Pancreatic abscess(PA)is the most serious complication of severe acute pancreatitis(SAP),which can lead to systemic and/ or local complications,and even death. PA cannot be resolved automatically after the formation. Once diagnosed,early drainage,anti-infection and nutrition support should be undertaken,the most important is early drainage. In the past,the treatment of PA was mainly based on surgical treatment. With the development of minimally invasive techniques,endoscopic ultrasound(EUS)guided drainage and percutaneous catheter drainage(PCD)offer a new way for the treatment of PA. Preventing and early diagnosis of PA become a challenge in the treatment of SAP. This article reviewed the progress in diagnosis and treatment of SAP complicated with PA.

Anti-Bacterial Agents ; adverse effects ; Humans ; Integrative Medicine ; Kidney Diseases ; chemically induced ; therapy

Objective To explore the effects of AKT2 expression in pancreatic cancer cell line Panc-1 on the sensitivity towards to gemcitabine.Methods The expression vector pAKT2 shRNA was constructed and transfected into Panc-1 cells by lipofecton.The mRNA and protein expression levels of AKT2 were detected by RT-PCR and Western blot assays,respectively.The changes of gemcitabine sensitivity after shRNA were examined by the MTT assay.Results The mRNA and protein levels of AKT2 in Panc-1 cells were significantly decreased after the transfection,and the median inhibition concentration of gemcitabine against Panc-1 cells was reduced from (1.96 ± 0.22) mg/L to (0.24±0.03) mg/L.The sensitivity of Panc-1 cells to gemcitabine was increased significantly after pAKT2-shRNA transfection.Conclusion The sensitivity of Panc-1 cells to gemcitabine could be enhanced by pAKT2-shRNA.

Objective To study the effect of RNA interference suppressing the expression of AKT2 on sensitivity of human pancreatic cancer cell line xenograft in nude mice to gemcitabine.Methods The human pancreatic cancer cell implanted tumor mode1 in the nude mice was established.By abdominal cavity administration and intratumoral injection,the mice bearing tumor were treated with gemcitabine in combination with vector of pAKT2-siRNA.Tumor growth of tumor tissues was observed,the AKT2 mRNA and protein expression levels in tumor tissues detected by RT-PCR and immunohistochemistry respectively,and tumor apoptosis measured by Tdt-mediated dUTP nick end labeling(TUNEL).Results In chemotherapy+AKT2-siRNA group the expression of AKT2 mRNA and protein was significantly lower than in control group,chemotherapy group and chemotherapy+blank plasmid group.The tumor weight and tumor volume in chemotherapy+AKT2-siRNA group were significantly reduced as compared with those in other three groups.The inhibition rate and apoptosis rate in chemotherapy+AKT2-siRNA group were significantly higher than those in other three groups.Conclusion Sensitivity of human pancreatic cancer cell line to gemcitabine could be significantly improved by RNA interference suppressing the expression of AKT2.

OBJECTIVE:To observe the curative effects and safety of compound glycyrrhizin injection combined with chemotherapy in the treatment of enteron malignant tumor at intermediate and advanced stage.METHODS:100patients were randomized into treatment and control group,the treatment group were given compound glycyrrhizin injection combined with chemotherapy,while the control group was treated with only chemotherapy,the curative effects and side effects were observed and compared between2groups.RESULTS:The short-term effective rates in the treatment group and the control group were58%and36%respectively(P

ObjectiveTo investigate the effects of splenectomy on the intestine mucosa barrier in rats with obstructive jaundice. Methods50 Wistar rats were divided randomly into the obstructive jaundice group (OJ), in which the animals underwent operation to ligate common bile duct, and the obstructive jaundice + splenectomy group (OJ+ S). Seven days post-operation, plasma endotoxin levels were detected. Intestinal mucosa permeability was measured by the ratios of lactulose and mannitol (L/M). Immunohistochemistry and Western blot were used to examine the expression of tight junction proteins (ZO-1 and occludin) in the distal ileum mucosa. Western blots images were analyzed quantitatively. ResultsAverage ratios of L/M and plasma endotoxin were decreased obviously in the OJ+S group compared to those in the OJ group (all P=0. 001). Compared with the OJ group, the average intestinal villus height and mucosa thickness were upgraded somewhat in the OJ + S group (P = 0.019, 0. 001 ). By immunohistochemistry staining seven days post-operation, same comment as above the amounts of strong positive expression of ZO-1 were significantly decreased in the OJ group (6/18, P-0. 021). There wewas no difference between the OJ+S group(8/17) and the OJ group.The amount of strong positive expression of occludin was higher in the OJ + S group than that of the OJ group(10/17 vs 4/18, P= 0. 026). The same outcomes were obtained by quantitative Western blot images. Conclusion The intestinal epithelial permeability was increased in rats with obstructive jaundice,and intestinal barrier was damaged. After excising spleen, the amount and distribution of tight junction proteins were changed and the impairment of intestinal barrier was abated.

Objective The tissue engineering technique and the microsurgery technology is combined to construct the uncellular tissue engineering complex with vascularization and membrane guided dual effect. Through comparing study of using the simple biomembrane guided bone regeneration technique to construct the uncellular tissue engineering complex to repair the large segment bone defect in the animal body,the bone reparative effect of the tissue engineering bone wrapped by pedical fascial flap with vessels and that wrapped by the simple biomembrane was compared, thus to provide experimental evidence for the clinical application. Methods Twenty-four Newzland 5-month-old rabbits were used to build the bilateral periosteumincluded bone defect modelsin the middle piece of the ulna and the length of the defect was 1 cm. Autologous red bone marrow was implanted in the tissue engineering bone which was prepared by osteoinductive absorbing material including BMP. The prepared tissue engineering bone was implanted in the bone defect area. The right side was wrapped by the simple absorbable biomembrane, whereas the left side was wrapped by pedical fascial flap with blood supply. At the fourth, eighth, twelfth and sixteenth week after the operation each group was examined by the radiograph (x-ray), the light density measurement, gross morphology and histological inspection,bone shape measurement analysis in the repairing area and the biomechanics measurement at the twelfth week. The data was analyzed to test the difference of the bond defect repair. Results The radiograph, gross morphology and histological inspection showed the growth of vessels in the implant area, the quantity and the forming speed of the bone trabecula and, the cartilaginous tissue, the formation of the mature bone structure,remodeling of the diaphysis, recanalization of the cavum ossis and the absorption and the degradation of the implant of the group of pedical fascial flap with blood supply was superior to that of the group of the simple absorbable biomembrane. At the fourth, eighth, twelfth and sixteenth week after the operation the bone trabecula area were( 20. 35 ± 2. 41 ) %, ( 40. 21 ± 1.97 ) %, (66. 67 ± 3.44 ) % and ( 86. 47 ± 3.99) % respectively in the group of pedical fascial flap with blood supply, and were ( 7. 46 ± 2.64 ) %, ( 20. 66 ± 2. 28 ) % , ( 40. 22 ±1.84)% and(58. 18 ± 1.79) respectively in the group of the simple absorbable biomembrane. At the same time point after the operation the light density were 0. 636 ± 0. 012,0. 596 ± 0. 062,0. 552 ± 0. 009 and 0. 451 ±0. 008 respectively in the group of pedical fascial flap with blood supply, and 0. 742 ± 0. 032,0. 713 ± 0. 022,0. 655 ±0. 018 and 0. 606 ±0. 015 respectively in the group of the simple absorbable biomembrane. The units of blood vessel reproductive area in the bone repair junctional zone were ( 18.75 ± 2. 09 ) %, ( 37.41 ± 3.22 ) %,(53. 06 ±2. 18)% and (36.72 ±4. 73)% respectively in the group of pedical fascial flap with blood supply,and (5. 34 ± 1.17 ) %, (9. 48 ± 2.96) %, ( 22.43 ± 2. 21 ) % and ( 26. 27 ± 3. 14 ) % respectively in the group of the simple absorbable biomembrane. The biomechanics intension was 26.62 ± 3.96 in the group of pedical fascial flap with blood supply and 18. 38 ±0. 71 in the group of the simple absorbable biomembrane at the twelfth week after the operation. All of the differences were significant( P ＜0. 05 ). Conclusion The pedical fascial flap with blood supply has significant effect in promoting the tissue engineering bone to vascularize and promoting the bone formation by vascularization. The membrane guided bone regeneration technique restricted not only the growth of the fibrous connective tissue in the reparative process of the large segment bone defect effectively, but also the ability of fast and effective vascularization, thus the chronic creep and substitution process would be needed. Simple application of the biomembrane can compensate the shortcoming of chronic creep of the implanted material by the growth of the external callus.

Objective To investigate the genetic association between polymorphisms of Ser447Stop in lipoprotein lipase (LPL) gene and ischemic stroke. MethodsA case-control study was performed in 563 acute ischemic stroke patients and 320 controls. LPL Ser447Stop genotypes in the subjects were detected by polymerase chain reaction and restriction fragment length polymorphism assay. The frequencies of the alleles in each group were statistically analyzed with Student t-test. ResultsNo significant difference was found in the frequency of G allele of LPL Ser447Stop polymorphism between the case and the control. When subjects were divided into 2 subgroups of cerebral thrombosis infarction and lacunar infarction, the frequency of G allele was significantly higher in the cerebral thrombosis infarction group (9. 7％ ) than that in the control (6. 6％, χ2= 3. 99,P = 0. 045 ), and an increased risk for thrombosis infarction was suggested in the G allele ( OR = 1. 510, 95％ CI 1. 012--2. 261 ). ConclusionThe G allele in polyim Ser447Stop in LPL may be associated with increased risk of cerebral thrombosis infarction.

Objective To analyze MR imaging manifestations of spinal area lymphoma in order to improve the recognition and understanding of the disease. Methods A group of 45 patients with pathologically or clinically proven spinal area lymphoma were reviewed. Five cases were primary NHL,40 cases were secondary with 9 HL and 31 NHL (27 B-cell type NHL and 4 T-cell type NHL). MR Imaging findings were analyzed and correlated with clinical and pathologic findings. Results (1) Location of lesions: 13 cases were focal type and 32 cases were multifocal type. All of the 5 patients with primary lymphoma were focal type, while 32 of 40 cases of secondary lymphoma were multifocal type. (2) Type oflesions: ①Vertebral destruction: 27 cases manifested as bone destruction with 23 of them had soft tissuemass and the extent of soft tissue masses were larger than that of bone destruction in 18 cases.②Soft tissuemasses: 6 cases manifested as soft masses without obvious bone destruction, of which 5 cases had soft tissuemasses imbedded vertebrae and communicated paravertebral and epidural spaces through intervertebralforamen.③Bone marrow infiltration: 9 cases of secondary spinal lympboma had signal intensity changes ofbone marrow without obvious cortical bone destruction and soft tissue mass. ④ Spinal cord infiltration:3 cases of secondary spinal lymphoma had spinal cord swelling and signal intensity changes. (3) MRIfindings: all lesions of bone destruction and marrow infiltration manifested as hypointense on T1-weightedimages, hypointense, isointense or hyperintense on T2-weighted images and hyperintense on T2-weightedimages with fat-suppression technique. All soft tissue masses were homogeneous hypointense on T1-weightedimages and hyperintense on T2-weighted images. After intravenous injection of contrast media, the lesions ofthe bone and the soft tissue showed mild or moderate enhancement without remarkable cystic degenerationand necrosis. Conclusions Most of the spinal area lymphoma is the secondary B type NHL with complexMRI manifestation. Osteolytic lesion with contiguous paravertebral soft tissue mass imbedded vertebrae whichcommunicated paravertebral and epidural spaces through intervertebral foramen with a mild or moderateenhancement may suggest the diagnosis of this rare disease.

OBJECTIVETo evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.

METHODSA total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.

RESULTSThe operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.

CONCLUSIONNo-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.

Adolescent ; Adult ; Circumcision, Male ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Postoperative Complications ; Young Adult