[Dynamic Wavelength Characteristics of Semiconductor Laser in Electric Current Tuning Process].

In order to measure the dynamic wavelength of semiconductor lasers under current tuning, an improved method of fi- ber delay self-heterodyne interferometer was proposed. The measurement principle, as well the beat frequency and dynamic wavelength of recursive relations are theoretically analyzed. The application of the experimental system measured the dynamic wavelength characteristics of distributed feedback semiconductor laser and the static wavelength characteristics measurement by the spectrometer. The comparison between the two values indicates that both dynamic and static wavelength characteristic with the current tuning are the similar non-linear curve. In 20-100 mA current tuning range, the difference of them is less than 0.002 nm. At the same time, according to the absorption lines of CO2 gas, and HITRAN spectrum library, we can identify the dynamic wavelength of the laser. Comparing it with dynamic wavelength calculated by the beat signal, the difference is only 0.001 nm, which verifies the reliability of the experimental system to measure the dynamic wavelength.

[Retrospective clinical analysis of 118 cases with malignant glaucoma].

OBJECTIVE: To study the clinical characteristics and pathogenesis of malignant glaucoma in a 5-year retrospective analysis in Zhongshan Ophthalmic Center (ZOC). METHODS: Medical records of 5-year malignant glaucoma patients in Zhongshan Ophthalmic Center were reviewed retrospectively. Patients' age, gender, original disease, duration before attack, axial length and the change of depth of anterior chamber, intraocular pressure and visual acuity before and after therapy and at final follow-up were checked and analyzed. RESULTS: One hundred and eighteen cases of malignant glaucoma were hospitalized in ZOC from April 2005 to March 2010, accounts for 2.17% of PACG patients. Average age of malignant glaucoma patients was lower than that of PACG patients. The mean axial length of malignant glaucoma patients was shorter than that of Chinese population. Malignant glaucoma attacked between 1 day and 4.5 years after surgery. Ninety-three percent patients required medication and surgeries. Lens extraction and anterior vitrectomy were more effective than anterior chamber reforming combined with vitreous aspiration. The mean age of failed patient with vitreous cavity suction combined with anterior chamber angioplasty surgery was (43.7 ± 4.8) years, and was significantly younger than succeed patients, (53.7 ± 12.6) years (P < 0.05). CONCLUSIONS: Malignant glaucoma are iatrogenic and nine tenths secondary to surgeries of PACG patients. Topical application of atropine is the first choice of medication. Lens extraction combined with anterior vitrectomy has more privileges, however, is not commended especially for younger patients.

Higher maternal thyroid resistance indices were associated with increased neonatal thyroid-stimulating hormone- analyses based on the Huizhou mother-infant cohort.

Objectives: This study aimed to explore the relationship of maternal thyroid function and thyroid resistance parameters with neonatal thyroid-stimulating hormone (TSH). Methods: This work was a longitudinal study. Singleton pregnant women without a history of thyroid disorders were recruited in their first prenatal visit from October 2018 to June 2020. Maternal thyroid markers including TSH, free triiodothyronine (FT3), free thyroxine (FT4), and neonatal TSH were tested in the clinical laboratory of the hospital by electrochemiluminescence immunoassay. Thyroid resistance indices including Thyroid Feedback Quantile-based Index (TFQI), TSH index (TSHI), and thyrotroph T4 resistance index (TT4RI) were estimated in accordance with maternal FT4 and TSH levels. Multivariable linear and logistic regression was applied to explore the associations of maternal thyroid indices with infantile TSH level. Results: A total of 3,210 mothers and 2,991 newborns with valid TSH data were included for analysis. Multivariable linear regression indicated that maternal thyroid variables were significantly and positively associated with neonatal TSH levels with standardized coefficients of 0.085 for TSH, 0.102 for FT3, 0.100 for FT4, 0.076 for TSHI, 0.087 for TFQI, and 0.089 for TT4RI (all P < 0.001). Compared with the lowest quartile, the highest quartile of TSHI [odds ratio (OR) = 1.590, 95% CI: 0.928-2.724; Ptrend = 0.025], TFQI (OR = 1.746, 95% CI: 1.005-3.034; Ptrend = 0.016), and TT4RI (OR = 1.730, 95% CI: 1.021-2.934; Ptrend = 0.030) were significantly associated with an increased risk of elevated neonatal TSH (>5 mIU/L) in a dose-response manner. Conclusion: The longitudinal data demonstrated that maternal thyroid resistance indices and thyroid hormones in the first half of gestation were positively associated with neonatal TSH levels. The findings offered an additionally practical recommendation to improve the current screening algorithms for congenital hypothyroidism.

Clinical application of Myelopathy-hand Functional Evaluation System in evaluating the postoperative hand motor function for myelopathy patients.

OBJECTIVE: Recovery of hand motor function after surgical treatment in myelopathy patients is commonly observed. Accurate evaluation of postoperative hand function contributes to assessing the efficacy of surgical treatment. However, no objective and effective evaluation method has been widely accepted in clinical practice. Therefore, the study aimed to explore the value of Myelopathy-hand Functional Evaluation System (MFES) in assessing the postoperative hand function for myelopathy patients. MATERIAL AND METHOD: MFES mainly consist of a pair of wise-gloves and a computer with software. One hundred and thirty myelopathy patients were included and all of them received optimal surgery treatment. The Japanese Orthopaedic Association (JOA) scores were marked at preoperative and at 6 months after surgery. All patients were asked to perform the 10-s grip and release test, and the hand movements were simulated and converted into waveforms by MFES. The waveform parameters were measured and analyzed. RESULTS: The JOA scores and the number of grip-and-release (G-R) cycles significantly increased after surgery. Correspondingly, the waveforms of ulnar three fingers were significantly higher and narrower, along with the significantly declined average time per cycle in postoperative. The a/b ratio (Wave height/wave width) of five fingers were significantly higher in postoperative than that in preoperative. Based on the improvement rate of a/b, the excellent and good rate of surgical outcomes was 62.30 %, which was significantly higher than that (47.69 %) based on the improvement rate of JOA scores (P = 0.019). CONCLUSION: MFES is an effective assessment tool in evaluating the postoperative hand function for myelopathy patients.

Clinical Application of a New Assessment Tool for Myelopathy Hand Using Virtual Reality.

STUDY DESIGN: A cross-sectional study. OBJECTIVE: To assess the effectiveness of a new assessment tool, myelopathy-hand functional evaluation system (MFES), in evaluating the hand dysfunction of patients with cervical myelopathy in the 10-second grip-and-release test (10 second G-R test). SUMMARY OF BACKGROUND DATA: Clumsy fingers movement is a common symptom of myelopathy patients. Evaluating the impaired hand function can provide a strong basis in assessing the severity of myelopathy. Currently, no objective and effective evaluation method is widely accepted in clinical practice. METHODS: MFES mainly consists of a pair of wise-gloves and a computer with software. One hundred and ninety-eight consecutive participants were asked to wear the wise-gloves and then perform 10 seconds G-R test. The movements of each finger were recorded by MFES and converted into waveforms. Relevant waveform parameters were measured and analyzed. The Japanese Orthopedics Association (JOA) scores of each patient were marked and the maximum spinal cord compression (MSCC) was measured on midsagittal T2-weighted magnetic resonance imaging (MRI). RESULTS: Myelopathy patients had a lower number of G-R cycles and a longer time per cycle than healthy subjects. There were significant differences in adduction and abduction time in patients with JOA scores greater than 6, but not in healthy subjects and patients with JOA scores less than 6. The waveforms of ulnar three fingers in myelopathy patients were lower and wider than those in healthy individuals. The average ratio value of wave height to wave width (a/b) could quantitatively reflect such differences of waveforms. According to receiver operating characteristic (ROC) curve analysis, the optimal threshold value of the normal average ratio was more than 1.92. The average a/b value was correlated with the JOA scores of the motor function in the upper extremities (r = 0.842). CONCLUSION: MFES appears to be an objective and quantitative assessment tool for patients with cervical myelopathy. LEVEL OF EVIDENCE: 3.

[Efficacy, safety and tolerance of Felodipine controlled release tablets and Felodipine controlled release tablets associated combination therapy in the treatment of mild to moderate essential hypertension in China].

OBJECTIVE: To evaluate the efficacy, safety and tolerance of Felodipine controlled release tablets and Felodipine controlled release tablets associated combination each with Metoprolol, Lisinopril or Hydrochlorothiazide in the 12 weeks treatment of mild to moderate essential hypertension in China. METHODS: Multicenter, random samples, and open study have been processed. RESULTS: (1)After 12 weeks associated combination treatment of anti-hypertension, the percentages of the persons who had attained the target were 80.2% of ITT group in Felodipine controlled release tablets associated combination with Hydrochlorothiazide, 74.1% of ITT group in with Metoprolol,and 80.5% of ITT group in with Lisinopril, respectively. (2)Mean reductions of systolic/diastolic blood pressure from baseline were 16.8/10.6 mm Hg in combination with Hydrochlorothiazide, 16.6/10.7 mm Hg in combination with Metoprolol,and 18.0/12.8 mm Hg in combination with Lisinopril each. There was no significant difference among these three groups (P>0.05). With the Felodipine controlled release tablets treatment alone, the mean reductions from baseline was 24.8/17.5 mm Hg. But in combination with Lisinopril, the blood pressure could lower more quickly, and then could reach the target more rapidly. (3)In the ITT group, the drug compliance with Felodipine controlled release tablets was 97.7%, with those in combination with Hydrochlorothiazide 89.8%, with those in combination with Metoprolol 100.0%, and with those in combination with Lisinopril 96.4%. The main adverse event related to Felodipine was headache, and to Lisinopril was cough. CONCLUSION: Antihypertensive drug Felodipine controlled release tablets are good and effective. And Felodipine controlled release tablet associated combination each with Metoprolol, Lisinopril or Hydrochlorothiazide can make most patients reach the treatment target, with safety, good tolerance, and high compliance.

Study on insulin resistance and genetic polymorphisms in essential hypertension patients of two different kinds of TCM constitution.

OBJECTIVE: To investigate the relationship of insulin resistance and the polymorphisms of insulin receptor-related genes in essential hypertension patients of two different kinds of TCM constitution. METHODS: Oral glucose tolerance test (OGTT) and insulin release test (InRT) were conducted in 217 essential hypertensive patients of either sluggish meticulous (SM) constitution (139 cases) or prosperous impetuous (PI) constitution (78 cases), and the polymorphism of three genes, including insulin-like growth factor-1 receptor (IGF-1R), insulin receptor substrate-1 (IRS-1) and 2 (IRS-2) genes were detected. RESULTS: (1) OGTT, InRT and insulin resistance index (Homa-IR) were higher and insulin sensitive index (ISI) was lower in the patients of SM constitution than those in patients of PI constitution. (2) Significant difference of ISI and Homa-IR was shown in patients of both constitutions with genotype G of the 3 genes. CONCLUSION: Decrease of insulin sensitivity and increase of insulin resistance are more obvious in hypertensive patients with genotype G of the 3 genes of SM constitution than in those of PI constitution. Therefore, the difference in constitution might be one of the genetic characteristics for insulin resistance in hypertensive patients.

[Modified viscocanalostomy for the surgical treatment with primary open angle glaucoma].

OBJECTIVE: To compare the clinical outcome of trabeculectomy with viscocanalostomy in patients with primary open angle glaucoma (POAG). METHODS: 100 patients (100 eyes) with uncontrolled POAG were randomly assigned to either trabeculectomy group (50 eyes) or viscocanalostomy (VCO) group (50 eyes) and followed up for average 28 months. Intraocular pressure (IOP) was measured with a non-contact Topcon CT80 tonometer. RESULTS: At 1 month after operation, IOP was (11.22 +/- 4.34) and (12.35 +/- 3.79) mmHg (1 mmHg = 0.133 kPa, n = 50) in the eyes undergoing VCO or trabeculectomy surgery, respectively. The complete success rate (IOP < 21 mmHg without antiglaucoma medications) was 98.0% in both groups. There was no significant difference in IOP and complete success rate between both groups. At 12 months, IOP in VCO group was significantly (P < 0.05) lower (14.50 +/- 3.22) than that in trabeculectomy group (16.58 +/- 4.73) mmHg, while the complete success rate in VCO group (87.5%) was significantly higher (P < 0.05) than that in trabeculectomy group (70.0%). The early transient complications such as shallow anterior chamber and encysted blebs were significantly (P < 0.01) more common in trabeculectomy group than in VCO group. CONCLUSIONS: VCO appears to have long term advantages over trabeculectomy in terms of complete success rate, IOP control, and less early transient postoperative complications in POAG.

[Clinical factors relating to the arterial elastic function measured by PWV, C1/C2 and AI in hypertensive patients].

OBJECTIVE: To analyze the clinical factors relating to arterial elastic function measured with pulse wave velocity (PWV), large and small arterial elastic indexes (C(1) and C(2)) and augmentation index (AI) in hypertensive patients. METHODS: A total of 2176 hypertensive patients were enrolled and divided into three groups: Elastic function was measured in 1100 subjects by (PWV), in 647 subjects by C(1) and C(2) and in 429 by AI. RESULTS: PWV was positively correlated with age, systolic pressure, pulse pressure and negatively correlated with body height and weights (all P < 0.05). C(1) and C(2) values were higher in male than that in female patients (P < 0.01) and negatively correlated with age, systolic pressure, pulse pressure and heart rate while positively correlated with body height, weight and body mass index. In hypercholesterolemia patients (n = 168), C(1) and C(2) were negatively correlated with serum cholesterol level (P < 0.05). AI value was higher in female than that in male patients (P < 0.01) and positively correlated with age, systolic pressure, diastolic pressure, pulse pressure while negatively correlated with body height, weight and heart rate. CONCLUSION: Age, systolic and pulse pressure as well as body height and weights are the main factors correlated to arterial elastic function measured by PWV, C(1) and C(2) and AI.

Genetic instability of BRCA1 gene at locus D17S855 is related to clinicopathological behaviors of gastric cancer from Chinese population.

AIM: To investigate genetic instability of gene BRCA1 at locus D17S855, and their relationship with clinicopathological characteristics of gastric cancer in Chinese population. METHODS: Microsatellite instability (MSI) and loss of heterozygosity (LOH) of gene BRCA1 at locus D17S855 were compared between 37 samples of gastric cancer and corresponding non-cancerous gastric tissue. RESULTS: MSI at locus D17S855 was positive in 7 of 37 samples of gastric cancer (18.95%). MSI had a close relationship with TNM staging but no relation with lymph node metastasis, histological type or tumor differentiation. MSI positive frequency in TNM I + II (31.58%, 6/19) was much higher than that in TNM III + IV (5.56%, 1/18), (P < 0.05). LOH positive rate was 18.92% (7/37). LOH had no relationship to histological type, tumor differentiation or lymph node metastasis, but LOH positive rate in TNM III + IV was 33.33% (6/18), much higher than that in TNM I + II ( 5.26%, 1/19), (P < 0.05). BRCA1 protein was expressed in 14 of 37 samples of gastric cancer. The positive rates of BRCA1 protein in TNM I + II and TNM III + IV were 57.89% and 16.67%, respectively, (P < 0.05). The positive rate of BRCA1 protein was 77.78% in high differentiation samples, 30.77% in middle differentiation and 12.50% in lower differentiation samples, (P < 0.05). CONCLUSION: MSI of BRCA1 gene could be used as a molecular marker in early phases of sporadic gastric cancer in Chinese population. LOH occurs at later period of gastric cancer, therefore, it could be used as prognostic factor.

Hypertriglyceridemic acute pancreatitis in a patient with Sheehan's syndrome.

BACKGROUND: There is no report on case of severe acute hyperlipidemic pancreatitis after treatment of Sheehan's syndrome. METHODS: A 32-year-old female patient was diagnosed as having acute hyperlipidemic pancreatitis after treatment of Sheehan's syndrome, and treated with diet and lipid-lowering agents in early stage. RESULTS: Abdominal pain and fever of the patient resolved within a few days. She was subjected to diet and oral lipid-lowering therapy on the 4th day after admission. The disease did not recur during the follow-up for more than one year. CONCLUSIONS: Estrogen replacement therapy should be prescribed for Sheehan's syndrome. The serum level of triglyceride should be monitored and treatment should be given to prevent severe acute pancreatitis. Lipid-lowering therapy in early stage is the key step towards a complete recovery.

[Relationship between the polymorphism of alpha-adducin gene and the two phenotypes of constitutions in patients with essential hypertension classified by TCM].

OBJECTIVE: To investigate the relationship between the polymorphism of alpha-adducin (ADD1) gene and the two phenotypes of constitution in patients with essential hypertension, the Yang-hyperactive (YH) type and phlegm-dampness (PD) type, classified by traditional Chinese medicine (TCM) approach. METHODS: Two hundred and seven patients differentiated by TCM approach as YH type (113 cases) or PD type (94 cases) were observed, with the systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting blood glucose (FBG), serum creatinine (Cr), uric acid (UA), total cholesterol (TC) and triglycerides (TG) as the criteria of observation. Gly460Trp polymorphism of the ADD1 gene was detected by MALDI-TOF mass spectrometry. Results The levels of BMI, DBP, FBG and UA, etc. in the PD group were significantly higher than those in the YH group respectively. The rate of GG, GT and TT type of ADD1 gene was 29.2%, 41.6% and 29.2% in the YH group, 28.7%, 48.9% and 22.3% in the PD group, showing no significant difference in ADD1 genotype distribution between the two groups, while there was also no difference in the hypertension phenotype distribution among different genotypes (both P > 0.05). For the patients with TT genotype, there were significant differences between the YH group and the PD group in BMI (24.11 +/- 3.04 kg/m2 vs 26.20 +/- 2.30 kg/m2), DBP (96.79 +/- 4.05 mmHg vs 99.56 +/- 3.90 mmHg), FBG (5.01 +/- 0.53 mmol/L vs 5.51 +/- 1.07 mmol/L) and UA level (302.22 +/- 71.95 micromol/L vs 358.25 +/- 88.75 micromol/L, all P < 0.05). CONCLUSION: There was no relation between ADD1 gene polymorphism and the TCM genotype of constitution in patients with essential hypertension. However, it is likely that for hypertension patients with TT genotype, those of PD type are more susceptible to cardiovascular disease and have worse prognosis than those of YH type.

The comparison of clinical and biological characteristics between IDH1 and IDH2 mutations in gliomas.

BACKGROUND: Mutations in isocitrate dehydrogenase 1 (IDH1) and isocitrate dehydrogenase 2 (IDH2) are frequent in low-grade gliomas and secondary glioblastomas (sGBM). Because they yield the same oncometabolite, D-2-hydroxyglutarate, they are often treated as equivalent and pooled. The objective of this study was to provide insight into the differences between IDH1 and IDH2 mutant gliomas. METHODS: To investigate the different clinical and molecular characterization between IDH1 mutant and IDH2 mutant gliomas, we studied 811 patients with IDH1 mutations, IDH2 mutations and IDH1/2 wild-type. In addition, whole-transcriptome sequencing and DNA methylation data were used to assess the distribution of genetic changes in IDH1 and IDH2 mutant gliomas in a Chinese population-based cohort. RESULTS: Among 811 gliomas in our cohort, 448 cases (55.2%) harbored an IDH1 mutation, 18 cases (2.2%) harbored an IDH2 mutation and 345 cases (42.6%) harbored an IDH1/2 wild-type. We found that IDH1 and IDH2 are mutually exclusive in gliomas, and IDH2 mutations are mutually exclusive with PTEN, P53 and ATRX mutations. Patients with IDH2 mutations had a higher frequency of 1p/19q co-deletion (p < 0.05) than IDH1 mutant patients. In addition, a Gene Set Enrichment Analysis (GSEA) showed that IDH2 mutant gliomas were associated with the oxidative phosphorylation gene set, and the four most representative biological processes for genes commonly altered by hypermethylation in IDH2 mutant gliomas were the regulation of cell proliferation, cell motion, cell migration and response to hypoxia. Patients with IDH2 mutant gliomas exhibited longer Overall survival (OS) (p < 0.05) and longer Progression-free survival (PFS) (p < 0.05) than patients with IDH1/2 wild-type gliomas. However, their OS and PFS did not differ from that of IDH1 mutant patients. CONCLUSIONS: Our study revealed an intrinsic distinction between IDH1 and IDH2 mutant gliomas, and these mutations should be considered separately because their differences could have implications for the diagnosis and treatment of IDH1/2 mutant gliomas.

Color Doppler ultrasonographic examination on the relationship between the gallbladder bed and major branch of the middle hepatic vein.

BACKGROUND: There is a controversy about the risk of injury to the branch of the middle hepatic vein during laparoscopic cholecystectomy. This study was conducted to further investigate the relationship between the gallbladder bed and the branch of the middle hepatic vein. METHODS: Color Doppler ultrasound was used to examine the anatomical relationship between the gallbladder bed and the branches of the middle hepatic vein in 143 healthy volunteers. RESULTS: Not all the middle hepatic vein extended close to the gallbladder bed, the branches and gallbladder beds in 23 subjects were not in the same plane during ultrasound scanning. In 21 of the 143 subjects the branch of the middle hepatic vein was completely adherent to the gallbladder bed with a diameter ranging from 1.2 mm to 3.6 mm. In 10 subjects the branches of the middle hepatic vein traversed approximately 1.0 mm from the gallbladder bed with a diameter ranging from 1.6 mm to 3.0 mm. CONCLUSIONS: In most subjects the branch of the middle hepatic vein and the gallbladder bed are well separated. Only patients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy.

Family-based associations between the angiotensin- converting enzyme insertion/deletion polymorphism and multiple cardiovascular risk factors in Chinese.

OBJECTIVE: We investigated, in a sample of Chinese families, the associations of body mass index (BMI), blood pressure (BP), serum lipids, fasting plasma glucose, serum creatinine and uric acid with the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene. METHODS: We genotyped 902 subjects from 186 nuclear families recruited in Shanghai, China, via a specialized hypertension clinic. We performed family-based association analyses for continuous and dichotomous phenotypic measurements using the quantitative and sib- transmission/disequilibrium tests (QTDT and Sib-TDT), respectively. RESULTS: The study sample included 121 parents and 781 offspring from 25 two-parent families, 71 one-parent families, and 90 families without parental information. The median number of offspring was four (range from 2 to 10). Of the 654 (85.4%) hypertensive offspring, 458 took antihypertensive drugs. The 354 male offspring were slightly younger than the 427 female siblings (48.1 versus 49.2 years, P = 0.03), but they had similar BMI (25.1 kg/m). In 482 informative offspring, QTDT analyses demonstrated a significant association between BMI and the transmission of the ACE D allele (regression coefficient 0.563, chi 2 = 4.02, P = 0.04). In 106 families with at least one hypertensive offspring and at least one normotensive sibling, Sib-TDT analyses showed that the ACE D allele was slightly over-transmitted from heterozygous parents to hypertensive offspring (P = 0.08). CONCLUSIONS: Our family-based study suggests that in Chinese, the ACE I/D polymorphism might play a role in the development of obesity and hypertension, which are closely linked cardiovascular risk factors.

Early diagnosis and treatment of severe acute cholangitis.

AIM: To investigate the diagnostic standard for early identification of severe acute cholangitis in order to lower the incidence of morbidity and mortality rate. METHODS: A diagnostic standard was proposed in this study as follows:documented biliary duct obstruction by ultrasound or computerized tomography or other imaging tools with the manifestation of systemic inflammatory response syndrome (SIRS). The surgical procedures included emergency common bile duct exploration with T tube insertion or cholecystostomy with secondary common bile duct exploration. And incidence of postoperative multiple organ dysfunction syndrome (MODS), duration of systemic inflammatory response and hospital mortality were analyzed. RESULTS: Fourty-three patients conforming to the diagnostic standard described above were employed in this study. 1 patient was admitted in acutely ill condition and complicated with acute relapse of chronic bronchitis, cholecystostomy procedure was performed but the patient was complicated with postoperative acute lung injury which was treated by assisted mechanical ventilation for 5 d; 2 wk later, two-stage common bile duct Exploration and T tube insertion were performed. The remaining 42 patients underwent primary common bile duct exploration and T tube insertion, 1 developed acute lung injury and recovered 3 d later, 2 patients developed acute renal dysfunction, 1 of which recovered 2 d later and the other died on d 4. For all patients, the postoperative systemic inflammatory response persisted for 2 to 8 d with median of 3 d. CONCLUSION: Early diagnosis of severe acute cholangitis can be made using this diagnostic standard, further development of systemic inflammatory response could be prevented and incidence of MODS as well as hospital mortality decreased.

Early definitive surgery in the management of severe acute pancreatitis.

OBJECTIVE: To assess the role of early peritoneal lavage and drainage in the management of severe acute pancreatitis. DATA SOURCES: Early peritoneal lavage and drainage was defined as that lavage and drainage should be done in the peritoneal cavity without interference of the pancreas within 72 hours after onset of acute pancreatitis. Biomedical literature database (Medline) from 1981 through 2003 was retrieved and papers about this treatment were analyzed. RESULTS: Nine papers retrieved included 179 patients with severe acute pancreatitis. In 108 patients undergoing closed peritoneal lavage and drainage, 7 died, in 15 patients having laparoscopic procedure, 1 died, and in 56 patients having open procedure 2 died. The total survival rate was 94.4%. CONCLUSIONS: Even if extensive pancreatic necrosis occurs, early peritoneal lavage and drainage is feasible to keep the inflammatory pancreas intact and drain peri-pancreatic region in an attempt to improve the survival rate.