Rainfall is a key climate parameter that affects most operations that affect human life, especially in the tropics. Therefore, understanding the various factors that affect the distribution and intensity of this rainf...Rainfall is a key climate parameter that affects most operations that affect human life, especially in the tropics. Therefore, understanding the various factors that affect the distribution and intensity of this rainfall is important for effective planning among the different stakeholders in the weather and climate sectors. This study aimed at understanding how intra seasonal rainfall characteristics, especially Consecutive Dry Days (CDD) and Consecutive Wet Days (CWD), in the two major rainfall seasons will change under two future climate scenarios of RCP4.5 and RCP8.5 in Uganda, covering two future periods of 2021-2050 and 2051-2080. The results indicate a high likelihood of reduced consecutive rainfall days, especially over the Northeastern regions of the country, for both 2021-2050 and 2051-2080. However, the trends in the entire country for the two major rainfall seasons, March to May and September to November, are not significant. Nonetheless, the distribution of these days is important for most agricultural activities during different stages of crop growth. The consecutive dry days show a fairly increasing trend in the eastern part of the country, particularly in the second season of September to November. An increase in consecutive dry days implies more frequent dry spells in the midst of the growing season, potentially affecting some crops during critical growth stages.展开更多
Background:Intra-abdominal hypertension(IAH) is a disease with high morbidity and mortality among critically ill patients.The study's objectives were to explore the prevalence of IAH and physicians' awareness ...Background:Intra-abdominal hypertension(IAH) is a disease with high morbidity and mortality among critically ill patients.The study's objectives were to explore the prevalence of IAH and physicians' awareness of the 2013 World Society of Abdominal Compartment Syndrome(WSACS) guidelines in Chinese intensive care units(ICUs).Methods:A cross-sectional study of four ICUs in Southwestern China was conducted from June 17 to August 2,2014.Adult patients admitted to the ICU for more than 24 h,with bladder catheter but without obvious intravesical pressure(IVP) measurement contraindications,were recruited.Intensivists with more than 5 years of ICU working experience were also recruited.Epidemiological information,potential IAH risk factors,IVP measurements and questionnaire results were recorded.Results:Forty-one patients were selected.Fifteen(36.59%) had IVP?12mm Hg.SOFA(Sequential Organ Failure Assessment) hepatic and neurological sub-scores were utilized as independent predictors for IAH via logistic backward analysis.Thirty-seven intensivists participated in the survey(response rate:80.43%).The average score of each center was less than 35 points.All physicians believed the IAH prevalence in their departments was no more than 20.00%.A significant negative correlation was observed between the intensivists' awareness of the 2013 WSACS guidelines and the IAH prevalence in each center(r=-0.975,P=0.025).Conclusion:The prevalence and independent predictors of IAH among the surveyed population are similar to the reports in the literature.Intensivists generally have a low awareness of the 2013 WSACS guidelines.A systematic guideline training program is vital for improving the efficiency of the diagnosis and treatment of IAH.展开更多
Background: To investigate the effect of intra-abdominal volume increment(IAVI) on intra-abdominal hypertension(IAH) in the kidneys.Methods: Eight minipigs were successfully established as IAH models and were randomly...Background: To investigate the effect of intra-abdominal volume increment(IAVI) on intra-abdominal hypertension(IAH) in the kidneys.Methods: Eight minipigs were successfully established as IAH models and were randomly divided into two groups: the IAVI group and the sham-operated group. The intravesical pressure, inferior vena cava pressure and urine volume were measured before shock, 2 h after IAH, and 22 h after surgery, respectively. The following indices were measured: serum creatinine, urea nitrogen, renal cortical thickness, ratio of abdominal anteroposterior diameter/transverse diameter, renal thickness, diameter of the renal sinus and the wet/dry ratio of renal tissues.Results: The intravesical pressure(IVP) of the 8 minipig IAH models was calculated to be 21.16±4.63 mmHg. There was a significant increase in the abdominal anteroposterior diameter/transverse diameter ratio. The minipigs in the IAVI group survived during the observational period, whereas 2 minipigs died at 18 h and 20 h in the sham-operated group. Twenty-two hours after surgery, the animals in the IAVI group displayed increased urinary volume(UV) and decreased Cr and Ur and remarkable decreases of VP and IVCP. After IAH, the renal cortical thickness and the renal thickness increased significantly. The renal wet/dry ratio in the sham-operated group was higher than that in the IAVI group.Conclusion: IAVI helps to control renal dysfunction after IAH, which may be related to lowering the intra-abdominal pressure, thus alleviating renal edema and blood stasis.展开更多
The comprehensive improvement strategy of intra-county environment pollution in the city and countryside was searched.By the research method which combined the microscopic view,the macroscopic view with the dynamic pe...The comprehensive improvement strategy of intra-county environment pollution in the city and countryside was searched.By the research method which combined the microscopic view,the macroscopic view with the dynamic perspective,the seriousness of rural water quality,soil and atmospheric pollution in Xiangxiang,Xiangtan and the surrounding areas in Shaoshan irrigated area was revealed.The control measure which was 'four-dimensional pollution in the city and countryside'—— low-carbon-high-value agriculture and the technology innovation was proposed.The low-carbon-high-value technology innovation industrialization demonstration in three parts which included the pre-production,mid-production and post-production deep-processing of cultivation and breeding industry in the ecological cyclic agricultural garden in Shaoshan irrigated area was the driving force.We tried to propel the low-carbon ecological cultivation and breeding industry which included the paddy rice,grass,tree,medicinal herbs and pig,cow,chick,duck,fish.We wanted to relieve the structural unbalance of previous cultivation and breeding industry,'cheap grain hurting the farmers' and the short-leg problem of social-economic-ecological benefit.The results showed that the low-carbon-high-value agricultural system was a poly-generation technology system which promoted the multi-level and grading utilization,saved the energy,reduced the consumption and cleaned the production based on the ecology.展开更多
Background: The focus of recent research has been directed toward the probiotic potential of Bacillus amyloliquefaciens(BA) on the gut health of animals. However, little is known about BA's effects on piglets with...Background: The focus of recent research has been directed toward the probiotic potential of Bacillus amyloliquefaciens(BA) on the gut health of animals. However, little is known about BA's effects on piglets with intra-uterine growth retardation(IUGR). Therefore, this study investigated the effects of BA supplementation on the growth performance,intestinal morphology, inflammatory response, and microbiota of IUGR piglets.Methods: Eighteen litters of newborn piglets were selected at birth, with one normal birth weight(NBW) and two IUGR piglets in each litter(i.e., 18 NBW and 36 IUGR piglets in total). At weaning, the NBW piglet and one of the IUGR piglets were assigned to groups fed a control diet(i.e., the NBW-CON and IUGR-CON groups). The other IUGR piglet was assigned to a group fed the control diet supplemented with 2.0 g BA per kg of diet(i.e., IUGR-BA group). The piglets were thus distributed across three groups for a four-week period.Results: IUGR reduced the growth performance of the IUGR-CON piglets compared with the NBW-CON piglets. It was also associated with decreased vil us sizes, increased apoptosis rates, reduced goblet cel numbers, and an imbalance between pro-and anti-inflammatory cytokines in the smal intestine. Supplementation with BA improved the average daily weight gain and the feed efficiency of the IUGR-BA group compared with the IUGR-CON group(P < 0.05). The IUGR-BA group exhibited increases in the ratio of jejunal vil us height to crypt depth, in ileal vil us height, and in ileal goblet cel density. They also exhibited decreases in the numbers of jejunal and ileal apoptotic cel s and ileal proliferative cel s(P < 0.05). Supplementation with BA increased interleukin 10 content, but it decreased tumor necrosis factor alpha level in the smal intestines of the IUGR-BA piglets(P < 0.05). Furthermore, compared with the IUGR-CON piglets, the IUGR-BA piglets had less Escherichia coli in their jejunal digesta, but more Lactobacil us and Bifidobacterium in their ileal digesta(P < 0.05).Conclusions: Dietary supplementation with BA improves morphology, decreases inflammatory response, and regulates microbiota in the smal intestines of IUGR piglets, which may contribute to improved growth performance during early life.展开更多
BACKGROUND: Non-operative therapy takes an impor- tant position in comprehensive therapy of liver cancer. De- spite some effects by using ethanol, acetic acid and heat sa- line for intra-tumor injection in the treatme...BACKGROUND: Non-operative therapy takes an impor- tant position in comprehensive therapy of liver cancer. De- spite some effects by using ethanol, acetic acid and heat sa- line for intra-tumor injection in the treatment of liver canc- er, it is difficult to attain a complete cure but bring about injury to the liver to some extent. Hence, searching for other drugs for the local treatment of liver tumor is an im- portant option. This study was designed to set up rat mo- dels of transplanted liver cancer, intra-tumor injection of Kang-Lai-Te (KLT), and negative control (saline) and positive control (ethanol). The effect of intra-tumor injec- tion of KLT in treating transplanted hepatoma in rats and its advantages and disadvantages were assessed and the pos- sibility of its use in treating patients with liver cancer was evaluated. METHODS: Forty rats were divided into 4 groups ( G1, G2, G3 and G4, 10 rats in each group). Different drugs were injected into their implanted hepatoma (G1 with 0.2 ml saline as control, G2 with 10 mg KLT, G3 with 20 mg KLT, G4 with 0.2 ml ethanol). After 3 and 8 days, the hepa- toma volume (HV), the serum levels of albumin, alanine aminotransferase(ALT), aspartate aminotransferase alkaline phosphatase( ALP) and creatinine, as well as the expression of proliferation cell nuclear antigen (PCNA) in hepatoma were detected. RESULTS: After 3 days, the HVs were smaller in G3 and G4 than in G1 (P <0.05), the serum levels of albumin were higher in G2 and G3 than in Gl and G4 (P <0.05), the se- rum levels of ALT and AST were lower in G2 and G3 than in G4 (P<0.05), the serum levels of ALP was lower in G2 and G3 than in Gl and G4 (P <0. 05), the PCNA labeling indexes (PCNA LI) were lower in G2 and G3 than in Gl and GA (P <0.05). After 8 days, the HVs were smaller in G2, G3 and G4 than in Gl (P <0.05), and the differences of HVs among G2, G3 and G4 were not significant. The serum levels of ALP were lower in G1, G2 and G3 than in G4 (P <0.05), and the PCNA LI were lower in G3 than in Gl andG4 (P<0.05). CONCLUSION: Intra-tumor injection of KLT into implan- ted hepatoma is evidently effective, but it is less effective than ethanol. The effect of KLT on liver function is markedly lower than that of ethanol.展开更多
The Yamansu belt,an important tectonic component of Eastern Tianshan Mountains,of the Central Asian Orogenic Belt,NW China hosts many Fe-(Cu)deposit.In this study,we present new zircon U-Pb geochronology and geochemic...The Yamansu belt,an important tectonic component of Eastern Tianshan Mountains,of the Central Asian Orogenic Belt,NW China hosts many Fe-(Cu)deposit.In this study,we present new zircon U-Pb geochronology and geochemical data of the volcanic rocks of Shaquanzi Formation and diorite intrusions in the Yamansu belt.The Shaquanzi Formation comprises mainly basalt,andesite/andesitic tuff,rhyolite and sub-volcanic diabase with local diorite intrusions.The volcanic rocks and diorites contain ca.315-305 Ma and ca.298 Ma zircons respectively.These rocks show calc-alkaline affinity with enrichment in large-ion lithophile elements(LILEs),light rare-earth elements(LREEs),and depletion in high field strength elements(HFSEs)in primitive mantle normalized multi-element diagrams,which resemble typical back-arc basin rocks.They show depleted mantle signature with ε_(Nd)(t)ranging from+3.1 to +5.6 for basalt;+2.1 to+4.7 for andesite;-0.2 to+1.5 for rhyolite and the ε_(Hf)(t)ranges from-0.1 to +13.0 for andesites;+5.8 to +10.7 for andesitic tuffs.We suggest that the Shaquanzi Formation basalt might have originated from a depleted,metasomatized lithospheric mantle source mixed with minor(3-5%)subduction-derived materials,whereas the andesite and rhyolite could be fractional crystallization products of the basaltic magma.The Shaquanzi Formation volcanic rocks could have formed in an intracontinental back-arc basin setting,probably via the southward subduction of the Kangguer Ocean beneath the Middle Tianshan Massif.The Yamansu mineralization belt might have undergone a continental arc to back-arc basin transition during the Late Carboniferous and the intra-continental back-arc basin might have closed in the Early Permian,marked by the emplacement of dioritic magma in the Shaquanzi belt.展开更多
BACKGROUND Non-steroid anti-inflammatory drugs(NSAIDs)have played a crucial role in the treatment of osteoarthritis,especially in the early stages.However,the cardiovascular risk and adverse gastrointestinal reactions...BACKGROUND Non-steroid anti-inflammatory drugs(NSAIDs)have played a crucial role in the treatment of osteoarthritis,especially in the early stages.However,the cardiovascular risk and adverse gastrointestinal reactions of oral NSAIDs in elderly people cannot be underestimated.Intra-articular injection of NSAIDs may be a new attempt for early knee osteoarthritis treatment.Parecoxib may be a suitable drug for intra-articular injection.AIM To observe the clinical efficacy of the intra-articular injection of parecoxib for early knee osteoarthritis.METHODS Early knee osteoarthritis patients(n=110)were retrospectively analyzed.These patients were divided into three groups:Basic treatment+oral glucosamine(group A,n=37),oral celecoxib+basic treatment+oral glucosamine(group B,n=37),and intra-articular injection of parecoxib+basic treatment+oral glucosamine(group C,n=36).Intra-articular injection of parecoxib was performed once every 2 wk at a dose of 40 mg each time,for three times total.The three groups were compared in terms of visual analogue scale(VAS)scores,Hospital for Special Surgery(HSS)scores and patient satisfaction before and after treatment.The levels of inflammatory cytokines in the synovial fluid were detected in the three groups before and after treatment.RESULTS All patients were followed up for an average of 15.5±2.7 mo.The clinical efficacy was estimated by VAS and HSS scores at 12 mo after treatment.Inflammatory cytokine levels in the synovial fluid were evaluated at 3 mo after treatment.VAS and HSS scores were significantly improved in each group compared with before(P<0.001).There were significant differences among the three groups in VAS and HSS scores(P<0.001).The clinical efficacy of group C was superior to that of groups A and B(P<0.001),while group B outperformed group A in this respect(P<0.001).The patient satisfaction was the highest in group C(P<0.001).After treatment,the levels of tumor necrosis factorα(TNF-α)and interleukin(IL)-6 in the synovial fluid decreased in each group compared with before(P<0.001),while the levels of IL-10 increased(P<0.001).The three groups differed significantly in the levels of TNF-a,IL-6 and IL-10 in the synovial fluid after treatment(P<0.001).CONCLUSION For patients with early knee osteoarthritis,intra-articular injection of parecoxib could effectively improve clinical symptoms.This method may be a reliable alternative for early knee osteoarthritis.展开更多
AIM: To evaluate the impact of postoperative infectious complications on hepatocellular carcinoma following curative hepatectomy.METHODS:We performed a retrospective analysis of200 hepatocellular carcinoma patients wh...AIM: To evaluate the impact of postoperative infectious complications on hepatocellular carcinoma following curative hepatectomy.METHODS:We performed a retrospective analysis of200 hepatocellular carcinoma patients who underwent hepatectomy at our institution between September2003 and June 2011.The patients’demographics,clinicopathological characteristics and postoperative infectious complications were analyzed.The ClavienDindo classification was adopted to assess the severity of complications.The dynamic change in the neutrophilto-lymphocyte ratio,defined as the absolute neutrophil count divided by the absolute lymphocyte count,after surgery was also investigated.The observation endpoints for this study were recurrence-free survival and overall survival of the patients.Statistical analysis of the survival curves was performed using the KaplanMeier method and the log-rank test.The prognosticvalue of each variable for predicting prognosis was assessed via multivariate Cox proportional hazards regression analysis.The cutoff score for each variable was selected based on receiver operating characteristic curve analysis.All statistical tests were two-sided,and significance was set at P<0.05.RESULTS:The median age of the patients was 49years,and the majority of patients were male(86%)and had been infected with hepatitis B virus(86%).The 30-d postoperative infectious complication rate was34.0%(n=68).Kaplan-Meier survival analysis revealed that postoperative infection was significantly correlated with tumor recurrence(P<0.001).The postoperative intra-abdominal infection group exhibited a worse prognosis than the non-intra-abdominal infection group(P<0.001).A significantly increased incidence of postoperative intra-abdominal infection was observed in the patients with hepatic cirrhosis(P=0.028),concomitant splenectomy(P=0.007)or vascular invasion(P=0.026).The patients who had an elevated postoperative neutrophil-to-lymphocyte ratio change(>1.643)clearly exhibited poorer recurrence-free survival than those who did not(P=0.009),although no significant correlation was observed between overall survival and the change in the postoperative neutrophilto-lymphocyte ratio.Based on multivariate analysis,hepatitis B surface antigen positivity,Child-TurcottePugh class B,an elevated postoperative neutrophilto-lymphocyte ratio change and intra-abdominal infection were significant predictors of poor recurrencefree survival.Hepatic cirrhosis,the maximal tumor diameter and intra-abdominal infection were significant predictors of overall survival.CONCLUSION:Postoperative intra-abdominal infection adversely affected oncologic outcomes,and the change in postoperative neutrophil-to-lymphocyte ratio was a good indicator of tumor recurrence in hepatocellular carcinoma patients after curative hepatectomy.展开更多
AIM: To systematically review evidence on pathophysiology of intra-abdominal pressure(IAP) in acute pancreatitis(AP) with its clinical correlates. METHODS: Systematic review of available evidence in English literature...AIM: To systematically review evidence on pathophysiology of intra-abdominal pressure(IAP) in acute pancreatitis(AP) with its clinical correlates. METHODS: Systematic review of available evidence in English literature with relevant medical subject heading terms on Pub Med, Medline and Scopus with further search from open access sources on internet as suggested by articles retrieved. RESULTS: Intra-abdominal hypertension(IAH) is increasingly gaining recognition as a point of specific intervention with potential to alter disease outcome and improve mortality in AP. IAH can be expected in at least 17% of patients presenting with diagnosis of AP to a typical tertiary care hospital(prevalence increasing to 50% in those with severe disease). Abdominal compartment syndrome can be expected in at least 15% patients with severe disease. Recent guidelines on management of AP do not acknowledge utility of surveillance for IAP other than those by Japanese Society of Hepato-BiliaryPancreatic Surgery. We further outline pathophysiologic mechanisms of IAH; understanding of which advances our knowledge and helps to coherently align common observed variations in management related conundrums(such as fluid therapy, nutrition and antibiotic prophylaxis) with potential to further individualize treatment in AP. CONCLUSION: We suggest that IAP be given its due place in future practice guidelines and that recommendations be formed with help of a broader panel with inclusion of clinicians experienced in management of IAH.展开更多
Although endoscopic ultrasound(EUS)-guided drainage has become the standard procedure for pancreatic pseudocysts in recent years and is generally regarded as a safe and effective method,there have been few reports of ...Although endoscopic ultrasound(EUS)-guided drainage has become the standard procedure for pancreatic pseudocysts in recent years and is generally regarded as a safe and effective method,there have been few reports of EUS-guided drainage of postoperative intra-abdominal abscesses.Here we report our experience with 4 cases of postoperative intraabdominal abscesses for which EUS-guided drainage was performed between May 2011 and May 2014.Distal pancreatectomy had been performed in 3 cases,whereas low anterior resection for rectal cancer was performed in the remaining case.All patients underwent transgastric naso-cystic drainage,which resulted in clinical improvement without complications,even when performed within 4 wk after surgery.On average,the naso-cystic drain was removed 10 d after placement,with no abscess recurrence.Based on these findings,we believe that EUS-guided drainage of postoperative intraabdominal abscesses is a safe and effective method,although further large-scale investigations are required to confirm our findings.展开更多
Objective： Diagnostic laparoscopy is recommended for the pretherapeutic staging of gastric cancer to detect any unexpected or unconfirmed intra-abdominal metastasis. The aim of this study was to evaluate the role and...Objective： Diagnostic laparoscopy is recommended for the pretherapeutic staging of gastric cancer to detect any unexpected or unconfirmed intra-abdominal metastasis. The aim of this study was to evaluate the role and indications of diagnostic laparoscopy in the detection of intra-abdominal metastasis. Methods： Standard diagnostic laparoscopy with peritoneal cytology examination was performed prospectively on patients who were clinically diagnosed with primary local advanced gastric cancer （CT≥2M0）. We calculated the rate of intra-abdominal metastases identified by diagnostic laparoscopy, and examined the relationship between peritoneal dissemination （P） and cytology results （CY）. Split-sample method was applied to find clinical risk factors for intra-abdominal metastasis. Multivariate logistic regression analysis and receiver-operator characteristic （ROC） analysis were performed in training set to find out risk factors ofintra-abdominal metastasis, and then validate it in testing set. Results： Out of 249 cM0 patients, 51 （20.5%） patients with intra-abdominal metastasis were identified by diagnostic laparoscopy, including 20 （8.0%） P1CY1, 17 （6.8%） POCY1 and 14 （5.6%） P1CY0 patients. In the training set, multivariate logistic regression analysis and ROC analysis showed that the depth of tumor invasion on computer tomography （CT） scan ≥21 mm and tumor-occupied 〉2 portions of stomach are predictive factors of metastasis. In the testing set, when diagnostic laparoscopy was performed on patients who had one or two of these risk factors, the sensitivity and positive predictive value for detecting intra-abdominal metastasis were 90.0% and 32.1%, respectively. Conclusions： According to our results, depth of tumor invasion and tumor-occupied portions of stomach are predictive factors ofintra-abdominal metastasis.展开更多
Objective： To explore the risk factors of intra-abdominal bacterial infection （IAI） after liver transplantation （LT） in patients with hepatocellular carcinoma （HCC）. Methods： A series of 82 HCC patients who re...Objective： To explore the risk factors of intra-abdominal bacterial infection （IAI） after liver transplantation （LT） in patients with hepatocellular carcinoma （HCC）. Methods： A series of 82 HCC patients who received LT surgeries in our department between March 2004 and April 2010 was recruited in this study. Then we collected and analyzed the clinical data retrospectively. Statistical analysis system （SPSS） software was adopted to perform statistical analysis. Chi-square test, t-test and Wilcoxon rank sum test were used to analyze the clinical data and compute the significance of the incidences of early-stage IAI after LT for HCC patients. Binary logistic regression was performed to screen out the risk factors, and multiple logistic regression analyses were performed to compute the independent risk factors. Results： A series of 13 patients （13/82, 15.9%） had postoperative IAI. The independent risk factors of postoperative intra-abdominal bacterial infections after LT for HCC patients were preoperative anemia [Hemoglobin （HGB） 〈90 g/L] and postoperative abdominal hemorrhage （72 hours 〉400 mL）, with the odds ratios at 8.121 （95% CI, 1.417 to 46.550, P=0.019） and 5.911 （95% CI, 1.112 to 31.432, P=0.037）. Conclusions： Postoperative IAI after LT in patients with HCC was a common complication. Preoperative moderate to severe anemia, as well as postoperative intra-abdominal hemorrhage more than 400 mL within the first 72 hours might independently indicate high risk of IAI for these patients.展开更多
Tetramethylpyrazine(TMP) is a traditional Chinese herbal medicine with strong antiinflammatory and cartilage protection activities, and thus a promising candidate for treating osteoarthritis. However, TMP is rapidly c...Tetramethylpyrazine(TMP) is a traditional Chinese herbal medicine with strong antiinflammatory and cartilage protection activities, and thus a promising candidate for treating osteoarthritis. However, TMP is rapidly cleared from the joint cavity after intra-articular injection and requires multiple injections to maintain efficacy. The aim of this study was to encapsulate TMP into poly(lactic-co-glycolic acid)(PLGA) microspheres to enhance the TMP retention in the joint, reducing injection frequencies and decreasing dosage. TMP microspheres were prepared by emulsion/solvent evaporation method. The intra-articular retention of the drug was assessed by detecting the drug concentration distributed in the joint tissue at different time points. The therapeutic effect of TMP microspheres was evaluated by the swelling of knee joints and histologic analysis in papain-induced OA rat model. The prepared freezedried microspheres with a particle size of about 10 μm can effectively prolong the retention time of the drug in the articular cavity to 30 d, which is 4.7 times that of the TMP solution.Intra-articular injection of TMP microspheres efficiently relieved inflammatory symptoms,improved joint lesions and decreased the depletion of proteoglycan. In conclusion, intraarticular injection of TMP loaded microspheres was a promising therapeutic method in the treatment of OA.展开更多
BACKGROUND: Severe acute pancreatitis (SAP) is a serious disease with many complications, high mortality and poor prognosis. It is characterized by rapid deterioration and poses one of the most difficult challenges in...BACKGROUND: Severe acute pancreatitis (SAP) is a serious disease with many complications, high mortality and poor prognosis. It is characterized by rapid deterioration and poses one of the most difficult challenges in clinical practice. Previous investigations suggest that SAP is one of the main causes of intra-abdominal pressure (IAP) increase. The aim of this study was to evaluate the utility of IAP-monitoring in predicting the severity and prognosis of SAP. METHODS: Eighty-nine patients with SAP who had been treated from February 2001 to December 2005 were studied. Since bladder pressure accurately reflects IAP, we measured it instead of IAP. Bladder pressure was measured at the time of admission and every 12 hours in the course of the disease, 9 consecutive times in all. The APACHE II scores of all patients were obtained within 24 hours after admission. According to a maximum bladder pressure <10 cmH(2)O, all patients were divided into two groups, mildly-elevated and severely-elevated. Mortality and mean APACHE II scores in the two groups were calculated. In addition, the mean bladder pressure and APACHE II scores in survivors were compared with those in deaths. RESULTS: Sixty-eight of the 89 patients were in the severely-elevated group. Mortality and mean APACHE II scores in this group were much higher than those in the mildly-elevated group (mortality, 39.71% vs. 9.52%; mean APACHE II score, 23.15 +/- 7.42 vs. 15.95 +/- 5.35, P<0.01). The mean bladder pressures and APACHE II scores in deaths were significantly greater than those in survivors (mean bladder pressure, 14.1 +/- 3.8 vs. 9.2 +/- 2.3 cmH(2)O, P<0.01; mean APACHE II score, 27.83 +/- 4.87 vs. 18.37 +/- 6.74, P<0.01). CONCLUSION: It is suggested that IAP may be used as a marker of the severity and prognosis of SAP.展开更多
The polymerase acidic protein is an important family of proteins from influenza A virus, which is classified as many different subtypes or spe-cies. Thus, an important question is if these classifications are numerica...The polymerase acidic protein is an important family of proteins from influenza A virus, which is classified as many different subtypes or spe-cies. Thus, an important question is if these classifications are numerically distinguishable with respect to the polymerase acidic protein. The amino-acid pair predictability was used to transfer 2432 polymerase acidic proteins into 2432 scalar data. The one-way ANOVA found these polymerase acidic proteins distinguish-able in terms of subtypes and species. However, the large residuals in ANOVA suggested a pos-sible large intra-subtype/species variation. Therefore, the inter- and intra-subtype/species variations were studied using the model II ANOVA. The results showed that the in-tra-subtype/species variations accounted most of variation, which was 100% in total for both inter- and intra- subtype/species variations. Our analysis threw lights on the issue of how to de-termine a wide variety of patterns of antigenic variation across space and time, and within and between subtypes as well as hosts.展开更多
Background: Intra-uterine crowding(IUC) observed in hyperprolific sows impairs myofiber hyperplasia and overall fetal growth. Arginine supplementation(ARG) in gestation diets has been shown to positively affect litter...Background: Intra-uterine crowding(IUC) observed in hyperprolific sows impairs myofiber hyperplasia and overall fetal growth. Arginine supplementation(ARG) in gestation diets has been shown to positively affect litter and muscle development. The study objective was to assess whether the effect of ARG on offspring characteristics, with special emphasis on myofiber hyperplasia, differs under IUC conditions from these responses,because in that situation growth retardation is particularly prevalent due to reduced fetal nutrient supply.Unilateral oviduct ligation(OL) was used as a model for an uncrowded and hyperprolificacy(IN) as a model for a crowded intra-uterine environment.Methods: Five OL and five IN sows were fed a diet supplemented daily with either 43 g L-alanine(Ctrl) or 25 g L-arginine from d 14 to 28 of gestation in a cross-over design(two periods: 5^( th) and 6^( th) parity). At farrowing, two male and two female offspring, respectively, with a low and intermediate birth weight(BtW) were selected. After euthanization, the Semitendinosus muscle(STM) was removed and weighed, and the light and dark portions(STM_d and STM_l) were prepared for myofiber histochemistry using ATPase staining and the entire STM for gene expression analysis of myogenesis-related genes using RT-qPCR. In addition, various organs were removed and weighed. Data were analyzed using the MIXED model in SYSTAT.Results: No effect of either IUC or dietary treatment was found in litter characteristics. Offspring of ARG sows displayed a greater muscle area in STM(P < 0.01) as a result of the greater myofiber hyperplasia(P < 0.01). The increase was more distinct in the STM_l(P < 0.05) than in the STM_d(P = 0.131). Offspring of OL sows were heavier at birth(P < 0.01), had a heavier STM(P < 0.05), liver(P < 0.01) and kidney(P < 0.05), but when expressed relative to birth weight, these differences were absent. In addition, IUC had an effect(P < 0.05) on the expression of one of the myogenesis-related genes investigated.Conclusions: Independent from the extent of IUC, ARG improved Bt W, muscle and organ weights and myofiber hyperplasia in offspring.展开更多
AIM To assess the usefulness of intra-arterial contrastenhanced ultrasonography(IAUS) during transarterial chemoembolization(TACE) with drug-eluting beads(DEB) for hepatocellular carcinoma(HCC).METHODS Thirty two pati...AIM To assess the usefulness of intra-arterial contrastenhanced ultrasonography(IAUS) during transarterial chemoembolization(TACE) with drug-eluting beads(DEB) for hepatocellular carcinoma(HCC).METHODS Thirty two patients with 39 HCC underwent DEB-TACE guided with IAUS, and examined by contrast-enhanced ultrasonography(CEUS) or dynamic CT after DEB-TACE were enrolled in this study. CEUS findings before DEBTACE and IAUS findings were compared. Treatments judged to be complete and incomplete for lesions were appropriate and insufficient, respectively. Findings on CEUS and/or dynamic CT performed 1, 3 and 6 mo after DEB-TACE were evaluated using m RECIST(CR/PR/SD/PD).RESULTS The treatments were complete and incomplete in 26 and 13 lesions, respectively. On imaging evaluation using CEUS and/or dynamic CT one month after treatment, 25 and 1 lesions were judged to be CR and PR, respectively, and at 6 mo after treatment, the results were CR, PR, SD and PD for 24, 1, 0 and 1 of these lesions, respectively, in the 26 completely treated lesions. Of the 13 lesions in which treatment was incomplete, the results on imaging at one month after treatment were CR, PR, SD and PD for 0, 6, 4 and 3 lesions, respectively. The overall CR rate at 6 mo after treatment was 61.5%(24/39).CONCLUSION A combination of DEB-TACE with IAUS can improve the therapeutic effects in patients with HCC.展开更多
The mortality rate of acute severe intraventricular hematoma is extremely high, and the rate of disability in survivors is high. Intraventricular hematoma has always been a difficult problem for clinical treatment. Al...The mortality rate of acute severe intraventricular hematoma is extremely high, and the rate of disability in survivors is high. Intraventricular hematoma has always been a difficult problem for clinical treatment. Although minimally invasive endoscopic hematoma evacuation is widely used to treat this disease, the technique still has room for improvement. Equipment for the intra-neuroendoscopic technique（INET） consists of two of our patented inventions： a transparent sheath（Patent No. ZL 200820046232.0） and a hematoma aspirator（Patent No. ZL 201520248717.8）. This study explored the safety and efficacy of INET by comparing it with extraventricular drainage in combination with urokinase thrombolytic therapy. This trial recruited 65 patients with severe intraventricular hemorrhage, including 35（19 men and 16 women, aged 53.2 ± 8.7 years） in the INET group and 30（17 men and 13 women, aged 51.5 ± 7.9 years） in the control group（extraventricular drainage plus urokinase thrombolytic therapy）. Our results showed that compared with the control group, the INET group exhibited lower intraventricular hemorrhage volumes, shorter intensive care-unit monitoring and ventricular drainage-tube placement times, and fewer incidences of intracranial infection, secondary bleeding, and mortality. Thus, the prognosis of survivors had improved remarkably. These findings indicate that INET is a safe and efficient new method for treating severe intraventricular hematoma. This trial was registered with Clinical Trials.gov（NCT02515903）.展开更多
文摘Rainfall is a key climate parameter that affects most operations that affect human life, especially in the tropics. Therefore, understanding the various factors that affect the distribution and intensity of this rainfall is important for effective planning among the different stakeholders in the weather and climate sectors. This study aimed at understanding how intra seasonal rainfall characteristics, especially Consecutive Dry Days (CDD) and Consecutive Wet Days (CWD), in the two major rainfall seasons will change under two future climate scenarios of RCP4.5 and RCP8.5 in Uganda, covering two future periods of 2021-2050 and 2051-2080. The results indicate a high likelihood of reduced consecutive rainfall days, especially over the Northeastern regions of the country, for both 2021-2050 and 2051-2080. However, the trends in the entire country for the two major rainfall seasons, March to May and September to November, are not significant. Nonetheless, the distribution of these days is important for most agricultural activities during different stages of crop growth. The consecutive dry days show a fairly increasing trend in the eastern part of the country, particularly in the second season of September to November. An increase in consecutive dry days implies more frequent dry spells in the midst of the growing season, potentially affecting some crops during critical growth stages.
基金supported by the grants from Program of China"Research of New Technology for Trauma Care and Integrated Demonstration"(2012BAI11B01)
文摘Background:Intra-abdominal hypertension(IAH) is a disease with high morbidity and mortality among critically ill patients.The study's objectives were to explore the prevalence of IAH and physicians' awareness of the 2013 World Society of Abdominal Compartment Syndrome(WSACS) guidelines in Chinese intensive care units(ICUs).Methods:A cross-sectional study of four ICUs in Southwestern China was conducted from June 17 to August 2,2014.Adult patients admitted to the ICU for more than 24 h,with bladder catheter but without obvious intravesical pressure(IVP) measurement contraindications,were recruited.Intensivists with more than 5 years of ICU working experience were also recruited.Epidemiological information,potential IAH risk factors,IVP measurements and questionnaire results were recorded.Results:Forty-one patients were selected.Fifteen(36.59%) had IVP?12mm Hg.SOFA(Sequential Organ Failure Assessment) hepatic and neurological sub-scores were utilized as independent predictors for IAH via logistic backward analysis.Thirty-seven intensivists participated in the survey(response rate:80.43%).The average score of each center was less than 35 points.All physicians believed the IAH prevalence in their departments was no more than 20.00%.A significant negative correlation was observed between the intensivists' awareness of the 2013 WSACS guidelines and the IAH prevalence in each center(r=-0.975,P=0.025).Conclusion:The prevalence and independent predictors of IAH among the surveyed population are similar to the reports in the literature.Intensivists generally have a low awareness of the 2013 WSACS guidelines.A systematic guideline training program is vital for improving the efficiency of the diagnosis and treatment of IAH.
基金support,in part,from the "Twelfth FiveYear Plan" Scientific and Technological Supporting Program of China (2012BAI11B00)Chongqing integrated demonstration project "Trauma Emergency Treatment and Rehabilitation Technology Platform"(cstc2013jcsfC10001)
文摘Background: To investigate the effect of intra-abdominal volume increment(IAVI) on intra-abdominal hypertension(IAH) in the kidneys.Methods: Eight minipigs were successfully established as IAH models and were randomly divided into two groups: the IAVI group and the sham-operated group. The intravesical pressure, inferior vena cava pressure and urine volume were measured before shock, 2 h after IAH, and 22 h after surgery, respectively. The following indices were measured: serum creatinine, urea nitrogen, renal cortical thickness, ratio of abdominal anteroposterior diameter/transverse diameter, renal thickness, diameter of the renal sinus and the wet/dry ratio of renal tissues.Results: The intravesical pressure(IVP) of the 8 minipig IAH models was calculated to be 21.16±4.63 mmHg. There was a significant increase in the abdominal anteroposterior diameter/transverse diameter ratio. The minipigs in the IAVI group survived during the observational period, whereas 2 minipigs died at 18 h and 20 h in the sham-operated group. Twenty-two hours after surgery, the animals in the IAVI group displayed increased urinary volume(UV) and decreased Cr and Ur and remarkable decreases of VP and IVCP. After IAH, the renal cortical thickness and the renal thickness increased significantly. The renal wet/dry ratio in the sham-operated group was higher than that in the IAVI group.Conclusion: IAVI helps to control renal dysfunction after IAH, which may be related to lowering the intra-abdominal pressure, thus alleviating renal edema and blood stasis.
基金Supported by " Research on The Control Technology of Subtropical Agriculture Pollution System" Special Project of National Environment Protection Public Welfare Industry Science Research "Research on The Construction Strategy of Ecological Civilization" Development Plan Research Project of State Development and Reform Commission+1 种基金Xiangxiang " High-output and Efficient Cultivation of High Quality Rice and Processing Technology Industrialization Demonstration " in The Plan Test Site of National Science and Technology Enriching People and Developing County Special Project Action" Xiangxiang Middle and Long-term Development Plan of Modern Agriculture" of Subtropical Agriculture Ecology Institute in Chinese Academy of Science
文摘The comprehensive improvement strategy of intra-county environment pollution in the city and countryside was searched.By the research method which combined the microscopic view,the macroscopic view with the dynamic perspective,the seriousness of rural water quality,soil and atmospheric pollution in Xiangxiang,Xiangtan and the surrounding areas in Shaoshan irrigated area was revealed.The control measure which was 'four-dimensional pollution in the city and countryside'—— low-carbon-high-value agriculture and the technology innovation was proposed.The low-carbon-high-value technology innovation industrialization demonstration in three parts which included the pre-production,mid-production and post-production deep-processing of cultivation and breeding industry in the ecological cyclic agricultural garden in Shaoshan irrigated area was the driving force.We tried to propel the low-carbon ecological cultivation and breeding industry which included the paddy rice,grass,tree,medicinal herbs and pig,cow,chick,duck,fish.We wanted to relieve the structural unbalance of previous cultivation and breeding industry,'cheap grain hurting the farmers' and the short-leg problem of social-economic-ecological benefit.The results showed that the low-carbon-high-value agricultural system was a poly-generation technology system which promoted the multi-level and grading utilization,saved the energy,reduced the consumption and cleaned the production based on the ecology.
基金provided by the National Science-Technology Support Plan Projects of China(No.2013BAD10B02–03)the Phase Ⅱ Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Background: The focus of recent research has been directed toward the probiotic potential of Bacillus amyloliquefaciens(BA) on the gut health of animals. However, little is known about BA's effects on piglets with intra-uterine growth retardation(IUGR). Therefore, this study investigated the effects of BA supplementation on the growth performance,intestinal morphology, inflammatory response, and microbiota of IUGR piglets.Methods: Eighteen litters of newborn piglets were selected at birth, with one normal birth weight(NBW) and two IUGR piglets in each litter(i.e., 18 NBW and 36 IUGR piglets in total). At weaning, the NBW piglet and one of the IUGR piglets were assigned to groups fed a control diet(i.e., the NBW-CON and IUGR-CON groups). The other IUGR piglet was assigned to a group fed the control diet supplemented with 2.0 g BA per kg of diet(i.e., IUGR-BA group). The piglets were thus distributed across three groups for a four-week period.Results: IUGR reduced the growth performance of the IUGR-CON piglets compared with the NBW-CON piglets. It was also associated with decreased vil us sizes, increased apoptosis rates, reduced goblet cel numbers, and an imbalance between pro-and anti-inflammatory cytokines in the smal intestine. Supplementation with BA improved the average daily weight gain and the feed efficiency of the IUGR-BA group compared with the IUGR-CON group(P < 0.05). The IUGR-BA group exhibited increases in the ratio of jejunal vil us height to crypt depth, in ileal vil us height, and in ileal goblet cel density. They also exhibited decreases in the numbers of jejunal and ileal apoptotic cel s and ileal proliferative cel s(P < 0.05). Supplementation with BA increased interleukin 10 content, but it decreased tumor necrosis factor alpha level in the smal intestines of the IUGR-BA piglets(P < 0.05). Furthermore, compared with the IUGR-CON piglets, the IUGR-BA piglets had less Escherichia coli in their jejunal digesta, but more Lactobacil us and Bifidobacterium in their ileal digesta(P < 0.05).Conclusions: Dietary supplementation with BA improves morphology, decreases inflammatory response, and regulates microbiota in the smal intestines of IUGR piglets, which may contribute to improved growth performance during early life.
基金The study was supported by a grant from the Science Foundation of the Health Department of Shandong Province (No 1998CA1CKA3)
文摘BACKGROUND: Non-operative therapy takes an impor- tant position in comprehensive therapy of liver cancer. De- spite some effects by using ethanol, acetic acid and heat sa- line for intra-tumor injection in the treatment of liver canc- er, it is difficult to attain a complete cure but bring about injury to the liver to some extent. Hence, searching for other drugs for the local treatment of liver tumor is an im- portant option. This study was designed to set up rat mo- dels of transplanted liver cancer, intra-tumor injection of Kang-Lai-Te (KLT), and negative control (saline) and positive control (ethanol). The effect of intra-tumor injec- tion of KLT in treating transplanted hepatoma in rats and its advantages and disadvantages were assessed and the pos- sibility of its use in treating patients with liver cancer was evaluated. METHODS: Forty rats were divided into 4 groups ( G1, G2, G3 and G4, 10 rats in each group). Different drugs were injected into their implanted hepatoma (G1 with 0.2 ml saline as control, G2 with 10 mg KLT, G3 with 20 mg KLT, G4 with 0.2 ml ethanol). After 3 and 8 days, the hepa- toma volume (HV), the serum levels of albumin, alanine aminotransferase(ALT), aspartate aminotransferase alkaline phosphatase( ALP) and creatinine, as well as the expression of proliferation cell nuclear antigen (PCNA) in hepatoma were detected. RESULTS: After 3 days, the HVs were smaller in G3 and G4 than in G1 (P <0.05), the serum levels of albumin were higher in G2 and G3 than in Gl and G4 (P <0.05), the se- rum levels of ALT and AST were lower in G2 and G3 than in G4 (P<0.05), the serum levels of ALP was lower in G2 and G3 than in Gl and G4 (P <0. 05), the PCNA labeling indexes (PCNA LI) were lower in G2 and G3 than in Gl and GA (P <0.05). After 8 days, the HVs were smaller in G2, G3 and G4 than in Gl (P <0.05), and the differences of HVs among G2, G3 and G4 were not significant. The serum levels of ALP were lower in G1, G2 and G3 than in G4 (P <0.05), and the PCNA LI were lower in G3 than in Gl andG4 (P<0.05). CONCLUSION: Intra-tumor injection of KLT into implan- ted hepatoma is evidently effective, but it is less effective than ethanol. The effect of KLT on liver function is markedly lower than that of ethanol.
基金financially supported by the Chinese National Basic Research 973-Program(No.2014CB440802)Project No.IS-2353 of GIGCAS
文摘The Yamansu belt,an important tectonic component of Eastern Tianshan Mountains,of the Central Asian Orogenic Belt,NW China hosts many Fe-(Cu)deposit.In this study,we present new zircon U-Pb geochronology and geochemical data of the volcanic rocks of Shaquanzi Formation and diorite intrusions in the Yamansu belt.The Shaquanzi Formation comprises mainly basalt,andesite/andesitic tuff,rhyolite and sub-volcanic diabase with local diorite intrusions.The volcanic rocks and diorites contain ca.315-305 Ma and ca.298 Ma zircons respectively.These rocks show calc-alkaline affinity with enrichment in large-ion lithophile elements(LILEs),light rare-earth elements(LREEs),and depletion in high field strength elements(HFSEs)in primitive mantle normalized multi-element diagrams,which resemble typical back-arc basin rocks.They show depleted mantle signature with ε_(Nd)(t)ranging from+3.1 to +5.6 for basalt;+2.1 to+4.7 for andesite;-0.2 to+1.5 for rhyolite and the ε_(Hf)(t)ranges from-0.1 to +13.0 for andesites;+5.8 to +10.7 for andesitic tuffs.We suggest that the Shaquanzi Formation basalt might have originated from a depleted,metasomatized lithospheric mantle source mixed with minor(3-5%)subduction-derived materials,whereas the andesite and rhyolite could be fractional crystallization products of the basaltic magma.The Shaquanzi Formation volcanic rocks could have formed in an intracontinental back-arc basin setting,probably via the southward subduction of the Kangguer Ocean beneath the Middle Tianshan Massif.The Yamansu mineralization belt might have undergone a continental arc to back-arc basin transition during the Late Carboniferous and the intra-continental back-arc basin might have closed in the Early Permian,marked by the emplacement of dioritic magma in the Shaquanzi belt.
基金National Natural Science Foundation of China,NO.81774274Project of Jiangsu Provincial Hospital of Traditional Chinese Medicine,NO.Y19058
文摘BACKGROUND Non-steroid anti-inflammatory drugs(NSAIDs)have played a crucial role in the treatment of osteoarthritis,especially in the early stages.However,the cardiovascular risk and adverse gastrointestinal reactions of oral NSAIDs in elderly people cannot be underestimated.Intra-articular injection of NSAIDs may be a new attempt for early knee osteoarthritis treatment.Parecoxib may be a suitable drug for intra-articular injection.AIM To observe the clinical efficacy of the intra-articular injection of parecoxib for early knee osteoarthritis.METHODS Early knee osteoarthritis patients(n=110)were retrospectively analyzed.These patients were divided into three groups:Basic treatment+oral glucosamine(group A,n=37),oral celecoxib+basic treatment+oral glucosamine(group B,n=37),and intra-articular injection of parecoxib+basic treatment+oral glucosamine(group C,n=36).Intra-articular injection of parecoxib was performed once every 2 wk at a dose of 40 mg each time,for three times total.The three groups were compared in terms of visual analogue scale(VAS)scores,Hospital for Special Surgery(HSS)scores and patient satisfaction before and after treatment.The levels of inflammatory cytokines in the synovial fluid were detected in the three groups before and after treatment.RESULTS All patients were followed up for an average of 15.5±2.7 mo.The clinical efficacy was estimated by VAS and HSS scores at 12 mo after treatment.Inflammatory cytokine levels in the synovial fluid were evaluated at 3 mo after treatment.VAS and HSS scores were significantly improved in each group compared with before(P<0.001).There were significant differences among the three groups in VAS and HSS scores(P<0.001).The clinical efficacy of group C was superior to that of groups A and B(P<0.001),while group B outperformed group A in this respect(P<0.001).The patient satisfaction was the highest in group C(P<0.001).After treatment,the levels of tumor necrosis factorα(TNF-α)and interleukin(IL)-6 in the synovial fluid decreased in each group compared with before(P<0.001),while the levels of IL-10 increased(P<0.001).The three groups differed significantly in the levels of TNF-a,IL-6 and IL-10 in the synovial fluid after treatment(P<0.001).CONCLUSION For patients with early knee osteoarthritis,intra-articular injection of parecoxib could effectively improve clinical symptoms.This method may be a reliable alternative for early knee osteoarthritis.
基金Supported by National Natural Science Foundation of China,No.81372374 and No.81000959the Combination Project of Production,Education and Research from Guangdong Province and Ministry of Education,No.2012B091100460Science and Technology Planning Project of Guangdong Province,No.2009B030801007
文摘AIM: To evaluate the impact of postoperative infectious complications on hepatocellular carcinoma following curative hepatectomy.METHODS:We performed a retrospective analysis of200 hepatocellular carcinoma patients who underwent hepatectomy at our institution between September2003 and June 2011.The patients’demographics,clinicopathological characteristics and postoperative infectious complications were analyzed.The ClavienDindo classification was adopted to assess the severity of complications.The dynamic change in the neutrophilto-lymphocyte ratio,defined as the absolute neutrophil count divided by the absolute lymphocyte count,after surgery was also investigated.The observation endpoints for this study were recurrence-free survival and overall survival of the patients.Statistical analysis of the survival curves was performed using the KaplanMeier method and the log-rank test.The prognosticvalue of each variable for predicting prognosis was assessed via multivariate Cox proportional hazards regression analysis.The cutoff score for each variable was selected based on receiver operating characteristic curve analysis.All statistical tests were two-sided,and significance was set at P<0.05.RESULTS:The median age of the patients was 49years,and the majority of patients were male(86%)and had been infected with hepatitis B virus(86%).The 30-d postoperative infectious complication rate was34.0%(n=68).Kaplan-Meier survival analysis revealed that postoperative infection was significantly correlated with tumor recurrence(P<0.001).The postoperative intra-abdominal infection group exhibited a worse prognosis than the non-intra-abdominal infection group(P<0.001).A significantly increased incidence of postoperative intra-abdominal infection was observed in the patients with hepatic cirrhosis(P=0.028),concomitant splenectomy(P=0.007)or vascular invasion(P=0.026).The patients who had an elevated postoperative neutrophil-to-lymphocyte ratio change(>1.643)clearly exhibited poorer recurrence-free survival than those who did not(P=0.009),although no significant correlation was observed between overall survival and the change in the postoperative neutrophilto-lymphocyte ratio.Based on multivariate analysis,hepatitis B surface antigen positivity,Child-TurcottePugh class B,an elevated postoperative neutrophilto-lymphocyte ratio change and intra-abdominal infection were significant predictors of poor recurrencefree survival.Hepatic cirrhosis,the maximal tumor diameter and intra-abdominal infection were significant predictors of overall survival.CONCLUSION:Postoperative intra-abdominal infection adversely affected oncologic outcomes,and the change in postoperative neutrophil-to-lymphocyte ratio was a good indicator of tumor recurrence in hepatocellular carcinoma patients after curative hepatectomy.
文摘AIM: To systematically review evidence on pathophysiology of intra-abdominal pressure(IAP) in acute pancreatitis(AP) with its clinical correlates. METHODS: Systematic review of available evidence in English literature with relevant medical subject heading terms on Pub Med, Medline and Scopus with further search from open access sources on internet as suggested by articles retrieved. RESULTS: Intra-abdominal hypertension(IAH) is increasingly gaining recognition as a point of specific intervention with potential to alter disease outcome and improve mortality in AP. IAH can be expected in at least 17% of patients presenting with diagnosis of AP to a typical tertiary care hospital(prevalence increasing to 50% in those with severe disease). Abdominal compartment syndrome can be expected in at least 15% patients with severe disease. Recent guidelines on management of AP do not acknowledge utility of surveillance for IAP other than those by Japanese Society of Hepato-BiliaryPancreatic Surgery. We further outline pathophysiologic mechanisms of IAH; understanding of which advances our knowledge and helps to coherently align common observed variations in management related conundrums(such as fluid therapy, nutrition and antibiotic prophylaxis) with potential to further individualize treatment in AP. CONCLUSION: We suggest that IAP be given its due place in future practice guidelines and that recommendations be formed with help of a broader panel with inclusion of clinicians experienced in management of IAH.
文摘Although endoscopic ultrasound(EUS)-guided drainage has become the standard procedure for pancreatic pseudocysts in recent years and is generally regarded as a safe and effective method,there have been few reports of EUS-guided drainage of postoperative intra-abdominal abscesses.Here we report our experience with 4 cases of postoperative intraabdominal abscesses for which EUS-guided drainage was performed between May 2011 and May 2014.Distal pancreatectomy had been performed in 3 cases,whereas low anterior resection for rectal cancer was performed in the remaining case.All patients underwent transgastric naso-cystic drainage,which resulted in clinical improvement without complications,even when performed within 4 wk after surgery.On average,the naso-cystic drain was removed 10 d after placement,with no abscess recurrence.Based on these findings,we believe that EUS-guided drainage of postoperative intraabdominal abscesses is a safe and effective method,although further large-scale investigations are required to confirm our findings.
基金supported by grants supporting the research program of early diagnosis, standardized treatment and therapy effect evaluation of gastric cancer (No. D141100000414004) from Beijing Ministry of Science and Technology
文摘Objective： Diagnostic laparoscopy is recommended for the pretherapeutic staging of gastric cancer to detect any unexpected or unconfirmed intra-abdominal metastasis. The aim of this study was to evaluate the role and indications of diagnostic laparoscopy in the detection of intra-abdominal metastasis. Methods： Standard diagnostic laparoscopy with peritoneal cytology examination was performed prospectively on patients who were clinically diagnosed with primary local advanced gastric cancer （CT≥2M0）. We calculated the rate of intra-abdominal metastases identified by diagnostic laparoscopy, and examined the relationship between peritoneal dissemination （P） and cytology results （CY）. Split-sample method was applied to find clinical risk factors for intra-abdominal metastasis. Multivariate logistic regression analysis and receiver-operator characteristic （ROC） analysis were performed in training set to find out risk factors ofintra-abdominal metastasis, and then validate it in testing set. Results： Out of 249 cM0 patients, 51 （20.5%） patients with intra-abdominal metastasis were identified by diagnostic laparoscopy, including 20 （8.0%） P1CY1, 17 （6.8%） POCY1 and 14 （5.6%） P1CY0 patients. In the training set, multivariate logistic regression analysis and ROC analysis showed that the depth of tumor invasion on computer tomography （CT） scan ≥21 mm and tumor-occupied 〉2 portions of stomach are predictive factors of metastasis. In the testing set, when diagnostic laparoscopy was performed on patients who had one or two of these risk factors, the sensitivity and positive predictive value for detecting intra-abdominal metastasis were 90.0% and 32.1%, respectively. Conclusions： According to our results, depth of tumor invasion and tumor-occupied portions of stomach are predictive factors ofintra-abdominal metastasis.
基金funded by a new round of the ShanghaiHealth System outstanding young talent training plan (XYQ2011030)
文摘Objective： To explore the risk factors of intra-abdominal bacterial infection （IAI） after liver transplantation （LT） in patients with hepatocellular carcinoma （HCC）. Methods： A series of 82 HCC patients who received LT surgeries in our department between March 2004 and April 2010 was recruited in this study. Then we collected and analyzed the clinical data retrospectively. Statistical analysis system （SPSS） software was adopted to perform statistical analysis. Chi-square test, t-test and Wilcoxon rank sum test were used to analyze the clinical data and compute the significance of the incidences of early-stage IAI after LT for HCC patients. Binary logistic regression was performed to screen out the risk factors, and multiple logistic regression analyses were performed to compute the independent risk factors. Results： A series of 13 patients （13/82, 15.9%） had postoperative IAI. The independent risk factors of postoperative intra-abdominal bacterial infections after LT for HCC patients were preoperative anemia [Hemoglobin （HGB） 〈90 g/L] and postoperative abdominal hemorrhage （72 hours 〉400 mL）, with the odds ratios at 8.121 （95% CI, 1.417 to 46.550, P=0.019） and 5.911 （95% CI, 1.112 to 31.432, P=0.037）. Conclusions： Postoperative IAI after LT in patients with HCC was a common complication. Preoperative moderate to severe anemia, as well as postoperative intra-abdominal hemorrhage more than 400 mL within the first 72 hours might independently indicate high risk of IAI for these patients.
文摘Tetramethylpyrazine(TMP) is a traditional Chinese herbal medicine with strong antiinflammatory and cartilage protection activities, and thus a promising candidate for treating osteoarthritis. However, TMP is rapidly cleared from the joint cavity after intra-articular injection and requires multiple injections to maintain efficacy. The aim of this study was to encapsulate TMP into poly(lactic-co-glycolic acid)(PLGA) microspheres to enhance the TMP retention in the joint, reducing injection frequencies and decreasing dosage. TMP microspheres were prepared by emulsion/solvent evaporation method. The intra-articular retention of the drug was assessed by detecting the drug concentration distributed in the joint tissue at different time points. The therapeutic effect of TMP microspheres was evaluated by the swelling of knee joints and histologic analysis in papain-induced OA rat model. The prepared freezedried microspheres with a particle size of about 10 μm can effectively prolong the retention time of the drug in the articular cavity to 30 d, which is 4.7 times that of the TMP solution.Intra-articular injection of TMP microspheres efficiently relieved inflammatory symptoms,improved joint lesions and decreased the depletion of proteoglycan. In conclusion, intraarticular injection of TMP loaded microspheres was a promising therapeutic method in the treatment of OA.
文摘BACKGROUND: Severe acute pancreatitis (SAP) is a serious disease with many complications, high mortality and poor prognosis. It is characterized by rapid deterioration and poses one of the most difficult challenges in clinical practice. Previous investigations suggest that SAP is one of the main causes of intra-abdominal pressure (IAP) increase. The aim of this study was to evaluate the utility of IAP-monitoring in predicting the severity and prognosis of SAP. METHODS: Eighty-nine patients with SAP who had been treated from February 2001 to December 2005 were studied. Since bladder pressure accurately reflects IAP, we measured it instead of IAP. Bladder pressure was measured at the time of admission and every 12 hours in the course of the disease, 9 consecutive times in all. The APACHE II scores of all patients were obtained within 24 hours after admission. According to a maximum bladder pressure <10 cmH(2)O, all patients were divided into two groups, mildly-elevated and severely-elevated. Mortality and mean APACHE II scores in the two groups were calculated. In addition, the mean bladder pressure and APACHE II scores in survivors were compared with those in deaths. RESULTS: Sixty-eight of the 89 patients were in the severely-elevated group. Mortality and mean APACHE II scores in this group were much higher than those in the mildly-elevated group (mortality, 39.71% vs. 9.52%; mean APACHE II score, 23.15 +/- 7.42 vs. 15.95 +/- 5.35, P<0.01). The mean bladder pressures and APACHE II scores in deaths were significantly greater than those in survivors (mean bladder pressure, 14.1 +/- 3.8 vs. 9.2 +/- 2.3 cmH(2)O, P<0.01; mean APACHE II score, 27.83 +/- 4.87 vs. 18.37 +/- 6.74, P<0.01). CONCLUSION: It is suggested that IAP may be used as a marker of the severity and prognosis of SAP.
文摘The polymerase acidic protein is an important family of proteins from influenza A virus, which is classified as many different subtypes or spe-cies. Thus, an important question is if these classifications are numerically distinguishable with respect to the polymerase acidic protein. The amino-acid pair predictability was used to transfer 2432 polymerase acidic proteins into 2432 scalar data. The one-way ANOVA found these polymerase acidic proteins distinguish-able in terms of subtypes and species. However, the large residuals in ANOVA suggested a pos-sible large intra-subtype/species variation. Therefore, the inter- and intra-subtype/species variations were studied using the model II ANOVA. The results showed that the in-tra-subtype/species variations accounted most of variation, which was 100% in total for both inter- and intra- subtype/species variations. Our analysis threw lights on the issue of how to de-termine a wide variety of patterns of antigenic variation across space and time, and within and between subtypes as well as hosts.
文摘Background: Intra-uterine crowding(IUC) observed in hyperprolific sows impairs myofiber hyperplasia and overall fetal growth. Arginine supplementation(ARG) in gestation diets has been shown to positively affect litter and muscle development. The study objective was to assess whether the effect of ARG on offspring characteristics, with special emphasis on myofiber hyperplasia, differs under IUC conditions from these responses,because in that situation growth retardation is particularly prevalent due to reduced fetal nutrient supply.Unilateral oviduct ligation(OL) was used as a model for an uncrowded and hyperprolificacy(IN) as a model for a crowded intra-uterine environment.Methods: Five OL and five IN sows were fed a diet supplemented daily with either 43 g L-alanine(Ctrl) or 25 g L-arginine from d 14 to 28 of gestation in a cross-over design(two periods: 5^( th) and 6^( th) parity). At farrowing, two male and two female offspring, respectively, with a low and intermediate birth weight(BtW) were selected. After euthanization, the Semitendinosus muscle(STM) was removed and weighed, and the light and dark portions(STM_d and STM_l) were prepared for myofiber histochemistry using ATPase staining and the entire STM for gene expression analysis of myogenesis-related genes using RT-qPCR. In addition, various organs were removed and weighed. Data were analyzed using the MIXED model in SYSTAT.Results: No effect of either IUC or dietary treatment was found in litter characteristics. Offspring of ARG sows displayed a greater muscle area in STM(P < 0.01) as a result of the greater myofiber hyperplasia(P < 0.01). The increase was more distinct in the STM_l(P < 0.05) than in the STM_d(P = 0.131). Offspring of OL sows were heavier at birth(P < 0.01), had a heavier STM(P < 0.05), liver(P < 0.01) and kidney(P < 0.05), but when expressed relative to birth weight, these differences were absent. In addition, IUC had an effect(P < 0.05) on the expression of one of the myogenesis-related genes investigated.Conclusions: Independent from the extent of IUC, ARG improved Bt W, muscle and organ weights and myofiber hyperplasia in offspring.
文摘AIM To assess the usefulness of intra-arterial contrastenhanced ultrasonography(IAUS) during transarterial chemoembolization(TACE) with drug-eluting beads(DEB) for hepatocellular carcinoma(HCC).METHODS Thirty two patients with 39 HCC underwent DEB-TACE guided with IAUS, and examined by contrast-enhanced ultrasonography(CEUS) or dynamic CT after DEB-TACE were enrolled in this study. CEUS findings before DEBTACE and IAUS findings were compared. Treatments judged to be complete and incomplete for lesions were appropriate and insufficient, respectively. Findings on CEUS and/or dynamic CT performed 1, 3 and 6 mo after DEB-TACE were evaluated using m RECIST(CR/PR/SD/PD).RESULTS The treatments were complete and incomplete in 26 and 13 lesions, respectively. On imaging evaluation using CEUS and/or dynamic CT one month after treatment, 25 and 1 lesions were judged to be CR and PR, respectively, and at 6 mo after treatment, the results were CR, PR, SD and PD for 24, 1, 0 and 1 of these lesions, respectively, in the 26 completely treated lesions. Of the 13 lesions in which treatment was incomplete, the results on imaging at one month after treatment were CR, PR, SD and PD for 0, 6, 4 and 3 lesions, respectively. The overall CR rate at 6 mo after treatment was 61.5%(24/39).CONCLUSION A combination of DEB-TACE with IAUS can improve the therapeutic effects in patients with HCC.
基金funded by a grant from the Clinical Research Project of Shenzhen Health and Family Planning Commission in China,No.SZLY2018007a grant from the Science and Technology Planning Project of Shenzhen City of China,No.JCYJ 20150403101028210+2 种基金a grant from the Science and Technology Development and Cultivation Project of Southern Medical University of China,No.KJ 20161115the Guangdong Provincial Medical Research Fund in China,No.A2016545the Shenzhen Health Planning Commission Research Fund in China,No.201601013,201506009
文摘The mortality rate of acute severe intraventricular hematoma is extremely high, and the rate of disability in survivors is high. Intraventricular hematoma has always been a difficult problem for clinical treatment. Although minimally invasive endoscopic hematoma evacuation is widely used to treat this disease, the technique still has room for improvement. Equipment for the intra-neuroendoscopic technique（INET） consists of two of our patented inventions： a transparent sheath（Patent No. ZL 200820046232.0） and a hematoma aspirator（Patent No. ZL 201520248717.8）. This study explored the safety and efficacy of INET by comparing it with extraventricular drainage in combination with urokinase thrombolytic therapy. This trial recruited 65 patients with severe intraventricular hemorrhage, including 35（19 men and 16 women, aged 53.2 ± 8.7 years） in the INET group and 30（17 men and 13 women, aged 51.5 ± 7.9 years） in the control group（extraventricular drainage plus urokinase thrombolytic therapy）. Our results showed that compared with the control group, the INET group exhibited lower intraventricular hemorrhage volumes, shorter intensive care-unit monitoring and ventricular drainage-tube placement times, and fewer incidences of intracranial infection, secondary bleeding, and mortality. Thus, the prognosis of survivors had improved remarkably. These findings indicate that INET is a safe and efficient new method for treating severe intraventricular hematoma. This trial was registered with Clinical Trials.gov（NCT02515903）.
