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1.
Article in Chinese | WPRIM | ID: wpr-1032250

ABSTRACT

Objective @#The purpose of this study was to investigate the effects of OTU deubiquitinase,ubiquitin aldehyde binding 2(OTUB2)on the activity of DEAD-box helicase 54(DDX54)and its influence on the formation of neutrophil extracellular traps(NETs)and the vitality and invasion ofcolorectal cancer(CRC)cells.@*Methods@#Peripheral blood neutrophils were isolated from CRC patients and healthy controls,then stimulated with phorbol-12- myristate-13-acetate(PMA)or DNase I for 4 hours.Westem blot analysis was performed to detect the expression of NETs markers,myeloperoxidase(MPO),and citrullinated histone H3(Cit-H3).The expression of OTUB2 or DDX54 was manipulated in SW480 cells,and they were co-cultured with neutrophils.The cells were divided into the following groups:Control group(without any treatment),NETs group,vector group,OTUB2 group,NETs+ si-OTUB2 group(SW480 cells,SW480 cells transfected with vector,OTUB2 overexpression plasmid and si- OTUB2 were co-cultured with PMA-treated neutrophils,respectively),OTUB2+DNase I group(SW480 cells transfected with OTUB2 overexpression plasmid co-cultured with neutrophils treated with DNase I),si- OTUB2group,OTUB2+si-NCgroup,OTUB2+si-DDX54group(SW480 cells transfected with si-0TUB2,OTUB2 overexpressing plasmid and si-NC,OTUB2 overexpressing plasmid and si-DDX54 were co-cultured with neutro- phils,respectively).ELISA was used to measure the relative expression of MPO-DNA complexes and the concen- tration of Cit-H3 in the supernatant of SW480 cells.MTT and Transwell assays were performed to evaluate cell via- bility and invasive ability.RNA sequencing was conducted to screen downstream genes regulated by OTUB2.The interaction between DDX54 and OTUB2 was validated using quantitative real-time polymerase chain reaction(qRT- PCR),co-immunoprecipitation(Co-IP),Clutathione S-Transferase(CST)pull-down,and His-tag pull-down experiments.@*Results @#Compared to healthy individuals,there was an increased formation of NETs in the peripheral blood of CRC patients.The CRC cells in the NETs group exhibited increased cell viability and invasion compared to the control group(P<0.05).In comparison to the vector group,the OTUB2 group showed increased relative ex- pression of MPO-DNA complexes and Cit-H3,as well as increased cell viability and invasion(P<0.05).Howev- er,when compared to the OTUB2 group,the OTUB2+DNase I group exhibited decreased relative expression of MPO-DNA complexes and Cit-H3,as well as decreased cell viability and invasion(P<0.05).Co-IP,GST pull- down,and His-tag pull-down experiments demonstrated the interaction between OTUB2 and DDX54.In comparison to the OTUB2 +si-NC group,the OTUB2 +si-DDX54 group showed decreased relative expression of MPO-DNA complexes and Cit-H3,as well as decreased cell viability and invasion(P<0.05). @*Conclusion @#deubiquitinating enzyme OTUB2 can increase the formation of NETs and promote CRC cell viability and invasion by up-regulating DDX54.

2.
Chinese Journal of Orthopaedics ; (12): 1266-1274, 2020.
Article in Chinese | WPRIM | ID: wpr-869082

ABSTRACT

Objective:To explore the epidemiological characteristics, clinical characteristics, treatment strategies and clinical results of non-dislocated hyperextension tibial plateau fracture.Methods:A total of 25 cases of non-dislocated hyperextension tibial plateau fracture patients were collected, including 12 males and 13 females, aged 27-79 years with an average age of 51±15 years. Causes of injury: 18 cases of traffic accident, 2 cases of heavy injury, 5 cases of falling injury. Schatzker classification of tibial plateau fracture: 4 cases of type II, 5 cases of type IV, 13 cases of type V, 3 cases of type VI. Three columns theoretical classification: 4 cases of simple lateral column, 5 cases of simple medial column, 7 cases of medial column+lateral columns, 9 cases of three columns. Preoperative tibial plateau posterior slope angle was -10-0 degrees, average-5.2 degrees. Preoperative MRI showed 5 cases of medial collateral ligament (MCL) injury, 3 cases of posterolateral complex (PLC) complex injury, 2 cases of PLC+ posterior cruciate ligament (PCL) injury and 10 cases of menisci injury. The change of tibial plateau posterior slope angle was more than 10 degrees in patients with ligament injury, 5 patients had a tibial plateau posterior slope angle change more than 15 degrees, 5 patients had a tibial plateau posterior slope angle change more than 10 degrees, and the patients with a tibial plateau posterior slope angle change less than 10 degrees had no ligament injury; 6 patients with simple lateral column or medial column fracture had a ligament injury, 2 patients with medial column+lateral column fracture had a ligament injury, and 2 patients with three column fracture had a ligament injury.Results:All patients were followed up for 12-24 months, with an average of 16.4 months. The operation time was 124±33 min (65-180 min), and the bleeding volume was 106±48 ml (20-200 ml). All patients were treated by open reduction and internal fixation. According to the characteristics of fracture, targeted reduction of articular surface and restoration of lower limb force line were carried out. The plate was placed on the anterior part of tibial plateau to fix the fracture fragment. Evaluation of postoperative fracture reduction: 20 cases were anatomic reduction, 5 cases were good reduction (between 2-5 mm articular surface collapse), and the excellent rate of fracture reduction was 100%. Internal fixation: 4 cases were treated with simple lateral plate, 2 cases with simple medial plate, 15 cases with medial+ lateral plate, 1 case with medial plate+ lateral anchor suture, 1 case with medial plate+ posterior screw, 1 case with lateral plate+ fibular screw, 1 case with medial plate + lateral plate+ lateral anchor suture. The meniscus was repaired in 8 patients, including 5 medial and 3 laterals. The fracture healing time was 3-6 months (mean 3.3 months). The postoperative knee Rasmussen score was 24.9±3.5 (18-29), and the postoperative knee joint mobility was 118°±9° (90°-130°). Superficial infection occurred in 2 patients.Conclusion:The main imaging characteristic of "non-dislocated hyperextension tibial plateau fracture" is the change of tibial plateau posterior slope angle. The injury of single anteromedial column/anterolateral column fracture is easy to combine with the "diagonal" injury, and when the tibial plateau posterior slope angle changes more than 10 degrees, it is easy to be associated with peripheral ligament injury. By using open reduction and internal fixation, restoring the joint articular surface and lower limb force line, repairing the soft tissue structure and ligament, and reconstructing the stability of knee joint, we can achieve satisfactory results.

3.
Chinese Journal of Orthopaedics ; (12): 845-854, 2019.
Article in Chinese | WPRIM | ID: wpr-802649

ABSTRACT

Objective@#To explore the revision strategy of the malunited tibial plateau fracture and to analysis the main points of four common revision operations and the clinical effect.@*Methods@#From January 2012 to December 2016, 18 patients (5 males and 13 females) aged 35-60 years (average 49.7 years) underwent tibial plateau revision surgery in our hospital were collected. The time from the second revision operation to the first operation was 2-24 months (average 10.4 months). Our revision strategies were as follows: Firstly, to determine whether there is an infection or not. If there was infection, we changed the original internal fixation to external fixator to control infection. Secondly, todetermine whether the patient could suffer re-reduction and internal fixation. If the patient was older (>65 years old) or with severe local bone defect, total knee arthroplasty should be performed. Thirdly, patients were divided into four operation modes according to the tibial plateau fracture malunion type: 1. the original fracture line osteotomy; 2. the tibial tubercle + original fracture line osteotomy; 3. tibial metaphyseal window-rod reduction; 4. the osteotomy of fibula head and original fracture line osteotomy.@*Results@#All patients were followed up for 12-30 months (average 16.8 months), and the operation time was 120-300 min (average 185 min). 2 cases were infected before operation and the original internal fixation were removed to instead of external fixator;1 patient underwent total knee arthroplasty; 3 cases were treated with metaphyseal open window-rod reduction and internal fixation; 6 cases were operated with the original fracture line osteotomy and internal fixation; 4 cases were treated with tibial tubercle osteotomy+original fracture line osteotomy and internal fixation; 2 patients underwent fibular head osteotomy+ original fracture line osteotomy and internal fixation. All patients achieved bony union at the last follow-up. The healing time was 3-6 months (mean 3.6 months). The postoperative knee Rasmussen score was 19-29 (average 22.9), compared with average 14.4 points before operation (t=-10.169, P=0.001). The postoperative range of motion of knee joint was 60-110 degrees (mean 94.5 degrees), compared with average 55 degrees before operation (t=-5.773, P=0.001). The post-operative VAS pain score was average 1.1 points, compared with average 4.2 points before operation (t=8.960, P=0.001). Fracture reduction was excellent in 12 cases and good in 5 cases, with the excellent and good rate of 100%. 3 patients still had 2mm collapse on the articular surface, while 3 patients still had mild valgus (less than 5 degrees). There were 2 cases of superficial infection of the wound surface after operation.@*Conclusion@#It was difficult to revise the malunion of tibial plateau fracture and it was necessary to make a detailed operation plan before the operation. Satisfactory clinical effects could be obtained for the patients by correct revision strategy. The key to success was the proper revision strategy which was adopted according to the different characteristics of the tibial plateau fracture malunion of the patients.

4.
Chinese Journal of Orthopaedics ; (12): 845-854, 2019.
Article in Chinese | WPRIM | ID: wpr-755227

ABSTRACT

Objective To explore the revision strategy of the malunited tibial plateau fracture and to analysis the main points of four common revision operations and the clinical effect. Methods From January 2012 to December 2016, 18 patients (5 males and 13 females) aged 35-60 years (average 49.7 years) underwent tibial plateau revision surgery in our hospital were col?lected. The time from the second revision operation to the first operation was 2-24 months (average 10.4 months). Our revision strategies were as follows: Firstly, to determine whether there is an infection or not. If there was infection, we changed the original internal fixation to external fixator to control infection. Secondly, todetermine whether the patient could suffer re-reduction and in?ternal fixation. If the patient was older (>65 years old) or with severe local bone defect, total knee arthroplasty should be per?formed. Thirdly, patients were divided into four operation modes according to the tibial plateau fracture malunion type: 1. the origi?nal fracture line osteotomy; 2. the tibial tubercle+original fracture line osteotomy; 3. tibial metaphyseal window-rod reduction; 4. the osteotomy of fibula head and original fracture line osteotomy. Results All patients were followed up for 12-30 months (aver?age 16.8 months), and the operation time was 120-300 min (average 185 min). 2 cases were infected before operation and the origi?nal internal fixation were removed to instead of external fixator;1 patient underwent total knee arthroplasty; 3 cases were treated with metaphyseal open window-rod reduction and internal fixation; 6 cases were operated with the original fracture line osteotomy and internal fixation; 4 cases were treated with tibial tubercle osteotomy+original fracture line osteotomy and internal fixation; 2 pa?tients underwent fibular head osteotomy+original fracture line osteotomy and internal fixation. All patients achieved bony union at the last follow?up. The healing time was 3-6 months (mean 3.6 months). The postoperative knee Rasmussen score was 19-29 (aver?age 22.9), compared with average 14.4 points before operation (t=-10.169, P=0.001). The postoperative range of motion of knee joint was 60-110 degrees (mean 94.5 degrees), compared with average 55 degrees before operation (t=-5.773, P=0.001). The post?operative VAS pain score was average 1.1 points, compared with average 4.2 points before operation (t=8.960, P=0.001). Fracture reduction was excellent in 12 cases and good in 5 cases, with the excellent and good rate of 100%. 3 patients still had 2mm col?lapse on the articular surface, while 3 patients still had mild valgus (less than 5 degrees). There were 2 cases of superficial infec?tion of the wound surface after operation. Conclusion It was difficult to revise the malunion of tibial plateau fracture and it was necessary to make a detailed operation plan before the operation. Satisfactory clinical effects could be obtained for the patients by correct revision strategy. The key to success was the proper revision strategy which was adopted according to the different charac?teristics of the tibial plateau fracture malunion of the patients.

5.
Chinese Journal of Orthopaedics ; (12): 556-562, 2018.
Article in Chinese | WPRIM | ID: wpr-708571

ABSTRACT

Objective To explore the treatment methods and prognosis of early infection and delayed infection after intramedullary nail fixation.Methods Data of 22 cases of postoperative infections after intramedullary nail from January 2013 to August 2017 were retrospectively analyzed.There were 18 males and 4 females aged from 20 to 72 years old,with an average age of 46.8 years.14 cases were tibias and 8 cases were femurs.In the early infection group,6 cases showed swelling,heat and pain in the affected area with drainage and pus.In the late infection group,12 cases showed sinus formation and 4 cases showed no sinus tract.According to whether the infection occurred within six weeks,it was divided into early infection and delayed infection groups.Of 6 patients in early infection group,there was 1 case of septic shock which underwent removal of intramedullary nails,debridement and antibiotic bone cement stick implantation.5 cases were retained intramedullary nail and underwent local debridement treatment.Late infection occurred in 16 patients.One patient with tibia infection was given partial dressing to heal the fracture.Then the intramedullary nail was removed and intramedullary debridement was performed.Two patients with poor general condition,the intramedullary nails were removed and debridement was performed.Calcium sulphate cement was implanted and fixed with external fixation.The remaining 13 cases were treated with debridement and antibiotic cement stick implantation.We compared the differences between early and late infections of internal fixation,infection control,fracture healing,and secondary fracture fixation.Results Of the 6 patients with early infection,1 patient with septic shock removed intramedullary nails to control infection.After infection controlled,the fracture was treated with intramedullary nailing.Of the 5 patients with retained intramedullary nails,2 patients' infection were controlled and 3 were uncontrolled.After removal of the intramedullary nails the infection was control.The success rate of retaining intramedullary nails was 33.3% (2/6).Late infection occurred in 16 cases and infection was all controlled.The fractures healed in 22 patients.The fracture healing time of 6 patients with early infection was 2-6 months,with an average of 3.67±2.08 months.The fracture healing time of 16 patients with late infection was 2-4 months (average 3.2±0.79) months.Conclusion Patients with early bone infections after femoral and tibial intramedullary nail surgery may attempt debridement therapy with retained intramedullary nails,but the failure rate is high.If the intramedullary nail fails to remain,follow the treatment of patients with delayed bone infection.For patients with delayed bone infection,because the fracture has not yet healed,thorough debridement is used after the removal of internal fixation,then calcium sulfate or antibiotic bone cement stick should be implanted and fixed with external fixation.For the second phase,we may choose plate,intramedullary nail or external fixation to fix the fractures according to the soft tissue condition.All of the fixation methods could provide good fracture healing.

6.
Chinese Journal of Orthopaedics ; (12): 1161-1169, 2018.
Article in Chinese | WPRIM | ID: wpr-708639

ABSTRACT

Objective To investigate the differences and clinical effects of extended anterolateral approach in the treatment of simple/complex tibial plateau fractures with posterolateral bone fragment.Methods From January 2013 to December 2015,forty-six patients with posterolateral tibial plateau fractures treated in our hospital were included in our research.The posterolateral plateau fractures were reduced and fixed by the extended anterolateral approach.According to Schatzker fracture classification,patients with type Ⅱ fractures were treated as simple group and patients with type Ⅴ and type Ⅵ fractures were treated as complex group.According to tibial plateau three column classification,patients were divided into single column group,double column group and three column group.The operative time,bleeding volume,fracture healing time,postoperative Rasmussen score,knee mobility,reduction and fixation of fractures and postoperative complications were compared among the groups.Results All 46 patients were followed up for 23-45 months,with an average of 31.9 months.There were 24 cases in simple fracture group and 22 cases in complex fracture group.The mean operation time of simple group was 124±33.8 min,and that of complex group was 175±65.5 min,with significant difference (t=2.302,P=0.025);the mean bleeding volume of simple group was 118±93.5 ml,and that of complex group was 190± 149.4 ml,with significant difference (t=1.905,P=0.028).12 cases were treated with arthroscopy.Bone union was achieved in all patients at the last follow-up,and daily activities were not limited.The average healing time was 4.58 months in simple group and 5.54 months in complex group.The excellent rate of fracture reduction was 83.3% in simple group and 27.3% in complex group (x2=14.679,P=0.000).Posterolateral bone fragment was not completely fixed in 4 cases (16.7%) in simple group and 8 cases (36.4%) in complex group.The average Rasmussen function score was 26.8±2.1 and the range of motion of knee joint was 100°-120° (average 115.5°±6.2°) in simple group;The average Rasmussen function score was 23.5±3.4 points and the range of motion of knee joint was 95°-115° (average 106.3°±7.4°) in complex group,neither with no significant differences.According to the three-column fracture classification system,there were 6 cases in the single-column group,24 cases in the double-column group and 16 cases in the three-column group.There were significant differences in the operative time (F=5.039,P=0.000),bleeding volume (F=5.215,P=0.000) and the excellent rate of fracture reduction (x2=7.003,P=0.030) between these three groups.But there was no significant difference in the time of fracture healing,un-fixation rate of posterolateral bone fragment,knee joint Rasmussen score and knee jointactivity.The excellent rate of fracture reduction was 83.3% in arthroscopy assisted cases and 47.1% in arthroscopy un-assisted cases respectively (x2=4.749,P=0.002).Postoperative wound infection occurred in 1 patient.Conclusion Extended anterolateral approach could provide good reduction and fixation of tibial plateau fractures with posterolateral bone fragment with satisfactory clinical outcomes obtained in both simple and complex fractures.The operation was relatively simple and posterolateral bone fracture could get better reduction and fixation in simple tibial plateau fractures,and arthroscopy treatment was helpful to improve fracture reduction.

7.
Chinese Journal of Neurology ; (12): 911-913, 2018.
Article in Chinese | WPRIM | ID: wpr-711049

ABSTRACT

Spinal vascular disease is rare in clinic, especially in cases of spinal cord embolism caused by abnormal embolism. It is rare in clinic and has not been reported in China. We report a case of pulmonary embolism complicated with abnormal spinal cord embolism due to lack of protein S activity and analyze its clinical data in order to improve clinical understanding of the disease.

8.
Chinese Journal of Orthopaedics ; (12): 96-102, 2016.
Article in Chinese | WPRIM | ID: wpr-485829

ABSTRACT

Objective To investigate the injury mechanism, fracture characteristics, treatment strategy and prognosis of Pilon fracture without fibula fracture. Methods 28 cases of Pilon fracture without fibula fracture (29 fractures) treated in our hos?pital were adapted from January 2009 to December 2014. 22 cases were male, 6 were female, aged 46 years old (23-75). Cause of injury:tumble in 14 cases, fall from high place in 8 cases, traffic accident in 5 cases, bruise in 1 case. 10 cases had associated in?juries, and 2 cases were open injuries. The OA/ATO fracture type, Rüedi&Allgower fracture type, and characteristics of fractures were summarized. The appropriate treatments were selected, and the operative method, operative time, surgical approach, fixation, fracture healing time, ankle Mazur score, Burwell?Charnley reduction score and postoperative complications were recorded. Re?sults On the mechanism of injury, 28 cases mostly had a median?low energy injury mechanism with little open injuries. On the fracture characteristics, there was a 96.6%anterior distal tibia articular fracture involved with no other specific fracture character?istics occurred. The treatment of the fracture mostly received a single operative approach to complete open reduction and internal fixation operation. The average operation time was 119 minutes, the average fracture healing time was 7.1 months, the excellent and good rate of ankle Mazur score was 86.2%and the satisfactory rate of Burwell?Charnley fracture reduction score was 93.1%. Skin infections occurred in 3 patients after operation. After effective antibiotic and correct clinical treatment, the incisions got healed in these 3 patients. Conclusion Pilon fracture with intact fibula mostly is caused by median to low energy injury when an?kle at neutral or varus position, most with anterior distal tibia articular fracture by foot dorsal flexion. Generally use a single anteri?or approach can complete open reduction and internal fixation operation with satisfactory clinical treatment. This kind of fracture could achieve good reduction, good bone healing, good function and little complications after correct treatment.

9.
Chinese Journal of Neurology ; (12): 93-97, 2016.
Article in Chinese | WPRIM | ID: wpr-488008

ABSTRACT

Objective To study the clinical and electrophysiological features of the patients with hereditary neuropathy with liability to pressure palsy ( HNPP) diagnosed by gene analysis.Methods Seven patients from two HNPP families were assessed on medical history, physical examination, electrophysiology findings and gene analysis.Results A clinical manifestation of acute, painless, recurrent peripheral nerve palsies was typical for HNPP.Median, ulnar and peroneal nerves were usually affected.Electrophysiology study revealed that prolonged distal motor latency and slowing nerve conduction velocity were prominent.Gene studies exhibited a deletion of the peripheral myelination protein 22 gene in all the seven patients.Conclusions HNPP usually affects areas where nerves are subject to entrapment, and many episodes are preceded by minor compression on the affected nerve.As a reliable screening tool in detecting HNPP, the electrophysiological study shows that segmental demyelination is most commonly seen at common nerve entrapment sites.

10.
Chin. med. j ; Chin. med. j;(24): 2900-2905, 2014.
Article in English | WPRIM | ID: wpr-318580

ABSTRACT

<p><b>BACKGROUND</b>Augmentation plating has been used successfully to treat hypertrophic non-union after nail fixation. This study compared the efficacy of augmentation plating and exchange plating for treating hypertrophic non-union of femoral shaft fracture after intramedullary nail fixation.</p><p><b>METHODS</b>A total of 12 patients received augmentation plating and 15 patients received exchange plating as treatment for femoral shaft hypertrophic non-union. The procedures were conducted at our medical centre between January 2005 and January 2012. Clinical follow-up was conducted at 2 weeks, 1 month and then monthly until union was achieved to compare union time, operation time, bleeding and complications between the two groups.</p><p><b>RESULTS</b>All patients underwent follow-up examinations until fracture union was achieved. The average length of follow-up time after the second treatment was (18.37 ± 3.28) months. The time needed for union was (4.17 ± 0.94) months in the augmentation plating group and (5.33 ± 1.72) months in the exchange plating group. The operation time was (90.00 ± 17.58) minutes in the augmentation plating group and (160.00 ± 25.35) minutes in the exchange plating group. The amount of blood loss during the operation was (270.00 ± 43.32) ml in the augmentation plating group and (530.00 ± 103.65) ml in the exchange plating group. Both groups showed significant difference (P < 0.05) in their results. No complications were reported after the second operation.</p><p><b>CONCLUSIONS</b>Augmentation plating after nail fixation could remove local rotation instability, facilitate simple operation, create minimal damage and enable exercise for early functional recovery. Therefore, augmentation plating is excellent for treating hypertrophic non-union after nail fixation in femoral shaft fracture.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bone Nails , Femoral Fractures , General Surgery , Fracture Fixation, Internal , Methods , Fracture Fixation, Intramedullary , Methods , Retrospective Studies
11.
Article in Chinese | WPRIM | ID: wpr-418455

ABSTRACT

To compare the diagnostic value of high-resolution uhrasonography (HR-US) with nerve conduction study (NCS) in patients with clinically defined carpal tunnel syndrome (CTS),a prospective study was conducted on 37 consecutive patients investigated for sensory hand symptoms. With the clinical diagnosis of CTS as gold standard,NCS showed higher diagnostic sensitivity (80%)than ultrasound (61%) (P =0.047 ).The positive predictive value of HR-US for CTS was 100%.The results indicated that HR-US could be used as a screening method for majority of clinically suspected CTS patients and only for those with negative HR-US results.

12.
Clinical Medicine of China ; (12): 381-384, 2012.
Article in Chinese | WPRIM | ID: wpr-425222

ABSTRACT

Objective To investigate the therapeutic effects of early enteral nutrition by gastroscopeguided naso-jejunal feeding tube placement on the intestinal endotoxemia of patient with severe acute pancreatitis (SAP).Methods Fourty-three patients were randomized into two groups:patients receiving early enteral nutrition (EN) by gastroscope-guided naso-jejunal feeding tube placement (24 cases) and those receiving total parenteral nutrition (TPN) ( 19 cases).The serum endotoxin(ET),albumin (ALB) and amylase (AMY) levels were measured.Abdominal distension and other complications were observed in the two groups.Results The abdominal pain and distension relief time,intestinal bleeding,infectious complications of EN group were significantly improved compared with that of TPN group ( P < 0.01 或 P < 0.05 或 P < 0.001 ).The serum ET levels of EN group was much lower ( [ 0.19 ± 0.11 ] EU/ml) than that of TPN group ( [ 0.85 ± 0.28 ] EU/ml)on day 14 post-treatment (t =10.456,P < 0.001 ).The serum AMY levels were decreased significantly in two groups after treatment,and the difference between two groups was not significant (t =3.l17,t =1.889,P >0.05 ).The serum ALB recovery of two groups was not significantly different ( P > 0.05 ).Conclusion Gastroscope-guided Naso-jejunal feeding tube placement for early enteral nutrition can protect intestinal mucosa,reduce complications,alleviate symptoms of patients with SAP,which are benefitial factors for the treatment of intestinal endotoxemia in patients with SAP.

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