Based on our clinic experience in the diagnosis and treatment of acute pancreatitis,this article discussed some basic problems of the chinese guide of acute pancreatitis management,such as the definition of acute pancreatitis,classification of acute pancreatitis,diagnosis and treatment of acute pancreatitis.

Objective To study the relation between p38 MAPK pathway and multidrug resistance of stomach cancer. Methods The activity of p38 MAPK in gastric cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR was examined by immunoprecipitation after treating with vincristine for 0,2,15,30,60 minutes. Results Vincristine could activate the activity of p38 MAPK in gastric cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR. The difference between them was that in cell SGC7901 vincristine activate the p38 MAPK rapidly whereas in cell SGC7901/VCR slowly. Conclusion Vincristine could affect the activity of p38 MAPK in gastric cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR.

To investigatethe relationship between p38 MAPK pathway and multidrug resistance of stomach cancer. The activity of p38 MAP kinase in stomach cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR were examined by immunoprecipition after adriamycin treatment SGC7901 for 0, 2, 15, 30 and SGC7901/VCR for 0, 2, 15, 30, 60 minutes,respectively. The results indicated that adriamycin could activate the activity of p38 MAP kinase in gastric cancer cell SGC7901 with time dependency, but could decrease remarkably the activity of p38 MAP kinase in gastric cancer multidrug resistant cell SGC7901/VCR after adriamycin treatment it for 15 minutes. It suggested that adriamycin could affect the activity of p38 MAPK in gastric cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR.

Objective To investigate the effects of propofol on death-associated protein kinase (DAPK) mRNA expression in a rat model of traumatic brain injury (TBI). MethodsSixty male Wistar rats with a mean age of 3-4 months and mean body weight of 250-300 g were randomly divided into 6 groups ( n = 10 each) : Ⅰ normal control;Ⅱ sham operation; Ⅲ TBI; Ⅳ normal saline (NS) +TBI;Ⅴ fat emulsinn+ TBI and Ⅵ propefol + TBI. TBI was produced according to Feeney et al. In group Ⅲ-Ⅵ the animals were killed and their brains were removed at 24 h after brain contusion. NS 2 ml·kg-1 · h-1 , 10% fat emulsion 2 ml · kg-1 · h-1 and propofol 2 ml·kg-1·h-1 were infused iv for 4 h after lead trauma in group Ⅳ, Ⅴ and Ⅵ respectively. DAPK mRNA expression in the brain tissue was determined by RT-PCR and neuronal apeptosis was assessed by TUNEL. Results The expression of DAPK mRNA and neuronal apoptosis were significantly increased in the TBI group as compared with normal control and sham operation groups. Propefol infusion significantly attenuated neuronal apoptosis and reduced DAPK mRNA expression as compared with TBI, NS and FE groups. ConclusionPropofol can protect the brain from traumatic injury by suppression of the expression of DAPK mRNA.

BACKGROUND: Dendritic cells, the most potent antigen presenting cells known at present, have been extensively used in the immunotherapy as adjuvant. OBJECTIVE: The present study was to construct Der p 2 eukaryotic expression vector and validate its expression in the mouse bone marrow-derived dendritic cells. DESIGN, TIME AND SETTING: A single sample observation was performed at the Institute of Respiratory Disease,Xinqiao Hospital, Third Military Medical University of Chinese PLA between May and December 2005. MATERIALS: C57BL/6 mice were included. Plambd-Der p 2 was the product of Heska Company, USA.pCI-neo plasmid was provided by the Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University of Chinese PLA.METHODS: Mouse bone marrow-derived dendritic cells were in vitro isolated and cultured.Complete Der p 2 cDNA was spliced from prokaryotic expression vector plambd-Der p 2, and then cloned into eukaryotic expression vector pCI-neo (pCI-neo-Der p 2).The positive recombinants pCl-neo-Der p 2 transfected into dendritic cells.Non-transfected and blank vector pCI-neo-transfected dendritic cells were used as controls. MAIN OUTCOME MEASURES: ①Identification of pCI-neo-Der p 2 recombinant plasmid.②Detection of Der p 2 mRNA and protein expression by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot techniques. RESULTS: Sequencing results showed Der p 2 cDNA in pCI-neo-Der p 2 was in coincidence with the sequence registrated in Gene Bank.RT-PCR and Western Blot results showed that expression of Der p 2 mRNA and protein could be detectable in the pCI-neo-Der p 2-transfected dendritic cells. CONCLUSION: The Der p 2 cDNA was successfully constructed into the eukaryotic expression vector, and Der p 2 gene and protein could be expressed efficiently in dendritic cells.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Female ; Humans ; Mental Disorders ; etiology ; Postoperative Complications ; Stents ; adverse effects

Objective To explore the value of non-spiral mode of low-dose chest scan in diagnosis of pulmonary nodules.Methods Thirty patients with chest X-ray suspected pulmonary nodules underwent spiral low-dose and non-spiral low-dose CT scan under Toshiba 4 row multi-slice spiral CT (Asteion 4).The parameters were defaulted as 35.5 mAs,20 mm/ round (pitch=l),0.75 s/rot in spiral scan,while in non-spiral scan wree defaulted as 24 mAs,20 mm/round (thickness = layer distance),0.48 s/rot.Other parameters including 120 kV,collimator 0.5×4,DFOV 300 mm,reconstruction slice thickness 5 mm were chosen in both scans.CT imaging quality was evaluated according to the degreex of image artifacts and the distinguishment of nodule,and the pulmonary nodules were counted,then the differences of finding the pulmonary nodules and effective radiation dose of both mode were analyzed.Results The images were good in one patient in both scanning mode,and excellent in 29 patients in spiral scanning mode,28 patients in non-spiral scanning mode.A total of 108 nodules were found with two modes.The effective radiation dose in non-spiral scan was lower than that in spiral scan.No significant difference was found between non-spiral mode scanning and spiral scanning mode in the low-dose chest examination in the discovery and diagnosis of pulmonary nodules.Conclusion Lower dose of non-spiral scanning mode is feasible in diagnosis of pulmonary nodules.

Objective To study the effect of methylprednisolone therapy assisted by direct current field to treat spinal rord injury.Methods In order to make up for the defect that the direct current field could tiol reduce or remove spinal-cord edema,methylprednisolone was used 2 hours after spinal-cord injury.24 Chinese dogs wore randomly divided into two groups.Their spinal cords were made completely injured with Allen method.In Group A the electric stimulator was put into the body directly 6 hours after the spinal cord injury,while in Group B a large dose of rneuiylprednisolone was first injected 2 hours after thf spinal cord injury and then the electric stimulator was put into the body 6 hours after the spinal cord injury.In both groups the nerve function,cortical somatosensory evoked potential and three kinds uf morphometric changes were observed at 1,2,and 3 months after the injury.Results All the indexes mentioned above in Group B were much better than those in Group A.The differences between the two groups were statistically significant.Conclusion The direct current field can promote spinul curd regeneration effectively.A large dose of methylprednisolone assisted by direct current field has synergislic effects in treatment of spinal cord injury,especially in accelerating neurological functional recovery.

Objective To explore the clinical significance of early invasive mechanical ventilation for acute respiratory distress syndrome (ARDS) caused by thoracic trauma.Methods We retrospectively analyzed the clinical data of 93 patients of invasive mechanical ventilation in those with ARDS caused by thoracic trauma,and divided them into delayed invasive mechanical ventilation group (n =45) and timely invasive ventilation group (n =48) by the time of invasive mechanical ventilation.We compared the blood gas analysis,oxygen index,heart rate,lactic acid,muscle use score of the two groups before and after invasive mechanical ventilation and the differences of mechanical ventilation time,incidence of complications,mortality and length of hospital stay between the two groups.Results Each index of the delayed invasive mechanical ventilation group and the timely invasive ventilation group was calculated:PaO2 (63.2 ± 12.3,74.2 ± 12.1)mm Hg,PaCO2 (39.4 ±8.7,38.9 +7.6) mm Hg,PaO2/FiO2 (196.2 ± 17.8,231.4 ± 18.2),respiratory rate (27.4 ±3.7,21.1 ± 3.4) beats/min,heart rate (117.2 ± 26.8,96.0 ± 25.1) beats/min,accessory muscle use score (2.69 ± 0.15,1.67 ± 0.10),lactic acid (4.23 ± 1.70,2.12 ± 0.80) mmol/L Except for PaCO2,the differences of each index were statistically significant (t values were respectively 4.346,9.420,3.949,5.436,38.809,7.736; P ＜ 0.05).The duration of mechanical ventilation treatment (10.21 ± 1.50,6.47 ± 1.20) d and the length of hospital stay (21.53 ± 1.90,16.32 ±2.10) d of the delayed group and the timely group were significantly different (t values were respectively 12.518,13.318; P ＜ 0.01).The timely group had significantly lower mortality rate (26.7％ (12/45),14.6％ (7/48)),VAP (46.7％ (21/45),22.9％(11/48)),acute gastric mucosal lesions (33.3％ (15/45),12.5％ (6/48)),MODS (40.0％ (18/45),16.7％ (8/48)) than the delayed group (x2 values were respectively 3.86,5.81,4.49,5.70; P ＜ 0.05).There is no significant difference on the incidence of pneumothorax between the two groups (11.1％ (5/45),8.3％ (4/48)).Conclusion Invasive mechanical ventilation is an effective treatment of ARDS caused by chest trauma.Early invasive mechanical ventilation can reduce the mortality rate and shorten the duration of mechanical ventilation and hospital stay of the patients with ARDS after severe thoracic trauma.

Objective To explore effects of sequel recanalization PCI therapy(primary coronary intervention,PCI) on cardiac function for the patients with acute ST segment elevation myocardial infarction(STEMI),and related factors.Methods 116 patients with STEMI enrolled were divided randomly into two groups:sequel recanalization PCI group(58 cases) and conventional PCI group(58 cases),and the patients of sequel recanalization PCI group were fully absorbed for thrombus before conventional PCI,then compared estoration of their cardiac function of the patients of two groups at once and 2 weeks after PCI procedure,respectively.Meantime to study the effect related-factors for cardiac function by Logistic regression analysis.Results There were significant differences between two groups in RESVmax(P =0.03) 、RESVmin(P = 0.00) 、REFmax(P = 0.00)、 REDVmax(P = 0.01) and the ratio of E/A(P =0.02)(all P＜0.05);it showed that the restoration of cardiac function of sequel recanalization PCI group was faster than that of conventional PCI group.If sequel recanalization PCI served as a variable for predicting REFmax being 50%,the results of logistic regression showed that OR(odds ratio) value was 3.47,95% CI(confidence interval) 1.39-9.75,P =0.04.Among other variables,as was time-to-recanalization(OR =4.59,P =0.01);infarct size(OR =4.59,P=0.01);Kiliip grades(OR = 3.99,P =0.02)and age(OR=2.75,P=0.04).Conclusion The sequel recanalization PCI could be better than conventional PCI for the patients with STEMI in restoration of heart function,but there should be some other effective factors.