Objective To investigate the influence of continuous renal replacement treatment on the therapy of severe acute pancreatitis(SAP) associated with kidney injury(AKI) and inflammatory mediators.Methods Clinical data of 54 SAP patients complicated with AKI,who received conventional treatment (control group) or conventional therapy combined with CRRT(observation group) were retrospectively analyzed.The clinical efficacy between the two groups before and after treatment was compared.Results The mechanical ventilation proportion in control group was significantly higher than in the observation group (x2 =4.464,P ＜ 0.05).The mortality rate between the two groups had no statistical di.fference(P ＞ 0.05).In observation group,TNF-alpha and IL-6 levels were significantly lower than before treatment(P ＜0.01),APN was significantly increased (P ＜ 0.01).APN also increased in the control group,but the extent was less than the observation group.The levels of TNF-αand IL-6 in the control group were significantly higher than before treatment(P ＜ 0.01).The urine output of observation group increased significantly after 72h therapy (P ＜ 0.01).And blood urea nitrogen (BUN),creatinine (SCr),APACHE Ⅱ score were significantly decreased(P ＜ 0.01),in the control group,urine output also increased (P ＜ 0.01),but the extent was less than the observation group,APACHE Ⅱ score had no significant difference compared with before treatment(P ＞0.05).In control group,BUN and SCr levels significantly increased than before treatment (P ＜ 0.05).Conclusion CRRT for the treatment of SAP patients complicated with AKI can significantly improve renal function and reduce mortality,and its mechanism may be clear a large number of inflammatory mediators and metabolites in body,reduce the body inflammatory response.

The cataloguing of documents of minority nationalities was outlined according to their nature, the literacy and special skills of their cataloguers were pointed out, and the training of their literacy and special skills was elabo-rated.

Objective To analyze the clinical relationship of progesterone(P) and estradiol(E2) for embryo arrest in early pregnant patients.Methods 118 patients with embryo arrest in early pregnancy were selected and divided into two groups,research group (58 cases,embryo arrest in early pregnancy) and control group (60 cases,threatened abortion but embryo keeping growth by tocolysis).Serum P and E2 were measured and compared between two groups.Receiver operating characteristic curves(ROC) of all indexes were drawn and the areas under the ROC curves were calculated to evaluate diagnostic value.Results Compared to control group,the serum P and E2 were lower in research group(P ＜ 0.05).To diagnosis embryo arrest,the threshold for P was less than 118.4nmol/L,with 93.9％ sensitivity and 87.3％ specificity; while the threshold value for E2 was less than 1110pmol/L,with 95.6％ sensitivity and 90.7％ specificity.Conclusion Detection of serum P and E2 may be helpful for the diagnosis of embryo arrest in early pregnancy,and the serum E2 had the best diagnostic value.

College reading course occupies an important position in English acquisition.The introduction of integrated approach in college English reading course can effectively improve students’reading capability.This article analyses the importance of integrated approach in college English reading course in aspects of teacher,student,and reading techniques and presents some specific methods to help students read better.

Objective To investigate the effect and safety of Qizheng Qingpeng ointment in the treatment of eczema.Methods Ninety -eight patients of eczema were randomly divided into two groups, who received either Qizheng Qingpeng ointment plus hydrocortisone butyrate cream or only hydrocortisone butyrate cream at the first 2 weeks,and all patients were treated of Qizheng Qingpeng ointment plus hydrocortisone butyrate cream at the further 2 weeds.Results At 1 week and 2 week post-treatment,the efficacy rates were 68.52%,87.03% for the study groups and 27.91%,58.13%for the control groups,the efficacy rate of the study groups was statistically better than that of the control groups (χ2 =14.21,8.99, all P<0.01 );At 4 week post -treatment, the efficacy rates were 94.44%for the study groups and 90.70%for the control groups,the difference of the efficacy rates in the two groups were no statistically significant (χ2 =0.11,P>0.05) .Conclusion The clinical efficacy of Qizheng Qingpeng oint-ment associated with corticosteriod for treatment of eczema was better than corticosteriod alone.

[ABSTRACT]OBJECTIVETo investigate the safety of the head and neck muscle pedicle flap or flaps with single vascular pedicle.METHODSThe characteristics of thoracoacromial artery were investigated in 20 autopsy cases. Farthest point into the muscle were checked by preoperative ultrasonography and intraoperative localization with perspective observation, the muscles 1-2 cm above the farthest point were cut off from the donor site, forming a simple arteriovenous island flap pedicled pectoralis major muscle. Using the same technology and methods, sternocleidomastoid island and lower trapezius island flap were harvested.RESULTSAnatomical observation revealed thoracoacromial artery single type accounts for 12.5% (5/40), double vessel type 67.5% (27/40), multiple vessel type 20% (8/40). The rate of furthest point localization with preoperative ultrasound was 29.1% (14/48), the DSA successfully developed breast artery perforator in 66.7% (12/18) of the cases. Forty eight pectoralis major island muscle flaps, 12 internal mammary artery flaps, 18 chin flaps, 4 lower trapezius island myocutaneous flaps, 4 sternocleidomastoid island myocutaneous flaps, 3 transverse cervical artery island shaped flaps, 3 thoracoacromial artery perforator island flaps were harvested. Two flaps were failure. Partial necrosis occurred in 3 pectoralis major myocutaneous flaps.CONCLUSIONThe design of single vascular pedicle island flap for the head and neck defects is feasible and safe, and patients benefite not only for easily shaped the island flap, but also for the region appearance and function preservation in both the donor site and recipient site.

Objective To analyze the usage of TCM decoction pieces in our hospital during 2011-2014;To provide references for clinical reasonable medicine using. Methods Statistic analysis was carried out from the aspects of annual amount of prescription, dosage, annual sales, and top 10 TCM decoction pieces among sales rank through management system of hospital pharmacy. Results Sales amount and dosage of TCM decoction pieces increased significantly. During the four years, six same TCM decoction pieces ranked among the dosage of top 10 TCM decoction pieces, namely Astragali Radix, Paeoniae Radix Alba, Angelicae Sinensis Radix, Salviae Miltiorrhizae Radix et Rhizoma, fried Atractylodis Macrocephalae Rhizoma, and Chuanxiong Rhizoma. The amount of prescription increased obviously. Conclusion TCM decoction pieces are commonly used in our hospital;dosage increased continuously;usage is generally reasonable.

Objective To analyze the prescriptions containing Panlongqi Pieces for clinical application;To guide reasonable usage of medicine in clinic. Methods Adopted retrospective investigation method by selecting 1178 prescriptions of Chinese patent medicine containing Panlongqi Pieces from January to March in 2014. The unreasonable elements in these prescriptions were analyzed. Results Among the 1178 prescriptions, there were 585 unreasonable prescriptions, occupying 49.66%. Problems in the application of Panlongqi Pieces in clinic lie in differentiation of syndromes, combination of medication, incompatibility of medicine in prescription, and usage and dosage. Conclusion Doctors should attach importance to differentiation and reasonable usage in clinical application, which can achieve expected therapeutic effect.

Introducing the progress of DRGs work in Beijing, its application in medical insurance payment, as well as in hospital management and appraisal.Recommendations were made for DRGs development in the country, including unification of DRGs standards nationwide, orchestrated efforts of government departments, and acceleration of DRGs use in payment mode reforms.