Objective To discuss the predisposing factors,prognosis and treatment of pancreatic encephalopathy(PE) in acute pancreatitis(AP). Methods Nineteen cases of AP complicated with PE were retrospectively studied. Results The occurrence rate of PE was 12.0%. PE often occurred in association with such factors as hyperpyrexia, water-electrolyte disturbance, and hypoxemia. Among the 19 patients,11 patients received surgical operation and 8 were treated conservatively.The total fatality rate reached 52.6%(10/19), significantly higher than other concurrently treated cases of severe acute pancreatits(SAP) (20.7%,P

Objective To study the treatment of intra-abdominal hypertension syndrome (IAHS) secondary to fulminant acute pancreatitis(FAP). MethodsWe retrospectively analyse therapeutic results of 14 IAHS cases secondary to FAP during the period of 1998～2003. ResultsFour out of the 6 cases receiving nonoperative therapy died with motality rate of 67.7% (4/6). Two out of the 8 cases treated by early surgery died. The motality rate was 25% (2/8), which was significantly different from that treated conservatively . ConclusionModerate to severe IAHS cases secondary to fulminant acute pancreatitis should undergo exploration in the early phase of disease to improve the prognosis of FAP.

Objective To study the diagnosis and treatment of primary liver cancer(PLC) with bile duct cancer thrombus (BDT). Methods The clinical data of 21 patients with PLC and BDT admitted in the past 8 years were analyzed retrospectively . Results The major clinical manifestations were the symptoms of primary liver cancer and obstructive jaundice. The correct diagnosis rate was 76.2% before operation. The diagnosis rate of B-us, CT, MRI, ERCP and PTC was 14.3%, 9.52%, 14.3%, 71.4% and 100% respectively. The operative procedures included hepatectomy with removal of BDT ( n =10), hepatectomy combined with extrahepatic bile duct resection ( n =5), thrombectomy through choledochotomy with TACE ( n =3), removal of BDT with HAI ( n =3). The 3,5-year survival rate were 43.20% and 24.60% respectively. Conclusions Multi-examinations should be applied in the diagnosis of PLC with BDT. The comprehensive therapy including surgery and other therapies must be adoptted for PLC with BDT.

Objective To study the significance of expressions of smad_4mRNA,TGF-?_1, and TGF-?R_1 in pancreatic carcinoma(PC) . Methods Smad_4mRNA was detected by in situ hybridization. TGF-?_1 and TGF-?R_1 were detected by immunohistochemical method. Results The positive rates of smad_4mRNA,TGF-?_1 and TGF-?R_1 were singnificantly lower in 53 slices of pancreatic carcinoma than those in 25 slices of paracancerous tissue (all P

Objective To assess the effect of intravenous infusion of octreotide in prevention of pancreatic fistula after pancreaticoduodenectomy. Methods The clinical data of 74 cases of pancreaticoduodenectomy performed from January 1996 to July 2003 were retrospectively reviewed. These included 36 cases in control group in which octreotide was not adminstered,and 38 cases in octreotide group in which octreotide was administered by intravenous infusion of 0.5?g/( kg?h) for 12 hours per day from the operative day to postoperative day 7. The study parameters included clinical manifestation,drainage from peritioned cavity and the amount of drainage of pancreatic fluid. Results The drainage of pancreatic fluid at postoperative day 1,3,5 the in octreotide group was significantly less than those in the control group,the average hospital stay and the incidence of pancreatic fistula were significantly lower than those in the control group,and the drainage of pancreatic fluid was significantly increased after the withdrawal of octreotide in the octreotide group. Conclusions Intravenous infusion of octreotide can significantly lower the incidence of pancreatic fistula after pancreaticoduodenectomy.

Objective To establish a method of gene mutation detection for congenital adrenal hyperplasia (CAH) by using sequencing, single nucleotide polymorphisms (SNP) analysis and T-A cloning. Methods The blood samples of 33 patients with 21-hydroxylase deficiency (21-OHD) , 2 patients with 17α-hydroxylase deficiency (17-OHD) , the parents of all the patients and 105 healthy children were collected. Genomic DNA were extracted form the blood samples. To detect the gene mutation of CYP21A2,highly specific primers for CYP21A2 gene were designed according to the sequence differences between CYP21A2 gene and its pseudogene. The whole CYP21A2 gene was amplified and sequenced. SNP analysis and TA cloning of PCR products were also carried out. The molecular diagnosis of 17-OHD was based on the amplification and sequencing of CYP17A1 gene. Results The corresponding gene mutations was determined in all the patients based on the method established in this study. Thirteen mutations of CYP21A2 gene were identified in 33 patients with 21-OHD. The 3 most frequent mutation of CYP21A2 gene were IVS2-13A/C >G, p. I172N and chimeric mutation, which accounted for 32% (21/66) ,27% (18/66) and 15% (10/66) respectively. Ninety-one persent mutations of CYP21A2 gene resulted from pseudogene conversion. In 2 patients with 17-OHD, homozygous mutations of CYP17A1 gene, IVS4-6A > G and p. 487_489del were identified separately. All the gene mutations detected in the patients were inherited from their parents. No mutation of CYP21A2 gene or CYP17A1 gene was found in the healthy children. Conclusion A method of gene mutation detection for CAH has been established. It will be beneficial to clinical diagnosis of CAH.

OBJECTIVE To analyze the distribution and anti-microbial resistance profile of pathogenic bacteria isolated from hospitalized neonates in Wuhan area.METHODS The strains of bacteria isolated from neonates in hospitalization of Wuhan area from 2006 to 2007 were identified by VITEK 32 automatic bacteria system and antimicrobial susceptibility test was performed by Kirby-Bauer method.The standards of NCCLS issued in 2006 were used to assess the results of antimicrobial susceptibility.RESULTS A total of 3892 strains of bacteria were isolated from 10053 specimens,the positive rate was 38.7%.The Gram-positive cocci and Gram-negative bacilli accounted for 41.0% and 55.2%,respectively.The leading 8 species on the list of isolated strains in the two years accounted for 90.8% of all the isolated strains.MRCNS accounted for 68.6% of coagulase negative staphylococcus,and the MRSA kept a low rate(2.6%) in Staphylococcus aureus.The infection rate of newborn by Enterococcus in blood was remarkably higher than that of the past report in this area.The ?-lactamases-producing Escherichia coli and Klebsiella pneumoniae were accounted for 46.9% and 34.7%,respectively.CONCLUSIONS The distribution and anti-microbial resistance of hospitalized neonates in Wuhan area have regional and group characteristics;it′s necessary to strengthen monitoring the regional epidemic characteristic status and the drug-resistant status of the pathogenic bacteria among neonates.

renal dysfunction.Logisitic regression showed that cardiovascular disease and hypoalbuminemia were correlated with perioperative death rate significantly. Conclusions Improving the perioperative management is very important for lowering the perioperative mortality in elderly patients with digestive tract disease.

Objective To investigate the relationship between NF-kB activity of pancreatic acinar cells(PAC) and blood inflammatory cytokines ( IL-2, IL-6, IL-10, TNF-? and ICAM-1) in rat's ANP. Methods Fourty rats were randomly divided into two groups: ANP model group and contrast group. ANP was induced by retrograde injection of 5% sodium taurocholate into the pancreatic duct. NF-KB activity in the cell nuclear and IkBa activity in the cell spasm of PAC were measured by EMSA and Western-blot. Inflammatory cytokines were measured by ELISA. Results ANP model's NF-KB activity increased [(31.4?5.7) ?mol/L vs. (8.3?2.4) ?mol/L.(39. 4 ? 6. 4) ?mol/L vs. (10.7 ?2.6) ?mol/L. (33. 8?6.0)?mol/Lvs. (11. 5 ?2. 7) ?mol/L.(25. 7 ?4. 9) ?mol/L vs. (9.4 ?2.6) ?mol/L](P

Objective To investigate the possibility and feasibility of the whole genome microarray scanning technique in clinical cytogenetic diagnosis of an uncertain karyotype and mentally retarded child. Methods The karyotype analysis of the mental development delayed child was 47, XY+mar. Genomic DNA was extracted from the peripheral blood and the whole genome microarray scanning technique was used to analyze the derivative chromosome. Results The whole genome microar-ray scanning technique indicated the derivative chromosome fragment had originated from 9p13.1-p24.3. Conclusions Com-paring to conventional cytogenetic analysis methods, the whole genome microarray scanning technique is of high resolution, high-throughput and high accuracy, which can detect the submicroscopic chromosomal aberrations and replace the conven-tional karyotype analysis.