Objective To discuss the nonoperative management strategy to prevent the conversion of acute pancreatitis to the severe form.Methods In recent 4 years,286 patients with mild acute pancreatitis admitted to our hospital were divided into control group and treatment observation group;routine conservative management was performed in control group,and the strategy of improving pancreatic microcirculation and preventing cell Ca~2+ overload and inhibiting pancreatic protease was added to the treatment observation group.Results Among the 144 patients with mild acute pancreatitis in control group,conversion to severe acute pancreatitis occurred in 20 patients,and 14 of the 20 patients with severe acute pancreatitis developed systemic complications.Among the 142 cases in treatment observation group,the conversion of mild to severe acute pancreatitis occurred in 8 patients,and 2 of the 8 patients developed systemic complications.Serum C-reactive protein levels and Balthazar CT severity index were significantly decreased at each time point in treatment observation group compared to control group.Conclusions In addition to routine management,improving pancreatic microcirculation,preventing cell Ca~2+ overload and inhibiting pancreatic protease might serve as a benificial strategy for preventing the progression of mild acute pancreatitis to the severe form.

Humans ; Enhanced Recovery After Surgery ; Stomach Neoplasms/surgery* ; Length of Stay ; Laparoscopy ; Postoperative Complications ; Gastrectomy

Actins ; metabolism ; Adult ; Antigens, Neoplasm ; metabolism ; Diagnosis, Differential ; Epithelioid Cells ; chemistry ; pathology ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Melanoma-Specific Antigens ; Mesenchymoma ; metabolism ; pathology ; surgery ; Neoplasm Proteins ; metabolism ; Uterine Neoplasms ; metabolism ; pathology ; surgery

BACKGROUND: Nucleotide-binding oligomerization domain (NOD)-like receptor plays an important role against inflammatory responses caused by pathogens and non-pathogens, as well as in the initial stage of autoimmune response. Meanwhile, NOD2 and NOD-like receptor protein 3 (NLRP3) are the representative proteins of NOD-like receptor family. OBJECTIVE: To detect the expression of NOD2 and NLRP3 in a rabbit model of osteoarthritis. METHODS: Thirty New Zealand rabbits were randomly divided into six groups (n=5 per group), including five experimental groups (2, 4, 6, 8 and 10 weeks) and one control group. The model of osteoarthritis was established by fixing the left knee joints using plaster cast, and were sacrificed at postoperative 2, 4, 6, 8 and 10 weeks. The controls received no intervention, and were killed at 10 weeks postoperatively. The left distal femur articular cartilage was taken for safranin-fast green staining. The pathological changes were evaluated by Mankin's scores, and the expression levels of NOD2 and NLRP3 were detected by immunohistochemistry. RESULTS AND CONCLUSION: The Mankin's scores in the experimental groups were significantly higher than those in the control group (P <0.01). Moreover, the scores in the experimental groups were significantly increased with time (P < 0.01). The expression levels of NOD2 and NLRP3 in the chondrocytes were also increased with time (P < 0.01). These results indicate that the expresison of NOD2 and NLRP3 in the cartilage cells is positively correlated with the pathological changes of osteoarthritis, which may be through promoting apoptosis in cartilage cells, thus accelerating the development of osteoarthritis.

Objective investigate the analgesic effect of dexmedetomidine combined with remifentanil in patients with mechanical ventilation after ICU surgery. Methods 120 patients with ICU underwent mechanical ventilation were divided into control group (propofol combined remifentanil) and observation group (dexmedetomidine remifentanil) according to the random number table method, 60 cases each group. Record the two groups of total sedation time, withdrawal time after the withdrawal, analgesic effect, adverse reactions. Results The scores of SAS score and CPOT were (3.98±0.52) and (2.23±1.04), respectively, which were significantly lower than those in the control group (4.36±0.96) and (3.46±2.23), respectively (P<0.05). (691.28±236.58) min and (1.22±0.05) min were significantly shorter than those in the control group (2642.33±341.58) min, (3.56±0.74) min, P<0.05, respectively. The adverse reaction rate was 3.33% (2/60) in the observation group, which was significantly lower than that in the control group (13.33%, 8/60),( χ2=3.92, P=0.04). Conclusion ICU postoperative mechanical ventilation patients with dexmedetomidine combined with remifentanil has a good analgesic effect, and is conducive to the patient wake up, less adverse reactions, with a certain safety.

BACKGROUNDChronic intermittent hypoxia (CIH) is the most important pathophysiologic feature of sleep apnea syndrome (SAS). To explore the relationship between SAS and dementia, the effects of CIH on the expression of Nip3, neuron apoptosis and beta-amyloid protein deposit in the brain cortex of the frontal lobe of mice were evaluated in this study.

METHODSThirty male ICR mice were divided into four groups: control group (A, n = 10, sham hypoxia/reoxygenation), 2 weeks CIH group (B, n = 5), 4 weeks CIH group (C, n = 5), and 8 weeks CIH group (D, n = 10). The ICR mice were placed in a chamber and exposed to intermittent hypoxia (oxygen concentration changed periodically from (21.72 +/- 0.55)% to (6.84 +/- 0.47)% every two minutes, eight hours per day). Neuron apoptosis of the cortex of the frontal lobe was detected by means of terminal deoxy-nucleotidyl transferase-mediated in situ end labeling (TUNEL). Immunohistochemical staining was performed for measuring expression of Nip3 and beta-amyloid protein. The ultrastructure of neurons was observed under a transmission electron microscope.

RESULTSTUNEL positive neurons in each square millimeter in the cortex of the frontal lobe were categorized by median or Ri into group A (1, 5.5), group B (133, 13), group C (252, 21), and group D (318, 24). There were significant differences among the above four groups (P = 0.000). The significance test was performed between the control group and each CIH group respectively: group A and B (P > 0.05); group A and C (P < 0.01); and group A and D (P < 0.005). The number of apoptotic neurons kept increasing in the ICR mice under CIH condition, and reached the peak in the group D, but there was no significant difference between groups B and C, between groups B and D, and between groups C and D. Nip3 positive neurons in each square millimeter in the cortex of the frontal lobe in each group were calculated by median or Ri as follows: group A (2, 5.5), group B (117, 13), group C (227, 26.2), and group D (479, 21.4). There were significant differences among the four groups (P = 0.000). The statistical test was performed between the control group and each CIH group respectively: groups A and B (P > 0.05); groups A and C (P < 0.005); and groups A and D (P < 0.005). There was no significant difference between groups B and C, groups B and D, and groups C and D. The expression of Nip3 was closely correlated with neuron apoptosis in the brain (P < 0.05). The expression of beta-amyloid protein in the brain of mice was negative in all CIH groups and the control group. Ultrastructure observation showed karyopyknosis of nucleus, swelling of chondriosomes, deposit of lipofuscins and degeneration of neural sheath in all CIH groups but not in the control group.

CONCLUSIONThe results of this study indicate that CIH could up-regulate the expression of Nip3, and result in neuron apoptosis and ultrastructural changes in neurons of the frontal cortex.

Amyloid beta-Peptides ; metabolism ; Animals ; Apoptosis ; physiology ; Cerebral Cortex ; cytology ; metabolism ; ultrastructure ; Gene Expression Regulation ; Hypoxia ; physiopathology ; Immunohistochemistry ; In Situ Nick-End Labeling ; In Vitro Techniques ; Male ; Mice ; Mice, Inbred ICR ; Microscopy, Electron, Transmission ; Neurons ; cytology ; metabolism ; Proto-Oncogene Proteins ; metabolism

BACKGROUNDDilation resistance to stenting in non-calcified coronary plaques was compared in patients with percutaneous coronary intervention (PCI) in order to confirm the clinical usefulness of multislice computed tomography in examining coronary plaque type and to provide information pertaining to the effects of plaque type on dilatation resistance.

METHODSA retrospective analysis of 64-slice computed tomography coronary imaging data collected in the month prior to coronary stenting in 93 patients (65 male and 28 female, mean age of (57.22±7.22) years) was conducted. Non-calcified coronary plaques were divided into lipid-rich (lipid content >25% of plaque volume) and fibrous plaques according to the Hammer-Hansen S method: where lipids, fiber, and intraluminal components were indicated by contrast using Hu values of -100-49, 50-129, and >130, respectively. Clinical features, pre-dilatation balloon specifications and filling pressure, and stent size and release pressure were compared.

RESULTSHigh-sensitivity C-reactive protein levels were higher in the lipid-rich plaque group. In patients with typical symptoms, unstable angina was more commonly observed in the lipid-rich plaque group. No significant differences in low density lipoprotein, pre-dilatation balloon specifications, pre-dilatation pressure, or stent specifications were observed. Stent release pressure in the lipid-rich plaque group ((1130.16±202.04) kPa), was significantly lower than that observed in the fibrous plaque group ((1240.61±193.29) kPa, P = 0.009).

CONCLUSIONSofter, lipid-rich plaques exhibit lower dilation resistance during stenting in PCI patients.

C-Reactive Protein ; metabolism ; Coronary Angiography ; Coronary Artery Disease ; pathology ; surgery ; Female ; Humans ; Lipids ; physiology ; Male ; Middle Aged ; Multidetector Computed Tomography ; Percutaneous Coronary Intervention ; Plaque, Atherosclerotic ; pathology ; surgery ; Retrospective Studies

OBJECTIVETo approach the treatment efficiency of replication defective adenovirus carrying HSV-tk gene under control of the human telomerase reverse transcriptase (hTERT) promoter in a mouse xenografts model of prostate cancer.

METHODSIt was erected that the model of human prostate cancer in BALB/C nude mouse followed by locally injecting Ad-hTERT-HSV-tk and peritoneal injection of GCV. The anti-tumor efficacy was evaluated by index of tumor volume, tumor weight, relative tumor curative, and tumor growth curve. Afterwards, the TUNEL and transmission electron microscope to overview apoptosis of tumor cells were used. Finally, immunohistochemistry for detecting PCNA of tumor cells were applied.

RESULTSCompared with the control group, all viruses treatment groups demonstrated tumor growth inhibition. Among 3 treatment groups, antitumoral effect of Ad-hTERT-HSV-tk/GCV was much stronger than other two groups (P < 0.05). Obvious necrosis and apoptosis was observed by TUNEL, and PCNA was detected by immunohistochemistry in tumor tissues in all viruses treatment group.

CONCLUSIONSAd-hTERT-HSV-tk/GCV system is highly efficacious to inhabit the growth of human prostate cancer.

Adenoviridae ; enzymology ; genetics ; Animals ; Female ; Genetic Therapy ; methods ; Genetic Vectors ; administration & dosage ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Promoter Regions, Genetic ; genetics ; Prostatic Neoplasms ; pathology ; therapy ; Recombination, Genetic ; Telomerase ; genetics ; Thymidine Kinase ; genetics

Professor CHENG Xin-nong has practiced in medicine for over 70 years and gained profound clinical experience. He points out that these rules below should be obeyed to improve the efficacy of acupuncture. Firstly, the diseases should be diagnosed basing on meridians order and meridian syndrome differentiation while acupoints should be chosen and adjuncted according to their main medical functions. Secondly, the three Cai inserting method should be flexibly applied on different patients, by adjusting the needling depth and manipulation to reinforce the deficiency and reduce the excess. Thirdly, the arrival of qi is a key point and such methods as the retaining of needles, electroacupuncture and moxibustion should be cointegrated used.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, 20th Century ; History, 21st Century ; Humans ; Medicine, Chinese Traditional ; history

OBJECTIVETo analyze the clinical factors relating to arterial elastic function measured with pulse wave velocity (PWV), large and small arterial elastic indexes (C(1) and C(2)) and augmentation index (AI) in hypertensive patients.

METHODSA total of 2176 hypertensive patients were enrolled and divided into three groups: Elastic function was measured in 1100 subjects by (PWV), in 647 subjects by C(1) and C(2) and in 429 by AI.

RESULTSPWV was positively correlated with age, systolic pressure, pulse pressure and negatively correlated with body height and weights (all P < 0.05). C(1) and C(2) values were higher in male than that in female patients (P < 0.01) and negatively correlated with age, systolic pressure, pulse pressure and heart rate while positively correlated with body height, weight and body mass index. In hypercholesterolemia patients (n = 168), C(1) and C(2) were negatively correlated with serum cholesterol level (P < 0.05). AI value was higher in female than that in male patients (P < 0.01) and positively correlated with age, systolic pressure, diastolic pressure, pulse pressure while negatively correlated with body height, weight and heart rate.

CONCLUSIONAge, systolic and pulse pressure as well as body height and weights are the main factors correlated to arterial elastic function measured by PWV, C(1) and C(2) and AI.

Age Factors ; Aged ; Arteries ; physiopathology ; Blood Pressure ; Body Height ; Body Weight ; Elasticity ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Pulse