Hemorrhoid sclerotherapy with the complication of abdominal compartment syndrome: report of a case.

The complications of injection sclerotherapy for hemorrhoid are always local. Herein, we report a case in which a female patient with abdominal compartment syndrome developed after receiving a local injection of a sclerosing agent for hemorrhoid.

Significance of trypsinogen activation peptides and interleukin-6 in experimental acute pancreatitis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the feasibility of using plasma trypsinogen activation peptides (TAP) and serum interleukin-6(IL-6) as early markers for predicting the severity of experimental acute pancreatitis.</p><p><b>METHODS</b>Ninety male adult Sprague-Dawley rats were equally randomized into five groups: edema pancreatitis group, treated with retrograde ductal infusion of 3% sodium taurocholate solution; necrosis pancreatitis group, treated with retrograde ductal infusion of 5% sodium taurocholate solution; treatment pancreatitis group, treated with retrograde ductal infusion of 3% sodium taurocholate solution and ulinastatin intravenous infusion half an hour later; control pancreatitis group, treated with 0.9% normal saline retrograde ductal infusion; and sham operation group, treated with sham operation. Rats in each group were equally randomized into three subgroups, which were killed by exsanguination 3, 6, or 24 hours after infusion, and blood specimens were obtained. Serum amylase, plasma TAP, and serum IL-6 were determined. The severity of pancreatitis was scored by two blinded pathologists under microscope.</p><p><b>RESULTS</b>At 3 and 6 hours after infusion, plasma TAP concentration of necrosis pancreatitis group [(4.798±0.169) and (3.999±0.299)nmol/L, respectively]were significantly higher than those of edema pancreatitis group [(2.416±0.148) and (3.356±0.211)nmol/L, respectively] (P<0.01); at 6 hours after infusion, serum IL-6 level of necrosis pancreatitis group [(1339.51±56.43)pg/ml]was significantly higher than that of edema pancreatitis group [(619.07±42.25)pg/ml] (P<0.01).</p><p><b>CONCLUSIONS</b>In this acute pancreatitis model, the peak levels of plasma TAP and serum IL-6 may appear earlier in rats with severer disease. Serum TAP level may be used as a marker for the accurate early prediction of the severity of acute pancreatitis.</p>

Effects of traditional Chinese medicine on intestinal mucosal permeability in early phase of severe acute pancreatitis.

BACKGROUND: Traditional Chinese medicine has been used widely for many years in China to treat acute pancreatitis. We have investigated the effects of Dachengqi decoction on intestinal mucosal permeability and outcome in patients with severe acute pancreatitis (SAP). METHODS: Forty patients with sustained SAP that required admission to the surgical intensive care unit were enrolled prospectively in the study. All of these patients were divided randomly into the Dachengqi decoction group (n = 20) and control group (n = 20) on admission. Intestinal permeability was assessed by measuring absorption of two metabolically inert markers, lactulose (L) and mannitol (M), which were administered orally. Serum concentrations of endotoxin (lipopolysaccharide, LPS) and the ratio of lactulose to mannitol in urine (L/M) were detected in all patients. RESULTS: Compared with those in the control group, urinary L/M ratio decreased significantly in the Dachengqi decoction group on the 7th day after admission (P = 0.001). Also, serum concentrations of LPS were reduced on the 5th and 7th day after admission (P = 0.006, P = 0.008, respectively). Incidence of multiple organ dysfunction syndrome (MODS) and pancreatic infection was significantly lower in the Dachengqi decoction group compared with those in the control group (P = 0.038,P = 0.025, respectively). CONCLUSION: Dachengqi decoction may promote the recovery of intestinal mucosal permeability and decrease the incidence of MODS and pancreatic infection in patients with SAP.

Triptolide prolonged allogeneic islet graft survival in chemically induced and spontaneously diabetic mice without impairment of islet function.

BACKGROUND: Triptolide (TPT) is a diterpenoid triepoxide extracted from the Chinese herb Tripterygium wilfordii Hook. F. It exhibits potent immunosuppressive and anti-inflammatory properties. This study was undertaken to investigate its effects on prolongation of islet allograft survival in rodents. Additionally, we investigated whether TPT would be toxic to islet function in vivo. METHODS: We transplanted BALB/c islets to either chemically induced diabetic C57BL/6 mice or spontaneously diabetic nonobese diabetic (NOD) mice. TPT was injected within 2 weeks or continuously, until rejection, in the two combinations. Then, we evaluated the toxicity of TPT on islet function by daily injection to naive BALB/c or diabetic BALB/c that was cured by syngeneic islet transplantation under the kidney capsule. Mice injected with cyclosporine A (CsA) or vehicle served as controls. Intraperitoneal glucose tolerance tests (IPGTTs) performed at 4 and 8 weeks in the naive BALB/c group, and at 2, 4, 6, and 8 weeks in the syngeneic transplanted group. RESULTS: The medium survival time of islets allograft from TPT treated C57BL/6 and NOD recipients were 28.5 days (range 24-30 days, n=10) and 33.0 days (range 15-47 days, n=6), respectively, and they were significantly different from those of the vehicle treated controls, which were 14.0 days (range 13-16 days, n=6) and 5.0 days (range 4-10 days, n=6), respectively (all P<0.0001). The IPGTT demonstrated that there was no difference between the TPT treated and vehicle treated groups, either in the normal or syngeneic transplanted islet BALB/c mice. However, CsA injection impaired islet function in both normal and syngeneic transplanted mice as early as 4 weeks. CONCLUSION: TPT prolonged islets allograft survival in a chemically induced diabetic or an autoimmune diabetic murine model without impairment of islet function.

[Comparison between primary anastomosis after intraoperative colonic defecation and Hartmann procedure in patients with obstructive left colon cancer].

OBJECTIVE: To compare primary anastomosis after intraoperative colonic defecation and Hartmann procedure for obstructive left colon cancer. METHODS: Clinical data of 68 patients who underwent emergent laparotomy for left colon cancer with acute bowel obstruction between January 2000 and January 2008 were analyzed retrospectively. RESULTS: Primary resection and anastomosis with intraoperative defecation was performed in 43 patients and Hartmann's procedure in 25 cases. Patients in both groups were comparable in terms of age, gender, nutritional status, underlying diseases, tumor location and stage, etc. The morbidity and mortality in the two groups were 25.6% vs 28.0% (P=0.761) and 2.3% vs 4.0% (P=0.369), respectively, and the differences were not statistically significant. The length of hospital stay (including first resection operation and second admission for colostomy closure) was (16.6+/-7.8) d in the primary anastomosis group and (24.6+/-9.4) d in the Hartmann procedure group, and the difference was statistically significant (P=0.002). The costs of hospitalization in the two groups were CNY 50,192.8+/-39,727.4 and CNY 58,382.1+/-30,304.9 (P=0.020). CONCLUSION: Primary resection with intraoperative colonic defecation is safe and effective, and should be considered as an alternative to Hartmann procedure for obstructive left colon cancer in selected patients.

Littoral cell angioma of the spleen.

Littoral cell angioma (LCA) is a rare primary benign vascular neoplasm of the spleen. The case of a 52-year-old female with LCA is reported. The patient did not have any symptoms or a significant past medical history. Computed tomography (CT) and ultrasound (US) imaging studies showed multiple lesions in the spleen and gallbladder stones. The tumour was removed successfully by laparoscopic splenectomy and simultaneously cholecystectomy was conducted for gallbladder stones. The patient recovered uneventfully. The tumour lining cells were positive for CD31/CD68 markers, and negative for CD34. This is the first report of a LCA combined with gallbladder stones.

Preliminary research on the pathological role of cathepsin-B in subcutaneous heteroplastic pancreatic carcinoma in nude mice.

BACKGROUND: Cathespin-B (cath-B) is an important proteolytic enzyme involved in the disease course of invasion in many types of cancer. Cath-B expression in subcutaneous heteroplastic pancreatic carcinoma in nude mice has not been studied. We investigated the role of cath-B in a model of heteroplastic pancreatic carcinoma in BALB/c nude mice. METHODS: Thirty-two six-week-old female BALB/c nude mice were equally divided into four groups. PANC-1 cells were inoculated subcutaneously in the left axillary region. Besides volume, weight of subcutaneous tumor, and change in body weight, cath-B expression in each group was measured by immunohistochemical staining, PCR and Western blotting. Its relationship to microvessel density (MVD), CD44v6, and placenta growth factor (PLGF) was also examined. CA-074Me, a specific inhibitor of cath-B, was injected intraperitoneally (i.p.) at different stages of tumor growth in group B and C. Gemcitabine (GEM), was also injected (i.p.) in group D to compare anti-tumor efficacy with CA-074Me. RESULTS: Expression of cath-B at different levels was related to tumor growth, MVD, and PLGF expression. In group A (control group), cath-B expression was enhanced more than that seen in other groups. CA-074Me clearly inhibited cath-B expression and tumor growth in group B. There was no difference between group C and D with respect to anti-tumor effect. CONCLUSIONS: Cath-B correlates with the growth and angiogenesis of tumors, but not with the adhesion induced by CD44v6. CA-074Me clearly inhibited cath-B expression and demonstrated an anti-neoplastic and anti-angiogenesis effect.

[Effects of contrast medium on the pancreatic pathology in severe acute pancreatitis experiment with rats].

OBJECTIVE: To investigate the effects of contrast medium on the pancreatic pathology in severe acute pancreatitis (SAP). METHODS: Twenty-four Wistar rats underwent injection of sodium taurocholate into the biliopancreatic duct to establish models of SAP and then randomly divided into 4 groups: Group A (SAP group), Group B (SAP models injected with normal saline injected group), Group C (SAP models with injection of 76% castrografin), and Group D (SAP models injected with ultravist-300). Another 6 rats were used as blank controls. The rats were killed to undergo pathological examination of their pancreases. Modified Schmidt method was used to score the pathological changes. RESULTS: The modified Schmidt scores of Groups A, B, C, and D were (6.5 +/- 1.2), (7.7 +/- 1.0), (7.5 +/- 1.5), and (7.2 +/- 1.2) respectively, all significantly higher than that of the control group [(3.2 +/- 1.7), all P < 0.05]. However, there was no significant difference among these 4 groups (all P > 0.05). CONCLUSION: CM has no adverse effects on the pathology of pancreas with SAP and does not worsen the disease.

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage.

AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP >or= 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE II scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 +/- 3.90 vs 15.70 +/- 4.25, P = 0.616; 3.70 +/- 0.93 vs 3.47 +/- 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period of the first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shock: 70.0% vs 11.1%, P < 0.001; MODS: 90.0% vs 31.5%, P < 0.001; mortality: 75.0% vs 3.7%, P < 0.001). CONCLUSION: IAH/ACS is a frequent finding in patients admitted to the ICU because of AP. Patients with IAP at approximately 10-12 mmHg and early signs of changes in physiologic variables should be seriously considered for urgent decompression to improve survival.

Severe acute pancreatitis in the elderly: etiology and clinical characteristics.

AIM: To investigate the etiology and clinical characteristics of severe acute pancreatitis (SAP) in elderly patients (> or = 60 years of age). METHODS: We reviewed retrospectively all the SAP cases treated in Xuanwu Hospital in Beijing between 2000 and 2007. RESULTS: In 169 patients with SAP, 94 were elderly and 16 died. Biliary and idiopathic etiologies were the first two causes that accounted for over 90% of SAP in the elderly. Biliary, hyperlipemic and alcoholic etiologies were the first three causes in the young. The proportion of co-morbidity of cholelithiasis, biliary infection, hypertension and coronary heart disease in the aged was significantly higher than that in their young partners. The scores of APACHE II and Ranson were also significantly higher in the elderly except the CT score. Organ failures were more common in the elderly, but the local pancreatic complications were not different between the two groups. Mortality of the aged was correlated with the severity of SAP, multiple co-morbidity and incidence of multiple organ dysfunction syndrome (MODS). MODS was the main cause of death. CONCLUSION: The etiology of SAP in the elderly is quite different from that in the young. Biliary and unknown factors are main causes in the aged. The elderly are subject to major organ failures but there is no difference in the occurrence of local pancreatic complications between the elderly and the young. It is crucial to monitor and improve the functions of major organs so as to prevent MODS in the aged with SAP.

[The management of bleeding pseudoaneurysms in patients with severe acute pancreatitis].

OBJECTIVE: To report the experience in diagnosis and management of bleeding pseudoaneurysms associated with severe acute pancreatitis (SAP). METHODS: The medical records of 12 patients with bleeding pseudoaneurysms associated with SAP treated between October 1990 and October 2006 were retrospectively reviewed. The etiologies of the 12 patients were gallstones in 6 patients, hyperlipidemia in 3 patients, hyperparathyroidism in 1 patient and the other 2 patients had no definitive causes. RESULTS: Abdominal computed tomography revealed bleeding pseudoaneurysms in 6 of 9 patients. Angiography determined correct diagnosis in 12 patients (12/12). The most involved vessels were peripancreatic arteries. Eight patients were managed by trans-catheter arterial embolization (TAE) as "one point" (a proximal point of the pseudo-aneurysm). Two patients were treated by TAE as "two points" (both distal and proximal to the pseudo-aneurysm). The last two cases were treated by surgery as suture and ligation. Four of the "one point" TAE patients were re-bleeding 4 to 7 days later, and 2 of them were treated with surgery, the other 2 patients were controlled with "two points" TAE. Three patients were died of infection and multiple organ dysfunction syndromes. Overall mortality rate was 25% (3/12). CONCLUSIONS: Angiography is the main diagnostic methods for bleeding pseudoaneurysms in SAP patients. "Two points" embolization and emergency surgery are an effective treatment options in these patients.

[Effects of duration of early organ dysfunction and therapeutic strategy on outcomes in patients with severe acute pancreatitis].

OBJECTIVE: To investigate the characteristics of early organ dysfunction in patients with severe acute pancreatitis (SAP) and therapeutic regimens. METHODS: A total of consecutive 74 patients with a confirmed diagnosis of SAP admitted between January 2000 and June 2005 were divided into two groups, transient group (72 h, n = 54). The differences in local complications and mortality were compared between the two groups. RESULTS: Among the seventy-four SAP patients, the incidence rate of cardiovascular dysfunction was 80%, respiratory dysfunction 47%, hepatic dysfunction 37% and renal dysfunction 20%. The incidence of multiple organ dysfunction in transient group was much lower than that in persistent group (P < 0.01). The local complications and death in transient group patients were less than that in persistent group (P = 0.038, P = 0.054, respectively), irrespective of onset of organ dysfunction on admission or later during the first week. CONCLUSIONS: The important determinant of risk of death from SAP is the persistence of early organ dysfunction for more than 72 h. Consequently, aggressively ameliorating the blood perfusion and the oxygenation in tissue is the priority in reducing organ dysfunction or shortening the duration of organ dysfunction.

Hyperlipidemia intensifies cerulein-induced acute pancreatitis associated with activation of protein kinase C in rats.

AIM: To investigate the effects of hyperlipidemia on acute pancreatitis (AP) and the possible mechanisms. METHODS: Rat models of hyperlipidemia and AP were established by Triton WR1339 and cerulein respectively. Human albumin was used to treat AP complicated by hyperlipidemia. In each group, we compared the histological score, volume of ascites, ratio of pancreatic wet/dry weight, serum amylase (AMY) and pancreatic acinar cell apoptosis. The level of protein kinase C (PKC) membrane translocation in pancreatic tissue was detected by Western blot. RESULTS: In the hyperlipidemia model established by Triton WR1339, triglyceride (TG) increased remarkably and reached its peak 6 h after injection, and most rats developed mild acute pancreatitis. Histological score, volume of ascites, ratio of wet/dry weight and serum AMY in AP animals with hyperlipidemia were obviously higher than those in AP animals (P < 0.05) and decreased after albumin therapy but not significantly (P > 0.05). Apoptotic cells detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) increased in AP animals with hyperlipidemia and did not change distinctly after albumin therapy. PKC membrane translocation level increased in AP animals with hyperlipidemia and decreased remarkably after albumin therapy (P < 0.05). CONCLUSION: Hyperlipidemia may induce AP or intensify pancreatic injury. Albumin therapy can not alleviate pancreatic lesion effectively. PKC activation may be one mechanism by which AP is intensified by hyperlipidemia.

[Effects of ethanol on the function of cultured hepatocytes].

OBJECTIVE: To develop a novel culture system to investigate the effects of ethanol on the function of cultured hepatocytes. METHODS: Sandwich configuration was used to culture hepatocytes and the effects of ethanol on functions of bile excretion and protein synthesis as well as the morphology of cultured hepatocytes were observed. RESULTS: Bile canaliculi-like structures decreased and anastomatic networks disappeared in ethanol treated hepatocytes. The ability for hepatocytes to internalize, metabolize and excrete compounds into bile was indicated by FDA metabolizing in the hepatocytes. In hepatocytes without ethanol, the bile excretion was showed clearly, but in ethanol-interfered hepatocytes, no bile excretion was observed. After ethanol was given, the level of protein secretion decreased and with the time going, it became lower and lower. CONCLUSION: Hepatocytes can be seriously damaged by ethanol. The study provides a new model to investigate the mechanism of some liver diseases caused by ethanol.

Alterations of intestinal immune function and regulatory effects of L-arginine in experimental severe acute pancreatitis rats.

AIM: To discuss the changes of intestinal mucosal immune function in rats with experimental severe acute pancreatitis (SAP) and the regulatory effect of L-arginine. METHODS: Male adult Wistar rats were randomly divided into pancreatitis group, sham-operation group, and L-arginine treatment group. Animals were killed at 24, 48, and 72 h after SAP models were developed and specimens were harvested. Endotoxin concentration in portal vein was determined by limulus endotoxin analysis kit. CD3+, CD4+, CD8+ T lymphocytes in intestinal mucosal lamina propria were examined by immunohistochemistry. Secretory immunoglobulin A (SIgA) in cecum feces was examined by radioimmunoassay. RESULTS: Compared to the control group, plasma endotoxin concentration in the portal vein increased, percentage of CD3+ and CD4+ T lymphocyte subsets in the end of intestinal mucosal lamina propria reduced significantly, CD4+/CD8+ ratio decreased, and SIgA concentrations in cecum feces reduced at 24, 48, and 72 h after SAP developed. Compared to SAP group, the L-arginine treatment group had a lower level of plasma endotoxin concentration in the portal vein, a higher CD3+ and CD4+ T lymphocyte percentage in the end of intestinal mucosal lamina propria, an increased ratio of CD4+/CD8+ and a higher SIgA concentration in cecum feces. CONCLUSION: Intestinal immune suppression occurs in the early stage of SAP rats, which may be the main reason for bacterial and endotoxin translocation. L-arginine can improve the intestinal immunity and reduce bacterial and endotoxin translocation in SAP rats.

[Surgical treatment of pancreatic head carcinomas].

OBJECTIVE: To compare the outcomes of patients undergoing surgical treatment for pancreatic head carcinomas during different time course over 40 years in one hospital. METHODS: Totally 346 cases of pancreatic head carcinoma in one hospital were retrospectively analyzed during the periods of 1958-1976, 1977-1987, 1988-1998, and 1999-2003. RESULTS: During the period of 1958-1976, 79 patients with pancreatic head carcinoma were diagnosed and the rate of pancreaticoduodenectomy (PD) was 20.6% (21/79). During the period of 1977-1987, 60 patients with pancreatic head carcinoma were diagnosed and the PD rate was 26.7% (16/60). During the period of 1988-1998, 109 patients with pancreatic head carcinoma were diagnosed and the resection rate was 20.18% (22/109). During the period of 1999-2003, 98 patients with pancreatic head carcinoma were diagnosed and the resection rate was 22.4% (20/98). The total resection rate of pancreatic head carcinomas was 22.8% (79/346). The complication rate of the operation was 42.3% (9/21) during 1958-1976, 37.5% (6/16) during 1977-1987, 27.3% (6/22) during 1988-1998, and 10.0% (2/20) during 1998-2003. The perioperative mortality was 19.0% (4/21) during 1958-1976 (2 cases of pancreatic fistula and 1 case of liver and renal failure), 12.5% (2/16) during 1977-1987 (1 case of multiple organ failure and 1 case of bleeding), and 4.5% (1/22) during 1988-1998 (1 case of multiple organ failure). One patient with bile duct fistula during 1977-1987 and one patient with pancreatic fistula during 1988-1998 were cured by non-operative treatment. There was no perioperative death during 1999-2003. During the period of 1958-1976, the survival rate of patients undergoing PD was 55.5% by 1 year, 23.1% by 3 year, and 11.0% by 5 year. During 1977-1987, it was 56.3% by 1 year, 25.0% by 3 year, and 12.5% by 5 year. During 1988-1998, it was 59.1% by 1 year, 27.2% by 3 year, and 13.6% by 5 year. CONCLUSIONS: Remarkable improvement have been achieved in perioperative preparation and care after surgical treatment of pancreatic head cancer in the past decades. However, the resection rate and prognosis of PC were still poor, although the accuracy of early diagnosis is increasing, and the complications and perioperative mortality of PD are decreasing.

[Surgical treatment of 475 patients with periampullary carcinoma].

OBJECTIVE: To compare of the outcome of all patients who received surgical treatment in one institute for periampullary carcinoma during different intervals over the past 40 years. METHODS: Retrospective review of 475 patients suffering from periampullary carcinoma in intervals 1958 approximately 1976, 1977 approximately 1987, 1988 approximately 1998 and 1999 approximately 2003 is presented. RESULTS: In interval 1958 approximately 1976, for 128 patients, the tumor resection rate was: pancreatic carcinoma (PC) 26.6% (21/79), ampullary carcinoma (AC) 86.2% (25/29), distal bile duct cancer (DBDC) 38.5% (5/13), and duodenal cancer (DC) 57.1% (4/7). In interval 1977 approximately 1987, for 70 patients, the tumor resection rate was: PC 26.7% (16/60), AC 66.7% (4/6), DBDC 100% (1/1), and DC 66.7% (2/3). In interval 1988 approximately 1998, for 147 patients, the tumor resection rate was: PC 20.2% (22/109), AC 75.0% (12/16), DBDC 50.0% (2/4), and DC 66.7% (12/18). In interval 1999 approximately 2003, for 130 patients, the tumor resection rate was: PC 20.4% (20/98), AC 100% (4/4), DBDC 75.0% (12/16), and DB 83.3% (10/12). Cumulatively, from 1958 to 2003, the incidence of DBDC has become significantly higher, and the average of total bilirubin level (TBIL) has gradually been going downward, the average of blood transfusion during operation and the diameter of resected tumor has been becoming smaller. From 1999 to 2003, none of the 130 periampullary carcinoma patients had received biliary drainage before operation. CONCLUSION: Mortality and complication have become significantly lower because of effective improvement in the perioperative preparation and the care after surgery of periampullary cancer in the recent years. Even though the accurate diagnosis has become increasing earlier than before, the resection rate and prognosis of periampullary carcinoma remain poor.

[The expression of Cyclin D1 modulated by somatotropin on human pancreas cancer cell lines Bxpc-3].

OBJECTIVE: To observe the growth effect of somatostapin on human pancreas cancer lines Bxpc-3. METHODS: The Bxpc-3 pancreas cancer cells were treated with Somatotropin. The cells hyperplasia were detected by MTT and were observed apoptosis cells determinated quantitatively by TUNEL, quantify immune fluoresence double marked the proliferation cells and apoptosis cells, the expression of Cyclin D1 detected by immunohistochemical. RESULTS: The growth effect of pancrea cancer cells were limited by 10(-7) M, 10(-8) M, 10(-9) M Somatotropin on 2 day. The limited effect was decreased from 3 day. The cells proliferation were increased by somotostapin on 4day to 5day. The relationship between the expression of Cyclin D1 and apoptosis was negative correlation and the cells hyperplasia was positive correlation in Bxpc-3 cell line. CONCLUSION: From the cell study we knew the expression of Cyclin D1 reflected the prolefiration of pancreas cancer cells.

[Clinical analysis of complications after non- invasive positive pressure ventilation and an inquiry into the respiratory treatment strategy in patients with SARS].

OBJECTIVE: To analyze the clinical data of severe acute respiratory syndrome (SARS) patients with pneumothorax and mediastinal emphysema occurring after the non-invasive positive pressure ventilation (NIPPV), and to inquire into relevant strategy in respiratory treatment in the SARS patients. METHODS: Twenty-seven serious cases of SARS undergone NIPPV were analyzed retrospectively. RESULTS: Pneumothorax and mediastinal emphysema occurred in 7 of 27 serious cases of SARS with NIPPV, and mediastinal emphysema occurred in 1 of 189 cases of SARS without mechanical ventilation (MV). The incidence of pneumothorax and mediastinal emphysema in serious cases of SARS with NIPPV was significantly higher (chi2=25.052, P<0.01) than that in cases of SARS without receiving MV. The peripheral blood oxygen saturation level was not changed significantly after reasonable adjustment of ventilation pressure and increase in oxygen concentration inhaled. Seven cases of pneumothorax and mediastinal emphysema improved gradually. CONCLUSION: The incidence of pneumothorax and mediastinal emphysema in serious SARS patients with NIPPV is significantly higher than that in SARS patients without receiving MV. This might be related to SARS related pulmonary injuries, intensive cough and high mechanical ventilation pressure. The pneumothorax and mediastinal emphysema improve gradually in all cases after reasonable adjustment of mechanical ventilative pressure. So when NIPPV is used in the treatment of serious SARS patients to improve hypoxemia, optimized mechanical ventilative pressure should be acquired in order to avoid pneumothorax and mediastinal emphysema.