Objective To investigate the effect of interventional therapy for acute severe pancreatitis.Methods A total of 70 patients with acute severe pancreatitis were randomly divided into Control(common medication) and Interventional Therapy groups(common medication plus interventional therapy) with 35 cases in each.The curative effect was compared between the two groups.Results Compared with the Control Group,the patients in the Interventional Therapy Group had a significantly lower mortality [25.7%(9/35) vs 5.7%(2/35);?2=5.285,P=0.022],lower incidence of ARDS [37.1%(13/35) vs 14.3%(5/35);?2=4.786,P=0.029],decreased incidence of pancreatic encephalopathy[34.3%(12/35) vs 11.4%(4/35);?2=5.185,P=0.023],shorter recovery time of serum amylase[(7.6?2.1) d vs(3.4?1.5) d;t=-9.628,P=0.000],and shorter hospital stay[(34.0?6.4) d vs.(23.5?8.9) d;t=-5.667,P=0.000].In the Interventional Group,the symptoms and signs disappeared at(10.0?2.4)d after the treatment,which was significantly earlier than that in the Control Group(18.0?2.6)d(t=-13.376,P=0.000).Conclusions Interventional therapy can effectively control acute severe pancreatitis and shorten the course of the disease.

In this paper an expert system for remote fault diagnosis in the ship lift was developed by analysis of the fault tree and combination with VPN. The fault tree was constructed based on the operation condition of the ship lift. The diagnosis model was constructed by hierarchical classification of the fault tree structure, and the inference mechanism was given. Logical structure of the fault diagnosis in the ship lift was proposed. The implementation of the expert system for remote fault diagnosis in the ship lift was discussed, and the expert system developed was realized on the VPN virtual network. The system was applied to the Gaobaozhou ship lift project, and it ran successfully.

Serine protease inhibitor (serpin) is a kind of serine protease activity regulator,which including nine subfamilies (SERPIN A ～ I).SERPINE (Serpin Peptidase Inhibitor,Clade E) can regulate many important life processes.In this paper,the physical and chemical properties,mechanisms and regulatory factors of SERPINE1 and SERPINE2 in the two important members of SERPINE family are introduced,and the research progress of SERPINE family in the fibrosis related diseases is described.

The paper was aimed to review the modeling methods of spleen-yang deficiency, which can be classified into imitating traditional Chinese medicine (TCM) etiology methods and modern medicine methods. At present, methods of modeling were not generally accepted and the main presented problems were as follows. Modern medicine methods did not conformed to the rules of TCM etiology and pathogenesis. The evaluation of yang deficiency models was not accurate. Some modeling methods can lead to other diseases at the same time. The names of spleen deficiency model were not unified. It was difficult to distinguish the modeling methods of spleen-yang deficiency and spleen-qi deficiency, and etc. Model evaluation of spleen-yang deficiency was various. However, the domestic standard evaluation system had not been formed. The main model evaluation problems were as follows. Macro symptoms of the model lacked of objective and quantitative evaluation. It lacked of evaluation indexes of pulse and tongue with TCM characteristics. The disproof of prescription selection was not unified. Similar syndromes had not been ruled out. The microscopic indexes were fragmented, and etc. This paper reviewed on animal modeling methods of spleen-yang deficiency.

Objective To evaluate the safety and effectiveness of TACE with radiofrequency ablation (RFA) in treatment of renal cell carcinoma.Methods Data of 23 cases of renal cell carcinoma were retrospectively analyzed.Firstly all patients were treated with renal TACE,and then RFA under the guidance of ultrasound and CT was performed 3 to 4 weeks later.The therapeutic effects were evaluated by enhanced CT or MR scans during the follow-up period.Meanwhile,the changes of Karnofsky Performance Status (KPS) scores and renal functions between preoperative and postoperative periods were also evaluated.Results To the end of the follow-up,in all 23 patients 21 cases (21/23,91.30％) survived and 2 cases died (2/23,8.70 ％).KPS scores and serum creatinine levels were observed in all 23 patients at the initial stage and the end of the follow-up period,there were no significant differences (all P＞0.05).At the end of follow-up,16 cases were complete remission,5 were partial remission and 2 were progressive disease.Conclusion TACE combined with RFA is a safe and effective method in treatment of renal cell carcinoma with less trauma,less complication and more effective.

This article was aimed to study the general reproductive toxicity in mice in order to give a better evalua-tion of the medicinal plant of pineapple leaves (A nanas comasus L). Adult male and female mice were orally admin-istered with pineapple leaves. And then, each of the male and female mice was put together in one cage for mating. The mating success females were fed continuously. The experimental observation was conducted in pregnancy, fetal development, as well as the offspring of mice. The results showed that in addition to a large dose of pineapple leaves (4 g·kg-1) of the parental male rats having a lower body weight, pineapple leaves did not significantly affect on other parameters. There were no significant effects on pregnant mice and their offspring of mice. It was concluded that the pineapple leaves did not influence the general reproductive function of mice apparently.

Objective To explore the clinical value of lidocaine combined with remifentanil intravenous anesthesia for radiofrequency ablation of liver tumors.Methods Totally 1 252 patients with hepatic tumors treated by radiofrequency ablation were analyzed.RITA cluster multipole radio needles were used in all cases.Local anesthesia with lidocaine was used before percutaneous puncture,and the dosage was 2 mg/kg of body mass.The initial dose of remifentanil was injected with pump at 0.05 μg/(kg · min) during operation.Mean arterial pressure (MAP),heart rate (HR) and saturation of peripheral oxygen (SPO2) were recorded 24 h before radiofrequency ablation (T0),at the beginning of operation (T1),30 min after operation (T2) and at the end of surgery (T3).Visual analogue scale (VAS) was used to assess the analgesic effect during the whole ablation procedure.Results Radiofrequency ablation were successfully performed in 1 250 patients (1 250/1 252,99.84％).The average time was (59.02 ±14.63) min.The average dosage of remifentanil was (242.22± 22.73)μg.The average VAS score was (2.42± 1.13) points.Compared with the preoperative T0 time point,SPO2 did not change significantly at each time of T1,T2 nor T3,but MAP and HR were significantly higher than those before operation (both P＜0.05).VAS scores were significantly higher in patients with tumors size ＞5 em than those in patients with tumors size ≤5 cm (P＜0.05).VAS scores were significantly higher in patients with lesions under hepatic capsule and in diaphragm dome than in patients with lesions in other parts (both P＜0.05).Severe anesthesia related complications occured in 2 patients,related to the respiratory inhibitory effect of remifentanil,and the patients were completely recovered after corresponding treatment.Conclusion Lidocaine combined with remifentanil intravenous anesthesia for radiofrequency ablation of liver tumors can effectively relieve the pain in patients.Tumor size and tumor location are the main impact factors on analgesic effect.

Objective To investigate the effectiveness and safety of TACE combined with radiofrequency ablation (RFA) and simple RFA in the treatment of hepatocellular carcinoma (HCC) with Meta-analysis.Methods The randomized controlled trials comparing of TACE combined with RFA and simple RFA in the treatment of HCC from January 2000 to November 2016 in Chinese and English literatures were included.Results A total of 12 articles were enrolled in this study.Meta-analyses showed that the 1-year,3-year overall survival rate and 1-year,3-year recurrence-free survival rate of TACE combined with RFA group were better than those of simple RFA group (all P＜0.05).And there was no significant difference between TACE combined with RFA group and simple RFA group in 5-year overall survival rate (P =0.07).There was no significant difference of the 1-year,3-year overall survival and 1-year and 3-year recurrence-free survival rate between TACE combined with RFA group and simple RFA group for tumor with maximum diameter ＜3 cm in HCC (all P＞ 0.05).There was no significant difference in the incidence of serious complication in both two groups (P=0.82).Conclusion The short-term and mid-term efficacy in the treatment of HCC using TACE combined with RFA is better than those using simple RFA,while the long-term efficacy of two kinds of therapy have no significant differences.

Objective:To evaluate the safety and effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in hepatocellular carcinoma (HCC) patients with Vp4 portal vein tumor thrombus (PVTT).Methods:Data of 15 patients undergoing TIPS for HCC with Vp4 PVTT and portal hypertension (PTN) in Peking University First Hospital from July 2018 to February 2023 were retrospectively analyzed, including 14 males and 1 female, aged (61.5±11.1) years old, ranging from 40 to 78 years old. The success rate of TIPS, portal pressure gradient (PPG) before and after procedure, perioperative adverse effects and complications were recorded. The survival status of patients was followed up by telephone review after surgery. Kaplan-Meier method was used for survival analysis.Results:The procedure of TIPS was performed uneventfully in all patients, with a technical success rate of 100% (15/15). PPG before and after TIPS were (31.73±5.48) mmHg (1 mmHg=0.133 kPa) and (17.60±3.66) mmHg, respectively, and the difference was statistically significant ( P<0.001). No perioperative death, hepatic artery or bile duct injury, acute liver failure or other major complications occurred. Compared with the preoperative status, the performance status scores [0(0, 0) vs. 3(3, 3)] and Child-Pugh scores [6(5, 8) vs. 9(8, 10)] were lower in patients one month after TIPS (all P<0.05). The median survival time was 228 d. Kaplan-Meier curves showed that the cumulative survival rates at 3, 6, 12 and 24 months after TIPS were 100%, 64.3%, 32.7% and 8.2%, respectively. Conclusion:TIPS could be safe and effective for HCC with Vp4 PVTT and severe PTN.

Objective:To describe the current situation of gastric lavage operation and put forward measures for improvement by analyzing the clinical characteristics of 294 patients with gastric lavage in Poisoning Treatment Center of The First Affiliated Hospital of Nanjing Medical University.Methods:The clinical data of 294 patients with acute poisoning and gastric lavage from 2019 to 2021 were collected and analyzed retrospectively, and the related parameters (poison type, gastric lavage volume, poisoning to gastric lavage time, etc.) of each year were compared.Results:A total of 653 poisoning patients underwent gastric lavage from 2019 to 2021, with an average age of (44.2 ±20.1) years, and 134 (45.6%) were male. The main causes of gastric lavage were pesticide poisoning (52.72%) and drug poisoning (42.86%). The volume of gastric lavage was less than 10 L for 43.8% of patients and 10-20 L for 32.7% of patients. Patients with gastric lavage within 60 min after ingestion of poison accounted for 45.3%, followed by 25.8% within 61-120 min. The in-hospital mortality rate was 17.7%. The common complications of gastric lavage were: the incidence of gastrointestinal bleeding (55/121, 45.5%), the incidence of aspiration pneumonia (54/140, 38.6%), and the incidences of electrolyte disorder (21% of low potassium, 29% low calcium, and 10.0% low sodium). Compared with the groups in different years, the proportion of gastric lavage in poisoning was 58.85% vs. 46.60% vs. 32.41%, which decreased year by year, with statistical difference ( P <0.05). And there was no difference in the period from ingestion to gastric lavage and gastric lavage fluid volume. There was an increasing trend in poison types between diquat and other insecticides, but there was no statistical difference. Conclusions:From 2019 to 2021, the most common causes of acute gastric lavage were pesticide poisoning and drug poisoning, and the proportion of diquat and other pesticides showed an overall upward trend. A majority of the patients (71.1%) had gastric lavage within 2 h, and 76.5% of the patients had less than 20 L gastric lavage fluid. In the future, we will further control the amount of gastric lavage fluid and pay attention to the gastric lavage operation of new insecticide poisoning.