Objective To analyze the diagnosis and treatment of pancreatic trauma with main pancreas duct break. Methods Forty-four cases of severe pancreatic trauma with main pancreas duet break were retrospectively analyzed including their diagnosis and different operation performed according to the severity of pancreatic trauma. Results All of severe pancreatic trauma could be diagnosed by CT scan and B-ultrasonic examination. But the main pancreas duct break or not should be determined by surgical exploration. Emergency operations were performed for all cases , distal part pancreaticojejunostomy in 27 cases; modified duodeno-divertiulaization in 3 cases, duode-nojejunostomy in 3cases, pancreaticeduodenectomy in 2 cases, 41 cases were cured. The mortality was 6.8%. Conclusion CT scan is the most helpful means to diagnose pancreatic trauma. An appropriate and timely emergen-cy operation is the key to reduce mortality.

Objective To retrospectively analyze the treatments of nonvalvular atrial fibrillation (nvAF) in elderly patients aged 80 years and over,and to investigate the influencing factors for occurrence of stroke and transient ischemic attack(TIA)and relationships between antithrombotic therapy and stroke or TIA.Methods 101 elderly patients with nvAF were enrolled and grouped according to the occurrence of stroke/TIA and antithrombotic-correlated bleeding.The influencing factors were retrospectively analyzed and antithrombotic schemes were compared.Results Incidence rate of stroke/TIA was 28.7％ (29/101).Among all patients,70 cases were treated with antiplatelet therapy,19 cases were treated with anticoagulation therapy,while 12 cases received no antithrombotic (antiplatelet or anticoagulation) therapy before stroke.Both the nvAF time course and the antithrombotic strategy were significantly different between post-AF stroke/TIA group and non-postAF stroke/TIA group(both P＜0.05).The difference was reflected in ratios of antiplatelet therapy/anticoagulation therapy.The proportion of anticoagulation therapy was higher in non stroke/TIA group(x2 =5.778,P =0.016).Different antiplatelet therapy scheme significantly affected occurrence of stroke/TIA(P＜0.05).There was no significant effect of antithrombotic schemes on hemorrhagic events(x2=0.708,P =0.702).Multiple logistic regression analysis showed that hypertension,coronary heart disease,cancer,diabetes and previous stroke history,as well as nvAF duration were the independent risk factors for post-AF stroke/TIA(OR=1.351,95 ％CI:1.129-1.617).Conclusions Currently,the proportion using anticoagulation therapy is low,and single antiplatelet therapy is the main regimen in the elderly patients with nvAF.For elderly patients with nvAF,anticoagulation therapy has a protective effect against the occurrence of post-nvAF stroke/TIA,meanwhile there is no significantly increased risk of bleeding,which makes anticoagulation therapy advisable in the elderly.The nvAF time course is one of the risk factors,which is worth experts' attention in risk evaluation of thrombus in elderly patients.

Child ; Child, Preschool ; Female ; Flow Cytometry ; methods ; Humans ; Infant ; Male ; Thrombasthenia ; classification ; diagnosis

Objective To investigate diagnosis and surgical treatment of primary retroperitoneal malignarnt tumor.Methods Retrospectively analyzed the clinical data with primary retroperitoneal tumor.Results Twenty-eight eases with benign tumor and 47 cases with malignant tumor underwent total resection,only 17cases with malignant tumor underwent local resection.Conclusion The diagnosis B-ultrasonography,CT and MR of primary retroperitoneal tumor is very important for preparative of preoperation and to estimate of involved organ.Involved organ resection and repeated operation for recurred tumor improve cure rate.

Objective To study effect of drug treatment in polycystic ovary syndrome patients withhyperprolactinemia.Methods We retrospectively studied 63 women with polycystic ovary syndrome and hyperprolactinemia from the Reproductive Medicine Center,Provincial Hospital between January 2005 andMarch 2007.According to the beginning time of bromocriptine,all women were divided into two groups.Group Ⅰ was composed of 48 cases who received bromocriptine administration before induction of ovulation cycles,and the dose of bromocriptine was modulated depending on the level of serum prolactin.When serum prolactin was controlled at normal levels,we decreased the dosage of bromocriptine step by step(1.25 mgonce),and then continued the treatment at maintenance dosage for no less than 3 weeks.After a baselineultrasonographic examination on day 3,patients were treated with clomiphene citrate at a dosage of 100 mg (2 tablets/day)for 5 days of a normal cycle or progesterone-induced bleeding.On day 9,we monitored the growth conditions of follicles routinely with trans-vaginal uhrasound.If there was no dominant follicle,we added human menopausal hormone(hMG,75 U/d)to the protocol.Human chorionic gonadotropin(hCG,6000-10000 IU)was given intramuscularly when the mean diameter of a follicle reached at least 18 mm.At the same time we instructed the patients to have sexual intercourses or carried out artificial inseminationsbefore and after ovulation.Group Ⅱ were 15 cases in which induction of ovulations were commenced almostsimultaneously with beginning of bromocriptine.The same protocol was given to patients in group Ⅱ.The procedures of ovulation induction and the outcomes of treatment were analyzed and compared.Results Compared with groupⅡ.the days of using hMG in Group Ⅰ was shorter by instructing the time of sexualintercourse.The difference was significant(P=0.004).And there were similar results in the artificial insemination cycles(P=0.009).The rate of pregnancy in group Ⅰ(40%,19/48)was higher than that in groupⅡ(27%,4/15),but the difference was not obvious(P=0.525).Conclusion Bromocriptine administration before the stimulated ovulation therapy can decrease the total dosage and treatment course of ovulating drugs.Induction of ovulations simultaneously with start of bromocriptine therapy can shorten the treatment time of infertility.

Antigens, CD20 ; metabolism ; CD5 Antigens ; metabolism ; Colonic Neoplasms ; complications ; metabolism ; pathology ; surgery ; Cyclin D1 ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Ileal Diseases ; complications ; pathology ; surgery ; Ileocecal Valve ; Intestinal Neoplasms ; complications ; metabolism ; pathology ; surgery ; Intestinal Polyps ; complications ; metabolism ; pathology ; surgery ; Intussusception ; complications ; pathology ; surgery ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; pathology ; Lymphoma, Mantle-Cell ; complications ; metabolism ; pathology ; surgery ; Middle Aged

OBJECTIVETo explore the role and mechanism of oxidative inflammatory cascade in pancreatic fibrosis progression of chronic pancreatitis (CP) in mice induced by dibutyltin dichloride (DBTC) plus ethanol.

METHODSThirty-six KM mice were randomly divided into 2 groups (n = 18): control group and model group (DBTC combined with ethanol). The mice in model group were intravenously injected with DBTC (8 mg/kg) in tail vein and drink 10% ethanol. After modeling 2 weeks, 4 weeks and 8 weeks, the mice were anesthetized and sacrificed, the pathological changes and the degree of fibrosis in the pancreas were observed by HE and Masson staining, the F4/80 expression level were detected by immunohistochemistry, the content of superoxide dismutase (SOD), malondialdehyde(MDA) and myeloperoxidase (MPO) were measured in the pancreatic homogenates.

RESULTSThe fibroblasts and macrophages (f4/80 positive staining) could be seen obviously in pancreas of model group at 2 weeks. At 4 weeks and 8 weeks, macrophages infiltration increased and pancreatic tissue was substituted by the proliferation of fibrosis significantly. At every time-point, in pancreatic homogenates SOD was decreased, MDA and MPO markedly increased. There was significant differences between two groups (P < 0.05).

CONCLUSIONDBTC injection joint ethanol drinking can successfully establish the model of chronic pancreatitis and pancreatic fibrosis in mice. Oxidative inflammatory cascade plays an important role in the progression of pancreatic fibrosis.

Animals ; Disease Progression ; Ethanol ; adverse effects ; Fibrosis ; Immunohistochemistry ; Malondialdehyde ; metabolism ; Mice ; Organotin Compounds ; adverse effects ; Oxidative Stress ; Pancreas ; pathology ; Pancreatitis, Chronic ; chemically induced ; physiopathology ; Peroxidase ; metabolism ; Superoxide Dismutase ; metabolism

Investigation of simvastatin and its related substances was carried out using a reversed phase ultra performance liquid chromatography/tandem mass spectrometry method. The identification of impurities in simvastatin was performed with a triple-quadrupole mass spectrometer, with an electrospray ionization (ESI) source in the negative/positive ion mode. A total of 12 compounds were characterized in commercial samples, among which 2 impurities had never been reported. All the impurities were deduced based on the MS fragment pathways of simvastatin and the biosynthetic pathway of lovastatin. This work provides very useful information for quality control of simvastatin.
Chromatography, High Pressure Liquid ; Chromatography, Reverse-Phase ; Drug Contamination ; Hypolipidemic Agents ; chemistry ; Quality Control ; Simvastatin ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Tablets ; Tandem Mass Spectrometry

Objective To study the effect of traditional Chinese medicine on survival time in children solid tumors with chemotherapy. Methods 76 children with solid tumors, which were collected from January 2005 to March 2006, were randomly divided into treatment group (35 cases), control group (41 cases). The treatment group was treated with chemotherapy + self-dispensing Fuzheng Jianpi Chinese medicine. The control group was treated with chemotherapy alone. Results The survival rate of the treatment group was higher than that of the control group, the difference was statistically significant (P = 0.0024). The average survival time after chemotherapy in the treatment group was (31± 2) months (95 % CI 27-34 months), the control group was (21±2) months (95 % CI 16-25 months), which was shorter than the treatment group.Conclusion Chinese medicine and chemotherapy can prolong the survival time of children with solid tumors.

?AIM: To study the association of the single nucleotide polymorphism ( SNP) rs1157699 in the calcitonin receptor-like receptor ( CRLR ) gene with primary angle closure ( PAC) in a Han Chinese population.?METHODS: All samples, involved 232 PAC cases and 306 controls, were obtained from an epidemiologic survey conducted in Funing, Jiangsu Province, China. Genotyping were carried out by TaqMan-MGB probe using the real time quantitative polymerase chain reaction system to study the relationship between SNP of rs1157699 in CRLR gene and PAC.?RESULTS: The prevalence of CRLRrs1157699 genotype was 67.4%, 30.0%, 2.6% for CC, CT, TT in cases, and 71.3%, 27.0%, 1.7% in controls respectively.There was no difference between the two groups in the distribution of genotype and allele frequencies of rs1157699 (P>0.05).?CONCLUSION:Our results do not support a significant role for rs1157699 in CRLR with PAC.