China ; Dyslipidemias ; prevention & control ; Guidelines as Topic ; Humans

Objective To study the diagnosis and treatment of choledocholithiasis in patients with low left and right posterior hepatic duct confluence.Methods Clinical data of 12 patients suffering from cholelithiasis with a low confluence of the left and right posterior hepatic ducts admitted between January 2000 to June 2013 were retrospectively analyzed.Results Of the 12 cases,the left and right posterior hepatic ducts joined between 2 cm below hilus hepatis and the superior border of the duodenum in 8 cases,below the superior border of the duodenum in 4 cases.Seven cases had a low confluence of the right and left hepatic ducts,and 5 cases had right posterior duct low confluence.As for bile duct stricture:the opening stricture at the junction of the right and left hepatic ducts were found in 4 cases,the opening stricture in the right hepatic ducts were found in 3 cases,the opening stricture of the left hepatic duct were found in 2 cases.There were left and right bile duct stones in 7 cases,right intrahepatic bile duct stones in 3 cases,left intrahepatic bile duct stones in 2 cases.Cystic duct joined the right hepatic duct in 5 cases,left hepatic duct in 2 cases.Seven cases with a low confluence of the right and left hepatic ducts were with double T tube drainage; five of low right hepatic duct confluence were treated by T tube drainage.The right posterior branch of hepatic ducts were injured in four cases and right hepatic duct was injured in one.Conclusions Low confluence of left and right posterior hepatic ducts often leads to misdiagnosis during surgery of cholelithiasis.Magnetic resonance cholangio-pancreatography or endoscopic retrograde cholangiopancreatography was helpful before cholecystectomy to avoid iatrogenic injury of biliary tract.

Pancreatic enzyme replacement therapy is given to manage pancreatic exocrine insufficiency (PEI) in cystic fibrosis (CF) and following pancreatectomy, total gastrectomy or chronic pancreatitis. The article reviews on aspects of pancreatic enzyme replacement therapy containing the assement of pancreatic exocrine function, the pathogenesis of exocrine pancreatic insufficiency, pancreatic enzyme preparations and their efficiency, dosing of pancreatic enzymes, enteral nutrition and pancreatic enzyme replacement, the modulation of pancreatic exocrine and adverse reactions to pancreatic enzyme.

Objective To evaluate the role of serum homocysteine (HCY) in diabetes mellitus(DM ) complicating proliferative diabetic retinopathy (PDR) .Methods 174 patients with DM were selected and divided into PDR ,non‐PDR(NPDR) and non‐dia‐betic retinopathy (NDR) groups .The serum HCY level was detected .Results Serum HCY levels in the PDR ,NPDR and NDR groups were (18 .20 ± 5 .60) ,(14 .40 ± 6 .70) and ,(12 .10 ± 6 .80)μmol/L respectively ,which was highest in the PDR group (P<0 .05) .Conclusion HCY could result in PDR generation possibly by injuring the retinal blood vessels .

Objective: The aim of this study is to investigate the clinical factors in association with venous thromboembolism (VTE) in patients with lung cancer, and to provide evidence for prevention and therapy of VTE. Methods: Clinical information of 2 053 patients with lung cancer definitely diagnosed by cytology or pathology between July 2008 and June 2010 was retrospectively analyzed. VTE wasconfirmed by chest spiral computed tomography (CT), pulmonary arteriography and colorful Dopplerultrasound. The clinical factors including age, gender, pathological type, operation, clinical stage,body mass index, co-morbidity and platelet count as well as D -dimer, interleukin-1 (IL-1) and tumornecrosis factor (TNF) were considered as the potential VTE-related factors. Results: Of 2 053 patients,89 (4.34%) were confirmed with VTE. The incidence rates of VTE in patients with adenocarcinoma andnon-adenocarcinoma were 5.65% (58/1 027) and 3.02% (31/1 026), respectively, and the difference wasstatistically significant (P £?0.003). The incidence rate of VTE in stage I-III A lung cancer patients was significantly lower than that in stage IIIB-IV lung cancer patients [1.48% (10/677) vs 5.74% (79/1 376); P<0.001]. In patients with stage I-IIIA undergoing surgical operation or not, the incidence rates of VTE were 1.55% (10/645) and 0% (0/32), respectively (P=0.044). Significant difference of incidence rate of VTE was also found between the patients with and without co-morbidity [6.73% (56/832) vs 2.70% (33/ 1 221); P<0.001]. The incidence rates of VTE in patients with normal levels of platelet count, D -dimer,IL-1 and TNF were 3.72%, 0.31%, 2.44% and 3.27%, respectively; whereas, the incidence rates in patients with increased levels of these measurements were 6.26%, 19.91%, 10.26% and 7.74%, respectively; the differences between two groups were all significant (P<0.05). Logistic multivariant regression analysisrevealed that the clinical factors of adenocarcinoma, operation, co-morbidy and high levels of D-dimer,IL-1 and TNF in blood were associated with increased risk of VTE (P<0.05). Conclusion: Adenocarcinomais the most common pathological type in lung cancer patients with VTE. The risk factors of VTE include operation, co-morbidity and high levels of D -dimer, IL-1 and TNF in blood. Copyright© 2011 by TUMOR.

Objective To introduce the method and to evaluate the therapeutic effect of collagenase chemonucleolysis for treatment of cervical disc herniation.Methods 92 patients with cervical herniated discs were selected from January 2002 to December 2004.The procedure was guided by DSA and the puncture was defined from C_(6~7) or C_7-T_1 extradural cavity.Collagenase(1200~2400 u) was injcted in the herniated extradural cavity through the micrcatheter.Results The procedure of 88 cases was successful.80 cases were followed up from 6 to 12 months.The effect showed that 70 cases(87.5%) were excellent or good.No serious complication occurred.Conclusion The method of collagenase chemonucleolysis for treating cervical disc herniation is safe and effective,it can be used in clinic.

Objective To deal with the inconvenience that doctors have to use current name but not trade name in writing the prescription after the institutional reform of medicine.Methods To meet the system requirement,the generating method of drug phoneticized code was altered in our hospital.Result The problem was solved by defining one item with multiple codes,i.e.one name with multiple codes or one code with multiple names.Conclusion With source program untouched,this method is simple and feasible in practical application.

[Objective] To investigate the effects of Qianggu capsule plus alendronate on postmenopausal osteoporosis.[Methods]By random number generating method,120 patients were randomly divided into a treatment group with Qianggu capsule plus alendronate,control group A only with Qianggu capsule,and control group B only with alendronate.The pain of the patient before treatment,3 m and 6 m after treatment was assessed.At the same time,the bone mineral density (BMD) before and 6 months after treatment was recorded.[Results] There was significant difference before and after 3 m in the score of pain in three groups,but the difference in treatment group was higher than other two control groups.After 6 m,all the scores of pain in 3 groups had changed significantly compared to the ones before treatment,but the scores of pain in treatment group were lower than 2 control groups.The BMD of both vertebral and ward in treatment group after 6 months treatment was higher than before.[Conclusions]Qianggu capsule plus alendronate has definite therapeutic effects on postmenopausal osteoporosis.

Objective To explore the curative effect of breathing machine in the treatment of acute heart failure complicated with respiratory failure.Methods 1 1 0 patients with acute heart failure and respiratory failure in emergency ICU of our hospital were selected,they were randomly divided into control group and observation group.The control group received routine therapy,the observation group was given breathing machine on the basis of routine therapy.The treatment efficacy of the two groups was compared.Results Before treatment,PaO2 ,PaCO2 ,PH and SaO2 between the two groups had no obvious differences (P >0.05 ).After treatment,PaO2 ,PH and SaO2 in the observation group were (1 1 .41 ±2.25)kPa,(7.42 ±0.1 9),(97.1 1 ±2.1 7)%,which were significantly higher than those in the control group,PaCO2 was (5.21 ±0.22)kPa,which was significantly lower than the that of the control group,the differences were statistically significant (t =2.501 ,P =0.01 4;t =2.598,P =0.01 1 ;t =2.855,P =0.005;t =-2.691 ,P =0.008).The level of sernm brain natriuretie peptide of the observation group[(472.32 ± 298.06)pg/L]was significantly lower than that of the control group,the difference was statistically significant(t =-2.263,P <0.05).Conclusion The clinical effect of breathing machine EICU in treatment of acute heart failure complicated with respiratory failure is remarkable,and can effectively improve the clinical symptoms,and is worth further clinical application.

Objective To study the qualitative analysis and quantitative analysis of flavonoids and other ingredients in leaves of Lonicera hypoglauca miq,and to optimize the reflux extraction condition for total flavonoids from leaves of lonicera hypoglauca miq. Methods Preliminary test was used for qualitative analysis. UV-spectrophotometry was used to determinate content of total flavonoids. By orthogonal design,the extraction rate of flavonoids was determined in different factors of ethanol reflux extracting. Results Leaves of lonicera hypoglauca miq contained alkaloids and flavonoids.The optimum conditions of ethanol reflux extracting total flavonoids are 12 times 50% ethanol,and refluence for 1.0h at water bath for two times.According to validate experiment,the average total flavonoids content was 16.6% in leaves of lonicera hypoglauca miq,with RSD=1.52%(n=3). Conclusion Flavonoids are in higher level in leaves of Lonicera hypoglauca miq. There are some chemical similarity in leaves of lonicera hypoglauca miq and leaves of flos lonicerae.