Severe acute pancreatitis( SAP),especially with secondary infection of pancreatic necrotic tissue,is clinically a very severe and critical condition. The mortality rate can be as high as 40% . Intestinal barrier dysfunction and translocation of enteric bacteria contribute to the infection of pancreatic necrotic tissue and peripancreatic accumulated fluid,promote systemic inflammatory response syndrome( SIRS)and multiple organ dysfunction syndrome( MODS). Because there is no specific and objective assessment criteria for intestinal function and the function is diversity,intestinal dysfunction is not included in the modified Marshall organ dysfunction scoring system in 2012 revision of the Atlanta International Consensus on Classification and Definitions of Acute Pancreatitis. Paying emphasis to prevention and treatment of intestinal dysfunction may reduce the infection of pancreatic necrotic tissue,preventing the progress of MODS and reducing the mortality rate of SAP. This article reviewed the pathogenic mechanism as well as prevention and treatment of intestinal dysfunction in SAP.

Objective To compare the effects of ouabain and digoxin on both the systolic blood pressure and sodium pump α-subunit isoforms gene expression in the aortic smooth muscle of rats. Methods Normal SpragueDawley rats were injected with ouabain (20μg·kg-1 ·d-1 ,i. p),digoxin (32 μg·kg-1 ·d-1,i. p)and normal saline once a day, respectively, and indirect systolic blood pressure was recorded once a week. Six weeks later,all the rats were killed and sodium pump α1-,α2-,and α3-subunit mRNA levels were detected in the aortic smooth muscle with reverse transcription polymerase chain reaction(RT-PCR) method. Results The systolic blood pressure of rats infused with ouabain increased significantly at the end of week 6 [132. 6± 9. 0 mmHg (1 mmHg ＝ 0. 133 kPa)vs 115. 7±8.2mmHg, P ＜0. 01] ,while no difference of blood pressure was found between digoxin group and NS group (P＞0.05).The expression of sodium pump α-subunit isoforms in aortic smooth muscle was regulated by either ouabain or digoxin:both ouabain and digoxin increased α1- and α3-subunit expression, α2-subunit decreased in digoxin group but unchanged in ouabain group. Conclusion These results suggest that both ouabain and digoxin could regulate sodium pump α-subunit isoform expression, which might be related to the physiological roles of endogenous ouabain and might be responsible for the difference between the pharmacological and toxicological effects of ouabain and digoxin,including their effects on blood pressure.

Based on the principles of the in vitro staining technique, hypotonic swelling test, and water test, the Eosin Y-water test method was developed to simultaneously detect the integrity of the sperm head and tail and sperm membrane structure and function. As a widely used method in clinical laboratories in China, the Eosin Y-water test is methodologically characterized by three advantages. Firstly, both the sperm head and tail can be detected at the same time, which allows easy and comprehensive assessment of membrane damage in different parts of sperm. Secondly, distilled water is used instead of the usual formula solution to simplify and standardize the test by eliminating any potential effects on the water molecules through the sperm membrane due to different osmotic pressure or different sugar proportions and electrolyte solutions. Thirdly, the test takes less time and thus can be repeated before and after treatment. This article focuses on the fundamental principles and modification of the Eosin Y-water test and its application in sperm function examination and routine semen analysis for male infertility, assessment of the quality of sperm retrieved by testicular fine needle aspiration, semen cryopreservation program development, and evaluation of sperm membrane integrity after microwave radiation.
Cell Membrane ; China ; Cryopreservation ; Eosine Yellowish-(YS) ; Fluorescent Dyes ; Humans ; Infertility, Male ; diagnosis ; Male ; Osmotic Pressure ; Semen Analysis ; methods ; Sperm Head ; Sperm Motility ; Sperm Tail ; Spermatozoa ; Staining and Labeling ; Water

Objective To identify the suitable echocardiographic predictor,the standard 2-demensional echocardiography and speckle tracking imaging (STI) techniques were applied for the late referred children with transposition of great arteries with intact ventricular septum (TGA-IVS) after neonatal period.Methods 22 children with TGA-IVS after neonatal period were enrolled.According to the intraoperative left ventricular (LV)/right ventricular systolic pressure ratio,they received pulmonary artery banding (PAB group,n =10) or arterial switch operation (ASO group,n =12).15 body surface area matched healthy children were served as control group,Echocardiography was performed before the operation.The dynamic images in basal and apical short axis view were collected respectively.Meanwhile,using the STI technique,the rotation curves at apex and base was analyzed.Results All the patients discharged eventually.A right to left bulging of the ventricular septum was observed in all the patients by the 2D short-axis view.There were no differences in wall thickness and ejection fraction between control,PAB and ASO group.Compared with the control group,the end diastolic diameter,end diastolic volume and indexed LV mass in PAB and ASO group were significantly reduced,however,no difference in the end diastolic diameter and volume and LV mass was observed between the PAB and ASO group.The hypoplasia of LV in PAB and ASO group was associated with an extended time to peak basal rotation and reduced basal rotation and global torsion.Furthermore,the shorter time to peak apical rotation and reduced apical rotation and global torsion were only observed in PAB group.Conclusions The standard echocardiography could be useful for the initial evaluation for regressed LV of the children with TGA-IVS.However,STI allows a much more precious approach to the assessment of LV regressing after neonatal period.The apical rotation and global torsion might be the better predictor to identify the borderline or regressed LV for the surgical management for the children with TGA-IVS.

AIM: To investigate the effect of phellodendron and three kinds of its main components, which have asuppressive effect on the immune system, on the membrane fluidity of normal murine splenocytes. METHODS: The fluidity ofmembrane lipid regions of splenocytes was determined by the fluorescence polarization technique using 1, 6 - diphenyl - 1, 3, 5- heatriene (DPH) as a fluorescence probe. RESULTS: The results showed that the water extract of phellodendron and one of itsmain components (palmatine) increased the cell membrane fluidity in the inactive state, but the other two components, berberineand jatrorrhizine, decreased the cell membrane fluidity. After activated by ConA, all of them can decrease the cell membrane flu-idity. CONCLUSION: These results suggest that their immunosuppressive function might be due to decreasing the cell membranefluidity.

Objective To explore the measures to prevent recurrent laryngeal nerve (RLN)injury during thyroid surgery.Methods The clinical data of 223 patients undergone thyroid surgery were retrospectively analyzed.Among the 223 surgeries,69 sides were undergone regional protection act of RLN and 191 sides were performed RLN exposure.Results There were 2 cases of RLN injury from the regional protection operation of RLN,including 1 case of temporary nerve injury which could be resulted from surgery clamp and 1 case of permanent nerve injury which might be caused by mistaking ligation during surgery.There was only 1 case of temporary nerve injury in RLN exposure procedure which was probably caused by the postoperative nerve edema and was recovered 2 months after the operation.The total RLN injury rate was 1.35％.Conclusion For benign thyroid lesions and non-dorsal lesions or during partial excision of the gland,the regional protection of RLN is helpful to prevent RLN injury.In cases with dorsal lesions of thyroid or contralateral RLN injury,or during lobe subtotal resection,lobe resection and reoperation,exposing RLN to prevent injury is necessary.Taking different approaches based on the profiles of lesions and surgical procedures to prevent RLN injury can significantly reduce the risk of RLN injury.

Objective To explore the relationship between the levels of inflammatory factors and carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).Methods Fifty patients with T2DM were recruited and divided into T2DM with insulin resistance(IR) group(26 patients) and T2DM without insulin resistance (NIR) group (24 patients) according to insulin resistance index (HOMA-IR).Twenty-four healthy individuals conducting physical examination were recruited as the healthy control group.All participants underwent carotid ultrasound IMT to assess carotid intima-media thickness.The level of fasting plasma glucose (FPG),fasting insulin (FINS),blood lipids,high sensitivity C reactive protein (hs-CRP) and tumor necrosis factor-α(TNF-α) were measured.Homeostasis model assessment (HOMA)index was used for quantitative analysis of HOMA-IR.Results The levels of HOMA-IR,hs-CRP,TNF-α and IMT in control group,NIR group and IR group increased gradually and were significantly different(HOMA-IR:(1.74 ±0.49) vs.(2.24 ±0.41) vs.(4.89 ±0.84) ;F =190.228,P ＜0.01) ;hs-CRP(mg/L):(1.75 ±0.83) vs.(3.08 ± 1.04) vs.(5.89 ± 1.17) ;F =106.523,P ＜ 0.01) ;TNF-α (ng/L):(15.25 ± 7.64) vs.(23.38 ± 8.82) vs.(47.42 ± 9.97) ;F =89.210,P＜0.01) ;IMT(mm):(0.69 ±0.31) vs.(1.07±0.32) vs.(1.49±0.43);F=30.942,P＜0.01).Correlation analysis showed that the level of hs-CRP was positively correlated with the levels of HOMA-IR and IMT (r =0.453 and 0.395 respectively,P ＜ 0.05) ;The level of TNF-α was positively correlated with the levels of HOMA-IR and IMT (r =0.428 and 0.376 respectively,P ＜ 0.05) ; The level of HOMA-IR was positively correlated with the level of IMT (r =0.403,P ＜ 0.05).Conclusion Inflammatory activity is found in patients with T2DM,which is significantly correlated with insulin resistance.Inflammatory factors and insulin resistance play an important role in the occurrence and development of carotid atherosclerosis in patients with T2DM.

Objective To observe the proportion of the peripheral artery disease (PAD) in patients with equal-risk to coronary heart disease and to explore the clinical value of ankle brachial index(ABI). Methods Six hundred and twenty-one cases with equal-risk to coronary heart disease were recruited to the study. Their clinical data and biochemical indicators were collected for further analysis. The value of ABI, which was popularly used in screening PAD, was measured by Oscillometric measurement. All data were statistically analyzed by SPSS 13.0 software. Results There were 169 cases had PAD,the proportion of it was 27.2%. The proportion of PAD in male and female were 34.6% and 16.1% respectively,which had significant difference(P ＜0.01). Compared with NonPAD group,the average age (65 ± 10 years vs. 60 ± 10 years,P ＜0.01) and total cholesterol level (5.4 ± 1.1 mmol/L vs. (5.1 ± 1.1) mtool/L, P ＜ 0.01) were significantly higher in PAD group. Logistic regression analysis showed that gender,age and total cholesterol were major risk factors of PAD in patients with equal-risk to coronary heart disease. Proportion of PAD was up to 50.0% in patients with combined coronary heart disease,ischemic stroke and diabetes. Conclusions ABI is a feasible and reliable index for screening PAD in patients with equal-risk to coronary heart disease. Gender,age and total cholesterol are major risk factors of low ABI in patients with equal-risk to coronary heart disease.

Objective To discuss the laparoscopic retroperitoneal dismembered pyeloplasty in the treatment of ureteropelvic junction (UPJ) obstruction. Methods From 2004 to 2007, a total of 41 consecutive patients (20 men and 21 women) with a mean age 30 years (range 12-45 years) un-derwent laparoscopic retroperitoneal dismembered pyeloplasty for UPJ obstruction. One patient had a congenital solitary kidney, 3 patients had renal calculi and 3 patients had horseshoe kidneys. Diuresis renogram and intravenous urography were performed at 3 and 6 months postoperatively, and annually thereafter. Success was defined by the absence of symptoms and improvement of intravenous urogra-phy and the diuretic renogram. Results The mean operative time was 160 min (range 95 to 300 min) with the average estimated blood loss was 35 ml (range 20 to 80 ml). There was no conversion to open surgery. Crossing vessels were found in 10 patients. Among these cases, the ureter was trans-posed anteriorly. Three patients with coexisting renal calculi were successfully had the stones re-moved. The mean hospital stay was 7.5 d (range 5 to 14 d). There were no intra-operative complica-tions. Postoperative complication was recorded in 1 patient with urine leakage. One patient developed an anastomotic stricture who took open surgery afterwards. The success rate was 97.6 % (40/41) at a mean follow-up of 28 months (range 13 to 52 months). Conclusion Laparoscopic retroperitoneal dismemebered pyeloplasty is effective and feasible.

Alzheimer's disease(AD),a most common type of dementia,often results in cognitive and behavioral dysfunction,A growing body of research suggested that there are specific correlations between AD and traditional vascular risk factors.There are significant associations between the incidence of AD and diabetes mellitus,hypercholesterolemia,hypertension,hyperhomocysteinemia,antioxidants,alcohol consumption,smoking,physical activity,and the presence of atrial fibrillation.These risk factors may he the potentially preventable etiologies of AD.