There was never a time in history that so many disciplines and specialists participate and try to lead the clinical management for acute pancreatitis. Chaos remains at bedside, and episodes of under-intervention and especially over-treatment frequently happened. Physicians are easily confused by questions and controversies in management for acute pancreatitis. We have reviewed the articles in acute pancreatitis and made our recommendations based on the latest evidences.

Objective To investigate the pathogentic factor of severe acute pancreatitis(SAP)-associated lung injury and the protective function of octreotide combined with alinastatin on SAP-associated lung injury in rats.Methods Eighty SD rats were randomly divided into 5 groups.Sham operative(S)group,SAP group,(octreotide)(O)group,ulinastatin(U)group and octreotide + ulinastatin (O+U)group,and each group was divided into 6h,12h sub-groups.After AP models were induced,the serum concentration of amylase(AMY),tumor necrosis factor?(TNF-?),malondiadehyde(MDA),and the concentration of(myeloperoxidase)(MPO) in lung tissue were determined;and the pancreas and lung pathology were graded,the changes of the above-mentioned indexes after using octreotide and ulinastatin were compared.Results(1)Compared to SAP group,AMY,TNF-?,MDA,MPO,and pancreas pathology score were decreased significantly in each of the 3 therapy groups during the same period;and at 12h,in O+U sub-group,lung pathology score also decreased compared to SAP group(P

0.05),but,serum AST and ALT were significantly decreased on the 12th hour in arterialization group(P

BACKGROUND:Intertrochanteric fractures can be generaly treated by surgical treatment. Along with deep research on the biomechanics of the proximal femur, proximal femoral locking compression plate appears recently. The locking plate fixation is not strong, can reduce the local stress shielding, and maintain optimal system stability, but fracture fixation failure often occurs due to the inappropriate choice of nail plate. OBJECTIVE:To evaluate the value of digital orthopedics technology in preoperative planning in locking plate fixation for intertrochanteric fracture. METHODS: Forty intertrochanteric fracture patients receiving CT tomography femur upper segment were selected and divided into two groups. In the conventional group, after reading X-ray films and CT images, patients received locking plate fixation. In the computer planning group, before repair, fracture model was established using Mimics software to segment fracture fragments, simulate operation reset and 3-matic software was used to reconstruct locking plate and screws. Locking plate was assembled with Mimics to obtain the best plate position, best screw angle and screw length. Proximal femoral locking compression plate fixation was performed. Fluoroscopy times, operation time, blood loss and fracture healing time were compared in both groups. RESULTS AND CONCLUSION: Three-dimensional models of proximal femur were reconstructed, and a series of data were obtained. The optimal position of each plate was obtained from each patient. The screw length was predicted, so preoperative operation planning was realized. Al patients were folowed up for 6-20 months. Fluoroscopy times, operation time, and blood loss were significantly less in the computer planning group than in the conventional group (P < 0.05). No significant difference in fracture healing time was detected between the two groups (P > 0.05). These findings suggest that digital orthopedics technology used in intertrochanteric fracture can simulate the locking plate position, determine the screw placement angle and length of the screw in advance, and reduce fluoroscopy times, operation time, blood loss and screw position misalignment.

Objective To investigate the effect of chronic intermittent hypoxia on blood pressure,sympathetic nerve activity and myocardial mitochondrial oxidative stress status in aged rats.Methods Chronic intermittent hypoxia(CIH)rat models were established.A total of 84 male Wistar rats(3-4 and 23-24 months old,respectively)were randomly and equally divided into four groups according to age:young control group,young CIH group,aged control group and aged CIH group.CIH exposure lasted for 3 weeks.The arterial blood pressure,the frequency of carotid sinus nerve action potential,the lung function,the levels of catecholamine,aconitase/fumarate ratio (A/F),plasma superoxide dismutase(SOD)in the plasma were measured and compared between four groups.Results The arterial blood pressure was significantly higher in young CIH group than in the young control group[(150.4 ±25.6)mmHg vs.(102.2±7.4)mmHg,P＜0.01].There was no significant difference in the arterial blood pressure between the aged CIH group[(132.8 ±16.2) mmHg] and the aged control group[(127.1 ± 26.8)mmHg].The minute volume ventilation was significantly lower in the aged control group than in young controlgroup[(331.7±53.5)ml· min-1 · kg-1vs.(554.8±111.9)ml· min-1 · kg-1P＜0.05].The min-1 · kg-1 ventilation showed no significant difference between the agedCIH group[(354.1±51.9)ml· min-1 · kg-1]and the aged control group[(331.7 ±53.5)ml· min-1 · kg-1].The rate of CSN frequency change by hypoxia stimulation was lower in the aged control group than in young control group[(6.2± 5.5)times vs.(11.8 ±6.6)times,P＜0.01],and was lower in the aged CIH group than in the young CIH group[(22.2 ± 13.5) times vs.(44.2± 12.1) times,P＜0.01].The levels of plasma norepinephrine and epinephrine were higher in the young CIH group than in the control group[(39.0±8.9)nmol/L vs.(20.8±10.6)nmol/L,(48.1±13.6)nmol/L vs.(26.7 ± 14.3)nmol/L,both P＜0.05].The levels of plasma norepinephrine and epinephrine showed no significant difference between the aged control group and the young control group,also no significant difference was found between the aged CIH group and the aged control group.The A/F ratio was lower in the young CIH group than in the young control group[(0.26±0.13)vs.(0.58 ±0.04),P＜0.01].The A/F ratio was lower in the aged control group than in the young control group [(0.29±0.02)vs.(0.58± 0.04),P＜0.01],but there was no significant difference in the A/F ratio between the aged CIH group and the aged control group.The level of SOD was significantly lower in the young CIH group than in the young control group [(5.30 ±± 0.90) NU/mgprot vs.(6.10 ± 1.73)NU/mgprot,P＜0.05].There was no significant difference in SOD level between aged control group and aged CIH group.Conclusions The effect of CIH on blood pressure in aged rats is different from the youth rats.This study shows adecreasedsympathetic nervous over activity and a reducedmitochondrial oxidative stress in aged rats.Aging probably suppresses two important pathogenic mechanisms,by which CIH affects blood pressure,therefore releases CIH induced blood pressure abnormality.

Objective To explore the elimination effect of radix Pulsatillae extracts on R plasmid of pseudomonas aeruginosa.Methods R plasmids of pseudomonas aeruginosa were isolated from the sputum of elderly patients suffering from respiratory infection,and the elimination test of radix Pulsatillae extracts on these plasmids was performed in vitro and in vivo.Results Being treated with the extracts for 24,48 and 72 h in vitro,the elimination rate of R plasmids was 0,1.8 %and 3.4 %respectively,while in SDS(sodium dode canesulphonate)control group the elimination rate was 0,0.8 %and 1.6 %respectively.Being treated with the extracts for 24,48 and 72 h in vivo,the elimination rate was 0,2 %and 12.8 %respectively,and 0 in the control group.Conclusions Both in vitro and in vivo,radix Pulsatillae extracts have an elimination effect on R plasmid of pseudomonas aeruginosa,and the effect in vivo is stronger than that in vitro.

Noise is a common occupational hazardous factor in the workplace. In addition to the specific damage to the auditory ， system of workers it can also harm the cardiovascular system and cause a serious disease burden. The mechanism of ， occupational noise on the cardiovascular system of workers is mainly oxidative stress inflammation and vascular endothelial ， - - - damage. As a stressor noise mainly leads to the changes of sympathoadrenal medullary system and hypothalamic pituitary ， ， ， - ， adrenal axis. The substances that play an important role include catecholamines cortisol angiotensin Ⅱ endothelin 1 - endothelial nitric oxide synthase and interleukin 6. The population epidemiological studies have shown that occupational noise ， exposure can lead to elevated blood pressure abnormal electrocardiogram and elevated blood lipids in workers. The influencing （ ， ， ） factors include noise characteristics intensity cumulative noise exposure and frequency and noise combined with other （ ， ， ， - ， occupational hazards such as high temperature welding fumes organic solvents hand transmitted vibration and work ） ， ， ， shifts . However due to the influence of research conditions experimental design and other factors some research conclusions still have limitations. More prospective and comprehensive studies are needed to verify the relevant conclusions in the future.

OBJECTIVE:To evaluate the effect of Stronger Neo-Mioniphagen C(SNMC)on liver function of the patients with hepatocarcinoma associated with cirrhosis.METHODS:55patients with hepatocarcinoma associated with cirrhosis were allocated to2groups randomly,group A:before operation SNMC(1ml/kg)was dripped intravenously to the patients,group B:before surgery NS(1ml/kg)was administered.On the1st、3rd、6th postoperative day,the index of liver function of the perive?nous blood were analyzed statistically.RESULTS:On the1st、3rd postoperative day,all the value of liver function in both group is higher than the basic,and the value in group A is lower than that in group B(P

Objective To evaluate the effect of Rab23 on the proliferation of a squamous cell carcinoma cell line Sa3,and to investigate its mechanisms.Methods Cultured Sa3 cells were classified into four groups:normal control group transfected with green fluorescent protein (GFP),Rab23-overexpressing group transfected with a GFP-labelled Rab23-overexpressing plasmid,Rab23-silencing group transfected with a plasmid carrying a Rab23-targeting shRNA,empty vector group transfected with an empty vector.After additional culture for different durations,plate colony formation assay and flow cytometry were performed to evaluate the proliferative activity of Sa3 cells,and Western blot was conducted to detect the expression of Erl/phosphorylated-Erk in Sa3 cells.Statistical analysis was carried out by t test,one-way analysis of variance and Bonferroni's multiple comparison test.Results Stable Sa3 cell lines with overexpression or silencing of Rab23 were established by plasmid construction and lentivirus-mediated transfection.The plate colony formation assay showed that the colony formation rate was significantly lower in the Rab23-overexpressing group than in the normal control group (2.3％ ± 0.2％ vs.3.6％ ± 0.3％,P ＜ 0.05),but higher in the Rab23-silencing group than in the empty vector group (4.1％ ± 0.2％ vs.1.8％ ± 0.03％,P ＜ 0.01).Rab23 overexpression induced G1 phase arrest in Sa3 cells.The proliferation index was significantly decreased in the Rab23-overexpressing group compared with the normal control group (0.581 ± 0.035 vs.0.698 ± 0.018,P ＜ 0.05),but increased in the Rab23-silencing group compared with the empty vector group (0.567 ± 0.015 vs.0.444 ± 0.014,P ＜ 0.01).As Western blot showed,there were no significant changes in the expression of Erk in the Rab23-silencing or-overexpressing group compared with the normal control group,whereas the expression of p-Erk was attenuated in the Rab23-overexpressing group compared with the normal control group,but enhanced in the Rab23-silencing group compared with the empty vector group.Conclusions Rab23 could inhibit the proliferation of Sa3 cells,which may be associated with the Erk pathway.

Objective To the value of ultrasonic imaging in diagnosis of appendiceal mucinous neoplasms in patients.Methods A retrospective review was performed for the 26 cases undergoing pre-operative ultrasonography and finally diagnosed as appendiceal mucinous neoplasms by pathology.The 26 patients were included in the study,11 elderly patients aged ≥60 years as group A,and 15 younger patients aged ＜ 60 years as group B.The characteristics of the ultrasonic imaging were analyzed.Results Features of ultrasound images leading to diagnosis were summarized as following.The lesion transverse diameter was over 2 cm,with anechoic or hypoechoic area of lesion or onion skin sign inside the lesions.There were distinct borderlines between lesions and surrounding tissues,with no or little blood in the color doppler flow imaging.Conclusions There are same u1trasonography characteristics of appendiceal mucinous neoplasms in two age groups.Improving the knowledge of this disease and grasping the clinical and sonography characteristics are stringent to enhance the accuracy rate of diagnosis.