From January 1985 to June 1992, 34 patients with acute necrotizing pancreatitis proved by operation and pathology were admitted. The patients consisted of 10 males and 24 females, aged 1～72 with an average age of 43.8years. The time from onset to operation was 10～63 hours (average 30.7 hours). All patients underwent pancreatic capsulotomy, mobilization of pancreatic bed, and necrosectomy with the exception of one treated by subtotal pancreatectomy. Twenty-nine cases were cured, the average hospital stay was 77.4 days. Five patients died with a mortality of 14.7 per cent. We take the view that all patients with acute necrotizing pancreatitis should be early operated when the diagnosis is established, and necrosectomy proved to be a simple, easy, safe and effective mode of operation.

Not only calmodulin (CAM) with Ca2+ regulates the activity of many enzymes and proteins, but also free-CaM (no Ca2+bound) and Ca2+-independent CaM-binding proteins play roles in plant and animal cells. There is no in vivo method to identify the interaction between free-CaM and Ca2+-independent CaM-binding protein (CaMBP). Using site-directed mutagenesis by polymerase chain reaction (PCR), 5 mutant Arabidopsis calmodulin isoform 2 (AtCaM2) genes, mCaM21, mCoM212,mCaM2123, mCaM2124 and mCaM21234 were obtained. The mutant mCaM2 encoded glutamine in place of glutamate (E32Q; E68Q; E105Q; E141Q) in one or more EF-hand Ca2+-binding motifs of AtCaM2. The recombinant mCaM2 proteins were produced in Escherichia coli, and subsequently separated on SDS-PAGE in the presence of Ca2+ or EGTA, their electrophoresis mobilities were related with that of mutant EF-hand motifs. 45Ca2+ overlay analysis indicated that the more glutamate replaced by glutamine, the lower affinity with Ca2+ in the mCaM2 proteins. The mCaM21234 mutant protein (E32Q; E68Q; E105Q;E141Q) was unable to bind Ca2+. Using yeast two-hybrid technique with mCaM21234 as bait, it was possible to see interaction in Arabidopsis of AtCaM2 with IQD26, a calcium-independent CaM-binding protein. Site-directed mutation of AtCaM2 will aid the research of Ca2+, CaM and Ca2+-independent CaMBPs in plant biological processes.

Objective To evaluate the matching degree of donor's and receptor's tissue typing and analyze the relationship between the degree and the early survival of cardiac transplantation with donor's and receptor's tissue typing of 9 cases of cardiac transplantation. Methods In accordance with the international standard, donor's and receptor's blood type, HLA antibody, lymphocytotoxicity and panel reactive antibody were determined in 9 cases of cardiac transplantation, and the donor's and receptor's matching degree evaluated by methods of amino acid triplets and cross-reactive group. Results Of 9 cases, 6 survived while 3 died. Of the 3 dead cases, 2 came respectively from the two best comprehensively evaluated matching cases and two worst, and postoperative biopsy showed that there was no rejection in either survival cases or the dead cases. Conclusion With the effective immunosuppressant, the HLA typing doesn't affect the early survival.

Objective To summarize the experience of 11 orthotopic allogeneic heart transplantations for patients suffering from terminal heart disease, and to discuss how to improve the selection of donor and recipient, protection for the donated heart, postoperative treatment and immune surveillance suitable for our country. Methods 1.All the donated hearts were protected by perfusing cold modified St.Thomas cardioplegia and cold oxygenated blood. 2. Orthotopic heart transplantation was performed with the standard technique of medium low temperature extracorporeal circulation. 3. FK506, mycophenolate mofetil(MMF) and steroid were given to prevent rejection. 4. Troponin I, ? 1 and ? 2 microglobulin, C reactive protein (CRP), interleukins, lymphocyte subgroups and mixed lymphocyte reaction (MLR) were employed to monitor the immune rejection reactions. Furthermore, myocardial biopsy and coronary arteriography were conducted periodically. Results Three patients died of systemic failure and infection due to hepatic failure and mental disorder after operation. All the others survived with no complications. Conclusion Strictness in selection of the recipient, high quality of donor heart, correct early postoperative treatment and sound use of immunosurppressant are key to achieving successful cardiac transplantation.

Objective To observe the influence of ulinastatin (UTI) on curative effect,inflammatory response and cellular immune function in patients with acute respiratory distress syndrome (ARDS).Methods 96 patients with ARDS were randomly divided into two groups:the control group (48 cases) were treated with conventional treatment,and the UTI group (48 cases) were added with UTI injection based on the control group treatment.The changes of oxygenation index,vital signs,inflammatory factors and T lymphocyte subsets of patients in the two groups were compared before treatment and after treatment in 7 days,recorded the duration of mechanical ventilation time,ICU treatment time and mortality rate in ICU in the two groups.Results After treatment in 7 days,the vital signs (RF,HR,MAP),inflammatory factors (TNF-α,IL-6,IL-8,PCT,CRP,WBC),liver function (AST,ALT),renal function (BUN,Cr) and APACHE Ⅱ score,MODS score of UTI patients in the UTI group were lower than those in the control group (P ＜ 0.05 or P ＜ 0.01).Oxygenation index (PaO2/FiO2) and cellular immunity (CD4+,CD4+/CD8+) in the UTI group were higher than those in the control group (P ＜ 0.01).Mechanical ventilation time,ICU treatment time in the UTI group were shorter than those in the control group (all P ＜ 0.05),the mortality rate of ICU in the UTI group was lower than that in the control group (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusions UTI can more effectively improve oxygen metabolism,vital signs for ARDS,liver and kidney function,reduce the APACHE Ⅱ score and MODS score,shorten the mechanical ventilation time and ICU treatment time,reduce the mortality rate of ICU.Its mechanism may relate to clearance of inflammatory factors and regulate cellular immune function of UTI.

Objective To assess the value of SureTouch tactile breast imaging (SureTouch) in early breast disease detection.Methods From April 2009 to March 2011,16 010 adults received health checkup in our center,5000 of whom took breast screening and were randonly selected to accept SureTouch.The results of the SureTouch were reviewed.Results In SureTouch,799 participants were normal,resulting in an abnormal rate of 84.02％.Four thousands and nineteen adults were found with breast hyperplasias (80.38％) and 150 with breast nodulars (3.00％),and another 32 women were suspected with malignant condition (0.64％).Breast hyperplasia was the most commonly seen disease in all age groups,although breast nodular and malignant changes were mainly found in 35-50 age group.The incidence of malignant disease showed a trend of affecting younger females.Pathological follow-up results of two controversial cases supported the diagnosis of SureTouch.Conclusions SureTouch shows high sensitivity in this study.The application of SureTouch in breast screening may play an important role in the early detection,diagnosis and treatment of breast diseases.

Objective To investigate the effects of resuscitation with limited fluid on rabbits with uncon-trolled hemordaagic shock. Method Uncontrolled hemorrhagic shock was produced in 40 rabbits. When the mean arterial pressure dropped to 40 manI-Ig and maintained for 30 minutes, resuscitation was initiated with Ringer solu-tion infusion into rabbits in large volume for group N3 (125 mL/kg) ,moderate volume for group N2 (92 mL/kg) and small amount for group N1 (57 mL/kg), and a drop of fluid was not given to rabbits of group N4. Besides, rob-bits of group N5 were controls without shock. MAP, fatality, volume of blood loss, SOD and Her were observed for 120 minutes or until death. Data were analyzed using SNK-q test and rank test. Results MAP, SOD and Het were higher, and fatality and blood loss were lower in group N5 than those in groups N1, N2,and N3 (P<0.01 ). MAP,fatality,blood loss and Het of group N4 were worse than those of groups N1,N2 and N3 (P<0.01). The blood loss and fatality in group N3 were significantly higher than those in groups N1 and N2 (P<0.01 ). SOD of kidney in group N3 was significantly lower than that in group N1 and N2(P<0.01). As the volume of fluid in-creased during resuscitation, Het of all animals was gradually becoming lower. As MAPS in groups N2, N3 and N4 were gradually becoming lower and lower, death increased. Conclusions Limited fluid resuscitation (57～92mL/kg) should be recommended to the therapeutic strategy for uncontrolled hemorrhagic shock.

Objective To investigate the influential factors of brachial-ankle artery pulse wave velocity (baPWV) in healthy individuals.Methods Total 716 healthy subjects including 503 males and 213 females,who underwent health check up in 2010,were enrolled in the study Bilateral baPWV was examined in all subjects and multiple factor linear regression was applied to evaluate the correlations of baPWV with sex,age,body mass index,arterial blood pressure,ankle-brachial index and biochemical variables.Results The mean baPWV of 716 healthy subjecs was ( 1224 ± 162) cm/s,and there was significant difference between men and women [ ( 1257 ± 159) cm/s vs.( 1144 ± 143) cm/s].There was a significant linear correlation of baPWV with sex,age,mean arterial blood pressure and plasma homocysteine concentration ; and the linear regression equation was:mean PWV =6.635 × age + 7.285 × mean arterial blood pressure + 2.682 × homocysteine concentration - 64.334 × sex + 347.500 ( sex:man =0,woman =1 ).Conclusion Age,sex,mean arterial blood pressure and plasma homocysteine concentration are independent influential factors of baPWV.