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.

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

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.

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.

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

On the basis of outpatients' medical records concerning primary liver cancer (PLC), data of 552 patients (with 2020 effective prescriptions) from the Outpatient Department of Changhai Hospital treated by Professor Ling Changquan were collected. The nature, flavor and meridian distribution of the herbs used in the prescriptions were summarized by frequency method, and the features of the herbs used according to syndrome differentiation were analyzed by logistic regression. The couple herbs used were analyzed by cluster analysis. All the data were analyzed in combination with the experience of the specialist. It showed that most of the frequently used herbs were herbs for invigorating the spleen to promote appetite, removing toxic materials to inhibit tumor growth, and activating blood circulation to dissipate blood stasis. These herbs are mostly of plain or cool nature, and mainly of sweet, bitter, or acrid taste. It also showed that the most frequently used herbs for qi deficiency were Astragalus membranaceus, Atractylodes macrocephala, and Pseudostellariae; Caulis Spatholobi and Chinese jujube for blood asthenia; Fructus Corni and Ophiopogon japonicus for yin deficiency; Agastache rugosa, Semen Plantaginis and Poria for water-dampness; cape jasmine fruit and baikal skullcap root for heat excess; peach seed and Radix Paeoniae Rubra for blood stasis; Curcuma wenyujin, Akebia trifoliata and Bupleurum chinese for qi stagnation. A total of 19 pairs of couple herbs were summarized by the cluster analysis.

To survey the current awareness of risk factors for osteoporosis in community health staff in Beijing.A total of 200 medical staff including general practitioners,community nurses and public health doctors from 4 Community Health Service Centers in Beijing were examined by purposeful sampling.Then their knowledge of osteoporosis risk factors was gauged by a questionnaire.The community health staff lacked a sufficient knowledge of osteoporotic risk factors.And the most knowledgeable factor was advanced age of which 41.5％ community health staff knew.The community health staff has an insufficient knowledge of osteoporosis so that its proper training should be strengthened.