus pancreaticogastrostomy after pancreaticoduodenectomy.The quality of the included trials was studied by assessing the inclusive and exclusive criteria (the PRISMA statement) by 2 researchers independently,then the data were extracted and analyzed using the RevMan 5.2.10 software.Results A total of 6 prospective randomized controlled trials which involved 976 patents were included in the study.There were significant differences between PG and PJ in terms of postoperative pancreatic fistula (RR:0.51 ; 95 ％ CI:0.37-0.70 ; P ＜ 0.0001),intra-abdominal fluid collection (RR:0.55 ; 95 ％ CI:0.34-0.89; P =0.01),and postoperative biliary fistula (RR:0.14; 95％ CI:0.03-0.59; P =0.0008).There was no significant difference in postoperative complications,mortality,delayed gastric emptying,postoperative hemorrhage,reoperation and length of hospital stay (P ＞ 0.05).Conclusions Pancreaticogastrostomy after pancreaticoduodenectomy is superior to pancreaticojejunostomy in safety and practicability.However,large,multicenter prospective randomized controlled trials are still needed to confirm the findings of this meta-anlaysis.

Objective To analyze the clinical features of patients with traumatic brain injury in the Ya' an earthquake and discuss the treatment experiences.Methods Medical records of 69 patients admitted from April 2013 to May 2013 because of traumatic brain injury in the Ya' an earthquake were collected.Retrospective review was performed for age,gender,causes of injury,time from injury to hospitalization,types of injury,associated injury,treatment methods and outcomes.Results There were 47 males and 22 females.Forty-two patients (61％) were injured from falling objects.Fifty-eight patients (84％) were sent to the West China Hospital within 72 hours postinjury.Twenty-two cases (32％) sustained associated injuries.Twenty-nine patients (42％) were critically injured.Twenty-four patients underwent operation at the local hospital and twelve patients had operation at our hospital.Outcome measure using GOS one month after treatment showed 55 favorable recovery,5 moderate disability,4 severe disability,and 5 coma.Conclusions Main cause of injury is hit by falling objects during the Ya' an earthquake.Majority of the patients obtained effective treatment in the time window.GCS in combination with patients' general condition used in casualty triage and critical patients charged by neurosurgeons and treated with the cooperation of multiple disciplinary teams are helpful to successful treatment.

Objective To investigate the essential role of Toll-like receptor (TLR) signaling in dendritic cells in rejection responses of skin transplantation in mice.Method Immature wild-type BALB/c bone marrow dentritic cells (BMDCs) were stimulated by a TLR agonist,CpG,in the presence of ST2825,an inhibitor of key molecule myeloid differentiation factor 88 (MyD88) in TLR signal transduction,or in the absence for 24 h in vitro.Co-stimulatory molecules CD80 and CD86 were analyzed by flow cytometry.Wild-type C57BL/6 na ve T cells stained with CFSE,a fluorescent dye,were co-cultured with BALB/c DCs for 3 days in the presence or absence of ST2825.CD3 +/CFSE+cells were analyzed by flow cytometry.Minor antigen-mismatched (HY-mismatched) skin allograft model was employed in this study in which the donors were all males and the recipients were all females.The experimental groups were divided as follows:the control group,the donors and the recipients were all wide type BALB/c mice; the MyD88 group,the donors and the recipients were all MyD88-konckout BALB/c mice; the DCs group,the donors and the recipients were all MyD88-knockout BALB/c mice and the recipients were transfused with donor-sourced DCs after transplantation; the experimental group,the donors and the recipients were all MyD88-knockout BALB/c mice and the recipients were transfused with donor-sourced DCs pre-treated with ST2825after transplantation.The survival time of skin allografts was observed.Result ST2825 could dose dependently inhibit the high level expression of co-stimulatory molecules CD80 and CD86 induced with CpG.Similarly,and it could also dosedependently inhibit the allo-reactive T cell proliferation upon the stimulation with DCs.The survival time of every group was as follows:the control group (22.8 ±2.8) days vs.the MyD88 group (＞100 days) vs.the DCs group (9.7± 2) days vs.the experimental group (＞100 days,P＜0.05,vs.the DC group).Conclusion DCs may play an essential role in rejection responses of transplantation via TLR signaling.The inhibitor of TLR signaling,ST2825,could inhibit the activation of DCs and the biological functions,which might be contributed to the inhibitory effects of ST2825 on DCs maturation and indirect suppression on the proliferation of allo reactive T cells.