Objective To explore the clinical effect of sometostatin in the treatment of severe acute pancreatitis and its influence on the level of TNF-α.Methods 68 cases with severe acute pancreatitis were randomly divided into two groups,34 cases in the control group were received general treatment,34 cases in the observation group were given sometostatin on the basi of general treatment for 5 ～ 7 days.The clinical effects and clinical indexes were observed and compared between the two groups.Results After treatment for 3 days,the level of TNF-α in the observation group was significantly lower than that in the control group( P ＜0.05 ),and the observation group patients recovered rapidly.The recovery time of blood amylase and intestinal function,hospital stay days,incidence of complications and mortality in the observation group were significantly shorter than those in the control group ( P ＜ 0.05 ).Conclusion Sometostatin is effective for treatment of severe acute pancreatitis,can decrease the level of TNF-α significantly,shorten disease course and improve the prognosis,which is good for clinical application.

Overview of the challenges faced by hospitals in China against prescription data leakage and the underlying causes is made in the paper,along with operable tactics proposed based on experience of data protection accumulated at the hospital.

Cloud computing is the third technological revolution of IT industry following personal computers and the Internet,which is bound to have a profound impact on hospital informationization.Based on an analysis of the barriers for building the information system in the hospital,we proposed the development and implementation plan of the private cloud.This plan proves the cloud can make server resources more efficient and downsize operating costs significantly.In the end,we discussed the value and perspective of hospital private cloud.

Objective To investigate the changes of diamine oxidase(DAO) and endotoxin(ET) during the treatment of systemic inflammatory response syndrome with human growth hormone and the relationship between human growth hormone and intestinal mucosal barrier injury. Methods One hundred and forty six patients with systemic inflammatory response syndrome were randomly divided into operative group and non operative group, which were again randomly divided into the study group and control group.Plasma concentration of DAO and ET were determined before the treatment and 1 week after the treatment.Results Plasma concentration of DAO and ET in study group decreased after treatment with significant difference ( P

Objective To evaluate clinical effects of laparoscopic radical colectomy for colon carcinoma.Methods Laparoscopic radical colectomy were performed in 25 patients with carcinoma of colon,including 17 cases of laparoscopic-assisted radical colectomy,and 8 cases of laparoscopic radical colectomy.Results Operation time was 100-310 min,with an average of 195 min.The mean of intraoperative blood loss was 180 ml(range,100-350 ml).Time to first bowl movement was 1-4 days(mean,1.7 days).Postoperative pathological examination revealed no residual and infiltration of tumor cells in stump.Infection of incision wound occurred in 2 cases,with no bleeding,leakage and stenosis of anastomosis.The length of postoperative hospital stay was 6-10 days,with an average of 7.5 days.19 cases were followed up for 2-38 months(mean,13 months),which showed no tumor recurrence and port-site metastasis in 17 cases,2 cases died from extensive metastasis at 12 and 14 months postoperatively.Conclusions Laparoscopic radical colectomy has advantages of minimal invasion,safety,quicker recovery after operation,better radical curative results.

Objective To discuss key techniques of laparoscopic resection of hydatid liver cysts. MethodsLaparoscopic resection of hydatid cysts was performed in 56 patients with hepatic echinococcosis.Under laparoscopic visualization,wicks with 3% dioxide hydrogen were routinely used for avoiding the contamination of the peritoneal cavity related with the spillage.A specially-designed puncture-aspiration cannula was employed to irrigate and evacuate all the contents of the cysts.Then the cysts were sterilized by the injection of 20% hypertonic saline solution.Afterwards,the residual cystic cavity was explored.Results The laparoscopic operation was successfully completed in all the 56 patients,without conversions to open surgery.The operation time was 45~150 min(mean,60 min).The intraoperative blood loss was 10~120 ml(mean,70 ml).No complications occurred.Follow-up observations for 1~12 years(mean,2 years and 6 months) in the 56 patients found no recurrence of hepatic echinococcosis.Conclusions Application of 3% dioxide hydrogen wicks for preventing the contamination,specially-designed puncture-aspiration cannula for irrigation,injection of 20% hypertonic saline solution for sterilization,and residual cystic cavity exploration are crucial to good surgical outcomes.

Objective:To evaluate the prognostic significance of standard pelvic lymphadenectomy on the disease-free survival (DFS) rate of bladder cancer patients undergoing radical cystectomy (RC) and to discuss the influencing factors of lymph node positivity and the relationship between positive lymph nodes and lymphadenectasis. Methods:This prospective analysis includes 120 cases of bladder cancer treated with pelvic lymphadenectomy and RC in Tianjin Medical University Cancer Institute and Hospital between 2008 and 2013. The cases were divided into two groups, namely, the standard pelvic lymphadenectomy group (Group A) and the nonstandard pelvic lymphadenectomy group (Group B). The relationships among positive lymph nodes, lymphadenectasis, tumor stage, and patho-logical grade were retrospectively analyzed. Results:The 1-, 3-, and 5-year overall survival rates of 120 patients were 84%, 69.9%, and 57.9%, respectively. Group A was significantly correlated with a better 3-year overall survival rate than Group B, i.e., 78.4%vs. 46.2%(P<0.05). Lymphadenectasis influenced the DFS rate of bladder cancer patients after RC with pelvic lymphadenectomy, i.e., 50.0%vs. 86.4%(χ2=9.303, P<0.05). Meanwhile, lymphadenectasis was positively correlated with lymph node positivity (P<0.001). Tumor stage, histological subtype (urothelial carcinoma and non-urothelial carcinoma), and age were the prognostic factors for bladder cancer (P<0.05). Conclusion:Intraoperative lymphadenectasis is the influencing factor of lymph node positivity. This study determined that standard pel-vic lymphadenectomy and lymphadenectasis may influence the DFS rate after RC and are the independent risk factors for the prognosis of bladder cancer. Creating evidence-based guidelines of standardized lymphadenectomy for further improvement of the surgical quali-ty and survival of bladder cancer patients is essential.

Objective To investigate the correlation between serum tumor necrosis factor (TNF)-α,neuron-specific enolase (NSE)and the degree of hypoxic-ischemic encephalopathy (HIE).Methods Forty-six HIE patients in acute and convalescent stage and 30 full-term newborn infant were enrolled in this study.The level of serum of TNF-α and NSE were detected.The relationship between TNF-α,NSE level and severity of HIE was analyzed.Results The level of serum TNF-α and NSE in acute stage of HIE group were (156.3 ± 28.8) ng/L and (21.5 ± 3.6) μg/L,in convalescent stage of HIE group were (80.7 ± 26.1) ng/L and (10.6 ± 1.7) μ g/L,and in control group were (76.3 ± 24.4) ng/L and (9.4 ± 1.6) μ g/L.The level of serum TNF-α and NSE in acute stage of HIE group were significantly higher than those in convalescent stage of HIE group and control group (P ＜ 0.05).The level of serum TNF-α and NSE in convalescent stage of HIE group had no significant difference compared with those in control group (P ＞ 0.05).The level of serum TNF-α and NSE in mild HIE group were (88.5 ± 25.6) ng/L and (9.7 ± 2.4) μ g/L,in moderate HIE group were (150.1 ± 16.5) ng/L and (17.8 ± 3.6) μ g/L,and in severe HIE group were (197.3 ± 30.2) ng/L and (23.6 ±4.3) μg/L.The level of TNF-αand NSE were increased with the aggravation of HIE and there had significant difference among different degree of HIE(P ＜ 0.05).The level of serum TNF-α and NSE in mild HIE group and control group had no significant difference (P ＞ 0.05),and there had significant difference between moderate HIE group,severe HIE group and control group (P ＜ 0.05).Spearman rank correlation analysis showed that the level of TNF-α and NSE had positive correlation with the degree of HIE (r =0.54,0.57,P ＜ 0.01 or ＜ 0.05).Pearson correlation analysis showed that the level of TNF-α had positive correlation with the level of NSE (r =0.46,P ＜ 0.05).Conclusions The variation of TNF-α and NSE level in HIE newborn infant is parallel to the severity of the disease,which can sensitively reflect the severity of HIE.Therefore,TNF-α and NSE may be used as vital indexes for the evaluation of the severity of HIE.

Objective To compare the short-term efficacies of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity and type 2 diabetes mellitus,and to investigate the relationship between the body weight loss and the decrease of glucose of the 2 treatment methods.Methods The clinical data of 40 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Changhai Hospital of the Second Military Medical University from January 2010 to December 2011 were retrospectively analyzed.There were 14 patients treated by LAGB (LAGB group) and 26 by LSG (LSG group).The body weight loss and the decrease of glucose at postoperative year 1 of the 2 groups were compared.The differences in the body weight and glucose before and after operation within groups were compared using the paired t test,and the differences in the body weight and glucose between the 2 groups were compared using the multiple analysis of variance.The correlation between the body weight loss and the decrease of glucose was analyzed using the linear regression analysis.Results Laparoscopic surgery was successfully done without conversion to open surgery or intraoperative complications.The operation time and volume of blood loss were (69 ± 16)minutes and (31 ± 14)mL in the LAGB group,(120 ± 15) minutes and (148 ± 48) mL in the LSG group.Complications including postoperative malnutrition,electrolyte disturbance,delayed gastric emptying,bleeding,anastomotic leakage did not occurr in the 2 groups.Two patients were complicated with abdominal incision fat liquefaction,and were cured by symptomatic treatment.(1) The body weight,body mass index (BMI) and waistline had a decrease trend.The body weight,BMI and waistline in the LAGB group were decreased from (117 ± 28)kg,(40 ± 8)kg/m2 and (118 ± 15) cm before operation to (94 ± 28) kg,(33 ± 8) kg/m2 and (92 ± 15) cm at postoperative week 48.The body weight,BMI and waistline in the LSG group were decreased from (119 ± 25)kg,(42 ± 6)kg/m2 and (123 ± 14)cm before operation to (74± 16)kg,(26± 4)kg/m2 and (86 ± 13)cm at postoperative week 48.The EWL had an increase trend in the 2 groups.The EWL in the LAGB group was increased from 7％ ± 2％ at postoperative week 1 to 53％± 24％ at postoperative week 48,and the EWL in the LSG group was increased from 11％ ± 4％ at postoperative week 1 to 90％ ± 20％ at postoperative week 48.There were significant differences in the changes of body weight,BMI,waistline and EWL between the 2 groups (F =60.660,74.490,57.650,90.020,P ＜ 0.05).(2) The levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LAGB group were decreased from 8.1％± 0.8％,(8.4±0.6)mmol/L,(21±8)μmol/L,7.9 ±2.9,(1.68±0.50)mmol/L,(6.0±1.1)mmol/L (4.1 ± 0.8) mmol/L,(1.09 ±0.15)mmol/L to 6.4％ ±0.8％,(6.3 ±0.3) mmol/L,(10 ± 3) μmol/L,2.7 ±0.9,(1.04 ± 0.09) mmol/L,(4.3 ± 0.8) mmol/L,(2.3 ± 0.4) mmol/L,(1.22 ± 0.09) mmol/L at postoperative week 48 ; the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LSG group were changed from 7.9％ ± 1.0％,(9.0±1.0)mmol/L,(21 ±9) μ mol/L,8.5 ±3.5,(2.09 ± 0.70) mmol/L,(6.0 ± 1.2)mmol/L,(3.9 ± 1.1) mmol/L,(1.06 ± 0.21) mmol/L before operation to 5.1％ ± 0.8％,(5.2 ± 0.4) mmol/L,(4 ± 1)μmol/L,0.9±0.2,(1.22±0.17)mmol/L,(4.2±0.8)mmol/L,(2.3 ±0.6)mmol/L,(1.30±0.13)mmol/L at postoperative week 48.There was a decrease trend of the glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,trigluceride,total cholesterol and low density lipoprotein and a increase trend of the high density lipoprotein in the 2 groups.There were significant differences in the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein between the 2 groups (F =57.650,74.270,36.750,42.960,10.870,30.650,32.560,11.490,P ＜0.05).The levels of glucose of the LAGB group at postoperative month 1 and 3 were influenced by BMI (b =0.543,0.753,P ＜ 0.05),while the levels of glucose of the LAGB group did not be influenced by BMI at postoperative month 6 and year 1 (b =0.130,0.222,P ＞0.05).The levels of glucose of the LSG group did not be influenced by BMI at postoperative month 1,3,6 and year 1 (b =0.185,0.035,0.212,0.126,P ＞0.05).Conclusions The efficacy of LSG is superior to LAGB for the treatment of obesity combined with type 2 diabetes mellitus.The efficacy of LAGB is correlated with the change of body weight,while the efficacy of LSG does not correlated with the change of body weight.

Analgesics are widely used in fracture patients before and after operation.The analgesics frequently used include non-steroidal anti-inflammatory drugs,as well as central nerve and local medications.Recently,researches report that some analgesics may inhibit fracture healing,which has attracted much attention from orthopedic surgeons.However,there are researchers who hold opposite opinions.Accordingly,this paper reviews the progress in research concerning the effect of analgesics on fracture healing.