Objective To observe the therapeutic effect of rhubarb combined with Probiotics for treatment of patients with severe acute pancreatitis (SAP) accompanied by acute lung injury (ALI). Methods A prospective randomized controlled trial was conducted. Sixty patients with SAP and ALI were randomly divided into a rhubarb group and a combination of rhubarb and Probiotics group (combined group), 30 cases in each group. Both groups were treated with conventional therapy. On that therapeutic base, the patients in rhubarb group were treated with rhubarb 3 g·kg-1·d-1 (Raw rhubarb in boiling water 200 mL was cooked for 30 minutes, then the decoction was divided into two parts to be infused through nasal jejunal tube, retaining for 1 hour);while in the combined group, beside the above rhubarb therapy, the patients were additionally given Probiotics [Clostridium butyric acid:Chang Lekang capsule, once 1 grain (0.42 g), twice a day] through nasal jejunal tube. The therapeutic course was 14 days in the two groups. The plasma endotoxin levels, oxygenation index, and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were observed before and after treatment for 7 days and 14 days, respectively. After treatment for 30 days, the time of intestine functional recovery and mechanical ventilation, number of damaged organs, number of infectious sites, number of pancreatic pseudocysts, length of intensive care unit (ICU) stay and 30-day fatality rate were observed in the two groups. Results With the prolongation of treatment, the plasma level of endotoxin and APACHEⅡscore in the two groups were gradually reduced, and the oxygenation index was gradually increased after treatment for 7 days and 14 days in the two groups compared with those before treatment, and there were statistically significant differences in above indexes on the 14th day after treatment between combined group and rhubarb group [endotoxin (μg/L): 19.16±1.90 vs. 21.20±1.05, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 369.50±5.45 vs. 341.50±7.36, APACHE Ⅱscore:11.84±0.60 vs. 13.00±0.86, P<0.05 or P<0.01]. The length of intestine functional recovery in the combined group was longer than that in the rhubarb group (days: 5.63±1.75 vs. 5.02±1.54), the number of damaged organs (2.08±0.74 vs. 2.70±1.11), the number of infectious sites (1.93±0.64 vs. 2.23±0.83), the number of pancreatic pseudocysts (1.22±0.34 vs. 1.63±0.11) and the mortality rate [10.0%(3/30) vs. 13.3%(4/30)] in the combined group were lower than those of the rhubarb group, but there were no statistically significant differences between two groups (all P > 0.05). The times of mechanical ventilation (days: 13.40±1.76 vs. 15.60±1.28) and the length of ICU stay (days:16.13±1.25 vs. 17.63±1.30) were significantly shorter in combined group than those in rhubarb group (both P<0.05). Conclusion Rhubarb combined with Probiotics for treatment of patients with SAP and ALI can promote their recovery of lung function and shorten their length of ICU stay.

Objective To evaluate the outcome of open repair of Bankart lesion in the treatment of anterior instability of shoulder.Methods From March 2001 to June 2005,34 cases (36 shoulders) of anterior instability of shoulder underwent open repair of Bankart lesion.Twenty-seven shoulders with Bankart injury were diagnosed by CT scan.Nine shoulders were diagnosed as ALPSA(anterior labrum periosteal sleeve avulsion).Twenty-five shoulders presented with anterior instability only,and 11 combined anterior and inferior instability.Twenty-seven cases had a definite history of injury.Twelve cases presented with Hill-Sachs sign.We used open incision to repair lesions to the capsule glenoid labrum complex with suture anchors.Results The average duration of follow-up was 2.2 years (six months to four years).By Walch-Duplay score system,the good to excellent rate was 86.1%,the moderate rate 8.3%,and the poor rate 5.6%.Redislocation occurred in one case after operation due to injury.The rate of recurrence was 3%.Conclusion Open repair of Bankart lesion in the treatment of anterior shoulder in- stability can lead to good recovery of shoulder function,few complications and a low rate of recurrence.

Objective To explore the pattern of functional reorganization in the cortex after corticospinal tract ( CST) injury and its relationship with the recovery of upper limb motor function. Methods Fifteen patients with complete paralysis on one side after acute cerebral infarction were studied. Within 1 week after the onset, func-tional magnetic resonance imaging ( fMRI ) and diffusion tensor tractography ( DTT) were performed in parallel with timed finger flexion and extension movements in all subjects. The number of nerve fibers in corticospinal tract ( CST) in the affected and healthy sides was measured by using Dtv.Ⅱ. R2 software. One and three months later, fMRI was performed while the affected fingers were flexed and extended passively and any cortical activation was observed. In addition, Fugl-Meyer arm motor function scores were assessed one week, one month and three months after the stroke. Results According to the reconstructed nerve fiber number in CST on the affected side, the patients were classified into three types. Type I:the number of newly-built CST nerve fibers is more than 2/3 of that on the healthy side;type II:the ratio is between 1/3 and 2/3;and type III:the ratio is less than 1/3. For typeⅠpatients, blood oxygenation level-dependent fMRI ( bold-fMRI) showed initial activation of the bilateral sensorimotor cortex ( SMC) and the sup-plementary motor area ( SMA) on the affected side. That was followed by a gradual decrease in the activity in the healthy SMC and an increase in the affected SMC at 1 and 3 months. Among the type II patients bold-fMRI indicated activation of the SMC and SMA on the affected side initially, significant activation of the bilateral SMC and SMA one month later and then stronger activation in the SMC on the healthy side and a weakening of activation in the SMC on the affected side. For typeⅢpatients, initially the SMA and the posterior parietal cortex were found to be slightly ac-tivated. One month later SM1 on the unaffected side was slightly activated, and 3 months later neither the SMC nor the SMA on either side was activated. One week after the onset, the average upper extremity FM scores of the three types of subjects were not significantly different. After one month the three groups′averages were all significantly dif-ferent from one another. But after three months the averages for types I and II were again not significantly different, but significantly better than the average of the type III patients. Conclusion Different CST injuries induce different modes of cortical reorganization. The reorganization is a dynamic process, and different activation patterns are closely correlated with clinical prognosis.

Influenza A/H1N1 virus-encoded nonstructural, or NS1, protein inhibits the 3'-end processing of cellular pre-mRNAs by binding the cellular protein: the 30-kDa subunit of CPSF (cleavage and polyadenylation specificity factor, CPSF30). CPSF30 binding site of the NS1 protein is a potential target for the development of drugs against influenza A/H1N1 virus. A yeast two-hybrid screening system was constructed and used for screening Chinese medicines that inhibit the interaction of the A/H1N1 flu NS1 protein and human CPSF30 protein. The NS1 gene of A/H1N1 virus was amplified by consecutive polymerase chain reaction (PCR), and the human CPSF30 gene of HeLa cell cloned by reverse transcriptase-polymerase chain reaction (RT-PCR). Then the two gene fragments confirmed by sequencing were subcloned into the yeast expression vectors pGBKT7 and pGADT7, respectively. The two constructs, bait vector pGBKNS1 and prey vector pGADCPSF, were co-transformed into yeast AH109. The eight individual yeast colonies were picked and subjected to verification by PCR/gel electrophoresis. The inhibition of the NS1-CPSF30 interaction was allowed the identification of selective inhibitors. The four of more than thirty identified Chinese medicines, including 'Shuanghuanglian oral liquid', showed the strong inhibition of the NS1-CPSF30 interaction.

Recently a great number of new immunodepressants have emerged due to the side effects of steroids.Therefore,relatively more perfect steroid withdrawl regimens have been studied by many researchers at home and abroad.This article reviews the course of steroid withdrawal in liver transplantation,introduces and compares different protocols of steroid withdrawal.

Objective To obtain antibiotic-resistant mutants producing metabolites with antitumor activity from wild-type actinomycete strains without antitumor activity. Methods An actinomycete strain L35-1 was used as an initial strain for obtaining antibiotic-resistant mutants, which is a marine-derived wild-type strain without antitumor activity with an inhibition rate of 2.8% at the 1000 μg/ml of high sample concentration on K562 cells. The antibiotic-resistant mutants both from auto-mutagenesis and chemical mutagen-induced mutagenesis were selected by single colony isolation on antibiotic-containing plates according to the method for obtaining drug-resistant mutants in ribosome engineering. The antitumor activity was assayed by the MTT method using K562 cells for the mutants with aqueous acetone extracts of the whole broth of their fermentation.Results A total of 114 neomycin-resistant (ner) and 68 streptomycin-resistant (str) mutants, all from auto-mutagenesis, was obtained on drug-containing plates. Among them, the 7 ner and 3 str mutants appeared to be bioactive with an inhibition rate above 20% at the 100 μg/ml sample concentration on K562 cells. On the other hand, 41 str and 32 ner mutants from DES-induced mutagenesis and 46 ner mutants from NTG-induced mutagenesis were obtained by mutagen-induced mutation coupled with the single colony isolation on antibiotic-containing plates, among which, one str mutant from DES-induced mutagenesis and one ner mutant from NTG-induced mutagenesis were bioactive with an inhibition rate over 20% at the 100 μg/ml sample concentration on K562 cells. Conclusions The present result has revealed that the wild-type actinomycete strains without bioactivity might become a great source initial strains to obtain bioactive mutants by drug-resistant mutation technique.

OBJECTIVETo explore the surgical method and its clinical effects of minimally invasive osteosynthesis on the treatment of complex ankle fractures.

METHODSFrom January 2007 to December 2011, 53 patients with complex ankle fractures were treated with minimally invasive osteosynthesis. There were 31 males and 22 females, with an average age of 38.2 years old (ranged, 18 to 65). According to the system of Lauge-Hansen, 32 fractures were supination external rotation injury (grade WV), 13 fractures were pronation external rotation (grade III or IV), 5 fractures were pronation abduction (grade III); and 3 fractures can not be classified due to serious comminution fracture of fibula. According to the system of Denis-Weber, there were 4 cases with type A, 34 cases with type B and 15 cases with type C. Seven cases were open fractures. The duration from injuries to operation ranged from 2 hours to 14 days with an average of 5 days. The sequence of reduction and fixation of ankle fractures was firstly posterior malleolus, then medial malleolus and lateral malleolus, and inferior tibiofibular syndesmosis lastly. The fractures of posterior malleolus were reduced and fixed through anterior ankle approaches; the fractures of medial and lateral malleolus were percutaneously fixed with bolts or blade plate or tensile force band; and inferior tibiofibular syndesmosis were firmly fixed if necessary. Baird-Jackson scoring system was used to evaluate clinical effects.

RESULTSForty-eight patients were followed up from 10 to 36 months with an average of 13 months. The fractures got healing with an average time of 12 weeks (ranged, 10 to 18). According to the Baird-Jackson scoring system, the mean score of ankle function was 94.7 +/- 4.2, and 28 cases obtained excellent results, 15 good, 3 fair and 2 poor. One case experienced superficial infections and was cured by changing dressings, 2 cases experienced fixed syndesmosis screw breakage.

CONCLUSIONThe surgical method of minimally invasive osteosynthesis can ensure the anatomical join restoration, protect the blood supply of fracture end, rebuild the function of ankle joint, obtain satisfactory clinical results in treating complex ankle fractures.

Adolescent ; Adult ; Aged ; Ankle Fractures ; Ankle Joint ; physiopathology ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods

During the washing process of coarse bear gall powder extracts, it is necessary to adjust the amount of ethyl acetate according to the properties of raw materials, which aims to improving the yield and purity of the final product. In the research, using NIR spectra to reflect the comprehensive properties of coarse bear gall powder extracts, the process is optimized in a flexible way. Forty batches experiments are designed according to the weight ratio of ethyl acetate and coarse extracts of bear gall powder. The NIR spectra of the coarse extracts of bear gall powder are collected and processed using principal component analysis (PCA) method. The first 8 principal components combined with the amount of the ethyl acetate are used as the input variables, and calibration models are established to predict the yield and purity of the final product 30 batches are used as calibration set, which is used to establish the models, and other 10 batches are used as validation set, which is used for the performance appraisal of the established models. The correlation coefficients of the calibration, inner cross-validation and external validation for the purity model are 0.902, 0.896 and 0.883, respectively, and the RMSEC, RMSECV and RMSEP are 1.22%, 1.48% and 1.59%, respectively. The correlation coefficients of the calibration, inner cross-validation and external validation for the yield model are 0.921, 0.859 and 0.916, respectively, and the RMSEC, RMSECV and RMSEP are 1.39%, 1.65% and 1.53% respectively. This work demonstrated that NIR spectra combined with technology parameter could be used to predict the yield and purity of the final product. Using the established models, the most appropriate amount of the ethyl acetate can be determined according to the properties of the coarse bear gall powder extracts, and the yield and purity of the final product can be improved.
Acetates ; chemistry ; Animals ; Gallbladder ; chemistry ; Medicine, Chinese Traditional ; Powders ; chemistry ; Principal Component Analysis ; methods ; Spectroscopy, Near-Infrared ; methods ; Ursidae

Acquired Immunodeficiency Syndrome ; psychology ; Humans ; Suicide

Objective To investigate the correlation between setup error and couch position error in radiotherapy.Methods A total of 25 patients with thoracic and abdominal tumors who recently finished image-guided radiotherapy were randomly selected.The data on couch position during treatment were obtained through the record validation system, and then the couch position error was calculated.The Pearson correlation analysis was used to investigate the correlation between setup error and couch position error during treatment.Results In the ≥5 setup errors among the 25 patients, the correlation coefficient between random setup error and random couch position error was 0.83(P=0.00), and the correlation coefficient between systematic setup error and systematic couch position error was 0.36(P=0.11).Conclusions In radiotherapy, the random setup error is highly correlated with the random couch position error, while a moderate or low correlation exists between the systematic setup error and the systematic couch position error.