Objective:To investigate the distribution of infection pathogens and their drug resistance in acute severe pancreatitis patients. Methods:Retrospective analysis was made on all pathogenic bacteria and their drug resistance of infection among 78 patients with acute severe pancreatitis patients. Results:Among 78 patients with acute severe pancreatitis 75 patients were cured,3 patients were dead.Of 286 clinical isolates,Gram negative organisms accounted for 61.19%,Gram positive ones 32.17%,fungi(6.64%).They resisted to antibiotics at high degrees.Among 92 strains of gram positive organism,60 were drug-resistance;also 172 strains of gram negative organism,above half were drug-resistance. Conclusion:Patients with acute severe pancreatitis are at high risk of infection.Due to drug-resistance are at high degrees in infection pathogens,effective drainage should be adopted to accelerate treating the infection besides selecting correct antibiotics according to the antibiotic sensitive essay results.

Objective:To examine whether the thyroxine treatment can affect the serum lipid levels in patients with subclinical hypothyroidism by Meta analysis.Methods:Pubmed and China National Knowledge Infrastructure(CNKI)were searched for randomized controlled trials reporting the effectiveness of thyroxine treatment on serum lipid levels in subclinical hypothyroidism patients from January 1980 to September 2006;hand-search was also performed.The included trails were analyzed by RevMan4.2 software.Results:Six studies were finally included and five of them found thyroxine to be significantly more effective than placebo in improving the serum lipid disorders;one of them found thyroxine had no obvious effect.The pooled effect sizes(95%CI)of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apoprotein A(ApoA),apoprotein B(ApoB)and lipoprotein a(Lp(a))were -0.39(-0.71, -0.07),-0.02(-0.07,0.04),-0.02(-0.06,0.03),-0.22(-0.31,-0.12),-0.08(-0.11,-0.06),-0.05(-0.08, -0.02),and -0.38(-2.41,1.64),respectively.The analysis results showed that thyroxine treatment was significantly effective on serum levels of TC,LDL-C,ApoA,and ApoB,but not on TG,HDL-C,or Lp(a).Conclusion:This Meta-analysis demonstrates that thyroxine treatment can improve thyroid function and lipid metabolism in patients with subclinical hypothyroidism,reducing the prevalence of artherosclerosis and coronary heart disease.

The aim of this study was to investigate the effect of total parenteral nutrition(TPN), infection, or growth hormone on changes in proliferation of intestinal mucosa epithelial cells and expression of mucosa c jun . Cecal ligation and puncture was used to replicate intra abdominal infection model, and transjugular intracaval catheterization was chosen to give TPN. Experimental rats were divided into four groups: normal control, TPN control, TPN plus sepsis group, and TPN plus growth hormone group. Changes in mucosa thickness, villus height, crypt depth , mucosa c jun mRNA expression and epithelial cell proliferation index were observed. The results showed that all of mucosa thickness, villus height, crypt depth of intestinal mucosa decreased, proliferation of epithelial cells were markedly inhibited in TPN group. Sepsis states aggravated the above changes in intestinal mucosa. Corresponding to mucosa atrophy, expression of c jun reduced obviously. Growth hormone could promote growth of intestinal mucosal cell, improve proliferation of epithelial cells and expression of mucosa c jun. It suggested that changes in c jun expression appeared to be associated with different proliferation states of intestinal mucosa epithelial cells. c jun mRNA could be used as an important marker to reflect mucosa epithelial cell proliferation .

With the initiation of laparoscopic techniques in general surgery and a significant expansion of minimally invasive techniques in the last 20 years.However,some of the shortcomings of laparoscopic technology has limited it's surgical application.More recently,the da Vinci robotic surgical system further defined the ability of a roboticassist device to address limitations in laparoscopy.This in cludes a significant improvement in instrument dexterity,dampening of natural hand tremors,three dimensional visualization,ergonomics,and camera stability.As experiencewith robotic technology increased and its applications to advanced laparoscopic procedures have become more understood,more procedures have been performed with robotic assistance.We review the current status of da Vinci robotic technology and its applications in general surgical procedures.

0.05).Conclusion Semiconductor laser can induce apoptosis of MG-63 cells by mitochondrion pathway,and the process may be associated with the increasing of ROS.

Hedgehog (HH) signaling pathway was firstly discovered in the regulation of embryonic segments development in Drosophila; later, the biochemical and functional homologs of Drosophila HH signaling genes were also isolated in vertebrates (including human). Researchers found that HH signaling not only controls the embryonic development, but also plays an important role in tumorigenesis. Gli, a zinc finger transcription factor in the vertebral HH signaling pathway, combines to the special sequences of distal HH targeted genes and directly controls the transcription of targeted genes, playing a key role in HH signaling pathway. In this article, we summarize the role of Gli in HH signaling pathway and its prospect in cancer therapy.

Triple-negative breast cancer (TNBC) is a subgroup of breast cancers defined by a lack of the expressions of estrogen,progesterone and HER2 receptors,with more aggressive biological and clinicopathological characteristics and a close relationship with basal-like and breast cancer susceptibility gene-1 (BRCA1)-related breast cancers.TNBC is insensitive to most available hormonal or standard therapeutic agents,associated with increased risk for distant metastases and with poorer prognosis than other types of breast cancer.A deeper insight into the biology of TNBC may lead to improved therapies and better clinical outcomes of the disease.

Objective To investigate the etiology of and therapy for duodenal fistula caused by distal common bile duct operation. Methods An retrospective analysis of 19 cases of duodenal fistula after distal common bile duct operation was made.All cases received surgical management after the fistula was identified.Surgical procedures included abdominal abscess drainage in 2 cases, gastrostomy and jejunostomy combined with abscess drainage in 11 cases, gastrostomy and jejunostomy combined with duodenal repair?abscess drainage in 3 cases,gastrojejunostomy with pyloric exclusion combined jejunostomy in 1 case, repair of fistula with padicled intestinal seromuscular patch combined with gastrostomy and jejunostomy in 1 case, and repair of fistula with padicled intestinal seromuscular patch combined with gastrostomy and jejunostomy plus sphincteroplasty in one case. Results Among 19 cases,15 were cured. Two died of gastrointestinal bleeding, one of severe retroperitoneal infection,one of severe pancreatitis. ConclusionsEarly diagnosis is of great importance for the treatment of duodenal injury. Drainage is the mainstay for the treatment of iatrogenic duodenal fistula, while enough enteral nutrition should be given to accelerate spontaneous closure of the fistula.

Objective To investigate the correlation between deep vein thrombosis(DVT) and clinical laboratory tests in the regulation of hemostasis. Methods Endothelin-1 (ET-1), thrombomodulin (TM), P-selectin, prothrombin fragment _ 1+2 (F_ 1+2 ), thrombin-antithrombin complex (TAT), thrombus precursor protein (TpP) and D-Dimer (D-D) were measured in DVT patients (n=72) and normal individuals (n=20) with ELISA method. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were evaluated for each of the items, and the area of the underlying receiver operating characteristic curve (AUC ROC ) was used to appraise diagnostic efficiency. Results Except ET-1, there were significant differences between the DVT group and normal control group in the other items. The AUC ROC of P-selectin, F_ 1+2 , TpP and D-D was bigger than that of ET-1, TM and TAT (P0.05). The TpP had the highest sensitivity, NPV and accuracy, and the D-D had the highest specificity and PPV. Conclusion The increase of D-D and TpP could reflect the occurrence of continuous coagulation and fibrolysis respectively. Thus the combination of measuring TpP and D-D could provide better laboratory evidence for the diagnosis of patients with DVT.

Objective To explore the expression of matrix metalloproteinase-14(MMP-14)protein in the human stomach carcinoma tissues and its correlation with carcinoma invasiveness and metastasis.Methods The MMP-14 protein expression was detected by immunohistochemistry in 59 cases of stomach carcinoma tissues (observation group)and 20 cases of normal stomach tissues (control group,the adjacent normal tissues from the tumor margin of 5 cm confirmed by pathology),and its correlation with the clinically pathological parameters was analyzed.The expression characteristics of MMP-14 among various TNM stages of stom-ach carcinoma were also analyzed.Results The positive rate of MMP-14 expression was 50.85%(30/59)in the observation group and 5.00% (1/20)in the control group,the positive rate of the observation group was significantly higher than that of the control group (P <0.01);the expression level of MMP-14 was correlated with the differentiation degree,regional lymph node metastasis degree,invasion depth,lymphatic invasion and TNM stage,which showing the statistical difference(P < 0.01);the expression of MMP-14 protein was up-regulated and showed the transferring trend from cytoplasm to cellular membrane along with the progres-sion of TNM stage.Conclusion The overexpression of MMP-14 protein exists in stomach carcinoma tissues,which contributing to the invasion and metastasis of stomach carcinoma cells.