Objective To investigate the clinical effect of ulinastatin in preventing pancreatitis after endoscopic retrograde cholangiopancre-atography (ERCP).Methods The Cochrane Library,PubMed,EMBASE,CNKI,VIP,and Wanfang Data were searched for randomized controlled trials (RCTs)on ulinastatin for the prevention of post -ERCP pancreatitis published from 1970 to June 2016.Two researchers se-lected RCTs,extracted data,and evaluated methodological quality independently,and RevMan 5.3 software was used for the meta -analy-sis.The chi -square test was used for the heterogeneity analysis of RCTs included,and the funnel plots were used to evaluate publication bi-as.Results A total of six RCTs with 923 patients were included in this analysis.Compared with the placebo,ulinastatin had significantly better effects in preventing post -ERCP pancreatitis (OR =0.26,95%CI:0.13 -0.53,P =0.000 2),hyperamylasemia (OR =0.47, 95%CI:0.33 -0.67,P <0.001),and abdominal pain (OR =0.56,95%CI:0.34 -0.91,P =0.020).Compared with gabexate,uli-nastatin had similar effects in preventing post -ERCP pancreatitis,hyperamylasemia,and abdominal pain (P =0.52,0.13,and 0.79);low -dose ulinastatin also had similar effects as gabexate in preventing post -ERCP pancreatitis and hyperamylasemia (P =0.49 and 0.25).The funnel plots based on the effect of ulinastatin in preventing post -ERCP pancreatitis were slightly asymmetric,which suggested the presence of publication bias.Conclusion Ulinastatin (≥15 ×104 U)can effectively prevent post -ERCP pancreatitis,hyperlipi-demia,and abdominal pain in the general population and it is recommended to start using this drug before surgery.

Objective To investigate the properties of the abilities of spontaneous counterfactual thinking(SCFT) and induced counterfactual thinking(ICFT) produced by undergraduate students with depressive symptoms.Methods Undergraduates were induced to produce SCFT after recalling a negative event and ICFT after reading a story about a traffic event.Then the undergraduates were demanded to complete the counterfactual inference test(CIT).The amount and rationality of CFT and the scores of CIT were analyzed.Results Mild depressive students(MDS) generated a higher amount of SCFT than non-depressive students(NDS),midrange depressive students and severe depressive students(SVDS)(P0.05).The rationality of SCFT generated by four groups were significantly different(P

Objective To investigate the feature of cerebral glucose metabolism of dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Methods Twenty-five DLB patients and Thirty-one PDD patients underwent positron emission tomography(PET) with 18F-fluorodeoxyglucose (18F-FDG) showing glucose metabolism. The region of interest (ROI) was selected from frontal cortex, temporal cortex, parietal cortex, occipital cortex, cerebellum cortex and corpora striata. 18F-FDG metabolism ratios between various cerebral regions and cerebellum cortex were compared as an indicator of regional cerebral glucose metabolic patterns.Results FDG metabolism ratio of frontal cortex, occipital cortex, parietal cortex, temporal cortex and corpus striatum decreased similarly in DLB and PPD (P>0.05). FDG metabolism ratio of occipital cortex decreased more significantly in DLB than in PDD (P<0.01). The decrease of FDG metabolism in corpus striatum of DLB was symmetric. For patients with PDD, FDG metabolism in corpus striatum contralateral to onset side decreased more significantly than that of corpus striatum ipsilateral to onset side (P<0.05). Conclusion There are similarities and discrepancies in cerebral glucose metabolism between DLB and PDD. These features may be useful in differential diagnosis between these two kinds of Lewy body disease.

Objective To investigate the value of extravascular lung water (EVLW) in predicting the prognosis of sepsis acute lung injury (ALI) / acute respiratory distress syndrome (ARDS).Methods Relevant published articles concerned with EVLW both in Chinese and in English from 1991-2011 were searched,and Meta-analysis was carried out with Stata software. Results Seven articles were selected for Meta-analysis according to the inclusion and exclusion criteria.The results indicated EVLW of dead patients group kept in a high level,while EVLW showed a down-trend in the survival group.The difference in level of EVLW between the two groups became more obvious with the day ( SMDd1＜ SMDd2 ＜ SMDd3 ) ( the 1st day:SMDd1=0.29,95％CI:0.047-0.532; the2nd day:SMDd2=1.64,95％CI:0.14-3.13; the 3rd day:SMDd3 =1.83,95％ CI:0.56-3.10).Conclusions EVLW and its dynamic change in the early stage of sepsis ALI/ARDS could predict the prognosis.This suggested the sustained high level would lead to high mortality.

Objective To investigate the value of plasma soluble triggering receptor expressed on myeloid cells-1 as a diagnosis marker of sepsis.Methods Articles on plasma soluble triggering receptor expressed on myeloid cells-1 as a marker of sepsis which were public published in the PubMed,Ovid,Springer,Wanfang database from 1991-2012 were searched and conducted a meta-analysis by MetaDiSc and Stata.Results Seven articles were selected to the meta-analysis according to the inclusion criteria,of which cut-off values varied signicantly from studies.Due to the data heterogeneity (I2 ＞ 50％,P ＜0.05),random model was used to pool the effect sizes.The overall combined effect sizes:sensitivity =81％ (95％CI:0.76-0.86); specificity =81％ (95％ CI:0.76-0.86); DOR =30.03 (95％ CI:7.89-114.37) ; AUC of SROC =0.905 9; Q*-0.837 6.Deek' s funnel plot showed little publication bias.Conclusions Plasma soluble triggering receptor expressed on myeloid cells-1 may be a useful adjunctive tool for the diagnosis of sepsis.However,further studies are needed in order to identify the best cut-off value in the diagnosis of sepsis.

To study the regulation of androgen receptor (AR) expression in human prostate cancer LNCaP cells by triptolide (TP) and the possible mechanism, by using qRT-PCR and Western blot, the AR mRNA and protein levels in TP treated LNCaP cells were detected, and the AR protein level in TP and NF-κB inhibitor treated LNCaP cells was also detected; a series of pGL3-AR promoter reporter gene vectors were built using restriction-free cloning method, and the vectors were employed to investigate the effects of TP on the transcriptional activity of AR promoter in LNCaP cells; the upstream proteins which may play regulatory roles were detected using western blot assay. After treated LNCaP cells with TP for 48 h, AR mRNA and protein expressions decreased with increasing TP concentration. The expression of AR target gene PART1 and prostate specific antigen (PSA) was also downregulated by TP treatment; a series of pGL3-AR promoter reporter vectors were constructed and validated by sequencing and luciferase activity; the results of dual luciferase reporter assay showed that TP downregulated AR at the transcriptional level; PI3K/AKT/NF-κB pathway which is associated with AR promoter activity was drowregulated by TP. In conclusion, our results demonstrated that the transcriptional activity of AR in LNCAP cells was downregulated by TP, and PI3K/AKT/NF-κB pathway may be involved in the regulation mechanism.

Objective To observe the effect and safety of treating senile abnormal lipid metabolism with LU Zhi-zheng's dampness-removing,turbid-resolving and heart-communicating formula.Methods 60 patients were randomly divided into a treatment,treated with LU's formula,one dosage per day,and a control group,treated with gypenosides,60mg/tablet,three times per day,with 30 patients in each group.Both groups were treated two therapeutic courses,which were 8 weeks.Results Except HDL-C,other indexes including TC,TG,LDL-C in the treatment group were all obviously improved after the treatment [the statistical values were (5.81 ± 1.70) mmol/L,(3.05±2.30) mmol/L,(3.39± 1.11 ) mmol/L respectively,P＜0.01 or 0.05],which were also better than the control group [the statistical values were ( 6.16 ± 1.91 ) mmol/L,( 3.03 ± 1.89 ) mmol/L,(3.81±0.63) mmol/L,P＜0.01 or 0.05].Symptoms improvement such as chest oppression,dizziness,heaviness of head,headache,sticky mouth without thirsty,constipation,nausea and vomiting,and heaviness of limbs in the treatment group were also better than the control group,with mean rank were 23.83、38.10、36.10、34.70、36.77、39.82、33.38、34.17 respectively.No abnormal changes were found in indexes of blood routine,urinary routine,stool routine,ECG,ALT,AST and Cr.Conclusion LU Zhi-zheng's dampness-removing,turbid-resolving and heart-communicating formula improved clinical symptoms and signs of abnormal lipid metabolism patients,its therapeutic effects were better than gypenosides.

OBJECTIVETo study the influence of actual defect length and gap width of the limbs main artery on the method selection of repairing and reconstruction.

METHODSRetrospective study was carried out for 32 patients with extremity main artery injury from 1996 to 2009, including 30 males and 2 females; 30 adults with an average age of 36 years old ranging from 18 to 51 years, 2 children of 4 and 5 years old respectively. Injured body parts involved axillary artery in 4 cases,brachial artery in 7 cases,radial artery in 2 cases, femoral artery in 4 cases, popliteal artery in 13 cases, posterior tibial artery in 2 cases. Main arterial injury defect gap width of all cases were observed and the reasons were analyzed. All cases were repaired by the method of end to end anastomosis after vessels stretch.

RESULTSThe artery defect width was 3 cm to 7 cm with an average of (4.375 +/- 1.200) cm. Defect width of the upper extremity brachial artery and axillary artery group was (5.73 +/- 0.63) cm,the lower extremity femoral and popliteal artery group (3.80 +/- 0.73) cm, the posterior tibial artery group (3.25 +/- 0.35) cm, the radial artery group (3.00 +/- 0.00) cm. Defect width of upper extremity brachial artery and axillary artery group was larger than that of the other three groups (P < 0.01). End to end anastomosis was performed successfully in all cases. Blood supply recovered well. Because of the severe limb infection 2 patients had amputation in the late. All patients received follow-up. The patients without fracture were followed up to 2 weeks postoperatively, all patients with fractures were followed up to 1 year at least. Limb blood supply was good in all patients during the follow-up.

CONCLUSIONBlood vessel defect gap width is different from the actual vessel defect, but is larger than the actual vessel defect. Misjudgment of the vascular defect length will lead to more vascular transplantation. The vast majority of vascular defect can be directly repaired by the method of end to end anastomosis after the vessel free and stretch.

Adolescent ; Adult ; Arm ; blood supply ; surgery ; Axillary Artery ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Vascular Surgical Procedures ; Young Adult

OBJECTIVETo study the ischemic times of the main artery injury in the limbs and the influence on the limbs survival rate, and to analyze the reasons for the formation of the ischemia time.

METHODSFrom June 1996 to November 2012, 83 patients with completely severed limb main artery treated in our hospital were retrospectively studied. There were 77 males and 6 females, including 81 adults (ranging in age from 16 to 52 years old, with a median age of 35 years old) and 2 children (4 and 5 years old respectively). Seventy-five patients were treated with end to end anastomosis, 7 patients were treated with great saphenous vein transplantation, and 1 patient was treated with artificial blood vessel transplantation. The prior to admission ischemia time, after admission ischemia time and total ischemia time for successful and unsuccessful patients, as well as the causes of the formation of the ischemia time were studied. Limb survival rate of different ischemic time was counted. Sharpness injury or blunt injury ischemia time and amputation rate were researched statistically. All data were analyzed using SPSS statistical software.

RESULTSThere were 72 limbs survived, 11 amputated. The average ischemia time was (7.45±5.94) h for limb-salvage group and (13.73±14.00) h for amputation group. Prior to admission ischemia time between amputation and limb-salvage group had no significant difference. After admission the ischemia time in amputation group was longer than limb-salvage group. The amputation rate for ischemia time 21 to 44 h group was higher than other three groups (≤ 5 h, 6 to 10 h, 11 to 20 h) (P=0.023, 0.038, 0.044). Amputation reasons can be divided into anastomosis failure in the operation, vascular thrombosis 2 to 4 days after operation and late infection.

CONCLUSIONVascular injury limbs can tolerate longer ischemia time and the limb salvage succeed. Only too long ischemia time (> 20 h), limb amputation rate increases significantly. The main cause of long time ischemia is delayed diagnosis in the hospital. Whether limb-salvage success mainly depends on the degree of trauma and the quality of the anastomosis than ischemia time.

Adolescent ; Adult ; Amputation ; Extremities ; blood supply ; Female ; Humans ; Ischemia ; surgery ; Limb Salvage ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Vascular System Injuries ; surgery

Objective To investigate the relationship between glucose metabolism and dopamine transporter in patients with Parkinson's disease.Methods Eleven patients at stage 2~3 of PD and three patients with essential tremor were examined by 18F-FDG PET and 11C-CFT PET in two separate days within four weeks.The regional glucose binding and dopamine transporter binding were assessed with PET specific software in anterior putamen,posterior putamen,caudate nucleus,thalamus and occipital cortex.The tracer uptake rate between the region of interest and occipital cortex was analyzed as the main variables.Results The marked reduction of 18F-FDG uptake and 11C-CFT uptake was observed in posterior putamen in patients with PD.The reduction of tracers uptake in posterior putamen contralateral to onset side was more significant than the posterior putamen ipsilateral to onset side (P