Objective To investigate the clinical significance of B-type natriuretic peptide(BNP) in the process of fluid resuscita-tion with different crystalloid-colloid ratio in the patients with severe acute pancreatitis (SAP) .Methods Clinical data of 85 SAP patients were analyzed retrospectively in the Emergency Center of Chongqing during January of 2010 to December of 2012 .Early goal-directed therapy(EGDT) was confirmed the end criterion of the end point of resuscitation .Low crystalloid-colloid ratio group (n=45) and high crystalloid-colloid ratio group(n=40) were divided according to crystalloid-colloid ratio (3∶1) as the borderline , BNP were observed at the time point of before fluid resuscitation ,and 1 ,2 ,3 days after resuscitation and the day before discharge . Results Different fluid resuscitation of crystalloid-colloid ratio could improve hemodynamics in patients ,BNP increased with the to-tal amount of resuscitation liquid ,were positively correlated with liquid volume .The total amount of fluid of the high crystalloid-colloid ratio group was significantly higher than that of the low crystalloid-colloid ratio group .Conclusion BNP could guide early fluid resuscitation and low crystalloid-colloid ratio should be adopted for SAP patients .

Objective:To explore an effective treatment method for mycobacterial infection of multiple abscesses in the face and breast after autologous fat injection.Methods:Six patients with non-tuberculous mycobacterial infection after autologous fat injection in the face and chest were treated from June to September in 2018. All patients underwent preoperative ultrasound localization. The small incision was opened for debridement and the necrotic granular tissues were completely scraped. Vacuum aspiration therapy in the sinus was used to promote wound growth, in line with the standard anti-tuberculosis drug treatment.Results:All six patients in this group were being followed up for 10-14 months. The average follow-up time was 12 months. All the infected patients were recovered, and the appearance of the infected site was satisfied by the patients.Conclusions:Small incision debridement with vacuum aspiration therapy combined with a variety of anti-tuberculosis drugs can effectively treat non-tuberculous mycobacterial infection after autologous fat injection, and achieve good results.

OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

Adult ; Brain Neoplasms ; diagnosis ; Humans ; Male ; Plasmacytoma ; diagnosis ; Temporal Bone ; pathology

Objective To observe the efficacy and security of Chinese Medicine fumigation based on tension balance acupuncture on spasticity after ischemic stroke. Methods From June, 2014 to June, 2017, 258 patients with spasticity after ischemic stroke were assigned into control group (n=130) and observation group (n=128). All the patients received routine rehabilitation and tension bal-ance acupuncture, and the observation group received Chinese Medicine fumigation in addition, for six weeks. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), modified Barthel In-dex (MBI) and Neurological Deficit Scale (NDS) before, three weeks and six weeks after treatment. The inci-dence of side-effect was recorded. Results There was no significant difference in scores of FMA, MBI and NDS between two groups three weeks after treatment (P>0.05). Six weeks after treatment, the scores of FMA, MBI and NDS improved in both groups (t>7.382, P<0.05), and improved more in the observation group than in the control group (t>4.412, P<0.05), while the clinical efficacy on spasm was also better (χ2=11.121, P=0.001). The side-effect was slight in both groups. Conclusion Combination with Chinese Medicine fumigation can ameliorate the spasticity of upper limb in ischemic stroke patients, to promote the recovery of motor function and activities of daily living.

BACKGROUND: Early reperfusion can effectively treat acute myocardial infarction (AMI) and reduce the mortality significantly. This study aimed to compare the role of plasma microRNA-1 (miR-1) and cardiac troponin T (cTnT) in early diagnosis of AMI patients. METHODS: From May 2011 to May 2012, plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR), and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student'st test or Fisher's exact test. The Mann-WhitneyU test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic (ROC) curve was established to discriminate the AMI patients from the controls. RESULTS: In the present study, the expression of plasma miR-1 was significantly increased in the AMI patients compared with the healthy controls (P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days (P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population (P>0.05). ROC curve analyses demonstrated that miR-1 was specific and sensitive for the early diagnosis of AMI, but not superior to cTnT. CONCLUSION: Plasma miR-1 could be used in the early diagnosis of AMI, but it is similar to cTnT.

BACKGROUNDThe coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relationships between coagulation function, clinical stage and metastasis in patients with renal cell carcinoma.

METHODSA total of 350 consecutive patients admitted to our Urology Department from 2004 to 2010 were diagnosed with renal cell carcinoma by histopathologic examination and were included in this study. A total of 231 cases of renal benign tumors were considered as the control group. Fibrinogen, prothrombin time, activated partial thromboplastin time and international normalized ratio were evaluated in all subjects. Tumor size, clinical stage, lymph node metastasis, and distant metastasis were evaluated using radiologic imaging, intraoperative findings, and histological studies.

RESULTSThe preoperative plasma fibrinogen levels of patients with renal cell carcinoma ((383.9 ± 146.7) mg/dl) were significantly higher than those of the control group ((316.7 ± 62.0) mg/dl) (P < 0.01). We divided the renal cell carcinoma group into stages Ia, Ib, II, III, and IV. The fibrinogen values were (315.6 ± 64.6) mg/dl, (358.3 ± 91.1) mg/dl, (465.6 ± 164.7) mg/dl, (500.0 ± 202.1) mg/dl, and (585.8 ± 179.7) mg/dl, respectively. There were no significant differences in fibrinogen values between stage Ia and control groups. However, results of other stages showed significant differences when compared to control group values (P < 0.01). Using the cutoff value of 440 mg/dl, which defines hyperfibrinogenemia, plasma fibrinogen levels had a positive predictive value of 39.8% and a negative predictive value of 93.3% for predicting distant metastasis, with a sensitivity of 64.7% and specificity of 83.3%.

CONCLUSIONSPreoperative plasma fibrinogen levels are elevated in patients with renal cell carcinoma with distant metastasis or lymph node metastasis. Potential metastasis is more likely if the tumor size larger than 4 cm. Increased preoperative plasma fibrinogen levels, especially hyperfibrinogenemia, may be an indicator of metastasis.

Adult ; Aged ; Blood Coagulation ; physiology ; Carcinoma, Renal Cell ; metabolism ; pathology ; physiopathology ; Female ; Fibrinogen ; metabolism ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; physiopathology ; Lymphatic Metastasis ; physiopathology ; Male ; Middle Aged ; Neoplasm Metastasis ; physiopathology ; Neoplasm Staging ; Retrospective Studies ; Thromboplastin ; metabolism

OBJECTIVETo observe the different extracts from Radix Isatidis on multiplication of mice lymphocytes.

METHODLymphocytes were separated and cultured. Immunological activities of different extracts from Radix Isatidis were studied by thermodynamics and the results were tested by the conventional pharmacological experiments.

RESULTThe results showed that the water extract and residue had significant immunological effects while organic solvent extracts had immunological activity to some extent.

CONCLUSIONThe comparison of immunological activity among the extracts from Radix Isatidis were as follows: residue after extracting > general extract > nBuOH extract > EtOAc extract > CHCl3 extract > P E extract.

Animals ; Calorimetry ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Isatis ; chemistry ; Lymphocytes ; drug effects ; Male ; Mice ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

Adult ; Aged ; Budd-Chiari Syndrome ; diagnostic imaging ; Female ; Humans ; Liver ; diagnostic imaging ; Liver Circulation ; Male ; Middle Aged ; Ultrasonography, Doppler, Color ; Young Adult

Objective To explore the ultrasound characteristics of intraductal papillary mucinous neoplasm of the bile duct( IPM N-B) and evaluate its diagnostic value . Methods Seventeen cases of IPM N-B were diagnosed by ultrasonic examination and confirmed by surgery and pathology . The ultrasound findings and distribution of color Doppler flow signals were observed and analyzed in comparison with the surgical and pathological results . Results Ultrasound revealed the characteristics of IPMN-B:① Bile duct mural nodules that looked like papillary or polypoid were observed; ② Asymmetry bile duct dilatation ,namely obvious dilatation in the lesion intrahepatic bile duct ,but only mild dilatation in the normal intrahepatic bile duct ;③Typical lesions showed mucus in bile duct along bile duct wall without acoustic shadow or move . High frequency ultrasound revealed that mucus in bile duct could float that looked like gelatin when operator vibrated probe in those superficial lesions . This is reliable characteristics of IPMN-B by ultrasound . Conclusions Ultrasound is of high value in the diagnosis of IPMN-B .