Objective To explore the significance of combining coagulation with bedside index for severity in acute pancreatitis (BISAP) scores in evaluation of severity of acute pancreatitis (AP).Methods One hundred and twenty-six patients with AP were diagnosed according to the AP:mild acute pancreatitis (MAP) group of 64 cases,severe acute pancreatitis (SAP) group of 62 cases,and selected 60 healthy persons as control group.AP patients BISAP scores were calculated in 24 h from admission,and the activity of partial thromboplastic time (AFTT),prothrombin time (PT),D-dimer and fibrinogen (FIB) were measured the next morning or after 8 h of fasting peripheral venous blood collected 3 ml.Results There was no significant difference in APTT,PT among three groups (P＞ 0.05).FIB and D-dimer in MAP group and SAP group were significantly higher than those in control group [(4.25 ± 1.01),(5.44 ± 2.19) g/L vs.(3.47 ± 0.49) g/L; (5.08 ± 3.20),(8.65 ± 6.43) mg/L vs.(3.41 ± 2.32) mg/L,P ＜ 0.05],SAP group was significantly higher than that in MAP group(P ＜ 0.05).The positive rate of D-dimer in MAP group was significantly lower than that in SAP group [26.6％(17/64) vs.85.5％ (53/62),P ＜0.01].BISAP scores and combining coagulation with BISAP scores predict the severity of AP AUC were 0.842(0.775-0.889),0.886 (0.839-0.925),there was no statistically significant difference (P ＞0.05).Conclusion The significance of combining coagulation with BISAP scores in the severity of AP is more accurate than only use BISAP scores,and will not increase the clinical application difficulty.

[Objective]To evaluate the effect of massive bioactive bone substitute in repairing large animals bone defect and to know its degrading rate.[Method]The massive Polylevolactic acid?collage calcium phosphate(PLLA?cTCP) carrieres by rapid forming technology was making,and then compounding rhBMP-2 and carrieres in a ratio of 3mg rhBMP-2 to one carrier was compounded to prepare the massive bioactive bone substitutes for dogs bone defect.Then the massive bone substitutes were implanted into 2.0cm dogss radius defects in the experiment group,and the massive carriers were implanted into in the control group.The repairing effect was evaluated by radiography,histology and biomechanics,and the degrading rate of the substitues was calculated in an image analysis apparatus.[Result]Radiographically,in the experiment group,the defects were connected by callus in all dogs in 12 weeks postoperatively;in 24 weeks,the callus rebuilt well.But in the control group,there was no callus formed in 24 weeks postoperatively,and the defects were not repaired.Histologically,in 12 weeks postoperatively,the outer layer of the callus in the experiment groups was lamellar bone and the center were trabecular bone,myeloid tissue and partial degrading carrier;in 24 weeks,the lamellar bone was more compact,trabecular bone decreased,myeloid tissue increased,and the carrier degraded more.In the control group,in 12 weeks postoperatively,the fibrous tissue wrapped and infiltrated into carrier,at the same time,part of the carrier degraded;in 24 weeks,the carrier was divided up by fibrous tissue and degraded more.The degrading rate of the carder in 12 weeks in the experiment group was 43.2%,in the control group was 35.7%,in 24 weeks 58.4% and 45.4%.Biomechanics,in 24 weeks after postoperation,the radius strength in the experiment group was superior to that in the normal bone.[Conclusion]The massive bioactive bone substitutes have satisfactory repairing effect on the radius bone defects of the large animal,but its degrading rate needs improving.

Objective: To evaluate the biocompatibility of self made nitinol alloy ventricular septal defect occluder. Methods: Six nitinol alloy ventricular septal defect occluder were implanted in the ventricular septum by catheter in 6 normal anaesthetized open chest pigs, and the animals were observed for 45 to 120 d(2 animals). Results: One deaths resulted from hemorrhage and another from embolization of occluder in abdominal aorta during the placement procedure. Successful placement of the occluder was achieved in 4 animals. Four animals were killed at 45, 60 and 120 d. Postmortem gross and microscopic examination of 4 devices 45 to 120 d after placement showed that both the right and left ventricular discs of the occluder were completely covered by a smooth, shiny, glistening thin layer of neoendocardium, and the surface of neoendocardium was covered by a monolayer of endothelium like cells. The inflammatory infiltrate around the occluder was found at 45 d, and disappeared and fibrosis formed at 120 d. These appeared as a repair process of the injury. Embolization in lung,liver, spleen, kidney, intestinal and colon were not found. Conclusion: These suggest that the self made nitinol alloy ventricular septal defect occluder has good biocompatibility. [

Aim To study the adaptive protection of H_2O_2 preconditioning against dopamine-induced damage in PC12 cells.Methods The apoptosis of PC12 cells was observed by electron microscope, PI stain flow cytometry (FCM) and Hoechst stain. The mitochondrial energy redox state was measured by MTT assay. The mitochondrial membrane potential(△?m) was investigated by the fluorescent probe of rhodamine 123.Results PC12 cells exposed to 50 ?mol?L -1 DA showed chromatin condensation and nucleus fragmentation observed by electron microscope. Exposure to DA (50 ?mol?L -1) for 24 h, the apoptosis of PC12 cells preconditioned by 10 ?mol?L -1 H_2O_2 for 90 min as measured by Hoechst stain was significantly decreased,compared with no-preconditioned cells. Exposure to 50,100,and 200 ?mol?L -1 H_2O_2 for 24 h, the proportion of apoptosis of PC12 cells was decreased from (20.9?1.8)%, (40.5?6.4)% and (88.1?3.9)% to (4.9?2.9)%, (12.0?1.4)%, (61.5?3.4)% after H_2O_2 preconditioning, respectively. By exposuring PC12 cells to 20,40,and 80 ?mol?L -1 DA for 24 h, the rates of MTT metabolism were reduced and the effect was prevented by H_2O_2 preconditioning. After 50 ?mol?L -1 DA exposure for 24 h,the mean fluorescence intensity of rhodamine 123 in no-preconditioned PC12 cells was decreased from (46.87?0.33) to (4.39?2.93),and that of preconditioned PC12 cells was decreased from (46.87?0.33) to (10.50?0.28). Conclusion H_2O_2 preconditioning possesses adaptive protection against dopamine-induced damage in PC12 cells.

Objective To develope a new method producing ventricular septal defect (VSD) model by transcatheter puncture and evaluate its feasibility and practicability. Methods Ten dogs underwent transcatheter ventricular septal puncture with Brockenbrough puncture needle via right jungular vein under fluoroscopy, and then dilated the defect with 6-8mm balloon catheter. Left ventricular (LV) angiography was performed with pigtail catheter by transaortic access after puncture. Right after the procedure and 1-4 months later, the dogs were sacrificed and the defects were inspected. Results VSDs were successfully made in 8 dogs, which were demonstrated by LV angiography with one defect at membranous part. The defects in other dogs were shown near membranous septum or muscular septum not far away from the membranous part. The distance from aortic valves to the rims of defect was 4-16mm, from tricuspid valves 4-10mm. Ⅲ?AVB was found in 1 dog which died 1 week later, with ruptured membranous part at autopsy. CRBBB was found in another dog. Conclusion Establishment of VSD animal by transcatheter puncture is feasible, practicable and of high successful rate and less complication.

Objective To explore the novel method to establish animal model of controllable sized atrial septal defect. Methods Fourteen dogs of both sexes were selected,with weight ranging from 15 to 20kg. Under guidance of fluoroscopy,ASD was established by using Brokenbrough needle and balloon dilatation. Results Tow dogs died of cardiac tamponade.Other twelve dogs had ASD created successfully without complication. Conclusion The method has the advantages of easy manipulation , size controllable and small amount of fluoroscopy exposure.

Objective To evaluate the methods of electrophysiological study (EPS) and radiofrequency catheter ablation (RFCA) for atrial tachycardia (AT) and the efficacy of RFCA. Methods Thirty-nine patients with AT were selected to undergo EPS and RFCA. The mean illness course was (4.5?1.6) years. Two patients had atrial septal defect, one had coronary artery disease, one dermatomyositis, and the other 35 patients had no structural heart disease. Identification of the earliest endocardial atrial activity (EAA) was based on the activation mapping recorded during AT. Results AT was induced spontaneously by atrial premature beats in 3 patients, and all other AT was inducible by atrial stimulation. Nine patients had other types of tachycardia combining with AT (including 5 patients with atrioventricular nodal reentrant tachycardia, 2 with atrial flutter and 2 accessory pathway). The site of AT was located by recording the EAA during AT and the region of successful FRCA. In 33 patients of successful ablation, the sites of AT were 9 near coronary sinus orifice, 5 near His bundle, 13 in right atrial lateral wall along crista terminalis, 2 in superior vena cava, 3 in atrial septum and 1 in right pulmonary vein. The successful rate was 81% (33/39) with all success of 9 other tachycardia. The mean fluoroscopic time was (16.4?2.1) minutes. None of patients had complications during and after ablation. Conclusions RFCA is an effective and safe treatment for AT. The activation mapping is the most effective method. Atrial septum and crista terminalis are the most common sites of AT.

Ablation Techniques ; adverse effects ; Animals ; Bone and Bones ; pathology ; Disease Models, Animal ; Extremities ; Swine

Objective To discuss the cause and treatment strategy for open laryngotracheal trauma.Methods The clinical data of 38 cases with open laryngotracheal trauma admitted from 1998 to 2012 were collected and analyzed.Of them,one patient died in emergency department despite energetic resuscitation,37 were hospitalized and given advanced treatment after life support measures in emergency department.They were treated with tracheotomy before or during operation.Of them,32 patients were regularly followed up for imaging studies.Result Except 1 patient died of exsanguination from carotid artery rupture,the other 37 survived after successful treatment.Twenty patients were treated with debridement and suture of the wounds and laryngoplasty (20/37,54.1％),8 patients were operated with laryngoplasty plus intraluminal stents implanted (8/37,21.6％) ; the rest 9 patients (9/37,24.3％) were separately given placement of nickel-titanium shape memory alloy stent (n =2),laryngofissure with rubber gloves throat models implanted and laryngoplasty (n =3),linear silicone tube implanted and laryngoplasty with trans-cervical approach (n =1) and tracheoesophageal fistula neoplasty with laryngoplasty and laryngofissure (n =3).The operated patients were followed-up for 0.5 to 3 years after discharge.Of them,35 patients (35/37,94.6％) had successful decannulation,breathing smoothly and swallowing normally,23 patients (23/37,62.2％) had almost normal pronunciation,12 patients (12/37,32.4％) had different degrees in hoarseness of voice,and 2 patients (2/37,5.4％) were referred to other hospital because of failure in extubation with severe stenosis of laryngotrachea.Conclusions When the patients with open laryngotracheal trauma were treated,the essential strategy was to prevent shock,hemorrhage,and asphyxia.In the case of patent respiratory tract and stable vital signs,laryngotracheal reconstruction should be carried out as soon as possible to prevent complications,thereby obtaining good therapeutic effect.

BACKGROUND:Recombinant human epidermal growth factor has been shown to promote granulation tissue formation and to accelerate the healing of burn wounds, but the antibacterial effect of recombinant human epidermal growth factor is limited. OBJECTIVE:To investigate the effect of nano-silver dressing combined with recombinant human epidermal growth factor gel in treatment of burns and the influence on the scar. METHODS:A total of 76 cases of shal ow II and depth II degree were randomly enrol ed and assigned to two groups. In the study group, recombinant human epidermal growth factor was coated on the surface of the wound, and then covered by nano-silver dressing. In the control group, recombinant human epidermal growth factor was coated on the surface of the wound, and covered by ordinary sterile gauze. The healing time, the positive rate of bacteria, scarring and adverse reactions were compared between the two groups. RESULTS AND CONCLUSION:The wound healing time and the rate of hypertrophic scars after healing were lower in the study group than in the control group (P<0.01). The rate of flat scar was greater in the study group than in the control group after healing (P<0.01). The bacterial positive rate was significantly lower in the study group than in the control group at 7, 14 and 21 days after treatment (P<0.05). No significant difference in incidence of al ergies and local burning sensation was detected between the two groups (P>0.05). These data confirmed that recombinant human epidermal growth factor gel combined with nano-silver dressing in the treatment of burn has good efficacy and accelerates the wound healing, reduces scar formation, and improves aesthetics.