Objective To observe the influence of early intestinal barrier protection in patients with severe acute pancreatitis(SAP). Methods To analyze the therapeutic methods and prognosis of 56 patients with SAP. The patients were randomly divided into the conventional therapy group (A) and the intestinal barrier protection group (B). The APACHE Ⅱ score, Ranson score, Marshall score, CT severity index (CTSI), gastrointestinal functions score (GFS), the ratio of Lactulose to Mannitol (L/M), plasma Endotoxin and Diamine Oxidase (DAO), serum C-reactive protein (CRP) and TNF-α, incidence of pancreatic infection and multiorgan dysfunction syndrome (MODS), and the hospitalization mortality were compared between the two groups. Results On the 7th day after admission, the APACHE Ⅱ score, GFS, L/M, Endotoxin, DAO, CRP and TNF-α were significantly less in group B than in group A (P<0. 05). There was no significant difference in the CTSI (P>0. 05)between the two groups at 2nd week after admission. The incidence of pancreatic infection and MODS in group B were significantly lower than in group A (P<0. 05). The hospitalization mortality was not significantly different (P>0. 05) between the two groups. Conclusion Early intestinal barrier protection in SAP alleviated systemic inflammatory response, and reduced the incidences of pancreatic infection and MODS, thus improved the prognosis.

0.05).Conclusions The higher level of SEB-specific IgM and IgE in AD and eczema indi cates the colonization of Staphylococcus aureus,which participates in the exace rbation of allergic inflammation,is involved in the pathogenesis of AD and ecz ema.

OBJECTIVETo investigate the safety and efficacy of fast track surgery (FTS) management in gastric cancer undergoing D2 gastrectomy.

METHODSEighty gastric cancer patients undergoing D2 gastrectomy were recruited prospectively. Patients were assigned to receive FTS management (n = 40) or conventional perioperative care (n = 40). The FTS care included shorten preoperative fasting time, no nasogastric decompressing tubes and abdominal drainage placed, early postoperative oral feeding, multimodal analgesia, and early mobilisation. The length of postoperative hospital stay, medical cost, nutritional status, gut function, and postoperative complications in the two groups were recorded and compared.

RESULTSFTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group [(5.6 +/- 1.3) d vs. (9.4 +/- 1.9) d, P < 0.05]. Medical cost was less [(18 620 +/- 2360) Yuan vs. (20 370 +/- 2440) Yuan, P < 0.05] and duration of intravenous infusion [(3.5 +/- 1.4) d vs. (5.8 +/- 1.9) d, P < 0.05] was also shorter. First passage of flatus was earlier in FTS group than in conventional care group [(4.3 +/- 0.4) d vs. (5.5 +/- 0.9) d, P < 0.05]. Loss of body weight in the postoperative period was less in FTS group [(3.2 +/- 0.8) kg vs. (4.3 +/- 1.6) kg, P < 0.05]. There was no difference in morbidity or mortality between the two groups.

CONCLUSIONFTS in D2 gastrectomy is safe and efficient, and it can shorten postoperative hospital stay and hasten return of gut function.

Adult ; Aged ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Length of Stay ; Male ; Middle Aged ; Perioperative Care ; Postoperative Complications ; prevention & control ; Prospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo observe the distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area, and to provide etiological evidences for secondary prevention.

METHODSAn iodine-staining endoscope census was conducted in 9536 residents with high-risk factors at Feicheng, a high esophageal cancer incidence community in Shandong province. Of which, 1507 pathologic biopsies were performed and chi2 test administrated.

RESULTSThere was no statistical significance found in biopsy pathologic diagnosis between females and males among 1507 samples. The mild and medium atypical hyperplasia was taken as pre-cancerous condition and severe atypical hyperplasia was taken as pre-cancerous lesion. Taking all the population attending census as denominator, the detection rate of the precancerous state and precancerous lesion were 6.98% (294/4214) and 1.23% (52/4214) for the males, and 3.68% (196/5322) and 0.47% (25/5322) for the females, respectively. A statistical significance was observed when comparing males with females (chi2 were 52.349 and 15.267, respectively, P < 0.05). Analyzed by age group, severe atypical hyperplasia pathological changes were mainly distributed in the age group of 50- and 65-. The constituent ratio between 45 - and 50 - was the highest for CIS. Early carcinoma was mainly distributed in five age groups from 45- to 65-. It showed that high incidence town had a high detection rate of cancer and pathological changes of esophageal cancer in the analysis of urban and rural distribution.

CONCLUSIONThe distribution of the pre-cancerous state and pathological changes of esophageal cancer of the residents should have provided a scientific basis for the primary and secondary prevention.

Adult ; Age Distribution ; Aged ; China ; epidemiology ; Community Health Services ; Esophageal Neoplasms ; epidemiology ; pathology ; prevention & control ; Female ; Humans ; Incidence ; Male ; Mass Screening ; Middle Aged ; Precancerous Conditions ; epidemiology ; pathology ; prevention & control ; Preventive Health Services

OBJECTIVETo detect the expression of VEGF receptors in papillary renal cell carcinoma and to explore the correlation between their expression and clinical prognosis.

METHODSExpression of VEGF receptors and PCNA (proliferating cell nuclear antigen) were evaluated in 82 patients with papillary renal cell carcinoma using tissue microarray and SP immunohistochemical staining.

RESULTSThe expression of VEGFR-1 in papillary renal cell carcinoma was 82.93%, VEGFR-2 63.41%, VEGFR-3 34.15% and PCNA 67.07%, respectively. Increased VEGFR-2 expression was significantly correlated with tumor size (P = 0.016), histological grade (P = 0.034) and distant metastasis (P = 0.002). VEGFR-3 expression was correlated with histological grade (P = 0.028), lymph node status (P = 0.010) and distant metastasis (P = 0.018), but not correlated with gender, age, location, tumor size and TNM staging. VEGFR-1 expression had no correlation with any clinic and pathologic factors. PCNA expression was correlated with histological grade (P = 0.011), but not correlated with other factors. The expression of VEGFR-2 and VEGFR-3 in death cases were higher than that in surviving patients.

CONCLUSIONBoth VEGFR-2 and VEGFR-3 can serve as markers for prognosis of papillary renal cell carcinoma. Differently, VEGFR-3 is a predictor of lymph node metastasis, increased VEGFR-2 expression could be used to predict a potential blood dissemination.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Papillary ; metabolism ; pathology ; Carcinoma, Renal Cell ; metabolism ; pathology ; Female ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Proliferating Cell Nuclear Antigen ; metabolism ; Proportional Hazards Models ; Survival Rate ; Tumor Burden ; Vascular Endothelial Growth Factor Receptor-1 ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism ; Vascular Endothelial Growth Factor Receptor-3 ; metabolism

BACKGROUNDAngiopoietin-2 (Ang-2) is one of the critical regulators of tumor angiogenesis. Studies have shown a significant correlation of Ang-2 expression to tumor invasion and metastasis in various human cancers, but little is known about the serum Ang-2 (sAng-2) levels in esophageal squamous cell cancer (ESCC) and its precursors. In this study, we aimed to investigate its role in screening for ESCC and its precursors.

METHODSWe carried out a free endoscopic screening in Feicheng City, a high ESCC incidence area in Shandong Province of China. Serum samples were collected as follows: 91 from normal subjects, 44 from patients with esophagitis, 85 from patients with hyperplasia, and 13 from patients with early ESCC. In addition, 28 serum samples were obtained from patients with invasive ESCC undergoing surgery in People's Hospital of Feicheng City. All the subjects of the five groups were diagnosed by histopathology. The sAng-2 levels were tested and compared, and the diagnostic power in early or/and invasive ESCC was calculated in terms of sensitivity and other parameters.

RESULTSThe sAng-2 levels were (22.0 +/- 5.5), (21.3 +/- 3.2), (20.5 +/- 3.3), (24.0+/- 5.0), and (29.8 +/- 5.0) U/ml in normal, esophagitis, hyperplasia, early ESCC, and invasive ESCC groups respectively. It was significantly higher in early ESCC than inhyperplasia group (P = 0.009). The invasive ESCC group showed the highest Ang-2 level among all groups (all P = 0.000). The sensitivities of sAng-2 to early and invasive ESCC were 23.1% and 78.6% respectively.

CONCLUSIONsAng-2 level is related to carcinogenesis and progression of ESCC, but it can not be used to screen for early ESCC.

Aged ; Angiopoietin-2 ; blood ; genetics ; Carcinoma, Squamous Cell ; blood ; diagnosis ; Esophageal Neoplasms ; blood ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; RNA, Messenger ; analysis

Objective To review the clinical-pathological features, the tendency of incidence over 20 years, the predisposing factors, and the differences between the cases of cutaneous malignant melanoma from two hospitals. Methods A collection of 305 cases diagnosed as cutaneous malignant melanoma, among which 185 cases had complete clinical-pathological data, during 1981-2000 was analyzed. Results Acral malignant melanoma accounted for 63.3%, and the cases associated with congenital small nevi at the primary site accounted for 15.8% of 305 patients. During the period 1981-1990 and 1991-2000, cutaneous malignant melanoma constituted 0.053% and 0.094%, respectively, of all diagnoses with pathological sections, with an growth rate of 3.9% yearly. There was a tendency of the increased lesions located on face and neck, and decreased lesions on acra, over 20 years. Conclusion A rise of diagnosis of cutaneous malignant melanoma has been noticed from two hospitals over 20 years. Acra, especially planta, is the predominant anatomical site of cutaneous malignant melanoma.

OBJECTIVETo summarize the clinical experiences in percutaneous endoscopic gastrostomy (PEG)/percutaneous endoscopic jejunostomy (PEJ).

METHODSWe retrospectively analyzed the clinical data of 578 patients who received either PEG or PEJ from July 2001 to December 2007 in our hospital. The data analyzed included the type, aim, duration, success rate, and complications of these procedures.

RESULTSOf 578 patients, 247 patients underwent PEG, 293 patients underwent percutaneous endoscopic gastrojejunostomy (PEGJ), 4 patients received percutaneous endoscopic duodenostomy (PED), 4 patients underwent direct percutaneous endoscopic jejunostomy (DPEJ), 4 patients underwent percutaneous endoscopic colostomy (PEC), and 26 patients received PEG/J combined stents. These procedures were performed in different clinical conditions, including enteral nutrition (n = 329), decompression combined enteral nutrition (n = 133), decompression of the gastrointestinal tract (n = 103), enteral nutrition combined bile refeeding (n = 5), perioperative applications (n = 4), and coloclysis (n = 4). Tubes were successfully placed in 578 patients (98.0%) in an average time of (7.5 +/- 1.9) min in PEG, (17.7 +/- 4.2) min in PEGJ, (14.8 +/- 2.1) min in DPEJ, (12.3 +/- 2.5) min in PED, (11.3 +/- 2.6) min in PEC, and (30.2 +/- 5.2) min in PEG/J combined stent, respectively. No procedure-related complications were observed. Major complications were found in 6 patients (1.04%) and minor complications in 36 patients (6.23%). The duration of tube functioning was (168.37 +/- 198.64) d.

CONCLUSIONSPEG/PEJ are easy to handle, effective, safe, and convenient for nursing. The endoscopic method of tube placement can be performed at the bedside and allow for enteral feeding, gastrointestinal decompression, and internal biliary drainage to be rapidly and efficiently achieved.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Enteral Nutrition ; methods ; Female ; Gastroscopy ; adverse effects ; methods ; Gastrostomy ; adverse effects ; methods ; Humans ; Jejunostomy ; adverse effects ; methods ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo study the polymorphisms and secondary structure of human immunodeficiency virus (HIV-1) tat exon 1 among subtype B' and B'/C HIV-1 infected people in China and to explore the relationship between the polymorphism of tat exon 1 and the disease progression.

METHODS8 subtype B' and 5 B'/C HIV-1 infected patients with slow disease progression were selected from Liaoning, Jilin and Yunnan province. 26 subtype B' and 9 B'/C HIV-1 infected patients with similar sex, age but with typical disease progression were selected. Provirus was extracted from the whole blood. The gene sequences of the Tat exon 1 were amplified by nest-polymerase chain reaction (nest-PCR). Products were purified and sequenced directly. The sequences were aligned, translated, amino acid substitution were analyzed and secondary structures were predicted.

RESULTSMany amino acid substitution could be found in the exon 1 of Tat in HIV-1 subtype B' and B'/C recombinant strain infected persons with different disease progression except A58T,none of them showed definitely relationship with HIV viral load and disease progression. 23N, 31S, 32Y and 46F were subtype-specific substitutions. No characteristic secondary structure of exon 1 of Tat was found.

CONCLUSIONSome of the mutations of tat exon 1 might be related to HIV viral load and disease progression. However, there was no relationship found between the secondary structure of Tat protein and the disease progression.

Acquired Immunodeficiency Syndrome ; genetics ; pathology ; Amino Acid Substitution ; Disease Progression ; Exons ; genetics ; Genes, tat ; genetics ; HIV Infections ; genetics ; pathology ; Human Immunodeficiency Virus Proteins ; genetics ; Humans ; Polymorphism, Genetic ; Viral Load

Objective To explore the expression of macrophage migration inhibitory factor(MIF)in rat hearts with experimental autoimmune myocarditis(EAM)and the possible mechanism of resveratrol's therapeutic effect.Methods Experimental myocarditis model was established by using porcine myocardial immunoglobulin. Twenty-four male 6-week-old Lewis rats were randomly divided into control group(Con),EAM model group(MC) and resveratrol treatment group(MC+ Res).All the rats were detected and compared in the cardiac function according to echocardiographic analysis,and the expression of MIF was detected by Western blot.The degree of myocardial injury was detected by HE staining and the degree of macrophage infiltration in the myocardium was detected by immunohistochemistry.Results In control group,there was no significant inflammatory infiltration or myocardial injury in the myocardium.Heavy local infiltration of macrophages,and dissolved and fractured myocardial fibers were observed in model group.Resveratrol significantly decreased macrophage density and myocardial injury in the heart(P＜ 0.05).Compared with those in control group,LVEDs were significantly increased(P＜0.01)while LVEF and LVFS were markedly decreased in model group(P＜0.01).Compared with model group,LVEDs were significantly decreased(P＜0.05)while LVEF and LVFS were markedly increased in resveratrol group(P＜0.05).The protein expression of MIF was markedly increased in rats of model group(P＜0.01),but was decreased in resveratrol group compared with model groups(P＜ 0.05).Conclusion Increased expression of MIF may be involved in the pathogenesis of EAM.The therapeutic effect of resveratrol on EAM may be associated with down-regulated MIF expression and decreased macrophage infiltration.