Objective To investigate the incidence of left-sided portal hypertension (LSPH) in chronic pancreatitis (CP) and other accompany conditions of CP and explore the diagnostic value of LSPH in chronic pancreatitis.Methods The clinical,pathological and imaging data of 125 CP patients received at least two imaging examination were retrospectively analyzed.The rates of abnormal pathologic findings,abnormal imaging findings and accompanying LSPH in CP were analyzed.The data were analyzed by chi-square test.Results Among 125 CP patients,29.6％ (37/125) received three or more than three kinds of imaging examinations.The pathological detection rates of pancreatic calcification or lithiasis,pancreatic ductal lesion,abnormal pancreatic morphology,pancreatic lesion and LSPH were 58.4％ (73/125),60.8％ (76/125),35.2％ (44/125),48.8％ (61/125) and 24.8％ (31/125),respectively.The sensitivities of imaging examination in those lesions were 68.5 ％(50/73),96.1％ (73/76),95.5％ (42/44),95.1％ (58/61) and 90.3％ (28/31),respectively.The detection rates of pancreatic calcification or lithiasis and pancreatic ductal lesion in pathological examination were significantly higher than those of the others,and differences were statistically significant (x2=33.764 and 37.932,both P＜0.01).The sensitivity of imaging examination in pancreatic calcification or lithiasis was lower than those of the others and the differences were statistically significant (x2 =36.526,P＜0.01).Among 125 CP patients with 223 pancreatic lesions detected by imaging examination,the rates of patients with 0,1,2,3,4 lesions accounted for pancreatic were 5.6％ (7/125),40.0％ (50/125),28.8％ (36/125),21.6％ (27/125) and 4.0％ (5/125),respectively.Of patients with pancreatic calcification or lithiasis,pancreatic ductal lesions,abnormal pancreatic morphology and pancreatic lesions detected by pathological examination,there were 23.7 ％(17/73),20.0％ (15/76),22.6％ (10/44) and 27.9％ (17/61) cases accompanied with LSPH,there was no difference between these groups (x2 =1.262,P=0.738).Conclusion LSPH may be a reference for CP diagnosis by imaging examination.

The efficiency of cold storage red blood cells (CSRBC) or whole blood at -80 degrees C used in 27 Rh (D) negative patients during surgical operation was reported. The Rh (D) negative patients received the transfusion of CSRBC or whole blood stored at -80 degrees C for 180 to 360 days. The changes in the indexes, such as blood TB, DB, K+, Na+, BUN, Cr, urine protein (URPO), UOB, Hb, HCT, serum total protein, relative to hemolytic reaction and blood volume before and after transfusion were observed. The results showed that after transfusion of CSRBC or whole blood 27 cases were negative for urine protein and UOB, and the levels of BUN and Cr were normal (P > 0.05). Blood TB, DB, Hb, and HCT were increased, while pH, blood K+ and blood Na+ was normal with the difference being not significant before and after operation (P > 0.05). Plasma protein was decreased, but there was no significant difference before and after operation (P > 0.05). It was suggested that CSRBC or whole blood at -80 degrees C could be safely infused to the Rh(D) negative patients without side effects during the surgical operation.
Blood Preservation/*methods ; Blood Transfusion/*methods ; *Cryopreservation ; Erythrocytes ; Intraoperative Care ; *Rh-Hr Blood-Group System

Objective:To construct I-Ad/IgG2b Fc baculovirus expression vector and express I-Ad/IgG2b Fc dimer fusion protein in Sf9 insect cells.Methods:I-Ad α,I-Ad β and IgG2b Fc gene sequences were amplified from BALB/c mouse lymphocytes by RT-PCR.I-Ad α and I-Ad β were connected with the leucine zipper sequence Fos and Jun respectively by overlapping PCR to form I-Ad α-Fos and I-Ad β-Jun.I-Ad α-Fos and IgG2b Fc fragments were ligated by restriction sites Xba I to form I-Ad α-Fos-IgG2b Fc recombination sequence.I-Ad α-Fos-IgG2b Fc and I-Ad β-Jun fragments were inserted to PPH and PP10,which were the downstream of the promoters in the plasmid pFastBacTMDual,to form pFastBacTMDual+[I-Ad/IgG2b Fc] recombinant plasmids.The constructed vector was identified by PCR,restriction endonuclease and sequencing.The recombinant plasmids pFastBacTMDual+[I-Ad/IgG2b Fc] was transferred into the DH10Bac competent cell to form recombinant baculovirus Bacmid+[I-Ad/IgG2b Fc].The recombinant baculovirus was transfected into Sf9 insect cells by liposome transfection reagent.After infected with Sf9 insect cells,the supernatant was collected and concentrated by PEG20000 to obtain I-Ad/IgG2b Fc dimer fusion protein.The fusion protein was detected by double-antibody sandwich ELISA and Western blot.Results:PCR,restriction enzyme digestion and sequencing confirmed that the recombinant vector pFastBacTMDual+[I-Ad/IgG2b Fc] had the correct sequence.The double antibody sandwich ELISA and Western blot showed that recombinant bacmid could successfully infect Sf9 insect cells,and the expressed fusion protein had the correct conformation.Conclusion:The pFastBacTMDual+[I-Ad/IgG2b Fc] baculovirus expression vector was successfully constructed and expressed in Sf9 insect cells,laying a foundation for the study of I-Ad-restricted T cells.

ObjectiveTo establish a practical and effective clinical pathway (CP) for the etiological diagnosis of acute biliary pancreatitis.MethodsA total of 2216 patients enrolled were randomly divided into control group (n =1120) and CP group (n =1096) according to different etiological diagnosis methods including following doctor's established experiences and habits and the designed CP in our study.ResultsThere was no significant difference in baseline data between the two groups.The etiology of acute pancreatitis was determined in 91.1％ (999/1096) of cases in the CP group which was significantly higher than the control group (65.5 ％,734/1120),P ＜ 0.05.The enhanced etiological determination of CP group was mainly consisted of the increased detection of biliary stones,duodenal diseases as well as pancreas divisum,P ＜ 0.05.The positive etiological determination of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in the CP group were 59.1％ (273/462) and 86.0％ (98/114),respectively.ConclusionsThe CP established in this study significantly enhances the biliary etiological determination of acute pancreatitis. It is easy to be conducted and may be of importance to improve the quality of etiological diagnosis of acute pancreatitis.

[Objective] To detect the expression of CD137L mRNA and protein in colorectal cancer tissues and discuss its possible clinical significance.[Methods] To detect the expression of CD137L mRNA in colorectal cancer tissues and adjacent noncancerous tissues by real-time RT-PCR and immunohistochemistry and to analyze the relationship between CD137L expression and clinical features.[Results] The mean level of CD137L mRNA in colorectal cancer tissues is significantly higher than that of adjacent noncancerous tissues (0.035 ± 0.013 vs.0.008 ± 0.005,P ＜ 0.05 ).CD137L mRNA expression in colorectal cancer show no significant differences among different age,sex,tumor location,Dukes classification,histological differentiation,and serum levels of CEA.We selected 8 colorectal cancer tissues and 3 adjacent tissues randomly to analyze the expression of CD137L by immunohistochemistry.CD137L was expressed on tumor cells in colorectal cancer tissues.The expression of CD137L was observed only in colorectal cancer tissues (6/8),but not in adjacent noncancerous tissues (0/3).[Conclusions] The expression of CD137L Mrna in colorectal cancer tissues is higher than that of adjacent noncancerous tissues and CD137 is expressed on tumor cell surface,it might be of biological importance for the progression of colorectal cancer.

OBJECTIVE: To investigate the safety, efficacy and long-term patency of parallel shunts (PS) in the management of the transjugular intrahepatic portosystemic shunt (TIPS) dysfunction. MATERIALS AND METHODS: Between March 2007 and October 2010, 18 patients (13 men and 5 women) who underwent TIPS revision with the creation of PS were evaluated retrospectively. In the first 10 patients, a 10-mm-diameter Wallgraft endoprosthesis was deployed; in the latter 8 patients, an 8-mm-diameter Fluency endoprosthesis was deployed. RESULTS: The creation of PS was technically successful in all patients. The mean +/- standard deviation portosystemic pressure gradient before and after the procedure was 25.5 +/- 7.3 mm Hg (range, 16-37 mm Hg) and 10.9 +/- 2.3 mm Hg (range, 7-16 mm Hg), respectively. The duration of follow-up was 16.7 +/- 10.8 months (range, 6-42 months). The primary shunt patency rates at 12 months after the creation of PS was 70% with Wallgraft endoprostheses and 87.5% with Fluency endoprostheses. CONCLUSION: TIPS revision with the creation of PS is a safe, effective and durable method for treating shunt dysfunction.
Adult ; Aged ; Blood Pressure Determination ; Female ; Humans ; Male ; Middle Aged ; Polytetrafluoroethylene ; Portasystemic Shunt, Transjugular Intrahepatic/adverse effects/*methods ; Prosthesis Design ; Reoperation/methods ; Retrospective Studies ; Stents

The efficiency of cold storage red blood cells (CSRBC) or whole blood at -80 degrees C used in 27 Rh (D) negative patients during surgical operation was reported. The Rh (D) negative patients received the transfusion of CSRBC or whole blood stored at -80 degrees C for 180 to 360 days. The changes in the indexes, such as blood TB, DB, K+, Na+, BUN, Cr, urine protein (URPO), UOB, Hb, HCT, serum total protein, relative to hemolytic reaction and blood volume before and after transfusion were observed. The results showed that after transfusion of CSRBC or whole blood 27 cases were negative for urine protein and UOB, and the levels of BUN and Cr were normal (P > 0.05). Blood TB, DB, Hb, and HCT were increased, while pH, blood K+ and blood Na+ was normal with the difference being not significant before and after operation (P > 0.05). Plasma protein was decreased, but there was no significant difference before and after operation (P > 0.05). It was suggested that CSRBC or whole blood at -80 degrees C could be safely infused to the Rh(D) negative patients without side effects during the surgical operation.
Adult ; Blood Preservation ; methods ; Blood Transfusion ; methods ; Cryopreservation ; Erythrocytes ; Female ; Humans ; Intraoperative Care ; Male ; Middle Aged ; Rh-Hr Blood-Group System

AIM:To investigate the expression and potential role of complement 5a receptor (C5aR) in chro-nic graft-versus-host disease (cGVHD).METHODS:The expression of C5aR on lymphocytes and the frequency of CD4+CD25+ Foxp3+ regulatory T cells (Tregs) in 20 cGVHD patients and 9 healthy donors was detected by flow cytometry.The correlation between the expression of C5aR and the percentage of Tregs in the cGVHD patients was analyzed.In addition, the splenocytes from the mice were cultured in vitro, and stimulated these splenocytes with recombinant mouse C5a protein (rmC5a).The peripheral blood mononuclear cells (PBMCs) from cGVHD patients were cultured in vitro, which was inhibited by C5aR antagonist (C5aRA).The frequency of Tregs in these splenocytes and the PBMCs were evaluated by flow cytometry.RESULTS:The expression of C5aR on the lymphocytes was significantly increased in the cGVHD patients compared with the healthy donors, while the percentage of Tregs was markedly lower in the cGVHD patients.The expression of C5aR was negatively correlated with the percentage of Tregs.Furthermore, the development of Tregs was suppressed by rmC5a stimulation, but was promoted by C5aRA in vitro.CONCLUSION:C5aR elevation is associated with Treg reduction in cGVHD, indicating that C5aR may play a potential role in suppressing Tregs, resulting in the incidence of cGVHD.

Objective: To examine the regulatory effect of ginsenoside Rg1 (G-Rg1) on endoplasmic reticulum stress and its effect on hepatocellular apoptosis in carbon tetrachloride (CCl₄)-induced acute liver failure (ALF). Methods: Forty healthy, adult male C57/BL mice were randomly divided into normal saline control (NS) group, G-Rg1 blank control (G-Rg1) group, CCl₄ model (CCl₄) group, and G-Rg1 preventive treatment (CCl₄+G-Rg1) group, and an ALF mouse model was established by CCl₄ induction. Blood and liver specimens were collected from all mice upon sacrifice at 12 hours post-intraperitoneal injection. Serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST) and total bilirubin (TBil) levels were determined using commercial test kits. The mRNA expression of glucose-regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) was measured using real-time PCR. The protein expression of GRP78, CHOP, caspase12, and caspase3 were measured by Western blot. Histological changes in the liver were assessed by hematoxylin-eosin staining, and the expression of GRP78 and caspase3 was detected by immunohistochemistry. Hepatocyte apoptosis was determined using terminal transferase dUTP nick end labeling. Quantitative data were analyzed using one-way ANOVA, and subsequent pairwise comparisons were performed using the LSD-t method. Results: Serum ALT, AST, and TBil levels in the CCl₄+G-Rg1 group were significantly reduced compared with those in the CCl₄ group (ALT: 691.30 ± 108.06 U/L vs 980.66 ± 110.29 U/L, F = 365.07, P < 0.05; AST: 195.40 ± 15.41 U/L vs 319.44 ± 89.32 U/L, F = 115.64, P < 0.05; TBil: 1.09 ± 0.11 mg/dl vs 1.56 ± 0.12 mg/dl, F = 211.29, P < 0.05). The relative mRNA expression of GRP78 and CHOP was significantly lower in the CCl₄ + G-Rg1 group than in the CCl₄ group (P < 0.05). The relative protein expression of caspase3, GRP78, caspase12, and CHOP was significantly reduced to different extents in the CCl₄+G-Rg1 group compared with those in the CCl4 group (P < 0.05). The CCl₄ + G-Rg1 group showed reduced liver tissue degeneration and necrosis compared with the CCl₄ group. Furthermore, the CCl₄+G-Rg1 group showed significantly fewer brown granules in the liver than the CCl4 group (P < 0.05), indicating that G-Rg1 preventive treatment reduced CCl₄-induced hepatocyte apoptosis. Conclusion G-Rg1 prophylaxis can inhibit inflammation and reduce hepatocyte necrosis and apoptosis during CCl₄-induced ALF. Its mechanism may involve the suppression of endoplasmic reticulum stress-related signaling molecules to alleviate hepatocyte endoplasmic reticulum stress and apoptosis. The results of this study suggest that G-Rg1 may inhibit liver inflammation and hepatocyte apoptosis through multiple targets to protect liver function.

Objective To summarize the etiology,diagnosis and treatment of three cases of duodenal perforation. Methods The data of 3 cases of children with duodenal perforation in our hospital from September 14,2016 to June 20,2017 were retrospectively analyzed. The causes,clinical features and treatment of children's duodenal perforation were summarized. Results A total of 2 males and 1 females aged 2 years,3 years and 5 years were included in the 3 cases. All 3 cases had fever history of upper respiratory tract infection before onset. Acute abdominal pain occurred after oral administration of ibuprofen several times,and all the abdominal plain films prompted pneumoperitoneum. Three cases of perforation sites were duodenal anterior wall,diameter were 0. 5-1 cm. Two cases of small amount of pneumoperitoneum were explored and repaired the duodenal perforation by 3D laparoscopic,1 case underwent laparotomy to repair the duodenal perforation due to a large number of liquid pneumoperitoneum and severe shock. Repair of 3 cases were covered with omentum. Three cases were all cured without anastomotic fistula, ulcer, adhesive intestinal obstruction or other complications. Followed-up in the department of gastroenterology,3 cases had no Helico-bacter pylori infection. Conclusion Repeatedly oral administration of ibuprofen can cause duodenal perfora-tion in children in the short term. Once the digestive tract perforation confirmed,emergency surgical explora-tion is needed. Laparoscopic repair of duodenum perforation is safe and effective and may have a faster recov-ery. We can choose exploratory laparotomy if conditions are not allowed.