Objective To investigate the cause and the therapy of acute pancreatitis. Methods 994 patients of acute pancreatitis admitted in the Surgery Ward in Ruijin Hospital between Jan. 2003 to Jan. 2007 were retrospectively analyzed. They were divided into groups according to etiology and therapy. Results In these 994 patients, 825 cases were with biliary origin (83.0%); 24 cases were alcoholic origin (2.41%); 29 cases were hyperlipidemia origin (2.92%); 16 cases were pregnancy origin (1. 61% ), 71 cases were idiopathic origin (7.14%); 4 cases were traumatic origin (0.40%); 25 cases were mixed origin (2.52%).There were 767 cases (77.2%)of mild acute pancreatitis (MAP) and 227 (22.8%) cases of severe acute pancreatitis (SAP). The overall cure rate was 91.2% , 87 cases were dead with a mortality of 8.8%. The mortality of alcoholic acute pancreatitis was 37.5% , which was significantly higher than that in biliary acute pancreatitis. Non - surgical treatment, ERCP + EST, cholecystectomy and exploration of common bile duct, or laparoscopic cholecystectomy after ERCP or debridement treatment was used for biliary acute pancreatitis. All patients underwent debridement treatment were SAP patients with a post-operative mortality of 25.0% , which was significantly higher than those in other treatment group ( P ＜ 0.01 ). There was no significant difference among the other 3 groups as regard to SAP patients and mortality. Conclusions The major cause of acute pancreatitis was biliary factor. Alcoholic pancreatitis was critical with poor prognosis. For biliary acute pancreatitis, the therapeutic efficacies of multiple treatment were not significantly different.

AIM: To investigate the effect of intraventricular pressure change by volume overload (VOL) on expression of proto-oncogene c- fos ,c- jun ,c- myc and egr-1 . METHODS: Left ventricular systolic pressure(LVSP) and left ventricular end diastolic pressure (LVEDP) of rat with VOL induced by aortacaval fistula operation and rats of control group were measured at 30 min, 1, 4, 6, 12 and 48 h after the operation,these mRNAs at the foregoing time points were measured by slot bloting method and quantified with densitometry. RESULTS: Be compared with the control group, VOL rats LVSP decreased ( P 0.05) after the operation.The proto-oncogene expression signals were not detected in the control,negative controls and VOL rats at 30 min after the operation. The c- fos, c- jun and egr-1 mRNA signals appeared earlier,at 1 h, and c- myc mRNA increased later at 4 h.All reached peak value at 4 h and then declined gradually.The c- fos mRNA were not detected at 48 h. The c- myc ,c- 0jun and egr-1 mRNA persisted throught the entire observation period from 1 h to 48 h. CONCLUSIONS: During VOL early phase the overload have effect on expression of the proto-oncogene mRNA,c- fos, c- jun and egr-1 mRNA appear earlier, c- myc later, egr -1,c- jun and c- myc persist longer period, but the expressions do not strengthen with the ventricule wall load increase.This sequential induction pattern may reflect the time course regularity of the proto-oncogenes expression induced by VOL,and indicate the proto-oncogenes expression initiate while the heart load accumulate some extent and duration and the load magnitude may not play a critical role.

OBJECTIVETo explore the expression of Ghrelin and high mobility group protein B1 (HMGB1) in the serum and the intestinal tissue of sepsis model rats, and to evaluate the effect of electro-acupuncture (EA) at Zusanli (ST36) on the expression of HMGB1 and Ghrelin.

METHODSForty-eight male Wistar rats were randomly divided into four groups, i.e., the sham-operation (sham), the cecal ligation and puncture group (CLP), the CLP + EA at Zusanli (ST36) group (EA), and the CLP + Ghrelin receptor blocking agent + EA group (GHSRA), 12 in each group. A sepsis rat model was prepared by CLP. The incision of the abdominal wall was immediately sutured along the ventral midline for rats in the Sham group. In the EA group EA at Zusanli (ST36) was performed 20 min after CLP surgery with the constant voltage (2 - 100 Hz, 2 mA) for 30 min. In the GHSRA group, Ghrelin receptor blocking agent, [D-Arg1, D-Phe5, D-Trp79, Leu11]-substance P (700 nmol/kg), was administered through intravenous injection immediately after CLP, and 20 min later, EA at Zusanli (ST36) was performed in the same way as for rats in the EA group. Blood samples were withdrawn 12 h after CLP. The serum levels of Ghrelin and HMGB1 were detected using ELISA. Ghrelin expressions and the number of Ghrelin immunopositive cell in the jejunum were determined by immunohistochemistry. HMGB1 contents of the jejunum tissue were detected by Western blotting.

RESULTSCompared with the Sham group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased and levels of Ghrelin and the expression rate of immunopositive cells significantly decreased in the CLP group (P < 0.05). Compared with the CLP group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly decreased, but levels of Ghrelin and the expression rate of immunopositive cells significantly increased in the EA group (P < 0.05). Compared with the EA group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased in the GHSRA group (P < 0.05), but there was no statistical difference in levels of Ghrelin between the two groups (P > 0.05). The serum level of HMGB1 was negatively correlated with Ghrelin in the Sham group, the CLP group, and the EA group (r = -0. 528, P < 0.01).

CONCLUSIONSEA at Zusanli (ST36) could inhibit the expression of HMGB1 in the jejunum of septic rats, and promote the expression of Ghrelin. The expression of HMGB1 was inhibited by Ghrelin receptor blocking agent, which suggested that the anti-inflammation of EA at Zusanli (ST36) might be associated with Ghrelin.

Animals ; Disease Models, Animal ; Electroacupuncture ; Ghrelin ; metabolism ; HMGB1 Protein ; metabolism ; Jejunum ; metabolism ; Male ; Rats ; Rats, Wistar ; Sepsis ; metabolism

BACKGROUNDRecurrent stroke following a transient ischemic attack or minor stroke is frequent but potentially preventable. The prevention outcome is, by and large, dependent on how well physicians understand and implement prevention guidelines. Yet, little is known about the scope of physicians' awareness and implementation of secondary stroke prevention guidelines in the mainland of China. This study aimed to identify the gaps between physicians' clinical practice and guidelines for secondary stroke prevention in China.

METHODSA nation-wide online survey with a 16-item questionnaire that reflects major components of the Chinese National Secondary Stroke Prevention Guidelines was performed between September 1, 2009 and October 31, 2009.

RESULTSA total of 3489 neurologists from third tier hospitals completed the survey. The percentage of the physicians who were aware of the control targets and prevention measures recommended in the Chinese national guidelines was generally lower than reported for developed countries.

CONCLUSIONSPhysicians in the mainland of China lack sufficient awareness of secondary stroke prevention guidelines. Continuing education is highly recommended.

China ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Physicians ; Platelet Aggregation Inhibitors ; therapeutic use ; Risk Factors ; Stroke ; prevention & control ; Surveys and Questionnaires

The high performance liquid chromatography-fluorescence micelle assay (HPLC-FMA) method for the content determination of polysorbate 80 in monoclonal antibody drugs was validated to study its applicability and transferability between various laboratories, and the feasibility to be included in the Chinese Pharmacopoeia. Both J.T. Baker and Nanjing Well-sourced polysorbate 80 was used in the collaborative validation of polysorbate 80 content analysis in seven different laboratories. The results show that when the protein concentration was no more than 20 mg·mL^-1 and the concentration of polysorbate 80 ranged from 0.05 to 0.5 mg·mL^-1, the method had good specificity. The recovery rates of the spiked samples ranged from 92.20% to 117.70% for J.T.Baker and from 93.90% to 117.20% for Nanjing Well. The intra-laboratory precision (%RSD) was less than 4.30% for J.T. Baker, and less than 2.60% for Nanjing Well, while the overall precision was less than 5.45% for J.T. Baker, and less than 6.70% for Nanjing Well. The linear correlation coefficient was more than 0.98 for J.T. Baker and more than 0.99 for Nanjing Well. The results of the collaborative validation prove that the HPLC-FMA method has good accuracy, precision, linearity, and specificity, and could be used for release control analysis of polysorbate 80 content in monoclonal antibodies across different laboratories.

Introduction: Tuberculosis (TB) in internal migrants is one of three threats for TB control in China. To address this threat, a project was launched in eight of the 19 districts of Shanghai in 2007 to provide transportation subsidies and living allowances for all migrant TB cases. This study aims to determine if this project contributed to improved TB control outcomes among migrants in urban Shanghai. Methods: This was a community intervention study. The data were derived from the TB Management Information System in three project districts and three non-project districts in Shanghai between 2006 and 2010. The impact of the project was estimated in a difference-in–difference (DID) analysis framework, and a multivariable binary logistic regression analysis. Results: A total of 1872 pulmonary TB (PTB) cases in internal migrants were included in the study. The treatment success rate (TSR) for migrant smear-positive cases in project districts increased from 59.9% in 2006 to 87.6% in 2010 (P < 0.001). The crude DID improvement of TSR was 18.9%. There was an increased probability of TSR in the project group before and after the project intervention period (coefficient = 1.156, odds ratio = 3.178, 95% confidence interval: 1.305–7.736, P = 0.011). Conclusion: The study showed the project could improve treatment success in migrant PTB cases. This was a short-term programme using special financial subsidies for all migrant PTB cases. It is recommended that project funds be continuously invested by governments with particular focus on the more vulnerable PTB cases among migrants.

OBJECTIVETo systematically review the effectiveness of bone substitute augmentation combined with internal fixation versus internal fixation alone in treating proximal femoral fractures in the elderly.

METHODSSubject term and keywords were searched from Pubmed, Cochrane databases and CNKI from database foundation to August 2015. Randomized controlled studies and qusi-randomized controlled studies on bone substitutes augmentation combined with internal fixation versus internal fixation alone for the treatment of proximal femoral fractures in the elderly were chosen. Postoperative re-displacement, re-operation rate, complications (infection and bone ununion), functional outcome, quality of life scores and muscle strength were seen as outcome indicators. Enumeration data were statistical analyzed by risk difference and 95% confidence interval. Measurement data were analyzed by standardized mean difference and 95% confidence interval. If the same measurement data were evaluated by different standards in different studies, standardized mean differences and 95% confidence interval were used. The methods of statistical analysis were used by Cochrane databases.

RESULTSEleven RCTs (677 patients) were included. Meta-analysis results indicated that bone substitutes augmentation combined with internal fixation occurred fewer re-displacement [SMD = -0.75, 95% CI (-1.03, -0.47)] and obtained better function [SMD = 0.40, 95% CI (0.20, 0.59)]. While there were no significant differences in reoperation rate [RD = 0.02, 95% CI (-0.05, -0.09)], pain at 1 week after operation [MD = -1.79, 95% CI (-13.55, -9.96)], pain ranged from 6 to 8 weeks [MD = -7.24, 95% CI (-20.07, -5.59)], postoperative pain at 12 weeks [MD = -0.32, 95% CI (-4.9, -3.55)], muscle strength [MD = 1.25, 95% CI (-6.98, -9.48)], bone ununion [RD = 0.02, 95% CI (-0.01, -0.05)] and postoperative complications [MD = 0.01, 95% CI (-0.03, -0.04)].

CONCLUSIONCompared with single internal fixation, bone substitutes augmentation combined with internal fixation for the treatment of proximal femoral fractures in the elderly less occur re-displacement and could obtain better functional recovery.

Aged ; Aged, 80 and over ; Bone Substitutes ; administration & dosage ; Female ; Femoral Fractures ; surgery ; therapy ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Treatment Outcome

Sound duration plays important role in acoustic communication. Information of acoustic signal is mainly encoded in the amplitude and frequency spectrum of different durations. Duration selective neurons exist in the central auditory system including inferior colliculus (IC) of frog, bat, mouse and chinchilla, etc., and they are important in signal recognition and feature detection. Two generally accepted models, which are "coincidence detector model" and "anti-coincidence detector model", have been raised to explain the mechanism of neural selective responses to sound durations based on the study of IC neurons in bats. Although they are different in details, they both emphasize the importance of synaptic integration of excitatory and inhibitory inputs, and are able to explain the responses of most duration-selective neurons. However, both of the hypotheses need to be improved since other sound parameters, such as spectral pattern, amplitude and repetition rate, could affect the duration selectivity of the neurons. The dynamic changes of sound parameters are believed to enable the animal to effectively perform recognition of behavior related acoustic signals. Under free field sound stimulation, we analyzed the neural responses in the IC and auditory cortex of mouse and bat to sounds with different duration, frequency and amplitude, using intracellular or extracellular recording techniques. Based on our work and previous studies, this article reviews the properties of duration selectivity in central auditory system and discusses the mechanisms of duration selectivity and the effect of other sound parameters on the duration coding of auditory neurons.
Acoustic Stimulation ; Animals ; Auditory Perception ; physiology ; Echolocation ; physiology ; Evoked Potentials, Auditory ; physiology ; Humans ; Inferior Colliculi ; physiology ; Mesencephalon ; physiology ; Sound Localization ; physiology ; Time Perception ; physiology

Objective To investigate the appropriate method in diagnosing precursor lesions of pancreatic cancer and its treatment. Methods From Jan. 2006 to Dec. 2007, 92 cases were operated for pancreatic neoplasms. Among them 7 cases had pancreatic precursors. The mucinous cystic neoplasm was found in 1 case, intraductal papillary mucinous neoplasm(IPMN) in 2 cases, endocrine tumor in 1 case and pancreatic intraepithelial neoplasia (PanIN) in 3 cases. CA19-9 level was tested by immunoflucence assay. All of the 7 patients were examined by CT. Endoscopic ultrasound(EUS) and endoscopic retrograde cholangio-pancreatography examinations were performed on 1 and 2 patients respectively. Results There was neither specific symptom related to these precursors nor any evidence of mass as revealed by CT or ultrasound. But dilatation and stricture of pancreatic duct were found in PanIN patients, and cystic dilatation of pancreatic duct in pancreatic head was present more in IPMN patients. For cystic neoplasms in pancreatic body and tail, they were commonly solid and isolated. CA19-9 level was slightly elevated in some patients but with no diagnostic value. Surgical resection was done with excellent result. Conclusion For the suspected pancreatic precursors, aggressive diagnostic approach and surgical resection will be the best option and can further prevent cancer development.

Objective To study lymph node micrometastasis in N0 colorectal cancer patients and its clinical significance. Methods In this study, 548 lymph nodes obtained from 62 cases of No colorectal cancer undergoing curative operation were examined by fluorescent quantity polymerase chain reaction assay for the expression of cytokeratin 20 (CK20) mRNA. Results Micrometastasis was detected in 55 lymph nodes (10.0% ) of 24 cases (39%). According to lymph node anatomical locations, micrometastasis was identified in 15. 8%, 5.0% and 3.3% lymph nodes in group Ⅰ ,Ⅱ and Ⅲ (grouped by the distance from the tumor), respectively. Micrometastasis was correlated with invasion depth of primary tumor, but was notrelated to gender, age, tumor size, tumor site and differentiation. Conclusions The expression of CK20mRNA in lymph nodes in patients with No coloreetal cancer could be used to improve the accuracy of clinical staging, and provide information for rational adjuvant therapy.