Objective To investigate the clinical manifestations, etiology and risk factors of chronic pancreatitis guided by the M-ANNHEIM classification of chronic pancreatitis and to evaluate the validity and clinical significance of this classification. Methods A review of clinical data of inpatients in our hospital from December 2007 to December 2009 was conducted. The classification was carried out according to the pancreatitis were enrolled. There were 256 adult patients and 51 children and adolescent patients (age of onset<18 yr). Among these cases, 129(42%) reported a drinking history. 110 cases (35.8%) had a smoking history, 31 cases (10.1%) presented with hyperlipoidemia. 12 cases had some factors related to pancreatic duct such as pancreas divisum, pancreas trauma. There were 231 (75.2%) cases with calcification of pancreas, 45 (14.7%) with exocrine insufficiency (steatorrhea), 58 (18.9%) with endocrine dysfunction (diabetes mellitus), 32 (10.4%) underwent pancreatic surgeries, and 39 (12.7%) with pancreatic pseudocysts, biliary obstruction, pancreatic cancer and other severe complications. The M-ANNHEIM clinical staging of chronic pancreatitis was: no case in stage 0, 220(71.7%) cases in stage Ⅰ , 69(22.5%) cases in stage Ⅱ ,12(3.9%) cases in stage Ⅲ and 6 cases in stage Ⅳ. The mean value of the M-ANNHEIM score and severity index was 7.78,69 (22.5%) cases were in the minor level, 174 (56.7%) were in the increased level,62(20.2%) cases were in the advanced level. Conclusions The M-ANNHEIM classification of chronic pancreatitis is a simple, objective, accurate and noninvasive tool in clinical practice. This new classification system will be helpful for investigating the impact and interaction of various risk factors on the course of the disease.

Objective: To study influence of glycosylated hemoglobin A1c (HbA1c) on major adverse cardiovascular events (MACE) in patients with diabetes mellitus (DM) complicated coronary heart disease (CHD) after percutaneous coronary intervention (PCI).Methods: A total of 100 DM+CHD patients after PCI were selected from our hospital.According to HbA1c level, they were divided into HbA1c<6.5% group (n=48) and HbA1c≥6.5% group (n=52).Levels of C reactive protein (CRP), tumor necrosis factor α (TNF-α), erythrocyte sedimentation rate (ESR) and interleukin (IL)-6 before PCI, incidence rate of MACE on six and 24 months after PCI were compared between two groups.Results: Compared with HbA1c<6.5% group before PCI, there were significant rise in serum levels of CRP[(18.5±6.2) mg/L vs.(25.8±4.2) mg/L]and TNF-α[(32.4±12.3) ng/L vs.(48.3±11.8) ng/L]in HbA1c≥6.5% group, P<0.01 both.On six months after PCI, incidence rate of myocardial infarction in HbA1c≥6.5% group was significantly higher than that of HbA1c<6.5% group (9.62% vs.0, P=0.028);24 months after PCI, compared with HbA1c<6.5% group, there were significant rise in incidence rates of myocardial infarction (2.08% vs.15.38%) and diseased vessel restenosis (12.50% vs.32.69%) in HbA1c≥6.5% group (P<0.05 all).Conclusion: In DM+CHD patients after PCI, those with lower HbA1c level possess better prognosis.

Objective:To explore therapeutic effect of behavioral nursing on patients with atherosclerotic stenosis after percutaneous coronary intervention (PCI).Methods: A total of 112 patients with atherosclerotic stenosis treated in our hospital were selected.According to ramdom number table and parallel control analysis method, they were randomly and equally divided into routine nursing group and behavioral nursing group (received more active behavioral nursing based on routine nursing group), both groups were treated and observed for six months.The self-care ability scale score before and after nursing, incidence of complications and quality of life (QOL) score after six months were compared between two groups.Results: Compared with before nursing care, after six-month nursing, self-care ability scores significantly rose in both groups, P<0.01 both;compared with routine nursing group after six months, there were significant rise in self-care ability score [(110.34±12.84) scores vs.(128.49±11.39) scores](P=0.001) and each dimension score of QOL(P=0.001 all), and significant reduction in incidence rate of complications (21.4% vs.7.1%,P=0.031) in behavioral nursing group.Conclusion: Behavioral nursing can improve self-care ability, quality of life, promote rehabilitation, effectively reduce occurrence of postoperative complications in patients with atherosclerotic stenosis after percutaneous coronary intervention.

Objective To evaluate the tumor targeting characteristic of the Folate-SPIO-DOX-Micelles by in vitro studies,and to test the feasibility of monitor tumor targeting using it and clinical MRI.Methods The polymeric micelles,Folate-SPIO-DOXO-Micelles were prepared.The in vitro tumor cell targeting efficacy of these folate modified and DOX or SPIO-loaded micelles (Folate-SPIO-DOX-Micelles)was evaluated by observing the cellular uptake of micelles by human hepatic carcinoma cells(Bel 7402 cells) which overexpressed folate surface receptors. Cell suspensions were incubated with Folate-SPIO-DOXO-Micelles for 1 h.Prussian blue staining was performed to show intracellular irons.Flow cytometry was used to further quantify the cellular uptake of the nanoparticles into Bel 7402 cells.MRl was performed to show the signal intensity changes by using T2 WI sequences at a clinical 1.5 T MR system.Results Prussian blue staining showed much more intracellular iron in cells incubated with Folate-SPIO-DOX-Micelles than the cells incubated with the non-targeting SPIO-DOX-Micelles.As revealed by flow cytometry,the mean fluorescence intensity of cells in the folate group and the non-folate group were 117.88 and 46.33,respectively.The T2 signal intensity in MRI of cells treated with the folate targeting micelles decreased significantly (when the concentration of SPIO in cell culture medium was 5,10,20,40,and 80 μg/ml,respectively,T2 signal intensity decreased by -5.02%,-23.58%,-45.89%,-70.34%,and -92.41%,respectively).In contrast,T2 signal intensity did not show obvious decrease for cells treated with the folate-free micelles (when the concentration of SPIO in cell culture medium was at 5,10,20,40,and 80 μg/ml,respectively,T2 signal intensity decreased by -3.77%,-2.16%,-2.18%,-2.74% and -19.77%,respectively).Conclusion The polymeric micelles,Folate-SPIO-DOX-Micelles has good targeting ability to the hepatic carcinoma cells in vitro,and the cell targeting events of the micelles can be monitored by using a clinical MR scanner.

Objective To synthesize the hydrophobic supraparamagnetic ironic oxide(SPIO) loaded and hydrophilic SPIO loaded polymeric nano-vesicles and to investigate the feasibility of using hydrophobic SPIO loaded and hydrophilic SPIO loaded polymeric nano-vesicles to display the tumor in MRI in vivo through animal experiments. Methods The polymeric nano-vesicles were prepared from poly (D, L-lactic acid) (PDLLA) and poly (ethylene glycol) (PEG) by a multiple emulsion/solvent evaporation method.The hydrophobic SPIO and hydrophilic SPIO were loaded in the polymeric nano-vesicles respectively.Eighteen nude mice models with human colorectal carcinoma xenograft were established. They were divided equally into three groups (n = 6). The three groups of nude mice models were injected with water-soluble SPIO, hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle via the mice caudal vein respectively.Dynamic MRI scan were performed in all the mice models. T2WI signal intensity and T2 relaxation time were measured in the tumor, liver and muscle by using T2 mapping software. ANOVA of repeated measurement was used to analyze if there were significant differences of signal intensity changes among the three groups, while Bonferroni method was used for pair-wise comparison. Results On T2 WI, tumors showed decrease in signal intensity after hydrophobic or hydrophilic SPIO loaded polymeric nano-vesicle injection, while no signal intensity decrease was found in the tumor after water-soluble SPIO administration. The maximum percentage of signal intensity decrease in tumor caused by hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle were 11.00%, 11.40%, respectively. There was statistical significant difference of signal intensity changes among these three groups (F = 10. 96, P ＜ 0. 01). The decrease in signal intensity in the groups with hydrophilic or hydrophobic SPIO loaded polymeric nano-vesicles injection were more pronounced as compared with that of water-soluble SPIO (P ＜ 0. 05), but there was no significant difference in signal intensity decrease between the groups of hydrophilic and hydrophobic SPIO-loaded polymeric vesicles injection (P ＞0. 05). The three agents could lead to signal intensity decrease in the liver. The maximum percentage of signal intensity decrease in liver caused by water-soluble SPIO, hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle were 32. 85%, 52. 77%, 56. 89%, respectively. There was statistical significant difference between these groups (F = 161.18, P ＜ 0. 01) . The groups of injecting hydrophilic and hydrophobic SPIO loaded polymeric nano-vesicles had the more obvious signal decrease than the one with water-soluble SPIO (P ＜ 0. 01). Hydrophilic SPIO loaded polymeric nano-vesicles exhibited more signal intensity decrease than hydrophobic SPIO loaded polymeric nano-vesicles (P ＜ 0. 01). All three agents could not lead to T2WI signal decrease in the muscle, and there was no significant difference in signal change on T2 WI among three groups (F = 0. 59, P ＞ 0. 05). Conclusion SPIO loaded polymeric nano-vesicles can cause significant T2WI signal loss in human colonic carcinoma on MR imaging in vivo. It can be used as tumor imaging contrast agents.

Objective:To explore the correlation between carotid lesion severity detected by ultrasound and pregnancy associated plasma protein A (PAPP‐A) expression in patients with acute coronary syndrome (ACS) .Methods :A to‐tal of 78 ACS patients hospitalized in our hospital from Feb 2012 to May 2015 were regarded as ACS group ,mean‐while ,another 78 healthy subjects were enrolled as healthy control group .Correlation between carotid lesion severi‐ty detected by ultrasound and PAPP‐A expression was analyzed . Results:Compared with healthy control group , there were significant rise in serum PAPP‐A concentration [ (0.97 ± 0.32) mg/L vs .(1.56 ± 0.19) mg/L] ,carotid intima‐media thickness [IMT ,(0.84 ± 0.13) mm vs .(1.28 ± 0.16) mm] and Crouse plaque score [ (2.98 ± 1.92) scores vs .(8.24 ± 1.13) scores] in ACS group ,P<0.01 all .Linear correlation analysis indicated that serum PAPP‐A concentration was significant positively correlated with Crouse plaque score and IMT ( r= 0.342、0.243 , P<0.05 all) .Multi‐factor gradual linear regression analysis indicated that carotid Crouse plaque score and IMT were in‐dependent risk factors for PAPP‐A (partial regression coefficient=1.932 ,17.722 ,P<0.01 both) .Conclusion:Ca‐rotid ultrasound Crouse plaque score ,IMT are significantly positively correlated with PAPP‐A expression ,which can indirectly reflect coronary artery disease severity in ACS patients ,it is worth extending .

Objective: To explore therapeutic effect of recombinant human brain natriuretic peptide (rhBNP) in aged patients with acute decompensated heart failure (ADHF).Methods: A total of 98 aged ADHF patients treated in our hospital were selected and randomly divided into routine treatment group (n=50) and rhBNP group (n=48, received intravenous injection of rhBNP based on routine treatment group).After 72h treatment, cardiac function indexes, total effective rate and incidence of adverse drug reactions (ADR) were measured and compared between two groups.Results: Compared with before treatment, after 72h treatment, there were significant rise in left ventricular ejection fraction (LVEF) and 24h urine volume in both groups(P=0.001 all);compared with routine treatment group after treatment, there were significant rise in LVEF [(45.9±7.8)% vs.(57.4±7.9)%] and 24h urine volume [(1637.5±103.2)ml vs.(1836.4±118.4)ml], P=0.001 all.On 7d after treatment, total effective rate of rhBNP group was significantly higher than that of routine treatment group (93.75% vs.82.00%, P=0.033).There was no significant difference in incidence rate of ADR between two groups, P=0.898.Conclusion: Recombinant human brain natriuretic peptide can significantly improve heart function, and the therapeutic effect is significant in aged patients with acute decompensated heart failure.

Objective To investigate the long-term effect of endoscopic management of chronic pan-creatitis(CP) prospectively. Methods Based on the M-ANNHEIM diagnostic criteria of CP, the patients with CP were treated with endoscopic procedures, including papillotomy or pancreatic sphincterotomy, calcu-Ins removal, stonosis dilation and stent insertion. Pre-and post-operative incidence of acute pancreatitis (AP), abdominal pain, weight, endocrine and exocrine functions and change of pancreatic duct diameter were analyzed. Results From January 1,2006 to December 31,2007, a total of 107 patients with CP, in-cluding 74 males and 33 females, with a mean age of 41.2 years at admission, were recruited. All patients except 2 lost ones were followed up at a mean duration of 15 months (3-27 months). During the follow-up, 4 patients received surgery. Abdominal pain was completely resolved in 70 patients and partly resolved in 19 patients, with a total remission rate at 88. 1%. Insufficient endocrine funetion presented as diabetes was de-tooted in 10 patients before the treatment and no improvement was observed during the follow-up. Steatorrhea was presented in 10 patients and was resolved in 7 after the treatments. Weight gain at an average of 4 kg was achieved in 56. 4% (57/101) of the patients. No significant change in diameter of pancreatic duct was observed before and after the endoscopic procedure, which was not correlated with patient outcome. Conclusion Endoscopic managements can relieve abdominal pain and increase body weight in patients with CP.

This study was aimed to develop non-toxic, high transfection efficiency polyethyleneimine(PEI) cationic nanoparticles. The exosyndrome of PEI cationic nanoparticles was measured by zeta sizer, ultraviolet and visible spectroscopy. The condensation ability and the resistance to DNaseI of pEGFP-N1/PEI and pEGFP-N1/PEI modified polyethylene glycol(PEG) were evaluated by agarose gel electrophoresis. The cell toxicity of polyethyleneimine cationic nanoparticles was measured by using MTT test. The orthogonal design was used to optimize the transfection efficiency with the N/P ratio, the grafting ratio and the gene dosage as the factors. The experimental results showed that pEGFP-N1/PEI nanoparticles have lower cell toxicity, better composite ability and better resistance to DNAseI. The highest transfection efficiency of PEI cationic nanoparticles was 91% by using the PEI nanoparticles with the N/P ratio 40:1 and gene dosages 6 microg/well. PEI cationic nanoparticle modified by PEG effectively transferred DNA to hepatoma carcinoma cells and it is a non-toxic, with high transfection efficiency, and a promising non-viral carrier for gene delivery. The transfection efficiency will be improved by optimizing the experiment condition.
Carcinoma, Hepatocellular ; genetics ; pathology ; Cell Line, Tumor ; Gene Transfer Techniques ; Humans ; Liver Neoplasms ; genetics ; pathology ; Nanoparticles ; chemistry ; Polyethylene Glycols ; chemistry ; Polyethyleneimine ; chemistry ; Transfection ; methods

OBJECTIVETo increase local blood supply of bone graft, a novel posterior lumbar spine fusion method with orthotopic paraspinal muscle-pediculated bone flaps was constructed, and the fusion rate and clinical effect.were observed.

METHODSFrom June 2007 to December 2010, 117 patients of lumbar spinal stenosis or lumbar destabilization treated with the novel posterior lumbar fusion method were studied, 49 males and 68 females, aged from 40 to 77 years, average 61.5 years. Clinical effect was evaluated by JOA and VAS score preoperatively and postoperatively, and the fusion result was evaluated by three-dimensional CT reconstruction postoperatively.

RESULTSSeventeen cases lost of follow up, the rest were followed up from 7 to 38 months, average 19 months. There was significant difference between pre- and postoperative JOA and VAS score (P < 0.01), the preoperative JOA score was 10.3 ± 1.9, and 25.4 ± 4.2 at the latest follow-up, the improvement rate was 81.0% ; the preoperative VAS score was 8.5 ± 0.8, and 2.3 ± 0.4 at the latest follow-up. The three-dimensional CT reconstruction showed that 126 of the 133 segments formed solid fusion in 100 patients who completed the follow-up, the fusion rate was 94.7%.

CONCLUSIONThe novel posterior lumbar fusion method make the bone graft position more precise, stable and increases the fusion rate, which can effectively reduce pseudarthrosis and have a promising clinical effect.

Adult ; Aged ; Bone Transplantation ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery ; Treatment Outcome