OBJECTIVE:To study the curative effect and mechanism of ulinastatin (UTI) administered by two different routes for severe acute pancreatitis (SAP). METHODS: 50 healthy male SD rats were randomly divided into 5 groups: sham operation (SO) group (fed with water ad libitum), SAP model group, positive control(nafamostat) group, ulinastatin peripheral venous perfusion group, and ulinastatin celiac arterial perfusion group. SAP model was established in the latter four groups, and then the rats were treated with corresponding drugs. 12h later, sample tissues were taken from pancreas and lungs for measurement of MPO level and histopathologic observation and the blood samples were collected for measurement of serum amylase, TNF-? and TXB2. RESULTS: Levels of amylase, TNF-?, TXB2, MPO and Hughes histopathologic scores of pancreas and lungs in all drug-treated groups were significantly lower than in SAP group (P

Objective To investigate the effects of Mailuoning on oxidative stress and ischemic brain injury. Methods A total of 126 healthy male Kunming mice were divided into sham operation (n = 18), normal saline control (n = 54) and Mailuoning (n = 54) groups. A middle cerebral artery occlusion (MCAO) model was induced Two hours after MCAO,Mailuoning injection and equivalent saline were injected via the tail vein in the Mailuoning and normal saline control groups, respectively, and then they were injected every other 24 h.Neurological score was performed, and brain water content, infarct volume, membrane potential,as well as protein oxidative stress metabolites such as 3-nitrotyrosine (3-NT), lipid oxidative stress metabolite 4-hydroxy-2-nonenal (HNE) and nucleic acid oxidative stress metabolite 8-hydroxy-2'-deoxyguanosine (8-OHdG) were detected at 12, 24 and 72 h after MCAO. Results Mailuoning injection could significantly improve the neurological function of cerebral ischemia in mice, decrease brain edema, and reduce infarct volume at different time points after cerebral ischemia Of those, it was most significant at 72 h. Mailuoning injection could reverse the decreased mitochondrial membrane potential in cerebral cortex and internal capsule, and significantly downregulate the increased 3-NT, HNE and 8-OHdG in cerebral cortex, internal capsule and serum after ischemia, of those, the effect of reducing HNE was most significant.Conclusions Mailuoning injection may effectively protect against ischemic brain injury in mice,and its mechanism is associated with inhibiting oxidative stress, particularly anti-lipid oxidation.

Objective To systematically review the efficacy and safety of drug-eluting stent(DES) versus coronary artery bypass grafting(CABG) in the treatment of left anterior descending coronary artery(CAD) stenosis.Methods Literature about the efficacy and safety of DES versus CABG for LAD stenosis was retrieved from digital databases of MEDLINE, EMbase, PubMed, and the Cochrane Library by November 2016.Data extraction and quality assessment of included studies were conducted by two independent reviewers.RevMan 5.3 software was used to perform meta-analysis.Results Ten studies involving 9771 patients were finally included.The results of meta-analysis showed that there was no significant difference in mortality [RR=0.88,95%CI(0.70,1.11),P=0.28],major adverse cardiovascular events[MACE,RR=1.04,95%CI(0.88,1.24),P=0.63] or myocardial infarction [MI,RR=0.92,95%CI(0.56,1.53),P=0.75], but PCI-DES significantly increased the risk of TVR [OR=2.43,95%CI(1.61,3.69),P<0.0001].Conclusion For LAD stenosis, PCI-DES strategy causes as high a rate of mortality, MACE and MI as CABG or DES, but PCI-DES can significantly increase the risk of TVR, so we should be cautious clinically.

Objective:To supply a reference measure,CD8+CD38+ expressin,AST,TBIL,PT were examined in patients with chronic hepatitis B.Methods:CD8+CD38+ expression of peripheral blood lymphocyte in 38 patients with chromic hepatitis B and 14 patients with liver cirrhosis were detected with flow cytometry. AST,TBIL,PT were also measured at the same time with instruments.Results:(1)CD8+CD38+ expression in patients with choronic hepatitis B and liver cirrcosis elevated significantly compared with those in normal controls. But CD8+CD38+ expression in patients with liver cirrhosis was lower significantly than those with chronic hepatitis B.(2)CD8+CD38+ expression in moderate chronic hepatitis B were higher than those in mild chronic hepatitis B. CD8+CD38+,CD8+,CD38+ expression in severe chronic hepatitis B were higher than those in mild chronic hepatitis B. CD38+ expression in severe chronic hepatitis B was higher than those in moderate chronic hepatitis B. CD8+CD38+,CD8+,CD38+ expression in liver cirrhosis was lower than those in mild,moderate,severe chronic hepatitis B. CD8+ expression in liver cirrhosis was lower than those in severe chronic hepatitis B.(3)CD8+CD38+ expression in patients under AST,TBIL,PT abnormal condition were higher than those in patients under AST,TBIL PT,normal condition.Conclusion:The increasing of CD8+CD38+ expression of peripheral blood lymphocyte in patients with chronic hepstitis B,reflect the fact that cell immunolgy was abnormally activated.There was a remarkable correlation on CD8+CD38+ and AST,TBIL,PT. To test expression of CD8+CD38+ of peripheral blood lymphocyte in chronic hepatitis B has very important clinical reference value on patient′s condition development and diagnosis.

Objective To evaluate the diagnostic value of 64-row VCT coronary angiography(CTA) in diagnosing coronary artery disease.Methods 64-row VCT coronary angiography(CTA) and cathter coronary angiography(CAG) were performed in 173 patients with suspected coronary artery disease.All images were analysed at GE AW4.3 workstation,the constructed images included maximum intensity projection(MIP),mlti-planar reconstruction(MPR) and volume rendering(VR).The results were compared with that of CAG.Results 746 segments of coronary artery with diameter ＞1.5 mm were showed by CTA in 173 patients.The sensitivity,specificity,positive predictive value and negative predictive value of the CTA in detecting coronary arterial stenosis were 94.15%(193/203),95.90% and 89.77% and 97.90% respectively.Statistical analysis using a 2-related χ~2 test showed that there were no obvious differences in diagnosing coronary arterial stenosis between CTA and CAG(χ~2=1.58,P＞0.05) and in evaluating the stenosis degree of coronary artery(Kappa=0.890,P＜0.001).Conclusion 64-row VCT has important clinical value in screening coronary arterial disease and in following-up post operational effectiveness of coronary stent implantation and vascular bypass.

Objective To evaluate the diagnostic performance of enhancement value and morphological features by using mul-tiphasic MDCT on differentiating untypical T4a from T3 gastric cancer.Methods Fifty-one histopathologically proven T3 and T4a gastric cancer patients with smooth serosa were collected retrospectively.Three radiologists read all images regarding morphological features,while the CT value and enhancement value of regions of interest (ROIs)located in the outer of lesion were calculated.Cut-off analysis was performed to determine optimal threshold levels of enhancement value to discriminate T4a and T3 gastric cancer.Di-agnostic performance of enhancement value and combination of enhancement value and morphologic assessment were compared with morphologic assessment by means of receiver operating characteristic (ROC)curve analysis.Results The sensitivity and specificity of morphological features was 66.67% and 33.33% respectively;the area under the ROC of enhancement value (between venous phase and plain scan)for differentiating T4a from T3 gastric cancer was 0.82,with a cut-off at 43.6 HU,sensitivity of 74.07% and specificity of 70.83%.Combined conventional standard and enhancement value,sensitivity of 100.00% and specificity 26.31%. Conclusion For differentiation of T4a and T3 gastric cancer by means of MDCT,enhancement value is found to be superior to con-ventional standard.

Objective To discuss the relationships between qi-arrival and mind-control, qi-arrival and qi-regulation, and to define qi-arrival by tracing the relevant records in Nei Jing (Classic of Internal Medicine) and Nan Jing (Classic of Difficult Issues). Method Thirty-seven relevant ancient books of the two classics were reviewed and the notes by WANG Bing, MA Shi, and YANG Shang-shan were referred. Result Mind-control requires the spirits of the practitioner, patient and environment, as well as observing and waiting for the arrival of qi. Regarding qi-regulation, theories involve that qi-arrival achieves same reinforcing and reducing effect as qi-regulation, qi-regulation is elucidated from the correct location of acupoint, proper needling depth and direction, and to regulate qi by observing the arrival of qi. Besides, the changes of internal and external environments also influence qi-arrival via qi-regulation and mind-control. Conclusion Qi-arrival is closely related to mind-control and qi-regulation in obtaining, differentiation, and adjustment. Mind-control and qi-regulation assist each other through the whole acupuncture process, which is the core of qi-arrival.

It's been confirmed that acupuncture-moxibustion is effective in treating primary dysmenorrhea, and the efficacy is closely related to the intervention time. By summarizing the latest research progress on real-time intervention and pre-intervention of acupuncture-moxibustion in treating primary dysmenorrhea, this articlewas to discuss about the effect of intervention time on the efficacy in treating primary dysmenorrhea and thus to provide evidence to choose the optimal intervention time. It brought up that real-time intervention of acupuncture-moxibustion can produce a significant analgesic effect in treating primary dysmenorrhea, while pre-intervention of acupuncture-moxibustion presents its advantages in generally regulating the body function. Therefore, the treatment of primary dysmenorrhea should combine real-time intervention and pre-intervention of acupuncture-moxibustion to enhance the clinical efficacy.

AIM:To investigate the expression of C/EBP homologous protein (CHOP) and its correlation with proliferative/apoptotic ratio (PAR) in colorectal adenoma-carcinoma sequence under the same genetic background .ME-THODS:Four kinds of tissue samples under the same genetic background from 23 patients, including normal colorectal tissue, adenoma with low-grade intraepithelial neoplasia , adenoma with high-grade intraepithelial neoplasia and colorectal adenocarcinoma samples , were collected .TUNEL method and Ki-67 immunohistochemistry were applied to determine the PAR.The expression of CHOP was detected by immunohistochemistry SABC method .RESULTS: ( 1 ) Under the same genetic background , the level of CHOP expression is significantly higher in colorectal adenocarcinoma than that in the ade -noma with high-grade intraepithelial neoplasia , the adenoma with low-grade intraepithelial neoplasia and the normal muco-sa.The level of CHOP expression was significantly higher in the adenoma with high -grade intraepithelial neoplasia than that in the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .The level of CHOP expression was signifi-cantly higher in the adenoma with low-grade intraepithelial neoplasia than that in normal mucosa .(2) Under the same ge-netic background , PAR was significantly higher in the colorectal adenocarcinoma than that in the adenoma with high -grade intraepithelial neoplasia , the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .PAR was significant-ly higher in the adenoma with high-grade intraepithelial neoplasia than that in the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .PAR was significantly higher in the adenoma with low-grade intraepithelial neoplasia than that in the normal mucosa.(3) CHOP levels were positively correlated with PAR in the adenoma with low-grade intraepi-thelial neoplasia , adenoma with high-grade intraepithelial neoplasia and colorectal adenocarcinoma .CONCLUSION:CHOP expression and PAR continuously increased and positively correlated along the adenoma -carcinoma sequence , indica-ting that endoplasmic reticulum stress mediates the carcinogenesis of colorectal adenomas .

A 46-year-old male patient developed scatterred reddish-brown plaques and nodules on the back 6 years prior to the presentation. Then, the lesions gradually spread to the axillary fossa and protothorax, and became indurated with slight itching in winter. Laboratory examination revealed hypergammaglobulinemia. Computed tomography(CT)scan showed multiple nodular or patchy shadows in both lungs, lymphadenectasis in axillary, mediastinal and inguinal regions, and spleen enlargement. Histopathological examination of skin lesions showed granulomatous infiltrates with plenty of lymphocytes, histiocytes and mature plasma cells in the middle and lower dermis with the presence of lymphoid follicle-like structures, but no cell atypia was observed. Immunohistochemical study showed positive staining for CD38, CD138, CD79a, κ and λ light chains. According to clinical manifestations and laboratory examination results, the patient was diagnosed with cutaneous and systemic plasmacytosis.