ABSTRACT
Objective: Accumulating evidence indicates that inflammation abnormalities may contribute to aggression behaviors in psychotic patients, however, the possible sources of inflammation remain elusive. We aimed to evaluate the associations among aggression, inflammation, and bacterial translocation (BT) in aggression-affected schizophrenia (ScZ) inpatients with 2 weeks of antipsychotics discontinuation. Methods: Serum specimens collected from 112 aggression and 112 non-aggression individuals with ScZ and 56 healthy adults were used for quantifications of inflammation- or BT-related biomarkers. Aggression severity was assessed by Modified Overt Aggression Scale (MOAS). Results: Proinflammation phenotype dominated and leaky gut-induced BT occurred only in cases with ScZ with a history of aggression, and the MOAS score positively related to levels of C-reactive protein, interleukin (IL)-6, IL-1ß, and tumor necrosis factor-α. Furthermore, serum levels of BT-derived lipopolysaccharide (LPS), as well as LPS-responded soluble CD14, were not only positively correlated with levels of above proinflammation mediators but also the total MOAS score and subscore for aggression against objects or others. Conclusion: Our results collectively demonstrate the presence of leaky gut and further correlate BT-derived LPS and soluble CD14 to onset or severity of aggression possibly by driving proinflammation response in inpatients with ScZ, which indicates that BT may be a novel anti-inflammation therapeutic target for aggression prophylaxis.
ABSTRACT
OBJECTIVE: To analyze the reasons for reoperation after failed laparoscopic surgery for acute abdomen. METHODS: A retrospective study was performed to review the clinical data of 17 patients who required reoperation after laparoscopic surgery from May 2006 to March 2011. RESULTS: There were 11 males and 6 females with 16-68 years old. The reasons for reoperation were as follows: 13 with abdominal abscess among whom 4 complicated with internal fistula, 1 with residual toothpick, 1 with ileocecal lymphadenoma complicated with bowel obstruction, 1 with obturator hernia, 1 with intestinal vascular malformation. Twelve patients underwent laparoscopic reoperation after conservative treatments were invalid, among whom 5 completed laparoscopic operation successfully and 7 converted to laparotomy. The other 5 patients underwent emergency abdominal operation. All the patients were cured and discharged from hospital 7-21 days postoperatively. CONCLUSION: The laparoscopic technique has unique advantages, but must strictly adhere to the indications of Laparoscopic exploration and strictly follow the surgical operation procedures. In the special condition,and in diagnosis and surgery difficulty,laparoscopic surgery should be timely and decisive conversion to open surgery in the diagnosis and treatment of surgical acute abdomen.
