Objective To compare enteral nutrition (EN) and total parenteral nutrition (TPN) in the treatment of severe acute pancreatitis(SAP) elucidate the advantage of EN. Methods Fifty-nine patients were assigned to TPN and EN groups. The nutritional index was detected, and the therapeutic efficacy was reviewed comparetively. Results After giving the nutritional support, the serum contents of albumin, pre-albumin, transferrin and beamoglobin were increased obviously (P < 0.05);and prealbumin, transferrin had statistical difference between the TPN and EN groups(P <0.05). APACHE Ⅱ score was lowered significant-ly in the EN group, comparing with the TPN group (P <0.05). In the EN group, complications, infection rate, food intake time, and hospitalization costs were significantly lower compared with the TPN group(P< 0.05), although mortality rate, hospital stay days had no statistical significance (P > 0.05). Conclusion EN is on ideal modality of nutrition support in SAP patients, which has many advantages in improving nu-tritional status, preserving gut mucosa barrier, decreasing bacterium and toxin shifting, regulating inflamma-tory and infective response, decreasing costs in the hospital.

0.05).Univariate analysis showed SOFA,APACHEII,CTSI,age and pancreatic infection were related to prognosis of SAP.Multivariate analysis revealed that only SOFA,APACHEII,CTSI were independent prognosis-related factors of SAP.Conclusions SOFA,APACHEII,CTSI all have good predictive ability for prognosis of SAP during dynamic in-hospital observation,and combination of the three factors has greater ability for prognosis of outcome of SAP.

Objective To apply electrical impedance tnmography that is a new evaluation ap-proach to monitor the development of retroperitoneal injury. We used retroperitoneal inject blood model in pigs to study the feasibility on monitoring retroperitoneal bleeding and to provide premise in theory and practice for clinical application. Methods Five pigs were used on the experiment. We insert a vessel into the retroperitoneal and inject blood to simulate retroperitoneal bleeding. Sixteen electrodes were atta-ched on the abdominal region circumference of pigs and used for electrical current injection and surface voltage measurement. Then the monitoring images were performed by electrical impedance tomography. Results The images of electrical impedance tomography retroperitoneal inject blood model of five pigs were clear, the minimal impedance scale was decreasing significantly as the bleeding volume increasing and the images were changed significantly too. The computerized tomography and the dissecting results confirmed the blood was limited in retroperitoneal. Conclusions The establishments of pigs retroper-itoneal inject blood model was successful. The images of electrical impedance tomography retroperitoneal inject blood model were clear with significant contrast. It's feasible to use electrical impedance tomography system to monitor the retroperitoneal bleeding. This technique may become a useful tool for monitoring ret-roperitoneal injury in intensive care patients.

Objective To evaluate the safety and clinical efficacy of the treatment for symptomatic uterine fibroids with MR guided focused ultrasound surgery(MRgFUS)in China. Methods Twenty five selected patients with symptomatic uterine fibroids underwent MRgFUS treatment in our perspective clinical study. Immediately after treatment the patients accepted pelvic enhanced MRI scans, and recorded the non-perfused volume(NPV)and calculated the non-perfused volume ratio(NPV%). We recorded the symptom severity score(SSS) and standard SSS change(ΔSSS)of the patients before, during and 1 week after treatment together with 1, 3, 6, 12 months and several years follow-up. The patients accepted pelvic enhanced MRI scans in the follow-up of 12 months after treatment,and recorded the volume and the volume change(ΔV) of fibroids. We observed the adverse reactions during the treatment and the follow-ups. Wilcoxon test or t test and Pearson or Spearman correlation analysis were used to analyze the data. Results Totally 31 fibroids of 25 patients were completed the treatment. Twenty two patients completed the 12 months follow-up and 15 patients completed the long-term follow-up which was during 34 to 66 months, median follow-up duration was(55 ± 11)months. The NPV was 4.5 to 295.0 cm3, median was 37.0 cm3. The NPV%was 6%to 94%, average was(64 ± 23)%. According to our follow up, the standard SSS continued to decline. Compared with screening standard SSS, all the follow-up standard SSS had significant difference(P<0.05), except for that of the first week. Among all the follow up, only the standard SSS change of 1 week after the treatment had a correlation with NPV%(r=0.552,P=0.005), and the others had no significant correlation with NPV%(P>0.05). The uterine fibroids volume decreased in the 12 months follow-up, which had a significant difference with the volume before treatment(P<0.05). And there was also correlation between the fibroids volume change and NPV(r=0.587,P=0.017). There was no correlation between the volume or volume change and standard SSS or standard SSS change(all P>0.05). None serious adverse effects occurred in all cases. Conclusion MRgFUS is a safe and effective way to treat uterine fibroids.

OBJECTIVE: To compare the outcome of mini-tract vs standard-tract percutaneous nephrolithotomy (PCNL) in staghorn calculi. METHODS: Between May 2009 and May 2011, 122 patients with renal staghorn calculi were treated by PCNL. Fifty-six patients underwent mini-PCNL and the others underwent standard-PCNL. The therapeutic effect and complication of the 2 groups were compared. RESULTS: The two groups had comparable demographic conditions. Although the operation time was significantly longer in mini-PCNL group [(126±24.5) min vs (98±18.9) min], there was no striking difference in hospital stay [(5.7±1.3) d vs (5.3±1.1) d], hemoglobin drop [(9.5±3.2) g/L vs (10.5±3.3) g/L], stone-free state before charge (91.1% vs 89.4%) and complications. CONCLUSION The efficacy and safety of mini-PCNL and standard-PCNL are not significantly different.
Adult ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Miniaturization ; Nephrostomy, Percutaneous ; methods ; Postoperative Complications ; etiology ; Retrospective Studies

Objective: To conduct a systematic review and meta-analysis of studies evaluating the oncological and fertility outcomes of early-stage endometrial cancer (EC) treated with the levonorgestrel-releasing intrauterine system (LIUS)-based regimens. Methods: The Meta-analyses Of Observational Studies in Epidemiology statement for meta-analyses was followed. Searches were conducted on MEDLINE, Embase, PubMed, Preprints, and the Cochrane Central Register of Controlled Trials from January 1990 to August 4, 2022. The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment. The primary endpoint was the complete response (CR) rate and the secondary endpoints were relapse, pregnancy, and live birth rate. Results: A total of 25 studies (821 women) were included. The CR rate of LIUS-based regimens was 63.4% (95% confidence interval [CI]=52.3%–73.2%), with 29.6% (95% CI=23.3%–36.8%) of cases experiencing recurrence during follow-up. In sensitivity analyses, patients younger than 45 years of age with a body mass index <30 kg/m2 who were treated with LIUS-based regimens achieved a high CR rate of 84.6% (95% CI=80.3%–88.1%) over a median follow-up of more than 24 months. Overall pregnancy and live birth rates were 37.9% (95% CI=24.1%–53.9%) and 39.3% (95% CI=24.0%–57.0%), respectively. No statistical differences were apparent in CR or relapse rates among the LIUS+GnRH agonist, LIUS+oral progesterone, or hysteroscopic resection followed by LIUS subgroups. Conclusion LIUS-based therapies are viable for the conservative management of early-stage endometrioid EC on CR and fertility outcome.

Objective: To develop a high efficient expression, purification system of recombinant arginine deiminase(ADI).Methods: cDNA fragment encoding for mycoplasma ADI was obtained by artificial synthesis and was cloned into prokaryotic expression vector(pBV220). The recombinant ADI was generated by the transformation of the recombinant vector into the host strain DH5?. Anion exchange and gel filtration chromatography was carried out for purification of the recombinant ADI. The biological activity of final product was detected by the assay of agrinine degradation in vitro. Results: A prokaryotic expression plasmid pBV220-ADI was generated successfully, and was identified by DNA sequencing; the recombinant protein was highly expressed in DH5?, the proportion of the recombinant protein is exceeded 35% of the whole protein. The inclusion bodies were solubilized with 6mol/L guanidine hydrochloride under reducing conditions in order to avoid incorrect disulfide-bond formation of the recombinant ADI molecules. Dilution and dialysis at lower degrees temperature were the optimum renaturation methods. After gel filtration, the purity and specific activity of rADI reached 95% and 80 IU/mg respectively. Conclusions: A set of protocols for high efficient rADI expression and purification has been established, which is simple, efficient and applicable.

Objective: This study aims to analyze factors associated with lymphovascular space invasion (LVSI) and evaluate the prognostic significance of LVSI in Chinese endometrioid endometrial cancer (EEC) patients. Methods: Five-hundred eighty-four EEC patients undergoing surgery in our center from 2006 to 2016 were selected for analysis. Univariate analysis and multivariate logistic regression were used to examine relevant factors of LVSI. To evaluate the prognostic role of LVSI, survival analyses were conducted. In survival analyses, both multivariate Cox regression and propensity score matching were used to control the confounders. Results: The incidence of LVSI was 12.16% (71/584). Diabetes history (p=0.021), lymph node metastasis (p=0.005), deep myometrial invasion (p<0.001) and negative PR expression (p=0.007) were independently associated with LVSI. Both Kaplan-Meier method and univariate Cox regressions showed LVSI negative and positive cases had similar tumor-specific survival (TSS) and disease-free survival (DFS). After adjusting for the influence of adjuvant therapy and other clinicopathological factors with multivariate Cox regressions, LVSI still could not bring additional survival risk to the patients (p=0.280 and p=0.650 for TSS and DFS, respectively). This result was verified by Kaplan-Meier survival analyses after propensity score matching (p=0.234 and p=0.765 for TSS and DFS, respectively). Conclusion LVSI does not significantly compromise the survival outcome of Chinese EEC patients.

Bile reflux is a common physiological phenomenon in the body,which is caused by the retrograde movement of bile into the stomach and above.Long-term bile reflux causes bile reflux gastritis.It can also lead to intestinal metaplasia,Barrett's esophagus,and even gastric cancer,esophageal cancer,pharyngeal cancer risk factors.Therefore,long-term frequent bile reflux should be regarded as pathological bile reflux.bile reflux is divided into primary bile reflux and secondary bile reflux.The common clinical symptoms of bile reflux include abdominal distension,bitter mouth,upper abdominal pain,nausea and vomiting.Primary bile reflux can occur without transgastric surgery,whereas secondary bile reflux often occurs after gastrointestinal surgery.This article reviews the pathogenesis,diagnosis and corresponding treatment progress of bile reflux,so as to provide reference for further research on bile reflux.

Objective To analyze the correlation between acute coronary syndrome (ACS) and stress differentiation factors (GDF-15), catecholamines, and heat shock proteins (HSP-70). Methods A total of 40 patients with ACS were selected from the Emergency Department of the PLA General Hospital from September 10, 2016 to October 10, 2016. 40 healthy volunteers were selected as the control group. The information of age, gender, history of smoking, drinking, hyperlipidemia, hypertension and diabetes. Inspection indicators of blood biochemistry (Creation kinase Isoenzyme, Total cholesterol, Triglyceride, High-density lipoprotein, Blood glucose, Total bilirubin, Direct bilirubin), serum level of GDF-15, catecholamine (Adrenaline,norepinephrine,dopamine)and HSP-70 were collected. Evaluation of Coronary Stenosis used with Coronary Artery Lesions and Gensini Score. Statistical analysis using SPSS 17.0 statistical software, measurement data are expressed as mean ± standard deviation (x±s),count data to the number of cases and percentage, measurement using t test, count data using chisquare test. Results Serum levels of GDF-15[(21.94±14.23) vs. (7.06±5.53), P=0.007],catecholami ne[(46592.15±30931.27) vs. (5507.14±2083.28), P<0.01], HSP-70 [(369.56±300.44) vs. (07.76±54.23),P<0.001],all higher than the control group. GDF-15 serum levels of Gensini scores> 40 compare with <20group was significantly higher [(324.27 ± 198.81) vs. (77.43 ± 699.22), P=0.035], serum catecholaminelevels of > 40 group compare with <20 group significantly increased [(18.71 ± 7.32) vs. (18.6±46.1),P=0.017], GDF-15 levels were significantly higher in the multi-vessel stenosis group than in the doublevessel stenosis group[ (618.40±434.42) vs. (292.07±219.65), P=0.033]. Conclusions GDF-15,catecholamine and HSP-70 are correlated with ACS, as well as the severity of coronary artery lesions.