Objective To evaluate the effects of treating severe acute pancreatitis (SAP) with XueBiJing injection and conventional therapy of western medicine.Methods This study was a randomized controlled study. 104 patients meet the inclusion criteria of SAP were randomly divided into a routine treatment group (52 cases) and aXuebijing treatment group (52 cases). Patients of both groups received immediate rescue together with performing ECG monitoring, fasting food, inhaling oxygen. On such basis, the conventional treatment group was treated with inhibiting enzyme activity and resisting infection; WhileXuebijing treatment group was treated withXuebijing injection on the basis of the conventional treatment group. After 7 days treatment, the therapeutic effect, WBC, CRP, blood and urinary amylase, TNF-α, LPS, and IL-6 were observed in both groups.Results The total effective rates in the treatment group and the control group were 92.31%(48/52)and 73.08%(38/52), respectively, with statistical difference(χ2=5.442,P=0.020). After the treatment, WBC (9.2 ×109/L ± 2.1 ×109/Lvs.12.2 ×109/L ± 3.1 ×109/L;t=5.778,P=0.000), amylase blood serum (305.4 ± 100.9 U/Lvs. 403.5 ± 197.8 U/L;t=3.186,P=0.002) and urine (702.3 ± 98.5 U/Lvs.1 102.4 ± 202.6 U/L;t=12.807,P=0.000), TNF-α (21.2 ± 9.1 ng/mlvs.27.5 ± 13.4 ng/ml;t=2.805,P=0.006), CPR (7.6 ±3.8 mg/Lvs.15.2 ± 9.8 mg/L;t=5.214,P=0.000), LPS (146.3 ± 52.1 EU/Lvs.281.2 ± 91.7 EU/L;t=9.224, P=0.000), and IL-6 (143.4 ± 52.4 ng/mlvs. 203.7 ± 79.8 ng/ml;t=4.555,P=0.000) in the treatment group were significantly reduced than those in the control group. The times to remission of abdominal distension (5.3 ± 1.3 d vs.6.1 ± 2.5 d;t=2.047,P=0.043) and abdominal paln (4.9 ± 2.3 dvs.6.0 ± 3.1 d;t=2.055,P=0.042), return to normal body temperature (4.3 ± 1.8 dvs.5.5 ± 2.1 d;t=3.129,P=0.002) in the treatment group were all significantly decreased than those in the control group.ConclusionXueBiJinginjection adjuvant to conventional therapy can effectively improve reduction of amylase in blood serum and urine, and symptoms remission,and also shorten treatment time in patients with SAP.

Objective To investigate the effect of early enteral nutrition combined with synbiotics agents on normal intestinal flora,fecal SIgA and infectious complications in patients with hypertensive intracerebral hemorrhage.Methods Fifty-three patients with hypertensive intracerebral hemorrhage were randomly divided into early enteral nutrition group (control group,n =26) and early enteral nutrition combined with synbiotics group (study group,n =27).The patients in control group started receiving enteral nutrition (RuiSu) within 24 to 48 hours after injury ; Patients in study group received a enteral nutritional support which as well as control group,but added synbiotics (Golden Bifid) in the first 14 days of enteral nutritional support.Stool specimens were Collected on day 0,day 4,day 8,day 15 of enteral nutrition support for quantitative analysis of normal intestinal flora and detection of stool SIgA through enzyme-linked immunosorbent assay.The difference of two groups in infectious complications were observed.Results On nutritional support day 8 and day 15,escherichia coli (P =0.004,P =0.004) and enterococci (P =0.032,P =0.048) expression were lower in study group than the control group,bifidobacteria (P =0.046,P =0.024) expression were higher in study group than the control group.During the study period lactobacillus,bacteroides and clostridium were no statistically significant between the two groups (P ＞ 0.05).Fecal SIgA expression in study group was higher than control group (P =0.035) on nutritional support dayl5.The incidence of infectious complications in study group was lower than the control group (33.33％ vs.46.15％),but there was no significant difference (P =0.230).Conclusion compared with ordinary enteral nutrition,enteral nutrition combined with synbiotics agents can be effective in improving intestinal flora imbalance and increase intestinal immune function in patients with hypertensive intracerebral hemorrhage.

AIM:To study the effect of dexamethasone(Dex)on the expression of aquaporin-1(AQP-1)in cultured rat pleural mesothelial cells and to offer experimental support for the investigation of the mechanisms of pleural fluid treatment.METHODS:Rat pleural mesothelial cells were cultured in vitro.The expression of AQP-1 was detected by immunocytochemistry and reverse transcription-PCR(RT-PCR)after cells were identified,then the cells were treated with Dex for 24 hours at concentrations of 10-8,10-7,10-6,10-5 and 10-4mmol/L,and for 6 h,12 h,24 h,36 h,48 h,72 h at concentration of 10-4 mmol/L.Western blotting was used to analyze the expression of AQP-1 in cultured control and Dex-treated rat pleural mesothelial cells,and image analysis system to analyze the expression of AQP-1.RESULTS:Aquaporin-1 was expressed in cultured rat pleural mesothelial cells.The protein of AQP-1 expressed in rat pleural mesothelial cells was 755.04?19.81,843.72?19.41,862.96?26.53,694.80?32.00,938.08?13.32 in those treated with Dex at concentrations of 10-8,10-7,10-6,10-5 and 10-4 mmol/L,respectively,the levels was 2.02,2.26,2.31,1.86,2.52 fold higher than that in control group(372.90?16.46,P

Objective To evaluate the clinical effect and safety of retroperitoneal laparoscopic partial nephrectomy in treatment of patients with T1b renal carcinoma.Methods Fourteen patients (11 males and 3 females) with T1b renal carcinoma were retrospectively performed.The age of patients was (54.5 ± 9.2)years old,with 8 cases on the left side and 6 cases on the right side.Tumor diameter was (5.1±1.3) cm.All the patients received retroperitoneal laparoscopic partial nephrectomy.Results None of the 14 cases was converted to open surgery.The operation time was (112.0 ± 24.7) min,the intraoperative blood loss was (64.6 ± 15.9) ml,the warm ischemia time was (26.5 ± 9.3) min.The 14 patients were not blood transfusion in intraoperative and postoperative.Postoperative negative pressure drainage placement time was (3.1 ± 1.5)d,lying in bed time was 72 h.Serum creatinine increase was found in 1 case postoperative 12 h,others were no severe complications.Postoperative pathology:the incisal margin of 14 cases were all negative,clear cell carcinoma was in 13 cases,the pathology stage was T1bNoM0;angiomyolipoma of kidney was in 1 case.All the patients were follow-up 3-16 (21.4 ± 9.6) months,all the patients had normal renal function and had no tumor recurrence or metastasis.Conclusion Retroperitoneal laparoscopic partial nephrectomy is safe and reliable for treatment of patients with T1b renal carcinoma.

Objective:To evaluate the effect of early enteral nutrition supplemented with synbiotics on the levels of C reactive protein (CRP) and Procalcitonin(PCT)level of patients with severe brain injury.The clinical outcomes were also observed.Methods:Forty-seven patients with identified severe brain injury were randomized into study group (n =24) and control group (n =23).All patients received enteral nutrition via nasogastric tube within 24 to 48 h following admission.Patients in the study group were also given synbiotics.Fasting blood samples were collected for detecting the levels of CRP,PCT on day 1,4,7 and 15,respectively.The incidence of lung infection,the length of ICU stay,the cost,the GCS score,the APACHE Ⅱ score,and the mortality in 30 days after administration were collected and compared between 2 groups.Results:Patients in the study group had a lower level of PCT than control group on day 7 and 15 (P ＜0.05,P ＜0.05),and a lower level of CRP on day 15 (P ＜0.01)was also found in the study group.The incidence of lung infection of the study group was also significantly lower than the control group (P ＜ 0.05).A reduced length of hospital stay and a lower cost were found in the study group (P ＜0.05).The GCS scores in the study group was higher on day 15 when compared with that in the control group (P ＜ 0.05).However,There was no significant change in APACHE Ⅱ score and mortality in 30 days(P ＞ 0.05).Conclusion:Nutrition supplemented with synbiotics leads to a lower rate of infection,a shorter length of ICU stay,a reduced the cost,and a better outcome in patients with severe brain injury.

Objective To assess the accuracy of histological type and molecular subtype observed in preoperative 11-gauge vacuum-assisted core needle biopsy(VACNB) specimens in breast cancer.Methods Patients diagnosed by preoperative 1 l-gauge VACNB and received subsequent open excisional biopsy (OEB) from Mar 1 st 2014 to Mar 31 st 2015 were included.Kappa testing was used to test the concordance rate of histological type,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor 2(Her-2),Ki-67 and molecular subgroups between VACNB and paired OEB specimens.ER,PgR,Her-2,and Ki-67 were determined by immunohistochemistry (IHC).Patients with Her-2 IHC (+ +) were further examined by FISH.Molecular subtypes were classified as follows:LuminalA,LuminalB,Triple Negative,and Her-2 positive.Results There were 36 patients analyzed(32 of them had invasive breast cancer).Between VACNB and paired OEB specimens,concordance rate of histological type,ER,PR,Her-2,Ki-67 and molecular group were 94.4％ (κ =0.934),96.9％ (κ =0.904),87.5％ (κ =0.710),100％ (κ =1.000),84.4％ (κ =0.570),78.1％ (κ =0.621).No significant difference was detected in the expression of ER,PR and Ki-67 between VACNB and OEB specimens according to paired t-test results.Concordance rate of each molecular subtype between VACNB and OEB specimens were 100％ for Her-2 positive subtype,94.1％ for LuminalB subtype,50％ for LuminalA,and 33.3％ for TNBC.When the threshold for ER/PR positivity was upgraded from ≥1％ to ≥10％ and Ki-67 cutoff value to≥20％,the concordance rate for ER,PR,Ki-67 and molecular subtype reached to 100％,93.8％,87.5％,81.3％.Conclusions 11 G vacuum-assisted core needle biopsy was accurate in determining histological type and molecular subtype in breast cancer.

Objective To investigate the effect of the artificial cycle on the prognosis after transcervical resection of adhesion (TCRA) and its mechanism .Methods 80 patients with intrauterine adhesion were randomly divided into the observation group and the control group .The observation group were performed TRCA and postoperative artificial cycle for successive 3 months :oral es-tradiol valerate(9 mg once daily) for 21 d ,adding oral medroxyprofgesterone acetate(10 mg once dialy) on 15 d ,then the medication discontinuation for 7 d ,which was taken as 1 cycle;the control group received only TCRA .The re-examination was performed after 3 months .The levels of follicle stimulating hormone(FSH) ,luteinizing hormone(LH) ,estradiol(E2 ) ,prolactin(PRL) ,progesterone (P) and testosterone(T) were examined by ELISA after TCRA three months .The expression of MMP-9 and TGF-β1 in adhesive endometrium were detected by real-time PCR and Western blot .Results Compared with the control group ,the artificial cycle thera-py combined with the operation could significantly increase the effective rate of TCRA for treating mild and moderate intrauterine adhesion(P<0 .05);the seum levels of FSH ,LH ,E2 ,PRL ,P and T had no statistical differences between the observation group and the control group(P>0 .05);the artificial cycle significantly improved the adhesive degree of intrauterine adhesion ,increased the MMP-9 expression and decreased the TGF-β1 expression .Conclusion Artificial cycle could improve the degree of uterine cavity ad-hesion after TCRA ,which the mechanism might be related to the increase of MMP-9 expression and decrease of TGF-β1 expres-sion .

This study was aimed to establish a rapid detection method for timosaponin BⅡ in Anemarrhenae Rhizoma in order to determine its concentration quickly,conveniently and efficiently.The concentration of timosaponin BⅡ in A.Rhizomadetected by HPLC in the Chinese Pharmacopeia was used as the actual measured value.The near-infrared spectroscopy (NIRS) was used to collect the spectrogram of A.Rhizomasamples.The partial least squares (PLS) of TQ Analyst 8.0 were used in the data analysis.Through the pretreatment,wavelength range and principal component number selection,the actual measured value and NIRS information were associated for the establishment of the optimal quantitative analysis model of timosaponin BⅡ.The results showed that the correlation coefficients (R2),root-mean-square error of calibration (RMSEC),root-mean-square error of prediction (RMSEP),root-mean-square error of cross-validation (RMSECV) and the performance index (PI) of the established model were 0.975 15,0.094 2,0.080 0,0.369 20,and 91.0,respectively.It was concluded that the established quantitative analysis model by NIRS with HPLC was able to determine the concentration of timosaponin BⅡ in A.Rhizomaquickly and accurately.

Objective: To understand the awareness of palliative care and its influencing factors in community residents in Hangzhou,so as to provide basis for the development of palliative care service. Methods: By convenient sampling method,the residents in the urban-rural junction of Xihu District were recruited. A self-designed questionnaire was used to investigate their awareness of palliative care. The logistic regression model was employed to analyze the influencing factors. Results : A total of 519 questionnaires were recovered,with a response rate of 97.92%. There were 227 males and 292 females,accounting for 43.74% and 56.26%,respectively. There were 43,218 and 258 residents with more,basic and little understanding about palliative care, accounting for 8.29%,42.00% and 49.71%. The residents learned about palliative care mainly through television and radio,with 245 cases accounting for 47.21%;and they thought that the main reason for low awareness of palliative care was a lack of related knowledge,with 396 cases accounting for 76.30%. The results of multivariate logistic regression analysis showed that 50-59 years old（OR = 0.467,95% CI：0.285-0.767）,primary school education and below（OR = 2.248,95%CI：1.239-4.079）and experience of caring for dying patients（OR = 1.551,95% CI：1.094-2.199）were the influencing factors for the awareness of palliative care. Conclusion The residents in Hangzhou had relatively low awareness of palliative care,which were associated with age,education level and experience of caring for dying patients.