Objective To study the experience of laparoscopic repair in gastric and duodenum perforation. Methods 35 patients with gastric and duodenum perforation were performed laparoscopic repair.Results 34 pati- ets with gastric and duodenum perforation were safely operated.1 case with perforation of gastric carcinoma was con- verted to open for radial gastrectomy.The mean time of hospitalization was 7.5 days.There was no intraoperative and postoperative complications.Pathological examination showed 4 patients with perforation of gastric ulcer and one with perforation of gastric carcinoma.Conclusion Laparoseopic repair was one of the safe,quick recovery and little suffering treatment for duodenum perforation.

In order to solve the problems of erratic drug absorption and low bioavailability after oral administration for poorly-water soluble drugs due to low solubility, a series of novel pharmaceutical dosage forms as solid dispersion, liposome, microemulsion, vesicle, cyclodextrin inclusion complexes and drug nanocrystal have been developed in recent years. Among which drug nanocrystal attracts more attentions for its simpler preparation method, higher drug loading and easier manufacturing technology in the design of dosage forms suitable for different administration routes. In this paper, the nanocrystals of the poorly-water soluble drugs prepared based on bottom-up and top-down technologies were introduced. The characteristics and applications of the nanocrystal-based dosage forms as suspension, tablet and capsule were also introduced and carefully evaluated with the focus on their pharmacokinetics, pharmacodynamics and tissue targeted drug distribution after delivery by oral administration, intravenous injection and pulmonary inhalation. The advantages of drug nanocrystals in their therapeutics effects over the bulk drugs were discussed together with the inherent mechanism. Finally, the problems existing in basic research and scaled-up manufacture of drug nanocrystal as well as the possible ways of solution were listed out so as to make the nanocrystal-based preparations exert their maximum therapeutic effect after clinical application.

Objective To study the effect of early rehabilitation on the ambulatory capacity and the relationship between motor , sensory function and ambulatory function in patients with acute spinal cord injury.Methods 47 patients with spinal cord injury were treated with comprehensive rehabilitation program. Their motor and sensory function were assessed using Standards for Neurological Classification of Spinal Cord Injury (ASIA, 1992) and their ambulatory function were assessed using Hoffer's ambulation classification during the treatment.Results Motor and sensory function increased significantly in the 12 months after trauma (P<0.05). Motor score at admission was correlated with the outcome of the ambulatory capacity(P<0.05).Conclusion Early rehabilitation was effective. The initial motor function was related to the outcome of the ambulatory capacity in patients with spinal cord injury.

Objective To evaluate the therapeutic effect of segmental hepatectomy for intrahepatic bile duct stones.Methods In this study, 414 patients suffering from intrahepatic bile duct stones underwent hepatectomy from Jan 1981 to Dec 2001. Stones distribution, operation modality,postoperative complication and therapeutic effect were evaluated. Results Postoperative complications occurred in 72 cases(17.4%), mortality was 0.7%. A follow up of 2 to 22 years was achieved in 305 patients (73.7%), with excellent or good result in 88.9%, residual stone in 15.7%,and stone recurrence in 4.6%.Conclusion Appropriate use of hepatectomy is effective for the treatment of intrahepatic bile duct stones.

Background The fundus autofluorescence (FAF)can reflect the function of retinal pigment epithelium(RPE) cell.As an invasive examination,it has been extensive used in retina disease,but there has not any report in syphilitic posterior uveitis.Objective This study was to characterize and contrast the FAF and fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) findings in patients with syphilitic posterior uveitis.Methods A retrospective series of cases observational study was designed.The clinical data of 27 eyes from 18 patients with syphilitic posterior uveitis were included in Shanghai First People's Hospital from 2010 May to 2012 October,and all the patients were diagnosed by serologic and ophthalmic tests.The patients were assigned to acute stage group(with the course ＜2 months)and chronic stage group(with the course ≥ 2 months).FFA,ICGA and FAF were performed respectively on all the patients,and the examination results were compared and analyzed.Results In the affected eyes with syphilitic posterior uveitis,the FFA image showed a retinal vasculitis sign and mottle-like fluorescence appearance in posterior pole and equator zone,and some affected eyes exhibited edema of optic disc and macula.Hypoautofluorescence zone was seen in the acute stage group and cystoid macular edema was found in the chronic stage group.ICGA presented with a wider damage of RPE,especially in the later phase of ICGA.A confluent of hyperautofluorescence with hypoautofluorescence in the posterior fundus,punctiform hyperautofluorescence as well as hypoautofluorescence in papillitis and macular edema were found on the FAF image.Conclusions The pathological basis of syphilitic posterior uveitis is retinal vasculitis and papillitis.ICGA indicates the damage of choroid membranes and RPE,and FAF reflects a metabolism disorder of RPE in the acute stage and atrophy and loss of RPE in the chronic stage.FAF is helpful for the diagnosis of syphilitic posterior uveitis as an assistant index.

Objective To analyze the utility of MRI with multiple contrast and dynamic contrast weightings enhancement(DCE) in evaluation of vulnerable atherosclerotic plaques. Methods Forty male New Zealand white rabbits were fed with hypercholesterolemic diet,and right iliac arteries including the common and external iliac arteries were examined by multiple contrast and DCE MRI at intervals 6 to 20 weeks after balloon denudation.For multiple contrast weightings scanning,T1-,T1-/T2WI with fat suppression,proton density weighted and double invention recovery were used.Meanwhile,post DCE T1-with fat suppression images were obtained in 1,5,15 and 25 min after a bolus injection of Gd-DTPA contrast agent.Then a comparative analysis of plaque morphology and components to images was performed. Results There were 34(42.5%) vulnerable plaques and 46(57.5%) stable plaques amomg the 80 atherosclerotic lesions located at the right common or external iliac arteries.The accuracy,sensitivity and specificity of MRI with multiple contrast weightings and DCE for the detection of vulnerable plaques were 87.5%,94.1% and 82.6%,respectively,significantly higher than those only with multiple contrast weightings,which were 73.8%,82.3% and 67.4%,respectively(P

Acute Disease ; Anemia, Refractory ; etiology ; therapy ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; methods ; Female ; Histocompatibility Testing ; Humans ; Leukemia ; complications ; pathology ; therapy ; Male ; Treatment Outcome

Objective To investigate the clinical characteristics and chronological change of ulcerative colitis(UC) in the Chinese PLA General Hospital in near 16 years. Methods Patients diagnosed with UC during the period from 1994 to 2009 in the Chinese PLA General Hospital were registered and their clinical profiles were analyzed. Results From 1994 to 2009, of 525 patients diagnosed with UC, with a median onset age of 42 years. The predominant form of UC was extensive colitis, which affected almost 33.3% (175/525), left-sided colitis was present in 21.3% (112/525) and rectum was present in 12.4%(65/525). The chronic relapsing type of UC was the most common (69.0%, 362/525 ), followed by the initial onset type (18. 1%, 95/525 ), chronic continuous type with intermittent exacerbations (9.7%,51/525), and acute fulminant type (3. 2%, 17/525 ). Two hundred and twenty-one patients (42. 1%,221/525) were graded as mild, 162 (30.9% , 162/525) as moderate, and 142(27.0%, 142/525) as severe UC. The proportion of mild colitis and rectum was significantly higher in patients with an onset age of over 60 years, compared with those with an onset age of less than 30 years( P ＜0. 05 ). The proportion of UC patients with old age onset ( P ＜ 0. 05 ), male sex ( P ＜ 0. 01 ), mild colitis ( P ＜ 0. 01 ), rectum ( P ＜0. 01 ) , relapse-free type ( P ＜ 0. 01 ) demonstrated a chronological increase from 1994 to 2009.Conclusions The distinctive clinical features and chronological change were seen in UC patients in recent years. Compare to those with an onset at less than 30 years, the proportion of mild colitis and rectum was significantly larger in patients with an onset at over 60 years of age, and the proportion of UC patients with old age onset, male sex, mild colitis, rectum, relapse type were less.

Objective:To investigate the role of extracellular signal-regulated kinase 1/2(ERK1/2)signal pathway in the pathogenesis of stress-induced gastric ulcer.Methods:Animal model of stress-induced gastric ulcer was established in rats with water-immersion restraint(WIR)stress.The mucosal activation of ERK1/2 was observed before and 5,15 and 30 min,and 1, 2 and 3.5 h after WIR stress.Some animals were also treated with an intravenous injection of PD98059(1 mg/kg),a specific ERK1/2 inhibitor,1 h prior to WIR stress.Expression of total ERK1/2 and caspase-3 were detected by Western blot analysis; ERK1/2 activity was measured by kinase activity assay using myelin basic protein as a specific substrate.DNA-binding activities of the transcription factors activator protein-1(AP-1)and nuclear factor-?B(NF-?B)were determined by electrophoretic mobility shift assays(EMSA).Mucosal TNF-?and IL-1?mRNA expression was analyzed by Northern blot analysis.The degrees of the gastric mucosal lesions were expressed as ulcer index(UI)and pathological evaluation.Apoptosis in the gastric mucosa was examined by an in situ TdT-mediated dUTP nick-end labeling(TUNEL)method.Results:Activated ERK1/2 was very weakly expressed in the gastric mucosa of normal rats.ERK1/2 was rapidly activated in the gastric mucosa of rats 15 min after WIR stress and the activity reached the maximal after 3.5 h.Pretreatment with PD98059 significantly inhibited ERK1/2 activation,decreased AP-1 and NF-?B activities and TNF-?and IL-1?mRNA expression,and obviously relieved gastric mucosal lesions,accompanied by caspase-3 activation and increased apoptosis.Conclusion:The present results indicate that ERK1/2 activation plays an important role in the development of stress-induced gastric ulcer.

The ergosterols were produced from corn straw hydrolysates fermented by ergosterol yeast,which was obtained from protoplast electrofusion.The effects on the yield of ergosterol were studied in the condition of shaker,such as initial sugar concentration,nitrogen source,pH value and fermentation time.The technical conditions were optimized according to the DPS center-united experimental design principles and the method of response surface analysis with four factors and three levels.The results indicated that the four factors had significant correlation to ergosterol accumulation.The biomass and the ergosterol content could be up to 8.67g/L and 2.37% respectively after cultivated for 32h under optimal technical condition.The structure of ergosterol crystal was characterized by UV,IR and SEM.A new approach of biomass source application was presented.