Objective To investigate the content of intestinal fatty acid binding protein (IFABP) and its clinical significance in patients with severe sepsis.Methods A prospective observational study was conducted.Fifty patients with severe sepsis admitted to intensive care unit (ICU) of the First Affiliated Hospital of China Medical University from July to December 2012 were enrolled,and 20 healthy patients served as control group.The concentrations of serum IFABP,interleukin-6 (IL-6),and tumor necrosis factor-α (TNF-α) were determined with enzyme-linked immunosorbent assay (ELISA) on days 0,1 and 3 after ICU admission.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) score,28-day prognosis,acute gastrointestinal injury (AGI) grade were recorded at the same time.Furthermore,the contents of IFABP were compared between control group and the severe sepsis group,abdominal infection group and non-abdominal infection group,the survival group and the death group,as well as among different AGI-grade groups.Correlation analysis of IFABP and inflammatory factors,IFABP and two scores,and IFABP and time of stay in ICU and mechanical ventilation were studied.Multivariate logistic regression and analysis of 28-day outcome of the patients were also studied.Results IFABP levels were increased in severe sepsis patients on days 0,1 and 3 compared with those of healthy control group (mg/L:731.90 ±53.91,592.07 ±41.94,511.85 ±47.97 vs.439.88 ±23.68,all P =0.000).There was no statistical significance of IFABP levels between abdominal infection group and non-abdominal infection group,the survival group and the death group,or among different AGI-grade groups.The correlation analysis showed that IFABP was statistically related with IL-6 (r=0.794,P=0.000),TNF-α (r=0.878,P=0.010),APACHE Ⅱ score (r=0.428,P=0.000) in patients with severe sepsis.Significant correlations were also found between IFABP and IL-6 (r=0.812,P=0.000),TNF-α (r=0.885,P=0.000) in abdominal infection group,as well as in non-abdominal infection group (IL-6:r=0.739,P=0.000; TNF-α:r=0.828,P=0.000).As shown by multivariate logistic regression analysis,SOFA scores on days 0,1,3 were the independent risk factors for death [odds ratio (OR) was 1.624 (P=0.004),1.411 (P=0.027),1.740 (P=0.012),respectively],but IFABP level,AGI grade,and APACHE Ⅱ score had no influence on death rate.Conclusion IFABP concentrations in patients with severe sepsis were significantly increased,and it is correlated well to IL-6,TNF-α and APACHE Ⅱ score,but did not related obviously with AGI grade and the prognosis of the patients.

Objective:To investigate the disinfection effectiveness of photodynamic therapy (PDT) combined with ethylenediaminetetraacetic acid (EDTA) disodium salt solution on enterococcus faecalis in lateral root canals.Methods:Sixty-four human single root canal premolars were selected to prepare artificial root canal collaterals, and E. faecalisin root canal collateral infection models were established. The infection model was divided into PDT group ( n=16), PDT combined with EDTA group ( n=16), positive control group ( n=16) and negative control group ( n=16) according to random number table method. In the PDT group, 40 μg/ml hematoporphyrin monomethyl ether was injected into the root canal, and then the root canal was irradiated with a 45 mW laser for 90 s after 5 min incubation. In the PDT combined with EDTA group, the root canal was given 5 ml EDTA solution with 17% mass fraction for 1 min, and then treated with the method same as the PDT group. In the positive control group, the root canal were given 5 ml NaClO solution with a mass fraction of 5.25 % for 1 min. In the negative control group, the root canal were given NaCl solution with a mass concentration of 9 g/L for 1 min. Before and after the treatments, samples were taken in the lateral branches of the root canal with a K file to count plate colonies. After treatments, the roots of each group were placed in sterile brain heart infusion broth (BHI) medium for anaerobic culture for 24 h, and then sampled with a K file, and the number of root canal collaterals was detected statistically. Scanning electron microscopy was used to observe the morphology of the inner wall of lateral branches of root canals after treatments. Results:The sterilization rate of PDT combined with EDTA group was 99.56%, which was significantly higher than that of negative control group (1.98%), positive control group (85.87%) and PDT group (87.53%), the differences were statistically significant (all P<0.05). The reply experiment shows that the number of infection root canals was only 5, which was less than the negative control group (15), positive control group (12) and PDT group (11), and the differences were statistically significant (all P<0.05). Scanning electron microscopy observations showed that no obvious E. faecalis adhered to the inner wall of root canal of PDT combined with EDTA group. Conclusions:PDT combined with EDTA has a good disinfection effectiveness on E. faecalis in lateral canals, and it is expected to provide a new method for the effective killing of E. faecalis in lateral canals in clinical root canal therapy.

Pancreaticoduodenectomy is the only possible surgical procedure for the cure of pancreatic head carcinoma. With the development of minimally invasive surgery, the minimally invasive surgical treatment of pancreatic head carcinoma has become more mature, and an increasing number of grade A tertiary hospitals have reported the minimally invasive surgery for pancreatic head carcinoma. With reference to related articles and experience of our center for pancreatic surgery, this article elaborates on the current status of minimally invasive surgical treatment of pancreatic head carcinoma and points out the perspectives and development directions of minimally invasive treatment of pancreatic head carcinoma.

Objective To evaluate the effect of intrathecal oxytocin on neuropathic pain in rats.Methods Thirty-six SPF male Sprague-Dawley rats,aged 4-6 weeks,weighing 100-150 g,were divided into 4 groups (n =9 each) using a random number table:control group (group C),neuropathic pain group (group NP),neuropathic pain plus normal saline group (group NPN) and neuropathic pain plus oxytocin group (group NPO).The neuropathic pain model was made by partial sciatic nerve injury in NP,NPN and NPO groups.In group NPO,oxytocin l0 μl (0.1 μg) was intrathecally injected on the day of establishing the model and 1 and 2 days after establishing the model,and then normal saline 10 μl was given for tube sealing at 9 a.m.and 4 p.m.every day.In group NPN,normal saline 20 μl was given for tube sealing at the corresponding time points.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before establishing the model and 1,2,3,4,5,6 and 7 days after establishing the model.The expression of the astrocyte marker glial fibrillary acidic protein (GFAP) and a specific marker of microglia ionized calcium-binding adaptor molecule 1 (IBa-1) was detected by Western blot at 1 day before establishing the model and 3 and 7 days after establishing the model.Results Compared with group C,the MWT was significantly decreased,TWL was shortened and the expression of GFAP and IBa-1 was up-regulated at each time point in NP and NPN groups (P＜0.05).There was no significant difference in MWT,TWL GFAP and IBa-1 at each time point between group NPN and group NP (P＞0.05).Compared with NP group,MWT was significantly increased at 2-4 days after establishing the model,TWL was prolonged at 1-4 days after establishing the model,the expression of IBa-1 was down-regulated on 3 days after establishing the model,and the expression of GFAP was downregulated on 3 and 7 days after establishing the model in group NPO (P＜0.05).Conclusion Oxytocin can reduce neuropathic pain,and the mechanism may be related to inhibiting activation of glial cells in the spinal cord of rats.