Objective To study the incidence rate and correlation of anomalous pancreaticobiliary ductal junction( APBDJ) for patients with biliogenic chronic pancreatitis (BCP). Methods From January 2000 to January 2012,the data of 1 373 patients who underwent ER-CP,MRCP or T-Tube cholangiography in which both biliary and pancreatic ducts in our hospital were analyzed retrospectively. Results Bil-iogenic chronic pancreatitis was found in 47 patients,of which 17 patients with APBDJ. The mean (SD) common channel was (19. 3±7. 2) mm in length ( range 11~40 mm) . Conclusion APBDJ may be the important reason of BCP among Chinese patients.

Objective To analyze the effect of different postoperative nutrition:enteral nutrition( EN) and parenteral nutrition( PN) in patients with colorectal cancer. Methods 84 patients with colorectal cancer were collected in this study from Jan. 2012 to Jan. 2014, and they were divided into the EN group (43 cases) and the PN group (41 cases). They were given EN or PN after operation. The nutritional parameters such as ALB, TF and PA were detected before surgery and 7 days after operation, Observe the adverse reaction, time of gastroin-testinal function recovery, infection and costs after operation. Results There was no statistical difference (P>0. 05) in the nutritional pa-rameters and rate of adverse reaction between the two groups. The rate of infection in EN group was lower than that in PN group(P<0. 01), and the time of gastrointestinal function recovery was shorter in EN group compared with that in PN group (P<0. 01). Conclusion EN is better in recovery of gastrointestinal function, and there is less complication compared to PN. EN have clinical application value for patients with gastrointestinal cancer.

ObjectiveTo study the effect of 1,25-(OH)2D3 analogs paricalcitol on proteinuriaindiabeticnephropathy (DN)rats, andtoinvestigateitspossiblemechanism.Methods DN model rats were established by intraperitoneal injection with streptozotocin.All the DN rats were randomly divided into the paricalcitol group(group P ) and DN group(group D).Healthy rats were chosen as healthy control group(group N).24-h urinary protein and serum biochemical indicators were examined after 12 weeks.ELISA was applied to detect the level of renin and Ang Ⅱ in the kidney.Immunohistochemistry and real-time PCR were used to detect the protein and mRNA expression of heparanases(HPA)and podoein.Results Compared with group N,24-h urinary protein,serum creatinine,renin and Ang Ⅱ in group D and group P were markedly increased,and they were significantly higher in group D as compared to group P (all P＜0.05).Compared with group N,the expression of HPA protein and mRNA in group D and group P increased markedly,and higher expression was found in group D(all P＜0.05).The expression of podocin protein and mRNA in group D and group P decreased markedly,and lower expression was found in group D(all P＜0.05).Renin level was positively correlated with HPA protein expression (r=0.78,P＜O.OS),negatively correlated with podocin protein expression(r=-0.63,P＜O.05),and not correlated with their mRNA expression.Conclusion Paricalcitol can significantly reduce the proteinuria,which may be associated with the inhibition of renin by down-regulating protein expression of HPAin glomerular basement membrane and up-regulating protein expression of podocin in podocyte.

Objective To explore clinical features and antimicrobial resistance of Klebsiella pneumoniae (K.pneumoniae) lower respiratory tract infection(LRTI) in children.Methods Clinical data of 107 children with K.pneumoniae LRTI confirmed by sputum culture from January to December 2015 were analyzed retrospectively.Results 62.62% of children with LRTI were aged less than 6 months and 64.49% episodes occurred in autumn and winter.All cases had cough and 39 had fever, the main complications were type I respiratory failure, type Ⅱ respiratory failure, cardiac insufficiency, and electrolyte disturbance, 39 cases(36.45%) had complications involving two systems, 5 cases(4.67%)had complications involving three systems,47 cases (43.93%) met the diagnostic criteria of severe pneumonia.43 cases (40.19%) had primary underlying diseases, the major were congenital heart disease, preterm and low birth weight, and malnutrition.Children with imipenem-resistant bacteria infection were more prone to develop extrapulmonary complications than those with non-resistant pathogenic infection.The resistance rate of K.pneumoniae to amikacin was the lowest(9.35%).90 cases were recovered and markedly effective, 11 cases were effective, 4 cases were not healed and voluntarily discharged from hospital, and 2 cases died.Conclusion Children aged less than 6 months and with underlying diseases are prone to develop LRTI, and complications are more.

Objective To analyze the epidemiologic feature of overseas imported malaria in order to provide the evidence for improving the surveillance and control of malaria in Wuhan City. Methods The epidemiological investigation data of overseas imported malaria cases were collected and analyzed with an epidemiological method including plasmodium species epidemic fo?cus distribution domestic distribution population characteristics attack?diagnosis interval clinical grading etc. in Wuhan City from 2008 to 2013. Results A total of 240 overseas imported malaria cases were reported including 180 cases from Afri?can countries and the proportion of Plasmodium falciparum infections was 82.22% and 60 cases from Southeast Asian coun?tries and the proportion of Plasmodium vivax infections was 76.67% and the proportions of the parasite species were significant?ly different between the two regions χ2=105.53 P 0.001 . The male and young adults were dominant. there were no statisti?cal significance between clinical grading and attack?diagnosis interval Z=-0.99 P = 0.32 vocational background χ2=10.61 P=0.10 then clinical symptoms aggravated the situation was occurred more easily among the first attack cases χ2=7.66 P 0.05 and the falciparum malaria cases χ2=24.27 P 0.001 . Conclusions The overseas imported malaria cases are increasing rapidly with years and the malignant malaria cases were more than other malaria cases in Wuhan City. Therefore the surveillance and management of the returnees from malaria endemic areas should be strengthened continually.

Objective To analyze the risk factors of subclavian venous catheter-related infections in patients with traumatic hemorrhagic shock (THS) and provide a basis for prevention and control of the infection. Methods A retrospective study was conducted. 357 patients with THS and indwelling of subclavian vein catheter admitted in the Department of Emergency of Affiliated Hospital of Sichuan Provincial Luzhou Medical College were enrolled, and according to the infection state, they were divided into infection group (56 cases) and non-infection group (301 cases). The patients' data of gender, age, history of underlying disease, catheter position, catheter indwelling time, time staying in hospital, situation of antimicrobial drug used, application of tracheotomy or not, white blood cell count (WBC) levels, etc were collected for univariate analysis. The resulting indexes with statistical significance were applied for carrying out the multivariate logistic regression analysis, and then the independent risk factors involved in the development of subclavian venous catheter-related infections in the shock patients could be screened out.Results In 357 patients with THS, 56 were infected (15.7%). Univariate analysis showed: age ≥ 60 years (χ2 = 19.839,P < 0.001), with diabetes mellitus in past history (χ2 = 6.252,P = 0.012), catheter indwelling time ≥ 7 days (χ2 = 19.261,P < 0.001), time staying in hospital ≥ 7 days (χ2 = 4.315,P = 0.038), time for use of antimicrobial drug≥ 7 days (χ2 = 16.161,P < 0.001), tracheotomy (χ2 = 40.969,P < 0.001), WBC < 4×109/L (χ2 = 39.451,P < 0.001) and the disease severity grade 4 - 5 (χ2 = 8.345,P = 0.004) were the risk factors of subclavian venous catheter-related infections in patients with THS. Multivariate analysis showed: catheter indwelling time ≥ 7 day [odds ratio (OR) = 16.713, 95% confidence interval (95%CI) 3.651 - 76.624), tracheotomy (OR = 6.861, 95%CI 2.377 - 18.246), WBC < 4×109/L (OR = 4.903, 95%CI 1.887 - 12.643) were the independent risk factors of subclavian venous catheter-related infections in THS patients.Conclusion The strict implementation of aseptic catheterization, shortening the time of catheter indwelling as much as possible and the rational use of antibiotics can effectively reduce and prevent the incidence of venous catheter-related infection in THS patients.

Objective To evaluate the effect of dexmedetomidine on the expression of c-fos protein in the dorsal root ganglion neurons in a rat model of neuropathic pain (NP).Methods Seventy-two adult male SpragueDawley rats,weighing 180-240 g,were randomly divided into 3 groups (n =24 each) using a random number table:sham operation group (group S),group NP,and dexmedetomidine group (group Dex).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex,dexmedetomidine 50μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before ligation (T0,baseline) and 3,7 and 14 days after ligation (T1-3).Eight animals were sacrificed after measurement of pain threshold at T13 and the dorsal root ganglions of the lumbar segments (L44) were removed for detection of c-fos expression (by immuno-histochemistry).Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of c-fos protein was up-regulated at T1-3 in NP and Dex groups.Compared with NP group,MWT was significantly increased,TWL was prolonged,and the expression of c-fos protein was down-regulated at T1-3 in Dex group.Conclusion Dexmedetomidine can inhibit upregulation of c-fos protein expression,thus attenuating NP in rats.

ObjectiveTo explore the effect of different properties and hemisphere of stroke on trunk control ability and the relationships between the trunk control and cognition, activities of daily living (ADL).Methods75 inpatient stroke patients were divided into the group A (right hemorrhages, n=15), group B (right infarcts, n=25), group C (left hemorrhages, n=14) and group D (left infarcts, n=21). All cases in four groups were assessed by Mini-Mental Status Examination (MMSE), Sheikh Trunk Control Evaluation and Modified Brathel Index (MBI) before and after rehabilitation therapy.ResultsThe scores of Sheikh and MBI of the group A and group C were significantly lower than that of the group B and group D before treatment ( P<0.05～0.001). After treatment, the scores of MMSE, Sheikh Trunk Control Evaluation and MBI of the patients in four groups all increased, but the scores of the patients in the group A and group C increased more than other groups. There was no significant difference in Sheikh scores between right and left hemisphere stroke. All groups had high relationship between Sheikh Trunk Control Evaluation and MBI before and after treatment. There was no relationship between Sheikh Trunk Control Evaluation and MMSE before treatment, but having part relationship after treatment.ConclusionThe trunk control of hemorrhage patients are damaged more severe than that of the infarct cases, but they resume also faster. There are no different between right and left hemisphere stroke in trunk control impairment. The ability of trunk control has high relationship with ADL before and after treatment, it has no relationship with cognize before treatment but has relationship after treatment.

In recent years, the study of autophagy in spinal cord injury (SCI) gradually becomes the hot spot. However, the function of autophagy in the injured spinal cord is still controversial. In order to further understand the role of autophagy after SCI, we summarized the activation of autophagy, autophagic cell death, the relationship between autophagy and apoptosis, the function of autophagy in promoting the molecular metabolism and the role of autophagy after spinal cord injury. We concluded that the role of autophagy after SCI is a double-edged sword. Upregulating the level of autophagy appropriately can promote damaged proteins metabolism and inhibit apoptosis. However, excessive activation of antophagy may induce autophagic cell dealth. So we consider that the proper regulation of autophagy will be a new target in the treatment of SCI.
Animals ; Apoptosis ; Autophagy ; physiology ; Humans ; Spinal Cord Injuries ; etiology ; pathology

Objective To explore the trend of changes of Th1 and Th2 cytokines within 6 months after adult liver transplantation (LT). Methods Twenty-three patients from Tianjin First Center Hospital were chosen as the patient group with an average age of (52.7 ± 7.6), range from 37 to 63 years old, including 21 males and 2 females. Twenty healthy staffs from Tianjin First Center Hospital formed the control group (C) with 15 males and 2 females whose average age was (31.0 ± 6.1) ranged from 22 to 24 years old. The patient group was treated with tacrolimus after LT as main immunosuppressive drug. The peripheral blood at time points before (T0) and 1 month (T1), 3 months (T3), 6 months (T6) after LT at 9:00 AM were collected. The blood sample was also collected form control group but only one time. Levels of IL-2, IFN-γ, IL-10 and TGF-βwere detected by ELISA. Results (1) The concentration of IL-2 showed a continuous up-going trend, which was not such obvious between T1 and T0, and until T3 reached a higher concentration than T0. The concentration at T6 was higher than T0 and T1. There were no significant differences in concentrations of T0 to T3 between patient group and control group, while T6 reached a higher concentration in patient group than that of the control group. (2) The concentration of IFN-γexperienced a shortly down-going trend from T0 to T3, and started rising, reached the peak at 3 months after the operation, then started its down-going trend. There were no significant differences in the concentrations of IFN-γfrom T1 to T6, and T3 reached a higher concentration than T1 while T6 was lower than T3. Only at T3, the concentration of IFN-γwas higher in patient group than that of control group. (3) There were no significant differences in the concentrations of IL-10 at various time points in patient group, and there were no significant differences in the concentrations of IL-10 at different time points between two groups (P>0.05). (4) The concentration of TGF-βshowed a gradual decline after the operation, and reached its bottom at T6, and which was lower than T0 to T3. Compared with the control group, the down-going trend was not such obviously at T0 and T1, and the concentration was down at T3 and T6(P<0.05). Conclusion Our results suggest that there is a tendency of an increasing Th1 cytokine expression at early stage in post-transplantation, while the TGF-βof Th2 cytokine is a decreasing trend. This tendency may associate with the autoimmunity response caused by LT and the immunosuppressive drugs.