Objective To investigate the clinical features and prognosis of elderly patients with acute panereatitis.Methods One hundred and twelve elderly patients with acute pancreatitis were included in our study.The clinical features and prognosis were compared with those of the 120 non -aged patients with acute pancreatitis during the same period.Results Cholecystolithiasis was the most common etiology of acute pancreatitis in both groups[81 cases(66.3%) in aged group,70 cases (58.3%) in non-aged group].Abdominal pain was the most common symptom in both groups, followed by fever.Two elderly cases were diagnosed only by autopsy because of mild abdominal pain and rapidly attack of shock.There were 31 cases with severe pancreatitis in aged group and 14 in non -aged group (P

Objective To evaluate the efficacy and safety of transdermal fentanyl path ( Durogesic, Xian Janssen) in patients with moderate to severe chronic non-cancer pain. Methods This open prospective study was approved by the Ethic committee of the hospital. After obtaining written informed consent we studied 46 ASA I - H patients (24 male, 22 female), aged 36-82 yr, suffering from moderate to severe chronic non-cancer pain. Durogesic 25 fxg/h was used. The patch and the site of application were changed every 3 days. The dose was adjusted to the level of pain reduction and side effects. The treatment was maintained for 2-4 weeks. The pain intensity measured using VAS, quality of life including appetite, mental state and sleep etc and side effects were recorded.Results Thirty-eight of the 46 patients completed the trial. The other 8 patients withdrew from the trial because of side effects. Durogesic significantly decreased pain (P

Objective To construct an recombinant adenovirus vector of vascular endothelial growth factor small interfering RNA(Ad5-VEGFsi) and to observe its inhibitory effect on the cell proliferation of human leukemia K562 cells. Methods The specific human VEGF siRNA was subcloned into the shuttle plasmid pSES-HUS and then cotransfected with plasmid pAdeasy-1 to produce pAd5-VEGFsi by homologous recombination. The identified recombinant plasmid pAd5-VEGFsi was packaged and amplified in 293 cells. At 72 h after the transfection of Ad5-VEGFsi into K562 cells, VEGF mRNA expression and the protein level of VEGF in the cell culture supernatant were determined by RT-PCR and ELISA, respectively. Cell proliferation was measured by MTT assay and cell apoptosis by flow cytometry. Results The recombinant adenovirus Ad5-VEGFsi was successfully constructed. Ad5-VEGFsi with the titer of 4.6?1011 pfu/ml was harvested by CsCl gradient purification. Compared with those in the control, EGF mRNA in cells decreased by 66.55% (P

Objective To analyze the main clinical manifestations of intestinal lipoma and discuss the treatment of intestinal lipoma.Methods The clinical data of 19 patients with intestinal lipoma treated in our hospital in recent 15 years were analyzed retrospectively.CT,ultrasonography,and colonoscopy were used in diagnosis.Local intestinal resection by laparoscopy and laparotomy were employde.Results Intestinal lipoma presented with a variety of symptoms including intestinal bleeding,abdominal pain,anemia,intussusception,and bowel obstruction.In 17 of the intestinal lipoma patients,the main clinical manifestations were change of bowel habits,abdominal pain and bloody stool;13 of them had intestinal intussusception or obstruction,and two patients were asymptomatic.Sixteen patients underwent colonoscopy,and seven of them were correctly diagnosed.Seventeen patients received surgical resection and recovered.The diameter of mass was 3-6.5 cm.The pathologic exam showed submucosal lipoma in 12 cases,two cases showed ulcer formation with erosion,2 cases had intermural lipoma and one case had atypical lipoma with potential malignant transformation.Two asymptomatic patients diagnosed by colonoscopic biopsy werre only followed up at regular intervals.Conclusions Imaging diagnosis and colonoscopy are helpful in the preoperative diagnosis of intestinal lipoma.The method of treatment is based on the size of the tumor and presence or absence of pedicle.Endoscopic electrosection is often used for tumor mass less than 3 cm in diameter,otherwise local intestinal resection is the treatment of chocie.

Medical postgraduates are the future core force of clinical diagnosis and treatment,scientific research,education and sanitary administration.Therefore,to cultivate qualified professionals,the key of contemporary medical postgraduate education is to pay more attention to comprehensive quality training in order to make students adapt to the continuous development of society and medical model.The First Clinical College in Wuhan University has implemented the hospital administration internship in combination with social needs and explored the education model of contemporary medical students with comprehensive quality.

Objective To explore the preventive and therapeutic role of silencing type Ⅰ rat platelet-binding protein motifs depolymerization protein-like metalloproteinase 2(ADAMTS2)by siRNA on experimental liver fibrosis in vitro.By studying the mechanism of siRNA silencing of ADAMTS2,we also aim to evaluate the feasibility of ADAMTS2 as a target for anti-liver fibrosis therapy.Methods Three pairs of siRNAs targeting ADAMTS2 mRNA 2237,2597 and 690 targets were designed and synthesized by utilizing RNA design software.The most effective siRNA was chosen to transfect HSC-T6 cell line to test the tendency of hepatic stellate cell(HSC)activation and ex pression of ADAMTS2,COL1α1,COL(I),α-SMA,TGF-β1,MMP-2 and TIMP-3.These were quantified using real time-PCR,Western blotting,and MTT assays.Results Of the same dosage and time of injection,siRNA 2237 inhibited ADAMTS2 gene expression significantly more than other siRNAs.siRNA-ADAMTS2 2237 markedly inhibited ADAMTS2 gene and protein expression of HSCT6 with more than 80％ efficiency.Conversely,siRNA-ADAMTS2 2237 markedly reduced the gene and protein expressions of COL(I),α-SMA and TGF-β1 on HSC-T6 and inhibited the proliferation of HSC.Conclusions siRNA-ADAMTS2 2237 could effectively knockdown the gene and protein expression of ADAMTS2 in HSC-T6 cell lines.Silencing ADAMTS2 by siRNA significantly inhibited the activation,proliferation of HSC and the gene and protein expressions of COL(I),α SMA,and TGF-β1,and it may have a potential anti-fibrotic effect.ADAMTS2 might be an efficient target for anti-fibrotic therapy.

Anything in the universe can be explained by Yin-yang theory of Chinese medicine. Synaptic connections in the central nervous system also embody a balance between Yin and Yang. To discover the synaptic processes of gathering,storing and retrieving information in the brain is a hotspot field of modem neuroscience. This paper attempts to analyze the synaptic connection in both structure and function from Yin-Yang theory. The connections of axons and dendrites between neurons arc malleable and constantly changing, showing a Yin-Yang balance anatomically. Remodeling, stabilization and plasticity changes of synaptic processes also embody the relationship of contradictions, conflicts and transformation of Yin-Yang functionally. Therefore, it is possible to achieve an unexpected result to solve some modem medical problems by using the thoughts and methods of Chinese medicine.

Objective To explore the effects of inhibiting DDR2 expression by siRNA on hepatic stellate cells and evaluate the role of DDR2 gene in hepatic fibrogenesis. Methods (1) Three pairs of chemically synthesized siRNAs targeting DDR2 were respectively transfected into HSC-T6 cells for evaluation of silence efficacy, and the most effective siRNA was used. (2) HSC-T6 cells were divided into three groups, group A served as normal controls, group B served as negative control and group C was RNA interference DDR2 (siRNA-DDR2) expression of HSC. The most effective RNA interference sequences targeting DDR2 gene was chosen to transfect HSC-T6 cells by plasmid transfection. The tendency of DDR2, α-smooth muscle actin(α-SMA) and collagen-Ⅰ mRNA expression were estimated using RT-PCR, and the protein expression of DDR2 was evaluated by Western blot. Meanwhile, MTT assay was employed to analyze the proliferation of HSC. Results (1) DDR2 siRNA, which began at nt 868, inhibited DDR2 gone expression stronger than the other two siRNAs. (2) After transfection of siRNA-DDR2, the mRNA expression of DDR2 (P<0.01) and α-SMA (P<0.01) significantly decreased compared with the normal group, and the protein expression of DDR2 also significantly decreased (P<0.01). In addition, the proliferation of HSC was also markedly suppressed as compared with the normal group (P<0.01). However, compared with the negative control group, none of them was markedly suppressed. Conclusion SiRNA targeting DDR2 significantly suppresses the activation, proliferation of HSC, and thus attenuates hepatic fibrogonesis in vitro.

Objective To investigate the effect of different operations for cardia carcinoma on the postoperative anastomotic stoma complications.Methods Between December,2000 and May,2007,the clinical data 156 patients with carcinoma of gastric cardia who received different operations were analyzed retrospectively.Results The thoracoabdominal incision was performed in 57 cases,abdominal incision in 68 and left thoracic incision in 31 cases.The occurrence rate of anastomotic stoma complications in the patients with thoraco-abdominal,abdominal and left thoracic incision was 7.0%(4/57),7.4%(5/68),and 12.9%(4/31),respectively.The occurrence rate of anastomotic stoma complications in the patients using 25 mm end-end autosuture was 4.2%(4/95),in using of the 28mm autosuture group was 16.1%(P=0.0102).Conclusions The occurrence rate of anastomotic stoma complications can be reduced by choosing correct operation methods and using autosuture correctly.