Acute Pancreatitis Classification Working Group published Classification of Acute Pancreatitis-2012:Revision of the Atlanta Classification and Definitions by International Consensus in 2012,which redefined the diagnosis,severity,local complication,local infection of acute pancreatitis (AP).Under the guidance of revised Atlanta classification (RAC),the constituent ratio of severe acute pancreatitis (SAP) decreases significantly,which is between 3.7％ ～ 25.4％,and less than 10.0％ is reported in most researches.The mortality of SAP is between 10.0％ ～ 52.9％,and more than 20％ is observed in most publications.The constituent ratio of mild severe acute pancreatitis (MSAP) is between 10.9％ ～ 40.1％,the mortality is between 0 ～ 4.8％,and the incidence rate of organ failure is between 4.6％ ～ 34.0％.The percentage of patients with SAP who need ICU care and surgery intervention is higher than that of MSAP,and the total hospital stay of SAP are longer than that of MSAP.RAC could better reflect the severity and predict the outcome of AP than Atlanta classification published in 1992,but RAC also has some potential limitations.For example,the “local infection” is not included in this classification.This paper veviewed the relavent issues.

OBJECTIVE To investigate distribution and drug resistance status of Stenotrophomonas maltophilia.METHODS Microscan WalkAway-40 automatic analyzer from American Dade Company was used to identify bacteria.PCIZ and NC11 combination plate was used to perform susceptibility test in vitro.The data were analyzed by WHONET5.3 software.RESULTS The susceptibility to 15 antibiotics was tested in 42 clinic isolates of S.maltophilia from Jan 2005 to Sept 2006.The drug susceptibility test showed that SMZ-TMP had the lowest resistance rate(21.4%).Then resistance rate of S.maltophilia to cefoperazone-sulbactam was 23.8%.And 100.0% isolates were resistant to imipenem and aztreonam.CONCLUSIONS S.maltophilia has natural broad-spectrum resistance.We should strengthen its monitoring and control.

Neuropathic pain is a common chronic pain with complicated underlying mechanisms and difficult to treat, which badly disturbs the daily life of the patient and presents a significant burden to society by increasing healthcare resource utilization and costs. In the recent years, the pivotal role of glia-centered neuroinflammation and neuroimmunity in the development and maintenance of neuropathic pain has been recognized gradually. This review presents the current understanding of the role of glia in neuropathic pain and therapies of glia modulation.

Several minimally invasive techniques were used to treat infection secondary to pancreatic and (or peri-pancreatic) necrosis recent years,including percutaneous catheter drainage (PCD),endoscopic transluminal treatment,min-incision surgery,video-assisted minimally invasive technique and laparoscopic surgery.We should grasp the indication of each technique.PCD/ endoscopic transluminal surgery usually acted as initial therapy.Open surgery is still effective,and acts as a rescue operation when minimally invasive techniques fail.

Objective To investigate the current situation of obstetric & gynecology clinical teaching,in order to improve it.Methods Questionnaire investigation was used to get the information of the gravidas and parturients' attitude to clinical teaching,and analysis the strategy.Results It was tough to make obstetric clinical teaching fine,especially to the male.Conclusion It was helpful to better the obstetric & gynecology clinical teaching,by improving teaching mode and paying more attention to communication between patient and doctor

Objective To study GFAP changes of astrocyte and expression of Endothelin-1 in molecular pathology in brainstem injury of human being and explore its forensic medical significance. Method 15 brain specimens of acute brainstem injury and 5 brain specimens of no brainstem injury in different time were selected and their microscopic morphological changes were observed with HE staining, and we study the pathological changes of GFAP of astrocyte and expression of Endothelin-1 in monoclonal antibody im-munohistochemistry SP method. Results The number of GFAP positive cells was increased, the bulk of the cell became bigger and expression of Endothelin-1 could be observed. Conclusion The above pathological changes might be a valuable base used for postmortem diagnosis of acute brainstem injury.

Air ; analysis ; Chromatography, Gas ; methods ; Methylene Chloride ; analysis ; Workplace

AIM: To evaluate the effects of simulated acute ischemia and reperfusion on L-type calcium current (ICa,L) in ventricular myocytes from diabetic and non-diabetic rabbits.METHODS: Using whole-cell patch clamp techniques, ICa,L was measured in left ventricular myocytes isolated from 6-week alloxan-induced diabetic rabbits and age-matched control ones at baseline, 5 min of simulated ischemia, and 5 min of reperfusion.RESULTS: There were no significant differences on baseline maximum ICa,L densities between diabetic and control ventricular myocytes. In control cells (n=11), maximal ICa,L densities of baseline, ischemia and reperfusion were (-8.36±1.63)pA/pF, (-5.90±1.75)pA/pF and (-4.22±1.02)pA/pF, respectively. The ICa,L of ischemia was less than that of baseline (P<0.01), while the ICa,L of reperfusion was less than those of baseline (P<0.01) and ischemia (P<0.05). In diabetic cells (n=9),the ICa,L of baseline, ischemia and reperfusion were (-7.55±1.62)pA/pF, (-6.05±1.58)pA/pF and (-5.12±1.13)pA/pF, respectively. Only ICa,L of reperfusion was less than that of baseline (P<0.01), while ICa,L of ischemia was not significantly different from that of baseline (P>0.05) or reperfusion (P>0.05).CONCLUSION: ICa,L in diabetic ventricular myocytes represents blunted response to acute ischemic injury, being decreased more slowly than that in control cells. Post-ischemic reperfusion is still a potent inhibitor against ICa,L in both diabetic and non-diabetic cells. This study may be indicative of the mechanism about ischemia-reperfusion injury to diabetic myocardium and the therapy for diabetic patients with ischemic heart disease.

Objective To provide the experimental evidence for clinical application of taurine,rat model of intrauterine growth restriction (FGR) was made to investigate influence of prenatal administration of taurine on neurogenesis.Methods Fifteen pregnant rats were divided into control,FGR model and taurine groups,5 rats for each group.Rats in the control group were supplied with unlimited food and drink while the other two groups were fed by 40％ food intake of the control group throughout pregnancy.Since gestational day 12,taurine (100 mg/kg) was added into diet of taurine group every day until term delivery.Brain tissues were obtained immediately after baby rats were born.Expression of proliferating cell nuclear antigen (PCNA),neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) of brain tissue was measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry; meanwhile,numbers of PCNA-immunoreactive cells in subventricular zone,subgranular zone and cerebral cortex were compared with ANOVA test or q test.Results Levels of PCNA mRNA and GFAP mRNA expression in FGR group were significantly higher than those of control group (PCNA mRNA:1.002±0.011 vs 0.894 ± 0.040,P＜0.01; GFAP-mRNA:1.012±0.013 vs 0.913±0.012,P＜0.01).Compared to FGR model group,mRNA expressions of PCNA and GFAP in taurine groups were higher (1.090±0.029,P＜0.01 ; 1.034±0.011,P＞0.05).There was a significant decrease in the expression of NSE mRNA in FGR group compared with control group (0.796±0.036 vs 1.582±0.057,P＜0.01),while the expression in taurine group (0.933±0.027) was significantly higher than that in FGR model group (P ＜ 0.01).PCNA immunoreactive cells were mostly distributed in subventricular zone,followed by subgranular zone and cerebral cortex.Conclusions Prenatal application of taurine could enhance neurogenesis of FGR newborn rats and improve survival of neurons to ameliorate FGR brain damage.

The paper introduced the attempts made by the hospital in the ongoing health reform.The hospital encouraged incentives of the medical workers to take part in the reform,as they upgrade their work in high quality nursing care,outpatient appointment registration,better specialist outpatient clinic service,and tiered medical services.These efforts help innovate medical services for fulfillment of goals of the health reform.