Objective To observe the effects of the Dachaihu decoction on intra-abdominal pressure in severe acute pancreatitis. Methods 70 patients with SAP from China-Japan Friendship Hospital were randomly divided into two groups. 35 patients in a conventional treatment group were treated with conventional treatment of severe acute pancreatitis, and 35 patients in a Dachaihu decoction treatment group were treated with the decoction through nasogastric tube based on conventional treatment. The changes of intra-abdominal pressure and the morbidity of IAH and ACS in both groups were observed in acute stage. Results The intra-abdominal pressure in both groups increased. But the pressure in the Dachaihu decoction treatment group (13.31 ± 4.42 mmHg, 13.02 ± 5.23 mmHg, 12.35 ± 3.34 mmHg, 11.26 ± 4.46 mmHg, 9.89 ± 3.44 mmHg) was lower than the conventional treatment group (16.89 ± 5.71 mmHg, 17.52 ± 3.37 mmHg, 16.21 ± 2.15 mmHg, 14.57 ± 5.56 mmHg, 12.11 ± 1.28 mmHg) from the third day on (P<0.05). And the morbidity of intra-abdominal hypertension and abdominal compartment syndrome in the Dachaihu decoction treatment group were lower than the conventional treatment group in the whole acut stage (40%vs. 8.75%).The differences between two groups were statistically significant (P<0.05). Conclusion The Dachaihu decoction may significantly reduce the intra-abdominal pressure and the morbidity of intra-abdominal hypertension and abdominal compartment syndrome among patients with severe acute pancreatitis.

Objective To explore the anti-apoptotic mechanism of Roux-en-Y gastric bypass (RYGB) through exam?ine the postoperative change of adiponectin levels and expressions of pancreatic islets relative apoptotic protein. Methods Sixty SD rats were randomly allocated to RYGB group (n=20), type 2 diabetes mellitus group (T2DM, n=20) and normal con?trol group (NC, n=20). Rats in the NC group were fed with normal diet. In order to make type 2 diabetic rat models, the rats in the T2DM and RYGB groups were fed with high fat diet (22.19 kJ/g) combined with administration of intraperitoneal strep?tozotocin injection (STZ, 30 mg/kg) on the 13th day of high fat diet. RYGB operation were performed in RYGB group and sham-operation were performed in the T2DM and NC groups when diabetic model was contructed. Rats were weight preoper?atively and at the 7th, 14th, 21st days after operations. Fasting plasma glucose and adiponectin (ELISA) were measured preoper?atively and at 21st day postoperatively. Protein expressions of Bcl-2,Caspase 8 and Caspase 9 in pancreatic islets were ex?amined by immunohistochemistry at the 21st day postoperatively. Results Body weights do not vary significantly among three groups preoperatively. Compared to rats in the NC group, fast plasma glucose level was higher but adiponectin was low?er in rats in RYGB and T2DM groups. Body weights of rats in RYGB group decreased significantly compared to those of rats in NC and T2DM groups postoperatively. Compared to rats in T2DM group, fasting glucose level was lower while adiponectin concentrations was higher in rats in RYGB group but no differences of these parameters were seen in rats in NC group at the 21st day postoperatively. Expression of Bcl-2 in RYGB group was significantly elevated while expressions of Caspase 8 and Caspase 9 were significantly decreased compared to those in T2DM group postoperatively. Conclusion Adiponectin levelswas elevated;expressions of Bcl-2 was increased;expressions of Caspase 8, Caspase 9 were decreased upon RYGB opera?tion in T2DM model. RYGB might reduce pancreatic islets apoptosis through mitochondrial pathway.

Objective To explore the imaging features and clinical significance of solitary costal hot spots on bone scintigraphy (BS). Methods Eighty-four patients with single costal hot spots were enrolled in the study. The sites of lesions were classified into four types: junction betweenaor rib. The shapes of hot spots were classified into three forms: Punctiform, clumping and strip. The above data were respectively analyzed. Results Single hot spots were mainly showed in the punctiform and strip shapes, and the distribution of punctiform spots were mainly in the sites of junction between costal cartilage and rib and frontal ribs, also mainly due to costal fractures (42/61, 68.85%). The majority of spots in strip shape were costal metastases(18/19, 94.74%). Hot spots in posterior ribs were also mainly costal metastases (24/29,82.76%). Conclusion Useful imaging features can be obtained from BS with al diagnosis of benign and malignant lesions.

ObjectiveTo observe the modified Xiaoqinglong decoction and its ingredient-reduced prescription on plasma levels of IL-5 and TNF-ct in rats,and to explore its mechanism of treating AR.To make clear the law of combination in modified Xiaoqinglong decoction.MethodsThe modified Xiaoqinglong decoction was divided into six groups,namely,reinforcing qi group,warming yang group,expelling retained morbid fluid group,reinforcing qi and warming yang group,reinforcing qi and expelling retained morbid fluid group,warming yang to expel retained morbid fluid group.90 rats were randomly divided into nine groups,namely,normal control group,model group,reinforcing qi group,warming yang group,expelling retained morbid fluid group,reinforcing qi and warming yang group,reinforcing qi and expelling retained morbid fluid group,warming yang to expel retained morbid fluid group,and the whole decoction group,with 10 rats in each group.Rat model of allergic rhinitis was made by the use of adjuvant systemic antigen sensitization and local attack,the normal control group and model group were fed with normal saline,the other groups were treated with appropriate drugs,once a day oral administration,continuous for 4 weeks.Detected plasma IL-5 and TNF-α levels of each group in rats.ResultsThe contents of plasma IL-5 (16.0±2.7)mg/L and TNF-α (57.5±8.0)mg/L in the model group was significantly increased,while it was significantly reduced in the reinforcing qi group,warming yang group,expelling retained morbid fluid group,refinorcing qi and warming yang group,reinforcing qi and expelling retained morbid fluid group,warming yang to expel retained morbid fluid group with plasma IL-5[each group was (12.9± 3.1) mg/L、(11.8 ±2.8) mg/L、(12.0±2.3) mg/L、(12.3±2.3) mg/L、(11.1±2.1)mg/L、(11.2±2.5)mg/L、(8.42.3)mg/L respectively]and TNF-α[each group was (27.7±5.7)mg/L、(29.5 ± 3.7) mg/L、(31.2 ± 4.9) mg/L、(28.1 ± 2.8) mg/L、(33.4 ± 5.6) mg/L、(26.3 ± 3.9) mg/L、(21.6 ±4.9) mg/L respectively],the whole decoction group effect was significant compared with the other treated groups (P＜0.05).ConclusionThe modified Xiaoqinglong decoction and its ingredient-reduced prescription can regulate plasma levels of IL-5 and TNF-α.The modified Xiaoqinglong decoction had best results in reinforcing qi,warming yang and expelling retained morbid fluid.

Objective To design a novel electronic device for measuring the pressure in the cuff of the artificial airway; and to study the advantage of this device on continuous and intermittent cuff pressure monitoring. Methods ① a portable electronic device for cuff pressure measurement was invented, which could turn pressure signal into electrical signal through a pressure transducer. Meantime, it was possible to avoid pressure leak from the joint and the inside of the apparatus by modified Luer taper and sophisticated design. If the cuff pressure was out of the normal range, the apparatus could release a sound and light alarm. ② Six traditional mechanical manometers were used to determine the cuff pressure in 6 tracheal tubes. The cuff pressure was maintain at 30 cmH2O (1 cmH2O =0.098 kPa) by the manometer first, and repeated every 30 seconds for 4 times. ③ Study of continuous cuff pressure monitoring: We used a random number generator to randomize 6 tracheal tubes, 6 mechanical manometers and 6 our products by number 1-6, which has the same number of a group. Every group was further randomized into two balanced groups, one group used the mechanical manometer first, and the other used our product first. The baseline pressure was 30 cmH2O, measurement was performed every 4 hours for 6 times. Results When traditional mechanical manometer was used for cuff pressure monitoring, cuff pressure was decreased by an average of 2.9 cmH2O for each measurement (F = 728.2, P = 0.000). In study of continually monitoring, at each monitoring point, the pressure measured by electronic manometer was higher than the mechanical manometer. All the pressures measured by mechanical manometer were dropped below 20 cmH2O at 8th hour, and there was no pressure decrease below 20 cmH2O measured by electronic manometer in 24 hours by contrast. In study of intermittent monitoring, the same result was found. The pressure was dropped significantly with time when measured by mechanical manometer (F = 61.795, P = 0.000), the drops below 20 cmH2O began at 8th hour; but when measured by electronic manometer, all the value stayed unchanged around the baseline in 24 hours (F = 0.511, P = 0.796). Conclusions Compared with traditional mechanical manometer, cuff pressures monitored by our novel electronic manometer were steadier in both continuous and intermittent monitoring. The device is compact and convenient, and can provide a good solution for continuously monitor of the tracheal cuff pressure.

Objective To investigate the efficacy of breast tissue flap cohesive treatment after breast augmentation injection mixture dis-placed.Methods A total of 78 patients with breast augmentation injection mixture polyacrylamide hydrogel(PAAG)shift in our hospital from January 2006 to March 2014 were divided into two groups according to different surgical methods,39 cases with the material shifted to abdominal wall in control group were treated by taking the cleaning operation to scrape residual cavity,39 patients in observation recieved new breast tissue flap design local treatment of breast fistula closed chest and abdominal wall channel after surgical elimination of the same abdom-inal wall cavities.Results The PAAG extensive deposition in the breast tissue,armpits,chest wall clearance were formed fistula communica-tion.The secretions of patients treated with tissue flap decreased 82%,the lacunar lesions reduced 80% after 2 weeks,while patients without tissue flap,the drain reduced 46%,the lesion size reduced 45%,the difference between the two groups was significant(P <0.01).The heal-ing rate of tissue flap group was higher than that of conventional group after 4 weeks.Conclusion The PAAG mixture shifting formed fistula communication in the abdominal wall is the main reason of the mass flow and a huge cavity.Flap can significantly promote abdominal wall fis-tula healing.

Objective To evaluate the effect of heart rate control with esmolol on hemodynamics, inflammatory cytokines and clinical outcomes in patients with septic shock.Methods A prospective randomized controlled trial was conducted. The patients with septic shock admitted to Department of Critical Care Medicine of China-Japan Friendship Hospital from August 2014 to October 2016 were enrolled. After 24 hours of resuscitation and other therapy, they were randomly divided into two groups by sealed envelope. The patients in experimental group was treated with continuous intravenous esmolol infusion for 24 hours, initial dose was 0.05 mg·kg-1·h-1, and was titrated to decrease the heart rate by 20% as compared with the value at the time of enrollment or below 95 bpm, while isotonicsaline was given to control group through intravenous line at 3 mL/h for 24 hours. The differences in hemodynamic parameters at 0, 1, 4, 8, 12, 24 and 48 hours, as well as serum inflammatory cytokines and blood lactate (Lac) at 0, 12, and 24 hours, 28-day mortality were compared between the two groups.Results Seventy-six septic shock patients were admitted during the study, 12 were excluded forsuspicious acute myocardial infraction (AMI) or acute left heart failure or for the history of chronic obstructive pulmonary disease (COPD), 4 were quitted the study for being unable to tolerate the lowest dose of esmolol, giving up treatment, or death within 24 hours. Finally, 60 patients completed the study, 30 patients in experimental group, and 30 in control group. There were no differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and infection source between two groups, indicating the general data between the two groups were balanced and comparable. The decrease in heart rate was more markedly in experimental group than that of control group at 1, 4, 48 hours after esmolol administration (bpm: 97.4±16.5 vs. 110.9±19.6, 95.2±15.3 vs. 105.1±17.9, 86.4±12.1 vs. 97.2±22.6, allP < 0.05), cardiac index (CI) at 8, 24, 48 hours was significantly increased(mL·s-1·m-2: 57.2±13.5 vs. 46.5±11.0, 57.7±15.7 vs. 48.7±14.7, 61.2±16.5 vs. 51.5±14.7, allP < 0.05), and stroke volume index (SVI) at 4, 8, 24 hours was significantly increased (mL/m2: 34.1±6.9 vs. 29.0±8.7, 35.0±6.1 vs. 28.8±9.6, 38.3±10.1 vs. 31.9±13.2, allP < 0.05). Interleukin-1β (IL-1β) at 24 hours in experimental group was significantly higher than that of control group (ng/L: 0.15±0.06 vs. 0.13±0.05,P < 0.01). There were no differences in mean arterial pressure (MAP), Lac, white blood cell (WBC), IL-6, IL-10, and tumor necrosis factor-α (TNF-α) between the two groups, and no difference in 28-day mortality between experimental group and control group was found (30.0% vs. 36.7%,χ2 = 0.300,P = 0.583).Conclusions It is efficient and safe to use esmolol for heart rate control in patients with septic shock after resuscitation. Esmolol can improve cardiac performance without affecting blood pressure and Lac, but has no effect on inflammatory cytokines and prognosis.

Objective To evaluate the correlation between serum procalcitonin (PCT) level and severity of diseases caused by different kinds of stress factors, and to identify the prognostic value of PCT on the prognosis in non-sepsis critically ill patients. Methods A retrospective case control study was conducted. The clinical data of non-sepsis critically ill patients with age of ≥ 18 years admitted to surgery intensive care unit (ICU) of China-Japan Friendship Hospital from August 2013 to December 2015 and stayed for more than 3 days were enrolled. The PCT level in the first 24 hours, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score and 28-day mortality were recorded. Patients were divided into different groups by the original injury, including trauma stress group, stroke stress group and non-infection inflammation stress group. According to PCT level, patients were divided into PCT normal group, low level group, medium level group and high level group. Furthermore, patients were divided into survival group and non-survival group according to 28-day prognosis. The clinical data of patients were compared among the groups, and the correlations among different markers were analyzed with Pearson or Spearman correlation analysis. The predictive value of PCT on prognosis of non-sepsis critically ill patients was evaluated with receiver operating characteristic curve (ROC). Results Ninety-four non-sepsis critical ill patients were enrolled, with 28 patients in trauma stress group, 30 in stroke stress group, and 36 in non-infection inflammation stress group, as well as 32 patients in PCT normal group, 18 in low level group, 18 in medium level group, and 26 in high level group. Of them, 78 survivors and 16 non-survivors were found. ① The PCT level of non-sepsis critically ill patients was significantly positively correlated with APACHE Ⅱ score and SOFA score (r1 = 0.688, r2 = 0.771, both P = 0.000). ② The PCT level in trauma stress group was significantly higher than that in stroke stress group and non-infection inflammation stress group [μg/L: 4.43 (0.86, 11.72 ) vs. 0.28 (0.16, 5.85), 2.39 (0.13, 4.11), both P < 0.01]. APACHE Ⅱ score (13.9±7.5, 13.9±7.0 vs. 9.4±4.4), SOFA score [7.0 (4.0, 9.0), 5.0 (3.0, 8.0) vs. 4.0 (2.0, 6.0)], and 28-day mortality [21.4% (6/28), 33.3% (10/30) vs. 0 (0/36)] in trauma stress group and stroke stress group were significantly higher than those of non-infection inflammation stress group (all P < 0.05). The abnormal rate of PCT in trauma stress group was significantly higher than that of stroke stress group and non-infection inflammation stress group [100.0% (28/28) vs. 33.3% (10/30), 66.7% (24/36), both P < 0.01]. ③ Non-survivors had significantly higher PCT level [μg/L: 6.02 (4.43, 18.34) vs. 0.76 (0.16, 4.11)], APACHE Ⅱ score (22.5±3.8 vs. 10.1±5.1) and SOFA score [9.0 (7.0, 11.0) vs. 4.0 (2.0, 8.0)] as compared with those of survivors (all P < 0.01). ④ APACHE Ⅱ score (7.8±2.8, 9.3±4.3, 13.7±6.2, 18.7±5.8, F = 22.495, P = 0.000), SOFA score [3.0 (1.2, 4.8), 4.0 (3.5, 4.5), 6.0 (3.5, 8.0), 10.0 (8.8, 12.0), Z = 51.040, P = 0.000], and 28-day mortality [0 (0/32), 11.1% (2/18), 22.2% (4/18), 38.5% (10/26), χ2 = 15.816, P = 0.001] were gradually increased as PCT level elevated. ⑤ The area under ROC curve (AUC) of PCT for evaluating prognosis of non-sepsis critically ill patients was 0.799 [95% confidence interval (95%CI) = 0.709-0.889, P = 0.000], when the cut-off value was 4.2 μg/L, the sensitivity was 87.5%, and the specificity was 77.6%. Conclusions Serum PCT level was positively correlated with severity of illness in non-sepsis critically ill patients, which had predicted value on prognosis. Trauma stress can lead to higher PCT level than stroke stress and non-infection inflammation stress can.

Objective To investigate the clinical effect of cosmetic suture technique applied in organs of facial emergency surgery. Methods There were 25 patients who were admitted in our hospital from August 2009 to December 2013. After anatomical reduction and functional restoration, they were given surgery with cosmetic suture technique on the base of debridement. Results All of the patients a-chieved good surgical result, the satisfaction is 100%. After the first stage of operation, 23 patients of them were of no obvious scar and good function recovery. The other 2 patiens also got good effects after secondary surgery. Conclusion Cosmetic suture technique pay attaintion to anatomical and functional restoration. It is of equisite technique, slight injury, less scar after operation and it can maximumly get close to the normal tissue structures and achieve the objective of beauty.

Objective To observe the effect of Yiqi Huexue Recipe on the expression of TGF-β1 and TNF-α on serum and lung of rots with radiation-induced lung injury in different radiation time,and discuss the preventative and curative effect and mechanisms of Yiqi Huoxue Recipe.Methods 66 Wistar rats were randomly allocated into irradiation with Yiqi Huoxue Recipe-treated group(A group)irradiation group(B group),and normal control group(C group).The first two groups were irradiated at right hemithorax with a dose of 30 Gy/6 fractions(in 6 weeks).The levels of TGF-β1,and TNF-α on rat serum and lung were measured by ELISA and immunohistochemistry at the end of the 4th,6th,8th,12th,and 26th week after the first irradiation.Results TGF-β1,and TNF-α level on rats serum and lung in irradiation group showed an increase from the 4th week after the first irradiation,peaking at the 12th week,and descending at the 26th week.In A group,the levels of TGF-β1 and TNF-α were significantly lower from the 4th week than those of B group.Conclusions Yiqi Huoxue Recipe could inhibit the excretion of TGF-β1,and TNF-α and might play an important role in the prevention and curation of radiation-induced lung injury,which might be related to inhibiting the expression of TGF-β1 and TNF-α.