Objective To investigate the efficacy and significance of endoscopic sphincterotomy(EST)and endoscopic nasobiliary drainage(ENBD)combined with the continuous blood purification(CBP)in the treatment of severe acute pancreatitis(SAP).Meth-ods The clinical data of 179 patients with SAP treated in our hospital over a period of ten years were retrospectively analyzed.The cases were divided into four groups according to the treatment methods.The conventional group was treated with the routine meth-od,the CBP group received the CBP therapy combibed with routine methods,the endoscopic group was given EST and ENBD on the basis of the routine methods and the combined group was treated with CBP,EST and ENBD.The patients′vital signs,WBC,CRP, APACHE Ⅱ score,abdominal signs change,incidence of complications,mortality and hospitalization days were compared among 4 groups.Results Compared with the conventional group,the clinical indicators,WBC,CRP,APACHEⅡ scores,blood amylase lev-el,incidence of local complications,mortality and hospitalization days in the rest three groups were decreased significantly(P<0.05),the total effective rate of abdominal signs relief was significantly increased(P<0.05);compared with the rest groups,the to-tal effective rate of abdominal signs relief in the combined group was increased(P<0.05),the blood amylase level,incidence of local complications and hospitalization days were decreased significantly(P<0.05),the mortality was significantly lower than that in the conventional group(P<0.05),however there was no difference between the CBP group and the endoscopic group(P>0.05).Con-clusion CBP combined with EST and ENBD in treating SAP has the active and effective role for improving the disease condition, reducing complications and the mortality,and shortening the hospitalization time.

Objective To compare the impact on the results tested with arterial blood gas analysis and peripheral blood with glucose meter for critical patients in ICU in different temperature states. Methods The samples of venous biochemical test, blood arterial blood gas analysis and peripheral blood of 196 cases of critical patients in ICU were collected synchronously, and measure the D-value, correlation and bias adjustment factor of glucose blood tested with a synchronous fasting blood glucose test and venous/biochemical analyzer in different temperature states and different blood glucose groups, and the results of blood glucose test were analyzed. Results In normal temperature state, hypoglycemia simultaneous rapid intravenous glucose monitoring blood glucose level results compared with the lowest positive rate 3.31%(5/151), while the pairwise comparison showed there was both statistical signifcance between hypoglycemia group and target group (χ2=38.469), hyperglycemia group and target group (χ2=15.504) when choosing a synchronous fasting blood glucose test and intravenous blood glucose test (P<0.01). In high temperatures state, hypoglycemia simultaneous rapid intravenous glucose monitoring blood glucose level results compared with the lowest positive rate 0. There was both statistical significance between hypoglycemia group and target group (χ2=18.187), hypoglycemia group and hyperglycemia group (χ2=12.857) when choose a synchronous fasting blood glucose test and intravenous blood glucose test (P<0.01). Conclusions In high temperatures state, a synchronous fasting blood glucose test can not reflect the true value of blood glucose for critical patients.

OBJECTIVE To investigate the site of nosocomial infection in ICU,distribution and resistance of bacteria in order to make the intervention strategy.METHODS Antimicrobial susceptibility of pathogenic bacteria isolated from nosocomial infection patients in ICU from Jul 2006 to Jul 2008 was performed by Kirby-Bauer method.RESULTS The main pathogens of nosocomial infection in ICU were Gram-negative organisms(48.09%),Gram-positives(38.93%),and fungi(12.98%).The most common pathogens were Staphylococcus aureus,Acinetobacter baumannii,Pseudomonas aeruginosa,fungi,and S.haemolyticus.All strains of S.aureus and S.haemolyticas were antimicrobial sensitive to vancomycin,teicoplanin and linezolid.All A.baumannii strains were antimicrobial sensitive to cefoperazone/sulbactam.They were resistant to other antimicrobial agents.CONCLUSIONS Gram-negative organisms are the main pathogenic bacteria of nosocomial infection in ICU,but the percentage of Gram-positives and fungi is increasing,S.aureus is the most main pathogenic bacterium of nosocomial infection in ICU.S.haemolyticus is also a main pathogenic bacterium.The pathogenic bacteria of nosocomial infection in ICU are highly resistant to the most antimicrobial agents.

Objective To review the literature and synthesize current evidence on the use of kidneys with small renal cancer as donor kidneys.Method To locate eligible studies,four bibliographic databases including PubMed,Embase,Cochrane Library and ClinicalTrials.gov were screened,while key informants were collected and bibliographies of included studies were scrutinised.Two reviewers independently assessed studies for inclusion,extracted data.Data were synthesised as a narrative review.Results 1680 articles were found while eventually 15 studies were selected for this systematic review.All of the 15 included studies were case reports or case series.Totally 96 documented cases of donor kidneys after resection of small renal cancer were transplanted and no definite recurrence happened.Conclusion It is suggested from current limited evidence that cancer recurrence rate of allotransplanting kidney after resection of SRC was relatively low,thus it deserved much more well-designed clinical trials and clinical use.

OBJECTIVE: To report the current situation of dialysis and transplantation in Foshan City. METHODS: A total of 18 hospitals performed dialysis filled the registration forms, which comprised situations of hospital, staff establishment, blood purification developing, blood purification equipments, hemodialysis patients, peritoneal dialysis patients, and acute renal failure patients. The registration time was form the beginning to ending of 2007, and the information was statistical analyzed.RESULTS: Totally 18 hospitals in Foshan district performed hemodialysis and 6 of them offered peritoneal dialysis simultaneously. There were 155 hemodialysis machines, 6 CRRT machines, and 15 dialyser reuse devices. Totally 1 718 patients received dialysis in 2007 year, including 93.60% hemodialysis patients and 6.40% peritoneal dialysis patients. Until the end of 2007, 1011 patients were received dialysis treatment, including 90.60% hemodialysis and 9.40% peritoneal dialysis. Glomerulonephritis (47.1%) was still the first primary disease of dialysis, then diabetic nephropathy (28%), third arteriosclerosis nephropathy (9.7%), fourth obstructive nephropathy (3.2%). Totally 743 hemodialysis patients stopped treating for reasons of death, improvement or recovery, changed to peritoneal dialysis, kidney transplantation, transfer, economics and lost follow-up, accounted for 20.3%, 20.1%, 7.2%, 4.1%, 21.5%, 20.2% and 6.6%, respectively. Cerebrovascular disease, cardiovascular disease, infection, dystrophy, synthetic factors and other were the main reasons for death, which accounted for 16.6%, 28%, 17.2%, 3.2%, 18.4% and 16.6%. A total of 16 patients stopped peritoneal dialysis for death (68.7%), improvement or recovery (18.7%), changed to hemodialysis (7.1%), or lost follow-up (6.3%). The causes of death were cerebrovascular disease (21.4%), cardiovascular disease (7.1%), infection (28.6%) and others (42.9%).CONCLUSION: There are 18 hospitals can perform dialysis treatment in Foshan district. Glomerulonephritis, diabetic nephropathy, arteriosclerosis nephropathy and obstructive nephropathy are the first four primary diseases of dialysis. Cerebrovascular disease and infection are the main causes of death.

The UK Ebola-countering Operation in Sierra Leone from September 2014 to November 2015 called Operation Gritrock and its countermeasures were briefly introduced , such as the national strategy , aero-maritime deployment , self medical support , base-oriented training and international cooperation .A comparative analysis was made of operations of the same type between the UK and China in terms of mission-orientation, command and control , deployment timeline , past experience, deployment routes, logistics and assistance effects.Four implications for China′s military function construction in future international disaster relief operations were also summarized at the strategic , operational and tactical levels .

Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P ＞ 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P ＞ 0.05).There were no complications in the experiment group while there were 14 complications (31.1％) in the control group,showing a significant difference (P ＜ 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.

Objective To investigate the characteristics of traditional Chinese medical syndromes and syndrome patterns in diabetic nephropathy (DN) from delta regions of pearl river. Methods A cross-section and retrospective trial was carried out in 292 DN inpatients from four hospitals(the First Affiliated Hospital of Guangzhou University of TCM, Foshan Hospital of TCM, Shenzhen Hospital of TCM, and Zhongshan Hospital of TCM) from January, 2003 to December, 2005. Demographic information, past history, symptoms and laboratory parameters of the patients were collected.Results Of the enrolled 292 patients, there were 14 in the clinical stage Ⅱ, 42 in stage Ⅲ, 210 in stage Ⅳ, and 26 in stage Ⅴ. The manifestations of TCM syndrome were dominated as lassitude and weakness (69.9%), loss of energy (54.1%), dry mouth (49.3%), aching waist (42%), dry mouth and throat (38%), numbness of extremities (69.9%), dry eyes (33.2%) and dry stool (31.5%), but the signs of frequent sighing, night sweating and tidal fever were less found. For the deficiency syndrome patterns, there existed deficiency of kidney (37.7%), spleen (27.7%), heart (8.9%), liver (3.8%) and lung (2.1%) when differentiating the syndromes according the five zang-organs; there was deficiency of yin (32.5%), Qi (19.5%), blood (9.6%) and yang (8.2%) when differentiating the syndromes according to Qi, blood, yin and yang; there were complex deficiency syndromes such as deficiency of Qi and yin (40.4%), deficiency of spleen and kidney Qi (26.4%), deficiency of lung and kidney Qi(4.8%) and deficiency of yin and yang (3.8%). For the excess syndrome patterns, there were blood stasis syndrome (49.7%), damp-heat syndrome (33.2%), water-dampness syndrome (25%), and Qi stagnation syndrome (7.5%). Conclusion The syndrome patterns of DN present the following characteristics: leading deficiency syndromes being kidney deficiency and spleen deficiency when differentiating the syndromes according the five zang-organs, being yin deficiency and Qi deficiency when differentiating the syndromes according to Qi, blood, yin and yang, and complex deficiency syndromes being Qi-yin deficiency and spleen-kidney Qi deficiency. The leading excess syndromes are blood stasis syndrome and damp-heat syndrome. The manifestations of DN are characterized by the concurrence of deficiency and excess, cold and heat. The pathogenesis of DN is classified into deficiency in the root and excess in the branch. The deficiency syndrome mainly involves Qi and yin, and is located in spleen and kidney. The excess syndrome is characterized by blood stasis and damp-heat, and by water-dampness and dampness-turbidity in the late stage of DN. In one word, the pathogenesis of DN is characterized by deficiency of Qi and yin, and blood-stasis blocking kidney collaterals.

Objective · To analyze the clinical distribution and drug resistance of Acinetobacter junii (A. junii) and Acinetobacter lwoffii (A. lwoffii) from a grade 3A hospital in Shanghai, China, and provide the foundation for prevention and control of infections caused by them. Methods · A. junii and A. lwoffii were collected from the hospital between Aug, 2011 and Aug, 2016. VITEK2 Compact of bioMérieux (French) was used for bacterial identification and antibiotic susceptibility tests, clinical information of each strain was also analyzed. Results · 28 strains of A. junii and 58 strains of A. lwoffii were enrolled. A. junii was mainly from the departments of urology, thoracic surgery and geriatrics, and the samples were mainly sputum and urine. The resistant rates of A. junii to gentamicin, ampicillin sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, imipenem, meropenem, levofloxacin, ciprofloxacin and cotrimoxazole were 35.71%, 3.57%, 10.71%, 3.57%, 3.57%, 3.57%, 3.57%, 3.57%, 0, 3.57% and 35.71%, respectively. A. lwoffii was mainly isolated from the departments of urology, geriatrics, respiratory and renal medicine, and the samples mainly included urine, blood and sputum. The rates of antibiotics (mentioned above) resistance were 29.31%, 13.79%, 13.79%, 6.90%, 20.69%, 18.97%, 12.07%, 15.52%, 18.97%, 31.03% and 31.03%, respectively. The levels of antibiotic resistance of these two strains were constant during the five years. Conclusion · A. junii and A. lwoffii antibiotic resistant rates were much lower than those of reported A. baumannii, the over-all antibiotic resistances of A. junii were lower than those of A. lwoffii. This study provided fundamental data for prevention or control of these two strains by empirical use of antibiotics.

Objective To investigate the effect of intracranial pressure fluctuation on the prognosis of patients with traumatic brain injury (TBI).Methods A retrospective case series study was conducted on the clinical data of 30 patients with TBI hospitalized between June 2012 and June 2014.There were 21 males and 9 females,aged (43.0 ± 19.8) years.After the intracranial pressure probe was implanted,the intracranial pressure of TBI patients was monitored continuously and the data were recorded per minute.A single cosine method was used in analyzing the circadian rhythm of intracranial pressure data.Furthermore,the ratio of the amplitude of the circadian parameter (A) to the median (M) value (A/M) was selected to evaluate the biologic rhythm of patients.The correlations of circadian rhythm parameter A/M with Glasgow Outcome Scale (GCS) and with extended Glasgow Outcome Scale (GOS-E) were analyzed using linear regression.Results The circadian rhythm was observed in all patients regardless of injury severity (P ＜ 0.01).The circadian rhythm parameter A/M of intracranial pressure was positively correlated with the GCS of patients at discharge (R2 =0.346,F =14.797,P ＜0.01) and with the GOS-E (R2 =0.356,F =15.502,P ＜ 0.01).Conclusion The intracranial pressure fluctuation of TBI patients follows circadian rhythm,which might be correlated with the prognosis of TBI patients.