Critical Illness ; Humans ; Pancreatitis, Acute Necrotizing ; diagnosis ; surgery ; therapy

Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.
Adult ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Immunocompromised Host ; Intestines ; Mucormycosis* ; Neutropenia ; Stomach

To investigate the effects of metallothionein (MT) on isolated rat heart, 16 Wistar rats were randomly divided into 2 groups. In control group (group C), distilled water was injected intraperitoneally and 24 h later isolated hearts were perfused with Langendorff and stored at 4 degrees C for 3 h with histidine-tryptophan-ketoglutarate (HTK) solutions, and then isolated hearts were perfused for 2 h by Langendorff. In experimental group (group E), 3.6% ZnSO(4) was injected intraperitoneally, 24 h later isolated hearts were perfused by Langendorff and stored at 4 degrees C for 3 h with HTK solutions, and then the isolated hearts were perfused for 2 h with Langendorff. MT content, the recovery of hemodynamics, myocardial water content (MWC), lactate dehydrogenase (LDH) and creatine kinase (CK) leakage, adenosine triphosphate (ATP) and malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, myocardial cell Ca(2+) content, Ca(2+)-ATPase activity of mitochondria ([Ca(2+)-ATPase](m)) and its Ca(2+) content ([Ca(2+)](m)), synthesizing ATP activity of mitochondria ([ATP](m)), and the ultrastructure of cells were examined. There were a significant increase in group E in hemodynamic recovery, ATP content, SOD activity, [Ca(2+)-ATPase](m) activity, [ATP](m) activity, and substantial reduction in MWC, LDH and CK leakage, MDA content, myocardial cell Ca(2+) content, [Ca(2+)](m) content, and the ultrastructural injury were obviously milder than that of group C. This study demonstrated that MT has protective effects on isolated rat heart.
Cardiotonic Agents/*pharmacology ; Creatine Kinase/*metabolism ; L-Lactate Dehydrogenase/metabolism ; Metallothionein/biosynthesis ; Metallothionein/*pharmacology ; Myocardium/*metabolism ; Myocardium/ultrastructure ; Random Allocation ; Rats, Wistar ; Superoxide Dismutase/metabolism ; Zinc Sulfate/pharmacology

Objective To investigate the radiosensitiation effect of berberine on human nasopharyngeal carcinoma ( NPC) in hypoxia condition and explore the underlying mechanisms. Methods MTT assay, clonogenic assay and flow cytometry were performed to analyze cell proliferation, colony formation and apoptosis, respectively. Male nude mice inoculated subcutaneously with CNE-2 cells were used to examine the radiosensitization effect of berberine in vivo. The expressions of HIF-1α and VEGF were assessed by Western blot. Results Berberine efficiently inhibited the proliferation of CNE-2 cells in time-dependent and dose-dependent fashions with an IC50 of ( 14?9 ± 2?2 ) μmol/L. Clonogenic survival assay showed that berberine ( 5 μmol/L ) sensitized CNE-2 cells to ionizing radiation in hypoxia and its SERD0 was 1?27. Under hypoxic condition, berberine alone (5, 15 μmol/L) could induce apoptosis (t=5?01, 9?02,P<0?05) and it further promoted 8 Gy radiation-induced apoptosis (t =5?31, 9?91,P <0?05). Moreover, berberine significantly delayed the tumor growth in the combination group (berberine +irradiation) compared with the mice received irradiation alone or PBS (t =2?96, 14?52, P <0?05). Immunobloting assay showed that berberine inhibited the upregulation of HIF-1α and VEGF induced by hypoxia in CNE-2 cells. Conclusion Berberine confers radiosensitivity on hypoxic NPC in vitro and in vivo, which is probably associated with the downregulation of HIF-1α and VEGF expressions.

Objective Establish an objective and fair evaluation index system for the implementation effectiveness of the National Major New Drug Development Program of China.Methods Based on literature review and Delphi method,the framework of the evaluation index system was built and analytic hierarchy process was applied to determine the priority of each indicator of the system.The objectiveness and validness of the results were assured by determining expert activeness coefficient,authority coefficient,indicator rationality,and by applying consistency check.Results A targeted and systematic evaluation index system was constructed for the National Major New Drug Development Program,and through expert consultation and analytic hierarchy process,the factor of product result was considered of the highest weight of 39.03％,followed by technical result,theoretical result and organization and management result.The evaluation index system suggested that product result and technical result are two relatively more significant factors to be considered during evaluation.Conclu sion After consultation on expert opinions,the evaluation index system for the National Major New Drug Development Program was constructed with each factor been assigned with a scientific and rational weight,and this will provide a guideline for the decision making of program administrators and evaluation practice.

Objective To compare the surgical and functional outcomes of single-site (transumbilical two-port) intracorporeal purse-suturing (IP) and single-port extracorporeal knotting (EK) for laparoscopic pediatric inguinal hernia (PIH) repair.Methods Between June 2008 and December 2014,358 PIH children underwent lapamscopic inguinal herniorrhaphy,including 126 treated by single-site intracorporeal purse string stitching using a needle-holder (IP group),and 232 by single-port extracorporeal knotting using an inner two-hook needle with preperitoneal hydrodissection (EK group).Results In all patients laparoscopic procedures were completed successfully without conversion.The operating time in IP group was significantly longer than that in EK group [unilateral:(20.4 ± 2.1) min vs.(9.4 ± 1.3) min,t=-5.23,P＜0.01;bilateral:(31.3 ±2.9) min vs.(15.2±1.7) min,t=-4.22,P＜0.01)].The hospital stay were similar between the two groups [(2.35 ±0.25) d vs.(2.38 ±0.18) d,t =-0.062,P ＞ 0.05].Five cases had intraoperative hematoma in the IP group while none in the EK group.One each suffered from recurrence in IP group and EK group.Three postoperative hydroceles were seen in IP group and one in EK group.Subcutaneous knot granulomas were seen in two in EK group.Conclusions Both IP and EK laparoscopic procedures are safe and feasible.With the assistance of preperitoneal hydrodissection technique,single-port laparoscopic EK herniorraphy is superior to single-site IP repair in easy performance and shorter operation time.

Objective To understand the vital signs on admission time and traumatic classification of the inpatients injured in Lushan Earthquake ,and provide a basis evidence for handling major disasters and treating masses of injured patients .Methods The information of patients injured in Lushan Earthquake who were admitted in Chengdu Military General Hospital was collected by“No .1 Military Medical Project” hospital information system and self-edited “Questionnaire for Hospitalized Patients Injured in 4 .20 Lushan Earthquake” .The data of the vital signs on admission time and traumatic classification of these patients were analyzed by SPSS 16 .0 .Results A total of 65 civilian patients were admitted in this hospital .Among these patients ,there were 30 men (46 .15% )and 35 women(53 .85% );with mean age of(45 .74 ± 20 .96)years old .On admission time ,the abnormal rates of tempera-ture ,pulse ,respiratory rate ,systolic pressure ,diastolic pressure of these patients were 18 .46% ,6 .15% ,21 .54% ,12 .31% and 23 .08% ,respectively .48(73 .85% )patients had closed injury .Traumatic condition:8(12 .31% )patients in mild degree ,17(26 .15% ) patients in moderate degree ,32 patients(49 .23% )patients in severe degree and 8(12 .31% )patients in critical degree .The top 4 traumatic parts were as follows :33(50 .77% )patients got waist(abdomen)division and pelvis(perineum);31(47 .69% )patients got lower limb injuries;18(27 .69% )patients got chest and back injuries and 10(15 .38% )patients got facial injuries .There were 39 skin and soft tissue injuries ,counting for 60 .00% ,and 38 fractures ,counting for 58 .46% .Conclusion The epidemiological characteris-tics of earthquake injuries are founded by analyzing the vital signs on admission time and traumatic classification of the inpatients in-jured in Lushan earthquake ,which suggests attention of the relevant scholars and departments .

OBJECTIVE: To analyze external factors affecting auditory ability of infants and toddlers after cochlear implantation in the first year of switch-on. METHOD: Seventy-five infants and toddlers after cochlear implantation were selected as subjects, using LittlEARS Auditory Questionnaire to assess and analyze the correlations with auditory ability and external factors (including gender, cochlear implanted age, pre-implant hearing aid fitting, caregivers' education background, household income and rehabilitation modes) in different stages (before switch-on, and 3 months, 6 months, 9 months, 12 months after switch-on). RESULT: The mean scores of LittlEARS were significantly different in cochlear implanted age group, pre-implant hearing aid fitting group and rehabilitation modes group (P < 0.05), and there was no significant difference in other groups such as external factor gender, caregivers' education background and household income (P > 0.05). The correlations with the mean scores of LittlEARS and cochlear implantation age or pre-implant hearing aid fitting were significant at 3 months or 6 months after switch-on(/r/ ≥ 0. 3, P < 0.01). However, the correlation with the mean scores of LittlEARS and rehabilitation modes was significant at 12 months after switch-on(/r/ > ≥ 0.3, P < 0.01). CONCLUSION Cochlear implanted age and pre-implant hearing aid fitting were the important factors affecting auditory ability of infants and toddlers after cochlear implantation in the first year of switch-on. The effect of rehabilitation modes on auditory ability of infants and toddlers after cochlear implantation was slow.
Age Factors ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness ; rehabilitation ; Hearing ; Hearing Aids ; Humans ; Infant ; Surveys and Questionnaires

ObjectiveTo explore the feasibility and outcomes of natural orifice transanal laparoscopic Soave procedure for Hirschsprung's disease and allied disorders (HAD).MethodsFrom March 2010 to December 2011,31 cases (at the age from 3 mos to 6 yrs) with Hirschsprung's disease or allied disorders (5 cases)underwent laparoscopic-assisted Soave pull-through procedure at two tertiary hospitals.We modified this technique by mobilizing the left hemicolon or whole colon via rectal muscular sleeve approach under transanal or transumbilical laparoscopic vision,then endorectal pull-through to completearectosigmoidectomyorsubtotalcolectomy. ResultsAllprocedureswerecompleted successfully.A rectosigmoidectomy was performed in 16 cases with classic HD and subtotal colectomy in 15 cases with extended HD and HAD.The average operative time was ( 117 ± 13) min.The length of the resected segment was 35 -80 cm,and the estimated blood loss was 5 -20 ml. One infant developed postoperative intestinal obstruction that required open exploration.Follow-up of one to 20 mos found no stoma stenosis or constipation recurrence. Enterocolitis developed in 1patient.ConclusionsTransanal or transumbilical laparoscopic-assisted Soave pull-through surgery is safe,effective and with a benefit of much less invasion and almost invisible scars.