ObjectiveTo study the efficacy and safety of early endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic sphincterotomy (EST) for patients with acute biliary pancreatitis.Methods420 patients who were admitted to our hospital for management of acute biliary pancreatitis were divided into early endoscopic therapy group (n=218 patients) and conservative therapy group (n=202 patients).The durations for complete disappearance of abdominal pain,decrease in serum and urine amylase levels to normal,liver function recovery time,white blood cell recovery time,and the mean duration and costs of hospitalizations were analyzed.ResultsIn the ERCP group,all patients received EST.The stones in 172 patients with choledocholithiasis were removed with dormia baskets or balloon catheters.In 20 patients with severe acute biliary pancreatitis,endoscopic pancreatic duct stents were inserted for drainage.The durations of complete disappearance of abdominal pain,decrease of serum and urine amylase values to normal,white blood cell recovery time,liver function recovery time,cost of hospitalization and duration of hospitalization were significantly shorter in the early ERCP group than the control group.The mortalities in the ERCP and the control groups were 8.0％ and 22.2％,respectively.Conclusions Early endoscopic management for patients with acute biliary pancreatitis was not only safe and efficacious,but the management helped to identify the underlying causes of pancreatitis and reduced the duration of hospital stay and expenses.

OBJECTIVE To evaluate the curative effect of acute cerebral stroke influenced by lower respiratory tract infection. METHODS To adopt previous way to compare one group included 178 cases with lower respiratory tract infection with the other group included 172 cases which had not been infected,and the relationship between the contact of lower respiratory tract infection and curative effect of acute cerebral stroke. RESULTS The neural function defects′score of the infected group was higher than the noninfected group(P

OBJECTIVETo investigate the effect of diet-induced obesity on the apoptosis of testicular spermatogenic cells in pubertal male rats.

METHODSForty healthy male rats were equally and randomly divided into a control and a high-fat group, the former fed on normal diet, while the latter high-fat and high-calorie diet. The testes of the rats were harvested at the end of 10 weeks for detection of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in the peripheral blood with the automatic biochemical analyzer. Pathological changes of the testis were observed under the light microscope, the apoptosis of the testicular cells detected by TUNEL, the expressions of Bcl-2 and Bax proteins determined by immunohistochemistry, and those of Bcl-2 mRNA and Bax mRNA measured by RT-PCR.

RESULTSThe levels of TC, TG, LDL-C and HDL-C were significantly higher in the high-fat group (5.17 +/- 0.17, 1.18 +/- 0.09, 1.76 +/- 0.11 and 5.08 +/- 0.18) than in the control (1.38 +/- 0.12, 0.39 +/- 0.05, 0.97 +/- 0.07 and 0.75 +/- 0.06) (P < 0.05), so was the apoptotic index of spermatogenic cells (37.17 +/- 2.74 versus 5.16 +/- 0.81, P < 0.01), and the apoptotic spermatogenic cells were mainly spermatogonia and spermatocytes. The expressions of Bax protein and Bax mRNA were markedly higher in the high-fat group (153.26 +/- 8.74 and 1.08 +/- 0.12) than in the control (101.81 +/- 6.14 and 0.37 +/- 0.04) (P < 0.01), while those of Bcl-2 protein and Bcl-2 mRNA remarkably lower in the former (139.26 +/- 7.21 and 0.46 +/- 0.05) than in the latter (159.37 +/- 8.96 and 1.05 +/- 0.11) (P < 0.01).

CONCLUSIONDiet-induced obesity can increase the apoptosis of spermatogenic cells in the rat testis, which may be associated with the reduced expression of Bcl-2 and elevated expression of Bax.

Animals ; Apoptosis ; Diet ; Lipids ; blood ; Male ; Obesity ; etiology ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Wistar ; Testis ; cytology ; pathology ; bcl-2-Associated X Protein ; metabolism

AIM AND METHODSThe effect of intrahippocampal microinjection of noradrenaline (NA) and its receptors antagonists and agonists on cellular immune functions were investigated in normal and adrenalectomy rat by determine the proliferative activity of Con A-stimulated splenic lymphocytes in MTT method and natural killer (NK) cell activity.

RESULTS(1) In normal group, the proliferative activity of Con A-Stimulated splenic lymphocytes were inhibited and the activity of NK cell were reduced with microinjection NA and beta1-, beta2-adrenergic receptor agonists Dobutamine (Dob, 4 microl, 6.0 x 10(-3) moL/L), Metaproterenol (Met, 4 microl, 8.0 x 10(-3) mol/L), compared with their intensity of effect, NA > Met > Dob; the immunosuppression effect induced by NA was partly hindered by alpha- and beta-receptor antagonists, phentolamine (Phen, 2 microl, 1.6 x 10(-2) mol/L) and propranolol (Prop, 2 microl, 1.6 x 10(-3) mol/L), and the action of Prop was more evident. (2) In adrenalectomy group, immunosuppression effect induced by NA was unconspicuous.

CONCLUSIONThe results suggested that NA in hippocampus could inhibit distinctly cellular immune functions, which was predominantly mediated by beta2- adrenergic receptor with a minor contribution of beta1- and alpha- adrenergic receptors. Moreover, keeping intact construction and function of adrenal gland have an important role in the effect of NA on cellular immune function.

Adrenergic Agonists ; pharmacology ; Animals ; Hippocampus ; drug effects ; Immunity, Cellular ; drug effects ; Killer Cells, Natural ; immunology ; Lymphocytes ; immunology ; Microinjections ; Norepinephrine ; pharmacology ; Rats ; Rats, Wistar ; Spleen ; cytology ; immunology

Objective To summarize the experience in laparoscopic spleen-preserving distal panereatectomy.Methods From Nov 2003 to July 2006,six patients with distal pancreatic cystic lesions underwent laparoscopic spleen-preserving distal pancreatectomy with splenic vessels preservation. Results All operations were successful with the operative time ranging from 140～265 min and the intraoperative blood loss ranged from 350～600 ml.One case received combination resection of right adrenal adenoma,1 case with combined laparoscopic myomectomy and left ovarian teratomeetamy,1 case with combined laparoscopic myomectomy,1 case with combined laparoscopic cholecysteetomy.All patients were discharged 4 to 9 days postoperatively.The pathologic diagnosis was retained cyst in 2 cases,serous cystadenoma in 2 cases,mucious cystadenoma in 2 cases.Symptoms disappeared in all cases after operations and there was no recurrence during a follow-up period that ranged from 1 month to 31 months.Conclusions Laparoscopic spleen-preserving distal pancreatectomy with splenic vessels preservation is the most suitable procedure for the distal pancreatic benign lesions,and in experienced hands this procedure is safe and effective.

OBJECTIVETo study the clinical efficacy of the endobutton in the treatment of acute acromioclavicular joint dislocation by reconstructing coracoclavicular ligaments.

METHODSFrom October 2008 to January 2010,12 patients with acute acromioclavicular joint dislocation were immobilized with the endobutton. All the patients had the dislocations of or above type III according to Rockwood classification. Among the patients, 9 patients were male and 3 patients were female, with an average age of 55 years (ranged from 31 to 83 years). Eight patients had injuries in the left, and 4 patients in the right. Four patients had accompanied injuries of rib fractures, 2 patients had brain injuries,and 1 patient had femoral fracture. Seven patients were injured by traffic accident, 4 patients were injured by falling down,and 1 patient was sports injuries. All the patients had pain and tenderness at the shoulder, positive piano sign, and shoulder confined activity. The duration from injury to operation ranged from 2 days to 10 days (averaged 6 days). The therapeutic effects were evaluated by Karlsson criteria based on range of motion of acromioclavicular joint, subjective feeling,and postoperative X-ray.

RESULTSAll the patients were followed up, and the duration ranged from 4 months to 19 months (averaged 11 months). The motion of the shoulder joint recovered to normal about 15 to 35 days after operation. There were no displacement, dislocation and redislocation occurred. All the patients got A degree results according to Karlsson criteria.

CONCLUSIONReconstruction of coracoclavicular ligament by using the endobutton to treat acute acromioclavicular dislocation of or above type III is a perfect method with advantage of rigid fixation, micro-injury, and early functional exercise.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; External Fixators ; Female ; Humans ; Joint Dislocations ; diagnostic imaging ; physiopathology ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; instrumentation ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo study the effect and mechanism of Coicis Semen oil (Kanglaite injection, KLT) on renal interstitial fibrosis induced by unilateral ureteral obstruction (UUO).

METHODFifty-four male SD rats were randomly divided into 3 groups, 6 in each group, the sham operated group, the model group, and the KLT group. Renal interstitial fibrosis model was established in rats by UUO. After administration of KLT (15 mL x kg(-1) x d(-1)) for 3, 7 and 14 days, the dynamic histological changes of renal interstitial tissues were observed and renal damage including tubular impairment and interstitial fibrosis were quantified on HE and Masson stained tissue sections. The expression of alpha-smooth muscle actin (alpha-SMA) and transforming growth factor-beta1 (TGF-beta1) were measured by immunohistochemistry staining sections. The protein expression of p-Smad2 and Smad7 were detected by Western blot respectively.

RESULTThe degree of tubular damage in KLT group was much lower than that in UUO group (P < 0.05). The expression of alpha-SMA and TGF-beta1 was decreased in both UUO group and KLT group, while it was significantly lower in KLT group at every time point. The protein expression of p-Smad2 was obviously decreased while the protein expressions of Smad7 was obviously increased in KLT group, compared with the UUO group (P < 0.05).

CONCLUSIONCoicis Semen oil could attenuate the tubulo-interstitial fibrosis, probable by intervening the TGF-beta/Smads signal transduction pathway of UUO rats.

Animals ; Coix ; Fibrosis ; Injections ; Kidney ; pathology ; Male ; Plant Oils ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects ; Smad2 Protein ; metabolism ; Transforming Growth Factor beta1 ; antagonists & inhibitors ; physiology ; Urethral Obstruction ; drug therapy ; pathology

Objective To investigate the efficacy and safety of preventive anticoagulant therapy at different time windows on formation of portal vein thrombosis after laparoscopic splenectomy and pericardial devascularization.Methods The study was performed as a randomized,prospective trial.83 patients with portal hypertension who underwent laparoscopic splenectomy and pericardial devascularization were divided into four groups:the non preventive anticoagulant group (n =21),the prophylactic anticoagulant group (n =23),the 24 hours of preventive anticoagulant group (n =19) and the 48 hours of preventive anticoagulant group (n =20).The incidences of postoperative portal vein thrombosis,the Yerdel grading,platelet count,APTT,and bleeding complications were studied.Results The incidences of portal vein thrombosis in the four groups were 100％,39.1％,47.3％,55％,respectively,and the difference among the 4 groups was significantly different (P ＜ 0.05).The incidences of portal vein thrombosis between the prophylactic anticoagulant group and the 24 hours of preventive anticoagulant group showed no significant difference (P ＞0.05),but the incidences of portal vein thrombosis after 48 hours of preventive anticoagulant group was significantly higher than the prophylactic anticoagulant group and the 24 hours of preventive anticoagulant group,respectively (P ＜ 0.05).Postoperative bleeding complications,platelet count and APTT after the operations showed no significant differences (P ＞ 0.05).However,the plasma level of D-dimer in the non preventive anticoagulant group was significantly higher than the preventive anticoagulant group (P ＜ 0.05).Conclusion Preventive anticoagulant therapy effectively reduced the incidence of portal vein thrombosis after laparoscopic splenectomy and pericardial devascularization,but it did not significantly increase the risk of postoperative bleeding complications.

PURPOSE: To evaluate the correlations among the Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score–Storage Subscore (IPSS-S), and the modified Urgency Severity Scale (USS) in patients with overactive bladder (OAB) and hypersensitive bladder (HSB) and to identify the most useful diagnostic tool for classifying the severity of OAB. METHODS: We retrospectively reviewed the charts of consecutive patients with OAB who visited our urologic clinics for treatment. All patients underwent a detailed history, physical examination, urinalysis, uroflowmetry, and postvoid residual volume measurement, and completed a 3-day voiding diary. All patients answered the Chinese versions of the IPSS, OABSS, and USS, according to which they were classified as having wet or dry OAB based on whether their chief complaint was urgency urinary incontinence or urgency without incontinence. HSB was defined as a functional bladder capacity <350 mL and a USS of 0 or 1. RESULTS: The records of 325 OAB patients (99 women and 226 men) were reviewed. The OAB subgroups included HSB (n=31), OAB-dry (n=74), and OAB-wet (n=220). One-way analysis of variance showed significant differences among the OAB subgroups evaluated using each scoring system. Each scoring system was significantly correlated with the OAB subgroups. The Spearman rho was 0.983 for the USS, 0.651 for the OABSS, and 0.428 for the IPSS-S. CONCLUSIONS: The IPSS-S, OABSS, and USS showed good correlations with the OAB subgroups. Their ranking in terms of discriminant ability for classifying OAB severity as HSB, OAB-dry, and OAB-wet was USS>OABSS>IPSS-S. The simplest survey, the USS, with a single item scored from 0 to 4, had the strongest correlation with the OAB severity subgroups.
Asian Continental Ancestry Group ; Female ; Humans ; Physical Examination ; Prostate* ; Residual Volume ; Retrospective Studies ; Urinalysis ; Urinary Bladder* ; Urinary Bladder, Overactive* ; Urinary Incontinence

OBJECTIVETo evaluate the feasibility and efficacy of laparoscopic distal pancreatectomy.

METHODSTotally 68 patients (male 23, female 45) aged 17 to 77 years, with distal pancreatic lesions, underwent laparoscopic distal pancreatectomy from November 2003 to December 2010. The clinical data were collected. Safety, feasibility and crucial technique manipulation were analyzed retrospectively.

RESULTSAll 68 operations were successful with two cases conversion to open, including 48 cases combined with splenectomy, and 18 cases with preservation of spleen. Fourteen cases received with combination resection of multi-organs, including 4 cases with cholecystectomy, 1 case resection of right adrenal adenoma and cholecystectomy, 1 case with myomectomy and left ovarian teratomectomy; 1 case with right ovarian teratomectomy, 1 case with resection of left adrenal adenoma, 1 case with resection of both adrenal adenoma, 1 case with resection of liver metastasis, 1 case with cholecystectomy and resection of liver metastasis, 1 case with resection of left adrenal adenoma and liver metastasis, 1 case with resection of left adrenal adenoma and colon and spleen, 1 case with biopsy of liver nodule. The mean operative time was (209 ± 58) minutes, the mean intraoperative blood loss was (191 ± 123) ml, and the mean postoperative hospital stay was (8 ± 4) days. The rate of overall postoperative complications was 18.1%, including an 12.1% rate of clinical pancreatic fistula. Only one case needed a reoperation, and there was no postoperative mortality.

CONCLUSIONLaparoscopic distal pancreatectomy with or without splenectomy is safe and feasible in the treatment of most distal pancreatic tumors.

Adolescent ; Adult ; Aged ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Pancreatectomy ; methods ; Retrospective Studies ; Young Adult