Objective To investigate the clinical efficacy and safety of ulinastatin combined with octreotide in the treatment of acute pancreatitis.Methods The clinical data of 50 patients with acute pancreatitis were retrospectively analyzed.According to different methods of treatment,they were divided into two groups.25 patients in the control group were treated with octreotide alone,while 25 patients in the observation group were treated with ulinastatin combined with octreotide.The clinical treatment effect and the incidence of complications were compared between the two groups.Results The total effective rate of the observation group was 96.00％,which was significantly higher than 80.00％ of the control group,the difference was statistically significant (x2 =9.64,P ＜ 0.05).The recovery time of abdominal pain and distension,recovery time of serum amylase,recovery time of urine amylase and the average hospitalization time of the observation group were (4.83 ± 1.21) d,(3.49 ± 1.08) d,(4.26 ± 1.17) d,(15.24 ± 3.16) d,which were significantly shorter than those of the control group (t =6.56,7.30,6.82,7.11,all P ＜ 0.05).The incidence rate of complications of the observation group was 12.00％,which was significantly lower than 36.00％ of the control group,the difference was statistically significant (x2 =8.56,P ＜ 0.05).Conclusion Ulinastatin combined with octreotide has significant effect in the treatment of acute pancreatitis,which can improve the symptoms and promote the early recovery,and the incidence rate of complication is low and the safety is high,which is worthy of clinical application and promotion.

Objective To investigate the clinical value of color Doppler ultrasound in the early diagnosis of acute cholecystitis infection ,in order to improve the diagnosis of acute cholecystitis infection .Methods 36 cases with acute cholecystitis infection were selected as the observation group , and during the same period the healthy people were randomly selected as the control group .The color Doppler performance of ultrasound was observed .The hepatic artery blood flow velocity and the maximum peak of the cystic artery (Vmax) and resistance index(RI) were meas-ured.ROC curve was observed to evaluate the specificity of color Doppler ultrasound for the disease .Results The incidence rates of weak bile sound transmission ,gallbladder wall thickness ,gallbladder enlargement ,ultrasound Mur-phy positive in the control group were 25.0%,16.7%,22.2%,8.3%,which in the observation group were 72.2%, 47.2%,100.0%,94.4%,the differences were statistically significant (χ2 =4.571,4.571,4.589,5.689,all P<0.05).The differences in hepatic artery and the cystic artery Vmax and RI were statistically significant between the two groups(P<0.05).ROC curve comparison showed that the correct rate of gallbladder enlargement in the observa -tion group was the highest (90.7%),the specificity was 90.7%,sensitivity was 90.6%,and other indicators of ultra-sound had no significant difference (χ2 =0.893,P>0.05).Conclusion Color Doppler ultrasound can show the form of acute infectious cholecystitis ,gallbladder wall degree of bile through sound etc .,it can improve the diagnostic value of the disease.

Objective To investigate the efficacy and safety of subretinal fluid extraction combined with intravitreal conbercept and gas injection in treating polypoidal choroidal vasculopathy(PCV)complicated with serous retinal pigment epithelium detachment(sPED).Methods From July 2019 to February 2021,13 patients(13 eyes)with PCV complicated with sPED who were treated with subretinal fluid extraction combined with intravitreal injection of conbercept and gas in the Weifang Eye Hospital were selected.All affected eyes received at least 3 times(once a month)of intravitreal anti-vas-cular endothelial growth factor(VEGF)(ranibizumab)injections before the surgery,and the treatment was ineffective.The changes in best corrected visual acuity(BCVA),central retinal thickness(CRT),macular foveal PED height and width before and 1 week,1 month,3 months and 6 months after the operation were observed,and the intraoperative and postop-erative complications were recorded.Results The BCVA of the affected eyes 1 week after operation was better than that before operation,and the difference was statistically significant(Z=-3.237,P=0.001).The CRT of the affected eyes at 1 week,1 month,3 months and 6 months after the operation were thinner than that before the operation,and the differ-ence was statistically significant(Z=-3.180,-3.180,-3.110 and-3.180,P=0.001,0.001,0.002 and 0.001).The height and width of PED at 1 week,1 month,3 months and 6 months after the operation were lower than those before the operation,and the differences were statistically significant(all P＜0.05).Thirteen eyes received an average of(4.15±1.40)intravitreal injections(ranibizumab)before the surgery,and the treatment duration was(5.92±3.95)months(equivalent to one injection every 6 weeks).During the 6-month follow-up,13 eyes received an average of(2.31±1.97)intravitreal injections(conbercept)(equivalent to once every 10 weeks).Partial correlation analysis showed a weak positive correla-tion between the increase in BCVA and the decrease in CRT 6 months after operation(r=0.416,P=0.203).There was no significant correlation between the increase in BCVA and the changes in PED height and width 6 months after operation(r=0.218,0.209,P=0.520,0.538).At 1 month after the operation,9 eyes had PED recurrence or different degrees of retinal nerve subepithelial effusion,and PED improved after repeated intravitreal injection of conbercept.At 6 months after opera-tion,subfoveal PED completely disappeared in 3 eyes,and the retina was completely reattached.There was still active exu-dation in the retina of 1 eye.No systemic or severe ocular complications occurred in 13 eyes during the follow-up period.Conclusion Subretinal fluid extraction combined with intravitreal injection of conbercept and gas in the treatment of PCV complicated with sPED can safely and effectively reduce CRT,improve PED,and reduce the damage to the retina caused by long-term PED,but it has no significant effect on the improvement of BCVA at 6 months after the operation.

AIM: To evaluate the clinical efficacy of amoxicillin from volume-based procurement (VBP) and potassium amoxicillin clavulanate in the eradication of helicobacter pylori (Hp) infection, providing basis for the selection of treatment programs. METHODS: Data from the patients who received Hp eradication therapy from May 2021 to May 2022 were recruited from the rational drug use management system. The data from the patients treated by amoxicillin (amoxicillin 1.0 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) and potassium amoxicillin clavulanate (potassium amoxicillin clavulanate 0.914 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) were selected and compared. RESULTS: A total of 171 cases were collected in the group treated by Amoxicillin program, and the eradication rate was 87.8% (150/171). A total of 69 cases were collected in the group of potassium amoxicillin clavulanate, and the eradication rate was 76.8% (53/69). There was no significant difference in baseline data between the two groups (P>0.05). There was a significant difference in clinical efficacy between the two groups (P< 0.05). In addition, the cost-effectiveness ratio (C/E) of the Amoxicillin treatment program was lower than that of the potassium amoxicillin clavulanate program CONCLUSION: The clinical efficacy of VBP Amoxicillin program in eradicating Hp infection is better than that of the potassium amoxicillin clavulanate program, which is worthy of clinical recommendation.