Acute pancreatitis is one of the most common acute abdominal disease requiring acute hospitalization worldwide.As severe acute pancreatitis associated with mortality up to 30％,rational diagnosis and management requires up-to-date evidence-based treatment guidelines.The Guidelines for the surgical management of acute pancreatitis composed by the International Association of Pancreatology (IAP) was published in 2002,since then there have been substantial improvements in the management of acute pancreatitis.The collaboration of the IAP and the American Pancreatic Association (APA) was undertaken to revise these guidelines using an evidence-based approach in 2013 and published their new guidelines 2013 IAP/APA evidence-based guidelines for the management of acute pancreatitis few months ago.This paper presented the understandings of this new guidelines and compared with related guidelines abroad.

BACKGROUND:Lisfranc ligament is the strongest one among three ligaments between the second metatarsal bone and the medial cuneiform, anditis critical for maintaining the stability between the second metatarsal bone and the medial cuneiform because Lisfranc ligament isthreetimes stronger than the dorsal ligament. However, there have been no reportsaddressingthe effects of Lisfranc ligament injury on the stability of tarsometatarsal joints.
METHODS/DESIGN:An anatomical and biomechanical study was performed. Anatomical measurements were performed in the origin, terminal, path, length, width, and thickness of Lisfranc ligament utilizing cadaverous embalmed specimens. In the experiment on fresh-frozen cadaveric specimens, the displacement changes between the first and the second metatarsal base under different loading were measured with biomechanical analysis after the successively resected dorsal ligament, Lisfranc ligament, and plantar ligament were loaded, respectively, exploring the effectof Lisfranc ligament on stability of tarsometatarsal joints.
DISCUSSION:This study providesthe theoretical basis for the treatment of tarsometatarsal joint injury in the clinic through exploring the effects of Lisfranc ligament on stability of tarsometatarsal joints. The attention
should be paid to Lisfranc ligament by the physicians when the tarsometatarsal joint injury occurs.

Iontophoresis possesses the unique superiority as an effective way for promoting the permeability in a therapy system which gives medicine through human' skin directly.It has been developing very quickly in recent years.The application of DC,pulse DC and the electroporation causes the flux greatly enhanced,especially the application of electroporation which can fast reduced the skin resistance and enhance the flux for its reversible function to the skin.What's more,there has been an improved way for iontophoresis now,which uses the AC with an offset of DC.This method can stabilize the skin resistance so as to stabilize the human epidermis membrane parameters,including the pore area,the pore distribution,the pore surface charge density,thus keeping the flux constant.

BACKGROUND: Unicompartmental knee arthroplasty (UKA) began in the early 1970s, which was once negated due to high postoperative repair rate. The methods for early unicompartment osteoarthritis of the knee include UKA, total knee arthroplasty, high tibial osteotomy and fibular truncation. A large number of retrospective studies and literatures have pointed that UKA is effective for unicompartment osteoarthritis of the knee and holds unique advantages.OBJECTIVE: To review the status and research progress of UKA for anteromedial compartment osteoarthritis of the knee in view of indications, contraindications, operation curve, operation process and main technical points and clinical efficacy.METHODS: The first author retrieved the databases of PubMed and CNKI from March 2006 to September 2016 using the keywords of unicompartmental knee arthroplasty, knee, osteoarthritis, clinical application in English and Chinese,respectively. A total of 95 literatures were searched, and 40 eligible articles were included in accordance with the inclusion criteria.RESULTS AND CONCLUSION: Only unilateral lesion (the degenerative cartilage surface of tibiofemoral joint) is replaced in UKA to treat early unicompartment osteoarthritis of the knee, which exhibits less trauma, rapid recovery, few complications, and normal postoperative proprioception of joint and high patient acceptance. Because of its narrow surgical indications, UKA application has been restricted compared with total knee arthroplasty. Indeed, total knee arthroplasty is matureand, and its long-term curative effect is clear. In contrast, UKA is carried out late in China, has not been popularized, and the long-term clinical efficacy remains to be verified further. But if we can accurately grasp the operation indications, choose appropriate patients, make careful preoperative preparation, and master mature skills, the clinical effect will be satisfactory. With the development of prosthesis, equipment design and operation technology, UKA will be prevailed in the treatment of anteromedial compartment osteoarthritis of the knee.

Patients with systemic lupus erythematosus,especially lupus nephritis,are often accompanied by arterial and venous thrombus at various sites.Thrombosis is associated with the extrinsic and intrinsic coagulation pathway activated by inflammation and endothelium injury.Anticoagulant therapy can interrupt the cycle between inflammation and thrombus,which not only prevents and treats the thrombotic disease but also lessens the inflammatory reaction in kidney and attenuates the renal injury.

The development of Continuous renal replacement therapies(CRRT) in saving the critically ill patients is rapidly because of its removing the toxins and inflammatory mediators,maintaining the balance of the internal enviroment and preventing the endothelial cell function.The aim of the present paper is to guide and standardize the clinical usage of CRRT in the primary hospitals,through clarifying some problems of CRRT in clinical practice,such as the selection of CRRT pattern,setting the blood flow rate and the prescription and dosage of replacement fluid in CRRT,the selection of anticoagulant and the anticoagulation strategy and the announcements in CRRT. Abstract:Summ ary:The developm ent of Continuous renal rep lacem ent therap ies(CRRT) in saving the critically ill patients is rap-id ly because of its removing the toxins and inflamm atory m ed iators,m aintain ing the balance of the internal envirom ent and preventing the endothelial cell function.The aim of the present paper is to gu ide and standard ize the c lin ical usage of CRRT in the prim ary hosp itals,through c larifying som e prob lem s of CRRT in c lin ical practice,such as the selection of CRRT pattern,setting the b lood flow rate and the prescription and dosage of rep lacem ent flu id in CRRT,the selection of anticoagu lant and the anticoagu lation strategy and the announcem ents in CRRT.

Cardiopulmonary Resuscitation ; adverse effects ; Chylothorax ; etiology ; Heart Arrest ; physiopathology ; Humans ; Infant ; Infant, Newborn ; Male ; Neonatology

Bone Marrow Neoplasms ; Humans ; Leukemia, Myeloid ; Proto-Oncogene Proteins c-cbl

BACKGROUND: The purpose of this study was to identify predictive factors for preventive behaviors of falls in elderly inpatients. METHODS: Data on 200 elderly inpatients at one university hospital were collected. Descriptive analysis, independent t-test, analysis of variance, and stepwise multiple regression analysis were done to analyze the data. RESULTS: The high risk group, scoring higher than 5.0 in the degree of self-awareness of fall risk, scored low in knowledge about falls while subjects with activity limitations and not using hearing aids scored significantly high in the same area. Subjects with no training regarding falls and the high risk group scored low in fall efficacy while subjects with activity limitations and using hearing aids scored significantly high in the same area. The degree of self-awareness of fall risk, knowledge about falls, and fall efficacy were significant factors affecting fall prevention activities. CONCLUSIONS: These findings suggest that self-awareness of the risk of falls, knowledge about falls, and fall efficacy are significant factors in preventing falls. These factors should be considered when developing nursing assessment tools and intervention programs for elderly inpatients.
Accidental Falls ; Aged ; Hearing Aids ; Humans ; Inpatients ; Nursing Assessment

PURPOSE: The purpose of this study is to discover the influence of the working conditions on women workers' occupational stress. METHODS: Descriptive method is used to identify women's stress depending on their general working features and conditions by conducting a survey of them in women-dominated service industries. SPSS 18.0 program is used for data analysis and descriptive statistics is presented with standard deviation, frequency and percentage. chi2-test is used as an analysis tool. To figure out factors that influence their stress, logistic regression analysis is used for general features and working conditions as independent variables, and occupational stress as a dependent variable. RESULTS: As a result, among the independent variables, employment status, weekly working hours, career, shiftwork, and work-family-balance are meaningful factors that influence their stress. Temporary workers' stress is 3.65 times higher (p<.001), and workers working over 48 hours a week have 1.97 times higher stress (p<.003). Workers with over 5 years' career are under 1.73 times higher stress (p<.046) and shift workers are under 3.51 times higher stress (p<.001). Work family balance results in 1.93 times higher stress (p<.009). CONCLUSION: It is necessary to seek how to prevent and manage women workers' stress considering features.
Employment ; Female ; Humans ; Logistic Models ; Statistics as Topic