Objective To sum up the experience on the diagnosis and treatment of abdominal compartment syndrome(ACS). Methods In this report, ACS was diagnosed by special clinical features in all 5 patients. Following emergency decompressive celiotomy, the abdominal viscera were covered with a 3 L sterile plastic bag for nutrition support. Results The first case died despite abdominal decompression through uper midline incision. 4 cases underwent decompressive celiotomy through incision from xiphoid to symphysis, one died postoperatively. The overall mortality in this series was 40% (2 / 5). Conclusions Close attention paid to the abdominal and systemic signs facilitates the diagnosis of ACS.Emergent decompressive celiotomy through a incision from xiphoid to symphysis is effective in treating ACS. Temporary abdominal closure could be fulfiled with 3L sterile plastic bag for nutrition support.

[ABSTRACT]AIM:Toinvestigatetheeffectofhypoxiacombinedwithexercisetrainingonmitochondrialcon-tent, and the role of mitochondrial biogenesis and mitophagy in this process .METHODS:Male Sprague-Dawley rats were randomly divided into 4 groups:normoxia control (NC) group, normoxia+training (NT) group, hypoxia+control (HC) group, and hypoxia+training (HT) group.The hypoxic animals were housed in normobaric hypoxic tent (11.3 % oxy-gen) for consecutive 4 weeks.The exercise training animals were exercised on a motor-driven rodent treadmill (5°) at a speed of 15 m/min, 60 min/d, 5 d/week for 4 weeks.Mitochondrial membrane potential was determined using JC-1 fluo-rescent probe .ATP synthesis capacity was determined using a bioluminescence technique .The protein expression of cyto-chrome C oxidase IV (COXIV), voltage-dependent anion channel-1 (VDAC-1), peroxisome proliferator-activated receptor gamma cofactor 1 alpha (PGC-1α), mitochondrial transcription factor A (Tfam),Bcl-2/adenovirus E1B 19 kD-interacting protein 3 (Bnip3) and beclin-1 in the muscles was detected by Western blotting .RESULTS:Compared with NC group, hypoxia attenuated mitochondrial membrane potential , ATP synthesis capacity , and the expression of COXIV , VDAC-1, PGC-1αand Tfam.Furthermore, hypoxia increased the expression of Bnip 3 and beclin-1.Compared with HC group , the exercise training elevated mitochondrial membrane potential , ATP synthesis capacity , and the expression of COXIV , VDAC-1, PGC-1α, Tfam, Bnip3 and beclin-1.CONCLUSION:A combination of reduced mitochondrial biogenesis and increased mitophagy seems to be responsible for the decrease in mitochondrial content after hypoxia .Exercise training with hypoxia elevates mitochondrial content and function in hypoxia , which may be mediated by appropriate increase and co-reg-ulation of mitochondrial biogenesis and mitophagy .

Objective To investigate the effects of 7 5% hypertonic saline (HS) on fluid balance after elective major abdominal surgery Methods Twenty two patients undergoing elective major abdominal surgery were assigned to receive either Ringer lactate solution followed by 4 ml/kg of 7 5% HS (study group, n =11) or Ringer lactate solution (control group, n =11) during the early postoperative period in ICU We compared fluid infusion volumes and urine outputs, fluid balance, and body weight change between the 2 groups Results Urine outputs in the operative day and the first postoperative day in study group were significantly more than in control group [(2?650?531)ml vs (2?046?572)ml, t =2 551?7, P

Objective To detect the change of the plasma hydrogen sulfide in patients with chronic heart failure (CHF) and explore its clinical significance.Methods A total of 118 patients with CHF was enrolled in this study.According to the NYHA standard,they were classified into grade Ⅱ (34 cases),grade Ⅲ (54 cases),grade Ⅳ (30 cases).The patients were divided into normal treatment group and sodium nitroprusside treatment group with 59 cases each.Another 30 healthy person were selected as control group.The plasma hydrogen sulfide level was detected by spectrophotometer.Results The plasma hydrogen sulfide level in CHF patients and healthy person was (32.45 ± 3.86),(54.26 ± 5.63) μ mol/L,and there was significant difference (P ＜ 0.05).The plasma hydrogen sulfide level in CHF patients of grade Ⅱ,Ⅲ,Ⅳwas (43.26 ±4.73),(31.87 ±4.12),(23.66 ±3.54) μmol/L,and there was significant difference (P＜0.05).The plasma hydrogen sulfide level before treatment in normal treatment group and sodium nitroprusside treatment group was(31.66 ± 3.75),(33.04 ± 4.02) μ mol/L,and there was no significant difference between two groups (P ＞ 0.05).The plasma hydrogen sulfide level after treatment in normal treatment group and sodium nitroprusside treatment group was (36.83 ± 4.32),(44.54 ± 4.68) μ tmol/L,and there was significant difference (P ＜0.05).The plasma hydrogen sulfide level after treatment in two groups was increased compared with that before treatment,and there was significant difference (P ＜ 0.05).The total effective rate in normal treatment group and sodium nitroprusside treatment group was 42.4％ (25/59) and 67.8％(40/59),and there was significant difference between two groups (P ＜ 0.05).Conclusions The abnormal plasma hydrogen sulfide level may be involved in the occurrence and development process of CHF,which could be used as a factor to monitor the disease.The upregulation of plasma hydrogen sulfide level can significantly improve the prognosis of CHF patients.

Objective: To study the protective effect of vitamin E in preventing contrast-induced nephropathy (CIN) in patient with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).
Methods: We prospectively studied 206 CAD patients with elective PCI in our hospital and divided them in 2 groups: Treatment group, the patients received oral vitamin E combining vinous hydration,n=102 and Control group, the patients received vinous hydration only,n=104. CIN was deifned by at 48h after contrast media injection, serum cretinin increased up to 25% from the baseline, or reached 44.2 μmol/L. Excluding the other kidney injury factors, the renal functions at 48 h before and after PCI were compared, the occurrence rate of CIN were also compared between 2 groups.
Results:①Overall, there were 19/206 (9.22%) patients suffered from CIN, the occurrence rate in Treatment group (4.90%) was lower than Control group (13.46%), χ2=4.506,P=0.034. For patients with hypertension, diabetes, chronic kidney disease, anemia and mehran risk score<10, the occurrence rate of CIN in Treatment group was lower than Control group,P<0.05.②Compared with pre-operative condition, at 48 h post-operation,Control group showed increased serum creatinine (Scr), blood urea nitrogen (Bun) and decreased creatinine clearance rate (Ccr), allP<0.05.③At 48 h post-operation, compared with Control group, Treatment group presented decreased Scr (86.72 ± 17.73) μmol/L vs (95.13 ± 21.67) μmol/L and increased Ccr (96.75 ± 27.23) ml/min vs (90.70 ± 17.85) ml/min, allP<0.05.④Multivariate regression analysis revealed that elder than 75 years of age (OR=7.278, 95% CI 5.158-11.480), diabetes (OR=3.919, 95% CI 1.330-8.200), chronic kidney disease (OR=6.325, 95% CI 2.137-16.816) and mehran risk score>10 (OR= 4.461, 95% CI 1.589-14.724) were the independent risk factors for CIN occurrence, allP<0.05.
Conclusion: Short-term application of vitamin E may reduce the risk of CIN occurrence at certain degree in CAD patients after PCI.

BACKGROUND:It is unclear whether short-term high-intensity interval training (HIT) can be used to protect against myocardium injury after acute myocardial infarction, as wel as the underlying mechanism.
OBJECTIVE:To observe the effects of short-term HIT on the ventricular remodeling and mitochondrial content after acute myocardial infarction, and the biological effect of mitochondrial biogenesis and autophagy in this process.
METHODS:Male Sprague-Dawley rats were modeled into acute myocardial infarction by ligating coronary artery. One week later, HIT was performed:each interval consisted of 4-minute high-intensity running (80%of maximal oxygen consumption) and 3-minute active recovery (40%of maximal oxygen consumption), for 4 consecutive weeks of 5 days each week, repeated 7 cycles.
RESULTS AND CONCLUSION:Four-week HIT after acute myocardial infarction could markedly enhance left ventricular pump function and mitochondrial content, improve mitochondrial membrane potential and ATP synthetic activity, inhibit mitochondrial reactive oxygen species generation, up-regulate PGC-1α/Tfam induced mitochondrial biogenesis and Bnip3/Beclin-1 induced autophagy. These results indicate that short-term HIT can improve normal mitochondrial content after acute myocardial infarction, which in turn ameliorates myocardial systolic property and energy metabolism. As a cardiac rehabilitation method, HIT exhibits fine timeliness.

Objective To investigated the different effect of moderate-intensity continuous training (MCT) and high-intensity interval exercise training (HIT) on ventricular remodeling and mitochondrial homeostasis after acute myocardial infarction (AMI).Methods The AMI rat model was achieved by ligating coronary artery.The AMI and sham operation rats were randomly (random number) divided into four groups:sham operation group (Sham),AMI control group (AMI),AMI MCT group (AMI + M),and AMI HIT group (AMI + H).Animals in the AMI + M and AMI + H groups underwent 4 weeks MCT and HIT respectively.Five weeks after AMI,hemodynamic changes,mitochondrial bioenergetics,and PINK1,Beclinl,Mfn2,Drp1,Tfam,COXⅣ,PGC-1α were detected.Results Comparing with AMI group,in AMI + M and AMI + H groups,Beclin1,PINK1,Mfn2 and PGC-1α expression elevated significantly (P ＜0.05 or P ＜0.01),whereas ROS generation and Drp1 expression showed dramatic decrease (P ＜ 0.05 or P＜0.01).In addition,in AMI + H group,±dp/dt max,mitochondrial membrane potential,ATP synthesis activity,Tfam and COXⅣ expression improved significantly (P ＜ 0.05).Comparing with AMI + M group,in AMI + H group,± dp/dt max,PGC-1α,Tfam and COX Ⅳ expression improved significantly (P ＜ 0.05).Conclusions HIT is superior to MCT for ameliorating ventricular remodeling and mitochondrial homeostasis after AMI.

Objective To explore the relationship between the histological alterations of Oddi sphincter lesions and clinical manifestations. MethodsFrom October 1995 to May 2003, biopsies of Oddi sphincter were undertaken during transduodenal sphincteroplasty (TSP) in 32 cases. Specimens were stained with Van Gieson Mason staining. ResultsThirty one out of 32 specimens were found with histological alterations in Oddi sphincter including diffuse fibrosis in 87 1% (27/31) , adenomyosis in 2 cases and chronic inflammatory infiltration in 2 cases. Impacted stone in the terminal common bile duct, benign papillary stenosis and visible postpancreatitis parenchymal changes were all found accompanying severe fibrosis of Oddi sphincter. ConclusionIn patients with impacted stones in the ampulla, intracholedochal sludge with recurrent cholangitis, and relapsing pancreatitis, endoscopic sphincterotomy is recommended.

Objective To test the safety and effectiveness of transpedicular fixation combined with transpedicular bone grafting via less invasive paraspinal intermusclar approach in treatment of thoracolumbar fractures.Methods The study involved 23 cases of thoracolumbar fractures treated with paraspinal multifidus intramusclular mini-incision,transpedicular bone grafting,and short-segment pedicle screw fixation from June 2009 to June 2012.There were 16 males and 7 females at age of 19-55 years (average 38.8years).Time from injury to surgery varied from 6 hours to 7 days (average 3.2 days).Fracture level was T11 in three cases,T12 in seven,L1 in nine,and L2 in four.According to Denis fracture classification,there were altogether 10 compression fractures and 13 burst fractures.McCormack load sharing classification scored average 5.3.Before operation,anterior vertebral body height ratio was average 58.6％(range,45 ％-73％) and kyphosis angle was average 23.7° (range,15°-34°).Results Operation lasted for average 95.5 minutes (range,75-130 minutes) with intraoperative bleeding of average 160.3 ml (range,115-220 ml).Unilateral incision that was averaged 3.5 cm (range 3.2-4.0 cm) in length obtained primary healing.Average follow-up time was 12.6 months (range,7.5-18 months).Average height of the anterior border was corrected to 97.3％ and average kyphosis angle was corrected to 4.6°.There was neither instrumentation failure nor symptom of persistent postoperative back pain.Conclusions Transpedicular fixation with transpedicular bone grafting via paraspinal muscle approach provides effective recovery of vertebral morphology and correction of kyphotic deformity.Furthermore,the technique gains advantages of easy operation,small trauma,less blood loss and rapid recovery.

Objective To discuss the effect of the interval between neoadjuvant therapy and surgery on downstaging for local advanced rectal cancer.Method s From May 2003 to December 2008 as earlier period,32 patients with clinical stage T3 or T4 rectal cancer received neoadjuvant therapy followed by surgery after 4 -6 weeks.From January 2009 to December 2010 as later period,21 patients with clinical stage T3 or T4 rectal cancer received neoadjuvant therapy followed by surgery after 8 weeks.Dworak classification,TNM stage and clinical outcome after surgery were compared between two group paitents.Results All patients with local advanced rectal cancer received R0 resection.No surgical complications and mortality were observed in all cases.Pathological results showed that 0 and 2 cases were Dworak classification Ⅳ,5 cases were Dworak classification Ⅲ,3 and 6 cases were Dworak classification Ⅱ and 24 and 8 cases were Dworak classification Ⅰ in earlier period and later period,respectively (x2 = 9.109,P = 0.028).The postoperative staging showed that 6 and 13 cases were ypT1N0M0,22 and 6 cases were ypT2N0M0,1 case was ypT3 N0M0,3 and 1 cases were ypT3N1 M0,respectively (x2 = 10.909,P = 0.012).There were 65.6% or 81.0% cases reserved anus in earlier period and later period,respectively(x2 = 1.468,P = 0.226).Conclusions The neoadjuvant therapy followed by surgery after 8 weeks is associated with a more significant downstaging effect for local advanced rectal cancer.However,the effect of an extended interval between neoadjuvant therapy and surgery on clinical outcome still needs further investigation.