Objective To propose a rational clinical classification of gallstone pancreatitis for better guide and select clinical treatment scheme. Methods On the basis of severity of pancreatitis and the presence or absence of biliary obstruction, 273 cases of gallstone pancreatitis were classified into four types: non obstructive mild type (type Ⅰ) , obstructive mild type (type Ⅱ) , obstructive severe type (type Ⅲ) , non obstructive severe type (type Ⅳ). Moreover, according to the presence or absence of common bile duct stone, every type was further classified into two subtypes: subtype a and subtype b. Then, the results of clinical classification, treatment methods and prognosis were analyzed. Results Ⅰa subtype: 34 cases, Ⅰ b subtype: 112 cases; Ⅱ a subtype; 59 cases, Ⅲ subtype; 11 cases; Ⅲa subtype; 6 cases, Ⅲ b subtype: 4 cases; Ⅳa subtype: 3 cases, Ⅳb subtype: 44 cases. The overall mortality was 3.3% (9/273) , the mortality in Ⅰ type, Ⅱ type, Ⅲ type or Ⅳ type was 0, 0, 10% (1/10), 17.0% (8/47), respectively. The difference was statistically significant (P<0.05). The mortality of Ⅳ type in early operation group, traditional non-operative group, and regional intra-arterial infusion group was 30. 8% (4/13) , 25% (3/12) , 4. 5% (1/22) , respec tively. The mortality of regional intra-arterial infusion group was significantly lower than those in other two groups (P<0.05). Conclusions This 4 types and 2 subtypes classification method of gallstone pancreatitis was rational. The treatment efficacy may be improved according to the clinical classification. However, attention shall be paid to the transformation of these clinical types.

Objective:To compare the differences of bond strength usi ng gold intermediate layer between Ni-Cr alloy and opaque porcelain(OP) baked at different temperatures. Methods:36 standard samples of Ni-Cr al loy and 36 of gold were prepared. The samples were divided into 4 groups with 9 in each. In group 1,OP was smeared to the surface of the samples and then baked at 950 ℃. In group 2,3 and 4 blendgold neu(a gold past) was put on the surface of the samples, then baked at 820 ℃,890 ℃ and 960 ℃ respectively. The samples were proccessed for further tests.The bond strength was tested by shear bond te st, and the electron probe was used to observe interfacial bond state and diffus ion of interfacial elements. Results:The bond strength(MPa) in g roup 1,2,3 and 4 was 19.66? 1.83,22.34?2.73,21.33?2.75 and 28.02?5.71 res pectively(group 1 vs group 4 P

Objective To study the clinic manifest-rations, mechanism, diagnosis and treatment of pulmonary arterial hypertention (PAH) in systemic lupus erythamatosus (SLE). Methods The clinic symptoms, laboratory tests. Doppler tests of patients who were diagnosed with PAH and SLE during last five years were analyze retrospectively. Results Anti-RNP antibody's prevalence rate was high. The presence of pulmonary arterial perssure (PAP) was not related to SLE disease active index (SLEDAI). Those who had PAP higher than 45 mm Hg were prone to have Raynaud's phenomenon PAH had no association to auto-antibodies and other systemic lesions. There were no differences in clinic features, auto-antibodies and other examinations between those with kidney injure and without kidney injure. Conclusion PAH may develop insidiously in SLE, so early diagnosis and prompt treatment of PAH can improve the prognosis.

Objective To evaluate the effects of four agents including cyclophosphomide,thalidomide,total glucosides of peony (TGP) and simvastatin on cell-proliferation and endothlin-1 secretion of human endothelial cells (ECs).Methods EA.by926 cells were cultured until confluence WSS achieved,then incubated separately for 24 h.48 h and 72 h with various concentration of these four agents.The proliferation of ECs waft detected with 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium-bromide (MTT).The amount of endothlin-1 in supernatants of ECs was determined with enzyme linked immunosorbent assay.Results (1)Cyclophosphomide,TGP and simvastatin inhibited ECs proliferation in a dose dependent manner at 72 h (P＜0.05).(2)Cyclophosphomide (50-2000 μmol/L) and simvastatin (5-10 μmol/L) decreased endothlin-1 secretion but not in dose dependent manner. Conclusion Cyclophosphomide.TGP and simvastatin can inhibit ECs proliferation.Cyelophosphomide and simvastatin can decrease endothlin-1 secretion of human ECs.

Objective To analyze the clinical characteristics and prognosis of ANCA associated microvasculitis patients with gastrointestinal tract hemorrhage. Methods A retrospective analysis was conducted in 8 ANCA associated microvasculitis patients with gastrointestinal tract hemorrhage admitted to our hospital from May 1987 to May 2007. The statistical treatment is Kaplan-Meier. Results This group contained 4 male and 4 female patients. The average age was (39±20) years. The time from the onset of their disease to gastrointestinal bleeding was (8 ±8) months. Wegener's granulomatosis was the most common disease.Hematochezia(7/8 ) was the most common clinical manifestation and the distal small bowel (5/8) was the most common involved site. After the diagnosis was confirmed, methylprednisolone bolus therapy was used in 2 patients and 1～2 mg·kg-1·d-1 prednisone in 6 patients. Surgical operations were performed for 3 patients.However, 5 patients died. The prognosis was poor with the average survival time of (373±108) days. The mean survival time was (46 ±10) days after bleeding. Conclusion ANCA associated microvasculitis with gastrointestinal tract hemorrhage is rare. Early diagnosis and treatment could improve the prognosis.

To investigate the etiology and differential diagnoses of patients with systemic lupus erythematosus (SLE) and fever of unknown origin (FUO).From January 2012 to December 2014,a total of 928 SLE patients were admitted to Peking Union Medical College Hospital.Only 50 patients were combined with FUO (5.4％).The most common reason of fever was caused by infections (33 cases,66.0％),including bacterial infection in 17 cases with 5 tuberculosis,viral infection in 11 cases,and fungal infection in 5 cases.The second reason offever was due to poor disease control or recurrence in 17 patients (34.0％).No fever was caused by malignant tumor.When clinical data was compared between 17 non-infected patients versus 33 infected patients,C reactive protein and procalcitonin in the infected group were significantly higher than those in the non-infected group.In SLE patients combined with FUO,infection is the most common etiology which is necessary to be paid attention to.

Objectives To understand the status of wild feces distribution and pollution in schistosomiasis endemic areas in Yunnan Province. Methods According to the distribution of Oncomelania hupensis snails and characteristics of human and ani-mal activities in recent five years 6 schistosomiasis endemic villages in Weishan Nanjian and Midu counties 2 villages each county were selected as the investigated areas and more than 4 hm2 area with snails around each village were investigated for the types and densities of wild feces. The schistosome infested feces was detected with the hatching method. Results Totally 63 hm2 were investigated and 420 wild feces were found in all kinds of environments. The densities of wild feces were 0.066 7 piles/100 m2 and the densities of wild feces of the road and the hillside were the highest 0.098 7 piles/100 m2 and 0.088 0 piles/100 m2 respectively . Totally 260 fresh wild feces were collected including the feces of human being cattle horse dog sheep and pig and the feces of cattle and dog was the most 37.38%and 30.71% respectively . No schistosome positive feces was found. Conclusions There are a lot of wild feces in snail areas in Yunnan Province and the risk of schistosomiasis transmission is still high. Therefore we should strengthen the banning grazing measures and the investigation of dogs.

Objectives In this retrospective study we investigated the causes of misdiagnosis and incorrect treatment of hepatic cholangiocarcinoma and ways helpful in the improvement of correct diagnosis.Methods There were altogether pathollgy proved 40 cases of hepatic cholangiocarcinoma. The preoperative diagnostic procedures and surgical measurcs adopted were reviewed. Results The primary misdiagnosis rate was 68%. Patients were misdiagnosed as cholelithiasis complicated by intrahepatic inflammatory mass, hepatic abscess, hepatic hydrocyst, and hepatic adenoma;The surgical procedure performed were: choledocholithotomy, hepatophyma incision drainage or liver puncture drainage on B mode ultrasound localization, and hepatic cyst fenestration. Conclusions The hepatic cholangiocarcinoma can mimic many other benign diseases leading to misdiagnosis and improper surgery. Hence clinical features,history and laboratory evidence characteristic of the cancer must be sought preoperatively and intraoperative biopsy should be taken before definite surgical procedure. [

OBJECTIVETo investigate the influence of post-core structure on the strength of endodontically treated and crowned teeth with or without a 2.0 mm dentine ferrule.

METHODSA total of 60 recently extracted human maxillary central incisors were endodontically treated and randomly divided into five groups of 12. They were given following treatments: Group A, endodontically treated; Group B, endodontically treated and crowned (PFM); Group C, cast metal post-core with 2.0 mm dentine ferrule and crowned (PFM); Group D, cast metal post-core with no dentine ferrule and crowned (PFM); Group E, prefabricated post and composite core with 2.0 mm dentine ferrule and crowned (PFM). All specimens were stored at 100% humidity at room temperature for 30 days before testing. Each specimen was in a special jig on the MTS 810 universal material testing machine and subjected to a load at a 135-degree angle to the long axis until failure, with crosshead speed of 0.02 cm/minute. Analysis of variance followed by the Newman-Keuls pairwise multiple comparison tests was used to compare the results.

RESULTSThere was a statistically significant difference between different restorative methods. The cast metal post-core with 2.0 mm dentine ferrule and crowned teeth had the highest fracture strength (1793.59 +/- 387.93N), followed by endodontically treated intact teeth (1466.68 +/- 240.11N). No significant difference in the fracture strength was found among the other three groups (958.49 +/- 286.02N; 992.98 +/- 291.00N; 994.94 +/- 285.04 N). There was a statistically significant difference in the fracture resistance between crowned teeth with and without 2.0 mm dentine ferrule (P < 0.01).

CONCLUSIONSNot all post-core structure could improve the strength of endodontically treated teeth. The dentine ferrule can effectively improve the fracture resistance of endodontically treated and crowned teeth.

Objective To investigate the clinical features and management of hepatolithiasis associated with intrahepatic cholangiocarcinoma. Methods Data of 84 patients of hepatolithiasis associated with intrahepatic cholangiocarcinoma in our hospital from 1990 to 2009 were retrospectively analyzed.Results The incidence of intrahepatic cholangiocarcinoma in patients of hepatolithiasis was 4. 6%(84/1840), among them only 47 patients got a definite diagnosis before operation. All cancer located in the bile duct containing cholelith. In 20 patients intrahepatic cholangiocarcinoma was identified 6 - 16 years after lithotomy. The clinical manifestation of hepatolithiasis associated intrahepatic cholangiocarcinoma included:refractory hepatic abscess, incurable infection of intrahepatic biliary tract, and progressive obstructive jaundice. Only 35 patients received radical excision, 26 patients received palliative excision, 4 patients received radiofrequency ablation therapy, 19 patients received biopsy only. Conclusions There has been a considerable high coincidence between intrahepatic cholangiocarcinoma and hepatolithiasis. Resection of the lobe containing intrahepatic stones may help to prevent the development of intrahepatic cholangiocarcinoma.