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Intranasal Steroids Ease Symptoms of Acute Sinusitis

The Character and Surgery of Pseudocyst Due to Acute Pancreatitis （Report of 115 Cases）

ObjectiveTo determine the characters of symptomatic pancreatic pseudocyst due to acute pancreatitis and effects of surgical treatment with two kinds of procedure （internal drainage or external drainage）. MethodsOne hundred and fifteen cases hospitalized during recent ten years were retrospectively analyzed.ResultsWe found that necrotic tissue existed in the pseudocyst in most cases and infection might occur in these pseudocyst. Although effect of two kinds of surgery was similar, the clinical course was different. The complications after surgery were fewer in patients underwent internal drainage than that with procedure of external drainage, and average hospital day was 7d in cases with internal drainage and 11d in cases with external one respectively. Surgery of internal drainage used in treatment was not only successful in noninfectious and single pseudocyst, but in infectious or multiple seudocyst.ConclusionInternal drainage should be used in most cases and considered as the first selection in surgery of pseudocyst due to acute pancreatitis.

Effects of Improved Gastric Lavage for Patients of Acute Poisoning

目的　探討改良洗胃法在急性中毒患者洗胃中的應用效果。 方法　將2010年1月－2012年2月收治的口服藥物中毒需采用電動洗胃機洗胃的患者分為觀察組和對照組，觀察組采用改良洗胃法，對照組采用傳統的洗胃方法，比較兩組患者洗胃總時間、洗胃總液量、一次性插管成功率、堵管發生率及并發癥發生率。 結果　觀察組患者洗胃總時間低于對照組[（28.60 ± 6.32）、（34.51 ± 5.37）min]，洗胃總液量低于對照組[（10 856 ± 3 818）、（17 962 ± 3 855）mL]，差異有統計學意義（P＜0.001）；一次性插管成功率高于對照組（93.02% 、67.44%），差異有統計學意義（P=0.03）；堵管發生率為低于對照組（4.88%、27.91%），差異有統計學意義（P=0.03）；并發癥發生率低于對照組（2.33%、37.21%），差異有統計學意義（P＜0.001）。 結論　改良洗胃法可減少洗胃總時間及洗胃液總量，提高一次性插管的成功率，同時可降低堵管及并發癥的發生率。

14例急性重癥胰腺炎的診斷及圍手術期治療

Target Antigen of Hyperacute Rejection in PigtoHuman Xenotransplantation

ObjectiveTo investigate the aim antigen coursing the hyperacute rejection of xenotransplantation. MethodsDocuments about hyperacute rejection in xenotransplantation were reviewed and summarized in detail. ResultsPig is thought to be one of the ideal donors of xenotransplantation, but the major obstacle is hyperacute rejection mediated by complement that is activated though human serum. αGal is recognized as the major antigen and its expression is controlled by α1,3 galactosyltransferase. Immunoabsorption of preexsisted antibody, enzymatic digestion of αGal, knockout αGT gene and transgenic technology have been used to solve this problem. Even so, there remain other antigens which can combine with natural antibodies in human serum, such as, 40×103 molecule in erythrocyte, 210×103, 105×103 and 50×103 antigen in pig embryo brain cell, etc. Conclusion αGal is the major antigen which course the hyperacute rejection. Besides αGal, many nonalphagal need further investigation.

Nutritional Supart in Patients with Severe Acute Pancreatitis

Clinical and Angiographic Characteristic of Patients with Spontaneous Reperfusion in ST Segment Elevation Myocardial Infarction

Objective　To study the clinical and angiographic features in ST Segment Elevation Myocardial Infarction (STEMI) patients with spontaneous reperfusion. Methods　A total of 519 patients with STEMI underwent Primary percutaneous coronary intervention (PCI) from January 2006 to December 2009 in Anzhen Hospital were enrolled. All patients were divided into the spontaneous reperfusion group (TIMI flow gradeⅢ ) and the non-spontaneous reperfusion group (TIMI flow grade 0-Ⅱ ) according to the TIMI flow grade before primary PCI. The incidence rate of spontaneous reperfusion through coronary angiography before primary PCI was observed, and the clinical relevant factors and angiographic lesion features of spontaneous reperfusion were analyzed. Results　There were significant differences in age, CTnI peak value, high thrombus burden, and lesion location in distant LAD (P=0.000, 0.000, 0.002, 0.000, and 0.003, respectively) between the two groups. But there were no significant differences in gender, hypertension, diabetes mellitus, smoking history, hyperlipemia, angina pectoris history, culprit vessel distribution, lesion distribution in LCX and RCA, and collateral circulation between the two groups (Pgt;0.05 for all). Conclusion　Compared to the patients without spontaneous reperfusion, patients with spontaneous reperfusion are younger in age, lower in CTnI peak value, and heavier in thrombosis burden, with culprit lesions mostly located in the distant LAD.

The Influence of Fish Bile on the Renal Function of Rabbits and Preliminary Study on Its Mechanism

目的　探討魚膽汁對兔腎臟的影響及其機制。 方法　將實驗新西蘭大耳白兔隨機分為灌胃組（GP組，n=19）與靜脈注射組（VI組，n=15），根據體重分別按3 mL/kg、0.3 mL/kg的劑量通過灌胃或耳緣靜脈注射方式給予魚膽汁。采集魚膽汁處理前與處理后1～5 h的血標本，測定腎功能、酸堿平衡及電解質指標，記錄GP組每個采樣點前20 min尿量及魚膽汁處理前、處理后5 h的尿常規。魚膽汁處理后5 h處死動物取腎做病理學檢查。 結果　給予一定量魚膽汁后5 h內，兩組兔血肌酐（Scr）、尿素氮、K+呈升高趨勢（P均＜0.05），而血HCO3?濃度呈下降趨勢（P＜0.05），其中VI組兔Scr、血K+改變早于GP組。GP組記錄尿量明顯下降，尿pH值升高，蛋白定量試驗、隱血試驗結果均呈陽性。兩組兔腎組織病理檢查均顯示腎小球血管充盈，少量中性粒細胞浸潤；腎小管水腫及間質充血，部分有局灶性出血，腎間質損傷較腎小球更為嚴重。 結論　無論經由消化道還是血管給予實驗兔魚膽汁均可導致急性腎功能損傷，與魚膽汁造成急性腎實質損傷、特別是腎小管間質損傷有關。

Treatment of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in an Adult

Objective　To search evidence in the treatment of Philadelphia chromosome （Ph）-positive acute lymphocytic leukemia （ALL） for guiding chnical practice. Methods　We searched MEDLINE （February, 1970～July, 2005 ） and SUMSEAILCH （till July, 2005 ）to identify systematic reviews（SIL）, randomized controlled trials（RCTs） and controlled clinical trials （CCTs） in the treatment of Ph-positive ALL. Results　One RCT and 8 CCTs were identified. The results showed that Ph-positive ALL had a very poor prognosis . Chemotherapy and bone marrow transplantation （BMT） were the two main ways to treat the disease. Outcome of conventional chemotherapy treatment for adults with the disease was poor. Outcome of treatment with hyper-CVAD and imatinib mesylate was better and BMT was the only way which could potentially cure the disease. Conclusions　Treatment of Ph-positive ALL with hyper-CVAD and imatinib mesylate may induce higher remission rate and disease free survival rate. BMT is the best way to cure the disease.

Modulation of Disorder of InflammatoryAssociated Cytokines with ImmunoSuppressive Agents in Acute Pancreatitis

bjectiveTo observe the effecacy of immunosuppressive agents on modulation of the disorders of inflammatory and antiinflammatory cytokines in acute pancreatitis, and to investigate the mechanism of treatment of acute pancreatitis with immunosuppressive agents. MethodsSD male rats were divided into 6 groups: group 1, the normal control group (n=6); group 2, acute pancreatitis induced by ductual injection of 5%sodium cholate sulfur at the volume of 1.0 ml/kg without treatment (n=8). After the pancreatitis were induced, the rest rats were injected intravenously with 5Fu 40 mg/kg (group 3, n=6); or methylprednisolone 30 mg/kg (group 4, n=6); or cyclophosphamide 20 mg/kg (group 5, n=6); or methotrexate 1.2 mg/kg (group 6, n=6). Twentyfour hours afteroperation, the animals were killed, the blood samples were taken for measurement of TNFα, IL1, IL6 (by bioassay), and IL10, TGFβ (by ELISA) as well as amylase. ResultsThe inflammatory cytokines (TNFα,IL1,IL6 ) and the antiinflammatory cytokines (IL10 and TGFβ), in blood of acute pancreatitis were increased significantly. After treated with immunosuppressive agents, both the inflammatory and antiinflammatory cytokines were decreased in different degrees. Some indexes of the severity of acute pancreatitis, such as amylase and pancreatic weight were improved obviously.ConclusionImmunosuppressive agents can regulate inflammatoryassociated cytokines increased remarkably in the acute pancreatitis. Therefore, improvement of acute pancreatitis can be achieved through rectifying the abnormal immunity and relieving the pathophysiological disorders of the acute pancreatitis by immunosuppressive agents.