The guidelines for the diagnosis and treatment of acute pancreatitis are the important reference for clinicians in treating acute pan-creatitis,especially severe acute pancreatitis (SAP).However,currently there is much discrepancy on the opinion and practice in China, which affects the treatment outcome and cure rate of this disease.Clinical focuses are described in terms of the diagnostic criteria and treat-ment for SAP,with the hope of initiating reflection and discussion on the clinical diagnosis and treatment of SAP.

Objective It has been reported that VacA receptor of H pylori on gastric cell membrane is belong to the receptors of protein tyrosine phosphatase(RPTP) family, which are associated with signal transduction of cells. However the mechanism of vacuolation is still unknown. There may be a new way to reduce the toxicity of H.pylori by interfering the signal transduction. Methods The concentrates of supernatants from H.pylori liquid culture was used as rough VacA. Protein tyrosine phosphatase inhibitor (PTPI) and protein tyrosine kinase inhibit or(PTKI) which were diluted and combined with rough VacA were incubated with SGC 7901 cells for 24 hours. Results PTPI could inhibit the vacuolating activity with a minimal concentration of 2.7 ?mol/L( A 550 =0.46?0.06 vs 0.59?0.04, P

Objective To study the clinical efficacy of Danhong injection for the treatment of idiopathic pul-monary fibrosis.Methods 84 patients with idiopathic pulmonary fibrosis were randomized into the control group ( prednisone treatment) and the observation group ( based on the prednisone treatment, added the Danhong injec-tion),42 patients per group.The clinical efficacy,oxygen partial pressure and CO diffusing capacity,the TGF-β1 in the serum and pulmonary ventilation in the two groups were observed and compared after 6-week treatment. Results Compared with the control group, the total effective rate was significantly increased ( 92.9% vs 71.4%) in the observed group(P<0.05);compared with the control group,the oxygen partial pressure [(67.57 ±9.93) vs (51.74 ±9.21)]mmHg and CO diffusing capacity[(18.98 ±3.44) vs (15.83 ±3.06)]mL/(min· mmHg) were obviously increased in the observed group after treatment( P<0.05);compared with the control group,the content of TGF-β1 in the serum was significantly reduced [(1.15 ±0.13) vs (3.02 ±0.28)]μg/L and the pulmonary ventila-tion [(1.85 ±0.36) vs (1.69 ±0.30)]L was obviously increased in the observed group after treatment(P<0.05);compared with the control group,the incidence of adverse reactions was obviously reduced (4.8%vs 19.0%) in the observed group(P<0.05).Conclusion The treatment of Danhong injection for the idiopathic pulmonary fibrosis has the significant efficacy and high safety,can effectively correct th hypoxemia,significantly improve the lung function, which is worthy of clinical promotion.

Objective To explore the clinical effect of bone allograft plus interlock plate internal fixation in the treatment of tibial plateau fractures.Methods 43 patients with tibial plateau fractures were treated by open reduction,bone allograft,locking plate fixation and early knee joint function training.Results All patients were followed up for 8 ～ 14 months with an average of 10 months.All patients achieved bone union and the duration of union was averaged 6.9 months.Knee joint function was rated based on HSS score system as excellent in 30 cases,good in 9 cases,fair in 3 cases and poor in 1 case.The excellent and good rate was 90％.Conclusion Reliable effect can be achieved for fracture of tibial plateau treatment with bone allograft plus interlock plate internal fixation.It provides satisfactory function of the knee.It has many advantages,such as stable and durable fixation and avoidance of secondary compression of tibial plateau.

ObjectiveTo observe the effect of monosialo gangliosides-1 (GM-1) and Radix salviae miltiorrhizae (RSM) on neonatal hyposemic ischemic encephalopathy (HIE).Methods62 cases of HIE were randomly divided into treatment group and control group, and both groups received conventional therapy. Injection of RSM and GM-1 were added into the treatment group in 7～10 days therapy. ResultsHigh curative effect, average curative effect and total curative effect in the treatment group of 31 cases were 80.6%, 16.1% and 96.8%, while that in control group of 31 cases were 32.3%, 51.6% and 83.9% respectively. There was significant difference in the high curative effect and total effect between the two groups (P<0.05). ConclusionThe treatment combined with RSM and GM-1 can enhance the curative effect on HIE without any side effect.

Aim To explore the effect of Osthole (Ost)on the right ventricle remodeling in monocrot-alinetreated rats and the possible mechanism.Meth-ods ♂ SD rats were randomly divided into normal control group,model group,low dose of Ost treatment group (10 mg·kg -1 )and high dose of Ost treatment group (20 mg·kg -1 ).All rats were given a single dose of MCT 50 mg·kg -1 subcutaneously to establish the right ventricle remodeling except normal control group.Then the rats in Ost treatment group were ga-vaged once daily.After 28 days of administration,the right ventricle(RV)and left ventricle plus septum(LV+SEP)were weighed separately.RV hypertrophy in-dex (RVHI)were measured by the relative weight rati-o of RV to LV +SEP.The morphological changes of right ventricle were executed by HE staining.The pro-tein expression of PPARαand PPARγwere detected by Western blot.Results Compared with the control group,RVHI was increased obviously (P <0.05 ), myocardial hypertrophy and structure disorders were observed in model group.The protein expression of PPARαand PPARγwere down-regulated significantly in model group (P <0.05).Compared with the model group,the value of RVHI (P <0.05),myocardial hy-pertrophy,structure disorders were improved signifi-cantly in Ost treatment group.The protein expression of PPARαand PPARγwere up-regulated in Ost treat-ment group (P <0.05).Conclusion Ost can attenu-ate the right ventricle remodeling induced by MCT in rats,which may be related to up-regulating the expres-sion of PPARαand PPARγ.

OBJECTIVETo compare the effectiveness of percutaneous microwave ablation ( MWA) versus hepatectomy for multifocal hepatocellular carcinoma.

METHODSFrom August 2002 to March 2012, one hundred and twenty-two patients with multifocal hepatocellular carcinoma (diameters 1 to 7 cm, 2 to 4 lesions) were treated by either complete MWA or radical hepatectomy, and their clinical data were collected and analyzed.The patients were divided into MWA group (n = 50) and resection group (n = 72), and the resection group was matched by MWA group based on clinical parameters. The survival and complications in the two groups were compared.

RESULTSThe overall 1-, 3- and 5-year survival rates were 100.0%, 73.0% and 62.0%, respectively, in the MWA group, and 80.0%, 56.0%, and 41.0%, respectively, in the resection group (P < 0.05). The corresponding recurrence-free survival rates were 88.0%, 63.0%, and 52.0% in the MWA group, and 68.0%, 45.0%, and 36.0%, respectively, in the resection group (P< 0.05). The multivariate Cox regression analysis indicated that albumin level, performance status, treatment modality, and tumor size were independent prognostic factors.

CONCLUSIONCompared with hepatectomy, percutaneous microwave ablation is a minimally invasive and reproducible procedure, and can improve the survival in patients with multifocal hepatocellular carcinoma.

Carcinoma, Hepatocellular ; mortality ; radiotherapy ; surgery ; Catheter Ablation ; Genetic Engineering ; Hepatectomy ; mortality ; Humans ; Liver Neoplasms ; mortality ; radiotherapy ; surgery ; Microwaves ; therapeutic use ; Regression Analysis ; Survival Rate ; Treatment Outcome

Objective To evaluate the blood-saving effect of acute hypervolemic hemodilution (AHH) with 6％ hydroxyethyl starch 130/0.4 (HES 130/0.4) in preschool children.Methods Forty ASA Ⅰ patients,aged 3-6 yr,weighing 11.5-22.5 kg,with body height of 78-120 cm,scheduled for orthopedic or general surgeries,were divided into 2 groups by drawing lots:group AHH (n =20) and group control (n =20).6％HES 130/0.4 10 ml/kg was infused over 30 min at a rate of 0.3 ml·kg-1 · min-1 through the internal jugular vein before surgery in group AHH.The fluid balance,blood loss,urine output and blood transfusion during operation were recorded.The blood routine,liver and kidney function and coagulation function (prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib)) were measured before AHH (T0) and at 0,4 and 24 h after AHH (T1-3).Hypokalemia,hypocalcemia and prolongation of PT and APTT during surgery,and pulmonary edema,heart failure and abnormal bleeding from the site in the wound during the perioperative period were recorded.Results The two groups were comparable with regard to the volume of multiple electrolyte solution consumed,blood loss,parameters of liver and kidney function,platelet count and incidences of hypokalemia and hypocalcemia (P ＞ 0.05).The urine output was significantly increased,Hct at T1 and Fib at T1,2 were significantly decreased,PT and APTT were prolonged,and the percentage of patients without allogeneic blood transfusion and incidences of prolongation of PT and APTT were significantly increased in group AHH as compared with group C (P ＜ 0.05).No pulmonary edema,heart failure and abnormal bleeding were found during the perioperative period.Conclusion AHH with 6％ HES 130/0.4 10 ml/kg provides better blood-saving effect in preschool children,has little effect on the internal environment,but prolongs the coagulation time and exerts effect on coagulation function to some extent.

Objective To explore the method and effect of prosthetic replacement for the management of intertrochanteric fracture in the elderly.Methods 24 elderly patients with intertrochanteric fracture were treated with prosthetic replacement.According to the Evans classification,there were 4 cases of Evans Ⅱ,16 Evans Ⅲ and 4 Evans Ⅳ.Results The mean time to ambulation following the surgery was (6.0 ± 2.2) days.No prosthetic loosening or infection were observed in the follow-up of 6 to 27 months(average 12 months).According to the Harris hip score,the excellent and good rate was 83.3％.Conclusion Prosthetic replacement is safe and effective for intertrochanteric fractures in elderly patients,which allows early ambulation and have a relatively low rate of complications.

OBJECTIVE:To promote rational use of traditional Chinese medicines. METHODS:The practical importance of applying basic pharmacoeconomic theory to the rational use of traditional Chinese medicines was analyzed and the measures regarding how to apply the pharmacoeconomic theory to guide rational use of traditional Chinese medicines were put forward. RESULT & CONCLUSION: It is quite necessary and practical to apply the basic pharmacoeconomic theory to the rational use of traditional Chinese medicine, which plays a positive role in promoting rational use of traditional Chinese medicines.