Objective To investigate the effect of chaishao chengqi decoction and mirabilite synthesis treatment for patients of severe acute panereatitis (SAP). Methods 62 cases of SAP were randomly divided into treatment group (n = 32) and control group (n = 30). Conventional treatment was administrated to control group, while chaishao chengqi decoction and mirabilite were added to treatment group. The duration of abdominal pain, the time of the first bowel, days of gastrointestinal decompression, average days of hospitalization, hyperamylasemia, complication and mortality was compared. Results The duration of abdominal pain, the time of the first bowel, days of gastrointestinal decompression, average days of hospitalization and complication rate were (5.8 ± 2.5) d, (1.84 ± 0. 67) d, (8.2 ± 2.2) d, (21.2 ± 12.5) d and 15.6% in treatment group,respectively, which were lower than those in the control group (P <0.05). Duration of hyperamylasemia (10.2 ± 3.2d) and mortality rate (3.12%) in treatment group was lower than those in the control group without statistic difference (P > 0. 05). Coucluslons Based on conventional therapy, chaishao chengqi Decoction and mirabilite could improve gastrointestinal function of SAP, shorten course of disease, reduce the occurrence of complication and improve the prognosis.

Objective To investigate the risk factors for cardiovascular complications in the elderly persons undergone with dialysis.Methods One hundred and eighteen patients undergone with hemodialysis(HD)or continuous ambulatory peritoneal dialysis(CAPD)at the Eastern Hospital, Tongji University, Shanghai during January 2002 to December 2006 were retrospectively analyzed.They were divided into four groups based oil their age and mode of dialysis, i.e., 44 patients in the elderly HD group(aged over 60years), 16 patients in the elderly CAPD group(aged over 60), 46 patients in medium-age HD group(aged under 60 years)and 12 patients in the medium-age CAPD group(aged under 60).Routine biochemical parameters were measured for all the patients and their difference was compared among the four groups.Logistic regression analysis was performed for the risk factors of cardiovascular complications.Results Pulse pressure(PP)was(66±21)mm Hg, serum level of triglycerides(TG)was(1.28±0.67)mmol/L, serum level of lipoprotein(a)[LP(a)]was(434±202)mg/L, C-reactive protein was(CRP)(21±15)mg/L, serum phosphorous(P3-)was(2.02±0.77)mmol/L, and product of serum calcium and phosphorous(Ca×P)was(4.3±1.6)mmol2/L2, respectively, in the elderly group with dialysis, all significantly higher than those in the medium-age group with dialysis(t=1.535, 1.016, 2.154, 2.252, 4.676, and 4.534, respectively, P＜0.05).Incidence of cardiovascular events was markedly lower in the CAPD group than that in the HD group(P＜0.05), either in the elderly or medium-aged patients.And, incidence of cardiovascular complications correlated positively with age, PP, LP(a), CRP and Ca×P of the patients with dialysis, but correlated reversely with serum level of albumin(all with P＜0.05).Conclusions There exist a few risk factors for cardiovascular complications in the elderly patients with dialysis, so proper mode of dialysis should be selected for those who need it and adequate intervention should be implemented for them to correct the risk factors.

Objective To investigate the diagnosis and treatment of major arterial injuries of the extremities. Methods In the period between September 1999 and June 2002, 129 patients with 176 arterial injuries were admitted to our hospital. 122 patients of them with 162 arterial injuries underwent microsurgical repair. Results The limbs of 116 patients with 154 arterial injuries survived. The total survival rate of affected extremities was 89.9% ; the blood vessel recanalization rate was 95.06% . Conclusion Careful physical examination and advanced vascular Doppler equipment can avoid missed diagnosis, and microsurgical technique in vascular repair can successfully save limbs.

MicroRNAs (miRNAs) are a class of non-coding RNAs about 18-25 nucleotides in length,involved in post-transcriptional genes regulation process.Previous studies showed that miRNAs played an important regulatory role in pancreatic development,gene expression,and synthesis and secretion of insulin.A variety of miRNAs which expressed in islet β cells may affect the proliferation and differentiation of islet β cells.Since miRNAs showed tissue specificity,their expression changes were closely related to some diseases.Thus,integrative studies with miRNAs over the essence of syndromes of traditional Chinese medicine could provide new ideas for the treatment of diabetes.

Objective To study the effects of recombinant human growth hormone(rhGH) on the treatment for valve replacement postoperative in rheumatic heart disease associated cardiac eaehex.Methods Fortytwo patients with rheumatic heart disease associated cardiac eachexia were divided into two groups.Group one(n=20,rhGH group) received standard enteral nutrition (15 kal·kg-1 · d-1)with rhGH 10U injection subeutaneously from postoperation day 7 to day 14 and group two(n = 22,eontrol group) received standard enteral nutrition (15 kal·kg-1· d-1) for the same period.Haemoglobin, serum total protein, serum albumin, blood glucose, handgrip exercise and triceps skin_fold thickness were determined.Meehanieal ventilation, hypostatie pneumonia incidence rate, and length of stay were observed.Results The levels of serum total protein, serum albumin and blood glucose eoneentration in the rhGH group at the 14th day were inereased significantly compared to that in the control group(P <0.01).Haemoglobin, triceps skinfold thiekness and handgrip exercise in rhGH group were significantly different from those in the control group(P <0.05).Postoperative meehanieal ventilation time, intensive care unit time, hospital stay time were signifieantly shorter than those in the eontrol group (P < 0.05), and hypostatie pneumonia was significantly lower than that in the eontroi group(P < 0.01).Conclusions The rhGH can obviously improve anabolie effects of patients with rheumatic heart disease associated cardiac eachexia whieh can reduce hypostatie pneumonia and shorten postoperative hospital stay time.

Objective To evaluate the curative effect of potassium magnesium aspartate on arrhythmia and heart function in valve replacement postoperative patients of rheumatic heart disease. Methods Two hundred and eighty patients with rheumatic heart disease were divided into 2 groups in random,with no statistical significance. Treatment group (n=155) were received i.v. potassium magnesium aspartate 40 ml every day and control group (n=125) were only given conventional therapy. At the same time they were given same treatment. Blood magnesium level,blood potassium levels,arrhythmia incidences and heart function were also observed. Results Blood magnesium and potassium levels of the treatment group were higher than those of the control group (P

97 cases of jaw bone fractures were treated with rigid internal fixation.16 cases had malocclusion postoperation.The etiology was analyzed and the prevention methods were proposed.Intermaxillary elastic traction or fixation and craniomaxillofacial fixation or craniomentum elastic traction were performed to treat the malocclusion.By this way,14 cases were cured.1 case was operated again to resume the normal occlusion,1 case received occlusal adjustment.Incomplete reduction,incorrect operative performance,deficiency of postoperative intermaxillary fixation and incorrect intermaxillary fixation were the main causes to malocclusion.So anatomic in time reduction,correct operative performance,intermaxillary fixation,application of craniomaxillofacial fixation or craniomentum elastic traction instead of intermaxillary fixation for some special cases are effective methods to correct postoperative malocclusion.

Objective To explore the postoperative care to hemodialysis patients with hypocalcemia after parathyroidectomy with refractory secondary hyperparathyroidism. Methods The nursing measures included timely correction of hypocalcemia, nursing of muscular spasm, dietary nursing and rational medication. Five of them developed numbness in the limbs, which was alleviated by administration of venous transfusion of calcium gluconate. After six months, the blood calcium in 6 patients resumed to normal level. For 1 case with lower blood calcium, the level of blood calcium maintained at 1.8~2.0mmol/L after supplement with high dose of calcium and high -calcium hemodialysis. Conclusions The hemodialysis patients with refractory secondary hyperparathyroidism after parathyroiddectomy are susceptible to hypocalcemia. The timely correction of hypocalcemia and related nursing measures are of significance for their recovery.

Objective To analyze and summarize the skills and complications of extracorporeal membrane oxygenation( ECMO) cannu-lation and vein intubation. Methods The clinical data of 21 patients of V-A or V-V ECMO in our hospital from January 2009 to July 2014 were analyzed retrospectively. And the techniques of different catheter sites were summarized. Results Three cases were successfully insert-ed catheter by jugular vein puncture with one time. Four patients with ascending aorta intubation died from uncontrolled severe hemorrhage. Eight peripheral catheter site had a small amount of bleeding,with no more bleeding after pressurized bandage. There were no complications like bleeding, hematoma, hemothorax and pneumothorax in the period of ECMO. Conclusion In the process of the ECMO catheter, the standardized operation could reduce the incidence of serious complicaions including bleeding.

BACKGROUND:Vertebral compression fractures are the most common vertebral fractures in the elderly patients with osteoporosis, and the correlation between the compression of anterior border of vertebral body and adjacent vertebral refractures is not clear.
OBJECTIVE:To establish a model of different compression of T12vertebral body with finite element method, and analyze the relationship between the compression of T12vertebral body and the stress of adjacent vertebral plate.
METHODS:Based on thoracolumbar CT data of normal adult volunteers, MIMICS/3-matic was imported. Through image segmentation, repair and three-dimensional mesh of accessto thoracic and lumbar T11-L1data, grid assigned material properties was imported to ABAQUS so as to establish ligament, joint and other small features and obtain realistic three-dimensional finite element model. The six degrees of freedom, including anteflexion, posterior extension, left and right flexion, left and right rotation, were loaded, to verify the validity of the normal model. With the frontier of vertebral body compression to 90%, 80%, 70%…10% of the nine states, MISES stressesof the T11andL1segment intervertebral disc endplate were extracted; the relationship curve of compression state and endplate stress was obtained.
RESULTS AND CONCLUSION:(1) The model was highly realistic and could reflect the actual stress state. (2) The stress value of T11vertebral body and L1vertebral body was positively correlated with the compression of T12vertebral body. Increased stress may lead to an increased likelihood of end plate fractures, which increases the risk of fractures in the adjacent vertebralbodies.