The incidence of intra-abdominal infection increases annually. The current management of intra-abdominal infection includes immediate resuscitation, prompt source control and appropriate usage of antibiotics. For patients with septic shock, fluid resuscitation should begin immediately when hypotension is present. Fluid resuscitation should be combined with vasoactive drugs. Damage control surgery promotes the development of ultrasound or CT guided percutaneous abscess drainage and open abdomen therapy. Rational use of anti-infective drugs could prevent prevalence of multiple antibiotics resistant bacteria and pan-resistant bacteria. The gut rehabilitation measures can improve the recovery of gut function and restore of enteral nutrition, and thus prevents bacterial translocation in intra-abdominal infection patients. Monitoring and modulations of immune function may further improve the successful rate of treatment of intra-abdominal infections. Non-thyroidal illness syndrome may develop in the severe intra-abdominal infection patients and should be promptly corrected.
Humans ; Intraabdominal Infections ; diagnosis ; therapy

Surgical site infection(SSI) is one of post-operative complications in gastrointestinal surgery. SSI may increase the morbidity and mortality of surgical patients and increase their hospital stay and expense. The risk factors can come from patients, physicians and hospital environments. Improving patients nutritional status and organ function, appropriate control of blood sugar level and abstinence from smoking can reduce the occurrence of SSI. Compare to current practice in China, the following recommendations have been identified as priorities for implementation: hair removal done immediately before operation; maintenance of normothermia intraoperatively; the abdominal wall should be closed with an absorbable suture and drains should be removed as early as possible. SSI could be diagnosed by symptoms, local signs and lab examinations and confirmed by physician. Source control is the key point in the management of SSI. Ultrasound and CT guided percutaneous abscess drainage is effective in the localized deep space surgical site infection and critically ill patients. Antibiotics should be used following clinical assessment and evidence based on local formulary.
Digestive System Surgical Procedures ; adverse effects ; Humans ; Infection Control ; Risk Factors ; Surgical Wound Infection ; diagnosis ; etiology ; prevention & control ; therapy

Objective To analysis the manifestation of primary gastric malignant lymphoma(PGL) under gastrointestinal barium meal(GIBM) and gastroscopy in order to increase preoperating diagnosis of PGL.Methods Values of gastrointestinal barium meal and gastroscopy were analyzed in diagnosing PGL.All PGL were verified by operation and pathology.Results Using GIBM preoperating diagnostic rate of PGL was 52 percent,including multituberculated type 8 cases,ulcerative type 4 cases,tumour type 3 cases,infiltrative type 3 cases,mixed type 7 cases;The gastroscopy preoperating diagnostic rate of PGL was 30.8 percent,including ulcerative type 7 cases,infiltrative type 4 cases,tumour type 5 cases,huge wrinkle type 6 cases,mixed type 4 cases.The barium meal combined with gastrscopy in diagnosing PGL was 71.4 percent.Conclusions Emphasizing the importance of PGL,deepgoing understanding to distinctive signs of PLG on X-ray and gastroscopy and a combined application of multiple diagnosing means might improve the diagnostic rate of PGL in preoperation.

Objective To study the clinical characteristics in elderly patients with colorectal carcinoma.Methods The clinical dafa of 76 cases of more than 70 years old with colorectal carcinoma were analyzed retrospectively. Results Among 76 elderly patients with colorectal carcinoma,64 cases( 84.2% ) suffered from common diseases in the elderly, such as hypertension, cardiac disease, diabetes ,lung of chronic disease et al. 27 patients had postoperative complications, and 3cases of them died from complications. The rate of postoperative complications in the elderly who had coexistent diseases was 39.1%. Conclusion The elderly patients with colorectal carcinoma frequently had blood hypertension. cardiac disease, diabetes. Strengthening the management of perioperation could improve the security of the operation and decrease the postoperative complications.

BACKGROUND:Systemic lupus erythematosus is a complex autoimmune disease of unknown origin affecting virtual y every organ in the human body. It is characterized by abnormal activation of T, B lymphocytes. While aberrant T cells provide help to autoreactive B cells, the autoreactive B cells produce a variety of pathological autoantibodies and immune complex deposition, which could infiltrate the smal blood vessels directly or deposit in the vessel wal , thereby causing inflammatory necrosis of the vessel wal s. These changes wil narrow the vascular lumen, and promote thrombosis, leading to local tissue ischemia and dysfunction. Mesenchymal stem cells can regulate the immune disorders, play an anti-inflammatory role, and repair the immune thrombosis.
OBJECTIVE:To summarize the pathogenesis of immune thrombosis in systemic lupus erythematosus, as wel as to introduce the mechanism of mesenchymal stem celltherapy for immunity thrombosis.
METHODS:We searched the PubMed database, Springlink database, ScienceDirect database and HighWire database from January 1990 to June 2013 with the key words of“systemic lupus erythematosus, mesenchymal stem cell, thrombosis, T cells, B cells”in English. An online search of CNKI database, Wanfang database, VIP database from January 1990 to June 2013 was also conducted with the key words of“systemic lupus erythematosus, mesenchymal stem cell, thrombosis, T cells, B cells”in Chinese. A total of 267 literatures were screened out, and 48 documents were included in the review based on the inclusion and exclusion criteria.
RESULTS AND CONCLUSION:Mesenchymal stem cells are multipotential nonhematopoietic progenitor cells capable of multi-directional differentiating into various celltypes. Mesenchymal stem cells can suppress T-lymphocyte activation and proliferation, and inhibit secretion of interferon-γ, interleukin-4. Mesenchymal stem cells can also inhibit the proliferation of B cells and the secretion of pathogenic immunoglobulin IgM, IgG, IgA. Thus, mesenchymal stem cells can regulate immune homeostasis and reduce the deposition of autoantibodies and immune complexes, thereby protecting the blood vessels from injury, reducing the secretion of inflammatory cytokines, balancing the coagulation-anticoagulation, and decreasing thrombosis in systemic lupus erythematosus.

Modern and international studies on new traditional Chinese medicines are the main trend of the development of traditional Chinese medicines at present. In Australia, new traditional Chinese medicines refer to complementary medicines, which are mainly registered and launched as listed medicines. The application documents of registered (listed) medicines in Australia mainly cover detailed description of active pharmaceutical ingredients, pharmacological and toxicological studies, dosage form and adverse effects. Each part has detailed specifications and instructions, which helps ensure that applicants could accurately understand the requirements in application for registering (listing) medicines, and provides very important reference to the studies and development of new traditional Chinese medicines in China.
Australia ; Drug Approval ; Drug Evaluation ; Medicine, Chinese Traditional

Traditional treatments of gastrointestinal fistula include early drainage, maintaining nutrition and then resection of fistula at the proper time,which usually take three to four months or even longer. Rapid treatments of gastrointestinal fistula mean promoting rapid spontaneous closure of tract fistula and early primary resection of fistula within two weeks after fistula occurrence. Early diagnosis is the premise of early management, and fistulography and abdominal CT scan are important early diagnostic methods. Most of fistula could close spontaneously in the maintaining stage. To promote the rapid closure, however, special measures including sufficient drainage, somatostatin and total parenteral nutrition in the early stage should be implemented to avoid intra-abdominal collection of intestinal fluid and infection, control further leakage of intestinal fluid and improve nutritional status. In the late stage,when leakage of intestinal fluid could be controlled, recombine human growth hormone (rhGH) and enteral nutrition should be administered in place of somatostatin and total parenteral nutrition respectively. The fistula can reach rapid spontaneous closure in both stages. Fibrin glue and rhGH used at the same time can improve the curative rate and shorten the treatment time even more. In the 1960s and 1970s, early primary resection of the fistula and re-anastomosis often resulted in anastomosis failure. The reasons for this included poor nutritional status, uncontrolled secretion of intestinal fluid, severe intra-abdominal infection and multiorgan dysfunction syndrome. Such stage management policy has been proposed, developed and persisted since late 1960s. Nowadays, the advance of medical science provided the possibility to change or improve the current policy. Our research proved that early resection of the primary fistula and re-anastomosis of the small bowel could be performed successfully in some selected patients whose general conditions are good and intestinal adhesion were not severe within ten to fourteen days after fistula occurrence. More studies are still needed to define the indications and contradictions for early resection of the primary gastrointestinal fistula, and prove the feasibility and rationality of rapid treatments of gastrointestinal fistula.
Early Diagnosis ; Humans ; Intestinal Fistula ; diagnosis ; therapy ; Parenteral Nutrition, Total

The association between psychogenic illness and human endogenous viruses (HEVs), including human endogenous retrovirus and Borna disease virus, remains unclear. As the component of human genome, HEVs may become the joint of various pathogenic factors of schizophrenia (SZ), such as heredity, environment, and immunity. In this review, we strive to uncover the clinical and laboratory evidence for the roles and possible pathogenic mechanism of HEVs in the development of SZ.
Animals ; Environment ; Humans ; Schizophrenia ; etiology ; genetics ; immunology ; virology ; Viruses ; genetics

The idiopathic macular hole ( lMH ) is research priority associated with the regenerate quickly of vitrectomy. The unaided visual acuity and the best corrected visual acuity is partial for the visual acuity of the patient with lMH. The mechanism and clinical significance of modern visual function measurements associated with lMH, including contrast sensitivity, visual field, multifocal electroretinogram, and stereoscopic vision, have been introduced. These measurements could be of great value in early diagnosis of lMH, assessment of surgical indication and evaluation of visual performance after vitrectomy. They would also be helpful to the analysis of postoperative impaired visual function and its management. Having an adequate understanding of the contents and significance of visual function is helpful to the improvement of lMH surgery techniques and postoperative visual acuity.

OBJECTIVETo discuss that pathogenesis evolvement regularity of Chinese miniature swine with phlege-stasis cementation syndrome of coronary heart disease.

METHODEighteen Chinese miniature swine were randomly divided to the normal control group, the model group and the Danlou tablet group, with six swine in each group. Except for the normal control group, all of the other groups were fed with high fat diet for two weeks. The coronary heart disease model with phlegm-stasis cementation syndrome was established by injuring left anterior descending artery with interventional balloons and continuously feeding with high fat diet for eight weeks. The levels of BMI, hemorheological parameters, lipids in serum and inflammatory cytokines were observed at the 0th (before the experiment), 2nd (before operation or drug administration), 6th (four weeks after drug administration) and 10th week (eight weeks after drug administration) of study. The levels of TG and TC in liver and the pathological changes in coronary artery tissues were also observed at the end of study.

RESULTCompared with the normal control group, the model group had showed significant increase in the levels of TC, TG, LDL-C and VLDL-C in serum (P < 0.01) from the second week to the end of the experiment, with notable rise in the whole blood viscosity under the shear rates of 5 s(-1) and 60 s(-1). At the 6th week, the levels of BMI and TG and TNF-alpha in serum significantly increased. At the 10th week, the levels of BMI and hs-CRP, IL-6 and TNF-alpha in serum significantly increased as well, with remarkable increase in coronary stenosis, intimal thickness and the ratio between intimal thickness and media thickness (P < 0.05 and P < 0.01), and significant rise in TC and TG in livers (P < 0.01). Compared with the model group, the Danlou tablet group showed obvious reduction in severity of coronary artery lesion, intimal thickness and lumen stenosis ratio and ratio between intimal thickness and media thickness (P < 0.01), BMI, TC, TG, LDL-C and VLDL-C in serum, TC and TG in liver, as well as hs-CRP, IL-6 and TNF-alpha levels in serum (P < 0.05 and P < 0.01), with notable decline in the whole blood viscosity under the shear rates of 5 s(-1) and 60 s(-1).

CONCLUSIONThe interaction of phlegm, blood stasis and toxin syndromes helps promote the progress and development of AS plaques, which is the key pathogenesis of phlegm-stasis cementation syndrome in coronary heart disease.

Animals ; Body Weight ; Coronary Disease ; blood ; physiopathology ; Female ; Hemodynamics ; Inflammation Mediators ; metabolism ; Lipids ; blood ; Liver ; metabolism ; Male ; Medicine, Chinese Traditional ; Swine ; Swine, Miniature