Pancreatic encephalopathy (PE)is one of the severe complications of severe acute pancreatitis (SAP).Early diagnosis mostly depends on the history of disease as well as clinical symptoms and signs.PE progresses rapidly and is often complicated by multiple organ dysfunction,and it may finally develop into multiple organ failure with a high fatality rate if not treated in time.It is currently known that de-myelination is one of the important pathological features of this disease,with fat -soluble demyelination of cerebral gray matter and white matter,as well as inflammatory changes such as hemorrhage and edema.The target antigen of demyelinating lesions,however,is myelin basic protein (MBP).This paper reviews the changes in MBP levels in the demyelinating lesions of the central nervous system among PE pa-tients,with the purpose of providing clues for the early diagnosis and prognostic study of demyelinating lesions in PE.

Objective To observe the preventive effect of immune tolerance induced by immature myeloid dendritic cell(iMDC) loading P2 58-73 peptide(P2 58-73aa-iMDC) in experimental autoimmune neuritis(EAN),and the effect on the expression of IFN-? and IL-33 mRNA.Methods(1)The iMDC were cultured in vitro for loading P2 58-73aa.(2) 21 adult female Lewis rats were randomly divided into the EAN(A)group,iMDC(B)group and P2 58-73aa-iMDC(C)group,and subcutaneously injected PBS,iMDC and P2 58-73aa-iMDC respectively.After 7 d,all the rats were immunized with P2 53-78aa and complete freunds adjuvant(CFA) to inducing EAN.Then,the situation of onset were observed and clinical score were evaluated till 16 d(the crest-time of onset) after immunization.(3) The lymphocyte proliferative response were assayed by 3H-TdR incorporation.The expression of IL-33,IFN-? mRNA in sciatic nerves,spleen and lymph node were detected by RT-PCR.Results(1)In the crest-time of onset,the clinical scores in groups A,B and C were(7.4?1.9),(5.2?1.6) and(3.4?0.9) respectively.There were significant differences between each two groups(allP

Objective To understand the antibody levels after the inoculation of measles ,poliomyelitis ,epidemic encephalitis B and hepatitis B vaccines among healthy children aged 7 - < 13 years old in Guangshui City of Hubei province to provide the scientif ‐ic basis for formulating the immune prevention and control strategy and risk assessment in whole city .Methods 4 616 healthy chil‐dren aged 7 - < 13 years old were sampled from the whole city .The enzyme‐linked immunosorbent assays (ELISA) was used to de‐tect the 4‐antibody levels .Results The antibody positive rates of measles ,poliomyelitis ,epidemic encephalitis B and hepatitis B a‐mong healthy children aged 7 - < 13 years old in Guangshui City were 94 .41% ,93 .07% ,93 .78% and 68 .72% respectively .The protection levels of first three kinds of antibody reached more than 85% ;the positive rates had statistical difference among 4 kinds of antibody(χ2 = 1 987 .08 ,P = 0 .000) .The antibody positive rates of epidemic encephalitis B had no statistical difference among different age periods (χ2 = 10 .141 ,P= 0 .071) ;the antibody positive rates of measles ,poliomyelitis and hepatitis B had statistical difference among different age periods(χ2 = 40 .471 ,P = 0 .000 ;χ2 = 25 .174 ,P = 0 .000 ;χ2 = 283 .641 ,P = 0 .000) .The positive rates of 4 kinds of antibody had no statistical difference between different genders (χ2 = 0 .019 ,P= 0 .889 ;χ2 = 1 .017 ,P= 0 .313 ;χ2 = 0 .018 ,P= 0 .892 ;P= 0 .639 ,P= 0 .424) ;the antibody positive rates of measles ,poliomyelitis and epidemic encephalitis B had no statistical differences among 17 villages and towns in the whole city (χ2 = 0 .099 ,P= 1 .000 ;χ2 = 0 .117 ,P= 1 .000 ;χ2 = 0 .134 , P= 1 .000) ,while the antibody positive rate of hepatitis B had statistical difference among these villages and towns (χ2 = 186 .179 , P= 0 .001) .Conclusion The antibody levels of measles ,poliomyelitis and epidemic encephalitis B reach the protection rate ,but the antibody level of hepatitis B needs to be increased .The monitoring work should be continuously strengthened and the seeking missed inoculation and re‐inoculation work should be reinforced .

Severe acute biliary pancreatitis can be treated by nonsurgical and surgical approaches,and choice of the surgical techniques as well as its timing are the keys points to the whole therapy.Early enteral nutrition via placing nasointestinal feeding tube plays an important role in the nutritional support for patients with severe acute pancreatitis.This paper intends to explore the experience in standardizing the therapy for all similar cases via reviewing and summarizing the treating process of a typical patient with severe acute biliary pancreatitis.

Objective To find up a suitable beginning scan time so that to assure the image quantity during CTA of brain.Methods 30volunteers were checked by heart colour sonography first,then CTA at earlier stage was done,when the density in basilar artery high up to120 HU,that time was regarded the time as beginning scan time,the relative curve between beginning scan time and ejection fraction(EF) was drew,according to this relative curve,34 patients were examined by CTA,the displaying situation of vessel was evaluated comparatively with DSA in part of patients.Results According to this method,the successful rate of CTA in patient’s group was 100%,the trunk of brain vessel and its 1~3 level branch were showed in 100%,the 4~5 level branch of middle cerebal artery showed in 94.1%(32/34).Conclusion According to EF of heart to determine the beginning scan time of CTA is practical,that the image quantity of CTA can be assured.

Objective To investigate the digital subtraction angiography (DSA) manifestations and clinical value of interventional embolization of renal artery with severe hemorrhage following percutaneous nephrolithotomy (PCNL).Methods 34 patients with severe hemorrhage following PCNL from Feb 2012 to Jun 2015 were subjected to perform renal arterial DSA, which was followed by super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2). The patients were followed up for 6 ~ 12 months.Results Of the 34 patients, DSA examination showed that renal artery pseudoaneurysm (RAP) was found in 22 (64.7%), renal arteriovenous ifstula (RAVF) in 8 (23.5%) and RAP associated with RAVF in 4 (11.8%). Successful embolization with single session was achieved in all 34 patients. Both the technical success rate and the hemostasis rate were 100.0%. Meanwhile, the renal tissue and function were mainly reserved and no serious complication of embolization was observed. No hematuria recurrence or renal function failure appeared in all patients during the follow-up period. In 26 patients, different degree of embolism syndrome was observed after the treatment.Conclusions Renal artery pseudoaneurysm and renal arteriovenous ifstula are the main types of renal artery injury resulting in severe hemorrhage after percutaneous nephrolithotomy. Super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2) is a minimally invasive method that can promptly stop the renal bleeding, and preserve the renal tissue and function to the greatest possible advantage. Therefore, this technique should be regarded as the ifrst choice in the treatment of the patients who suffered from severe hemorrhage occurred after PCNL.

BACKGROUND: Physical training induces adaptation changes on physiological function and anatomic structure of body, which significantly exist in individuals. Individual variation responses to physical training is determined by gene polymorphism. OBJECTIVE: To summarize the research progress on the association between gene polymorphism and exercise training sensitivity in recent years. RETRIEVAL STRATEGY: A computer-based search of Pubmed database was undertaken to identify the articles published from January 2002 to December 2006 with the key words of "gene polymorphism, endurance training, strength training, aerobic training" in English. Simultaneously, China Journal Full-text Database was searched for the relevant articles published from January 2002 to December 2006 with the same key words in Chinese. Totally 58 relevant articles were collected after the first trial. Inclusive criteria: ①articles on association between gene polymorphism and endurance training, ②articles on association between gene polymorphism and strength training, ③articles on association between gene polymorphism and hypoxia training. LITERATURE EVALUATION: The articles collected were prospective cohort studies on association of gene polymorphism with some physiological and biochemical parameters response to physical training. DATA SYNTHESIS: ①The individual variation responded to physical training in physiological and biochemical parameters are mostly determined by genetic factors, such as gene polymorphism.②Recently, there are lots of studies on association of gene polymorphism with physiological and biochemical parameters response to endurance training, strength training and hypoxia training.③Mostly studies indicate that there are associations among physiological and biochemical parameters response to endurance training, strength training and hypoxia training and I/D polymorphism in ACE gene, C1772T in HIF-1? gene and so on. CONCLUSION: Although gene polymorphism is a genetic marker of determining the physiological phenotype of human, the various genetype of the same gene polymorphism can cause different sensitivity change of physiological phenotype in the different races response to training. With the research progress on association between gene polymorphism and physical training sensitivity, it will indicate its related mechanism.

Objective To introduce 13 clinical cases of reconstructing traumatic defect on skin of thumb and first web using nail skin flap of big toe connectedwith tibial flap of second toe.Methods From May 2003 to April 2007,a series of 13 case8 of traumatic thumb and first web defect were treated by transplantation of nail skin flap of big toe connecting with tibial skin flap of second toe.Among which two total hand degloving injury cages were included too.Two kind of way according the Gilbert type of the Ist metatarsus dorsal artery were used.Results All the cases were successful and healed by first intention.The contour of reconstructed thumbs showed to be normal or approximately normal.Follow-up examination were obtained in nine cases for 3-17 postoperative months(average 7 months).Sensations of pain,touch and temperature recovered.The two-point-discrimination sensation were found to be 7-17 mm respectively.Opposition measured were 60°-85°(average 75°).All the patients can be back to work and restored activities of daily living.Conclusion In treating soft tissue defect of thumb and first web,transplantation of the nail skin flap of big toe connecting with tibial lateral skin flap Can yield ideal skin covering and exceHent motor function.

A 26-year-old woman presented with scaly atrophic erythema on the chest and abdomen for nearly 2 years.Direct microscopic examination of the lesion scrapings revealed numerous stubby hyphae and clustered spores.Periodic acid-Schiff (PAS) staining of the biopsy tissue showed the presence of numerous hyphae and spores in the horny layer.The stain for elastic fibers revealed that the number of elastic fibers decreased,and some elastic fibers became fine and disrupted.The patient was diagnosed with atrophying pityriasis versicolor.The lesions subsided and direct microscopic examination was negative after 1-week treatment with oral itraconazole of 200 mg once daily and 4-week treatment with topical 2％ sertaconazole cream.

Objective To study the different oral compound polyethylene glycol electrolyte powder on the effect of bowel preparation before colonoscopy.Methods A total of 602 inpatients or outpatients were selected from department of gastroenterology,and they were randomly divided into tranditional group(n =288)and improvement group(n =314).All patients took a dose of two box of compound polyethylene glycol electrolyte powder 4 hours before colonoscopy.Endoscopic doctor investigated the antibiotic tolerance,adverse reactions,heart rate,blood pressure,blood electrolytes and blood glucose during treatment in form of questionnaire with single blind Bosdon bowel preparation scale (BBPS)score.Results The BBPS scores of the tranditional group and improvement group were (7.03 ± 1.24)points,(7.82 ±1.12)points,the score of the improvement group was significantly higher than the traditional group(t =2.259,P <0.05).The taste scores were (1.89 ±0.07)points,(1.25 ±0.09)points (t =2.624,P <0.05),the fully taking rates were 90.28%,95.86%(χ2 =7.375,P <0.05 ),and the second taking rates were 88.54%,93.95%(χ2 =5.566,P <0.05).In contract,the score of adverse reactions of the improvement group was significantly lower than that of the traditional group [(2.58 ±0.07)points vs(2.22 ±0.09)points,t =2.068,P <0.05].There was no significant difference of colonoscopy time between the two groups[(10.78 ±4.34)min vs (9.89 ± 1.77)min,t =1.766,P >0.05 ],althought the improvement group was shorter than the tranditional group. Conclusion The modified way of oral compound polyethylene glycol electrolyte powder not only can improve the qulity of intestinal cleaning,but also acts as a more effective method in preparation of colonoscopy due to its high tolerance, good comfort,less pain and high acceptance of patients.Therefore,it is worthy of clinical promotion and application.