Minimally invasive treatment of pancreatic necrosis

AIM: To systematically review these minimally invasive approaches to infected pancreatic necrosis. METHODS: We used the MEDLINE database to investigate studies between 1996 and 2010 with greater than 10 patients that examined these techniques. Using a combination of Boolean operators, reports were retrieved addressing percutaneous therapy (341 studies), endoscopic necrosectomy (574 studies), laparoscopic necrosectomy via a transperitoneal approach (148 studies), and retroperitoneal necrosectomy (194 studies). Only cohorts with at least 10 or more patients were included. Non-English papers, letters, animal studies, duplicate series and reviews without original data were excluded, leaving a total of 27 studies for analysis. RESULTS: Twenty-seven studies with 947 patients total were examined (eight studies on percutaneous approach; ten studies on endoscopic necrosectomy; two studies on laparoscopic necrosectomy via a transperitoneal approach; five studies on retroperitoneal necrosectomy; and two studies on a combined percutaneous-retroperitoneal approach). Success rate, complications, mortality, and number of procedures were outcomes that were included in the review. We found that most published reports were retrospective in nature, and thus, susceptible to selection and publication bias. Few reports examined these techniques in a comparative, prospective manner. CONCLUSION: Each minimally invasive approach though was found to be safe and feasible in multiple reports. With these new techniques, treatment of infected pancreatic necrosis remains a challenge. We advocate a multidisciplinary approach to this complex problem with treatment individualized to each patient.

A neighbor information based false data filtering scheme in wireless sensor networks

In sensor networks,the adversaries can inject false data reports from compromised nodes.Previous approaches to filter false reports,e.g.,SEF,only verify the correctness of the message authentication code (MACs) carried in each data report on intermediate nodes,thus cannot filter out fake reports that are forged in a collaborative manner by a group of compromised nodes,even if these compromised nodes distribute in different geographical areas.Furthermore,if the adversary obtains keys from enough (e.g.,more than t in SEF) distinct key partitions,it then can successfully forge a data report without being detected en-route.A neighbor information based false report filtering scheme (NFFS) in wireless sensor networks was presented.In NFFS,each node distributes its neighbor information to some other nodes after deployment.When a report is generated for an observed event,it must carry the IDs and the MACs from t detecting nodes.Each forwarding node checks not only the correctness of the MACs carried in the report,but also the legitimacy of the relative position of these detecting nodes.Analysis and simulation results demonstrate that NFFS can resist collaborative false data injection attacks efficiently,and thus can tolerate much more compromised nodes than existing schemes.

Effect of dietary fiber on constipation:A meta analysis

AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed for articles on dietary fiber intake and constipation using the terms:constipation,fiber,cellulose,plant extracts,cereals,bran,psyllium,or plantago.References of important articles were searched manually for relevant studies.Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency,stool consistency,treatment success,laxative use and gastrointestinal symptoms.The data were extracted independently by two researchers(Yang J and Wang HP) according to the described selection criteria.Review manager version 5 software was used for analysis and test.Weighted mean difference with 95%CI was used for quantitative data,odds ratio(OR)with 95%CI was used for dichotomous data.Both I2 statistic with a cut-off of ≥ 50% and the χ2 test with a P value < 0.10 were used to define a significant degree of heterogeneity.RESULTS:We searched 1322 potential relevant articles,19 of which were retrieved for further assessment,14 studies were excluded for various reasons,five studies were included in the analysis.Dietary fiber showed significant advantage over placebo in stool frequency(OR = 1.19;95%CI:0.58-1.80,P < 0.05).There was no significant difference in stool consistency,treatment success,laxative use and painful defecation between the two groups.Stool frequency were reported by five RCTs,all results showed either a trend or a significant difference in favor of the treatment group,number of stools per week increased in treatment group than in placebo group(OR = 1.19;95%CI:0.58-1.80,P < 0.05),with no significant heterogeneity among studies(I2= 0,P = 0.77).Four studies evaluated stool consistency,one of them presented outcome in terms of percentage of hard stool,which was different from others,so we included the other three studies for analysis.Two studies reported treatment success.There was significant heterogeneity between the studies(P < 0.1,I2 > 50%).Three studies reported laxative use,quantitative data was shown in one study,and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use(OR = 1.07;95%CI 0.51-2.25),and no heterogeneity was found(P = 0.84,I2= 0).Three studies evaluated painful defecation:one study presented both quantitative and dichotomous data,the other two studies reported quantitative and dichotomous data separately.We used dichotomous data for analysis.CONCLUSION:Dietary fiber intake can obviously increase stool frequency in patients with constipation.It does not obviously improve stool consistency,treatment success,laxative use and painful defecation.

Pancreatic schwannoma:Case report and an updated 30-year review of the literature yielding 47 cases

Pancreatic schwannomas are rare neoplasms. Authors briefly describe a 64-year-old female patient with cystic pancreatic schwannoma mimicking other cystic tumors and review the literature. Databases for PubMed were searched for English-language articles from 1980 to 2010 using a list of keywords, as well as references from review articles. Only 41 articles, including 47 cases, have been reported in the English literature. The mean age was 55.7 years （range 20-87 years）, with 45% of patients being male. Mean tumor size was 6.2 cm （range 1-20 cm）. Tumor location was the head （40%）, head and body （6%）, body （21%）, body and tail （15%）, tail （4%）, and uncinate process （13%）. Thirty-four percent of patients exhibited solid tumors and 60% of patients exhibited cystic tumors. Treatment included pancreati- coduodenectomy （32%）, distal pancreatectomy （21%）, enucleation （15%）, unresectable （4%）, refused opera- tion （2%） and the detail of resection was not specified in 26% of patients. No patients died of disease with a mean follow-up of 15.7 mo （range 3-65 too）, although 5 （11%） patients had a malignancy. The tumor size was significantly related to malignant tumor （13.8 ＋ 6.2 cm for malignancy vs 5.5 ＋ 4.4 cm for benign, P = 0.001） and cystic formation （7.9 ~ 5.9 cm for cystic tumor vs 3.9 ＋ 2.4 cm for solid tumor, P = 0.005）. The preoperative diagnosis of pancreatic schwannoma remains difficult. Cystic pancreatic schwannomas should be considered in the differential diagnosis of cystic neoplasms and pseudocysts. In our caset intraoperative frozen sec- tion confirmed the diagnosis of a schwannoma. Simple enudeation may be adequate, if this is possible.

县级监测站环境监测中信息技术的应用

随着计算机技术的迅猛发展,加强信息化建设已成为环境监测建设的一项重要工作内容,尽快用信息化、数字化的设施设备武装实验室,建设实验室计算机网络,改善和提高实验室硬件条件和软件水平,更好地为环境管理和客户服务.

Patient Perceptions and Effects of Single Community Pharmacy Systems： Key Elements for Transitions of Care

The primary objective of the study was to evaluate baseline patient perception on single versus multiple community pharmacy systems. The secondary objective was to determine effects of a pharmacist provided educational intervention on perception of using a single community pharmacy system. This was a prospective survey based study implemented in a single grocery store chain pharmacy and one location of a large retail pharmacy. An anonymous pre-survey was administered to eligible patients. The primary investigator then delivered a brief educational intervention followed by an anonymous post survey. This aimed to determine if there was a change in perception of components assessed in the pre-survey. Data analysis was performed using descriptive statistics. Subjects reported using approximately 1.5 pharmacies. Major reasons included cost, location, and immunizations. 63% of subjects answered that their pharmacist will not have an accurate medication list when using multiple pharmacies, however, 92% of subjects responded that the pharmacist should be aware of all medications they take. Education on multiple pharmacy use may help protect against its risks. Cognizance of medications filled at other pharmacies and close communication between patients and pharmacists may help foster pharmacist-patient relationships while reducing the risk of multiple pharmacy use.

Computer Management of Quantitative Analysis Chemistry Experiment

The application of computer in the quantitative analysis chemistry experiment is a chemistry experiment teaching applications software, developed by Visual Basic （6.0）, based on the content of quantitative analysis chemistry experiment of chemistry major in higher institute. This software has the function of the automatic processing the experimental data, the automatic generation of test report copies, and the automatic evaluation of students＇ experimental results, which solve the reliability, objectivity and accuracy problems of the students＇ experiment data processing and evaluation, and avoid interference with human factors. The software has the characteristic of the easy installation, the easy operation, the strong practicability, pertinence, the systematicness and the running stability, so it provides a platform in the quantitative analysis chemistry experiment for the students＇ assessment system of automatic processing, and it has a high popularization value. The project＇s technical route design is reasonable, the research method is correct, and the experimental data processing results are reliable, which has reached the leading domestic level in the quantitative analysis chemistry experiment teaching field of computer data processing. And this project has been through the achievements appraisal of Gansu Provincial Sci. ＆ Tech. Department.

New European Union＇s Requirements and IFRS Practice Statement ＂Management Commentary＂： Does MD＆A Disclosure Quality Affect Analysts＇ Forecasts？

The Management Discussion and Analysis （MD＆A） is a mandatory document under the European Union＇s （EU） law. In 2003, the EU issued Directive 2003/51/EC, which broadened the information that firms have to provide in their MD＆A, and in 2010 the International Accounting Standards Board （IASB） issued the International Financial Reporting Standards （IFRS） Practice Statement ＂Management Commentary＂, a non-binding guidance for the presentation of this document. The aim of this paper is to examine the relationship between MD＆A disclosure quality and properties of analysts＇ forecasts. In fact, although most studies found that financial analysts mainly refer to financial statement data in forecasting earnings, there are few researches highlighting the importance of MD＆A disclosures for financial analysts. On this basis, Ramnath, Rock, and Shane （2008） called for researches in order to better understand the relationship between the information really used by analysts and their forecasts. To assess the quality of MD＆A disclosures, we developed a multidimensional measure on the basis of the EU requirements and the IFRS Practice Statement, and then we regressed this variable on both forecast accuracy and dispersion. The findings show that our measure of MD＆A disclosure quality is significantly and positively related to forecast accuracy. We conducted other analyses in order to better understand the previous relationship and we found that, if we analyze the different information contained in the MD＆A statement, financial analysts consider useful accounting and financial data in forecasting earnings. These results enhance our understanding of the role of MD＆A disclosures in the wide set of information that firms provide to financial statement users.

The Impact of Switching Standard on Accounting Quality

In a developing country, modernization and change of the accounting regime are possible if the standards are in compliance with global ones. The change of accounting standards adopted by Turkey started to be implemented, and this created a number of qualitative and quantitative results. This study examines the impact of change of accounting standards on accounting quality. In order to determine how switching standard reflects accounting quality, first of all, the earnings management, timely loss recognition, and value relevance variables pertaining to accounting quality were listed and the findings were stated after subjecting the obtained data to statistical analyses. Accordingly, by the transition to International Financial Reporting Standards （IFRS）, the earnings management practices were observed to decrease as compared with the pre-IFRS period and the timely loss recognition and value-relevance values were observed to increase, which constitute the dimensions of accounting quality. It was also concluded that by the switch from domestic accounting standards to International Accounting Standards （IAS）, the quality of accounting in the country was improved and the market became more active than it was before.

Production response to price risk and market liberalization of Nigerian major agricultural crops

This study models supply response for major agricultural crops in Nigeria which include the standard arguments and price risk. The data comes from Central Bank of Nigeria annual reports and statement of account, National Bureau of Statistics＇ abstract of statistics and annual Agricultural survey manual. The data are analyzed using autoregressive distributed lag and cointegration and error correction models. The results indicate that producers are responsive not only to price but also to price risk and exchange rate.