Objective To evaluate the value of the combination detection of serum amylase (AMY) and lipase(LPS) in the diag‐nose of acute pancreatitis .Methods Serum AMY and LPS were detected in 51 patients with acute pancreatitis ,418 patients with a‐cute abdomen disease and 78 healthy control subjects .Results The sensitivity of serum AMY and LPS increase in 51 patients with acute pancreatitis was 86 .3 % and 92 .2 % respectively .The specificity of serum AMY and LPS increase ,and both AMY and LAS increase in 418 non‐pancreatitis patients with acute abdomen disease was 90 .4% ,91 .7% and 100% respectively .Conclusion The combination detection of serum AMY and LPS can increase the sensitivity and specificity for diagnosing acute pancreatitis and has an important significance for rapid diagnosis of acute pancreatitis .

Objective To investigate the clinical significance of early lactate clearance rate in respect of the prognosis of patients with severe chronic obstructive pulmonary disease (COPD) . Methods A total of 108 COPD patients with respiratory failure were studied prospectively. The patients were divided into survival group ( n = 82) and the death group ( n = 26) , and the survival group further divided into the conventional treatment subgroup ( n = 55 ) and the invasive ventilation subgroup ( n = 27 ) . Arterial blood lactate, arterial gas analysis, APACHE Ⅱ score and the 6-hour clearance rate were measured before and 6 hours after treatment in 3 groups. The high lactate clearance rate group (n =71 ) was defined as a lactate clearance rate ＞ 10% , and the low lactate clearance rate group (n = 37) with a lactate clearance rate ＜ 10%. The correlation between 6-hour lactate clearance rate and prognosis in patients was analyzed. Results Compared the survival patients in invasive ventilation group with the death group, there were no statistical differences in arterial blood lactate, pH value, PaCO2, PaO2, oxygenation index and APACHE Ⅱ score before the treatment. The 6-hour lactate clearance rate in survival patients in conventional treatment group or invasive ventilation group was significantly higher than that in the death group (t =31.2, P＜0. 01; t =34.6, P＜0. 01, respectively), while there were no statistical differences in APACHE Ⅱ score and pH value between these 3 groups. Between the conventional ventilation treatment group and the invasive ventilation treatment group, there was no statistical difference in 6-hour lactate clearance rate ( P ＞ 0. 05 ) . There was no statistical difference in APACHE Ⅱ score between before treatment and after treatment in 3 groups. Mortality in high lactate clearance rate group (4. 2% ) was significantly lower than that in low lactate clearance rate group (62. 2% ) (x2 = 121.9, P ＜ 0. 01 ) .Conclusions The early (6h) lactate clearance rate could be used as a marker for evaluating the severity,therapeutic efficacy and prognosis of patients with severe COPD.

Objective To study the T/P rate and smoothness index of Candesartan Cliexetil on slight and middle essential hypertension. Methods 50 patients with slight and middle essential hypertension were treated by Candesartan Cliexetil 8mg taken orally everyday,the course of treatment was 4 weeks. 24h ambulatory blood pressure monitoring(ABPM) was given before and after treatment, the T/P rate and smoothness index were calculated. Results Four weeks after treatment, 24h SBP(148.2±10.7) mm Hg and 24 h D BP (97.6±6.5) mm Hg, dSBP(152.5±9.8) mm Hg and dDBP(96.0±5.3) mm Hg, nSBP(138.3±7.6) mm Hg and nDBP(89.2±8.3) mm Hg, SBP load (87.5±12.2) % and DBP load (36.48±26.4) % with pre-treatment (130.2±7.2) mm Hg, (79.5±7.8) mm Hg, (133.4±7.2)mm Hg, (81.8±6.6)mm Hg,(121.9±7.3) mm Hg, (72.1±7.4) mm Hg, (84.7±9.9)%,(26.7 ±8.3) % have significant difference(P < 0.01). T/P rates were SBP 70% and DBP 63%. Smoothness indexes were SBP(1.21±0.82) and DBP(1.13±0.51). Conclusion Candesartan cilexetil in the treatment of essential hyper-tension is safe and effective,can get a good T/P ratio and smoothness index.

Evidence has shown that the abnormal expression of specific microRNAs (miRNAs) is associated with the occurrence,development and prognosis of pancreatic cancer,which is the potential target of forecast about invasion and metastasis of pancreatic cancer.There is close relation between miRNAs and biological characteristics of pancreatic cancer invasion and metastasis.Therefore,miRNAs are expected to become the new research targets of the mechanism of invasion and metastasis of pancreatic cancer.

With flexibly mounted ultra microelectrode, we have succesfully recorded the myocardial cell action potentials from the following 12 species experimental animals in situ: dog, sheep, pig, cat, rabbit, guinea pig, rat, mouse, chicken, pigeon, toad and frog.

Objective:To study the effects of Jiaweitaohechengtang on expression of?-SMA protein in hepatic fibrosis rats induced by CCl4.Methods:Hepatic fibrosis models were induced by CCl 4 .All the experimental rats were divided into six groups:normal control group,model control group,colchicine positive treatment group,jiaweitaohechenqitang groups with high- dosage,medium-dosage and low-dosage.Drugs were given to rats for 8 weeks by intragastric administration.Scores of hepatic fibrosis were assessed with semiquantitive scoring system(SSS)through tianlanghong staining.Protein expression levels of ?-smooth muscle actin(?-SMA)were determined with immunohistochemical steining method.Results:SSS in model control group were higher than those in normal control group,but lower than those in three treatment groups with jiaweitaohechengqitang. Compared with nornal control group,the protein expression levels of?-SMA in liver tissues in model control group increased markedly,but decreased when it was compared to jiaweitaohechengqitang groups.There was a significant difference between model control group and three treatment groups.Conclusion:Jiaweitaohechengqitang has therapeutic effects on hepatic fibrosis.The mechanism may be ralated to the inhabitition of the activation of HSC.

Objective ToexploretheapplicationofVasoCT,astentimagingtechnique,instent-assisted coilaneurysmembolization.Methods Twentyconsecutivepatientswith23intracranialaneurysmswere treated with stent-assisted aneurysm embolization in the General Hospital of Armed Police Forces from December 2013 to November 2014 were enrolled. The patients performed VasoCT scan immediately after procedure. Then all the available images were used for stent-optimized reconstruction respectively. Under the XpertCT mode,the available images were observed with both volume imaging and maximum intensity projection. The available images were analyzed and they were divided into very clear,less clear,and not clearaccordingtothestentdevelopingclarity.Results Ofthe22aneurysmstreatedwithstent-assisted embolization,16 were occluded completely,6 were occluded partially. All the stents were expanded completely and were released to the expected locations;11 aneurysm stents developed clearly,9 developed less clearly,and 2didnotdevelopclearly.Conclusion VasoCTcanbeusedinthestent-assistedaneurysmembolization.It can clearly reveal the microscopic structure of the stents,location,relationship with the artery wall,and relationship between stents and coils. The clarity of stent development is associated with the diameters of the packed coils,and the stents are also affected by the metal artifacts projecting direction and the dense degree of the packing coils.

Objective To analyse the risk factors of medical complications after hip fracture surgery.Methods Clinical data of 327 hip fracture patients undergoing surgical treatment in Beijing Haidian Hospital from January 2009 to December 2013 were retrospectively studied.There were 114 males and 213 females with a mean age of (75.1 ±15.6) years, 129 patients(39.4%) had femoral neck fractures, and 198 patients ( 60.6%) had intertrochanteric fractures.Fifty four patients had medical complications during hospitalization ( complication group) and 273 patients did not have complications ( non-complications group ) . The clinical features, presurgical comorbidities and operative parameters were documented and compared between two groups.The risk factors of medical complications were assessed by regression analysis.Results Univariate analysis showed that age ( t =2.85, P=0.007), lying in bed before fracture(χ2 =12.86,P =0.000), the history of chronic obstructive pulmonary diseases(COPD) (χ2 =9.45, P=0.000), coronary heart disease(χ2 =10.67,P=0.000), heart failure(χ2 =15.85,P=0.000), diabetes (χ2 =3.22,P=0.024), cerebrovascular disease(χ2 =4.21,P=0.008), anesthesia method(χ2 =8.67,P=0.018), American Society of Anesthesiologists(ASA) score ≥3 level(χ2 =2.01, P=0.042) and the delay time of operation (t=4.24, P=0.037) were significantly different between two groups.Multivariate regression analysis revealed that age(β=0.030, OR=1.030), lying in bed before fracture (β=2.303, OR=10.716), the history of COPD (β=0.831, OR =1.995), coronary heart disease(β=0.858, OR=2.392), heart failure(β=1.971, OR=7.333)and ASA score ≥3 level(β=0.809,OR=2.583) were the independent risk factors of medical complications after hip fracture surgery. Conclusion Age, lying in bed before fracture, the history of COPD, coronary heart disease, heart failure and ASA score≥3 level would increase the risk of postoperative medical complications for patients with hip fracture.

Clinical practice record manual contains the information about medical students' clinical studying process, clinical teaching process and the concept of clinical teaching management. First, we should design and optimize clinical practice record manual and then collect and analyze the relevant data. In addition, we should give the analysis to the students, teachers, clinical departments and hospitals on time, and at the same time, get their feedback. Through these steps, we can find and solve the problem efficiently and promote the quality of teaching, learning and management of clinical internship, so as to improve the clinical teaching quality control standard.