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.

Objective To summarize the treatment experience of acute cerebral infarction (ACI)combined with deep venous thrombosis (DVT) of lower extremities in the elderly. Methods Thirty cases of elder patients with ACI combined with DVT (ACI group) were enrolled in this study, and 31 cases of elder patients with DVT were served as control group. All the patients were immobilized for 3 days and treated with low molecular heparin calcium (100 IU/kg,Q12 hX14 d). On the tenth day,warfarin was used and INR was controlled in 2.0～2.5. Low molecular dextran was infused intravenously per day for 14 days (500mg/d). Results Edema in the lower limbs of patients were apparently reduced. 4 eases had cerebral hemorrhage in ACI group, and none in the control group.Hemorrhage occured from 3 to 7 days during the treatment with low molecular heparin calcium. One of the patient died of massive intraeranial hemorrhage with lung infection. Conclnsions It should be more careful to use the low molecular heparin to treat the elder patients older than 80 years old with ACI combined with DVT.

Antiplatelet drugs are widely used for various cardiovascular diseases. However, there is no standard for pharmaceutical care of antiplatelet drugs. In the paper, the development and application in antiplatelet drugs of thrombelastography were reviewed to analyze the application value of thrombelastography in effectiveness evaluation of antiplatelet drugs.

Objective To understand the effect of health management to enhance the community hypertensive patients' self-efficacy. Method With the method of stratified random sampling, 347 patients who come from communities were diagnosed as hypertension were selected as research subjects from the range of Yingze in Taiyuan of Shanxi province. There were 191 males and 156 females, the age ranged from 38 to 72 (55.90±9.60) years. The self efficacy promotion plan was conducted on high blood pressure patients. A comparison before and after six months of health management was made among the self efficacy scores, daily life scores, health behavior scores, drug behavior scores, medical compliance behavior scores by using self-efficacy scale. Excel 2007 and SPSS 19.0 were used for data analyses. Result Before the implementation of health management, the self efficacy scores of research subjects were 26.96 ± 0.77. After the implementation of health management, the value increased to 29.51 ± 0.86 (t=-41.23, P<0.05). In four dimensions, daily life (before and after management 6.85 ± 0.20 and 7.49 ± 0.31, t=-40.66), drug behaviors (before and after management 7.52 ± 0.21 vs. 7.98 ± 0.23, t=-26.93) and medical compliance behavior scores (before and after management 5.26±0.15 vs. 6.78±0.19, t=-115.97) were higher than those before the health management except health behaviors (before and after management 7.25 ± 0.40 vs. 7.26 ± 0.40, t=-1.94, P<0.05). Conclusion Health management regulated the self care behavior of patients with hypertension, improved the patients' compliance and enhanced self efficacy, which played an important role in controlling the development of disease.

At present, the suitable sports rehabilitation methods for frail old people mainly include endurance training, resistance train-ing and comprehensive functional training, while comprehensive functional training includes aerobic exercise and anaerobic exercise, and is suitable for the frail elderly to do exercise at home, which is more conducive to further large-scale promotion. In addition, long-term low and medium intensity exercise can improve the balance ability of the elderly, prevent them from fall, improve the physiological function, and ef-fectively regulate muscle potential;while, the high intensity exercise has greater risk for older people. This article introduced the types and effects of exercise in order to provide reference basis for frail old people in China.

Objective To detect and type herpes simplex virus (HSV) in genital lesions of the patients attending STD clinic. Methods Clinical data were collected and analyzed from patients with anogenital non-herpetic lesions including induration or furuncle, fissure, folliculitis, single ulcer and so on. HSV was detected and typed by culture and PCR with specimens taken from these lesions. Results One hundred and five cases were recruited in this study. Among them, 18 cases presented induration (furuncle), 15 fissure, 16 folliculitis, 7 abrasion, 12 single ulcer, 25 nonspecific erythema and 12 balanoposthitis with edema and exudation. HSV was found in 33.3%(6/18), 20%(3/15), 37.5%(6/16), 28.6%(2/7), 33.3%(4/12), 20%(5/25) and 50%(6/12) of these lesions, repectively, by PCR, while in 22.2%(4/18), 13.3%(2/15), 25%(4/16), 14.3%(1/7), 33.3%(4/12), 8%(2/25) and 41.7%(5/12), repectively, by viral culture. The positive rates of HSV from all these non-herpetic lesions were 30.5% (32/105) and 21% (22/105), respectively (? = 0.095, P = 0.114), by PCR and viral culture. The results of HSV typing were consistent between PCR and immunofluorescence with type-specific monoclonal antibodies. Among those with HSV infections, HSV-1 infection acounted for 9.4% (3/32), and HSV-2 90.6% (29/32). Conclusions The clinical manifestations of genital HSV infections vary, and HSV could be isolated from lesions of induration (furuncle), fissure, folliculitis, abrasion, single ulcer, nonspecific erythema and balanoposthitis with edema and exudation. HSV-2 is the predominant type.

Objective To analyze the language function impairment differences between the two steps from the form to sound processing and from the sound to meaning processing for pseudo-words reading in Alzheimer' s disease (AD).Methods The pseudo-words reading test consists two parts:pseudo-true words and pseudopseudo words.Each part had 10 words.All of the 20 words were presented randomly.Correct reading presents the processing of from form to sound,and correct judging presents the processing of from sound to meaning.Each correct respond get 1 score,otherwise get 0.Each part had a total score of 20.Results The pseudo-words reading test was performed to 41 mild AD participants with Mini-mental State Examination (MMSE) average scores of (21.06 ±2.86),and 135 normal controls with MMSE average scores of (28.08± 1.52).The two groups were matched in age,gender and education.For all of the mild AD group and normal control group,there was no significant difference between reading score and judging score in either pseudo-true words or pseudo-pseudo words (P＞0.05).Comparing with mild AD group and normal control group,there was no significant difference in reading score in either pseudo-true words or pseudo-pseudo words (P＞0.05).For judging score,there was significant difference in pseudotrue words (P＜0.01) but not in pseudo-pseudo words (P＞0.05).Conclusion Understanding real syllable is impaired in patients with mild AD.

Objective To investigate the value of differential diagnosis for subcortical ischemic vascular dementia(SIVD)and Alzheimer's disease(AD)with memory and executive screening(MES) scale. Methods Fifty SIVD and 50 AD patients treated in the outpatient and wards of the Department of Neurology,Fuxing Hospital,Capital Medical University from June 2012 to November 2013 were enrolled retrospectively. They were enrolled in either a SIVD group or an AD group. Fifty healthy subjects in Yuetan community of Fuxing hospital were selected as a control group at the same period. The age,sex and education level of the subjects in the 3 groups were matched. The Mini-Mental State Examination( MMSE) and MES were used to measure all subjects and were compared;receiver operating characteristic curves was used to analyze the radio of memory and executive part for SIVD and AD discrimination. Results (1)There was no significant difference in total MMSE score between the SIVD group and the AD group(20. 6 ± 5. 5 vs. 20. 6 ± 3. 3;P>0. 05).(2)There were significant differences in each MES indexes among the patients of the 3 groups(all P>0. 05). The 1,3,4 and 5 scores for the sentence memory in the SIVD group were significantly higher than those of the AD group. There were significant differences(all P<0. 01). The indicators of executive part:the continuous action,instruction and action contradictory stimulation,knock and un-knock with finger scores of the SIVD group were all lower than those of the AD group(5. 1 ± 3. 1 vs. 7. 3 ± 2. 1, 5. 2 ± 3. 0 vs. 7. 7 ± 1. 9,3. 5 ± 4. 4 vs. 6. 2 ± 4. 3;all P<0. 01). The MES-R of the SIVD group was higher than that of the AD group(1. 2 ± 0. 7 vs. 0. 5 ± 0. 2;P>0. 05).(3)When MES-R was≥0. 7,the sensitivity and specificity of differentiating SIVD were 76. 7% and 83. 3%,and the total score of MMSE for differentiating the sensitivity and specificity of SIVD were 40. 0% and 0. 7%. Conclusion The differences of MES reflecting sentence memory and executive part may better distinguish the patients with SIVD and AD.

Objective To establish a method for the preparation of long-circulating liposomes (LCL) containing etoposide and to observe its stability in rats plasma.Methods The etoposide-containing liposome was prepared by ethanol injection method. Polyethylene glycol-distearoyl phosphatidylethanolamine (PEG2000-DSPE) was used to modify the membrane of the liposome. Reversed-phase high pressure liquid chromatography (RP-HPLC) was used to detect the concentration of the liposome,and dynamic release method was used to study its stability in mice plasma.Results The mean size of the LCL containing etoposide was (180?26) nm,and the mean concentration of etoposide was (4.78?0.22) mg/mL,with the entrapment efficiency being (88.71?8.2)%. The leakage ratio of the conventional liposome containing etoposide and LCL containing etoposide in mice plasma were (80.14?1.59)% and (46.72?2.61)%,respectively.Conclusion LCL containing etoposide with high entrapment efficiency and low leakage rate can be obtained by using ethanol injection method. Additionally,modification by PEG2000-DSPE could raise the stability of the liposome.

Objective To study the protective effects and mechanism of aqueous extract of arctium lappa root on vas?cular endothelial cell injury in hypertensive rats. Methods The hypertensive rat model was induced by N-nitro-L-argi?nine. Rats were randomly divided into normal control group, model control group, positive control group (aptopril 15 mg/kg), low concentration of aqueous extract of arctium lappa root (0.5 g/kg), medium concentration of (1 g/kg) and high concentra?tion of (2 g/kg) groups. After six weeks of continuous intragastric administration, the systolic blood pressure levels at tail ar?tery were measured at 1, 4, 7, 10, 13, 16, 19, 22, 29, 36 and 42 d after treatment. And other indicators related to inflammato?ry factors were detected including C-reactive protein (CRP) and interleukin (IL)-6. The intercellular adhesion molecule-1 (ICAM-1) level was detected by taking samples of thoracic aorta. Results (1) The systolic blood pressure level at tail ar?tery was significantly lower in aqueous extract of arctium lappa root group than that of model control group ( P<0.05). (2) The aqueous extract of arctium lappa root can significantly improve the vascular endothelial cell injury, suppress vascular endo?thelial cell loss and blood cell adhesion, and cell proliferation with collagen fibers in muscle membrane. ( 3) The serum levels of IL-6, CRP and vascular endothelial ICAM-1 were significantly reduced in aqueous extract of arctium lappa root group than that of model control group (P<0.05). Conclusion Aqueous extract of arctium lappa root can significantly improve vascular endothelial cell injury in hypertensive rats. The mechanism may be related to the inhibition of inflammatory cyto?kines like IL-6, CRP and the expression of ICAM-1, and the improvement of chronic inflammatory response in vascular en?dothelium of hypertensive rats.