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ObjectiveTo develop a deep learning system for early ultrasound screening of developmental dysplasia of the hip （DDH）， a new smart-hip ultrasound technique （S-hip）， and to validate its clinical application. MethodsWe selected 11，100 annotated and reviewed coronal ultrasound images of infant hips between November 2021 and August 2022， 8，100 of which were used for the training set and 3，000 for the test set， to build a S-hip deep learning system. To verify the consistency between the automated measurement by S-hip and the manual measurements by sonographers， 174 standard coronal ultrasound images of 87 infants' bilateral hips were acquired， then α angle， β angle and femoral head coverage （FHC） were measured by S-hip， an ultrasound expert and a resident. The measurement data and the time required for the measurements were recorded and statistically analyzed. Another 100 standard coronal ultrasound images of the hips were randomly selected and measured twice respectively by the ultrasound expert and resident to assess the intra-sonographer repeatability. ResultsThe intraclass correlation coefficient （ICC） （95% CI） values of α angle， β angle and FHC results measured by S-hip and ultrasound expert were 0.799 （0.738， 0.847）， 0.798 （0.737， 0.846） and 0.934 （0.954， 0.975）， respectively. Those values measured by the ultrasound expert and resident were 0.725 （0.645， 0.789）， 0.674 （0.583， 0.748） and 0.931 （0.908， 0.949）， respectively. The mean absolute errors （MAE） of α angle， β angle and FHC results between measurements by S-hip and ultrasound expert were 2.69 °， 4.43 ° and 2.47%， respectively. The time required for measurements by S-hip， ultrasound expert and resident was （1.59±0.36） s， （18.76±2.23） s and （19.45±2.76） s， respectively. The automated measurement by S-hip cost much shorter time than the manual measurements by sonographers and the difference was statistically significant （P<0.001）. The ICC （95% CI） values of α angle， β angle and FHC results between two measurements by the ultrasound expert were 0.943 （0.916， 0.961）， 0.959 （0.940， 0.972）， and 0.981 （0.971， 0.987）， respectively. Those values by the ultrasound resident were 0.884 （0.833， 0.921）， 0.921 （0.884， 0.946）， and 0.962 （0.944， 0.974）. ConclusionThe S-hip based on a deep learning system is a highly reliable automated technique to accurately measure α angle， β angle and FHC. Compared with ultrasound residents， S-hip allows for a more simplified and significantly quicker measurement， which may enhance the widespread use of hip ultrasound screening in infants.
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Coronavirus disease(COVID-19) is a novel explosive infectious disease that has caused a serious public health crisis all over the world. The immunosuppression after novel coronavirus infection and insidiously progressive disease evolution lead to a series of unique characteristics of severe COVID-19 that are different from other severe infection.The key to reduce fatality rate of this disease is fully recognizing the evolution characteristics of severe COVID-19 patients, early warning and identification of patients who will progress to severe, and giving appropriate personalized nutrition support and organ function support scheme to the severe patients.So that we can buy the time for the patients to repair the immune function and remove viruses. This paper discussesed the special pathophysiological characteristics and clinical management of severe COVID-19 patients, so as to provide some references for the management of such patients in the future.
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ObjectiveTo study the relationship between acute myocardial injury（AMI） and coagulation function in patients with COVID-19.MethodsA retrospective study was carried out to record the general and laboratory data of 133 patients diagnosed with COVID-19 who were hospitalized in Wuhan TongJi Guanggu Hospital, Wuhan, Hubei Province from February 10 to February 29, 2020. The laboratory data includes blood routine, liver and renal function, myocardial infarction tests, coagulation function, inflammatory factors, hypersensitive C-reactive protein, procalcitonin etc. The patients were divided into two groups according to cardiac troponin I（TNI）34.2 ug/L. The differences of general conditions and laboratory data between the two groups were compared. Besides, the correlation between coagulation function and coagulation function, and the ROC curve of D-dimer in AMI were conducted .ResultsAmong the 133 patients, 9 (6.77%) had cTnI greater than 34.2 μg/L, and 124 (93.23%) had normal cTnI. There were significant differences between the two groups in age, COPD history, blood routine (neutrophil count, lymphocyte count, platelet count), myoglobin, liver function (direct bilirubin, indirect bilirubin), cytokines (IL-2 receptor, IL-6, IL-8, IL-10, TNF-α), coagulation function (PT, PTA, D-dimer). D-dimer level was positively correlated with TnI, CK-MB and myoglobin levels. The cut off value of D-dimer was 2.35 μg/ml in acute myocardial injury.ConclusionAcute myocardial injury in COVID-19 patients may be related to coagulation dysfunction. Therefore, monitoring of coagulation function dynamically, screening of thrombus and starting anticoagulant and antiplatelet therapy timely help to reduce acute myocardial injury.
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ObjectiveTo study the relationship between acute myocardial injury（AMI） and coagulation function in patients with COVID-19.MethodsA retrospective study was carried out to record the general and laboratory data of 133 patients diagnosed with COVID-19 who were hospitalized in Wuhan TongJi Guanggu Hospital, Wuhan, Hubei Province from February 10 to February 29, 2020. The laboratory data includes blood routine, liver and renal function, myocardial infarction tests, coagulation function, inflammatory factors, hypersensitive C-reactive protein, procalcitonin etc. The patients were divided into two groups according to cardiac troponin I（TNI）34.2 ug/L. The differences of general conditions and laboratory data between the two groups were compared. Besides, the correlation between coagulation function and coagulation function, and the ROC curve of D-dimer in AMI were conducted .ResultsAmong the 133 patients, 9 (6.77%) had cTnI greater than 34.2 μg/L, and 124 (93.23%) had normal cTnI. There were significant differences between the two groups in age, COPD history, blood routine (neutrophil count, lymphocyte count, platelet count), myoglobin, liver function (direct bilirubin, indirect bilirubin), cytokines (IL-2 receptor, IL-6, IL-8, IL-10, TNF-α), coagulation function (PT, PTA, D-dimer). D-dimer level was positively correlated with TnI, CK-MB and myoglobin levels. The cut off value of D-dimer was 2.35 μg/ml in acute myocardial injury.ConclusionAcute myocardial injury in COVID-19 patients may be related to coagulation dysfunction. Therefore, monitoring of coagulation function dynamically, screening of thrombus and starting anticoagulant and antiplatelet therapy timely help to reduce acute myocardial injury.
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Background@#Although the use of extra-corporeal membrane oxygenation (ECMO) has been rapidly increasing, the benefit of ECMO in patients with acute respiratory distress syndrome (ARDS) remains unclear. Our objective was to investigate the effect of venovenous ECMO (VV-ECMO) on adult patients with severe ARDS.@*Methods@#We conducted a multi-center, retrospective, cohort study in the intensive care units (ICUs) of six teaching hospitals between January 2013 and December 2018. Patients with severe ARDS who received VV-ECMO support were included. The detailed demographic data and physiologic data were used to match ARDS patients without ECMO. The primary endpoint was the 28-day mortality.@*Results@#Ninety-nine patients with severe ARDS supported by VV-ECMO and 72 patients without ECMO were included in this study. The acute physiology and chronic health evaluation II score was 23.1 ± 6.3 in the ECMO group and 24.8 ± 8.5 in the control group (P = 0.1195). The sequential organ failure assessment score was 12.8 ± 3.4 in the ECMO group and 13.7 ± 3.5 in the control group (P = 0.0848). The 28-day mortality of patients with ECMO support was 39.4%, and that of the control group was 55.6%. The survival analysis curve showed that the 28-day mortality in the ECMO group was significantly lower than that in the control group (P = 0.0097). Multivariate Cox regression analysis showed that the independent predictors of the 28-day mortality were the requirement of vasopressors before ECMO (hazard ratio [HR]: 1.006; 95% confidence interval [CI]: 1.001–1.013; P = 0.030) and duration of mechanical ventilation before ECMO (HR: 3.299; 95% CI: 1.264–8.609; P = 0.034).@*Conclusions@#This study showed that ECMO improved the survival of patients with severe ARDS. The duration of mechanical ventilation and the requirement of vasopressors before ECMO might be associated with an increased risk of death.
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Objective Very few studies have been reported on the application of quantitative electroencephalogram (qEEG) in patients with postoperative cognitive dysfunction (POCD). This study was to investigate the qEEG features of POCD and provide some help for the early detection and diagnosis of the condition. Methods We enrolled 31 postoperative patients treated in our Department of Critical Care Medicine from January 2018 to October 2018. Based on the pre- and post-operative scores on the Mini-Mental State Examination (MMSE), we divided the patients into a POCD (MMSE score >2, n = 11) and a non-POCD control group (MMSE score ≤2, n = 20). Using the brain function instrument, the electrode set according to the standard international 10-20 system and with bipolar longitudinal F3-P3 and F4-P4 four channels, we conducted bedside monitoring for all the patients and calculated the average value of the consecutive clips of 10-min qEEG. Then, we analyzed the amplitude-integrated EEG (aEEG), relative frequency band energy, relative α variability and spectrum entropy, and the correlation of relative frequency band energy and relative α variability with the MMSE scores. Results Compared with the non-POCD controls, the POCD patients showed significant decreases in the total MMSE scores (28.35 ± 1.27 vs 18.91 ± 2.34, P < 0.05), orientation score (9.75 ± 0.44 vs 6.82 ± 1.47, P < 0.05) and memory score (2.90 ± 0.31 vs 2.09 ± 1.04, P < 0.05) as well as in the concentration, calculation, recalling and language scores (all P < 0.05); and the POCD patients also exhibited marked reduction in the left α variability ([22.59 ± 10.98]% vs [14.39 ± 8.25]%, P < 0.05), right α variability ([24.07 ± 9.73]% vs [15.70 ± 9.59]%, P < 0.05), left α frequency band energy ([7.17 ± 4.73] vs [3.83 ± 2.62] μV2, P < 0.05) and right α frequency band energy ([6.94 ± 4.53] vs [3.82 ± 2.51] μV2, P < 0.05). The MMSE scores were found to be negatively correlated with left α variability (r = -0.793, P = 0.004), right α variability (r = -0.835, P = 0.001), left α frequency band energy (r = -0.633, P = 0.037) and right α frequency band energy (r = -0.682, P = 0.021). Conclusion Quantitative EEG of POCD patients is characterized by significantly decreased α variability and α frequency band energy, which may contribute to the early detection and diagnosis of POCD.
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Objective To evaluate the protective effect and mechanism of mild hypothermia on swine kidney after cardiopulmonary resuscitation, and whether changes in body temperature during mild hypothermia weaken the protective effect of mild hypothermia. Methods 18 swines were randomly divided into constant mild hypothermia group (CMH), variable mild hypothermia group (VMH) and control group (CON), with 6 swines in each group. Cardiac arrest model was successfully made. Then ECPR and temperature management was adopted. The target body temperature was 34℃ in the CMH group, and 37℃ in the control group, while the target body temperature of the VMH group fluctuated from 33 to 35 ℃ every two hours. After 24h, the animals were slowly reheated and then sacrificed. The kidneys were taken for real-time quantitative PCR, immunohistochemistry and histopathological examination. Results The expression levels of Bax, GRP78 and CHOP in the CMH group were lower than those in the CON group. Moreover, the expression of GRP78 in the CMH group were lower than those in the VMH group. The expression of Bcl-2 in the CMH group were higher than those in the VMH group and the CON group, and the expression of Bcl-2 in the VMH group were higher than those in the CON group (all P < 0.05). The positive expression of Bax was the most significant in the CON group and the least in the CMH group. The positive expression of Bcl-2 was the most significant in the CMH group and the least in the CON group. The nuclear membrane of porcine kidney cells shrank, nucleoli shrank and mitochondria swelled obviously in the CON group. The morphological injury changes were mild in the CMH group compared with the VMH group, while the CON group showed the severest change. Conclusion Mild hypothermia could attenuate the renal tubular cells apoptosis after cardiopulmonary resuscitation by inhibiting endoplasmic reticulum stress pathway, thus playing a protective role to the kidney. While aAbnormal temperature fluctuation during mild hypothermia maintenance may weaken the protection of kidney by mild hypothermia.
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Objective Constant light exposure can lead to hypercatabolism. The aim of this study was to investigate the effects of different light rhythm on skeletal muscle metabolism in endotoxemia rats, and looked for the optimal light rhythm that could reduce skeletal muscle consumption and enhance the recovery of patients with sepsis. Methods 54 adult male S-D rats were randomly divided into 3 groups on average：Control group (intraperitoneal injection of normal saline +12h/12h light-dark cycle for 7 days), LPS- regular light group (intraperitoneal injection of lipopolysaccharide(LPS) +12h/12h light-dark cycle for 7 days) and LPS-constant light group (intraperitoneal injection of LPS + constant light for 7 days). All experimental animals were sacrificed on the 8th day. The level of skeletal muscle metabolites 3-methylhistidine (3-mh) and tyrosine, atrophy genes MAFbx and murf-1 mRNA and hypothalamic clock genes BMAL1, CLOCK and neuropeptide POMC were also detected. Results The food intake, weight growth ratio and the ratio of extensor digitorum longus/weight in the LPS-constant light group were significantly lower than those in the LPS-regular light group (P <0.05), and both groups were significantly lower than those in the control group (P <0.01). The skeletal muscle metabolites 3-methylhistidine(nmol/g) and tyrosine(nmol/g) in the LPS-constant light group rats (6.200±0.273 and 461.039±13.292) were significantly higher than those in the LPS- regular light group (5.197±0.263 and 375.744±20.308) and the control group (3.244±0.275 and 290.935±19.065,all P <0.05). The expression levels of atrophic genes MAFbx and murf-1 mRNA and tnf-alpha and il-1 mRNA in hypothalamus in the LPS-constant light group were significantly higher than those in the LPS- regular light group(P <0.05), and both groups were significantly higher than those in the control group (P <0.05). The expression of the clock genes(BMAL1 and CLOCK) in the showed obvious rhythm (SE (A) /A<0.3) in the LPS-regular light group and the control group. The expression of BMAL1 was highest at the beginning of the illumination period, while the expression of CLOCK was high during the illumination period and decreased during the darkness period. In the LPS-constant light group, the expression of BMAL1 and CLOCK rhythm lost rhythm. Conclusion Normal light rhythm can maintain the normal rhythm expression of hypothalamic clock gene in rats with endotoxemia and reduce POMC-mediated skeletal muscle consumption, which may be of positive significance for the enhanced recovery of sepsis.
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With the rapid development of critical care medicine, more and more patients can survive from the initial severe stress and though the acute period of the disease, but fail to recover completely and consequently develop chronic critical disease, leading to extended hospital stay in the ICU. To resolve this urgent problem in critical care medicine, we present an overview of the commonly accepted concepts of enhanced recovery in the ICU, focusing on early mobilization, phased strategy of nutrition treatment, appropriate analgesia and sedation, promotion of sleep recovery in the ICU, and protocolized family support intervention, so as to reduce various avoidable stresses and promote the recovery of the patient in the ICU.
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Bowel obstruction is one of the common acuteabdominal diseases in surgery. The primary task of itstreatment is to replace the effective circulating blood volumelost caused by loss of digestive juice and increased exudationof inflammation through fluid therapy,and stabilize thehemodynamic state of patients. Therefore,optimizing thetiming,amount and composition of fluid therapy according tothe pathophysiological characteristics of fluid loss in patientswith bowel obstruction,and evaluating the effect of fluidtherapy scientifically and reasonably by the cardiac preload,tissue perfusion and oxygen metabolism are the keys to improve fluid therapy for bowel obstruction.
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BACKGROUND@#Although the use of extra-corporeal membrane oxygenation (ECMO) has been rapidly increasing, the benefit of ECMO in patients with acute respiratory distress syndrome (ARDS) remains unclear. Our objective was to investigate the effect of venovenous ECMO (VV-ECMO) on adult patients with severe ARDS.@*METHODS@#We conducted a multi-center, retrospective, cohort study in the intensive care units (ICUs) of six teaching hospitals between January 2013 and December 2018. Patients with severe ARDS who received VV-ECMO support were included. The detailed demographic data and physiologic data were used to match ARDS patients without ECMO. The primary endpoint was the 28-day mortality.@*RESULTS@#Ninety-nine patients with severe ARDS supported by VV-ECMO and 72 patients without ECMO were included in this study. The acute physiology and chronic health evaluation II score was 23.1 ± 6.3 in the ECMO group and 24.8 ± 8.5 in the control group (P = 0.1195). The sequential organ failure assessment score was 12.8 ± 3.4 in the ECMO group and 13.7 ± 3.5 in the control group (P = 0.0848). The 28-day mortality of patients with ECMO support was 39.4%, and that of the control group was 55.6%. The survival analysis curve showed that the 28-day mortality in the ECMO group was significantly lower than that in the control group (P = 0.0097). Multivariate Cox regression analysis showed that the independent predictors of the 28-day mortality were the requirement of vasopressors before ECMO (hazard ratio [HR]: 1.006; 95% confidence interval [CI]: 1.001-1.013; P = 0.030) and duration of mechanical ventilation before ECMO (HR: 3.299; 95% CI: 1.264-8.609; P = 0.034).@*CONCLUSIONS@#This study showed that ECMO improved the survival of patients with severe ARDS. The duration of mechanical ventilation and the requirement of vasopressors before ECMO might be associated with an increased risk of death.
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Objective Sepsis is often accompanied by serious disorder of energy metabolism, which is characterized by high catabolism, leading to irreversible acute skeletal muscle decomposition. As a new sedative, dexmedetomidine can alleviate the hypercatabolism of sepsis to a certain extent, so it has the potential to improve acute skeletal muscle decomposition. The present work aims to investigate the effects of dexmedetomidine on the expressions of hypothalamus neuropeptides and skeletal muscle atrophy gene in endotoxemic rats.Methods Thirty-six male Sprague Dawley rats were randomly divided into three groups (n=12): control group(group CON),-model group(group LPS-CON) and intervention group(group LPS-DEX). The endotoxemic rat model was established by injecting lipopolysaccharide (LPS) intraperitoneally. After 24 hours intervention, the expressions of hypothalamic neuropeptide (POMC, CART, AgRP and NPY) mRNA as well as MuRF-1 and MAFbx mRNA in skeletal muscle in rats were detected by RT-PCR.Results Compared with control group, the expressions of POMC, CART, MuRF-1 and MAFbx mRNA were significantly up-regulated (P＜0.05), while the expression of AgRP mRNA was significantly down-regulated in-model group (P＜0.05). Compared with-model group, the expressions of POMC, CART, MuRF-1 and MAFbx mRNA were significantly down-regulated (P＜0.05), while the expression of AgRP mRNA was significantly up-regulated in intervention group (P＜0.05).Conclusion Dexmedetomidine could regulate the expressions of hypothalamus neuropeptides and skeletal muscle atrophy gene in endotoxemic rats.
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Objective To construct the recombinant varicella zoster virus (VZV)carrying 3xflag gene,3xflag was added to the VZV open reading frame 7 (ORF7)using GalK-based homologous recombination.Methods GalK and 3xflag gene fragments with 50 bp VZV ORF7 homologous arms were amplified by PCR.The obtained fragments were purified and transferred to the competent cells of VZV bacterial artificial chromosome (SW102-VZVWTBAC). The clones of VZV ORF7 with 3xflag (SW102-VZV ORF7-3xflag-BAC)were obtained by homologous recombination and selection from medium containing GalK and replaced GalK. The recombinant plasmids were extracted and transfected into ARPE-19 cells.The effect of VZV ORF7-3xflag on ARPE-19 cells was observed.Results The clones of VZV ORF7 with 3xflag (SW102-VZV ORF7-3xflag-BAC)were obtained.The virus patches with green fluorescence were observed three days after SW102-VZVWTBAC and SW102-VZV ORF7-3xflag-BAC were transfected into ARPE-19 cells.Western blot showed that ORF7 expression was effectively enhanced with 3xflag.Conclusion The recombinant VZV carrying 3xflag gene was obtained,which suggests that GalK-based homologous recombination is convenient,efficient and accurate in manipulating the gene virus of interest.
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Acute and chronic cholecystitis is often complicated by gallstones.With the rapid development of modern surgery,especially the renovation in surgical concepts,techniques,and methods represented by noninvasive surgery,surgery becomes the most important method for the treatment of such disease.However,surgical treatment is also limited by different disease stages,disease onset status,and individual factors.As an indispensible part of the whole treatment system for such disease,non-surgical treatments,especially integrated traditional Chinese and Western medicine therapy,still have unique advantages.This article briefly summarizes the history of the treatment of acute and chronic cholecystitis and related hot topics and controversies,as well as the concepts and methods of integrated traditional Chinese and Western medicine therapy.
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Objective To evaluate the muscular irritation,hemolysis and sensitization of Aripiprazole Injection.Methods The local muscle irritation of Aripiprazole Injection was observed through sc injection on quadriceps femoris in rabbits.The 2％ red blood cell suspension in the blood of rabbit was used to check whether Aripiprazole Injection could cause the reaction of emolysis and erythrocyte agglutination.The method of systemic active allergic test (ASA) was used to evaluate the effect of Aripiprazole Injection on allergic reaction in Guinea pigs.Results No evidence ofhemolyzation and aggregation on rabbit erythrocyte in vitro was observed after Aripiprazole Injection treatment.Test substance was sc injected by single or multiple doses for 7 d,both of them had muscular irritation on New Zealand rabbits,the major pathologic change was the degeneration and necrosis of myofibers,myofibers broke apart and disappeared,lots of inflammatory cells immersed.After drug withdrawal,muscular irritation was recovered.No allergic reactions on Guinea pigs in vivo were observed at the low dose of 3.75 mg and the high dose of 7.5 mg.Conclusion Aripiprazole Injection has no hemolyzation and sensitization,but may cause muscle irritation at higher concentration.
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Isobaric peptide termini labeling ( IPTL) is a technology which uses light and heavy isotopes to label C-terminus and N-terminus of peptides. As the masses of labeled peptides are equivalent, the complexity of sample is low when analyzing MS data produced by this technology. Besides, paired b and y ions are helpful while analyzing MS/MS data in this kind of experiments. On the basis of this, a novel scoring algorithm, all ions scoring algorithm (AISA), has been designed for IPTL experiments. The information of quantification and qualification can be acquired at the same time using AISA. On Q-Exactive HeLa 2D RPLC dataset, peptide spectrum matches ( PSMs) , distinct peptides and protein groups identified by AISA are 15%, 26%and 22% higher than Morpheus. On human-HCC-HL dataset, PSMs, distinct peptides and protein groups identified by AISA are 24%, 39% and 27% higher than Morpheus. Quantification ratio on Q-Exactive HeLa and human-HCC-HL datasets are 1. 18 and 0. 90, respectively, which are very close to 1. Besides, quantification ratios between 0. 5 and 2. 0 are 91% and 94%, respectively.
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Objective To investigate the synergism and attenuation effects of Pini Pollen on paclitaxel and cisplatin ( TP) chemotherapy in model mice. Methods Forty-eight model nude mice with H456 cell line xenograft were divided into 8 groups: model group, TP chemotherapy group, Pini Pollen (150, 300 and 600 mg/kg) group and TP chemotherapy plus Pini Pollen (150, 300 and 600 mg/kg) group. The tumor inhibition rates, body weight, food intake, hematology and blood biochemistry indexes were selected to evaluate the synergism and attenuation effects of intragastric administration of Pini Pollen (150,300,600 mg/kg) on TP chemotherapy. Results Compared with the TP chemotherapy group, the tumor inhibition rates, body weight, food intake, white blood cell count were increased and liver and kidney function damage were alleviated significantly in the TP chemotherapy plus Pini Pollen groups. Conclusions Pini Pollen has a significant synergism and attenuation effects on TP chemotherapy.
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Isobaric peptide termini labeling ( IPTL) is a technology which uses light and heavy isotopes to label C-terminus and N-terminus of peptides. As the masses of labeled peptides are equivalent, the complexity of sample is low when analyzing MS data produced by this technology. Besides, paired b and y ions are helpful while analyzing MS/MS data in this kind of experiments. On the basis of this, a novel scoring algorithm, all ions scoring algorithm (AISA), has been designed for IPTL experiments. The information of quantification and qualification can be acquired at the same time using AISA. On Q-Exactive HeLa 2D RPLC dataset, peptide spectrum matches ( PSMs) , distinct peptides and protein groups identified by AISA are 15%, 26%and 22% higher than Morpheus. On human-HCC-HL dataset, PSMs, distinct peptides and protein groups identified by AISA are 24%, 39% and 27% higher than Morpheus. Quantification ratio on Q-Exactive HeLa and human-HCC-HL datasets are 1. 18 and 0. 90, respectively, which are very close to 1. Besides, quantification ratios between 0. 5 and 2. 0 are 91% and 94%, respectively.
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Objective To investigate the synergism and attenuation effects of Pini Pollen on paclitaxel and cisplatin ( TP) chemotherapy in model mice. Methods Forty-eight model nude mice with H456 cell line xenograft were divided into 8 groups: model group, TP chemotherapy group, Pini Pollen (150, 300 and 600 mg/kg) group and TP chemotherapy plus Pini Pollen (150, 300 and 600 mg/kg) group. The tumor inhibition rates, body weight, food intake, hematology and blood biochemistry indexes were selected to evaluate the synergism and attenuation effects of intragastric administration of Pini Pollen (150,300,600 mg/kg) on TP chemotherapy. Results Compared with the TP chemotherapy group, the tumor inhibition rates, body weight, food intake, white blood cell count were increased and liver and kidney function damage were alleviated significantly in the TP chemotherapy plus Pini Pollen groups. Conclusions Pini Pollen has a significant synergism and attenuation effects on TP chemotherapy.
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<p><b>OBJECTIVE</b>To compare the clinical effectiveness of percutaneous US- or CT-guided drainage and laparotomy for patients with infective pancreatic necrosis.</p><p><b>METHODS</b>Data of 90 infective pancreatic necrosis patients admitted from January 2008 to December 2009 were included. They were divided into two groups by the different treatment choices. Twenty-seven patients in the percutaneous group received percutaneous US- or CT-guided drainage as first choice. After that a sump suction apparatus was applied for controlled drainage. If no improvement was achieved after 3 days, they would received operation soon. While patients in the laparotomy group received surgical drainage at the time when the diagnosis of infected pancreatic necrosis was confirmed. Continuous drainage was also applied for these ones.</p><p><b>RESULTS</b>The percutaneous group had a significant low rate of reoperation (7.1% vs. 14.3%, P < 0.05) and postoperative residual abscesses (7.1% vs. 28.6%, P < 0.05). Furthermore, 48.1% of patients in percutaneous group successfully avoid laparotomy. In the regard of complications, the percutaneous group presented lower incidence of both single organ dysfunction (7.4% vs. 28.6%, P < 0.05), intestinal fistula (7.4% vs. 27.0%, P < 0.05) and long-term complications (3.7% vs. 22.2%, P < 0.05). In addition, the percutaneous group costed less medical resources as evidenced by shorter ICU duration (21.2 ± 9.7 vs. 28.7 ± 12.1, P < 0.01), shorter hospital duration (48.2 ± 12.5 vs. 59.6 ± 17.5, P < 0.05) and less expenditure (191 762 ± 5892 vs. 341 689 ± 10 854, P < 0.05).</p><p><b>CONCLUSIONS</b>Percutaneous drainage can effectively lower the surgical rates and the rates of complications and reoperations in patients with infective pancreatic necrosis. Besides that, it could also reduce the cost of medical resources.</p>