Objective To investigate the pattern of organ dysfunction in acute pancreatitis.Methods Seven hundred and eighty-three SAP patients who were treated in Department of Surgery,Ruijin Hospital from January 2001 to December 2008 were retrospectively analyzed.According to 2012 acute pancreatitis classification,these SAP patients were further divided into MSAP and SAP.Diagnosis of organ dysfunction was based on SOFA scores.Results Among the 783 patients,there were 573 MSAP patients and 210 SAP patients.The main etiology was of biliary origin (47.9％).Six hundred and ninety-eight patients survived,and 85 patients died with the mortality rate of 10.9％.Among the 783 patients,organ dysfunction occurred in 273(34.9％) patients,and the number of patients with 1,2,3,4 or more organs dysfunction was 109,81,60 and 23,and the mortality was 1.8％ (2 patients),37.0％ (30 patients),50.0％ (30 patients),100％.Among the 109 patients with single organ dysfunction,there were 48 MSAP and 61 SAP patients,and 98.2％ was cured,only 2 patients died.Among the 164 patients with multiple organ dysfunction,there were 15 MSAP and 149 SAP patients,and 50.6％ died.Respiratory,cardiovascular,nervous,renal,hematologic and liver dysfunction occurred in 206 (26.3％),103 (13.2％),92 (11.7％),80 (10.2％),41 (5.2％),27 (3.4％); and the mortality rates were 38.8％ (126/206),49.5％ (51/103),37.0％ (34/92),63.8％ (51/80),53.7％ (22/4),44.4％ (12/27).Respiratory dysfunction had the highest incidence,and renal failure was associated with the highest mortality.Conclusions In the course of acute pancreatitis,single organ dysfunction has the highest incidence but the mortality is low.Four or more organs dysfunction has the lowest incidence,but the mortality is 100％.Respiratory and cardiovascular dysfunction has the highest incidence,and renal,hematologic dysfunction is associated with poorest prognosis.

Angioplasty, Balloon, Coronary ; Coronary Disease ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

Objective To observe the postoperative analgesic effects of ultrasound-guided transversus abdominis plane block after cesarean section. Methods Forty patients having underwent cesarean section under intraspinal anesthesia were selected, and they were divided into experiment group and control group by random digits table method with 20 cases each. All the patients were given ultrasound-guided transversus abdominis plane blocks when surgery finished. The patients in experiment group were injected 0.25%ropivacaine 20 ml, and the patients in control group were injected 0.9% sodium chloride 20 ml. All the patients received patient controlled intravenous analgesia (PCIA) pump after surgery. The movement and resting visual analog score (VAS), incision VAS at 4, 8, 12 and 24 h after surgery, and the compression time of analgesis pump were compared between 2 groups. The correlated adverse reaction of transversus abdominis plane block were recorded. Results The movement VAS at 4 and 8 h after surgery in experiment group were (4.1±1.7) and (5.3±1.8)scores, and in control group were (6.3±2.0) and (7.0±1.2) scores, and there were statistical differences (P<0.05). The incision VAS at 4 and 8 h after surgery in experiment group were (0.9±0.4) and (1.2±0.8) scores, and in control group were (3.6±2.1) and (6.8±2.4) scores, and there were statistical differences (P<0.05). The compression time of analgesis pump in experiment group was significantly lower than that in control group: (2.8± 1.4) times vs. (4.0±1.9) times, and there was statistical difference (P<0.05). The using dose of tramadol in experiment group was significantly lower than that in control group:(214±12) mg vs. (224±15) mg, and there was statistical difference (P<0.05). All the patients did not appear the correlated adverse reaction of transversus abdominis plane block. Conclusions Ultrasound-guided transversus abdominis plane block is accurate and easy. It provides effectual post-cesarean section analgesia with lower adverse reaction, which is a better choice of multimodal analgesia for cesarean section.

China ; Critical Pathways ; Humans ; Medicine, Chinese Traditional ; Myocardial Infarction ; therapy

Aging ; Cytoskeleton ; Endothelium ; Humans ; Research

AIM:To study the mechanisms of effects of the ?-opioid receptor(?-OR) on neonatal rat hypertrophic myocardial cells induced by isoproterenol(ISO).METHODS:Myocardial cells of neonatal rats were cultured in vitro.The total protein content was detected by the Lowry's assay.The volume of myocardial cell was measured by computer photogragh analysis system and the protein synthesis was assayed with[3H] leucine intake method.The degree of extracellular signal-regulated kinase(ERK) phosphorylation was determined by western-blotting.RESULTS:U0126(an inhibitor of ERK) decreased the total protein content,the cell size,the[3H]leucine incorporation and the ERK phosphorylation degree in hypertrophic myocardial cells induced by ISO.1 ?mol/L U50,488H(a ?-opioid receptor antagonist) could decrease the total protein content,the cell size,the[3H]leucine incorporation and the degree of ERK phosphorylation.But these effects could be diminished when incubated with U0126.CONCLUSION:?-opioid can abolish the hypertrophic response induced by ISO of cardiac myocytes,which was associate with ERK pathway.The inhibitor of ERK significantly inhibits the ISO-induced hypertrophied effect.

The animal models of hypoxic-ischemic brain injury have been established inmany animals, such as monkeys, dogs, rats, mice, rabbits, and pigs. These models have provideda great deal of important information for neonatal hypoxic-ischemic brain injury. Howerver, thedifferent species vary in their susceptibility to the various types of ischemic insults. This articlereviews the animal models of hypoxic-ischemic brain injury in different species.

Community rehabilitation of cardiovascular disease is of great significance. Exercise therapy of cardiovascular disease in communities is necessary and feasible. At present, the main problems China faced to carry out community exercise therapy of cardiovascular disease include: cardiovascular patients with a weak sense of community exercise therapy, lack of professional rehabilitation personnel, inadequate community-based exercise therapy practice and lack of community rehabilitation funding. To solve above problems, we should strengthen the community exercise therapy practice of cardiovascular disease, and promote the cooperation between community rehabilitation and hospital rehabilitation. In all, comprehensive efforts should be made in order to solve the problems.

ObjectiveTo evaluate the effect of selective posterior rhizotomy(SPR),local corrective surgery and the training of rehabilitation on the relief of limb spasm secondary to cerebral palsy.MethodsThe "open window" of bilateral vertebral lamina resection, the the posterior roots of L2-S1 were separated from anterior roots and splited into rootlets. The rootlets sensitive to lower threshold of electrical stimulation were sectioned. The ratios of cut root,acorrding to muscle tension, myodynamia, body weight, muscle function,were estimated and all of them <30%. The local plastic operation was performed for nonimprovement of lower limb spasm and the training of rehabilitation began at postoperation. ResultsThe SPR have been performed on 28 cases. The rate of spasticity relief was 90% and the rate of functional improvement was 80% with follow-up. ConclusionsIt is a successful way to treat spastic cerebral palsy with SPR and procedural method.

Objective To evaluate long-term efficacy of microwave hyperthermia combined with chemoradiotherapy for nasopharyngeal carcinoma (NPC) with cervical lymph node metastasis. Methods A total of 154 patients with stage N2 or N3 NPC ('92 staging system) were randomized into two groups:microwave hyperthermia combined with chemoradiotherapy (Group A, 76 cases) and chemoradiotherapy alone (Group B, 78 cases). Both of the two groups received 1 -2 cycles of chemotherapy of cisplatin and 5-fluorouracil, followed by conventional radiotherapy of 70 - 78 Gy in 35 - 39 fraction to the nasopharynx and 68 -72 Gy in 34 - 36 fractions to the neck. Group A received microwave hyperthermia to the metastatic cervical nodes at the beginning of radiotherapy. The hyperthermia was given as 45 min every time, twice a week for 8 - 14 times totally. Results The 5-year complete response rates of cervical lymph nodes in group A and B were 97% and 77% (x2 = 14. 24,P<0. 01). The distant metastasis rates in the two groups were 37% and 44% (x2 = 0. 73, P > 0. 05). The disease-free survival rates were 51% and 21% (x2 = 15.91, P <0. 01). The 5-year overall survival rates were 59% and 41%, respectively (x2 = 5.09, P < 0. 05).Conclusions For patients with stage N2 or N3 NPC, microwave hyperthermia combined with chemoradiotherapy can improve the complete response, disease-free survival and overall survival.